bluuebunny/crossref_metadata_2025 huggingface dataset:
Proficiency‐based progression training for robotic surgery skills training: a randomized clinical trial
Authors: De Groote Ruben , Puliatti Stefano , Amato Marco , Mazzone Elio , Rosiello Giuseppe , Farinha Rui , Paludo Artur , Desender Liesbeth , Van Cleynenbreugel Ben , Bunting Brendan P. , Mottrie Alexandre , Gallagher Anthony G. ,   the Junior ERUS/YAU working group on robot‐assisted surgery of the European Association of Urology and the ERUS Education Working Group
Published: May 2022

Objective

To determine whether proficiency‐based progression (PBP) training leads to better robotic surgical performance compared to traditional training (TT), given that the value of PBP training for learning robotic surgical skills is unclear.

Materials and Methods

The PROVESA trial is a multicentric, prospective, randomized and blinded clinical study comparing PBP training with TT for robotic suturing and knot‐tying anastomosis skills. A total of 36 robotic surgery‐naïve junior residents were recruited from 16 training sites and 12 residency training programmes. Participants were randomly allocated to metric‐based PBP training or the current standard of care TT, and compared at the end of training. The primary outcome was percentage of participants reaching the predefined proficiency benchmark. Secondary outcomes were the numbers of procedure steps and errors made.

Results

Of the group that received TT, 3/18 reached the proficiency benchmark versus 12/18 of the PBP group (i.e. the PBP group were ~10 times as likely to demonstrate proficiency [P = 0.006]). The PBP group demonstrated a 51% reduction in number of performance errors from baseline to the final assessment (18.3 vs 8.9). The TT group demonstrated a marginal improvement (15.94 vs 15.44) in errors made.

Conclusions

The PROVESA trial is the first prospective randomized controlled trial on basic skills training in robotic surgery. Implementation of a PBP training methodology resulted in superior surgical performance for robotic suturing and knot‐tying anastomosis performance. Compared to TT, better surgical quality could be obtained by implementing PBP training for basic skills in robotic surgery.
Nasopharyngeal cancer cell‐derived exosomal PD‐L1 inhibits CD8+ T‐cell activity and promotes immune escape
Authors: Yang Jie , Chen Jierong , Liang Hu , Yu Yahui
Published: May 2022

Programmed cell death ligand 1 (PD‐L1) is an immune surface protein that binds to programmed cell death 1 (PD‐1) and allows tumors to evade T‐cell immunity. This study aims to define the role of PD‐L1 shuttled by tumor cell‐derived exosomes in the immune escape of nasopharyngeal carcinoma (NPC). PD‐L1 expression was determined in the exosomes isolated from the plasma of NPC patients or from NPC cells. It was found that PD‐L1 was highly expressed in the exosomes from the plasma of NPC patients and also in the exosomes from NPC cells. PD‐L1/PD‐1 binding was identified in the presence or absence of interferon‐gamma (IFN‐γ) or anti‐PD‐L1 antibody. PD‐L1 expression was elevated following IFN‐γ treatment. Binding of PD‐L1 to PD‐1 was augmented by IFN‐γ and blocked by anti‐PD‐L1 antibody. Following this, CD8+ T cells were sorted out from peripheral blood samples to assess the binding between exosomal PD‐L1 and PD‐1 on the CD8+ T‐cell surface, and to measure the percentage of Ki‐67‐positive T cells. The results indicated that exosomal PD‐L1 bound to the PD‐1 on CD8+ T‐cell surface, leading to a reduced percentage of Ki‐67‐positive CD8+ T cells and downregulated production of cytokines. In vivo data confirmed that exosomal PD‐L1 promoted NPC tumor growth in mice by suppressing CD8+ T‐cell activity. In conclusion, NPC cell‐derived exosomes deliver PD‐L1 to bind to PD‐1 on the CD8+ T‐cell surface, through which cytotoxic CD8+ T‐cell function was attenuated and the immune escape was thus promoted in NPC.
Gradient Terrain Authoring
Authors: Guérin Eric , Peytavie Adrien , Masnou Simon , Digne Julie , Sauvage Basile , Gain James , Galin Eric
Published: May 2022

Digital terrains are a foundational element in the computer‐generated depiction of natural scenes. Given the variety and complexity of real‐world landforms, there is a need for authoring solutions that achieve perceptually realistic outcomes without sacrificing artistic control. In this paper, we propose setting aside the elevation domain in favour of modelling in the gradient domain. Such a slope‐based representation is height independent and allows a seamless blending of disparate landforms from procedural, simulation, and real‐world sources. For output, an elevation model can always be recovered using Poisson reconstruction, which can include Dirichlet conditions to constrain the elevation of points and curves.

In terms of authoring our approach has numerous benefits. It provides artists with a complete toolbox, including: cut‐and‐paste operations that support warping as needed to fit the destination terrain, brushes to modify region characteristics, and sketching to provide point and curve constraints on both elevation and gradient. It is also a unifying representation that enables the inclusion of tools from the spectrum of existing procedural and simulation methods, such as painting localised high‐frequency noise or hydraulic erosion, without breaking the formalism. Finally, our constrained reconstruction is GPU optimized and executes in real‐time, which promotes productive cycles of iterative authoring.
Volumetric Multi‐View Rendering
Authors: Fraboni Basile , Webanck Antoine , Bonneel Nicolas , Iehl Jean‐Claude
Published: May 2022

Rendering photo‐realistic images using Monte Carlo path tracing often requires sampling a large number of paths to reach acceptable levels of noise. This is particularly the case when rendering participating media, that complexify light paths with multiple scattering events. Our goal is to accelerate the rendering of heterogeneous participating media by exploiting redundancy across views, for instance when rendering animated camera paths, motion blur in consecutive frames or multi‐view images such as lenticular or light‐field images. This poses a challenge as existing methods for sharing light paths across views cannot handle heterogeneous participating media and classical estimators are not optimal in this context. We address these issues by proposing three key ideas. First, we propose new volume shift mappings to transform light paths from one view to another within the recently introduced null‐scattering framework, taking into account changes in density along the transformed path. Second, we generate a shared path suffix that best contributes to a subset of views, thus effectively reducing variance. Third, we introduce the multiple weighted importance sampling estimator that benefits from multiple importance sampling for combining sampling strategies, and from weighted importance sampling for reducing the variance due to non contributing strategies. We observed significant reuse when views largely overlap, with no visible bias and reduced variance compared to regular path tracing at equal time. Our method further readily integrates into existing volumetric path tracing pipelines.
Learning Spectral Unions of Partial Deformable 3D Shapes
Authors: Moschella Luca , Melzi Simone , Cosmo Luca , Maggioli Filippo , Litany Or , Ovsjanikov Maks , Guibas Leonidas , Rodolà Emanuele
Published: May 2022

Spectral geometric methods have brought revolutionary changes to the field of geometry processing. Of particular interest is the study of the Laplacian spectrum as a compact, isometry and permutation‐invariant representation of a shape. Some recent works show how the intrinsic geometry of a full shape can be recovered from its spectrum, but there are approaches that consider the more challenging problem of recovering the geometry from the spectral information of partial shapes. In this paper, we propose a possible way to fill this gap. We introduce a learning‐based method to estimate the Laplacian spectrum of the union of partial non‐rigid 3D shapes, without actually computing the 3D geometry of the union or any correspondence between those partial shapes. We do so by operating purely in the spectral domain and by defining the union operation between short sequences of eigenvalues. We show that the approximated union spectrum can be used as‐is to reconstruct the complete geometry [MRC*19], perform region localization on a template [RTO*19] and retrieve shapes from a database, generalizing ShapeDNA [RWP06] to work with partialities. Working with eigenvalues allows us to deal with unknown correspondence, different sampling, and different discretizations (point clouds and meshes alike), making this operation especially robust and general. Our approach is data‐driven and can generalize to isometric and non‐isometric deformations of the surface, as long as these stay within the same semantic class (e.g., human bodies or horses), as well as to partiality artifacts not seen at training time.
Multi‐photon microscopy for the evaluation of interstitial fibrosis in extended criteria donor kidneys: A proof‐of‐concept study
Authors: So Wei Zheng , Teo Rachel Zui Chih , Ooi Li Yin , Goh Benjamin Yen Seow , Lu Jirong , Vathsala Anantharaman , Thamboo Thomas Paulraj , Tiong Ho Yee
Published: May 2022

Introduction

To evaluate the initial use of label‐free second harmonic generation (SHG) imaging with two‐photon excitation (2PE) auto‐fluorescence in multiphoton microscopy (MPM) for the quantification of collagen/fibrosis on preimplantation biopsies of extended criteria donors (ECD).

Materials and methods

Twenty preimplantation core biopsies were extracted from 10 donor kidney samples, of which originated from seven donors. Kidney Donor Profile Index (KDPI) and Remuzzi scores of biopsies were calculated. Collagen parameters measured included quantification by the Collagen Area Ratio in Total Tissue (CART) and qualitative measurements by Collagen Reticulation Index (CRI).

Results

Biopsies classified with > 85% KDPI scores had significantly higher CART (p = .011) and lower CRI values (p = .025) than biopsies with ≤ 85% KDPI scores. Increase in CRI values correlated significantly with rise in recipient creatinine levels 1‐year post‐transplant (p = .027; 95% CI: 4.635‐66.797).

Conclusion

MPM is an evolving technology that enables the quantification of the amount (CART) and quality (CRI) of collagen deposition in unstained preimplantation biopsies of donor kidneys stratified by KDPI scores. This initial evaluation found significant differences in both parameters between donor kidneys with more or less than 85% KDPI.
Species range size shapes distance‐decay in community similarity
Authors: Martín‐Devasa Ramiro , Martínez‐Santalla Sara , Gómez‐Rodríguez Carola , Crujeiras Rosa M. , Baselga Andrés
Published: May 2022

Aim

(i) To assess the dependence between the form of the decrease in biological similarity with distance (distance‐decay) and species range size and (ii) to introduce the use of a sigmoidal model, the Gompertz function, as a flexible alternative able to fit distance‐decay models under a wide variety of species range sizes.

Location

Applicable worldwide.

Methods

We computed distance‐decay curves from simulated communities to assess how the species range sizes shape the functional form of distance‐decay patterns (i.e. negative exponential, power‐law or sigmoidal [Gompertz] relationships). Simulations were performed using different sample sizes and species detection probabilities. We also used distribution data of South American mammals to explore the relationship between species range size and the distance‐decay form in an empirical dataset.

Results

Our simulations showed that the power‐law is the best supported model when range sizes tend to be small. An increase in range sizes leads to a negative exponential relationship, taking the shape of a sigmoidal (Gompertz) relationship with the largest range size values. Similar results have been found in the distance‐decay pattern of South American mammals. Remarkably, the Gompertz function fits the data reasonably well in all scenarios.

Main conclusions

The functional form of distance‐decay patterns depends on a key biogeographical attribute: species range size. This dependence makes it an interesting tool to detect biodiversity threats associated with species range expansion, such as the biotic homogenization of faunas. The Gompertz function is the mathematical model that best accommodates different frequency distributions of species range size and, thus, allows cross‐taxa comparison of this biogeographical and ecological pattern.
Role of the endoscopic Doppler probe in nonvariceal upper gastrointestinal bleeding: Systematic review and meta‐analysis
Authors: Chapelle Nicolas , Martel Myriam , Bardou Marc , Almadi Majid , Barkun Alan N.
Published: May 2022

Objectives

The effectiveness of the Doppler endoscopic probe (DEP) remains unclear in nonvariceal upper gastrointestinal bleeding (NVUGIB). We thus performed a systematic review characterizing the effectiveness of DEP in patients with NVUGIB addressing this question.

Methods

A literature search was done until July 2021 using MEDLINE, EMBASE, and ISI Web of Science. A series of meta‐analyses were performed assessing outcomes among observational and interventional studies for DEP signal positive and negative lesions as well as DEP‐assisted versus standard endoscopies. The primary outcome was “overall rebleeding”; secondary outcomes included all‐cause mortality, bleeding‐related mortality, need for surgery, length of stay, intensive care unit stay, and angiography.

Results

Fourteen studies were included from 1911 citations identified. Observational studies compared bleeding lesions with DEP‐positive versus DEP‐negative signals (11 studies, n = 800 prehemostasis; five studies, n = 148 with posthemostasis data). Three interventional studies (n = 308) compared DEP‐assisted to standard endoscopy management. DEP signal positive versus negative lesions either prior to or following any possible hemostasis were at greater risk of overall rebleeding (odds ratio [OR] 6.54 [2.36, 18.11] and OR 25.96 [6.74, 100.0], respectively). The use of DEP during upper endoscopy significantly reduced overall rebleeding rates (OR 0.27 [0.14, 0.54]). When removing outcomes analysis for which only one study was available, all evaluable outcomes were improved with DEP characterization of management guidance except for all‐cause mortality.

Conclusion

Although with low certainty evidence, DEP‐related information improves on sole visual prediction of rebleeding in NVUGIB, with DEP‐guided management yielding decreased overall rebleeding, bleeding‐related mortality, and need for surgery.
Hammersmith婴儿神经检查用于监测婴儿早期神经运动表现和预测后期认知发展
Authors: 黄美欢 曹建国
Published: May 2022

此文章是针对Romeo等人原始研究的述评。若要查看该研究,请访问https://doi.org/10.1111/dmcn.15201.
‘Low‐normal’ motor skills in infants at high risk for poor developmental outcomes: A prevalence and prognostic study
Authors: Danks Marcella , Flynn Emma J. , Gray Peter H. , Hurrion Elizabeth M.
Published: May 2022

Aim

To investigate the prevalence and prognostic value of ‘low‐normal’ motor skills in infants at high‐risk for poor developmental outcomes.

Method

Infants born extremely low‐birthweight and extremely preterm discharged from neonatal intensive care between 2015 and 2018 completed the Alberta Infant Motor Scale (AIMS), Neuro‐Sensory Motor Developmental Assessment (NSMDA) at corrected age 4, 8, and 12 months, and Griffiths Mental Development Scale at corrected age 12 months.

Results

Participating infants (n = 191) with a mean gestational age (95% confidence interval [CI]) of 26.80 weeks (26.60, 27.1) and mean birthweight (95% CI) of 869 grams (843, 895) included 45 (23.80%) infants small for gestational age. AIMS rated 50.32%, 35.37%, and 14.86% of infants within the ‘low‐normal’ motor skills range (1–2 SD below the mean for age) at 4, 8, and 12 months respectively. Of the infants within the AIMS ‘low‐normal’ skills range, 55.70%, 88.46%, and 59.10% were classified as having impairment by NSMDA at 4, 8, and 12 months respectively. Griffiths assessment at 12 months identified only 7.33% of infants with ‘low‐normal’ skills and 3.33% with motor disability. Minimal motor impairment rating on the NSMDA at 4 or 8 months significantly predicted general development at 12 months.

Interpretation

High‐risk infants with ‘low‐normal’ motor skills may warrant referral to early intervention as associated impairment represents increased risk for poorer general development outcomes.

What this paper adds

High prevalence of ‘low‐normal’ motor skill exists in high‐risk infants.

Clinical motor assessment validly identifies infants with motor impairment.

Minimal motor impairment in high‐risk infants is prognostic of general development.

High‐risk infants with ‘low‐normal’ motor skills may warrant early intervention.

Griffiths Scales of Child Development, Third Edition assessment at 12‐months age may under‐identify motor difficulties.
Continuous metabolic syndrome severity score and the risk ofCVDand all‐cause mortality
Authors: Tang Xiaoya , Wu Mingyang , Wu Shouling , Tian Yaohua
Published: May 2022

Background

The dualistic diagnostic criteria for metabolic syndrome overlooked the severity of metabolic syndrome, and the relationships between the severity of metabolic syndrome and adverse health conditions are poorly characterized. We therefore aimed to investigate the associations of metabolic syndrome severity with incident cardiovascular disease (CVD)/all‐cause mortality.

Methods

A total of 116,772 participants from the Kailuan study were followed up biennially between 2006 and 2018. The severity of metabolic syndrome was evaluated using a continuous metabolic syndrome severity score (MetS score). Cox proportional hazards model was used to examine the association between MetS score and the risk of CVD and all‐cause mortality. Restricted cubic spline analyses were performed to explore the dose–response associations.

Results

We found that the risk of CVD and all‐cause mortality increased consistently with the MetS score. In the multivariable‐adjusted model, the hazard ratios of CVD and all‐cause mortality were 2.05 (95% CI 1.86–2.25) and 1.45 (95% CI 1.35–1.56), respectively, in those subjects>75th percentile compared with those <25th percentile. Additionally, a J‐shaped dose–response relationship was found between MetS score and the risk of all‐cause mortality (pnonlinearity <.001), while a linear relationship between MetS score and the risk of CVD was observed in this study (pnonlinearity = .737).

Conclusions

This study suggests significant dose–response relationships between MetS score and the risk of CVD/mortality. Subjects without metabolic syndrome but with a relatively high MetS score should raise their awareness and pay more attention to the possible increased risk of CVD events.
Autoantibodies against apolipoprotein A‐1 after COVID‐19 predict symptoms persistence
Authors: L’Huillier Arnaud G. , Pagano Sabrina , Baggio Stephanie , Meyer Benjamin , Andrey Diego O. , Nehme Mayssam , Guessous Idris , Eberhardt Christiane S. , Huttner Angela , Posfay‐Barbe Klara M. , Yerly Sabine , Siegrist Claire‐Anne , Kaiser Laurent , Vuilleumier Nicolas
Published: May 2022

Background

SARS‐CoV‐2 infection triggers different auto‐antibodies, including anti‐apolipoprotein A‐1 IgGs (AAA1), which could be of concern as mediators of persistent symptoms. We determined the kinetics of AAA1 response over after COVID‐19 and the impact of AAA1 on the inflammatory response and symptoms persistence.

Methods

All serologies were assessed at one, three, six and twelve months in 193 hospital employees with COVID‐19. ROC curve analyses and logistic regression models (LRM) were used to determine the prognostic accuracy of AAA1 and their association with patient‐reported COVID‐19 symptoms persistence at 12 months. Interferon (IFN)‐α and‐γ production by AAA1‐stimulated human monocyte‐derived macrophages (HMDM) was assessed in vitro.

Results

AAA1 seropositivity was 93% at one month and declined to 15% at 12 months after COVID‐19. Persistent symptoms at 12 months were observed in 45.1% of participants, with a predominance of neurological (28.5%), followed by general (15%) and respiratory symptoms (9.3%). Over time, strength of correlations between AAA1 and anti‐SARS‐COV2 serologies decreased, but remained significant. From the 3rd month on, AAA1 levels predicted persistent respiratory symptoms (area under the curves 0.72‐0.74; p < 0.001), independently of disease severity, age and gender (adjusted odds ratios 4.81–4.94; p = 0.02), while anti‐SARS‐CoV‐2 serologies did not. AAA1 increased IFN‐α production by HMDMs (p = 0.03), without affecting the IFN‐γ response.

Conclusion

COVID‐19 induces a marked though transient AAA1 response, independently predicting one‐year persistence of respiratory symptoms. By increasing IFN‐α response, AAA1 may contribute to persistent symptoms. If and how AAA1 levels assessment could be of use for COVID‐19 risk stratification remains to be determined.
The role of demographic compensation in stabilising marginal tree populations in North America
Authors: Yang Xianyu , Angert Amy L. , Zuidema Pieter A. , He Fangliang , Huang Shongming , Li Shouzhong , Li Shou‐Li , Chardon Nathalie I. , Zhang Jian
Published: May 2022

Demographic compensation—the opposing responses of vital rates along environmental gradients—potentially delays anticipated species’ range contraction under climate change, but no consensus exists on its actual contribution. We calculated population growth rate (λ) and demographic compensation across the distributional ranges of 81 North American tree species and examined their responses to simulated warming and tree competition. We found that 43% of species showed stable population size at both northern and southern edges. Demographic compensation was detected in 25 species, yet 15 of them still showed a potential retraction from southern edges, indicating that compensation alone cannot maintain range stability. Simulated climatic warming caused larger decreases in λ for most species and weakened the effectiveness of demographic compensation in stabilising ranges. These findings suggest that climate stress may surpass the limited capacity of demographic compensation and pose a threat to the viability of North American tree populations.
Sudomotor dysfunction in people with neuromyelitis optica spectrum disorders
Authors: Habek Mario , Andabaka Marko , Fanciulli Alessandra , Brecl Jakob Gregor , Drulović Jelena , Leys Fabian , Di Pauli Franziska , Hegen Harald , Auer Michael , Pekmezović Tatjana , Mesaroš Šarlota , Jovičević Vanja , Junaković Anamari , Wenning Gregor K. , Deisenhammer Florian , Gabelić Tereza , Barun Barbara , Adamec Ivan , Krbot Skorić Magdalena
Published: May 2022

Background and purpose

The aim was to determine the extent of sudomotor dysfunction in people with neuromyelitis optica spectrum disorder (pwNMOSD) and to compare findings with a historical cohort of people with relapsing–remitting multiple sclerosis (pwRRMS).

Methods

Forty‐eight pwNMOSD were enrolled from four clinical centers. All participants completed the Composite Autonomic Symptom Score 31 to screen for symptoms of sudomotor dysfunction. Sudomotor function was assessed using the quantitative sudomotor axon reflex test. The results were compared with a historical cohort of 35 pwRRMS matched for age, sex and disease duration.

Results

Symptoms of sudomotor dysfunction, defined by a score in the Composite Autonomic Symptom Score 31 secretomotor domain >0, were present in 26 (54%) of pwNMOSD. The quantitative sudomotor axon reflex test confirmed a sudomotor dysfunction in 25 (52.1%) of pwNMOSD; in 14 of them (29.2%) sudomotor dysfunction was moderate or severe. No difference was observed between pwNMOSD and pwRRMS in any of the studied parameters. However, symptomatic sudomotor dysfunction was more frequent in pwNMOSD (n = 8, 22.9%) compared to pwRRMS (n = 1, 3%; p = 0.028). In a multivariable logistic regression analysis, statistically significant predictors for symptomatic sudomotor failure were age and diagnosis of neuromyelitis optica spectrum disorder.

Conclusions

Sudomotor dysfunction is common in pwNMOSD and more often symptomatic compared to pwRRMS.
Molecular tracking and prevalence of the red colour morph restricted to a harvested leopard population in South Africa
Authors: Tensen Laura , Power John , Camacho Gerrie , Godinho Raquel , Jansen van Vuuren Bettine , Fischer Klaus
Published: May 2022

The red leopard (Panthera pardus) colour morph is a colour variant that occurs only in South Africa, where it is confined to the Central Bushveld bioregion. Red leopards have been spreading over the past 40 years, which raises the speculation that the prevalence of this phenotype is related to low dispersal of young individuals owing to high off‐take in the region. Intensive selective hunting tends to remove large resident male leopards from the breeding population, which gives young male leopards the chance to mate with resident female leopards that are more likely to be their relatives, eventually increasing the frequency of rare genetic variants. To investigate the genetic mechanisms underlying the red coat colour morph in leopards, and whether its prevalence in South Africa relates to an increase in genetic relatedness in the population, we sequenced exons of six coat colour‐associated genes and 20 microsatellite loci in twenty Wild‐type and four red leopards. The results were combined with demographic data available from our study sites. We found that red leopards own a haplotype in homozygosity identified by two SNPs and a 1 bp deletion that causes a frameshift in the tyrosinase‐related protein 1 (TYRP1), a gene known to be involved in the biosynthesis of melanin. Microsatellite analyses indicate clear signs of a population bottleneck and a relatedness of 0.11 among all pairwise relationships, eventually supporting our hypothesis that a rare colour morph in the wild has increased its local frequency due to low natal dispersal, while subject to high human‐induced mortality rate.
Anoxia decreases the magnitude of the carbon, nitrogen, and phosphorus sink in freshwaters
Authors: Carey Cayelan C. , Hanson Paul C. , Thomas R. Quinn , Gerling Alexandra B. , Hounshell Alexandria G. , Lewis Abigail S. L. , Lofton Mary E. , McClure Ryan P. , Wander Heather L. , Woelmer Whitney M. , Niederlehner B. R. , Schreiber Madeline E.
Published: May 2022

Oxygen availability is decreasing in many lakes and reservoirs worldwide, raising the urgency for understanding how anoxia (low oxygen) affects coupled biogeochemical cycling, which has major implications for water quality, food webs, and ecosystem functioning. Although the increasing magnitude and prevalence of anoxia has been documented in freshwaters globally, the challenges of disentangling oxygen and temperature responses have hindered assessment of the effects of anoxia on carbon, nitrogen, and phosphorus concentrations, stoichiometry (chemical ratios), and retention in freshwaters. The consequences of anoxia are likely severe and may be irreversible, necessitating ecosystem‐scale experimental investigation of decreasing freshwater oxygen availability. To address this gap, we devised and conducted REDOX (the Reservoir Ecosystem Dynamic Oxygenation eXperiment), an unprecedented, 7‐year experiment in which we manipulated and modeled bottom‐water (hypolimnetic) oxygen availability at the whole‐ecosystem scale in a eutrophic reservoir. Seven years of data reveal that anoxia significantly increased hypolimnetic carbon, nitrogen, and phosphorus concentrations and altered elemental stoichiometry by factors of 2–5× relative to oxic periods. Importantly, prolonged summer anoxia increased nitrogen export from the reservoir by six‐fold and changed the reservoir from a net sink to a net source of phosphorus and organic carbon downstream. While low oxygen in freshwaters is thought of as a response to land use and climate change, results from REDOX demonstrate that low oxygen can also be a driver of major changes to freshwater biogeochemical cycling, which may serve as an intensifying feedback that increases anoxia in downstream waterbodies. Consequently, as climate and land use change continue to increase the prevalence of anoxia in lakes and reservoirs globally, it is likely that anoxia will have major effects on freshwater carbon, nitrogen, and phosphorus budgets as well as water quality and ecosystem functioning.
Late recurrence in patients with non‐muscle‐invasive bladder cancer after 5‐year cancer‐free periods
Authors: Hirata Yurie , Higuchi Madoka , Osawa Takahiro , Hinotsu Shiro , Harabayashi Toru , Mochizuki Tango , Enami Nobuyasu , Nounaka Osamu , Shinno Yuichiro , Kikuchi Hiroshi , Matsumoto Ryuji , Abe Takashige , Murai Sachiyo , Shinohara Nobuo
Published: May 2022

Objectives

There is no consensus about the follow‐up schedule after 5‐year cancer‐free periods. In this study, we aimed to elucidate the risk factors for the recurrence in patients with non‐muscle‐invasive bladder cancer who remained cancer free for more than 5 years.

Methods

Data from six Japanese institutions were retrospectively reviewed. Among the patients with non‐muscle‐invasive bladder cancer who were treated with transurethral resection of bladder tumor between 1990 and 2013, those who had no recurrence for more than 5 years were included in this study. The Kaplan–Meier method and Cox hazards model were used to estimate recurrence‐free survival and to determine the pathologic and clinical factors affecting late recurrence.

Results

In total, 434 patients were enrolled in this study. Of these patients, 55 patients (12.7%) experienced late recurrence. The median follow‐up time was 8.9 years (interquartile range 6.9–11.3 years). Prior history of bladder cancer before the most recent transurethral resection was a significant predictor for late recurrence (hazard ratio 1.99 [95% confidence interval 1.13–3.47], P = 0.019), although other clinical factors including tumor grade, pathologic stage, tumor multiplicity, and current risk classification systems were not associated with late recurrence.

Conclusions

Late recurrence after a long tumor‐free period is not rare and it was not predicted by current risk classification systems. Only prior history of bladder cancer was a significant predictor for late recurrence in this study.
Communication pathways from the emergency department to community mental health services: A systematic review
Authors: McIntyre Heather , Reeves Verity , Loughhead Mark , Hayes Laura , Procter Nicholas
Published: May 2022

This systematic review synthesizes existing peer reviewed evidence reporting on evaluated strategies used for enhancing communication pathways for continuity of care between the emergency department and mental health community supports. Following the PRISMA guidelines and the PICO framework, this review was conducted between January and July 2021. Included articles needed to evaluate communication pathway interventions for continuity of care between the emergency department and mental health community services which support service users with mental health and/or suicidal crisis. The seven included studies identified three support coordination interventions, two motivational interviewing interventions, an electronic record enhanced strategy and results from a phone follow‐up study. This review demonstrates that support coordination, motivational interviewing, education, or an enhanced electronic record strategy can improve continuity of care, and in some cases, reduce the need for people to re‐present to ED when they are experiencing mental health concerns or suicidal crisis. Results of this review reveal that a multipronged approach of communication pathways for continuity of care would enable more effective connections with mental health community supports and enable better outcomes for people requiring services.
Kr ion irradiation study of polymer‐derived SiFeOC–C–SiC nanocomposite
Authors: Lu Kathy , Singh Sanjay Kumar Devendhar , Shao Lin
Published: May 2022

This study focuses on the pyrolysis and ion irradiation behaviors of polymer‐derived SiFeOC–C–SiC ceramic. The pyrolyzed material is composed of SiO2 and SiOC (amorphous), carbon (amorphous and turbostratic), and Fe3Si and β‐SiC (nanocrystalline). Irradiation was carried out at both room temperature and 600°C using 400 keV Kr ions with fluences of 4 × 1015 and 1 × 1016 ions cm−2, respectively. The Fe3Si and SiC nanocrystals are stable against irradiation up to 3 displacement per atom (dpa) at room temperature and up to 12 dpa at 600°C. The SiOC tetrahedrals show phase separation and minor carbothermal reduction. The high irradiation resistance and the dense, defect‐free amorphous microstructure of SiFeOC–C–SiC after prolonged irradiation demonstrate its great potential for advanced nuclear reactor applications.
Surfactant pollution, an emerging threat to ecosystem: Approaches for effective bacterial degradation
Authors: Arora Jayati , Ranjan Anuj , Chauhan Abhishek , Biswas Rima , Rajput Vishnu D. , Sushkova Svetlana , Mandzhieva Saglara , Minkina Tatiana , Jindal Tanu
Published: May 2022

The use of surfactants in households and industries is inevitable and so is their discharge into the environment, especially into the water bodies as effluents. Being surface-active agents, their utilization is mostly seen in soaps, detergents, personal care products, emulsifiers, wetting agents, etc. Anionic surfactants are the most used class. These surfactants are responsible for the foam and froth in the water bodies and cause potential adverse effects to both biotic and abiotic components of the ecosystem. Surfactants are capable of penetrating the cell membrane and thus cause toxicity to living organisms. Accumulation of these compounds has been known to cause significant gill damage and loss of sight in fish. Alteration of physiological and biochemical parameters of water decreases the amount of dissolved oxygen and thus affecting the entire ecosystem. Microbes utilizing surfactants as substrates for energy form the basis of the biodegradation of these compounds. The main organisms for surfactant biodegradation, both in sewage and natural waters, are bacteria. Several Pseudomonas and Bacillus spp. have shown efficient degradation of anionic surfactants namely: sodium dodecyl sulphate (SDS), linear alkylbenzene sulphonate (LAS), sodium dodecylbenzenesulphonate (SDBS). Also, several microbial consortia constituting Alcaligenes spp., Citrobacter spp., etc. have shown efficacy in the degradation of surfactants. The biodegradation efficiency studies of these microbes/microbial consortia would be of immense help in formulating better solutions for the bioremediation of surfactants and help to reduce their potential environmental hazards.
Patient‐reported outcomes and costs associated with vascular closure and same‐day discharge following atrial fibrillation ablation
Authors: Steinberg Benjamin A. , Woolley Shannon , Li Haojia , Crawford Candice , Groh Christopher A. , Navaravong Leenhapong , Ranjan Ravi , Zenger Brian , Zhang Yue , Bunch T. Jared
Published: May 2022

Background

We aimed to measure patient‐reported outcomes (PROs) and costs associated with same‐day discharge (SDD) for atrial fibrillation (AF) ablation and vascular closure device implantation in clinical practice.

Methods

PROs were prospectively measured in 50 AF ablation patients, comparing complete vascular device closure (n = 25) versus manual compression hemostasis (n = 25). Health‐system costs for SDD patients receiving vascular device closure were compared to matched controls with one‐night stays who did not receive any closure device.

Results

Prospectively enrolled patients receiving vascular device closure for AF ablation had a mean age of 65 years, 17% were female, with a mean CHA2DS2‐VASc score of 3. The mean number of venous sheaths was higher among patients receiving vascular device closure (3.8 vs. 3.1, p < 0.001), and there was one case of rebleeding in a patient receiving a vascular closure device (no other complications). Same‐day discharge rates (76% vs. 8.3%, p < 0.001), patient satisfaction with bedrest time (8.5 vs. 6, p = 0.004) and with pain (8 vs. 5.1, p = 0.009) were significantly better among patients receiving vascular closure. In matched analyses of health‐system costs, patients with vascular closure had mean age 66, 32% were female, and the mean CHA2DS2‐VASc score was 2 (p = NS vs. controls). SDD with vascular closure was associated with the significantly lower facility, pharmacy, and disposable costs, but higher implant costs. Overall costs for ablation were not significantly different (mean difference 1.10%, 95% confidence interval [CI] −3.03 to 5.42).

Conclusions

Vascular closure for AF ablation improves patient experience in routine care. The use of vascular closure and SDD after AF ablation reduces several components of healthcare system costs, without an overall increase.
Initial experience of left bundle branch area pacing using stylet‐driven pacing leads: A multicenter study
Authors: De Pooter Jan , Ozpak Emine , Calle Simon , Peytchev Peter , Heggermont Ward , Marchandise Sebastien , Provenier Frank , Francois Bart , Anné Wim , Pollet Peter , Barbraud Cynthia , Gillis Kris , Timmermans Frank , Van Heuverswyn Frederic , Tung Roderick , Wauters Aurélien , le Polain de Waroux Jean‐Benoit
Published: May 2022

Background

Left bundle branch area pacing (LBBAP) has been performed exclusively using lumen‐less pacing leads (LLL) with fixed helix design. This registry study explores the safety and feasibility of LBBAP using stylet‐driven leads (SDL) with extendable helix design in a multicenter patient population.

Methods

This study prospectively enrolled consecutive patients who underwent LBBAP for bradycardia pacing or heart failure indications at eight Belgian hospitals. LBBAP was attempted using SDL (Solia S60; Biotronik) delivered through dedicated delivery sheath (Selectra3D). Implant success, complications, procedural, and pacing characteristics were recorded at implant and follow‐up.

Results

The study enrolled 353 patients (mean age 76 ± 39 years, 43% female). The mean number of implants per center was 25 (range: 5–162). Overall, LBBAP with SDL was successful in 334/353 (94%), varying from 93% to 100% among centers. Pacing response was labeled as left bundle branch pacing in 73%, whereas 27% were labeled as myocardial capture. Mean paced QRS duration and stimulus to left ventricular activation time measured 126 ± 21 ms and 74 ± 17. SDL‐LBBAP resulted in low pacing thresholds (0.6 ± 0.4 V at 0.4 ms), which remained stable at 12 months follow‐up (0.7 ± 0.3, p = .291). Lead revisions for SDL‐LBBAP occurred in 5 (1.4%) patients occurred during a mean follow up of 9 ± 5 months. Five (1.4%) septal coronary artery fistulas and 8 (2%) septal perforations occurred, none of them causing persistent ventricular septal defects.

Conclusion

The use of SDL to achieve LBBAP is safe and feasible, characterized by high implant success in low and high volume centers, low complication rates, and stable low pacing thresholds.
C1q tumor necrosis factor‐related protein 4 is associated with coronary artery disease in patients with type 2 diabetes
Authors: Gao Jie , Lu Jun , Qiu Junhui , Sun Dusang , Xu Bilin , Wang Zhihua , Lei Tao
Published: May 2022

Aims/Introduction

To evaluate the correlation of circulating C1q tumor necrosis factor‐related protein 4 (CTRP4) with coronary artery disease (CAD) in type 2 diabetes mellitus patients.

Methods

A total of 240 individuals with type 2 diabetes mellitus were enrolled in our center between January 2020 and December 2020. They were assigned into two groups, including the CAD and non‐CAD groups, based on coronary angiography or computed tomography angiography findings. Serum CTRP4 levels were detected by an enzyme‐linked immunosorbent assay kit. The association of CTRP4 with CAD was determined by logistic regression analysis. The predictive value of CTRP4 for CAD was calculated by receiver operating characteristic curve analysis.

Results

Median serum CTRP4 amounts were markedly elevated in the CAD group in comparison with the non‐CAD group (10.37 vs 3.75 ng/mL, P < 0.01). Binary logistic regression showed that CTRP4 was associated with CAD and even the amount of coronary artery lesions (P < 0.05). In receiver operating characteristic curve analysis, the area under the receiver operating characteristic curve was greater for CTRP4 compared with HbA1c or CRP (0.87 vs 0.74, 0.87 vs 0.80, P < 0.01). The area under the curve for CTRP4 and glycated hemoglobin in combination was larger than that obtained for CTRP4 combined with CRP (0.91 vs 0.87, P < 0.01). According to the maximum Youden index criteria, the optimal cut‐off of CTRP4 was 5.42 ng/mL, which yielded a sensitivity of 84.4% and a specificity of 76.7% in predicting CAD in type 2 diabetes mellitus patients.

Conclusions

Serum CTRP4 levels are positively correlated with CAD occurrence and severity. Combining CTRP4 and glycated hemoglobin has a better predictive value for CAD in type 2 diabetes mellitus patients.
After the spawn and on the hook: Sea trout Salmo trutta biophysical responses to different components of catch and release in a coastal fishery
Authors: Blyth Samuel A. , Bower Shannon D.
Published: May 2022

This study investigated the biophysical responses of sea run brown trout Salmo trutta to catch‐and‐release in the coastal fishery around Gotland, Sweden. It used information recorded on individual angled S. trutta (n = 162), including fight time, handling time, total air exposure time, injury, bleeding, fish length, body condition, spawning status, water temperature, hook location and difficulty of hook removal. Reflex action mortality predictors (equilibrium, operculum beats, tail grab response, body flex response and vestibular‐ocular response), tests of blood glucose and lactate, and observation of hooking injury were used to measure the relative impact of the angling event on the fish's physical state and stress experienced. The results of this study suggest low rates of post‐release mortality and generally limited stress responses to angling events, and relatively high post‐release survival supported by the recapture of many tagged S. trutta. However, a number of scenarios were identified in which stress responses are likely to be compounded and where anglers should take additional action to reduce sublethal physiological disturbances and the risk of delayed mortality. Particular care should be taken to limit cumulative total air exposure to <10 s, and to reduce handling time and risk of additional injury in angling events with extended fight times, when water temperatures >10°C, or where S. trutta show evidence of being physically compromised by injury or having recently spawned. The results also indicate the importance of using appropriately sized single hooks rather than larger treble hooks to reduce hooking injury and handling time during unhooking.
Diversity and antimicrobial susceptibility profiles of Aeromonas spp. isolated from diseased freshwater fishes in Thailand
Authors: Mursalim Muhammad Fadhlullah , Budiyansah Hendri , Raharjo Hartanto Mulyo , Debnath Partho Pratim , Sakulworakan Rungnapa , Chokmangmeepisarn Putita , Yindee Jitrapa , Piasomboon Patharapol , Elayaraja Sivaramasamy , Rodkhum Channarong
Published: May 2022

Motile Aeromonas septicemia (MAS), a disease caused by Aeromonas spp., is recognized as a major disease in freshwater aquaculture. This study aimed to investigate the distribution and diversity of Aeromonas spp. and their antimicrobial susceptibility patterns. A total of 86 isolates of Aeromonas spp. were recovered from diseased freshwater fishes from 13 farms in Thailand. All isolates were identified using biochemical characteristics, matrix‐assisted laser desorption ionization‐time of flight mass spectrometry (MALDI‐TOF MS), polymerase chain reaction assays, and the gyrB gene sequence analysis. The result of MALDI‐TOF MS showed 100% (86 isolates) accuracy at genus‐level identification, and 88.4% (76 isolates) accuracy at species‐level identification. Six species of Aeromonas were confirmed through nucleotide sequencing and phylogenetic analysis of the gyrB gene Aeromonas veronii (72.1%), Aeromonas jandaei (11.6%), Aeromonas schubertii (9.3%), Aeromonas diversa (3.5%), Aeromonas hydrophila (2.3%), and Aeromonas punctata (1.2%). Antimicrobial susceptibility tests for all isolates revealed resistance against amoxicillin (99%), ampicillin (98%), oxolinic acid (81.4%), oxytetracycline (77%), trimethoprim‐sulfamethoxazole (24%), and enrofloxacin (21%). The multiple antibiotic resistance (MAR) index varied between 0.14 and 0.86, with MAR values more than 0.2 in 99% of isolates. Furthermore, four diverse multidrug‐resistant (MDR) patterns were found among Aeromonas isolates. Our finding show that A. veronii is the most abundant species in Thai cultured freshwater fish with the highest MDR patterns.
Cyber risk management in the US banking and insurance industry: A textual and empirical analysis of determinants and value
Authors: Gatzert Nadine , Schubert Madeline
Published: May 2022

In this paper, we first construct a cyber risk consciousness score using a text mining algorithm, applied to annual reports of large‐ and mid‐cap US banks and insurers from 2011 to 2018. We next categorize the firms' cyber risk management based on keywords to study determinants and value‐relevance. Our results show an increasing cyber risk consciousness, regardless of the industry. In addition, for the entire sample we find that firms belonging to the banking industry, with a higher cyber risk consciousness score and a higher general risk awareness are more likely to implement cyber risk management, which also holds for both industries separately. We find the opposite in the case of profitable firms for the entire sample and the insurer subsample. Finally, we observe a significant positive relationship between cyber risk management and firm value measured by Tobin's Q for the entire sample and the subsamples of banks and insurers.
Ethical and legal balance of modern economic intelligence
Authors: Razinkina Irina , Bulatenko Mariya , Chernov Sergei , Prasolov Valeriy
Published: May 2022

Against the background of the economic confrontation between Western countries and China, it is evident that the concept of economic intelligence is changing, manifesting itself in several planes simultaneously, and corporate confrontation moves to the level of protection of national interests. At the same time, the factors influencing the perception of corporate confrontation methods are subject to changes. The purpose of this study is to examine the current transformation of approaches to the understanding of ethical behavior in economic intelligence in the context of existing legal constraints. Based on the assumption that methods and tactics of economic intelligence are not static, the study aims to identify factors that influence their ethical perception. The study argues that the transformation of approaches to the understanding of ethical behavior and the very definition of ethical behavior in economic intelligence is directly related to the technological aspect, the transition of many business processes in the digital plane. In cyberspace, the psychological perception of wrongdoing changes significantly. Commitment to ethical behavior may naturally decrease due to the lack of personal contact between the agent of influence and the source.