bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal variation in emergency surgical conditions
Authors: Lee Martin Siu‐chung , So Owen Chun‐hin , Wong Kevin KF , Leung Siu‐kee
Published: September 2021

Aim

Seasonality has been shown to affect incidence of emergency surgical conditions in the West. There is yet no local data to suggest the causal relationship between seasonality and emergency surgical conditions. We aim to investigate on the effects of seasonal variation on common general surgical conditions for (i) ruptured abdominal aortic aneurysm, (ii) perforated peptic ulcer disease, (iii) ischaemic bowel, and (iv) acute cholecystitis in the New Territory West Cluster (NTWC).

Method

The present study was a retrospective study of 7653 patients who underwent emergency operations from 1 July 2008 to 30 June 2018 in the NTWC. Seasonality was defined according to the Chinese lunar calendar. Seasonal variation in the aforementioned surgical conditions were studied by emergency operations performed and recorded by the cluster's Surgical Outcomes Monitoring and Improvement Programme (SOMIP) data. The primary outcome is to analyse the presence of overall seasonal variation across the four seasons for each surgical condition by the goodness of fit test. The secondary outcome is to analyse the relationship of each season (Spring, Summer, Fall, Winter) and extreme weather condition, in this study, the cold weather warning signal, on the surgical conditions by the 2 × 2 Chi‐square test.

Results

For primary outcome, statistically significant variation exists in all general surgical conditions except ischaemic bowel across the four seasons. For secondary outcomes, statistically significant relationships exist between each season and different surgical conditions. Moreover, cold weather warning has a statistically significant relationship with emergent surgeries for perforated peptic ulcer disease and ruptured abdominal aortic aneurysm.

Conclusion

There is seasonal variation in emergency surgical conditions.
The impact and restoration of colorectal services during the coronavirus disease 2019 pandemic: A view from Oxford
Authors: Yeung Trevor , Merchant Julia , Chen Patrick , Smart Corinne , Ghafoor Hamira , Woodhouse Fran , James David , Symons Nicholas , Boyce Stephen , Jones Oliver , George Bruce , Lindsey Ian
Published: September 2021

Aim

The coronavirus pandemic has significantly disrupted the way we deliver healthcare worldwide. We have been flexible and creative in order to continue providing elective colorectal cancer operations and to restart services for benign cases during the recovery period of the pandemic. In this paper, we describe the impact of coronavirus on our elective services and how we have implemented new patient pathways to allow us to continue providing patient care.

Patients and Methods

Data on major colorectal elective resections were prospectively collected in an Enhanced Recovery After Surgery (ERAS) database. Data on the number of proctology cases and telemed appointments were collected from the hospital theatre information management system and electronic patient record system, respectively.

Results

During the pandemic, there was a complete shift towards cancer cases, with benign services and proctology cases being placed on hold. Hospital length of stay was reduced. We implemented earlier hospital discharge and more intense telephone follow‐up after elective major surgery. This has not resulted in an increase in postoperative complications, nor any increase in readmission to hospital. During the recovery phase, we have introduced a higher proportion of telemed consultations, including one‐stop telemed proctology clinics, resulting in straight to tests or investigations.

Conclusion

We have created a streamlined multidisciplinary pathway to reinstate our elective colorectal services as soon as possible and to minimise potential harm caused to patients whose treatment have been delayed. We anticipate many of these changes will be permanently incorporated into our clinical practice once the pandemic is over.
Liver injury during hepatectomy
Authors: Fan Sheung‐tat
Published: September 2021

During hepatectomy the liver may sustain various forms of injury due to inflow occlusion, congestion, raised intraductal pressure from bile duct obstruction, choledochoscopy and electrohydraulic lithotripsy, and portal hyperperfusion related to small liver remnant. This review elaborates the possible mechanism of liver injury during hepatectomy and their prevention.
Fostering the high‐involvement model of human resource management: what have we learnt and what challenges do we face?
Authors: Boxall Peter , Huo Meng‐Long
Published: September 2021

The high‐involvement model of human resource management (HRM) is seen as offering major benefits to organisations, employees and societies through enhancing employee motivation, enabling people to reach more of their potential, and producing better quality and innovation. However, it would be a mistake to imagine that we can stimulate more of it by simply ‘turning up the volume’ on its virtues. In this article, we highlight what we have learnt about the model, including the contextual factors that enable and constrain its uptake. We also discuss the tensions that affect the quality and sustainability of particular implementations. These include the need to retain employee commitment when it is threatened by all‐too‐common periods of restructuring, the need to manage the relationship between greater involvement and work intensification, and the need to ensure a good match between the kinds of autonomy that employees value and the working arrangements that organisations need in complex, interdependent teamwork.
Trauma‐focused psychotherapies for post‐traumatic stress disorder: A systematic review and network meta‐analysis
Authors: Jericho Brooke , Luo Aileen , Berle David
Published: September 2021

Introduction

Meta‐analytic reviews suggest similar outcomes across trauma‐focused psychotherapies for adults with post‐traumatic stress disorder (PTSD). However, this conclusion may be premature due to suboptimal statistical‐review methodologies. Network meta‐analysis (NMA) allows a detailed rank‐ordering of the efficacy of established psychotherapy interventions derived from indirect evidence as well as results from direct head‐to‐head comparisons.

Objective

We sought to determine the efficacy and attrition rates of psychotherapy interventions for PTSD by applying NMA.

Methods

We searched EMBASE, PsychINFO, PTSDPubs and PubMed for randomised controlled trials that compared psychotherapies either head‐to‐head or against controls for adults with PTSD. A frequentist NMA was used to compare direct and indirect effects to determine the efficacy and attrition rates of psychotherapy interventions.

Results

Of the 5649 papers identified, 82 trials comprising of 5838 patients were included. The network comprised 17 psychotherapies and four control conditions. Network estimates indicated superior efficacy of meta‐cognitive therapy and cognitive processing therapy over other psychotherapies (ESs between = 0.26 and 2.32). Written exposure therapy and narrative exposure therapy were associated with lower risk of drop out when considered alongside other psychotherapies. Confidence in the network meta‐analytic estimates was considered moderate for both outcomes.

Conclusions

In broad terms, therapeutic commensurability was evident. Nevertheless, with additional studies and larger sample sizes, meta‐cognitive and written exposure therapies could indeed differentiate themselves from other approaches as having favourable efficacy and acceptability respectively. These findings may inform clinical decision‐making, as well as guide future research for PTSD.
Are market mechanisms associated with alcohol and other drug treatment outcomes?
Authors: Ritter Alison , van de Ven Katinka , Vuong Thu , Chalmers Jenny , Dobbins Timothy , Livingston Michael , Berends Lynda
Published: September 2021

Background and Aims

The configuration of alcohol and other drug treatment service systems has been influenced by the uptake of market mechanisms for treatment funding and purchasing. This study measured the impact of market mechanisms for funding and purchasing alcohol and drug treatment services on client outcomes.

Design

An observational cross‐sectional study, employing multi‐level analysis: episodes of care data, nested within person‐level data, nested within treatment site and nested within organization.

Setting and participants

One hundred and seventy‐eight alcohol and other drug treatment service sites in Australia.

Measurements

Client outcome variables were length of stay and successful treatment completion. Predictor variables were competitive tendering, number of funding contracts, recurrent funding, the ratio of episodes to staff, type of professions, years of clinical experience, staff turnover and type of provider (government; non‐government). Analyses controlled for drug type, type of treatment received and client characteristics.

Findings

There were no significant associations between the procurement and contracting variables and length of stay [incidence rate ratios (IRRs) ranged between 1.01 and 1.07, all P > 0.05; Bayes factors (BF) < 0.03], and inconclusive results for treatment completion [odds ratios (ORs) ranged between 1.04 and 1.15, all P > 0.05, BF = 0.51–0.63]. Having an alcohol and other drug (AOD) work‐force relative to an ‘other’ work‐force (IRR = 0.79, P = 0.021) and lower case‐loads (IRR = 0.99, P = 0.047) may be associated with longer stay in treatment. Receiving services from a government compared to non‐government provider may also be associated with less treatment completion (OR = 0.34, P = 0.023, BF = 2.14).

Conclusions

There appears to be no association between client outcomes and procurement and funding contract arrangements for alcohol and drug treatment services.
Opioid use disorder and its association with self‐reported difficulties participating in social activities
Authors: Ashrafioun Lisham , Allan Nicholas P. , Stecker Tracy A.
Published: September 2021

Background and Objectives

Difficulties participating in social activities are associated with increased mortality and are underemphasized in addressing the opioid epidemic. This study assessed the association of difficulties participating in social activities and opioid use disorder (OUD) and suicidal ideation and suicide attempts and difficulties participating in social activities among individuals with OUD.

Methods

Data on OUD, difficulties participating in social activities, suicidal ideation, suicide attempts, and other characteristics were assessed in 398,962 respondents from the 2008–2017 National Survey of Drug Use and Health. Logistic regressions examined the association of difficulties participating in social activities and OUD, and then among only respondents with OUD, difficulties participating in social activities and suicidal ideation and suicide attempts.

Results

Respondents with OUD reported higher levels of difficulties participating in social activities compared with respondents without OUD (severe difficulties: odds ratio [OR] = 4.10, 95% confidence interval [CI] = 3.40–4.93). Among those with OUD, difficulties participating in social activities were associated with suicidal ideation (severe difficulties: OR = 2.45, 95% CI = 1.77–3.38), but not attempts.

Conclusion and Scientific Significance

The findings indicate that people with OUD experience difficulties participating in social activities and these difficulties are associated with suicidal ideation. It may be important to address difficulties participating in social activities within the context of OUD treatment, potentially as it relates to suicide prevention. This is the first study utilizing 10 years of nationally representative data to assess difficulties participating in social activities, OUD, and suicidal ideation and suicide attempts. Difficulties participating in social activities represent an under‐addressed, potentially important therapeutic target to address OUD.
Trajectories of asthma and allergy symptoms from childhood to adulthood
Authors: Forster Felix , Ege Markus Johannes , Gerlich Jessica , Weinmann Tobias , Kreißl Sylvia , Weinmayr Gudrun , Genuneit Jon , Nowak Dennis , von Mutius Erika , Vogelberg Christian , Radon Katja
Published: September 2021

Background

Phenotypes of asthma and allergic diseases are mainly studied separately for children and adults. To explore the role of adolescence and young adulthood, we investigated symptom trajectories at the transition from childhood into adulthood.

Methods

Latent class analysis (LCA) was conducted in a population initially recruited for the German arm of Phase II of the International Study of Asthma and Allergies in Childhood and followed‐up three times until their early 30s (N=2267). Indicators included in LCA were 12‐month prevalences of symptoms of wheeze, rhinoconjunctivitis, and eczema. Latent classes were further characterised regarding important traits such as skin prick tests. Logistic regression models were used to investigate associations with environmental determinants such as smoking and occupational exposures.

Results

Six latent classes were identified: an asymptomatic one as well as three with single and two with co‐occurring symptoms. All trajectories essentially established between baseline assessment at around 10 years and the first follow‐up at around 17 years. Probabilities for symptoms increased from childhood to adolescence, especially for wheeze‐related latent classes, while they remained constant in adulthood. Wheeze‐related latent classes were also positively associated with exposures during adolescence (e.g. active smoking).

Conclusion

Distinct trajectories of asthma and allergy symptoms establish from childhood through adolescence and stabilize during early adulthood. This pattern was most notable in wheeze‐related latent classes which also showed the strongest positive associations with environmental exposures in adolescence/young adulthood. Therefore, not only childhood but also adolescence is relevant for disease development and offers considerable potential for prevention and health promotion.
Perinatal outcome after selective termination in dichorionic twins discordant for congenital anomalies
Authors: Bennasar Mar , Ponce Júlia , Torres Ximena , Gómez Olga , Sabrià Joan , Gratacós Eduard , Borrell Antoni , Martínez Josep M.
Published: September 2021

Introduction

Our objective was to evaluate the perinatal outcome of selective termination of dichorionic twin pregnancies with discordant anomalies, according to gestational age at time of procedure.

Material and methods

Retrospective review of 147 dichorionic twin pregnancies referred to our Fetal Medicine Unit between 2003 and 2018 for selective termination. Gestational age at delivery, fetal loss, and overall and 28‐day post‐delivery survival rates, were evaluated according to gestational age at time of procedure. Selective termination procedure was defined as early, intermediate, and late when performed before 18 weeks, between 18 and 23 weeks, and after 23 weeks, respectively. Kruskal–Wallis and chi‐squared test were used to compare groups.

Results

Overall survival at 28 days post‐delivery, pregnancy loss, and preterm delivery before 32 weeks of gestation rates were 93.4%, 6.9%, and 15.5%, respectively. When stratified by gestational age at procedure, intermediate selective termination was associated with a lower survival rate than early and late procedures (86% vs. 96.9% and 100%, respectively; p = 0.035), and a nonsignificant trend for higher pregnancy loss (12% vs. 3.1%). Preterm delivery before 32 weeks of gestation occurred in 27% of late procedures, which was significantly higher than in early (9.5%) and intermediate (18.2%) procedures.

Conclusions

Selective termination in dichorionic twin pregnancies with discordant fetal anomaly is associated with low pregnancy loss and preterm delivery rate, primarily when performed before 18 weeks. When legally possible, late procedures can be a good alternative, particularly in those cases diagnosed beyond the 18th week of gestation.
Globally chained economies, unwitting victims of the US‐China trade war
Authors: Wu Jie , Huh Chan‐Guk , Wood Jacob
Published: September 2021

The USA and China have been engaged in a trade war since 2018—an economic tussle that has had repercussions for not only the two countries directly involved but also for their trading partners participating in the industrial global value chains (GVC). To assess the gravity of the dispute, we measure the impacts of the US‐China bilateral tariff hikes on the participants, as well on their trading partners linked by global supply chains, whose structure is estimated using the OECD Inter‐Country Input–Output Model. Our assessment relies on two metrics: the effective rate of protection (ERP) and total factor productivity (TFP). We calculate ERPs following a methodology that reflects the globally fragmented production linkages. From our assessments, the tariff increases raised the ERPs of the warring countries but lowered those of their trading partners. Moreover, the bilateral tariff hikes significantly raised the input tariffs of many major trading partners through the transmission of GVCs. Consequently, the TFPs of the major trading countries are likely to fall by 0.16 to 0.41 per cent.
Intestinal chemosensitivity in irritable bowel syndrome associates with small intestinal TRPV channel expression
Authors: Grover Madhusudan , Berumen Antonio , Peters Stephanie , Wei Ting , Breen‐Lyles Margaret , Harmsen William S. , Busciglio Irene , Burton Duane , Vazquez Roque Maria , DeVault Kenneth R. , Camilleri Michael , Wallace Michael , Dasari Surendra , Neumann Helmut , Houghton Lesley A.
Published: September 2021

Background

Irritable bowel syndrome (IBS) patients often experience meal‐associated symptoms. However, the underlying mechanisms are unclear.

Aim

To determine small intestinal mechanisms of lipid‐induced symptoms and rectal hypersensitivity in IBS

Methods

We recruited 26 IBS patients (12 IBS‐C, 14 IBS‐D) and 15 healthy volunteers (HV). In vivo permeability was assessed using saccharide excretion assay. Rectal sensitivity was assessed using a barostat before and after small bowel lipid infusion; symptoms were assessed throughout. Next, an extended upper endoscopy with probe‐based confocal laser endomicroscopy (pCLE) was performed with changes induced by lipids. Duodenal and jejunal mucosal biopsies were obtained for transcriptomics.

Results

Following lipid infusion, a higher proportion of HV than IBS patients reported no pain, no nausea, no fullness and no urgency (P < 0.05 for all). In a model adjusted for sex and anxiety, IBS‐C and IBS‐D patients had lower thresholds for first rectal sensation (P = 0.0007) and pain (P = 0.004) than HV. In vivo small intestinal permeability and mean pCLE scores were similar between IBS patients and HV. Post‐lipid, pCLE scores were higher than pre‐lipid but were not different between groups. Baseline duodenal transient receptor potential vanilloid (TRPV) 1 and 3 expression was increased in IBS‐D, and TRPV3 in IBS‐C. Duodenal TRPV1 expression correlated with abdominal pain (r = 0.51, FDR = 0.01), and inversely with first rectal sensation (r = −0.48, FDR = 0.01) and pain (r = −0.41, FDR = 0.02) thresholds.

Conclusion

Lipid infusion elicits a greater symptom response in IBS patients than HV, which is associated with small intestinal expression of TRPV channels. TRPV‐mediated small intestinal chemosensitivity may mediate post‐meal symptoms in IBS.
Estimating body weight of pigs from posture analysis using a depth camera
Authors: Okayama Tsuyoshi , Kubota Yoshifumi , Toyoda Atsushi , Kohari Daisuke , Noguchi Go
Published: September 2021

A noninvasive method for estimating the body weight (BW) of a pig considering its posture using a low‐cost depth camera (Kinect v2) was proposed. A total of 150 pigs were used, and 738 depth images (point clouds) were obtained for them. The pig “volume” was calculated from the pig point cloud, and it was found to have a very high correlation to BW. To evaluate the posture of a pig quantitatively, seven posture angles were calculated based on the “spine” extracted from a pig point cloud. We found the posture angles representing the height of the head position correlated with the accuracy of BW estimation using the “volume.” Based on this finding, we proposed an “adjusted volume,” which was adjusted based on the relationship between the posture angles and the estimation error. The BW of pigs was estimated using the simple regression model with the “adjusted volume,” and the MAPE and RMSPE were 4.87% and 6.13%, respectively. The accuracy of the suggested model was similar to that of the volume‐based estimation models of other studies that used only data with an appropriate pig posture for BW estimation.
Novel radical pelvectomy technique to treat chondrosarcoma in a large‐breed dog
Authors: Gordon C , Nakahara N , Thomson C , Mitchell RAS
Published: September 2021

Surgical management of chondrosarcoma with hemipelvectomy is well described, but there have been no reports on extensive excision involving bilateral pubis and unilateral ischium. This report describes a novel pelvectomy technique for the treatment of chondrosarcoma in a large‐breed dog. A 12‐year‐old Labrador Retriever presented for tenesmus due to a large, intra‐pelvic mass which was confirmed on computed tomography (CT). Surgery involved removal of the entire left ischium and both pubic bones with preservation of both hind limbs. Histopathology confirmed the diagnosis of a high‐grade chondrosarcoma with tumour‐free margins of less than 3 mm. The dog recovered well following surgery and regained ambulation within 9 days. Four months postoperatively, the dog had no ongoing pain or tenesmus and only a mild gait abnormality in the left hind limb. Pelvectomy involving the entire pubis and unilateral ischium was well tolerated in a large‐breed dog. This technique may offer a novel surgical option to treat neoplasia previously considered too extensive for complete excision.
Flow adhesion of whole blood to P‐selectin: a prognostic biomarker for vaso‐occlusive crisis in sickle cell disease
Authors: Hines Patrick C. , Callaghan Michael U. , Zaidi Ahmar U. , Gao Xiufeng , Liu Ke , White Jennell , Tarasev Michael
Published: September 2021

Blood cell adhesion to P‐selectin and vascular cell adhesion molecule‐1 (VCAM‐1) contributes to the pathophysiology of vaso‐occlusion crisis (VOC) events in individuals with sickle cell disease (SCD). We evaluated the use of standardized flow adhesion biomarkers in a six‐month, 35‐subjects longitudinal study (ELIPSIS). Flow adhesion of whole blood on P‐selectin (FA‐WB‐Psel) and VCAM1 (FA‐WB‐VCAM), and of isolated white blood cells on P‐selectin (FA‐WBC‐Psel) and VCAM‐1 (FA‐WBC‐VCAM) were elevated on VOC days compared with non‐VOC days, but only FA‐WB‐Psel reached statistical significance (P = 0·015). Optimal cut‐off values were established with Cox regression models for FA‐WB‐Psel [46 cells/mm²; hazard ratio (HR): 2·3; 95% confidence interval (CI):1·4–4·0; P = 0·01] and FA‐WB‐VCAM (408 cells/mm², HR:1·8; 95% CI: 0·9–3·45; P = 0·01). A combined (FA‐WB‐Psel and FA‐WB‐VCAM) multimarker risk score was also significantly (P = 0·0006) correlated with VOC risk that was two‐fold higher for intermediate and 5·64‐fold higher for high score. The concordance (C)‐index for the multimarker score was 0·63 in the six‐month period (95% CI: 0·56–0·70), indicating a better ability to distinguish patient risk of VOC, compared to individual biomarkers FA‐WB‐VCAM (C‐index: 0·57; 95% CI: 0·49–0·65) or FA‐WB‐Psel (C‐index: 0·58; 95% CI: 0·53–0·62). The presented multimarker score can be used to risk‐stratify individuals with SCD during their steady state into low, intermediate, and high‐risk strata for self‐reported VOCs. Such risk stratification could help focus healthcare resources more efficiently to maintiain health, personalize treatment selection to each patient’s individual needs, and potentially reduce healthcare costs.
Is perfectionism a killer of creative thinking? A test of the model of excellencism and perfectionism
Authors: Goulet‐Pelletier Jean‐Christophe , Gaudreau Patrick , Cousineau Denis
Published: September 2021

The standards that a person pursue in life can be set in a rigid or flexible way. The recent literature has emphasized a distinction between high and realistic standards of excellence, from high and unrealistic standards of perfection. In two studies, we investigated the role of striving towards excellence (i.e., excellencism) and striving towards perfection (i.e., perfectionism) in relation to divergent thinking, associative thinking, and openness to experience, general self‐efficacy, and creative self‐beliefs. In Study 1, 279 university students completed three divergent thinking items, which called for creative uses of two common objects and to name original things which make noise. A measure of openness to experience was included. Results from multiple regression indicated that participants pursuing excellence tended to generate more answers and more original ones compared with those pursuing perfection. Openness to experience was positively associated to excellencism and negatively associated to perfectionism. In Study 2 (n = 401 university students), we replicated these findings and extended them to associative tasks requiring participants to generate chains of unrelated words. Additional individual differences measures included general self‐efficacy, creative self‐efficacy, and creative personal identity. The results suggested that excellencism was associated with better performance on divergent thinking and associative tasks, compared with perfectionism. Excellencism was positively associated with all four personality variables, whereas perfectionism was significantly and negatively associated with openness to experience only. Implications for the distinction between perfectionism and excellencism with respect to creative indicators are discussed. In addition, the paradoxical finding that perfection strivers had high creative self‐efficacy and creative personal identity but lower openness to experience and poorer performance on objective indicators of creative abilities is discussed.
Protecting privacy? Government and parliamentary responsiveness to the privacy commissioner of Canada
Authors: Bergman Gwyneth , Macfarlane Emmett
Published: September 2021

This article examines the policy influence of the federal privacy commissioner via an analysis of how Parliament and the government of the day have responded to the commissioner’s recommendations. We conduct a systematic analysis of the commissioner’s annual reports on the Privacy Act and a content analysis of appearances before relevant committees of the House of Commons. We then examine the implications of this survey for assessing the overall receptivity of government and parliamentarians to the commissioner’s recommendations. We also undertake a qualitative case study of two bills, passed under two different governments, on anti‐terrorism policy. We trace the influence of, and government responsiveness to, the commissioner’s recommendations throughout the development of these bills. We argue that, while the commissioner has real capacity to influence government policy, the influence is significantly constrained by the willingness of government to engage with the commissioner’s recommendations.
Canada’s legal preparedness against the COVID‐19 Pandemic: A scoping review of federal laws and regulations
Authors: Srikanth Reddy K. , Kumar Chattu Vijay , Wilson Kumanan
Published: September 2021

As the world continues to grapple with the COVID‐19 pandemic, the preparedness of governments to respond to it will likely undergo review. A key component is the legislative capacity and authority that governments had in place or could rapidly introduce to address the social, economic and health consequences of the emergency. We review Canada’s legal preparedness for public health emergencies and the use of federal legislation to address the pandemic. We provide an overview of the concept of legal preparedness, summarize the federal statutes, regulations and orders enacted, and analyze the coherence of federal activity and its relevance to provinces, territories and international health regulations. We determine that the federal government has relied on spending power rather than constitutional authority over public health or existing legislation on influencing the course of the pandemic.
Increased epithelial backscatter: A novel finding in subclinical and clinical keratoconus
Authors: Toprak Ibrahim , Gunes Celal Emre
Published: September 2021

Background

To assess alterations in backscatter from the corneal epithelium, anterior stroma and lens surface in eyes with subclinical, mild and moderate keratoconus (KC).

Methods

In this single‐centre, cross‐sectional study involving 24 eyes with subclinical KC, 107 eyes with manifest KC (mild = 40 and moderate = 67 eyes) and 90 controls, line densitometry was performed with Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany) to obtain simultaneous backscatter values for the corneal epithelium, anterior stroma and anterior lens surface. Backscatter values and Pentacam parameters were used in subsequent statistical analyses.

Results

Eyes with subclinical, mild and moderate KC had similar epithelial and stromal backscatter (P > 0.05) that was significantly increased compared with the controls (P < 0.05). Although anterior lens surface backscatter did not differ between the control and KC groups (P > 0.05), it was significantly higher in the mild and moderate KC groups than in the subclinical KC group (P < 0.05). In the KC group (n = 131) epithelial backscatter was strongly correlated with stromal backscatter (r = 0.911, P < 0.0001).

Conclusions

Increased epithelial backscatter and a strong correlation with anterior stromal backscatter in the KC groups were consistent with the epithelium‐stroma interaction involved in KC pathogenesis. Single‐point backscatter analysis can be used with point clouds to construct epithelial and stromal backscatter maps in Pentacam to aid the detection of KC as a novel feature.
One year into the COVID‐19 pandemic: What do we know so far from studies assessing risk and mitigation of droplet aerosolisation during endonasal surgery? A systematic review
Authors: Williams Stephen P. , Leong Samuel C.
Published: September 2021

Objectives

As we pass the anniversary of the declaration of a global pandemic by the World Health Organisation, it invites us to reflect upon the inescapable changes that coronavirus has wrought upon ENT and, in particular, rhinological practice. As it remains unclear when we will emerge from the shadow of COVID‐19, a critical analysis of the evidence base on both the assessment and mitigation of risk is vital for ENT departments worldwide. This article presents a systematic review of the literature examining articles which consider either the quantification of risk or strategies to mitigate risk specifically in the setting of rhinological surgery.

Design

Systematic literature review.

Results

The literature search yielded a total of 3406 returns with 24 articles meeting eligibility criteria. A narrative synthesis stratified results into two broad themes: (1) those which made an assessment as to the aerosolisation of droplets during sinus surgery, further sub‐divided into work which considered macroscopically visible droplets and that which considered smaller particles; (2) and those studies which examined the mitigation of this risk.

Conclusion

Studies considering the aerosolisation of both droplets and smaller particles suggest endonasal surgery carries significant risk. While results both highlight a range of innovative adjunctive strategies and support suction as an important intervention to reduce aerosolisation, appropriate use of personal protective equipment (PPE) should be considered mandatory for all healthcare professionals involved in rhinological surgery. Studies have demonstrated that close adherence to PPE use is effective in preventing COVID‐19 infection.
Exploring Aceh Tsunami Museum Visitors’ Motivation, Experience and Emotional Reaction
Authors: Hanafiah Mohd Hafiz , Abd Hamid Maisarah , Muttaqim Hakim
Published: September 2021

This study explores how the Aceh Tsunami Museum visitors’ motivation and experience affect their emotional reactions. The study expands current theorisations by examining the merits of emotional reaction in visitors’ behaviour models. A total of 384 visitors completed a self‐administered survey via online forms. The results show that visitors’ emotional reaction is affected by motivational factors and their experience visiting the museum. This study fills in the gaps in the limited research on visitors’ motivations, experiences, and emotional reactions to the dark museum site. From a practical perspective, this one of the early studies proving that the Aceh Tsunami Museum is well perceived as a popular dark tourism site and can be promoted as a potential niche tourism product by the Aceh government.
The developmental hourglass model is applicable to the spinal cord based on single‐cell transcriptomes and non‐conserved cis‐regulatory elements
Authors: Mukaigasa Katsuki , Sakuma Chie , Yaginuma Hiroyuki
Published: September 2021

The developmental hourglass model predicts that embryonic morphology is most conserved at the mid‐embryonic stage and diverges at the early and late stages. To date, this model has been verified by examining the anatomical features or gene expression profiles at the whole embryonic level. Here, by data mining approach utilizing multiple genomic and transcriptomic datasets from different species in combination, and by experimental validation, we demonstrate that the hourglass model is also applicable to a reduced element, the spinal cord. In the middle of spinal cord development, dorsoventrally arrayed neuronal progenitor domains are established, which are conserved among vertebrates. By comparing the publicly available single‐cell transcriptome datasets of mice and zebrafish, we found that ventral subpopulations of post‐mitotic spinal neurons display divergent molecular profiles. We also detected the non‐conservation of cis‐regulatory elements located around the progenitor fate determinants, indicating that the cis‐regulatory elements contributing to the progenitor specification are evolvable. These results demonstrate that, despite the conservation of the progenitor domains, the processes before and after the progenitor domain specification diverged. This study will be helpful to understand the molecular basis of the developmental hourglass model.
Benefit of insulin glargine/lixisenatide for reducing residual hyperglycaemia in Japan: Post hoc analysis of the LixiLan JP‐O2 trial
Authors: Iizuka Katsumi , Baxter Mike , Watanabe Daisuke , Yabe Daisuke
Published: September 2021

Aim

To compare the benefits of iGlarLixi, a fixed‐ratio combination of insulin glargine 100 U/mL and lixisenatide (iGlarLixi), with insulin glargine (iGlar) for reducing residual hyperglycaemia (defined as HbA1c ≥ 7% despite fasting plasma glucose [FPG] < 130 mg/dL) in Japanese people with type 2 diabetes (T2D) inadequately controlled on oral antidiabetic drugs.

Materials and Methods

The open‐label LixiLan JP‐O2 study compared iGlarLixi with iGlar over 26 weeks in 521 people with T2D. This post hoc analysis assessed the proportions of participants with residual hyperglycaemia in the overall population, and in subgroups defined by age and dipeptidyl peptidase‐4 inhibitor (DPP4i) use at screening.

Results

At 26 weeks, significantly fewer participants had residual hyperglycaemia in the iGlarLixi versus the iGlar arm (8.1% vs. 19.6%; P = .0002). There was also less residual hyperglycaemia with iGlarLixi than iGlar in all subgroup analyses: 9.0% versus 16.8% in participants aged younger than 65 years (P = .0369); 6.5% versus 24.2% in participants aged 65 years or older (P = .0008); 10.1% versus 20.5% (P = .0202) in participants with DPP4i use; and 6.2% versus 18.8% in those without DPP4i use (P = .0024). The proportion reaching both HbA1c less than 7% and FPG less than 130 mg/dL was higher with iGlarLixi versus iGlar in the overall population (50.8% vs. 31.5%; P < .0001), and in all studied subgroups.

Conclusions

iGlarLixi reduced the prevalence of residual hyperglycaemia in Japanese people with uncontrolled T2D compared with iGlar, both in the overall population and in subgroups defined by age and DPP4i use at screening.
Associations of weight loss with obesity‐related comorbidities in a large integrated health system
Authors: Mariam Arshiya , Miller‐Atkins Galen , Pantalone Kevin M. , Iyer Neeraj , Misra‐Hebert Anita D. , Milinovich Alex , Bauman Janine , Mocarski Michelle , Ramasamy Abhilasha , Smolarz B. Gabriel , Hobbs Todd M. , Zimmerman Robert S. , Burguera Bartolome , Kattan Michael W. , Rotroff Daniel M.
Published: September 2021

Aims

To determine the health outcomes associated with weight loss in individuals with obesity, and to better understand the relationship between disease burden (disease burden; ie, prior comorbidities, healthcare utilization) and weight loss in individuals with obesity by analysing electronic health records (EHRs).

Materials and Methods

We conducted a case‐control study using deidentified EHR‐derived information from 204 921 patients seen at the Cleveland Clinic between 2000 and 2018. Patients were aged ≥20 years with body mass index ≥30 kg/m2 and had ≥7 weight measurements, over ≥3 years. Thirty outcomes were investigated, including chronic and acute diseases, as well as psychological and metabolic disorders. Weight change was investigated 3, 5 and 10 years prior to an event.

Results

Weight loss was associated with reduced incidence of many outcomes (eg, type 2 diabetes, nonalcoholic steatohepatitis/nonalcoholic fatty liver disease, obstructive sleep apnoea, hypertension; P < 0.05). Weight loss >10% was associated with increased incidence of certain outcomes including stroke and substance abuse. However, many outcomes that increased with weight loss were attenuated by disease burden adjustments.

Conclusions

This study provides the most comprehensive real‐world evaluation of the health impacts of weight change to date. After comorbidity burden and healthcare utilization adjustments, weight loss was associated with an overall reduction in risk of many adverse outcomes.
Seizure prevalence in neurodegenerative diseases—a study of autopsy proven cases
Authors: Vöglein Jonathan , Kostova Irena , Arzberger Thomas , Noachtar Soheyl , Dieterich Marianne , Herms Jochen , Schmitz Peer , Ruf Viktoria , Windl Otto , Roeber Sigrun , Simons Mikael , Höglinger Günter U. , Danek Adrian , Giese Armin , Levin Johannes
Published: September 2021

Background and purpose

Knowledge about the seizure prevalence in the whole symptomatic course, from disease onset to death, in neurodegenerative diseases (ND) is lacking. Therefore, the aim was to investigate seizure prevalence and associated clinical implications in neuropathologically diagnosed ND.

Methods

Clinical records of cases from the Neurobiobank Munich, Germany, were analyzed. Neuropathological diagnoses of the assessed cases included Alzheimer disease (AD), corticobasal degeneration (CBD), frontotemporal lobar degeneration (FTLD), Lewy body disease (LBD), multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). Seizure prevalence during the whole symptomatic disease phase was assessed and compared amongst ND. Associations between first clinical symptom and seizure prevalence and between seizures and disease duration were examined.

Results

In all, 454 patients with neuropathologically diagnosed ND and with available and meaningful clinical records were investigated (AD,n = 144; LBD,n = 103; PSP,n = 93; FTLD,n = 53; MSA,n = 36; CBD,n = 25). Seizure prevalence was 31.3% for AD, 20.0% for CBD, 12.6% for LBD, 11.3% for FTLD, 8.3% for MSA and 7.5% for PSP. Seizure prevalence was significantly higher in AD compared to FTLD (p = 0.005), LBD (p = 0.001), MSA (p = 0.005) and PSP (p < 0.001). No other significant differences regarding seizure prevalence were found between the studied ND. Cognitive first symptoms in ND were associated with an increased seizure prevalence (21.1% vs. 11.0% in patients without cognitive first symptoms) and motor first symptoms with a decreased seizure prevalence (10.3% vs. 20.5% in patients without motor first symptoms). Seizures were associated with a longer disease duration in MSA (12.3 vs. 7.0 years in patients without seizures;p = 0.017).

Conclusions

Seizures are a clinically relevant comorbidity in ND, particularly in AD. Knowledge of the first clinical symptom in ND may allow for estimation of seizure risk.
Fracture and repair in a bio‐inspired self‐healing structure
Authors: Hone Timothy , Kelehan Sarah , Taylor David
Published: September 2021

Many self‐healing materials have been developed, but very few self‐healing structures. We designed a structure in the form of a cylinder required to resist bending. Taking inspiration from plant stems, it has a cellular structure including longitudinal vascular channels for the delivery of healing agents. The structure was found to be capable of absorbing energy effectively, by deformation and fracture of cell walls. The introduction of healing agents (a two‐part liquid adhesive) into the vascular channels allowed fractured cell walls to be repaired. The resulting structure was capable of near‐perfect self‐healing, restoring its original mechanical properties even after significant damage. A computer simulation (finite element analysis) successfully predicted the early‐stage deformation and the initiation of damage. We advocate this structure‐level approach as a more appropriate way to introduce self‐repair into engineering systems.
Evaluation of variation in background nitrous oxide emissions: A new global synthesis integrating the impacts of climate, soil, and management conditions
Authors: Yin Yulong , Wang Zihan , Tian Xingshuai , Wang Yingcheng , Cong Jiahui , Cui Zhenling
Published: September 2021

Robust global simulation of soil background N2O emissions (BNEs) is a challenge due to the lack of a comprehensive system for quantification of the variations in their magnitude and location. We mapped global BNEs based on 1353 field observations from globally distributed sites and high‐resolution climate and soil data. We then calculated global and national total BNE budgets and compared them to the IPCC‐estimated values. The average BNE was 1.10, 0.92, and 0.84 kg N ha−1 year−1 with variations from 0.18 to 3.47 (5th–95th percentile, hereafter), 0.20 to 3.44, and −1.16 to 3.70 kg N ha−1 year−1 for cropland, forestland, and grassland, respectively. Soil pH, soil N mineralization, atmospheric N deposition, soil volumetric water content, and soil temperature were the principle significant drivers of BNEs. The total BNEs of three land use types was lower than IPCC‐estimated total BNEs by 0.83 Tg (1012 g) N year−1, ranging from −47% to 94% across countries. The estimated BNE with cropland values were slightly higher than the IPCC estimates by 0.11 Tg N year−1, and forestland and grassland lower than the IPCC estimates by 0.4 and 0.54 Tg N year−1, respectively. Our study underlined the necessity for detailed estimation of the spatial distribution of BNEs to improve the estimates of global N2O emissions and enable the establishment of more realistic and effective mitigation measures.
Biochar in agriculture – A systematic review of 26 global meta‐analyses
Authors: Schmidt Hans‐Peter , Kammann Claudia , Hagemann Nikolas , Leifeld Jens , Bucheli Thomas D. , Sánchez Monedero Miguel Angel , Cayuela Maria Luz
Published: September 2021

Biochar is obtained by pyrolyzing biomass and is, by definition, applied in a way that avoids its rapid oxidation to CO2. Its use in agriculture includes animal feeding, manure treatment (e.g. as additive for bedding, composting, storage or anaerobic digestion), fertilizer component or direct soil application. Because the feedstock carbon is photosynthetically fixed CO2 from the atmosphere, producing and applying biochar is essentially a carbon dioxide removal (CDR) technology, which has a high‐technology readiness level. However, for swift implementation of pyrogenic carbon capture and storage (PyCCS), biochar use in agriculture needs to deliver co‐benefits, for example, by improving crop yields and ecosystem services and/or by improving climate change resilience by ameliorating key soil properties. Agronomic biochar research is a rapidly evolving field of research moving from less than 100 publications in 2010 to more than 15,000 by the end of 2020. Here, we summarize 26 rigorously selected meta‐analyses published since 2016 that investigated a multitude of soil properties and agronomic performance parameters impacted by biochar application, for example, effects on yield, root biomass, water use efficiency, microbial activity, soil organic carbon and greenhouse gas emissions. All 26 meta‐analyses show compelling evidence of the overall beneficial effect of biochar for all investigated agronomic parameters. One of the remaining challenges is the standardization of basic biochar analysis, still lacking in many studies. Incomplete biochar characterization increases uncertainty because adverse effects of individual studies included in the meta‐analyses might be related to low‐quality biochars, which would not qualify for certification and subsequent use (e.g. high content of contaminants, high salinity, incomplete pyrolysis, etc.). In summary, our systematic review suggests that biochar use in agriculture has the potential to combine CDR with significant agronomic and/or environmental co‐benefits.
Host state reactions to home state diaspora engagement policies: Rethinking state sovereignty and limits of diaspora governance
Authors: Baser Bahar , Féron Élise
Published: September 2021

During the last few decades, institutions, policies, and other state‐sponsored mechanisms linking home states and diasporas have expanded well beyond traditional areas. Numerous states have established diaspora engagement policies and institutions to tap diaspora resources and maximize their political, economic, and cultural interests. Previous research largely focused on these policies’ motivations and their impact on diasporas, with little attention being paid to the host states’ context. How do host states react to other states’ diaspora engagement policies within their borders? Where do host states draw the line for other states’ involvement in their territory? In this article, we examine Turkey's diaspora engagement initiatives in European countries, and zero in on host states’ reactions to these extraterritorial activities. We argue that diaspora engagement has limits and its scope is determined by the foreign and domestic political processes of the host states and their concern over their sovereignty and security.
Post‐translational modifications of proteins associated with yeast peroxisome membrane: An essential mode of regulatory mechanism
Authors: Infant Terence , Deb Rachayeeta , Ghose Suchetana , Nagotu Shirisha
Published: September 2021

Peroxisomes are single membrane‐bound organelles important for the optimum functioning of eukaryotic cells. Seminal discoveries in the field of peroxisomes are made using yeast as a model. Several proteins required for the biogenesis and function of peroxisomes are identified to date. As with proteins involved in other major cellular pathways, peroxisomal proteins are also subjected to regulatory post‐translational modifications. Identification, characterization and mapping of these modifications to specific amino acid residues on proteins are critical toward understanding their functional significance. Several studies have tried to identify post‐translational modifications of peroxisomal proteins and determine their impact on peroxisome structure and function. In this manuscript, we provide an overview of the various post‐translational modifications that govern the peroxisome dynamics in yeast.