bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive accuracy of the shock index for severe postpartum hemorrhage in high‐income countries: A systematic review and meta‐analysis
Authors: Makino Yuto , Miyake Kentaro , Okada Asami , Ikeda Yumie , Okada Yohei
Published: June 2022

Aim

The shock index has been suggested as a screening tool for predicting postpartum hemorrhage (PPH); however, there is little comprehensive evidence regarding its predictive accuracy. This systematic review and meta‐analysis aim to investigate the predictive accuracy of the shock index for severe PPH in high‐income countries.

Methods

A comprehensive search was conducted on MEDLINE, Cochrane Central Register of Controlled Trials, and Web of Science (from inception to June 2021). Studies assessing the predictive performance of the shock index for PPH in high‐income countries were included. Two or more reviewers independently extracted the data and assessed the risk of bias and applicability concerns using the modified Quality Assessment of Diagnostic Accuracy Studies 2 tool. PPH requiring higher‐level care, such as blood transfusions, were considered as primary analyses. We described the hierarchical summary receiver‐operating characteristic curve for data synthesis.

Results

Nine studies were included after the eligibility assessment. All studies were considered to either have a high risk of bias or high applicability concerns. The sensitivity of the four studies that defined severe PPH as PPH requiring blood transfusion ranged from 0.51 to 0.80, whereas their specificity ranged from 0.33 to 0.92.

Conclusions

This review shows that the predictive performance of the shock index for severe PPH is inconsistent. Therefore, the evidence for using the shock index alone as a screening tool for PPH in high‐income countries is insufficient.

Study registration

This review was prospectively registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN000044230).
The efficacy of misoprostol in reducing intraoperative blood loss in women undergoing elective cesarean section. A systematic review and meta‐analysis
Authors: Maged Ahmed M. , Wali Ahmed A. , Metwally Ahmed A. , Salah Noha
Published: June 2022

Objectives

To evaluate the efficacy of misoprostol to minimized blood loss during and after cesarean delivery (CD).

Search Strategy

Screening of MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials from inception to February 2021 using the keywords related to misoprostol, CD, postpartum hemorrhage, and intraoperative blood loss and their MeSH terms.

Selection criteria

Only RCTs were included. Participants included women undergoing CD whether elective or selective. Thirty studies including 6593 women, 26 in English, 2 in Thai, 1 in French, and 1 in Chinese.

Data Collection and Analysis

Data from all selected studies were extracted independently by two authors. Data extracted included location of the trial, sample size, inclusion and exclusion criteria, participants characteristics, intervention details including timing, dose, and route of drug administration. Outcomes assessed included estimated intraoperative and postoperative blood loss, occurrence of postpartum hemorrhage, the need for additional uterotonics, and hemoglobin difference.

Main Results

Four studies (968 women) compared preoperative to postoperative misoprostol and found a mean difference in intraoperative blood loss of −205.00 (−339.22, −70.77), p = 0.003 and in postoperative blood loss −216.27 (−347.08, −85.46), p < 0.001 and a significantly lower need for additional uterotonics with a risk ratio of 0.54 (0.46, 0.64), p < 0.00001. Twenty‐two studies (4701 participants) compared misoprostol to oxytocin. There was a mean difference in intraoperative blood loss of −108.43 (−156.04, −60.82), p < 0.0001. Nine of these trials with 1978 participants evaluated postoperative blood loss. These found a mean difference of −64.12 (−116.19, −12.04) with a p = 0.02. Fourteen trials with 3166 participants measured the difference between preoperative and postoperative hemoglobin. These found a mean difference of −0.25 (−0.35, −0.15) with a p < 0.001. Twenty trials with 4416 participants measured the need for administration of additional uterotonics. These found a risk ratio of 0.62 (0.49, 0.78) with a p value of <0.001.

Conclusion

The combined use of misoprostol and oxytocin during CD is effective in reducing blood loss during and after CD.
Melatonin may suppress lung adenocarcinoma progression via regulation of the circular noncoding RNA hsa_circ_0017109/miR‐135b‐3p/TOX3 axis
Authors: Wang Yuanyong , Wang Zhaoyang , Shao Changjian , Lu Guofang , Xie Mei , Wang Jian , Duan Hongtao , Li Xiaofei , Yu Wanpeng , Duan Weixun , Yan Xiaolong
Published: June 2022

Melatonin is a hormone synthesized in the pineal gland and has widespread physiological and pharmacological functions. Moreover, it can activate protective receptor‐dependent processes. These processes can prevent tissue carcinogenesis and inhibit malignant tumor progression and metastasis. Therefore, we investigated the regulatory effects of melatonin on dysregulated circular RNAs in human lung adenocarcinoma (LUAD) cells. In this study, we treated LUAD cells with melatonin and measured the expression of hsa_circ_0017109, miR‐135b‐3p, and TOX3 by quantitative reverse transcription polymerase chain reaction. Colony formation and cell counting kit‐8 assays were used to determine cell proliferation. The wound‐healing assay and Transwell experiment were carried out to evaluate the migration potential and invasive capacity of LUAD cells. Also, cell apoptosis was detected using a cell apoptosis kit, and protein production was identified by Western blot. It was suggested that melatonin could inhibit LUAD progression in vivo and in vitro, and the role of TOX3 in this process was explored. Additionally, hsa_circ_0017109 was found to sponge miR‐135b‐3p, a downstream factor of circ_0017109, which was demonstrated to target TOX3 in LUAD cells and could promote the Hippo pathway and epithelial–mesenchymal transition pathway. To summarize, we demonstrated that melatonin decreases the expression of circ_0017109 and suppresses the non‐small‐cell lung cancer cell migration, invasion, and proliferation through decreasing TOX3 expression via direct activation of miR‐135b‐3p.
Effects of periodontal and bisphosphonate treatment on the gingival crevicular levels of sclerostin and dickkopf‐1 in postmenopausal osteoporosis with and without periodontitis
Authors: Ozden Feyza Otan , Demir Esra , Lutfioglu Müge , Acarel Elif Eser , Bilgici Birsen , Atmaca Aysegül
Published: June 2022

Objective and Background

Both periodontitis and osteoporosis are associated with osteoclast‐related bone resorption. Bone metabolism is regulated by wingless‐type MMTV integration site family (WNT), and WNT/β‐catenin signals are controlled by physiological antagonists including dickkopf‐1 (DKK‐1) and sclerostin (SOST). This study examined the effects of periodontal and bisphosphonate (BP) treatment on the gingival crevicular fluid (GCF) sclerostin (SOST) and dickkopf‐related protein‐1 (DKK‐1) levels in osteoporotic and systemically healthy postmenopausal women with and without periodontitis.

Materials and Methods

A total of 48 postmenopausal women were divided into 4 groups (n = 12) according to periodontal health and osteoporosis status, as follows: Group OP/P: subjects with both osteoporosis and periodontitis; Group P: systemically healthy subjects with periodontitis; Group OP: periodontally healthy subjects with osteoporosis; Group H: systemically and periodontally healthy controls. Clinical data and GCF SOST and DKK‐1 levels of the participants were collected at baseline and at 6 and 12 months following the initiation of periodontal and/or BP treatment in the experimental groups. GCF SOST and DKK‐1 data were obtained by ELISA.

Results

Clinical improvements were observed in all experimental groups. GCF SOST and DKK1 baseline levels varied significantly between groups due to periodontal disease (p < .001). Following treatment, significant increases in SOST and DKK‐1 concentrations and significant decreases in total amounts of SOST were observed in both periodontitis groups (OP/P, P). However, while total amounts of DKK‐1 decreased in Group OP/P, in Group P, these amounts had significantly increased at 12 months post‐treatment (p < .05). At both 6 and 12 months post‐treatment, SOST and DDK1 total amounts in Groups OP/P, OP, and H were similar (p > .05), whereas significant differences were observed between Groups H and P, indicating a deviation from periodontal health in Group P (p < .01).

Conclusions

Significant changes in GCF SOST and DKK‐1 levels were observed among women with osteoporosis who received both periodontal and BP treatment. A more detailed examination of how these treatment protocols can be combined may lead to new therapeutic approaches towards periodontal disease.
Neuronal‐spiking‐based closed‐loop stimulation during corticalON‐ andOFF‐states in freely moving mice
Authors: Kahn Martin , Krone Lukas B. , Blanco‐Duque Cristina , Guillaumin Mathilde C. C. , Mann Edward O. , Vyazovskiy Vladyslav V.
Published: June 2022

The slow oscillation is a central neuronal dynamic during sleep, and is generated by alternating periods of high and low neuronal activity (ON‐ and OFF‐states). Mounting evidence causally links the slow oscillation to sleep's functions, and it has recently become possible to manipulate the slow oscillation non‐invasively and phase‐specifically. These developments represent promising clinical avenues, but they also highlight the importance of improving our understanding of how ON/OFF‐states affect incoming stimuli and what role they play in neuronal plasticity. Most studies using closed‐loop stimulation rely on the electroencephalogram and local field potential signals, which reflect neuronal ON‐ and OFF‐states only indirectly. Here we develop an online detection algorithm based on spiking activity recorded from laminar arrays in mouse motor cortex. We find that online detection of ON‐ and OFF‐states reflects specific phases of spontaneous local field potential slow oscillation. Our neuronal‐spiking‐based closed‐loop procedure offers a novel opportunity for testing the functional role of slow oscillation in sleep‐related restorative processes and neural plasticity.
Immunogenicity and safety of a third dose of anti‐SARS‐CoV‐2 BNT16b2 vaccine in liver transplant recipients
Authors: Toniutto Pierluigi , Cussigh Annarosa , Cmet Sara , Bitetto Davide , Fornasiere Ezio , Fumolo Elisa , Fabris Martina , D'Aurizio Federica , Fabris Carlo , Grillone Lucrezia , Sartor Assunta , Curcio Francesco , Falleti Edmondo
Published: June 2022

Background & aims

A strategy to improve the low rate of anti‐SARS‐CoV‐2 mRNA vaccine‐induced immunogenicity in liver transplant recipients (LTs) is urgently needed.

Methods

We analysed the rate of positive (≥0.8 U/ml) anti‐SARS‐CoV‐2 receptor domain‐binding protein (RBD) antibody response 2 months after a third dose of the BNT16b2 vaccine in 107 LTs who completed the second vaccine dose 7 months earlier.

Results

A positive anti‐SARS‐CoV‐2‐s‐RBD antibody response after the third vaccine dose was detected in 98 (91.6%) LTs compared to 82 (76.6%) after the second vaccine dose (p = .003). The median of anti‐SARS‐CoV‐2 RBD antibody titres increased from 22.9 U/ml 6 months after the second to 3500 U/ml 2 months after the third vaccine dose (p < .001). Fourteen (14.3%) responder patients presented antibody titres <100 U/ml, 57 (58.2%) between 100 and 9999 U/ml and 27 (27.6%) ≥10 000 U/ml. Seropositivity after the second dose was maintained after the third dose. Independent predictors of antibody response failure after the third vaccine dose were taking a higher daily dose of mycophenolate mofetil (MMF, p < .001) and had a lower (<60 ml/min/1.73 m2) estimated glomerular filtration rate (p = .007). Nine (9.1%) LTs experienced symptomatic SARS‐CoV‐2 infection after the third vaccine dose. Median antibody titres were not statistically different between infected and not infected LTs (1325 vs 3515 U/ml, p = .678).

Conclusions

The third dose of the BNT16b2 vaccine increased the number of LTs who developed a positive anti‐SARS‐CoV‐2 s‐RBD antibody response. A proportion of patients remained unresponsive, mainly for modifiable factors, such as the use of MMF or multiple immunosuppressants.
Gastrointestinal symbiont diversity in wild gorilla: A comparison of bacterial and strongylid communities across multiple localities
Authors: Mason Bethan , Petrzelkova Klara J. , Kreisinger Jakub , Bohm Torsten , Cervena Barbora , Fairet Emilie , Fuh Terence , Gomez Andres , Knauf Sascha , Maloueki Ulrich , Modry David , Shirley Matthew H. , Tagg Nikki , Wangue Nadege , Pafco Barbora
Published: June 2022

Western lowland gorillas (Gorilla gorilla gorilla) are Critically Endangered and show continued population decline. Consequently, pressure is mounting to better understand their conservation threats and ecology. Gastrointestinal symbionts, such as bacterial and eukaryotic communities, are believed to play vital roles in the physiological landscape of the host. Gorillas host a broad spectrum of eucaryotes, so called parasites, with strongylid nematodes being particularly prevalent. While these communities are partially consistent, they are also shaped by various ecological factors, such as diet or habitat type. To investigate gastrointestinal symbionts of wild western lowland gorillas, we analysed 215 faecal samples from individuals in five distinct localities across the Congo Basin, using high‐throughput sequencing techniques. We describe the gut bacterial microbiome and genetic diversity of strongylid communities, including strain‐level identification of amplicon sequence variants (ASVs). We identified strongylid ASVs from eight genera and bacterial ASVs from 20 phyla. We compared these communities across localities, with reference to varying environmental factors among populations, finding differences in alpha diversity and community compositions of both gastrointestinal components. Moreover, we also investigated covariation between strongylid nematodes and the bacterial microbiome, finding correlations between strongylid taxa and Prevotellaceae and Rikenellaceae ASVs that were consistent across multiple localities. Our research highlights the complexity of the bacterial microbiome and strongylid communities in several gorilla populations and emphasizes potential interactions between these two symbiont communities. This study provides a framework for ongoing research into strongylid nematode diversity, and their interactions with the bacterial microbiome, among great apes.
Community assembly and metaphylogeography of soil biodiversity: Insights from haplotype‐level communityDNAmetabarcoding within an oceanic island
Authors: Andújar Carmelo , Arribas Paula , López Heriberto , Arjona Yurena , Pérez‐Delgado Antonio , Oromí Pedro , Vogler Alfried P. , Emerson Brent C.
Published: June 2022

Most of our understanding of island diversity comes from the study of aboveground systems, while the patterns and processes of diversification and community assembly for belowground biotas remain poorly understood. Here, we take advantage of a relatively young and dynamic oceanic island to advance our understanding of ecoevolutionary processes driving community assembly within soil mesofauna. Using whole organism community DNA (wocDNA) metabarcoding and the recently developed metaMATE pipeline, we have generated spatially explicit and reliable haplotype‐level DNA sequence data for soil mesofaunal assemblages sampled across the four main habitats within the island of Tenerife. Community ecological and metaphylogeographic analyses have been performed at multiple levels of genetic similarity, from haplotypes to species and supraspecific groupings. Broadly consistent patterns of local‐scale species richness across different insular habitats have been found, whereas local insular richness is lower than in continental settings. Our results reveal an important role for niche conservatism as a driver of insular community assembly of soil mesofauna, with only limited evidence for habitat shifts promoting diversification. Furthermore, support is found for a fundamental role of habitat in the assembly of soil mesofauna, where habitat specialism is mainly due to colonization and the establishment of preadapted species. Hierarchical patterns of distance decay at the community level and metaphylogeographical analyses support a pattern of geographic structuring over limited spatial scales, from the level of haplotypes through to species and lineages, as expected for taxa with strong dispersal limitations. Our results demonstrate the potential for wocDNA metabarcoding to advance our understanding of biodiversity.
Gene flow, genomic homogenization and the timeline to speciation in Amazonian manakins
Authors: Barrera‐Guzmán Alfredo O. , Aleixo Alexandre , Faccio Maya , Dantas Sidnei de Melo , Weir Jason T.
Published: June 2022

Phylogeographical studies of the most species‐rich region of the planet—the Amazon basin—have repeatedly uncovered genetically distinctive, allopatric lineages within currently named species, but understanding whether such lineages are reproductively isolated species is challenging. Here we harness the power of genome‐wide data sets together with detailed phylogeographical sampling to both characterize the number of unique lineages and infer levels of reproductive isolation for three parapatric manakin species that make up the genus Pipra. The mitochondrial and nuclear genomes both support six distinctive lineages. The youngest lineages are now highly admixed with each other across major portions of their geographical ranges with one lineage now extinct in a genomically unadmixed state. In contrast, the oldest sets of lineages—dated to 1.4 million years—exhibit narrow hybrid zones. By fitting demographic models to parapatric lineage pairs we found that levels of gene flow and genomic homogenization decline with increasing evolutionary age. Only lineages descending from the basal node at 1.4 million years ago in the genus experience negligible gene flow, possess genomes resistant to homogenization and are separated by narrow hybrid zones. We conclude that a million years or more were required for Pipra manakins to become reproductively isolated. We suggest the six lineages be reclassified as two or three reproductively isolated species. Our unique approach to quantifying reproductive isolation in parapatric lineages could be applied broadly to other phylogeographical studies and would help determine species classification of the plethora of newly identified lineages in the Amazon basin and other regions.
Comparison of four diagnostic criteria for invasive pulmonary aspergillosis—A diagnostic accuracy study in critically ill patients
Authors: Schroeder Maria , Giese Melanie , Wijaya Charles , Winterland Sarah , Nuechtern Annika , Grensemann Joern , Matthews Hanna , Wichmann Dominic , Stamm Johannes , Rohde Holger , Christner Martin , Ozga Ann‐Kathrin , Steurer Stefan , Heinemann Axel , Simon Marcel , Fischer Marlene , Kluge Stefan
Published: June 2022

Background

In the absence of lung biopsy, there are various algorithms for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients that rely on clinical signs, underlying conditions, radiological features and mycology. The aim of the present study was to compare four diagnostic algorithms in their ability to differentiate between probable IPA (i.e., requiring treatment) and colonisation.

Methods

For this diagnostic accuracy study, we included a mixed ICU population with a positive Aspergillus culture from respiratory secretions and applied four different diagnostic algorithms to them. We compared agreement among the four algorithms. In a subgroup of patients with lung tissue histopathology available, we determined the sensitivity and specificity of the single algorithms.

Results

A total number of 684 critically ill patients (69% medical/31% surgical) were included between 2005 and 2020. Overall, 79% (n = 543) of patients fulfilled the criteria for probable IPA according to at least one diagnostic algorithm. Only 4% of patients (n = 29) fulfilled the criteria for probable IPA according to all four algorithms. Agreement among the four diagnostic criteria was low (Cohen's kappa 0.07–0.29). From 85 patients with histopathological examination of lung tissue, 40% (n = 34) had confirmed IPA. The new EORTC/MSGERC ICU working group criteria had high specificity (0.59 [0.41–0.75]) and sensitivity (0.73 [0.59–0.85]).

Conclusions

In a cohort of mixed ICU patients, the agreement among four algorithms for the diagnosis of IPA was low. Although improved by the latest diagnostic criteria, the discrimination of invasive fungal infection from Aspergillus colonisation in critically ill patients remains challenging and requires further optimization.
Changes in volumetric bone mineral density and bone quality after Roux‐en‐Y gastric bypass: A meta‐analysis with meta‐regression
Authors: Hernández‐Martínez Alba , Veras Lucas , Boppre Giorjines , Soriano‐Maldonado Alberto , Oliveira José , Diniz‐Sousa Florêncio , Fonseca Hélder
Published: June 2022

This meta‐analysis aimed to assess the effect of Roux‐en‐Y gastric bypass (RYGB) on three‐dimensionally assessed volumetric bone mineral density (vBMD) with the effect of time on these changes, on bone quality, and the agreement of dual‐energy X‐ray absorptiometry (DXA) with quantitative computed tomography (QCT) or high‐resolution peripheral QCT (HR‐pQCT) estimates of bone loss. We searched PubMed, Web of Science, Cochrane, Scopus, and EBSCO. Longitudinal studies on adults undergoing RYGB in which vBMD was assessed by QCT or HR‐pQCT with ≥6 months follow‐up were included. Total hip (TH) changes were reported in four studies, lumbar spine (LS) in eight, radius in eight, and tibia in seven. Significant post‐RYGB vBMD reductions occurred at all skeletal sites analyzed. Meta‐regression revealed that time post‐RYGB was significantly associated with vBMD deterioration in all skeletal sites except at the TH. RYGB also led to significant deterioration on bone quality. DXA underestimated LS and overestimated TH bone losses post‐RYGB. In conclusion, RYGB was associated with significant vBMD loss, which makes screening of bone mass progression by three‐dimensional technology a crucial clinical issue to prevent fracture risk and osteoporosis.
Usefulness of the over‐the‐wire microelectrodes catheter in treatment of ventricular arrhythmia arising from the left ventricular summit
Authors: Shirai Yasuhiro , Goya Masahiko , Sasaki Takeshi , Nagasawa Ryo , Toya Chisashi , Hayasaka Kazuto , Sugiyama Koji , Shimizu Shigeo , Yamamoto Tasuku , Nishimura Takuro , Tao Susumu , Takigawa Masateru , Miyazaki Shinsuke , Sasano Tetsuo
Published: June 2022

Background

This study was aimed to investigate the efficacy of the over‐the‐wire (OTW) microelectrodes catheter in coronary venous system (CVS) mapping and treatment of outflow tract ventricular arrhythmia (OTVA) arising from the vicinity of the left ventricular summit (LVS).

Methods

Consecutive 62 patients with idiopathic OTVA in whom the OTW microelectrodes catheter was routinely used for CVS mapping were analyzed. CVS mapping was performed for both main trunk (from great cardiac vein to anterior interventricular vein) and branches including the annular branch or septal branch.

Results

The earliest activation site (EAS) was within the CVS in 21 patients. Among them, the EAS was within the main trunk of the CVS in seven (33%) and within the branch of the CVS in 14 (67%) patients. Radiofrequency catheter ablation was started at an anatomically adjacent site to the EAS, which eliminated OTVA in 16 (76%) patients　(the endocardial LVOT in 10 and the aortic sinus of Valsalva in six patients). For the remaining five patients with unsuccessful catheter ablation at an anatomically adjacent site, targeted OTVA was eliminated by catheter ablation at the EAS within the CVS in two patients and by chemical ablation with ethanol injection in one patient, resulting in the overall success rate of 90% (19/21).

Conclusion

The OTW microelectrodes‐guided ablation of OTVA from the vicinity of the LVS was effective. In maximizing the efficacy of ablation, CVS branch mapping is important since the earliest activation was commonly recorded not in the main trunk but within the branch of the CVS.
Micra AV leadless pacemaker implantation after transcatheter aortic valve implantation
Authors: Mechulan Alexis , Prevot Sébastien , Peret Angélique , Nait‐Saidi Lyassine , Miliani Ichem , Leong‐Feng Lauriane , Leude‐Vaillant Elisabeth , Vaillant Alain , Cornen Alain , Latiere Bernard , Giacomoni Marie‐Paule , Collet Frédéric , Bechet Vincent , Bouharaoua Ahmed , Dieuzaide Pierre
Published: June 2022

Background

Transvenous pacemaker (PM) implantation is a complication in patients undergoing transcatheter aortic valve implantation (TAVI). Recently, a second generation of leadless PMs able of atrioventricular (AV) synchronous pacing has been introduced and could be an alternative when ventricular pacing is required after TAVI. Real‐world data on Micra AV after TAVI are still lacking. Our aim was to determine the per‐ and post‐procedural outcomes in patients with Micra AV leadless PM implantation after TAVI.

Methods

A total of 20 consecutive patients underwent Micra AV leadless PM implantation after TAVI between November 2020 and June 2021.

Results

The main indication for ventricular pacing was high‐degree AV block (55% of patients) and left bundle branch block (LBBB) associated with prolonged HV interval (45% of patients). At discharge, mean (SD) ventricular pacing threshold was 0.397 ± 0.11 V at 0.24 ms and ventricular impedance was 709.4 ± 139.1 Ω. At 1‐month follow‐up, 95% of patients were programmed in VDD pacing mode. Mean (SD) ventricular pacing threshold was 0.448 ± 0.094 V at 0.24 ms. In patients with ventricular> pacing > 90% (n = 5), mean AM‐VP was 72.5% ± 8.3%. Pacing threshold at 1 month was not significantly different compared to discharge (p = .1088). Mean (SD) impedance was 631.0 ± 111.9 Ω, which remained stable at discharge (p = .0813). No procedural complications occurred during implantation. At 1‐month follow‐up, two patients displayed atrial under‐sensing.

Conclusions

Micra AV leadless PM implantation after TAVI is associated with a low complication rate and good device performance at 1‐month post‐implantation.
Carbon fluxes and environmental interactions during legume development, with a specific focus on Pisum sativum
Authors: Morin Amélie , Maurousset Laurence , Vriet Cécile , Lemoine Rémi , Doidy Joan , Pourtau Nathalie
Published: June 2022

Grain legumes are major food crops cultivated worldwide for their seeds with high nutritional content. To answer the growing concern about food safety and protein autonomy, legume cultivation must increase in the coming years. In parallel, current agricultural practices are facing environmental challenges, including global temperature increase and more frequent and severe episodes of drought stress. Crop yield directly relies on carbon allocation and is particularly affected by these global changes. We review the current knowledge on source‐sink relationships and carbon resource allocation at all developmental stages, from germination to vegetative growth and seed production in grain legumes, focusing on pea (Pisum sativum). We also discuss how these source‐sink relationships and carbon fluxes are influenced by biotic and abiotic factors. Major agronomic traits, including seed yield and quality, are particularly impacted by drought, temperatures, salinity, waterlogging, or pathogens and can be improved through the promotion of beneficial soil microorganisms or through optimized plant carbon resource allocation. Altogether, our review highlights the need for a better understanding of the cellular and molecular mechanisms regulating carbon fluxes from source leaves to sink organs, roots, and seeds. These advancements will further improve our understanding of yield stability and stress tolerance and contribute to the selection of climate‐resilient crops.
Ignorance, truth, and falsehood
Authors: Le Morvan Pierre
Published: June 2022

According to the Ignorance Factivity Thesis, for every proposition p, one is ignorant of p only if p is a truth. By contrast, according to the Ignorance Non‐Factivity Thesis, it is false that, for every proposition p, one is ignorant of p only if p is a truth. I argue that, on balance, the case for the latter thesis is stronger than the case for the former.
Populist media diets
Authors: de Rooij Eline A. , Stecuła Dominik A. , Pickup Mark A.
Published: June 2022

Objective

The changing media landscape highlights the need to understand the dynamic nature of Americans’ news consumption patterns. Research to date has focused on understanding how media diets vary across partisanship, while other, cross‐cutting cleavages remain underexplored. We focus on the relationship between populism and where Americans get their news and how they assess news media credibility.

Methods

Using an original, national survey of Americans (N = 1009) fielded in March 2020, we explore the news media diets of populists, controlling for partisanship, ideology, and relevant covariates.

Results

Analyses demonstrate that two primary dimensions of populism—anti‐elitism and distrust of experts—relate to media diets in complex ways.

Conclusion

Those who distrust experts have a more ideologically extreme media diet and put trust in fringe outlets and social media, whereas those with anti‐elite attitudes do not shy away from mainstream outlets and hold positive views of journalists and mainstream media.
The 70‐year search for the voltage‐sensing mechanism of ion channels
Authors: Catacuzzeno Luigi , Franciolini Fabio
Published: June 2022

This retrospective on the voltage‐sensing mechanisms and gating models of ion channels begins in 1952 with the charged gating particles postulated by Hodgkin and Huxley, viewed as charges moving across the membrane and controlling its permeability to Na+ and K+ ions. Hodgkin and Huxley postulated that their movement should generate small and fast capacitive currents, which were recorded 20 years later as gating currents. In the early 1980s, several voltage‐dependent channels were cloned and found to share a common architecture: four homologous domains or subunits, each displaying six transmembrane α‐helical segments, with the fourth segment (S4) displaying four to seven positive charges invariably separated by two non‐charged residues. This immediately suggested that this segment was serving as the voltage sensor of the channel (the molecular counterpart of the charged gating particle postulated by Hodgkin and Huxley) and led to the development of the sliding helix model. Twenty years later, the X‐ray crystallographic structures of many voltage‐dependent channels allowed investigation of their gating by molecular dynamics. Further understanding of how channels gate will benefit greatly from the acquisition of high‐resolution structures of each of their relevant functional or structural states. This will allow the application of molecular dynamics and other approaches. It will also be key to investigate the energetics of channel gating, permitting an understanding of the physical and molecular determinants of gating. The use of multiscale hierarchical approaches might finally prove to be a rewarding strategy to overcome the limits of the various single approaches to the study of channel gating.

image
Aprender a crear contenido digital interactivo para enseñar ciencias
Authors: Castiñeira-Rodríguez Nuria , Pérez-Rodríguez Uxío , Lorenzo-Rial María Asunción
Published: June 2022

En este artículo se presenta una experiencia didáctico-científica relacionada con la aplicación de las TIC en la innovación educativa.En ella participaron estudiantes del Máster en Educación; el objetivo principal fue contribuir al desarrollo de sus competencias profesionales tecnocientíficas. Por esta razón, se diseñó una experiencia de creación de contenido digital para pizarra digital interactiva (PDI), previa recopilación y análisis de diferentes herramientas digitales, y se utilizó un cuestionario KPSI a modo de pre y post-test. Los resultados del cuestionario mostraron diferencias significativas en la evolución de la percepción del nivel de competencia digital docente sobre la creación de contenido didáctico-científico.
Elección escolar de familias inmigrantes en una comuna de Santiago
Authors: Laborda-Contreras Alonso , González-López Juan , Assael Budnik Jenny , Vargas-Pérez Sebastián
Published: June 2022

En las últimas décadas, ha crecido significativamente la cantidad de familias inmigrantes en Chile. El proceso de elección de escuela para estas se configura como una temática emergente y relevante para su inclusión en el sistema escolar. El objetivo de esta investigación es analizar este proceso, desde un enfoque cualitativo, mediante entrevistas en profundidad y mapas de viaje con cinco familias inmigrantes de dos escuelas públicas de una comuna de Santiago. Como resultados se describen las determinantes y dinámicas del proceso de elección de escuela y se presentan hallazgos que refuerzan la importancia de la emocionalidad en el proceso.
Internal decoherence in nano-object interferometry due to phonons
Authors: Henkel C. , Folman R.
Published: June 2022

We discuss the coherent splitting and recombining of a nanoparticle in a mesoscopic “closed-loop” Stern–Gerlach interferometer in which the observable is the spin of a single impurity embedded in the particle. This spin, when interacting with a pulsed magnetic gradient, generates the force on the particle. We calculate the internal decoherence, which arises as the displaced impurity excites internal degrees of freedom (phonons) that may provide WelcherWeg information and preclude interference. We estimate the constraints this decoherence channel puts on future interference experiments with massive objects. We find that for a wide range of masses, forces, and temperatures, phonons do not inhibit Stern–Gerlach interferometry with micro-scale objects. However, phonons do constitute a fundamental limit on the splitting of larger macroscopic objects if the applied force induces phonons.
Early Introduction of Plant Polysaccharides Drives the Establishment of Rabbit Gut Bacterial Ecosystems and the Acquisition of Microbial Functions
Authors: Paës Charlotte , Gidenne Thierry , Bébin Karine , Duperray Joël , Gohier Charly , Guené-Grand Emeline , Rebours Gwénaël , Barilly Céline , Gabinaud Béatrice , Cauquil Laurent , Castinel Adrien , Pascal Géraldine , Darbot Vincent , Aymard Patrick , Debrusse Anne-Marie , Beaumont Martin , Combes Sylvie
Published: June 2022

Our study was designed to gain a better understanding of how different feeding patterns affect the dynamics of gut microbiomes and microbe–host interactions. This research showed that the timing of solid food introduction is a key component of the gut microbiota shaping in early developmental stages, though with lower impact on settled gut microbiota profiles in older individuals.
Liberty ship sinking disrupts military medical mobilisation in 1942
Authors: Shanks George Dennis
Published: June 2022

Medical mobilisation is vital to support tropical campaigns where many disease casualties are expected. Much of the medical supplies and equipment for nine station and three general hospitals that were being placed in Australia were aboard the Liberty Ship SS Rufus King when it went aground off Moreton Island on 7 July 1942. A concerted salvage operation rescued 85% of the stores from the freighter that had broken in half on the Amity sandbar. This emergency effort allowed medical support to New Guinea to proceed without delays due to medical supplies that were nearly lost at sea.
Stakeholders’ perceptions of adolescents’ sexual and reproductive health needs in Southeast Nigeria: a qualitative study
Authors: Okeke Chinyere Cecilia , Mbachu Chinyere Ojiugo , Agu Ifunanya Clara , Ezenwaka Uchenna , Arize Ifeyinwa , Agu Chibuike , Obayi Chinonso , Onwujekwe Obinna
Published: June 2022

Objectives

This study explored the perceptions of adult stakeholders on adolescents sexual and reproductive health (SRH) needs, variations of perceived needs by different social stratifiers and adolescent’s perceived interventions to address these needs. This will provide evidence that could be useful for policy and programme reviews for improving access and use of services in to meet the SRH needs of adolescents.

Design

A qualitative cross-sectional study was conducted in Ebonyi state, Southeast, Nigeria. Data were analysed using thematic framework and content analysis approaches.

Setting and participants

This qualitative study was conducted in six selected local government areas in Ebonyi state, Nigeria. The study participants comprised of adult stakeholders including community leaders, adolescent boys and girls aged 13–18 years. Adolescents were purposively selected from schools, skill acquisition centres and workplaces. A total of 77 in-depth interviews, 6 (with community leaders) and 12 (with adolescents) focus group discussions were conducted using pretested question guides.

Results

Adolescent SRH needs were perceived to be unique and special due to their vulnerability, fragility and predisposition to explore new experiences. Recurring adolescent SRH needs were: SRH education and counselling; access to contraceptive services and information. These needs were perceived to vary based on sex, schooling and marital status. Adolescent girls were perceived to have more psychological needs, and more prone to negative health outcomes. Out-of-school adolescents were described as more vulnerable, less controlled, less supervised and more prone to sexual abuse. Unmarried adolescents were perceived more vulnerable to sexual exploitation and risks, while married were perceived to have more maternal health service needs.

Conclusions

Perceptions of adolescents’ SRH needs converge among stakeholders (including adolescents) and are thought to vary by gender, schooling and marital status. This calls for well-designed gender-responsive interventions that also take into consideration other social stratifiers and adolescent’s perceived SRH intervention strategies.
Barriers and facilitators to implementation of non-medical independent prescribing in primary care in the UK: a qualitative systematic review
Authors: Edwards Judith , Coward Melaine , Carey Nicola
Published: June 2022

Objectives

To support workforce deficits and rising demand for medicines, independent prescribing (IP) by nurses, pharmacists and allied health professionals is a key component of workforce transformation in UK healthcare. This systematic review of qualitative research studies used a thematic synthesis approach to explore stakeholders’ views on IP in primary care and identify barriers and facilitators influencing implementation.

Setting

UK primary/community care.

Participants

Inclusion criteria were UK qualitative studies of any design, published in the English language. Six electronic databases were searched between January 2010 and September 2021, supplemented by reference list searching. Papers were screened, selected and quality-appraised using the Quality Assessment Tool for Studies with Diverse Designs. Study data were extracted to a bespoke table and two reviewers used NVivo software to code study findings. An inductive thematic synthesis was undertaken to identify descriptive themes and interpret these into higher order analytical themes. The Diffusion of Innovations and Consolidated Framework for Implementation Research were guiding theoretical anchors.

Primary and secondary outcome measures

N/A.

Results

Twenty-three articles addressing nurse, pharmacist and physiotherapist IP were included. Synthesis identified barriers and facilitators in four key stages of implementation: (1) ‘Preparation’, (2) ‘Training’, (3) ‘Transition’ and 4) ‘Sustainment’. Enhancement, substitution and role-specific implementation models reflected three main ways that the IP role was used in primary care.

Conclusions

In order to address global deficits, there is increasing need to optimise use of IP capability. Although the number of independent prescribers continues to grow, numerous barriers to implementation persist. A more coordinated and targeted approach is key to overcoming barriers identified in the four stages of implementation and would help ensure that IP is recognised as an effective approach to help alleviate workforce shortfalls in the UK, and around the world.

PROSPERO registration number

CRD42019124400.
Associations between use of expressed human milk at 2 weeks postpartum and human milk feeding practices to 6 months: a prospective cohort study with vulnerable women in Toronto, Canada
Authors: Mildon Alison , Francis Jane , Stewart Stacia , Underhill Bronwyn , Ng Yi Man , Rousseau Christina , Di Ruggiero Erica , Dennis Cindy-Lee , Kiss Alex , O'Connor Deborah L , Sellen Daniel W
Published: June 2022

Objectives

To examine whether use of expressed human milk in the first two weeks postpartum is associated with cessation of human milk feeding and non-exclusive human milk feeding up to 6 months.

Design

Pooled data from two prospective cohort studies

Setting

Three Canada Prenatal Nutrition Program (CPNP) sites serving vulnerable families in Toronto, Canada.

Participants

337 registered CPNP clients enrolled prenatally from 2017 to 2020; 315 (93%) were retained to 6 months postpartum. Exclusions: pregnancy loss or participation in prior related study; Study B: preterm birth (<34 weeks); plan to move outside Toronto; not intending to feed human milk; hospitalisation of mother or baby at 2 weeks postpartum.

Primary and secondary outcome measures

Main exposure variable: any use of expressed human milk at 2 weeks postpartum. Outcomes: cessation of human milk feeding by 6 months; non-exclusive human milk feeding to 4 months and 6 months postpartum.

Results

All participants initiated human milk feeding and 80% continued for 6 months. Exclusive human milk feeding was practiced postdischarge to 4 months by 28% and to 6 months by 16%. At 2 weeks postpartum, 34% reported use of expressed human milk. Any use of expressed human milk at 2 weeks was associated with cessation of human milk feeding before 6 months postpartum (aOR 2.66; 95% CI 1.41 to 5.05) and with non-exclusive human milk feeding to 4 months (aOR 2.19; 95% CI 1.16 to 4.14) and 6 months (aOR 3.65; 95% CI 1.50 to 8.84).

Trial registration numbers

NCT03400605, NCT03589963.
Randomised controlled trial comparing intraoperative cell salvage and autotransfusion with standard care in the treatment of hip fractures: a protocol for the WHITE 9 study
Authors: Dickenson Edward , Griffin Xavier Luke , Achten Juul , Mironov Katy , O'Connor Heather , Parsons Nicholas , Murphy Mike , Wyse Matthew , Mason James , Appelbe Duncan , Athwal Amrita , Griffin Damian
Published: June 2022

Introduction

People who sustain a hip fracture are typically elderly, frail and require urgent surgery. Hip fracture and the urgent surgery is associated with acute blood loss, compounding patients’ pre-existing comorbidities including anaemia. Approximately 30% of patients require a donor blood transfusion in the perioperative period. Donor blood transfusions are associated with increased rates of infections, allergic reactions and longer lengths of stay. Furthermore, there is a substantial cost associated with the use of donor blood. Cell salvage and autotransfusion is a technique that recovers, washes and transfuses blood lost during surgery back to the patient. The objective of this study is to determine the clinical and cost effectiveness of intraoperative cell salvage, compared with standard care, in improving health related quality-of-life of patients undergoing hip fracture surgery.

Methods and analysis

Multicentre, parallel group, two-arm, randomised controlled trial. Patients aged 60 years and older with a hip fracture treated with surgery are eligible. Participants will be randomly allocated on a 1:1 basis to either undergo cell salvage and autotransfusion or they will follow the standard care pathway. Otherwise, all care will be in accordance with the National Institute for Health and Care Excellence guidance. A minimum of 1128 patients will be recruited to obtain 90% power to detect a 0.075-point difference in the primary endpoint: EuroQol-5D-5L HRQoL at 4 months post injury. Secondary outcomes will include complications, postoperative delirium, residential status, mobility, allogenic blood use, mortality and resource use.

Ethics and dissemination

NHS ethical approval was provided on 14 August 2019 (19/WA/0197) and the trial registered (ISRCTN15945622). After the conclusion of this trial, a manuscript will be prepared for peer-review publication. Results will be disseminated in lay form to participants and the public.

Trial registration number

ISRCTN15945622.
Carbon monoxide: raising awareness of the silent killer in the emergency department
Authors: Malik Fahad Siddique , Ghazal Asswad Randa , Clarke Simon
Published: June 2022

Background

Carbon monoxide (CO) is an odourless gas produced by the incomplete combustion of carbon containing materials. CO poisoning causes a range of symptoms of which headache is the most common, occurring in up to 90% of patients. An audit in the Emergency Department at University Hospital Aintree, Liverpool, UK found a lack of clinical awareness among healthcare professionals (HCPs) with CO exposure being considered in only 0.8% of patients presenting with non-traumatic headache. This Quality Improvement Project (QIP) aimed to increase this consideration to 50% of presentations.

Methods

Three separate sequential Plan Do Study Act (PDSA) cycles were instigated. Interventions involved verbal reminders to frontline HCPs (cycle 1), using strategically placed CO posters (cycle 2) and finally designing and introducing a CO sticker education scheme (cycle 3). These stickers, highlighting the approved CO COMA acronym, were placed in patient notes to serve as a physical reminder for HCPs when seeing patients. Rapid cycle sequencing was used with each cycle lasting 2 weeks. Patient notes were analysed for evidence that the HCP considered a diagnosis of CO.

Results

An average of 61 patients were included in each PDSA cycle. Given baseline findings, each cycle demonstrated positive results with CO awareness being considered in 1.7% and 10.0% of patients with non-traumatic headache following cycles 1 and 2, respectively. The final PDSA cycle demonstrated significant increase in consideration of CO to 42.1% of non-traumatic headache presentations.

Conclusion

This QIP demonstrated that even small interventions can lead to significant change in awareness of CO exposure. Implementation of a CO sticker education scheme is a feasible way of increasing awareness among emergency care professionals and serves as a low-cost, easy to use, transferable and sustainable solution to address the lack of CO awareness in acute emergency settings. Importantly, this serves to promote improved patient safety.