bluuebunny/crossref_metadata_2025 huggingface dataset:
Using the health belief model to identify barriers to seasonal influenza vaccination among Australian adults in 2019
Authors: Trent Mallory J. , Salmon Daniel A. , MacIntyre C. Raina
Published: February 2021

Background

Each year tens of thousands of Australians become ill with influenza, resulting in thousands of severe infections that require hospitalisation. However, only 40% of adults receive the annual influenza vaccine. We surveyed Australian adults to provide up to date, population‐specific data on the predictors and barriers of seasonal influenza vaccination.

Methods

We administered an online survey to a nationally representative sample of Australian adults. We designed survey questions using the theoretical constructs of the health belief model. Using simple and multivariable Poisson regression, we identified attitudes and beliefs associated with influenza vaccination in 2019.

Results

Among 1,444 respondents, 51.7% self‐reported influenza vaccination in 2019. We estimated vaccine coverage to be 44% for adults under 45, 46% for adults aged 45 to 64 and 77% for adults aged 65 and over. The strongest individual predictors of self‐reported vaccination were believing the vaccine is effective at preventing influenza (APR = 3.71; 95% CI = 2.87‐4.80), followed by recalling their doctor recommending the vaccine (APR = 2.70; 95% CI = 2.31‐3.16). Common perceived barriers that predicted self‐reported vaccination included believing the vaccine could give you influenza (APR = 0.59; 95% CI = 0.52‐0.67), believing the vaccine can make you ill afterwards (APR = 0.68; 95% CI = 0.62‐0.74) and preferring to develop immunity “naturally” (APR = 0.38; 95% CI = 0.32‐0.45).

Conclusion

Although vaccine uptake in 2019 appears to be higher than previous years, there are perceived barriers which may limit uptake among Australians. Tailored interventions are needed to combat widespread influenza vaccine hesitancy, particularly among high‐risk groups.
Enhanced interfacial electronic transfer of BiVO4 coupled with 2D g‐C3N4 for visible‐light photocatalytic performance
Authors: Xu Min , Zhu Yan , Yang Jingkai , Li Wei , Sun Chaoyang , Cui Yan , Liu Lu , Zhao Hongli , Liang Bo
Published: February 2021

A BiVO4/2D g‐C3N4 direct dual semiconductor photocatalytic system has been fabricated via electrostatic self‐assembly method of BiVO4 microparticle and g‐C3N4 nanosheet. According to experimental measurements and first‐principle calculations, the formation of built‐in electric field and the opposite band bending around the interface region in BiVO4/2D g‐C3N4 as well as the intimate contact between BiVO4 and 2D g‐C3N4 will lead to high separation efficiency of charge carriers. More importantly, the intensity of bulid‐in electric field is greatly enhanced due to the ultrathin nanosheet structure of 2D g‐C3N4. As a result, BiVO4/2D g‐C3N4 exhibits excellent photocatalytic performance with the 93.0% Rhodamine B (RhB) removal after 40 min visible light irradiation, and the photocatalytic reaction rate is about 22.7 and 10.3 times as high as that of BiVO4 and 2D g‐C3N4, respectively. In addition, BiVO4/2D g‐C3N4 also displays enhanced photocatalytic performance in the degradation of tetracycline (TC). It is expected that this work may provide insights into the understanding the significant role of built‐in electric field in heterostructure and fabricating highly efficient direct dual semiconductor systems.
Multilevel analysis of the educational use of technology: Quantity and versatility of digital technology usage in Finnish basic education schools
Authors: Kaarakainen Meri‐Tuulia , Saikkonen Loretta
Published: February 2021

The adoption of technology in teaching has been identified to relate to various factors from attitudes and self‐efficacy to subjective norms and digital references. The aim of this study is to broaden the perspective to hierarchical grouping effects. Multilevel modelling of the study utilizes the data of 2355 Finnish basic education teachers. The results show that, before the coronavirus pandemic, Finnish teachers used digital devices in teaching at least once a week, on average, and many times on a daily basis, varying according to the subject being taught. The variation in teachers' technology usage occurs mainly at the individual level, with a small proportion between schools; higher‐level hierarchies proved redundant in the context of Finland. At the teacher level, digital skills, age, and digital self‐efficacy increase technology usage in teaching. At the end, the significance and limitations of the research and the direction of future research in the post‐pandemic era are discussed.
A comparison of post‐stroke hypertension medication use between US Stroke Belt and Non‐Stroke Belt residents
Authors: Tran Phoebe , Tran Lam , Tran Liem
Published: February 2021

Although hypertension is a contributing factor to higher stroke occurrence in the Stroke Belt, little is known about post‐stroke hypertension medication use in Stroke Belt residents. Through the use of national Behavioral Risk Factor Surveillance System surveys from 2015, 2017, and 2019; we compared unadjusted and adjusted estimates of post‐stroke hypertension medication use by Stroke Belt residence status. Similar levels of post‐stroke hypertension medication use were observed between Stroke Belt residents (OR: 1.09, 95% CI: 0.89, 1.33) and non‐Stroke Belt residents. After adjustment, Stroke Belt residents had 1.14 times the odds of post‐stroke hypertension medication use (95% CI: 0.92, 1.41) compared to non‐Stroke Belt residents. Findings from this study suggest that there is little difference between post‐stroke hypertension medication use between Stroke Belt and non‐Stroke Belt residents. However, further work is needed to assess whether use of other non‐medicinal methods of post‐stroke hypertension control differs by Stroke Belt residence status.
Beyond multimorbidity: What can we learn from complexity science?
Authors: Sturmberg Joachim P. , Getz Linn O. , Stange Kurt C. , Upshur Ross E.G. , Mercer Stewart W.
Published: February 2021

Multimorbidity ‐ the occurrence of two or more long‐term conditions in an individual ‐ is a major global concern, placing a huge burden on healthcare systems, physicians, and patients. It challenges the current biomedical paradigm, in particular conventional evidence‐based medicine's dominant focus on single‐conditions. Patients' heterogeneous range of clinical presentations tend to escape characterization by traditional means of classification, and optimal management cannot be deduced from clinical practice guidelines. In this article, we argue that person‐focused care based in complexity science may be a transformational lens through which to view multimorbidity, to complement the specialism focus on each particular disease. The approach offers an integrated and coherent perspective on the person's living environment, relationships, somatic, emotional and cognitive experiences and physiological function. The underlying principles include non‐linearity, tipping points, emergence, importance of initial conditions, contextual factors and co‐evolution, and the presence of patterned outcomes. From a clinical perspective, complexity science has important implications at the theoretical, practice and policy levels. Three essential questions emerge: (1) What matters to patients? (2) How can we integrate, personalize and prioritize care for whole people, given the constraints of their socio‐ecological circumstances? (3) What needs to change at the practice and policy levels to deliver what matters to patients? These questions have no simple answers, but complexity science principles suggest a way to integrate understanding of biological, biographical and contextual factors, to guide an integrated approach to the care of people with multimorbidity.
The Withdrawal Assessment Tool to identify iatrogenic withdrawal symptoms in critically ill paediatric patients: ACOSMINsystematic review of measurement properties
Authors: Zaccagnini Marco , Ataman Rebecca , Nonoyama Mika Laura
Published: February 2021

Rationale, Aims and Objectives

The Withdrawal Assessment Tool (WAT‐1) is one of the most widely used clinician‐reported outcome measures to evaluate iatrogenic withdrawal symptoms (IWS) in critically ill children. However, the WAT‐1's measurement properties have not been aggregated. Aggregating psychometric research on the WAT‐1 will enhance appropriate use, and outline gaps for future empirical research. The aim of this systematic review is to critically appraise, compare, and summarize the measurement properties and evidence quality, and describe the interpretability and feasibility of the WAT‐1 for identifying IWS symptoms in critically ill children.

Methods

A systematic search of Medline, Embase and CINAHL was conducted from inception to 15 April 2020. Study inclusion/exclusion, data extraction, and measurement property evidence and the modified GRADE quality scoring were applied according to the COnsensus‐based Standards for the selection of health Measurement Instruments (COSMIN) guidelines.

Results

Six studies were included in the review. There was sufficient, high‐quality evidence for reliability, structural validity, criterion validity, measurement error, construct validity, and feasibility. More information is required to support the WAT‐1's content validity, responsiveness, internal consistency, cross‐cultural validity, and interpretability according to COSMIN guidelines.

Conclusion

The results of this review indicate that the WAT‐1 is a precise, easy to use measure of IWS in critically ill children despite some measurement property inconsistencies and gaps in the publication record. More information is required to support its content validity, responsiveness, internal consistency, cross‐cultural validity, and interpretability.
A qualitative exploration of dietitians’ experiences of prescribing oral nutritional supplements to patients with malnutrition: A focus on shared tailoring and behaviour change support
Authors: Liljeberg Evelina , Nydahl Margaretha , Lövestam Elin , Andersson Agneta
Published: February 2021

Background

Oral nutritional supplements (ONS) are commonly prescribed to patients with malnutrition. Dietitians have been suggested as preferred prescribers but generally lack ONS prescribing rights. How dietitians with prescribing rights experience their professional practice of prescribing ONS remains understudied. Thus, by exploring dietitians’ experiences of prescribing ONS, the present study aimed to obtain a deeper understanding of specific aspects that are of importance for dietitians when providing a nutrition therapy including ONS.

Methods

Qualitative individual interviews were conducted with 13 dietitians prescribing ONS to free‐living adult outpatients with malnutrition or at nutritional risk in the hospital or primary care setting. Systematic text condensation was used for data analysis.

Results

Two main categories signifying important aspects were identified and labelled: ‘Shared tailoring of the ONS prescription’ and ‘Supporting and facilitating ONS use’. First, the dietitians described tailoring the ONS prescription together with the patient, having their acceptance as a prerequisite, and being flexible regarding products and amounts prescribed. Second, they described performing different communication strategies and organising of practical issues (e.g., ONS delivery and support from others) to support and facilitate patients’ ONS usage.

Conclusions

The present study identifies patient involvement and the role of dietitians as behaviour change facilitators as two important aspects when dietitians prescribe ONS. These findings allow for dietitians’ ideals and strategies on how to prescribe ONS to be made more visible, which can inform both clinical practice and clinical trials for future improvements in nutrition therapy to address malnutrition.
PSD‐93 mediates the crosstalk between neuron and microglia and facilitates acute ischemic stroke injury by binding to CX3CL1
Authors: Zhang Qingxiu , He Lei , Chen Mo , Yang Hui , Cao Xiaowei , Liu Xiaomei , Hao Qi , Chen Zhengwei , Liu Tengfei , Wei Xiu‐e , Rong Liangqun
Published: February 2021

Post‐synaptic density 93 (PSD‐93) mediates glutamate excitotoxicity induced by ischemic brain injury, which then induces microglial inflammatory response. However, the underlying mechanisms of how PSD‐93 mediates the crosstalk between neurons and microglia in the post‐synaptic dense region remain elusive. CX3 chemokine ligand 1 (CX3CL1) is a chemokine specifically expressed in neurons while its receptor CX3CR1 is highly expressed in microglia. In this study, we examined the interaction of PSD‐93 and CX3CL1 in the crosstalk between neurons and microglia in acute ischemic stroke. We utilized male C57BL/6 mice to establish the middle cerebral artery occlusion model (MCAO) and designed a fusion small peptide Tat‐CX3CL1 (357‐395aa) to inhibit PSD‐93 and CX3CL1 interaction. The combination peaks of PSD‐93 and CX3CL1 at 6 hr after I/R were observed. The binding sites were located at the 420–535 amino acid sequence of PSD‐93 and 357–395 amino acid sequence of CX3CL1. Tat‐CX3CL1 (357‐395aa) could inhibit the interaction of PSD‐93 and CX3CL1 and inhibited the pro‐inflammatory cytokine IL‐1β and TNF‐α expression and provided neuroprotection following reperfusion. Together, these data suggest that PSD‐93 binds CX3CL1 to activate microglia and initiate neuroinflammation. Specific blockade of PSD‐93‐CX3CL1 interaction reduces I/R induced neuronal cell death, and provides a new therapeutic target for ischemic stroke.

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Possible clinical efficacy and tolerability of platelet‐rich plasma in the treatment of patients with recalcitrant plane warts: The first clinical study
Authors: Abu El‐Hamd Mohammed , Aboeldahab Soha
Published: February 2021

Background

Plane warts are prevalent cutaneous diseases, caused by different serotypes of human papillomavirus.

Aims

This study aimed to assess the possible clinical efficacy and tolerability of platelet‐rich plasma (PRP) in the treatment of patients with multiple recalcitrant plane warts.

Methods

This prospective cohort clinical study was carried out on 25 patients with clinical and dermoscopic evident multiple recalcitrant plane warts. The patients were treated with autologous intralesional PRP injections every month until a complete clearance or for a maximum of two sessions. Then, patients were clinically evaluated one month after every session and after a six‐month follow‐up from the last injection.

Results

Of the included patients, 20 (80%) patients had facial plane warts, 3 (12%) patients had plane warts in the dorsum of hands, and 2 (8%) patients had plane warts in the dorsal aspect of feet. 60% of the patients have more than 100 plane warts, and all the patients had plane warts than 1 cm in size. The complete improvement was observed in 20% and 100% of the patients after the first and second sessions, respectively. No recurrence was detected after a six‐month follow‐up. No side effects were recorded after the treatment sessions.

Conclusion

Intralesional injection of PRP could be potentially effective and well‐tolerated immunotherapy for the treatment of multiple recalcitrant plane warts. Whatever, more studies are needed with a larger sample size and a longer period of follow‐up. Also, randomized and controlled studies are required to evaluate its efficacy in treating different clinical types of warts.
Dapsone for acne: Still in use after half a century!
Authors: Searle Tamara , Al‐Niaimi Firas , Ali Faisal R.
Published: February 2021

Background

Sixty years ago, Ross discussed the use of oral dapsone in the treatment of acne vulgaris. Ross was fundamental in demonstrating the importance of this medication in dermatology. Following this, topical formulations have been used for the treatment of acne vulgaris which has not responded to traditional therapies. We explore the impact that the discovery of dapsone has had on subsequent research and clinical practice and explore the typical doses and side effects of this often sidelined therapy.

Methods

We conducted a review of the literature on the use of dapsone for acne using key terms “acne vulgaris,” “dapsone,” “isotretinoin,” “systemic,” “topical” searching databases such as MEDLINE, EMBASE, and PubMed. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Centre of Evidence‐Based Medicine 2011 guidance.

Results

Oral dapsone and topical dapsone have been used in acne vulgaris and acne fulminans. Systemic dapsone seems to be less effective than other treatment options, and further research is required to examine the use of the topical formulation for acne vulgaris compared with alternative treatments.

Conclusion

Dermatologists may wish to consider the use of this long‐established medication for the treatment of acne vulgaris. With careful monitoring, oral dapsone is an important alternative therapy where isotretinoin is contraindicated or not tolerated.
Possible prevention of post‐partum depression by intake of omega‐3 polyunsaturated fatty acids and its relationship with interleukin 6
Authors: Nagayasu Yoko , Fujita Daisuke , Daimon Atsushi , Nunode Misa , Sawada Masami , Sano Takumi , Ohmichi Masahide
Published: February 2021

Aim

This study examined whether the intake of omega‐3 polyunsaturated fatty acids (PUFA) prevented post‐partum depression and if interleukin 6 (IL‐6) was involved in this effect. We hypothesized that omega‐3 supplementation has a protective effect against post‐partum depression.

Methods

We measured eicosapentaenoic acid (EPA), the arachidonic acid (AA)/EPA ratio, and IL‐6 in 80 singleton pregnant women during the first and second trimesters, and post‐partum. The women also completed a dietary questionnaire, and post‐partum depression was measured using the Edinburgh Postnatal Depression Scale (EPDS). We examined the correlations between the frequency of eating fish and EPA, the AA/EPA ratio and IL‐6 in the first and second trimesters, and post‐partum. We also investigated the correlation between the EPDS and the EPA, the AA/EPA ratio and IL‐6.

Results

The frequency of eating fish was significantly correlated with EPA in the second trimester and post‐partum and with the AA/EPA ratio in the second trimester. There was no correlation between IL‐6 levels and the frequency of eating fish. Post‐partum levels of EPA and the AA/EPA ratio were higher in the EPDS >7 group than in the EPDS ≤7 group. In the second trimester, a higher AA/EPA ratio was associated with EPDS >7. IL‐6 levels did not differ between the two groups.

Conclusion

In conclusion, a low dietary intake of omega‐3 PUFA during pregnancy was correlated with lower EPA levels, which tended to lead to post‐partum depression. The relationship between the IL‐6 level and the pathogenesis of post‐partum depression was unclear from the results of this study.
ES Sampler, a minimally invasive endometrial sampling tool that obtains specimens suitable for both cytological and histological analysis
Authors: Zhang Yinglan , Zhao Yu , Lang Jing He , Li Yuan
Published: February 2021

Aim

Conventional endometrial examination by dilatation and curettage (D&C) is not accepted by many patients because it is associated with pain and risk of injury and typically requires anesthesia and hospitalization. While several less invasive endometrial screening tools have been developed, their diagnostic value is generally inferior to D&C. Therefore, the purpose of this study was to evaluate the effectiveness of a new, minimally invasive device, called the ES Sampler, for outpatient endometrial screening.

Methods

This was a single‐blind study of 96 patients (age: 36.8 ± 8.1 years) who attended Peking Union Medical College Hospital from March 2015 to August 2016. Specimens were collected from each participant using the ES Sampler, followed by traditional D&C by hysteroscopy, and evaluated by histology and/or cytology. The sampling adequacy, sensitivity, specificity, positive and negative predictive value, and diagnostic accuracy were compared, and patient acceptability was assessed.

Results

Compared to traditional D&C, the ES Sampler exhibited 99.0% sampling adequacy, and the combined (histology and cytology) results demonstrated 88.9% sensitivity, 95.6% specificity, 88.9% positive predictive value, 95.6% negative predictive value, and 93.7% accuracy. Moreover, the majority of study participants reported mild or no pain associated with the ES Sampler, and blood loss was minimal.

Conclusions

Our findings suggest that the minimally invasive ES Sampler is a reliable and accurate endometrial screening tool that is easily accepted by patients. The ES Sampler could be useful for screening high‐risk patients who may need further, more invasive examination, thereby conserving medical resources and minimizing patient discomfort.
Difficulty in prenatal diagnosis of the volvulus of the small intestine: A peculiar clinical course of two cases with massive bowel dilatation and loss of peristalsis
Authors: Shimizu Takahiro , Yokomine Masato , Yoshizato Toshiyuki , Araki Kenshiro , Higashidate Naruki , Saikusa Mamoru , Ushijima Kimio
Published: February 2021

We report two cases of fetal intestinal volvulus (jejunum in case A, ileum in case B) with massive bowel dilatation and loss of peristalsis, which suddenly appeared in the third trimester. The bowel was dilated to different sizes and there were various echogenic patterns of the intestines in case A and a sausage‐like appearance in case B. Case A developed polyhydramnios, whereas case B did not. Among 47 cases of fetal intestinal volvulus (29 articles) in which 32 were diagnosed prenatally, almost all cases with a prenatal diagnosis showed “whirlpool sign” or “coffee bean sign” by sonography and/or findings indicating intestinal hemorrhage. Even without these findings, the presence of dilatation of the intestines and loss of peristalsis occurring in the third trimester were diagnostic clues. The presence of different sizes and various patterns of bowel dilation and hydramnios may be helpful for predicting the involved site of intestinal volvulus.
Are There Limits to Diversification in Emerging Economies? Distinguishing between Firm‐Level and Business Group Strategies
Authors: Gopal Shaleen , Manikandan K. S. , Ramachandran J.
Published: February 2021

The viability of unrelated diversification as a strategy in emerging economies is an unresolved puzzle. Because business groups dominate the landscape in these economies, and are known to diversify either by expanding the scope of existing affiliate firms and/or setting up new firms, we argue that it is important to make a distinction between firm‐level and business group‐level diversification. The results of our study covering the 15‐year period following India’s economic liberalization confirm our thesis. Whereas all firms, including business group affiliates, reduced unrelated scope to negotiate product and capital market pressures, business groups took advantage of the opportunity‐rich, post‐reform environment to enter into new unrelated businesses by setting up new affiliates. Our findings echo suggestions that as institutions strengthen, the locus of unrelated diversification moves away from managers of public corporations to entities with different types of ownership structures. We present the business group as one such ownership structure.
On multidimensional poverty rankings of binary attributes
Authors: Peragine Vito , Pittau Maria G. , Savaglio Ernesto , Vannucci Stefano
Published: February 2021

We address the problem of ranking distributions of attributes in terms of poverty, when the attributes are represented by binary variables. To accomplish this task, we identify a suitable notion of “multidimensional poverty line” and characterize axiomatically the Head‐Count and the Attribute‐Gap poverty rankings, which are the natural counterparts of the most widely used income poverty indices. Finally, we apply our methodology and compare our empirical results with those obtained with some other well‐known poverty measures.
Cultivation and Photophysiological Characteristics of Desmids in Moderately Saline Aquaculture Wastewater
Authors: Stamenković Marija , Steinwall Elin , Wulff Angela
Published: February 2021

Although desmids typically inhabit freshwater environments characterized by low amounts of nutrients and low salinity, several desmid species have been recorded in eutrophic waters, indicating their adaptation to elevated pollution and conductivity. This study aimed to determine whether desmids could be used for remediation of moderately saline aquaculture wastewater (AWW) from a fish farm situated in the southeast of Sweden. Fourteen desmid strains isolated from different climates (tropical to polar) and trophic conditions (oligotrophic to eutrophic) were cultivated in diluted AWW and we estimated their growth rates, biomass, nutrient removal efficiency, chlorophyll fluorescence parameters and cellular C, N and P quotas. Despite being grown at moderate salinity, unfavourable N:P ratio, and relatively low light/temperature regime the eutrophic strains, Cosmarium humile, Cosmarium laeve and a meso‐oligotrophic species Cosmarium impressulum, completely absorbed nitrate and phosphate from AWW media after 7 d, indicating their potential for remediation of fish effluents in colder climates. These species, along with the typical eutrophic species, Cosmarium meneghinii and Staurastrum chaetoceras, had biomass in the range 0.45–1.19 g · L−1 while maximum growth rates ranged from 0.36 to 0.51 · d−1, similar to published rates for several fast‐growing green microalgae cultivated in various AWW types. Tropical desmids had distinctly high values of saturating irradiance (Ik > 1,000 µmol photons · m−2 · s−1), and, along with eutrophic desmids, had high potential electron transport (rETRmax > 155 rel. units). Hence, the desmids studied demonstrated inherent photophysiological responses corresponding to their climate and trophic origin under the suboptimal growth conditions.
Day‐to‐day associations between sleep characteristics and affect in community dwelling adults
Authors: Wong Patricia M. , Hasler Brant P. , Kamarck Thomas W. , Wright Aidan G. C. , Hall Martica , Carskadon Mary A. , Gao Lei , Manuck Stephen B.
Published: February 2021

Despite the high co‐occurrence of sleep and mood disturbances, day‐to‐day associations between sleep characteristics (sleep duration, continuity, and timing) and dimensions of mood (positive affect and negative affect) remain unclear. The present study aimed to test whether there is a daily, bidirectional association between these sleep characteristics and affective states, while addressing methodological limitations in the extant literature by using actiography and ecological momentary assessment methods. Participants were community dwelling, midlife adults (aged 30–54 years, N = 462, 47% male) drawn from the Adult Health and Behavior Project‐Phase 2 study. Participants’ sleep patterns were assessed with actiography over a 7‐day monitoring period, and on 4 of those days, participants completed an ecological momentary assessment protocol that included hourly assessments of positive affect and negative affect during their wake intervals. Using hierarchical linear modelling, we tested whether participants’ sleep characteristics on a given night predicted next‐day affect and vice versa. We also explored whether nocturnal sleep characteristics would differentially associate with affect at different times of day (morning, afternoon, and evening) while controlling for multiple health behaviours. We found that when participants reported higher positive affect on a given day, they slept later that night (B = 0.22, p = .010). Although we found no other statistically significant associations in our primary analyses (all p > .05), we found several sleep–affect associations specific to time of day (B ranges: 0.01–0.18, all p ≤ .02), which warrants further study. Overall, our findings suggest that healthy adults may be resilient to daily fluctuations in their sleep and mood.
Physical properties of a model set of solid, texture‐modified foods
Authors: Stading Mats
Published: February 2021

Those suffering from swallowing disorders, or dysphagia, require texture‐modified foods for safe swallowing. The texture is modified according to the severity of the disorder, as maintained by the guidelines outlining classes of texture‐modified foods, ranging from viscous soups to soft, solid foods. As a basis for studies of bolus rheology and oral response of solid texture‐modified foods, a set of well‐defined, solid foods has been identified and characterized regarding texture and physical properties. Gelled food is compared to both the firmer timbale class and to the corresponding regular food. Foods eaten at room temperature were chosen to avoid temperature effects: bread, cheese, tomato, and the combination into a sandwich. All foods were tested as gel, timbale, and regular food. The texture was determined by compression and penetration tests, thereby showing a decrease in strength (compression stress), stiffness (modulus), and penetration force for increased degree of modification. The moisture content increased with increased degree of modification. The structural change from room to oral temperature was monitored by the complex shear modulus that showed a decrease with increasing temperature. Cheese and the gelatine‐based tomato gel showed a distinct melting when the temperature was increased to 37°C. The texture‐modified foods were softer and moister in all aspects as compared to the regular foods, which follows the intended modification. The classes for the texture‐modified foods were qualitatively comparable to other national classification systems with regard to solid foods, but there is a lack of objective, physics‐based classification of texture, especially for solid, texture‐modified foods.
Disease burden and economic impact of diagnosed non‐alcoholic steatohepatitis in five European countries in 2018: A cost‐of‐illness analysis
Authors: Schattenberg Jörn M. , Lazarus Jeffrey V. , Newsome Philip N. , Serfaty Lawrence , Aghemo Alessio , Augustin Salvador , Tsochatzis Emmanuel , de Ledinghen Victor , Bugianesi Elisabetta , Romero‐Gomez Manuel , Bantel Heike , Ryder Stephen D. , Boursier Jerome , Leroy Vincent , Crespo Javier , Castera Laurent , Floros Lefteris , Atella Vincenzo , Mestre‐Ferrandiz Jorge , Elliott Rachel , Kautz Achim , Morgan Alice , Hartmanis Sally , Vasudevan Sharad , Pezzullo Lynne , Trylesinski Aldo , Cure Sandrine , Higgins Victoria , Ratziu Vlad
Published: February 2021

Background and aims

Non‐alcoholic steatohepatitis (NASH) is a chronic disease that can progress to end‐stage liver disease (ESLD). A large proportion of early‐stage NASH patients remain undiagnosed compared to those with advanced fibrosis, who are more likely to receive disease management interventions. This study estimated the disease burden and economic impact of diagnosed NASH in the adult population of France, Germany, Italy, Spain and the United Kingdom in 2018.

Methods

The socioeconomic burden of diagnosed NASH was estimated using cost‐of‐illness methodology applying a prevalence approach to estimate the number of adults with NASH and the attributable economic and wellbeing costs. Given undiagnosed patients do not incur costs in the study, the probability of diagnosis is central to cost estimation. The analysis was based on a literature review, databases and consultation with clinical experts, economists and patient groups.

Results

The proportion of adult NASH patients with a diagnosis ranged from 11.9% to 12.7% across countries, which increased to 38.8%‐39.1% for advanced fibrosis (F3‐F4 compensated cirrhosis). Total economic costs were €8548‐19 546M. Of these, health system costs were €619‐1292M. Total wellbeing costs were €41 536‐90 379M. The majority of the undiagnosed population (87.3%‐88.2% of total prevalence) was found to have early‐stage NASH, which, left untreated, may progress to more resource consuming ESLD over time.

Conclusions

This study found that the majority of economic and wellbeing costs of NASH are experienced in late disease stages. Earlier diagnosis and care of NASH patients could reduce future healthcare costs.
Exome sequencing in patient‐parent trios suggests new candidate genes for early‐onset primary sclerosing cholangitis
Authors: Haisma Sjoukje‐Marije , Weersma Rinse K. , Joosse Maria E. , de Koning Barbara A. E. , de Meij Tim , Koot Bart G. P. , V. M. Wolters , Norbruis Obbe , Daly Mark J. , Stevens Christine , Xavier Ramnik J. , Koskela Jukka , Rivas Manuel A. , Visschedijk Marijn C. , Verkade Henkjan J. , Barbieri Ruggero , Jansen Dianne B. H. , Festen Eleonora A. M. , van Rheenen Patrick F. , van Diemen Cleo C.
Published: February 2021

BACKGROUND & AIMS

Primary sclerosing cholangitis (PSC) is a rare bile duct disease strongly associated with inflammatory bowel disease (IBD). Whole‐exome sequencing (WES) has contributed to understanding the molecular basis of very early‐onset IBD, but rare protein‐altering genetic variants have not been identified for early‐onset PSC. We performed WES in patients diagnosed with PSC ≤ 12 years to investigate the contribution of rare genetic variants to early‐onset PSC.

METHODS

In this multicentre study, WES was performed on 87 DNA samples from 29 patient‐parent trios with early‐onset PSC. We selected rare (minor allele frequency < 2%) coding and splice‐site variants that matched recessive (homozygous and compound heterozygous variants) and dominant (de novo) inheritance in the index patients. Variant pathogenicity was predicted by an in‐house developed algorithm (GAVIN), and PSC‐relevant variants were selected using gene expression data and gene function.

RESULTS

In 22 of 29 trios we identified at least 1 possibly pathogenic variant. We prioritized 36 genes, harbouring a total of 54 variants with predicted pathogenic effects. In 18 genes, we identified 36 compound heterozygous variants, whereas in the other 18 genes we identified 18 de novo variants. Twelve of 36 candidate risk genes are known to play a role in transmembrane transport, adaptive and innate immunity, and epithelial barrier function.

CONCLUSIONS

The 36 candidate genes for early‐onset PSC need further verification in other patient cohorts and evaluation of gene function before a causal role can be attributed to its variants.
The Effects of Women's Descriptive Representation on Government Behavior
Authors: Homola Jonathan
Published: February 2021

Does the representation of women in cabinet and party leadership positions affect whether governments are more or less likely to fulfill the policy promises they make during election campaigns? This research note studies the effects of women's descriptive representation in cabinet and party leadership on policymaking by analyzing the pledge fulfillment of parties in 10 European countries, the United States, and Canada. The empirical analysis suggests that governing parties are more likely to fulfill their election promises when levels of women's representation are higher. The results have implications for our understanding of the descriptive and substantive representation of women, as well as for party competition and policymaking more broadly.
Cats Felis catus as a threat to bats worldwide: a review of the evidence
Authors: Oedin Malik , Brescia Fabrice , Millon Alexandre , Murphy Brett P. , Palmas Pauline , Woinarski John C.Z. , Vidal Eric
Published: February 2021

Cats Felis catus, in all their forms (domestic, free‐roaming/stray and feral), have been identified as a major global threat to biodiversity, especially birds and small mammals. However, there has been little previous consideration of the extent and impact of predation of bats by cats, or of whether specific characteristics make certain species of bats particularly vulnerable to predation by cats.

We reviewed the impact of cats on bats, based on a collation of scientific literature and the International Union for Conservation of Nature (IUCN) Red List database. Our aim was to produce a synthesis of the extent to which cats prey upon and threaten bats. We also collated available data on cat diet, which provide information on predation rates of bats by cats.

Few studies (n = 44) have identified bat species preyed upon or threatened by cats, with a disproportionate number of studies from islands. In these studies, 86 bat species (about 7% of the global extant tally) are reported as preyed upon or threatened by cats, and about one quarter of these species are listed as Near Threatened or threatened (IUCN categories Critically Endangered, Endangered, or Vulnerable). In IUCN Red List assessments, cats are more frequently mentioned as a threat to threatened or Near Threatened bat species than to non‐threatened species (IUCN category Least Concern).

In studies reporting on the incidence of bats in cat dietary samples (scats, stomachs and guts), the frequency of occurrence of bats in samples averaged 0.7 ± 2.1% (mean ± standard deviation; n = 102). Many studies had sample sizes that were too small to be likely to detect bats.

All forms of cat are reported to kill bats, and such predation has been reported in all major terrestrial habitats. We conclude that predation by cats is an under‐appreciated threat to the world’s bat species.
Learning decision boundaries for cone penetration test classification
Authors: Erharter Georg H. , Oberhollenzer Simon , Fankhauser Anna , Marte Roman , Marcher Thomas
Published: February 2021

In geotechnical field investigations, cone penetration tests (CPT) are increasingly used for ground characterization of fine‐grained soils. Test results are different parameters that are typically visualized in CPT based data interpretation charts. In this paper we propose a novel methodology which is based on supervised machine learning that permits a redefinition of the boundaries within these charts to account for unique soil conditions. We train ensembles of randomly generated artificial neural networks to classify six soil types based on a database of hundreds of CPT tests from Austria and Norway. After training we combine the multiple unique solutions for this classification problem and visualize the new decision boundaries in between the soil types. The generated boundaries between soil types are comprehensible and are a step towards automatically adjusted CPT interpretation charts for specific local conditions.
ppGpp influences protein protection, growth and photosynthesis in Phaeodactylum tricornutum
Authors: Avilan Luisana , Lebrun Regine , Puppo Carine , Citerne Sylvie , Cuiné Stephane , Li‐Beisson Yonghua , Menand Benoît , Field Ben , Gontero Brigitte
Published: February 2021

Chloroplasts retain elements of a bacterial stress response pathway that is mediated by the signalling nucleotides guanosine penta‐ and tetraphosphate ((p)ppGpp). In the model flowering plant Arabidopsis, ppGpp acts as a potent regulator of plastid gene expression and influences photosynthesis, plant growth and development. However, little is known about ppGpp metabolism or its evolution in other photosynthetic eukaryotes.

Here, we studied the function of ppGpp in the diatom Phaeodactylum tricornutum using transgenic lines containing an inducible system for ppGpp accumulation. We used these lines to investigate the effects of ppGpp on growth, photosynthesis, lipid metabolism and protein expression.

We demonstrate that ppGpp accumulation reduces photosynthetic capacity and promotes a quiescent‐like state with reduced proliferation and ageing. Strikingly, using nontargeted proteomics, we discovered that ppGpp accumulation also leads to the coordinated upregulation of a protein protection response in multiple cellular compartments.

Our findings highlight the importance of ppGpp as a fundamental regulator of chloroplast function across different domains of life, and lead to new questions about the molecular mechanisms and roles of (p)ppGpp signalling in photosynthetic eukaryotes.
Work Hard or Play Hard? Degree Class, Student Leadership and Employment Opportunities*
Authors: Baert Stijn , Verhaest Dieter
Published: February 2021

This study investigates the impact on first hiring outcomes of two main curriculum vitae (CV) characteristics by which graduates with a tertiary education degree distinguish themselves from their peers: degree class and extra‐curricular activities. These characteristics were randomly assigned to 2,800 fictitious job applications that were sent to real vacancies in Belgium. Academic performance and extra‐curricular engagement enhance job interview rates by 7.0% (CI 95% [0.3%, 13.7%]) and 6.5% (CI 95% [−0.5%, 13.4%]), respectively. We did not find evidence for these CV characteristics to reinforce or reduce their effect.
Clinical manifestations of neonatal seizures
Authors: Nguyen Thuy , Wusthoff Courtney J.
Published: February 2021

Neonatal seizures present a unique diagnostic challenge with clinical manifestations often subtle or absent to the bedside observer. Seizures can be overdiagnosed in newborns with unusual paroxysmal movements and underdiagnosed in newborns without clinical signs of seizures. Electroclinical “uncoupling” also adds to the diagnostic challenge. Reliable diagnosis requires additional tools; continuous electroencephalogram (EEG) monitoring is the gold standard for diagnosis of neonatal seizures. Certain high‐risk neonatal populations with known brain injury, such as stroke or hypoxic‐ischemic encephalopathy, are most likely to benefit from continuous EEG. Studies have shown that risk stratification for continuous EEG has positive impact on care, including rapid and accurate diagnosis and treatment of neonatal seizures, which leads to reduced use of antiseizure medicines and length of hospital stay. This review describes common clinical manifestations of neonatal seizures, and clinical situations in which EEG monitoring to screen for seizures should be considered.
Partial aggregation in ethics
Authors: Horton Joe
Published: February 2021

Is there any number of people you should save from paralysis rather than saving one person from death? Is there any number of people you should save from a migraine rather than saving one person from death? Many people answer ‘yes’ and ‘no’, respectively. The aim of partially aggregative moral views is to capture and justify combinations of intuitions like these. These views contrast with fully aggregative moral views, which imply that the answer to both questions is ‘yes’, and with non‐aggregative moral views, which imply that the answer to both questions is ‘no’. In this article, I review the most natural and influential ways of developing partially aggregative views and explain the main problems they face.
Selective herbicide control: using furrows and carbon seed coatings to establish a native bunchgrass while reducing cheatgrass cover
Authors: Terry Tyson J. , Madsen Matthew D. , Gill Richard A. , Anderson Val Jo , St. Clair Samuel B.
Published: February 2021

Invasion by exotic grasses is degrading dryland ecosystems worldwide and efforts to restore native vegetation in invaded areas have been largely unsuccessful. Control of invasive grasses with herbicide also limits restoration efforts using native seed. In this study, we evaluated two approaches that could allow for the restoration of a native species Pseudoroegneria spicata while reducing an invasive annual grass Bromus tectorum with a herbicide mixture in the sagebrush steppe ecosystem (the United States). We used two methods to protect native seeds from herbicide: activated carbon was applied as a seed coating with the intent of absorbing the herbicide around the seed, and furrows were used to side‐sweep soil sprayed with herbicide away from the planted seed. Our results indicate that imazapic + glyphosate herbicide application had a strong negative effect on the invasive annual grass, reducing B. tectorum cover 91% after 1 year, and 39% after 2 years. Herbicide also had strong negative effects on P. spicata without a carbon‐coating or furrow treatment, reducing seedling emergence 38%, 2‐year plant density 65%, and 2‐year total growth 90%. Both activated carbon seed coatings and furrow treatments limited herbicide effects on P. spicata 2‐year growth, but neither treatment alone mitigated herbicide effects on all life stages. Combining carbon coatings and furrow treatments mitigated harmful herbicide effects on several plant stages (seedling emergence, plant densities, and growth). Our results suggest that combining activated carbon coatings and furrow results in similar establishment of a native perennial as a non‐herbicide seeding and lowers B. tectorum abundance.
Fire versus grazing as tools to restore serpentine grasslands under global change
Authors: Hernández Eliza , Shaw E. Ashley , Aoyama Lina , Brambila Alejandro , Niederer Christal , Weiss Stuart B. , Hallett Lauren M.
Published: February 2021

Grassland restoration in a world of change—including nitrogen deposition and invasion—requires solutions that can be sustained and effective in the face of novel drivers. This challenge is amplified in systems characterized by high spatiotemporal variability, as management to address novel drivers may affect a system differently across its range of variability. California serpentine grasslands epitomize this challenge: they host a high diversity of native species, are characterized by temporal and spatial variability, and are experiencing atmospheric nitrogen deposition that leads to a conversion from native annual forbs to non‐native annual grasses. Here, we test the interactive effects of grazing and fire to restore native serpentine species following annual grass invasion and litter accumulation. We assess management outcomes (burned‐grazed, burned‐ungrazed, and unburned‐ungrazed) using a long‐term (2004–2012) monitoring dataset. A 2004 wildfire led to a reduction in annual grasses and a transient increase in native species (forb) richness. In 2008, cattle grazing was reintroduced and crossed with the burn legacy, which sustained post‐fire diversity and eventually led to native recovery in unburned areas, with a caveat that a period of high precipitation promoted the growth of annual grasses. Our study indicates that short‐term management, such as fire, can promote native forb recovery in invaded serpentine grassland communities, but that ongoing treatments like grazing are necessary to maintain restoration outcomes. We speculate that this recovery may be due to the presence of a robust native seed bank, which may persist despite a period of annual grass conversion.