bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a national database of completed investigations into radiology service complaints in New Zealand: What can the radiologist, and radiology service providers, learn?
Authors: Ruppeldt Philip , Baker Mike , Wheeler Luke D
Published: May 2022

Introduction

The Health and Disability Commissioner (HDC) is responsible for dealing with most complaints from service users resulting from their interactions with a healthcare service provider in New Zealand. We analysed all published reports involving a radiologist or radiology service in order to gain insights that might promote safer working across the radiology community.

Methods

We searched the entire HDC online report database choosing a limit of ‘radiologist’ as occupation.

Results

Twenty‐seven investigations were included, published between 1999 and 2021. Seventeen (63%) involved private radiology providers and 10 (37%) involved public providers. Ultrasound featured in 12 cases (44%), x‐ray 6 (22%), CT 5 (19%), mammography 2 (7%), MRI 1 (4%) and interventional 1 (4%). Obstetric ultrasound accounted for 9 (75%) of the ultrasound cases. In 24 (89%) cases, the HDC felt an error had been made. Of the 34 radiologists investigated, 21 (62%) were found in breach of the HDC code, with adverse comment made regarding 4 (12%). A total of 46 incidences of different error types were identified including: communication 14 (30%), perceptual 11 (24%), technical 8 (17%) and interpretative 7 (15%). Forty‐five incidences of contributing factors were identified, including organizational 9 (20%) and clinical information provided 7 (16%).

Conclusion

Errors in radiology practice, leading to complaints, are often multifactorial and systemic. Reflection on the myriad of error types and contributing factors (including ‘human factors’) is imperative to reduce errors. Multifaceted strategies are likely required for radiologists to enhance their systems and practice.
Programmed death‐ligand 1 expression and use of immune checkpoint inhibitors among patients with advanced non‐small‐cell lung cancer in a resource‐limited country
Authors: How Soon Hin , Tho Lye Mun , Liam Chong Kin , Hasbullah Harissa H. , Ho Gwo Fuang , Muhammad Nor Ibtisam , Poh Mau Ern , Ho Kean Fatt , Thiagarajan Muthukkumaran , Samsudin Azlina , Omar Azza , Ong Choo Khoon , Pang Yong Kek , Soon Sing Yang
Published: May 2022

Introduction

Immune checkpoint inhibitor (ICI) therapy is an established treatment for advanced non‐small‐cell lung cancer (NSCLC) and programmed death ligand‐1 (PD‐L1) expression is a recognized biomarker to determine response to therapy. We retrospectively analyzed NSCLC patients in the Malaysia Lung Cancer Registry (MLCR) and report on the clinical characteristics associated with PD‐L1 expression and ICI use in Malaysia, a low‐ to middle‐income country.

Methods

All 901 NSCLC patients in the MLCR who were diagnosed from January 1, 2017 to December 31, 2020 from 14 hospitals across the country were analyzed.

Results

Out of 901 patients, 505 had PDL‐1 testing done with complete data available only in 489 patients. The most common histology was adenocarcinoma (84.7%) followed by squamous cell carcinoma (10.2%). The majority (95%) presented with stage 3 or 4. The number and percentage of patients with PDL‐1 tumor proportion scores of ≥50%, 1–49%, and <1% were 138 (28.2%), 158 (32.3%), and 193 (39.5%), respectively. In multivariate analysis, the presence of genomic mutation is the only independent characteristic associated with negative PD‐L1 expression (crude odds ratio 0.579, 95% confidence interval 0.399–0.840, p = 0.004). Of 292 patients eligible for ICI therapy, only 100 patients (34.2%) received ICIs. Seventy‐eight patients received ICI therapy as first‐line treatment, 15 patients as second‐line treatment, and 7 patients as third‐line treatment.

Conclusions

This is the first analysis on PD‐L1 expression and ICI use in Malaysia. Despite the proven efficacy of ICI therapy, only 56% of our patients had PD‐L1 tests performed and only 34.2% of eligible patients received ICIs.
Root and canal morphology of the maxillary second premolars as indicated by cone beam computed tomography
Authors: Olczak Katarzyna , Pawlicka Halina , Szymański Witold
Published: May 2022

The aim was to evaluate the morphology of maxillary second premolars. The root canal configurations were classified according to Vertucci and a new system by Ahmed et al. based on CBCT images. In addition, the number of roots and the level where they bifurcated were identified, and morphological measurements were performed based on anatomical landmarks. Single‐rooted forms were most common. Bifurcation occurred most often in the middle part of the root. The most common canal configuration was type I according to Vertucci and code 1SP1 according to the new classification. The measurements showing the results were as follows (mm): palatal cusp/buccal cusp/the lowest point of the occlusal surface to pulp chamber ceiling 6.18/6.54/4.77; the ceiling of the pulp chamber was found at the CEJ in 92.28% of the specimens. The maxillary second premolars tended to be single‐rooted and with one root canal.
Antiracism defined as equitable sociocultural interactions in prekindergarten: Classroom racial composition makes a difference
Authors: Curenton Stephanie M. , Rochester Shana E. , Sims Jacqueline , Ibekwe‐Okafor Nneka , Iruka Iheoma U. , García‐Miranda Arlene G. , Whittaker Jessica
Published: May 2022

This study used secondary data from the My Teaching Partner‐Math/Science 2013–2016 randomized control trial to explore whether equitable sociocultural classroom interactions (see Curenton et al., 2019) were associated with the skills of 105 four‐ and five‐year‐olds (52% boys; drawn from 20 unique video recordings of preschool teachers/classrooms; 43% were Black, Latine, Asian, or other racially marginalized learners). Equitable interactions predicted children's skills with effect sizes ranging from small (0.01–0.44) to large (1.00). Moderation analyses revealed that when classrooms had more racially marginalized learners, teachers’ use of equitable disciplinary and personalized learning practices were associated with higher executive functioning gains across prekindergarten. Findings illustrate how classroom composition can be a key indicator between equitable classroom interactions and young children's early skills.
Quantitative autofluorescence findings in patients undergoing hydroxychloroquine treatment
Authors: Parrulli Salvatore , Cozzi Mariano , Airaldi Matteo , Romano Francesco , Viola Francesco , Sarzi‐Puttini Piercarlo , Staurenghi Giovanni , Invernizzi Alessandro
Published: May 2022

Background

To measure quantitative autofluorescence (qAF) in patients under treatment with hydroxychloroquine (HCQ) and at risk of retinal toxicity but with no apparent signs of retinal toxicity and to compare it with that of untreated subjects.

Methods

Consecutive patients at risk for the development of HCQ retinal toxicity (duration of treatment >5 years or daily HCQ dose >5 mg/kg of actual body weight [ABW]) but no alterations on spectral domain—optical coherence tomography, short‐wavelength autofluorescence and 10–2 visual field examination were recruited. Healthy subjects matched by age and sex were also enrolled in the study. All subjects underwent qAF measurements in one eye. Images were analysed using the conventional qAF grid by Delori calculating the qAF of eight sectors of the intermediate ring and the mean of those values (qAF8).

Results

Thirty‐nine patients treated with HCQ (38 females, mean age 52.1 ± 8.6 years) and 39 untreated subjects (38 females, mean age 51.2 ± 8.6 years) were included. In both HCQ patients and untreated subjects, qAF8 was positively correlated with age (p = 0.004). Although HCQ patients showed a higher mean qAF8 compared with untreated subjects (294.7 ± 65.3 vs. 268.9 ± 57.5), the difference was not significant (p = 0.068). HCQ patients showed significantly higher mean qAF values in the inferior‐temporal, inferior and inferior‐nasal sectors of the intermediate ring of qAF grid compared with untreated subjects (all p < 0.05).

Conclusions

These results suggest a possible preclinical increase of qAF values in inferior parafoveal sectors probably induced by HCQ exposure.
‘We can play tag with a stick’. Children's knowledge, experiences, feelings and creative thinking during the COVID‐19 pandemic
Authors: Waboso Nwakerendu , Donison Laurel , Raby Rebecca , Harding Evan , Sheppard Lindsay C. , Grossman Keely , Myatt Haley , Black Sara
Published: May 2022

Using a relational approach, we draw on repeated interviews with a group of 30 diverse children from Ontario to share and reflect on their knowledge, experiences and feelings early in the COVID‐19 pandemic. Prioritising relational interdependence and relational agency, this paper illustrates our participants' embedded engagements with the pandemic and their contribution to the co‐production of knowledge. We emphasise their thoughtful responses to the pandemic; their creative, self‐reflexive strategies for managing a difficult time; and their advice to others. We thus prioritise children's viewpoints and emphasise their relational interconnections with others during a time that was marked by social isolation.
Programmed cell death ligand 1 expression on monocytes is inversely correlated with tumour response to preoperative chemoradiotherapy for locally advanced rectal cancer
Authors: Tojo Mineyuki , Horie Hisanaga , Koinuma Koji , Miyato Hideyo , Tsukui Hidenori , Kaneko Yuki , Futoh Yurie , Kimura Yuki , Takahashi Kazuya , Saito Akira , Ohzawa Hideyuki , Yamaguchi Hironori , Lefor Alan Kawarai , Sata Naohiro , Kitayama Joji
Published: May 2022

Aim

The clinical efficacy of chemoradiotherapy (CRT) is largely dependent on host immune status. The aim of this study was to identify possible markers expressed on circulating mononuclear cells to predict tumour response in patients with locally advanced rectal cancer (LARC).

Methods

Peripheral blood samples were obtained from 47 patients diagnosed with LARC before and after CRT. The numbers of lymphocytes and monocyte subsets were analysed using flow cytometry. Based on clinical and pathological findings, patients were classified as high or low responders.

Results

Lymphocyte counts were markedly decreased after CRT. Total numbers of lymphocytes (p = 0.030) and CD4(+) T cells (p = 0.041) in post‐CRT samples were significantly lower in low responders than in high responders. In contrast, monocyte counts were not reduced and the number of CD14dim(+) CD16(+) nonclassical (patrolling) monocytes were somewhat increased after CRT (p = 0.050). Moreover, the ratios of programmed cell death ligand 1 (PD‐L1) (+) cells on patrolling monocytes before and after CRT were significantly higher in low responders than in high responders (p = 0.0046, p = 0.0006). The same trend was observed for classical and intermediate monocytes. The expression of PD‐L1 on patrolling monocytes before CRT correlated inversely with the number of T cells and natural killer (NK) cells after CRT. PD‐L1(+) ratio in patrolling monocytes was an independent predictor for response to CRT.

Conclusion

Programmed cell death ligand 1 (PD‐L1) expression on patrolling monocytes suppresses cell‐mediated immunity in patients receiving CRT which could be related to tumour response, and may be a useful biomarker for decision‐making in the management of patients with LARC.
Tubulin‐binding peptide RR‐171 derived from human umbilical cord serum displays antitumor activity against hepatocellular carcinoma via inducing apoptosis and activating the NF‐kappa B pathway
Authors: Zhu Donglie , Fang Cheng , Yang Zelong , Ren Yanjie , Yang Fengrui , Zheng Shi , Jiang Mingzuo , Miao Xiangxia , Liu Duoduo , Chen Biliang , Yao Xuebiao , Chen Yong
Published: May 2022

Objectives

Hepatocellular carcinoma (HCC) still presents a high incidence of malignant tumours with poor prognosis. There is an urgent need for new therapeutic agents with high specificity, low toxicity and favourable solubility for the clinical treatment of HCC.

Materials and Methods

The bioactivity of human umbilical cord serum was investigated by proteomics biotechnology and a primitive peptide with certain biological activity was identified. The antitumour effect of RR‐171 was detected by cell viability assay in vitro, and determined by subcutaneous xenograft models assay and miniPDX assay in vivo. Pull‐down experiments were conducted to identify the potential targeting proteins of RR‐171. Immunofluorescence assay and tubulin polymerization assay were conducted to explore the relationship between RR‐171 and α‐tubulin. Fluorescence imaging in xenograft models was used to explore the biodistribution of RR‐171 in vivo. A phosphospecific protein microarray was performed to uncover the underlying signalling pathway by which RR‐171 induces tumour cell death.

Results

The results indicated that RR‐171 could be effective in the treatment of HCC in vivo and in vitro. RR‐171 could aggregate significantly in solid tumours and had no obvious systemic toxicity in vivo. RR‐171 could interact with α‐tubulin and activate the NF‐Kappa B pathway in HCC cells.

Conclusions

Taken together, RR‐171 exhibited significant antitumour activity against HCC in vivo and in vitro and could potentially be used in the clinical application of HCC.
GFI1 regulates chromatin state essential in human endothelial‐to‐haematopoietic transition
Authors: Kang Baoqiang , Zhang Tian , Huang Ke , Wang Tianyu , Li Yuhang , Mai Yuchan , Li Jinbing , Dang Shiying , Zhang Zhishuai , Huang Wenhao , Wang Junwei , Gao Minghui , Wang Yi , Pan Guangjin
Published: May 2022

Objectives

During embryonic haematopoiesis, haematopoietic stem/progenitor cells (HSPCs) develop from hemogenic endothelial cells (HECs) though endothelial to haematopoietic transition (EHT). However, little is known about how EHT is regulated in human. Here, we report that GFI1 plays an essential role in enabling normal EHT during haematopoietic differentiation of human embryonic stem cells (hESCs).

Results

GFI1 deletion in hESCs leads to a complete EHT defect due to a closed chromatin state of hematopoietic genes in HECs. Mechanically, directly regulates important signaling pathways essential for the EHT such as PI3K signaling.etc.

Conclutions

Together, our findings reveal an essential role of GFI1 mediated epigenetic mechanism underlying human EHT during hematopoiesis.
Ordering decisions under supply uncertainty and inventory record inaccuracy: An experimental investigation
Authors: Hofstra Nienke , Spiliotopoulou Eirini , de Leeuw Sander
Published: May 2022

Uncertainty on the supply side is a common issue planners face. How do decision‐makers incorporate inventory uncertainty when placing orders? We investigate ordering decisions under two forms of uncertainty regarding total inventory available to satisfy demand: supply uncertainty (SU; unreliability in incoming shipments) and inventory record inaccuracy (IRI; internal inefficiencies leading to a discrepancy between physical and recorded inventories). The experimental results reveal behavioral regularities in ordering decisions under both forms of total inventory uncertainty. We find that subjects overstock in settings with low profit margins, and overstocking is more pronounced under IRI than under SU. This overstocking under low profit margins is similar to observed ordering decisions under demand uncertainty. In these settings, subjects show a stronger shortage aversion under IRI (which is internal uncertainty) than under SU (which is external uncertainty). Furthermore, we find that subjects chase past realizations of supply/on‐hand inventory, although the effect depends on the uncertainty type. Although SU and IRI are, in practice, often simultaneously present, their causes are different. By providing insight into the relative effect of the types of uncertainty on the quality of inventory replenishment decisions, this study highlights the importance of reducing SU and IRI for products with low profit margins.
Entomopathogenic potential of Bacillus subtilis and Bacillus amyloliquefaciens strains against Musca domestica under controlled conditions
Authors: Torres María Julia , Rocha Voyko Flores , Petroselli Gabriela , Villena Reinaldo Rojas , Audisio Marcela Carina
Published: May 2022

The housefly, Musca domestica L. (Diptera: Muscidae), is a key pest in animal production areas; the resistance of this insect to chemical insecticides makes it necessary to develop new control alternatives. The aim of this work was to study the entomopathogenic activity of eight strains of Bacillus subtilis Ehrenberg ssp. subtilis and two strains of Bacillus amyloliquefaciens Priest et al., isolated from different ecological niches, against the housefly. Cell suspension (CS) of each Bacillus strain and cell‐free supernatant (CFS) and crude lipopeptide fraction (LF) of 7 mg ml−1 of B. amyloliquefaciens CBMDDrag3 and CBMDLO3 strains were evaluated. Various housefly cohorts, resulting from systematic crosses, were used for the bioassays. The eight strains of B. subtilis ssp. subtilis affected the survival of the larvae by 10–20%, whereas strains CBMDDrag3 and CBMDLO3 decreased the survival of these individuals by 30 and 50%, respectively. CBMDLO3 was the strain with the highest pupicidal activity, reducing the survival of these individuals by up to 50%. To evaluate the effect of CBMDLO3 on the fertility of housefly females and longevity of individuals, adults from larvae fed CS, CFS, and LF were used. Females from the CS and CFS diets reduced their oviposition capacity by approximately 50% compared to females from the DL and DMH control diets (i.e., DCS 144.3 eggs, DCFS 128 eggs, and DL 346.5 eggs, respectively). On the other hand, the life cycle of females and males was only affected by LF, i.e., 4 and 6 days shorter than the control, respectively. The UV MALDI TOF analysis of CBMDLO3 LF identified several surfactin homologues. Results show the ability of B. amyloliquefaciens CBMDLO3 strain to reduce the survival of larvae and pupae of M. domestica and the fecundity of female adults, thus allowing cycles of inhibition of housefly development in laying hen farms. Therefore, B. amyloliquefaciens CBMDLO3 strain can make an important contribution to the continuous search of new biocontrol alternatives.
Long‐term safety and efficacy of ravulizumab in patients with paroxysmal nocturnal hemoglobinuria: 2‐year results from two pivotal phase 3 studies
Authors: Kulasekararaj Austin G. , Griffin Morag , Langemeijer Saskia , Usuki Kensuke , Kulagin Alexander , Ogawa Masayo , Yu Ji , Mujeebuddin Arshad , Nishimura Jun‐ichi , Lee Jong Wook , Peffault de Latour Régis ,   301/302 Study Group
Published: May 2022

Objectives

The complement component 5 (C5) inhibitor ravulizumab demonstrated non‐inferiority to eculizumab following 26 weeks of treatment in complement inhibitor‐naïve and complement inhibitor‐experienced patients with paroxysmal nocturnal hemoglobinuria (PNH; studies 301 and 302, respectively). This study aims to describe the results of both studies from 27 weeks to 2 years.

Methods

Patients (N = 441) continued to receive ravulizumab throughout the extension period. Efficacy endpoints included lactate dehydrogenase (LDH) normalization, transfusion avoidance and fatigue score (FACIT‐F). Safety analyses were also performed.

Results

From 27 weeks to 2 years, improvements in LDH levels were maintained in both study populations. Transfusion avoidance was maintained in 81.9% (study 301) and 85.6% (study 302) of patients, and FACIT‐F scores remained stable. Ravulizumab was well tolerated, and the incidence of adverse events (AEs) were similar between patients of both studies. Incidence of serious AEs deemed related to ravulizumab treatment was low (<3%).

Conclusions

This study reports, to date, the longest period of follow‐up in over 400 patients with PNH treated with ravulizumab (662 patient‐years). Long‐term, ravulizumab demonstrated durable efficacy and was well tolerated, highlighting the importance of C5 inhibitors as the mainstay of PNH treatment.
Lung adenocarcinoma manifesting as subsolid nodule potentially represents tumour in the equilibrium phase of immunoediting
Authors: Xiao Rongxin , Ma Yi , Li Hao , Li Xiao , Sun Zewen , Qi Qingyi , Yin Ping , Yang Fan , Qiu Mantang
Published: May 2022

Lung adenocarcinomas manifesting as subsolid nodules (SSN‐LUADs) possess distinct dormant behaviour. This study was designed to compare the immune landscapes of normal lungs (nLungs), SSN‐LUADs and LUADs manifesting as solid nodules (SN‐LUADs) so as to better understand the status of anti‐tumour immunity in SSN‐LUADs. Mass cytometry by time‐of‐flight analysis was performed on 299, 570 single cells from nLung, SSN‐LUAD and SN‐LUAD tissues. The immune cells were identified by phenotype, and the percentages of different immune cell subclusters were compared between SSN‐LUADs, SN‐LUADs and nLungs. Elevated percentage of CD8+ T cells were identified in SSN‐LUADs compared with in nLungs and SN‐LUADs. Elevated CD56bright NK cells and decreased CD56dim NK cells were identified in both SSN‐LUADs and SN‐LUADs compared with in nLungs. The immune landscape of SSN‐LUAD fits the theory of equilibrium phase of immunoediting, thus functional adaptive anti‐tumour immunity but impaired innate anti‐tumour immunity potentially contributes to the maintaining of its dormant behaviour.
Ketoprofen, piroxicam and indomethacin-suppressed quorum sensing and virulence factors in Acinetobacter baumannii
Authors: Elshaer Soha Lotfy , Shaldam Moataz A. , Shaaban Mona I.
Published: May 2022

Aim

Quorum sensing (QS) inhibition is a promising strategy to suppress bacterial virulence and control infection caused by Gram-negative and Gram-positive bacteria. This study explores the QS inhibiting activity of the non-steroidal anti-inflammatory drugs (NSAIDs) in Acinetobacter baumannii.

Methods and Results

Ketoprofen, piroxicam and indomethacin revealed QS inhibition via elimination of violacein production of the reporter strain Chromobacterium violaceum ATCC 12472 without affecting bacterial growth. The minimal inhibitory concentration (MIC) of ketoprofen, piroxicam and indomethacin was determined against A. baumannii strains ATCC 17978, ATCC 19606, A1, A11 and A27 by the microbroth dilution method. The MICs of ketoprofen against tested isolates were 0.7–6.25 mg ml−1, piroxicam MICs were 1.25–2.5 mg ml−1, and indomethacin MICs were 3.12–12.5 mg ml−1. Those compounds significantly inhibited QS-associated virulence factors such as biofilm formation, and surface motility, as well as, significantly increased bacterial tolerance to oxidative stress without affecting bacterial growth. On the molecular level, the three compounds significantly inhibited the transcription of QS regulatory genes abaI/abaR and biofilm-regulated genes cusD and pgaB. Molecular docking analysis revealed the potent binding affinity of the three compounds with AbaI via hydrogen and/or hydrophobic bonds.

Conclusion

These results indicate that NSAIDs, ketoprofen, piroxicam and indomethacin, could be potential inhibitors of the QS and could suppress the QS-related virulence factors of A. baumannii.

Significance and Impact

Ketoprofen, piroxicam and indomethacin could provide promising implications and strategies for combating the virulence and pathogenesis of A. baumannii.
Betelvine (Piper betleL.): A comprehensive insight into its ethnopharmacology, phytochemistry, and pharmacological, biomedical and therapeutic attributes
Authors: Biswas Protha , Anand Uttpal , Saha Suchismita Chatterjee , Kant Nishi , Mishra Tulika , Masih Harison , Bar Ananya , Pandey Devendra Kumar , Jha Niraj Kumar , Majumder Madhumita , Das Neela , Gadekar Vijaykumar Shivaji , Shekhawat Mahipal S. , Kumar Manoj , Radha  , Proćków Jarosław , Lastra José M. Pérez de la , Dey Abhijit
Published: May 2022

Piper betleL. (synonym:Piper betelBlanco), or betel vine, an economically and medicinally important cash crop, belongs to the family Piperaceae, often known as the green gold. The plant can be found all over the world and is cultivatedprimarily in South East Asian countries for its beautiful glossy heart‐shaped leaves, which are chewed or consumed as betelquidand widely used in Chinese and Indian folk medicine, as carminative, stimulant,astringent, against parasitic worms, conjunctivitis, rheumatism, wound, etc., andis also used for religious purposes. Hydroxychavicol is the most important bioactive compound among the wide range of phytoconstituents found in essential oil and extracts. The pharmacological attributes ofP. betleare antiproliferation, anticancer, neuropharmacological, analgesic, antioxidant, antiulcerogenic, hepatoprotective, antifertility, antibacterial, antifungal and many more. Immense attention has been paid to nanoformulations and their applications. The application ofP. betledid not show cytotoxicity in preclinical experiments, suggesting that it could serve as a promising therapeutic candidate for different diseases. The present review comprehensively summarizes the botanical description, geographical distribution, economic value and cultivation, ethnobotanical uses, preclinical pharmacological properties with insights of toxicological, clinical efficacy, and safety ofP. betle. The findings suggest thatP. betlerepresents an orally active and safe natural agent that exhibits great therapeutic potential for managing various human medical conditions. However, further research is needed to elucidate its underlying molecular mechanisms of action, clinical aspects, structure–activity relationships, bioavailability and synergistic interactions with other drugs.
Long‐term proton pump inhibitor use and risk of osteoporosis and hip fractures: A nationwide population‐based and multicenter cohort study using a common data model
Authors: Park Da Hee , Seo Seung In , Lee Kyung Joo , Kim Jinseob , Kim Yerim , Seo Won‐Woo , Lee Hyung Seok , Shin Woon Geon , Yoo Jong Jin
Published: May 2022

Background and Aim

Association between protonpump inhibitors (PPIs) and osteoporosis, hip fractures has not been fully elucidated. We aimed to evaluate the relationship between PPIs use and the risk of osteoporosis and hip fractures in the databases converted to a common data model (CDM) and to compare the results across the databases.

Methods

This was a population‐based, propensity‐matched, retrospective cohort study that included patients aged ≥ 50 years who were prescribed with PPIs for over 180 days. We compared the incidence of osteoporosis and hip fractures between new PPI user and new user of other drugs using the Cox proportional hazards model and performed meta‐analysis in the electronic health record (EHR) databases.

Results

In the Korean National Health Insurance Service (NHIS)–CDM database, long‐term PPI users had greater risk of osteoporosis [PPIs vs non‐PPIs groups, 28.42/1000 person‐years vs 19.29/1000 person‐years; hazard ratio (HR), 1.62; 95% confidence interval (CI), 1.22–2.15; P = 0.001]. The meta‐analytic results of six EHR databases also showed similar result (pooled HR, 1.57; 95% CI, 1.28–1.92). In the analysis of hip fracture, PPI use was not significantly associated with a hip fracture in the NHIS–CDM database (PPI vs non‐PPI groups, 3.09/1000 person‐years vs 2.26/1000 person‐years; HR, 1.45; 95% CI, 0.74–2.80; P = 0.27). However, in the meta‐analysis of four EHR databases, the risk of hip fractures was higher in PPI users (pooled HR, 1.82; 95% CI, 1.04–3.19).

Conclusions

Long‐term PPI was significantly associated with osteoporosis; however, the results of hip fractures were inconsistent. Further study based on better data quality may be needed.
Turning trash into treasure: An approach to the environmental assessment of waste prevention and its application to clothing and furniture in Switzerland
Authors: Wiprächtiger Maja , Rapp Martina , Hellweg Stefanie , Shinde Rhythima , Haupt Melanie
Published: May 2022

According to the waste hierarchy, waste prevention is environmentally superior to recycling or recovery, hence its inclusion in government policy. The assessment and prioritization of waste prevention strategies are impeded, inter alia, by ambiguous definitions and the lack of a sound environmental assessment method. In this study, a systematic approach to the environmental assessment of waste prevention activities (WPAs), covering the whole life cycle of products, was developed. The approach combines material flow analysis and life cycle assessment with a sustainable circular system design framework whilst giving special consideration to pivotal factors such as diffusion factor (share of population engaging in WPA), substitutability (degree to which a new product is replaced), effects on use‐phase impacts, and rebound effects. The application of the approach to the case studies of clothing and household furniture in Switzerland revealed lower impact saving potential than assumed initially, due to lack of participation, low substitutability, or high rebounds. For example, reusing clothing locally, instead of exporting it to low‐income countries, as currently done, displayed no or even negative impact savings since secondhand clothing in high‐income countries is often consumed in addition to new clothing. Drastic scenarios for clothes led to only moderate impact reductions of less than 15%, whereas a take‐back scheme for furniture reduced impacts by 70%. Concluding, the four factors (diffusion rate, substitutability, effects on use‐phase impacts, and rebounds) proved crucial in the assessment of waste prevention strategies and the approach presented was able to pinpoint improvement potentials of the waste prevention scenarios investigated.
Trainable segmentation for transmission electron microscope images of inorganic nanoparticles
Authors: Bell Cameron G. , Treder Kevin P. , Kim Judy S. , Schuster Manfred E. , Kirkland Angus I. , Slater Thomas J. A.
Published: May 2022

We present a trainable segmentation method implemented within the python package ParticleSpy. The method takes user labelled pixels, which are used to train a classifier and segment images of inorganic nanoparticles from transmission electron microscope images. This implementation is based on the trainable Waikato Environment for Knowledge Analysis (WEKA) segmentation, but is written in python, allowing a large degree of flexibility and meaning it can be easily expanded using other python packages. We find that trainable segmentation offers better accuracy than global or local thresholding methods and requires as few as 100 user‐labelled pixels to produce an accurate segmentation. Trainable segmentation presents a balance of accuracy and training time between global/local thresholding and neural networks, when used on transmission electron microscope images of nanoparticles. We also quantitatively investigate the effectiveness of the components of trainable segmentation, its filter kernels and classifiers, in order to demonstrate the use cases for the different filter kernels in ParticleSpy and the most accurate classifiers for different data types. A set of filter kernels is identified that are effective in distinguishing particles from background but that retain dissimilar features. In terms of classifiers, we find that different classifiers perform optimally for different image contrast; specifically, a random forest classifier performs best for high‐contrast ADF images, but that QDA and Gaussian Naïve Bayes classifiers perform better for low‐contrast TEM images.
The hunter and the lion: Amplifying health care consumers' voices in health care education
Authors: Brand Gabrielle , Dart Janeane
Published: May 2022

This commentary discusses ways in which we can amplify healthcare consumers' voice by co‐designing healthcare education to teach dimensions of professionalism.
The Curious Case of the Irrational Disputant: Insights and Strategies from the Science of Moral Reasoning
Authors: Juliano Jane
Published: May 2022

In mediation and negotiation, we sometimes encounter people who make decisions that seem to be inconsistent with what they say they care about and want, and with their alternatives to settlement. Some seemingly irrational decisions may be a result of automatic, intuitive moral judgments, which are best approached at a corresponding intuitive level. Social scientists have identified two “systems” of thinking: an automatic, quick process made outside of awareness (System 1), and an effortful, deliberate, logical, conscious one (System 2). In their social intuitionist model and moral foundations theory, Jonathan Haidt and colleagues propose that individuals make automatic, quick, intuitive moral judgments along five universal moral domains: care/harm, fairness/cheating, loyalty/betrayal, authority/subversion, and sanctity/degradation. These moral judgments are difficult to engage with reasoned arguments. A seemingly irrational party may be in the midst of an intuitive moral judgment that is not logic‐based. The literature on these and related lines of research explains when and why a mediator should seek to explore whether a party’s assessments may be a result of intuitive moral judgments, and if so, ways a mediator could communicate with the party on that level. This may be done most effectively by shifting the focus within or to another relevant moral domain, using moral reframing, and making liberal use of stories in communicating alternative intuitive moral perspectives. These methods engage on an intuitive level.
Robust metagenomic evidence that local assemblage richness increases with latitude in ground‐active invertebrates of North America
Authors: Weiser Michael D. , Siler Cameron D. , Smith Sierra N. , Marshall Katie E. , McLaughlin Jessica F. , Miller Matthew J. , Kaspari Michael
Published: May 2022

Biodiversity monitoring is imperative for understanding how changing climate may impact the distributions of taxa from single species to the spatial distribution of biological diversity. Large‐scale and cross‐taxa biodiversity monitoring also allows an empirical understanding of biogeographic patterns across taxa. One such pattern, where in taxonomic richness peaks at tropical latitudes are typically treated as a biogeographical rule with few notable exceptions. Here we leveraged the invertebrate pitfall collections of the National Ecological Observatory Network (NEON) across North America to describe patterns of local taxonomic richness across taxa and across taxonomic scale. We focused on Arthropoda, Annelida and Mollusca. Additionally, we estimated regional species richness using expert‐identified samples of three NEON sentinel taxa: Carabidae, Culicidae and Ixodida. To sample pitfall animals, we filtered storage ethanol and employed environmental DNA‐barcoding methodologies to amplify and sequence extracted DNA from the filtrate for two regions of a mitochondrial gene. We assigned taxonomic names to these sequences at 97% similarity to reference sequences and calculated local taxonomic richness at the levels of species, genus, family and order. We calculated local species richness for 12 common invertebrate taxa. We used generalized linear models to describe the relationships between taxonomic richness and spatial, climatic and abundance predictor variables. At four taxonomic scales, ranging from species to order, taxonomic richnessincreased significantly as a function of latitude. Of the twelve invertebrate taxa weexamined, seven mirrored this positive latitudinal gradient in species richness. At theregional scale, two of three NEON Sentinel Taxa showed positive latitudinal gradientsin species richness. Temperature, precipitation, abundance and sequence read numberplayed minor roles in explaining patterns of taxonomic richness. When considering these mostly temperate sites that span 46 degrees of latitude, we found no support for the expected negative latitudinal gradients across taxa and taxonomic scales. Instead, for many of these taxa and taxonomic scales, we observed significant, positive richness gradients with increasing latitude among ground‐dwelling invertebrate communities. Thus, one of the most ‘general' patterns in biogeography was not found for most invertebrate taxa across temperate latitudes.
Impact of a Comfortable in our Skin interactive workshop on social media awareness and self‐confidence in adolescents
Authors: Mumber Hannah E. , Rashid Sarem , Carey Grace , Navarro Alexis , Oh Eric , Nasir Muhammad , Lee Margaret S.
Published: May 2022

Social media use contributes to body dissatisfaction and reduced quality of life among adolescents. This study examines the impact of social media use and skin conditions on body image and suggests that a Comfortable in Our Skin (CIOS) pilot community‐based workshop may promote healthier body image and social media usage among urban adolescents.
In Situ Prepared NRCPFs as Highly Active Photo Platforms for in Situ Bond Formation Between Aryldiazonium Salts and Heteroarenes
Authors: Singh Satyam , Yadav Rajesh Kumar , Kim Tae Wu , Singh Chandani , Singh Pooja , Chaubey Surabhi , Rose Baimuratova , Gulzhian Dzhardimalieva , Khare Prateek
Published: May 2022

Covalent perylene frameworks (CPFs) with melamine linkages have newly received rising interest for a variety of applications because of nitrogen‐rich content and high stability. Herein, we account a new simple strategy to in situ attain nitrogen‐rich covalent perylene frameworks (NRCPFs) as highly active photo platforms for in situ bond formation between aryldiazonium salts and heteroarenes (C–H bond arylation) through the controlled photoredox route.
Success and failure of invasive races of plant pathogens: The case of Puccinia striiformis f. sp. tritici in France
Authors: Vidal Tiphaine , Boixel Anne‐Lise , Maghrebi Essia , Perronne Rémi , du Cheyron Philippe , Enjalbert Jérôme , Leconte Marc , de Vallavieille‐Pope Claude
Published: May 2022

Invasions of new races can have contrasting consequences on populations of Puccinia striiformis f. sp. tritici, causing yellow rust of wheat. For example, the emergence of PstS7 (Warrior race) had major impacts in Europe and in France. By contrast, PstS2 had no impact in France, while it significantly affected other parts of the world. The objective of this study was to better understand factors that govern the success of an invasive race, taking the contrasting history of PstS7 and PstS2 in France as a case study. We compared these two races for three key factors driving invasive potential: (a) virulence against local cultivars, (b) aggressiveness in local environmental conditions, and (c) competitiveness against local races. During the period when PstS2 was detected, 70% of the grown wheat area was protected against this race by at least one known Yr resistance gene. By contrast, we found that only 15% of the wheat area had a low risk of infection by PstS7. In planta competition experiments suggested a higher competitiveness of PstS7 against local isolates compared to PstS2 in optimal thermal conditions. In silico experiments, based on thermal performance curves, suggested a high competitiveness of PstS7 considering infection efficiency. PstS2 was extremely competitive against local races in all considered environments (20 French sites × 15 years) due to its short latency period. Our findings highlight the importance of considering adaptation to environmental conditions, particularly temperature, in addition to virulence spectrum, in order to understand the evolutionary trajectories of emerging strains in pathogen populations.
Especialização do Ministério Público nos Estados na Temática Educação
Authors: Ximenes Salomão Barros , Stuchi Carolina Gabas , Marinho Carolina Martins , Taporosky Barbara Cristina Hanauer , Jurkstas André Barreto
Published: May 2022

O trabalho investiga a especialização do Ministério Público (MP) nos vinte e seis estados, na temática Educação, um fenômeno que decorre tanto de obrigações legais como de decisões institucionais de cada estado, em parte relacionadas a orientações nacionais emanadas do Conselho Nacional do Ministério Público (CNMP). No presente estudo, a unidade de análise é cada órgão especializado do MP dos Estados, classificados conforme o grau de especialização, o tipo, as atribuições funcionais que reúnem e a amplitude de atuação, dentre outros elementos. As fontes são as normas de organização, portais de transparência e entrevistas complementares aplicadas aos membros e servidores, quando necessário. Como resultados, propomos um modelo de classificação e análise da especialização temática na área da educação e analisamos os achados à luz da literatura estabelecida. Com isso, o trabalho permite avançar na compreensão teórica e no conhecimento da realidade institucional do MP, um dos principais protagonistas do sistema de justiça no marco dos direitos sociais da Constituição de 1988, que lhe assegurou poderes e autonomias sem precedentes. A atuação do MP, neste marco, impacta diretamente o processo de políticas públicas e, como consequência, interfere nas disputas políticas sobre a distribuição de bens e direitos na sociedade brasileira. Estudar a especialização do MP permite desvelar também as orientações político-institucionais do MP que, assim definidas, orientam a atuação de seus membros em direção a temáticas tidas como prioritárias ou, ao menos, entendidas como passíveis de um direcionamento específico via política institucional.
Experimental Investigation on Spray Evaporation and Dispersion Characteristics of Impinged Biodiesel-Butanol Blends
Authors: Zhang Qiankun , Xia Jin , Wang Jianping , He Zhuoyao , Zhao Wenbin , Qian Yong , Zheng Liang , Liu Rui , Lu Xingcai
Published: May 2022

The objective of the investigation is to explore the spray evaporation and dispersion characteristics of impinged biodiesel-butanol blends at various n-butanol ratios (0, 10%, 30%, 50%) and ambient conditions. A total of 180 experimental cases were performed in a constant-volume combustion chamber. The liquid- and vapor-phase sprays were captured by backlight imaging technique and Schlieren imaging technique, respectively. Several macroscopic parameters were measured and discussed, including impinged spray structure, width, height, and area. Some novel parameters are derived to analyze spray evaporation and dispersion. Results show that biodiesel blended with 30% n-butanol transits better from liquid-phase to vapor-phase compared with other blends, displaying rapid liquid-phase evaporation an steady vapor-phase dispersion. After wall impingement, an increase in the ambient pressure or temperature hinders the liquid-phase dispersion in the vertical direction significantly, leading to a rapid decrease in the height of the impinged spray. The vapor-phase diffusion rate in the horizontal direction is about four times the rate in the vertical direction, and the rate ratio is slightly affected by ambient conditions and injection pressure. Compared with the free jet, the impinged spray is not beneficial for liquid-phase evaporation and vapor-phase dispersion, presenting larger liquid-phase area and smaller vapor-phase area. However, impinged biodiesel blended with 30% n-butanol displays better spray evaporation and dispersion.
Design And Development of a Novel Assistive Device for Laparoscopic Surgery Using Granular Jamming
Authors: Andy Huang Chenan , Song Sang-Eun
Published: May 2022

Laparoscopic surgery has a notably high learning curve, hindering typical approaches to training. Due to unique challenges that are not present in open surgery (the hinge effect, small field of view (FoV), lack of depth perception, and small workspace), a surgical resident may be delayed in participating in laparoscopic surgery until later in residency. Having a narrow window to complete highly specialized training can lead to graduates feeling under-prepared for solo practice. Additionally, delayed introduction may expose trainees to fewer than 200 laparoscopic cases. Therefore, there is a need for surgical residents to increase both their caseload and training window without compromising patient safety. This project aims to develop and test a proof-of-concept prototype that uses granular jamming technology to controllably vary the force required to move a laparoscopic tool. By increasing tool resistance, the device helps prevents accidental injury to important nearby anatomical structures such as urinary tract, vasculature, and/or bowel. Increasing the safety of laparoscopic surgery would allow residents to begin their training earlier, gaining exposure and confidence. A device to adjust tool resistance has benefits to the experienced surgeon as well – surgeries require continuous tool adjustment and tension, resulting in fatigue. Increasing tool resistance can assist surgeons in situations requiring continuous tension and can also provide safety against sudden movements. This investigational device was prototyped using SolidWorks CAD software, then 3D printed and assessed with a laparoscopic box trainer.
Evaluating Gender Differences in Treatment of Simulated Gunshot Wounds Using a Female Retrofit
Authors: Craig Curtis M. , Drahos Bradley , Schwieters Katelyn R. , Morris Nichole L. , Lye Mandi , Kowalewski Timothy M. , Norfleet Jack E. , Mazzeo Mark V.
Published: May 2022

Female soldiers are at greater risk of injury and have higher death rates compared to male soldiers. Female casualties are underrepresented in existing training materials for battlefield medics and the patient simulators are often masculine in appearance. The current study assesses the suitability of a female retrofit for male patient simulators and explores the existence of disparities in treatment between male and female patient simulators among combat medic trainees. Thirty-six participants undergoing training at a U.S. Army Medical Simulation Training Center performed a series of basic procedures on both a male patient simulator and a similar patient simulator with a female retrofit. The chest seal procedure was video-recorded and coded for errors committed by the trainees and analyzed to determine whether the apparent gender and order of the patient simulators affected error likelihood and rate. The results indicated that gender and order did not affect the likelihood of optimal performance, but if trainees treated the female retrofitted patient simulator first, they tended to commit more errors. Therefore, the use of a female retrofit may be useful for providing parity in training for gender; however, the issue of gender disparities remains a pressing issue for medical device design and research.
Evaluation of Endoscope Control Assessment System
Authors: Hussain Saira , Zhou Yuqi , Liu Ruiji , Pauli Eric , Haluck Randy , Fell Barry , Moore Jason
Published: May 2022

Colonoscopy procedures are commonly performed to screen the colon for cancer-causing polyps. These procedures require highly trained practitioners and extensive training is necessary to perform proficiently. The Endoscopic Control Assessment System (ECAS) was developed to train and assess practitioners using a magnetic tracker and camera imaging. The magnetic tracker is used to track the tip motion of an endoscope during the insertion and retraction procedure of colonoscopy. In addition, camera imaging is used to track the angle of the control knobs during the procedure. The colon deflection of a manikin during a colonoscopy was successfully tracked to be averaged as 31, 54, and 10 mm for the three trials. Visual processing showed the control knob motion could be successfully tracked during a manikin colonoscopy procedure. The ECAS system was shown to be able to successfully measure user inputs during a manikin procedure.