bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Achilles tendon rupture: a novel modification of surgical technique described by El Shewy
Authors: Gunaratne Rajitha , Chong Yu Chuan , Heng Yi , Hahn Jayhee , Lek Jeremy , Randazzo Amy , Brankov Boris
Published: May 2021

Background

Chronic Achilles tendon rupture is commonly defined as a rupture presenting 6 weeks after the time of injury and operative management is recommended. This research aims to describe a novel modified surgical technique in the repair of chronic Achilles tendon rupture and to report the result of this technique.

Methods

This is a retrospective study performed between January 2007 and January 2017, and a novel modification of El Shewy et al.'s surgical technique is described. Fifteen patients with chronic rupture of Achilles tendon repaired with the technique by a single experienced surgeon were identified. Patients were contacted via phone call and questionnaires completed. Achilles Tendon Rupture Score and pain score were assessed via questionnaires.

Results

Thirteen patients were contacted and two patients were uncontactable. Ten patients were able to return to their premorbid level of function. Twelve patients were satisfied or very satisfied with the outcome. Only one patient was very dissatisfied with the outcome. The average Achilles Tendon Rupture score was 72 (n = 7, 54%). The average pain score was 1.23 (n = 13, 100%).

Conclusions

This novel modified surgical technique demonstrated good functional outcomes and high levels of patient satisfaction in patient with chronic Achilles tendon rupture. It can be considered in the repair of chronic Achilles tendon rupture.
Visual perception problems and quality of life in young adults with foetal alcohol spectrum disorders
Authors: Gyllencreutz Emelie , Aring Eva , Landgren Valdemar , Landgren Magnus , Grönlund Marita Andersson
Published: May 2021

Purpose

To investigate visual perception problems (VPPs), health‐related quality of life (HRQoL) and vision‐related quality of life (VRQoL) in young adults with foetal alcohol spectrum disorders (FASD) and to compare the results with healthy controls.

Methods

Thirty young adults with FASD (13 female; mean age 23 years) and 29 controls (20 female; mean age 25 years) participated. Five areas of VPPs were assessed by a structured history‐taking. In the FASD group, VPPs were investigated both in childhood (mean age 8 years) and in early adulthood in a prospective follow‐up. Health‐related quality of life (HRQoL) was investigated with the Pediatric Quality of Life Inventory™ (PedsQL) and VRQoL with the 25‐item Visual Function Questionnaire (VFQ‐25).

Results

Visual perception problems (VPPs) in at least one area were reported by 16/30 FASD participants (53%) and 1/29 controls (3%) (p = 0.0001, Fisher’s exact test), with a similar rate in the same individuals in childhood as in early adulthood (8/27 and 15/27, respectively p = 0.09, McNemar’s test). PedsQL total score was lower in the FASD group (n = 20; median: 83; 95% confidence interval (CI) 76–88) compared with controls (n = 29; median: 91; 95% CI 90–95; p = 0.0001, Mann–Whitney U‐test). VFQ‐25 subscale general vision indicated lower VRQoL in the young adults with FASD (n = 19; median: 80; 95% CI 80–100) compared with controls (n = 29; median: 100; 95% CI 100–100; p = 0.003).

Conclusion

Young adults with FASD in the present study had more VPPs and worse VRQoL and HRQoL than healthy controls. In the FASD group, VPPs were reported in childhood as well as in early adulthood.
Positive functioning at work during COVID‐19: Posttraumatic growth, resilience, and emotional exhaustion in Chinese frontline healthcare workers
Authors: Lyu Yizhi , Yu Yongju , Chen Shuquan , Lu Shuang , Ni Shiguang
Published: May 2021

Research on traumatic events often emphasizes the importance of posttraumatic growth (PTG) and resilience, yet few studies have explored their trends and their relationship throughout the progression of traumatic events. This paper explores the longitudinal relationship between resilience and PTG, as well as the role of job burnout in this relationship, among frontline healthcare workers during the COVID‐19 pandemic, who have been exposed to high‐risk work environments over extraordinarily long workdays. In Study 1, 134 Chinese frontline healthcare workers completed a three‐wave survey (Time 1, Time 2, and Time 3) in February–May 2020. In Study 2, 401 frontline healthcare workers completed a cross‐sectional survey. The cross‐lagged analysis suggested that resilience at Time 1 positively predicted PTG at Time 2, which in turn positively predicted resilience at Time 3. PTG at Time 1 also positively predicted resilience at Time 2 (Study 1). However, job burnout was negatively related to both resilience and PTG; in particular, emotional exhaustion moderated the link between PTG and resilience (Study 2). Our findings support a cycle of reinforcement between resilience and PTG over time. The positive effect of PTG on resilience, however, is undermined by emotional exhaustion. Implications for future intervention research and workplace support are discussed.
The mechanised testing and sequential wear‐analysis of replica Bronze Age palstave blades
Authors: Andrews Miriam , Polcar Tomas , Sofaer Joanna , Pike Alistair W. G.
Published: May 2021

There have been few attempts to conduct highly controlled laboratory experiments to isolate how wear propagates on metal artefacts with differing metallurgy during simulated use. This reflects a lack of appreciation for the underlying structure of materials within the production of reference datasets for metalwork wear analysis. Here, we present the use of a drop tower (Instron CEAST 9350) to reconstruct use on replica Bronze Age palstave axes with archaeologically relevant microstructures. The development, form, and properties of surface wear at the cutting edge were sequentially analysed by low‐power microscopy (digital), high‐power microscopy (Scanning Electron Microscope), and microhardness indentation. Major deformations of the blade were documented by photography. This intensive approach reveals the impact of abrasive wear associated with sharpening and use, as well as the frequency and morphology of larger deformations generated by repeated impact—all of which, we demonstrate, can be overtly modified by subtle differences in metallurgy.
Making implicit CSR explicit? Considering the continuity of Japanese “micro moral unity”
Authors: Horiguchi Shinji
Published: May 2021

While there are many studies that address how well Japanese companies have adopted explicit CSR practices, our understanding of their own views on such practices is still limited, particularly of the difference in their views before and after the process of making implicit CSR explicit. The present research thus aims to address this apparent change by providing comparative case studies of two Japanese companies selected from two different time periods. The findings indicate there is a continuity observable in the mindset of these companies not a change. This contradicts existing literature and suggests that the process of making CSR explicit has not been accompanied by any real change in their mindset. The result shows that ethically questionable practices have been going on behind the explicitly articulated CSR policies and implies the difficulties of delegating the power to address societal issues to business organisations. This is important particularly now when the expectations of the public regarding the responsibilities of business towards society are on the rise.
Late survival of woodland contrasts with rapid limnological changes following settlement at Kalmanstjörn, Mývatnssveit, northeast Iceland
Authors: Hiles William , Lawson Ian T. , Roucoux Katherine H. , Streeter Richard T.
Published: May 2021

The settlement of Iceland is known to have had profound impacts on vegetation and landscape stability, but there remain uncertainties around the spatial variability and timing of environmental change, and the impacts of settlement on aquatic ecosystems. Here a new multiproxy palaeoenvironmental reconstruction spanning the last 3000 years is presented from Kalmanstjörn, a small lake in Mývatnssveit, northeast Iceland. Sedimentology, pollen and non‐pollen palynomorphs, and geochemical proxies, dated using tephrochronology, are used to reconstruct terrestrial vegetation, landscape stability and aquatic ecosystems. The data reveal complex environmental dynamics after settlement. At this site, substantial tree populations persisted until the late 15th century, in strong contrast to the rapid deforestation shown by almost all other records from Iceland. The eventual loss of woodland may have been caused by changes in direct human activity and the location of extensive grazing, in combination with Little Ice Age climatic cooling. The loss of woodland was accompanied by increased soil erosion. Conversely, the lake ecosystem showed an immediate response to settlement, becoming more productive for several centuries, perhaps in response to increased availability of nutrients from grazing herbivores. The late persistence of woodland in the Kalmanstjörn record adds to our understanding of the spatial variations in ecosystem responses to settlement in Iceland, while the evidence for decoupling of the aquatic and terrestrial systems suggests that palaeolimnological reconstructions focusing on aquatic ecosystem responses may be important new sources of information on the wider ecological consequences of human settlement.
CNS inflammation after natalizumab therapy for multiple sclerosis: A retrospective histopathological and CSF cohort study
Authors: Häusler Darius , Akgün Katja , Stork Lidia , Lassmann Hans , Ziemssen Tjalf , Brück Wolfgang , Metz Imke
Published: May 2021

Natalizumab, a recombinant humanized monoclonal antibody directed against the α4 subunit of the integrins α4ß1 and α4ß7, has been approved for the treatment of active relapsing‐remitting MS. Although natalizumab is a highly beneficial drug that effectively reduces the risk of sustained disability progression and the rate of clinical relapses, some patients do not respond to it, and some are at higher risk of developing progressive multifocal leukoencephalopathy (PML). The histopathological effects after natalizumab therapy are still unknown. We, therefore, performed a detailed histological characterization of the CNS inflammatory cell infiltrate of 24 brain specimens from natalizumab treated patients, consisting of 20 biopsies and 4 autopsies and 21 MS controls. To complement the analysis, immune cells in blood and cerebrospinal fluid (CSF) of 30 natalizumab‐treated patients and 42 MS controls were quantified by flow cytometry. Inflammatory infiltrates within lesions were mainly composed of T cells and macrophages, some B cells, plasma cells, and dendritic cells. There was no significant difference in the numbers of T cells or macrophages and microglial cells in lesions of natalizumab‐treated patients as compared to controls. A shift towards cytotoxic T cells of a memory phenotype was observed in the CSF. Plasma cells were significantly increased in active demyelinating lesions of natalizumab‐treated patients, but no correlation to clinical disability was observed. Dendritic cells within lesions were found to be reduced with longer ongoing therapy duration. Our findings suggest that natalizumab does not completely prevent immune cells from entering the CNS and is associated with an accumulation of plasma cells, the pathogenic and clinical significance of which is not known. As B cells are considered to serve as a reservoir of the JC virus, the observed plasma cell accumulation and reduction in dendritic cells in the CNS of natalizumab‐treated patients may potentially play a role in PML development.
A method for assessing sustainability, with beef production as an example
Authors: Broom Donald M.
Published: May 2021

A comprehensive approach to decisions about the use of land and other world resources, taking full account of biological and other scientific information, is crucial for good decisions to be made now and in future. The sustainability of systems for producing food and other products is sometimes assessed using too narrow a range of component factors. A production system might be unsustainable because of adverse effects on a wide range of aspects of human welfare, animal welfare, or the environment. All factors should be included in sustainability evaluation, otherwise products or actions might be avoided without adequate consideration of key factors or of the diversity of production systems. A scoring method that is based on scientific information and potentially of general relevance is presented here, using beef production as a example with a review of each of its sustainability components. This includes an overall combined score and specific factors that make the system unacceptable for some consumers. The results show that, in this example, the sustainability of the best systems is very much better than that of the worst systems. By taking account of scores for a wide range of components of sustainability in comparing beef‐production systems, better quality policies about beef use can be formulated than when statements referring only to one system are considered. The least sustainable beef‐production systems are extensive grazing that causes land degradation and the use of feedlots or indoor housing with grain feeding. Semi‐intensive silvopastoral systems are the most sustainable beef‐production systems, and well‐managed pasture‐fed beef from areas where crop production is uneconomic is also sustainable. This simple, scientifically based scoring system could be modified to use positive as well as negative scores and is of value for policy makers, researchers, producers, organisations aiming to improve sustainability, and the general public.
The social side of innovation: When and why advice network centrality promotes innovative work behaviours
Authors: Cangialosi Nicola , Odoardi Carlo , Battistelli Adalgisa , Baldaccini Antonio
Published: May 2021

Drawing from a social network perspective on innovation, this study aims to explore the relationship between advice network centrality, and innovative work behaviour by focusing on the mediating role of voice behaviour and the moderation of organizational tenure. Hypotheses were tested using a sample of 478 employees in an Italy‐based aerospace organization. The results indicated that a central position in the advice network was positively associated with innovative work behaviour and that voice behaviour mediated this relationship. Additionally, moderated mediation analysis highlighted that the path between advice network centrality and voice behaviour was stronger for individuals with shorter organizational tenure. These findings offer guidance for organizations that aim to strengthen employee‐driven innovation by highlighting the importance of a social network approach. Several implications for theory and practice are discussed.
Les théories sociologiques comme expression de l'appropriation culturelle, un point de vue critique
Authors: Hamel Jacques
Published: May 2021

In light of the importance assumed by the English language in the sociological orbit, this article seeks to show how certain theoretical currents induce epistemologies in national sociologies, to use the expression dear to Foucault, even epistemologies likely to compromise the explication of sociological subject matter of interest within francophone countries, for example. It can be shown that intersectionality and standpoint theory emerge from the “historical configuration” of Anglo‐Saxon countries like the United States, and particularly from the political and militant struggles known in this country, at the root of the political correctness, safe spaces and cultural appropriation that prevail today on American campuses. In conclusion, considerations on “epistemologically correct” sociological theory are exposed, with the intention of nuancing them on an epistemological level.
Values‐Alignment Messaging Boosts Adolescents’ Motivation to Control Social Media Use
Authors: Galla Brian M. , Choukas‐Bradley Sophia , Fiore Hannah M. , Esposito Michael V.
Published: May 2021

Two preregistered experiments with 2,733 U.S. high school students (age range = 13–19 years) compared the impact of different messages on adolescents’ motivation to control social media use (SMU). A traditional message emphasized the benefits of avoiding SMU, whereas a values‐alignment message framed controlling SMU as being consistent with autonomy and social justice. Compared to no message or a traditional message, in both studies, a values‐alignment message led to greater motivation to control SMU immediately afterward, and in Study 2, awareness of “addictive” social media designs 3 months later. As hypothesized, values‐alignment messaging was more motivating for girls than boys. Results offer preliminary support for leveraging adolescents’ drives for autonomy and social justice to motivate self‐regulation of SMU.
Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated
Authors: Pilz Anna Caroline , Zink Alexander , Schielein Maximilian C. , Hell Katharina , Romer Katrin , Hillmann Elena , Bäumer Daniel , Reinhardt Maximilian , Wagner Nicola
Published: May 2021

Background and objectives

Due to the development of new anti‐psoriatic drugs in combination with improved structures for implementation throughout Germany, the medical care of psoriasis patients has markedly improved. In this study we investigated the real‐life utilization of the health care system and identified reasons for dissatisfaction in affected individuals.

Patients and methods

This non‐interventional cross‐sectional study was conducted as an anonymous online survey from 12/2018 to 01/2019 in Germany. Participants with a self‐reported physician‐confirmed diagnosis of psoriasis and symptoms answered questions about their disease, its influence on daily life and their medical care.

Results

649 participants with a mean age of 42.5 ± 13.7 years and equal gender distribution (male: 50.2 %) were evaluated. 54.1 % received medical treatment at the time of the study, 45.9 % did not. Among the participants with medical care, 59.3 % were only moderately or less satisfied with their treatment. Reasons for dissatisfaction with the medication included lack of efficacy and side effects. Participants without medical treatment specified a physician’s lack of time as a main reason for not seeking medical help.

Conclusions

Despite the availability of efficient therapeutic options in Germany, many individuals with psoriasis are not satisfied. This under‐treated group was identified as a new target population.
Multi‐taxa colonisation along the foreland of a vanishing equatorial glacier
Authors: Rosero Pedro , Crespo‐Pérez Verónica , Espinosa Rodrigo , Andino Patricio , Barragán Álvaro , Moret Pierre , Gobbi Mauro , Ficetola Gentile Francesco , Jaramillo Ricardo , Muriel Priscilla , Anthelme Fabien , Jacobsen Dean , Dangles Olivier , Condom Thomas , Gielly Ludovic , Poulenard Jérôme , Rabatel Antoine , Basantes Rubén , Cáceres Correa Bolívar , Cauvy‐Fraunié Sophie
Published: May 2021

Retreating glaciers, icons of climate change, release new potential habitats for both aquatic and terrestrial organisms. High‐elevation species are threatened by temperature increases and the upward migration of lowlands species. Improving our understanding of successional processes after glacier retreat becomes urgent, especially in the tropics, where glacier shrinkage is particularly fast. We examined the successional patterns of aquatic invertebrates, ground beetles, terrestrial plants, soil eukaryotes (algae, invertebrates, plants) in an equatorial glacier foreland (Carihuairazo, Ecuador). Based on both taxonomical identification and eDNA metabarcoding, we analysed the effects of both environmental conditions and age of deglacierization on community composition. Except for algae, diversity increased with time since deglacierization, especially among passive dispersers, suggesting that dispersal was a key driver structuring the glacier foreland succession. Spatial β‐diversity was mainly attributed to nestedness for aquatic invertebrates, terrestrial plants and soil algae, likely linked to low environmental variability within the studied glacier foreland; and to turnover for soil invertebrates, suggesting competition exclusion at the oldest successional stage. Pioneer communities were dominated by species exhibiting flexible feeding strategies and high dispersal ability (mainly transported by wind), probably colonising from lower altitudes, or from the glacier in the case of algae. Overall, glacier foreland colonisation in the tropics exhibit common characteristics to higher latitudes. High‐elevation species are nevertheless threatened, as the imminent extinction of many tropical glaciers will affect species associated to glacier‐influenced habitats but also prevent cold‐adapted and hygrophilous species from using these habitats as refuges in a warming world.
A combination of phenobarbital and the bumetanide derivative bumepamine prevents neonatal seizures and subsequent hippocampal neurodegeneration in a rat model of birth asphyxia
Authors: Johne Marie , Käufer Christopher , Römermann Kerstin , Gailus Björn , Gericke Birthe , Löscher Wolfgang
Published: May 2021

Objectives

Bumetanide was suggested as an adjunct to phenobarbital for suppression of neonatal seizures. This suggestion was based on the idea that bumetanide, by reducing intraneuronal chloride accumulation through inhibition of the Na‐K‐2Cl cotransporter NKCC1, may attenuate or abolish depolarizing γ‐aminobutyric acid (GABA) responses caused by birth asphyxia. However, a first proof‐of‐concept clinical trial failed. This could have had several reasons, including bumetanide's poor brain penetration, the wide cellular NKCC1 expression pattern in the brain, and problems with the general concept of NKCC1’s role in neonatal seizures. We recently replicated the clinical failure of bumetanide to potentiate phenobarbital's effect in a novel rat model of birth asphyxia. In this study, a clinically relevant dose (0.3 mg/kg) of bumetanide was used that does not lead to NKCC1‐inhibitory brain levels. The aim of the present experiments was to examine whether a much higher dose (10 mg/kg) of bumetanide is capable of potentiating phenobarbital in this rat model. Furthermore, the effects of the two lipophilic bumetanide derivatives, the ester prodrug N,N‐dimethylaminoethylester of bumetanide (DIMAEB) and the benzylamine derivative bumepamine, were examined at equimolar doses.

Methods

Intermittent asphyxia was induced for 30 min by exposing male and female P11 rat pups to three 7 + 3 min cycles of 9% and 5% O2 at constant 20% CO2. All control pups exhibited neonatal seizures after the asphyxia.

Results

Even at 10 mg/kg, bumetanide did not potentiate the effect of a submaximal dose (15 mg/kg) of phenobarbital on seizure incidence, whereas a significant suppression of neonatal seizures was determined for combinations of phenobarbital with DIMAEB or, more effectively, bumepamine, which, however, does not inhibit NKCC1. Of interest, the bumepamine/phenobarbital combination prevented the neurodegenerative consequences of asphyxia and seizures in the hippocampus.

Significance

Both bumepamine and DIMAEB are promising tools that may help to develop more effective lead compounds for clinical trials.
Conservation risks and portfolio effects in mixed‐stock fisheries
Authors: Moore Jonathan W. , Connors Brendan M. , Hodgson Emma E.
Published: May 2021

Fish biodiversity sustains the resilience and productivity of fisheries, yet this biodiversity can be threatened by overharvest and depletion in mixed‐stock fisheries. Thus, the biodiversity that provides benefits may also make sustainable resource extraction more difficult, a key challenge in fisheries management. We simulated a mixed‐stock fishery to explore relationships between different dimensions of biodiversity and fishery performance relative to conservation and fishery objectives. Different dimensions of biodiversity (number of stocks, evenness, asynchrony among stocks, heterogeneity in stock productivity) exacerbated trade‐offs between fishery and conservation objectives. For example, fisheries targeting stock‐complexes with greater asynchrony, and to a lesser extent richness, had greater stability in harvest through time but also greater risks of overfishing weak stocks and reduced yield compared to less biodiverse stock‐complexes. These trade‐offs were ameliorated by increasing management control—the capacity of fishery managers to harvest specific stocks. To explore these trade‐offs in real‐world fisheries, we contrasted the fishing and population status of individual stocks within three major mixed‐stock sockeye salmon (Oncorhynchus nerka, Salmonidae) fisheries—Bristol Bay, Fraser River, and Skeena River. In general, the fisheries with lower management control had individual stocks that were more often being over‐ or under‐fished, compared with those with higher management control, though variation among regions in biodiversity, scale of management, and magnitude of habitat alteration likely also contribute to these relationships. Collectively, our findings emphasize that there is a need to extract less or regulate better in order to conserve and benefit from biodiversity in fisheries and other natural resource management systems.
Comparative analysis of the pivotal studies of extended half‐life recombinant FVIII products for treatment of haemophilia A
Authors: Mannucci Pier Mannuccio , Cortesi Paolo Angelo , Di Minno Matteo Nicola Dario , Sanò Mario , Mantovani Lorenzo Giovanni , Di Minno Giovanni
Published: May 2021

The need to reduce the burden of injections, and improve adherence and clinical outcomes in haemophilia A led to the development of recombinant FVIII products endowed with an extended plasma half‐life (EHL‐rFVIII) in comparison with standard half‐life products (SHL‐rFVIII). Lack of head‐to‐head studies makes difficult to grasp the relative value of each treatment option. We conducted a combined evaluation of the individual pivotal trials in order to assess between‐product differences regarding the reported efficacy results and FVIII consumption. We evaluated 4 EHL‐rFVIII products available to treat patients with haemophilia A without inhibitors and also a SHL‐rFVIII as a comparator. In the frame of these clinical studies, all the EHL‐rFVIII products showed a decrease in the injection burden coupled with good clinical efficacy, even though there were between‐product differences in terms of reduction in injection frequencies. Further, between‐product differences in terms of weekly/yearly consumption of rFVIII expressed in IU/Kg were identified, suggesting a different economic impact for the different EHL‐rFVIII products in the context of comparable clinical efficacy. The present findings based upon the review of pivotal studies done in the frame of a highly selected clinical scenario should be integrated with real‐life data.
Dynamic space use of Andalusian rice fields by Lesser Black‐backed Gulls (Larus fuscus) is driven by flooding pattern
Authors: van Rees Charles B. , Aragonés David , Bouten Willem , Thaxter Chris B. , Stienen Eric W. M. , Bustamante Javier , Green Andy J.
Published: May 2021

Research on the space use and behaviour of waterbirds yields important insights on human–wildlife interactions of ecological and societal importance under global change. The extent to which dynamic (within‐season) changes in anthropogenic landscapes affect these interactions is poorly understood. Lesser Black‐backed GullsLarus fuscusare prominent bio‐vectors of biological, synthetic and inorganic materials and have exhibited large increases in abundance in parts of southern Europe in recent decades. We combined GPS tracking, earth observation, accelerometry and field observations to study the space use of overwintering gulls in a mixed rice field landscape in Andalusia, southern Spain. We used Manly selectivity metrics, a common quantitative measurement of habitat selection, and classified remote sensing imagery directly to evaluate space use and habitat selection for these gulls and how it changed throughout the rice harvest cycle. Analysis of over 45 000 GPS fixes and 14 classified remotely sensed images from winter 2016/17 showed dynamic space use driven by the harvest‐related flooding across the rice harvest cycle. Prior to harvest, gulls foraged in rice paddies during the day and roosted in adjacent waterbodies (the River Guadalquivir and fish ponds) at night. During harvest, they spent nearly 100% of their daily cycle within the rice fields, foraging in harvested paddies and roosting in post‐harvest, flooded paddies. After harvest, they roosted in flooded paddies at night and foraged at landfills in the surrounding landscape. Gull space use at landscape and paddy scales was closely linked to dynamic land and water management over the rice agricultural cycle, illustrating how human activities influence the movements of ecologically important, human‐associated bio‐vectors such as gulls. The frequent early‐spring movement patterns of gulls between landfills and agricultural fields makes them an important bio‐transport link for potentially toxic materials and pathogens between waste sites and places where food is grown for human consumption.
Enzalutamide with androgen deprivation therapy in Japanese men with metastatic hormone‐sensitive prostate cancer: A subgroup analysis of the phase III ARCHES study
Authors: Iguchi Taro , Kimura Go , Fukasawa Satoshi , Suzuki Hiroyoshi , Uemura Hiroji , Nishimura Kazuo , Matsumoto Hiroaki , Yokomizo Akira , Armstrong Andrew J , Rosbrook Brad , Sugg Jennifer , Baron Benoit , Chen Lucy , Kunieda Futoshi , Stenzl Arnulf
Published: May 2021

Objective

To evaluate the efficacy and safety of enzalutamide plus androgen deprivation therapy in Japanese men with metastatic hormone‐sensitive prostate cancer.

Methods

A post‐hoc analysis of the Japanese subgroup in the phase III, randomized, multinational ARCHES study (NCT02677896) was carried out. Patients with metastatic hormone‐sensitive prostate cancer were randomized to receive enzalutamide or a placebo, plus androgen deprivation therapy, stratified by disease volume and prior docetaxel therapy. The primary end‐point was radiographic progression‐free survival. Secondary end‐points included time to prostate‐specific antigen progression and overall survival.

Results

Of 1150 patients, 92 Japanese patients were randomized to enzalutamide (n = 36) or a placebo (n = 56), plus androgen deprivation therapy; none received prior docetaxel. Enzalutamide plus androgen deprivation therapy reduced the risk of radiographic progression or death in Japanese patients by 61% versus the placebo, similar to the overall population. Similar results were observed with secondary end‐points, showing clinical benefit of enzalutamide plus androgen deprivation therapy in Japanese patients. Overall survival data were immature. Grade 3–4 adverse events were reported in 47% and 25% of the enzalutamide and placebo groups, respectively. Nasopharyngitis, hypertension and abnormal hepatic function were reported more frequently in Japanese patients versus the overall population.

Conclusions

Enzalutamide plus androgen deprivation therapy has clinical benefit with a tolerable safety profile in Japanese men with metastatic hormone‐sensitive prostate cancer, consistent with the overall population.
A century of BCG: Impact on tuberculosis control and beyond
Authors: Ahmed Asma , Rakshit Srabanti , Adiga Vasista , Dias Mary , Dwarkanath Pratibha , D’Souza George , Vyakarnam Annapurna
Published: May 2021

BCG turns 100 this year and while it might not be the perfect vaccine, it has certainly contributed significantly towards eradication and prevention of spread of tuberculosis (TB). The search for newer and better vaccines for TB is an ongoing endeavor and latest results from trials of candidate TB vaccines such as M72AS01 look promising. However, recent encouraging data from BCG revaccination trials in adults combined with studies on mucosal and intravenous routes of BCG vaccination in non‐human primate models have renewed interest in BCG for TB prevention. In addition, several well‐demonstrated non‐specific effects of BCG, for example, prevention of viral and respiratory infections, give BCG an added advantage. Also, BCG vaccination is currently being widely tested in human clinical trials to determine whether it protects against SARS‐CoV‐2 infection and/or death with detailed analyses and outcomes from several ongoing trials across the world awaited. Through this review, we attempt to bring together information on various aspects of the BCG‐induced immune response, its efficacy in TB control, comparison with other candidate TB vaccines and strategies to improve its efficiency including revaccination and alternate routes of administration. Finally, we discuss the future relevance of BCG use especially in light of its several heterologous benefits.
Social innovations and the fight against poverty: An analysis of India's first prosocial P2P lending platform
Authors: Ravishankar M. N.
Published: May 2021

Prosocial P2P lending platforms are a novel and powerful example of a digital social innovation (DSI) in which the operating model relies primarily on digital technologies and the overarching focus is on the “social” aspect of the innovation. These platforms establish a virtual connection between low‐income individuals and lenders, helping the former access loans at low rates of interest. In realising their mission of fighting poverty, prosocial P2P lending platforms maintain a challenging hybrid – online and offline – focus. This paper explores how prosocial P2P lending platforms enact their hybrid orientation. It draws on an inductive qualitative study of Rang De, India's first prosocial P2P lending platform. The analysis highlights five clusters of actions: digital attention‐building, digital credibility‐building, digital empathy‐building, intermediary relationship‐building, and borrower relationship‐building. The paper argues that significant strengths on the online side help establish a sustainable business model. A willingness and commitment to maintain a high degree of engagement with the complex offline world of low‐income borrowers helps develop the model as an impactful social innovation.
Sexual maturity varies with melanic plumage traits in the barn owl
Authors: Béziers Paul , Roulin Alexandre
Published: May 2021

The age at first reproduction can significantly impact fitness. We investigated the possible source of variation in the age at first reproduction (‘sexual maturity') and its consequences for lifetime reproductive success in a wild population of barn owls. This raptor is sexually dimorphic for two melanin‐based plumage traits shown to covary with sex‐specific behaviour and physiology. We observed that females were sexually mature earlier than males, an effect that depended on the colour of their plumage and birth date. Among females born early in the season, dark melanic (i.e. more pheomelanic with large and many black feather spots) yearlings were sexually mature earlier than light melanic females. The relationship was in the opposite direction in those born late in the season. In yearling males, the opposite result, albeit less pronounced, was discovered, i.e. lightly melanic males born early in the season were sexually mature earlier than dark melanic males, an effect that was in the opposite direction in males that were born late in the season. Individuals that matured faster produced a larger number of fledglings per year than individuals that matured slower, an effect that was found only in dark melanic females and in light melanic males. Dark melanic females also achieved a higher lifetime reproductive success (LRS) than light melanic conspecifics. Our results suggest that a light melanic plumage is beneficial in males and a dark melanic plumage in females suggesting sexually antagonist selection.
A deep learning technique based flood propagation experiment
Authors: Hou Jingming , Li Xuan , Bai Ganggang , Wang Xinhong , Zhang Zongxiao , Yang Lu , Du Ying'en , Ma Yongyong , Fu Deyu , Zhang Xianguo
Published: May 2021

This work presents an experiment involving detailed fluvial flood propagation process. Comparing to the existing flood experiments which collect hydrodynamical data just at gauges, flood evolution process in river channel and flood plain is measured and temporal–spatial data are provided. In the experiment, three inflow patterns are considered to reflect the different severity of the floods. The flood propagation and inundation are captured by using an array of surveillance cameras. The images are pre‐processed by applying camera calibration method to correct the barrel distortion. A deep learning technique is introduced to automatically identify inundated area. The inundation process is therefore obtained by identifying image series. In addition to the spatial data, the water level evolutions at three gauges are also monitored to supply detailed hydrodynamic information at gauges. The repeatability of the experiments and reliability of the deep learning technique are verified. The experimental data including spatial and point hydrodynamic features for flood events can be used to systematically validate numerical model and calibrate parameters.
The BNT162b2 vaccine is associated with lower new COVID‐19 cases in nursing home residents and staff
Authors: Domi Marsida , Leitson Michael , Gifford David , Nicolaou Anna , Sreenivas Kiran , Bishnoi Courtney
Published: May 2021

Background/Objectives

The effectiveness of the BNT162b2 vaccine on preventing the spread of COVID‐19 and deaths in nursing homes (NH) is unknown.

Design

We used zero‐inflated negative binomial mixed effects regressions to model the associations of time since the vaccine clinic ending the week of December 27, 2020 (cohort 1), January 3, 2021 (cohort 2), or January 10, 2021 (cohort 3) controlling for county rate of COVID‐19, bed size, urban location, racial and ethnic census, and level of registered nurses with resident cases and deaths of COVID‐19 and staff cases of COVID‐19.

Setting and Participants

All 2501 NHs who held a vaccine clinic from the first 17 states to initiate clinics as part of the Pharmacy Partnership for Long‐Term Care Program.

Main Outcome(s) and Measure(s)

Adjusted Incidence Rate Ratio (IRR) for time in 3, 4, 5, and 6 weeks after the first vaccine clinic for resident cases and deaths of COVID‐19 and staff cases of COVID‐19.

Results

Resident and staff cases trended downward in all three cohorts following the vaccine clinics. Time following the first clinic at 5 and 6 weeks was consistently associated with fewer resident cases (IRR: 0.68 [95% CI: 0.54–0.84], IRR: 0.64 [95% CI: 0.48–0.86], respectively); resident deaths (IRR: 0.59 [95% CI: 0.45–0.77], IRR: 0.45 [95% CI: 0.31–0.65], respectively); and staff cases (IRR: 0.64 [95% CI: 0.56–0.73], IRR: 0.51 [95% CI: 0.42–0.62], respectively). Other factors associated with fewer resident and staff cases included facilities with less than 50 certified beds and high nurse staffing per resident day (>0.987). Contrary to prior research, higher Hispanic non‐white resident census was associated with fewer resident cases (IRR: 0.42, 95% CI: 0.31–0.56) and deaths (IRR: 0.18, 95% CI: 0.12–0.27).

Conclusions

The BNT162b2 vaccine is associated with decreased spread of SARS‐CoV‐2 in both residents and staff as well as decreased deaths among residents.
Emergency department visits for emergent conditions among older adults during the COVID‐19 pandemic
Authors: Janke Alexander T. , Jain Snigdha , Hwang Ula , Rosenberg Mark , Biese Kevin , Schneider Sandra , Goyal Pawan , Venkatesh Arjun K.
Published: May 2021

Background/objective

Emergency department (ED) visits have declined while excess mortality, not attributable to COVID‐19, has grown. It is not known whether older adults are accessing emergency care differently from their younger counterparts. Our objective was to determine patterns of ED visit counts for emergent conditions during the COVID‐19 pandemic for older adults.

Design

Retrospective, observational study.

Setting

Observational analysis of ED sites enrolled in a national clinical quality registry.

Participants

One hundred and sixty‐four ED sites in 33 states from January 1, 2019 to November 15, 2020.

Main outcome and measures

We measured daily ED visit counts for acute myocardial infarction (AMI), stroke, sepsis, fall, and hip fracture, as well as deaths in the ED, by age categories. We estimated Poisson regression models comparing early and post‐early pandemic periods (defined by the Centers for Disease Control and Prevention) to the pre‐pandemic period. We report incident rate ratios to summarize changes in visit incidence.

Results

For AMI, stroke, and sepsis, the older (75–84) and oldest old (85+ years) had the greatest decline in visit counts initially and the smallest recovery in the post‐early pandemic periods. For falls, visits declined early and partially recovered uniformly across age categories. In contrast, hip fractures exhibited less change in visit rates across time periods. Deaths in the ED increased during the early pandemic period, but then fell and were persistently lower than baseline, especially for the older (75–84) and oldest old (85+ years).

Conclusions

The decline in ED visits for emergent conditions among older adults has been more pronounced and persistent than for younger patients, with fewer deaths in the ED. This is concerning given the greater prevalence and risk of poor outcomes for emergent conditions in this age group that are amenable to time‐sensitive ED diagnosis and treatment, and may in part explain excess mortality during the COVID‐19 era among older adults.
A scoping review of rebel nurse leadership: Descriptions, competences and stimulating/hindering factors
Authors: de Kok Eline , Weggelaar‐Jansen Anne Marie , Schoonhoven Lisette , Lalleman Pieterbas
Published: May 2021

Aims

To (1) give an overview of rebel nurse leadership by summarising descriptions of positive deviance, tempered radicals and healthcare rebels; (2) examine the competences of nurse rebel leadership; and (3) describe factors that stimulate or hinder the development of rebel nurse leadership.

Background

Research shows nurses have lower intention to leave their jobs when they can control their work practices, show leadership and provide the best care. However, organisational rules and regulations do not always fit the provision of good care, which challenges nurses to show leadership and deviate from the rules and regulations to benefit the patient. Three concepts describe this practice: positive deviance, healthcare rebels and tempered radicals.

Design

Scoping review using the Joanna Briggs Institute methodology and PRISMA‐ScR checklist.

Methods

Papers describing positive deviance, healthcare rebels and tempered radicals in nursing were identified by searching Scopus, CINAHL, PubMed and PsycINFO. After data extraction, these three concepts were analysed to study the content of descriptions and definitions, competences and stimulating and hindering factors.

Results

Of 2705 identified papers, 25 were included. The concept descriptions yielded three aspects: (1) positive deviance approach, (2) unconventional and non‐confirmative behaviour and (3) relevance of networks and relationships. The competences were the ability to: (1) collaborate in/outside the organisation, (2) gain and share expert (evidence‐based) knowledge, (3) critically reflect on working habits/problems in daily care and dare to challenge the status quo and (4) generate ideas to improve care. The factors that stimulate or hinder the development of rebel nurse leadership are as follows: (1) dialogue and reflection, (2) networking conditions and (3) the managers’ role.

Conclusions

Based on our analysis, we summarise the descriptions given of rebel nurse leadership, the mentioned competences and provide an overview of the factors that stimulate or hinder rebel nurse leadership.

Relevance to clinical practice

The descriptions produced in this review of rebel nurse leadership and the stimulating or hindering factors listed should help nurses and managers encourage rebel leadership.
Rural‐urban differences in informal caregiving and health‐related quality of life
Authors: Cohen Steven A. , Ahmed Neelam , Brown Monique J. , Meucci Marissa R. , Greaney Mary L.
Published: May 2021

Objectives

Rural‐urban health disparities are pervasive among older adults. Rural US locations have a disproportionately high population of older adults, have reduced access to services, and are therefore more reliant on family and friends for care. However, little is known about rural‐urban disparities among the 40+ million informal caregivers nationwide. There is a critical need to understand how rural‐urban disparities impact caregiving experiences and health‐related quality of life (HRQoL). The objectives of this study were to assess rural‐urban differences in informal caregiving status, caregiving intensity (caregiving hours/week and types of care provided), and caregiver HRQoL.

Methods

Data were abstracted from the 2018 Behavioral Risk Factor Surveillance System. The primary measure of rural‐urban status was “metropolitan status.” Associations between rural‐urban status and caregiving and rural‐urban differences in caregiving intensity and HRQoL were examined using generalized linear models, controlling for confounding and accounting for complex sampling.

Results

Rural respondents were more likely to be caregivers than urban respondents (OR = 1.17, 95% CI: 1.02‐1.34). After adjustment for confounders, rural caregivers were more likely than urban caregivers to provide 20 or more hours of caregiving per week (OR 1.38, 95% CI: 1.07‐1.77), although the findings for health and HRQoL were somewhat mixed.

Conclusion

Results indicate that rural older adults offer more care than urban counterparts, which may have implications for caregiver health, well‐being, and quality of life. These results can inform policies designed to improve caregiver health, and facilitate the translation and adaptation of existing policies, programs, and interventions to address rural caregivers’ needs.
Comparable response of wild rodent gut microbiome to anthropogenic habitat contamination
Authors: Lavrinienko Anton , Hämäläinen Anni , Hindström Rasmus , Tukalenko Eugene , Boratyński Zbyszek , Kivisaari Kati , Mousseau Timothy A. , Watts Phillip C. , Mappes Tapio
Published: May 2021

Species identity is thought to dominate over environment in shaping wild rodent gut microbiota, but it remains unknown whether the responses of host gut microbiota to shared anthropogenic habitat impacts are species‐specific or if the general gut microbiota response is similar across host species. Here, we compare the influence of exposure to radionuclide contamination on the gut microbiota of four wild mouse species: Apodemus flavicollis, A. sylvaticus, A. speciosus and A. argenteus. Building on the evidence that radiation impacts bank vole (Myodes glareolus) gut microbiota, we hypothesized that radiation exposure has a general impact on rodent gut microbiota. Because we sampled (n = 288) two species pairs of Apodemus mice that occur in sympatry in habitats affected by the Chernobyl and Fukushima nuclear accidents, these comparisons provide an opportunity for a general assessment of the effects of exposure to environmental contamination (radionuclides) on gut microbiota across host phylogeny and geographical areas. In general agreement with our hypothesis, analyses of bacterial 16S rRNA gene sequences revealed that radiation exposure alters the gut microbiota composition and structure in three of the four species of Apodemus mice. The notable lack of an association between the gut microbiota and soil radionuclide contamination in one mouse species from Fukushima (A. argenteus) probably reflects host “radiation escape” through its unique tree‐dwelling lifestyle. The finding that host ecology can modulate effects of radiation exposure offers an interesting counterpoint for future analyses into effects of radiation or any other toxic exposure on host and its associated microbiota. Our data show that exposure to radionuclide contamination is linked to comparable gut microbiota responses across multiple species of rodents.