bluuebunny/crossref_metadata_2025 huggingface dataset:
Elderly and middle-aged intention to use m-health services: an empirical evidence from a developing country
Authors: Moudud-Ul-Huq Syed , Sultana Swarna Rebeka , Sultana Mahmuda
Published: May 2021

Purpose

m-health services for different age groups are becoming an emerging field in the health-care industry, especially in low-resource environments such as developing countries such as Bangladesh. Hence, this study’s primary aim is to identify the factors that influence the middle-aged and elderly’s intention to use m-health services.

Design/methodology/approach

This study applied the extended version of the unified theory of acceptance and use of technology to explore middle-aged and elderly’s intention to use m-health services. There were 235 respondents, of which 123 (52.34%) were in the middle-aged group, whereas 112 (47.66%) were in the older group. Both groups were found to have more male participants than female participants. The partial least square (PLS) method was used to analyze data.

Findings

The study found that performance expectancy, effort expectancy, facilitating condition, technological anxiety and resistance to change (p < 0.05) had a significant influence on middle-aged intention to use m-health services. Social influence and perceived physical condition (p > 0.05) had no significant effect on middle-aged intention to use m-health services. On the other hand, performance expectancy, effort expectancy, facilitating condition and resistance to change (p <* 0.05) significantly influenced the elderly’s intention to use m-health services. However, the social impact of perceived physical condition and technological anxiety (p > 0.05) had no significant effect on the elderly’s intention to use m-health services.

Originality/value

A good number of studies are available in the current literature, examining the factors adoption of m-health services in both developed and developing economy context. However, very few studies examine the factors that influence behavioral intention to use m-health services concerning the two different age groups, such as middle-aged and elderly. Moreover, to the best of the authors’ knowledge, there is a shortage of literature on this topic built on the comparative analysis between the two age groups.
The role of transformative healthcare technology on quality of life during the COVID-19 pandemic
Authors: Salam Mohammad Asif , Bajaba Saleh
Published: May 2021

Purpose

The purpose of this study is to investigate the role of the COVID-19 health-care system quality (HSQ) and its impact on the individual (satisfaction) and social (quality of life [QOL]) outcomes in the context of a transformative health-care delivery system using service-dominant logic (SDL).

Design/methodology/approach

A sample consisting of 1,008 individuals who have experienced the COVID-19 health-care system was drawn from four different regions of Saudi Arabia using the simple random sampling technique. The survey was conducted using an online survey and 1,008 respondents answered, based on their experience and knowledge of the COVID-19 health-care system. Partial least squares structural equation modeling was applied to test the proposed research model.

Findings

The study findings suggest that service system satisfaction (SAT) significantly mediates the role of the HSQ in delivering and enhancing the QOL. HSQ also has a significant role to play on the SAT as well as the QOL. These findings contribute to the body of knowledge on SDL in the context of HSQ in understanding the significant role of technologies can play in enhancing service satisfaction and better QOL during a crisis such as COVID-19. This study also improves the understanding of the importance of customer-centricity, real-time visibility through tracking and tracing of service flow, agile decision-making, fewer but better-defined service objectives, and finally shaping mindsets and behaviors of all the relevant parties involved in the HSQ service delivery process.

Research limitations/implications

One of the major limitations of this study is that, although COVID-19 is an ongoing global pandemic, cross-sectional data were collected in only one country. The findings may not be generalizable across subsequent waves of the pandemic. The best practices of HSQ could be studied around the globe and the results used to support continuous improvement.

Originality/value

This study advances the understanding of the SDL in the context of a transformative health-care system for a transitional economy by focusing on individual and social well-being during an unexpected crisis such as the COVID-19 pandemic. This study also contributes toward the understanding of the roles of enabling technologies to improve the service delivery system which results in an improved SAT, as well as better QOL for the society at large. Based on SDL this research validates the HSQ model, relevant measures and its overall impact on SAT and QOL in the context of a transformative health-care service system in Saudi Arabia.
Does e-government control corruption? Evidence from South Asian countries
Authors: Ali Muhammad , Raza Syed Ali , Puah Chin Hong , Arsalan Tazeen
Published: May 2021

Purpose

This study aims to examine the relationship between e-government and corruption in selected South Asian countries (Pakistan, India, Bangladesh and Sri Lanka).

Design/methodology/approach

The sample data were gathered from reliable secondary sources over a sample period of 2003–2018. Additionally, this study incorporated other potential determinants or corruption, such as government effectiveness, press freedom, education and economy. To assess sample data, this study used panel data econometric procedures.

Findings

Results indicated that e-government had a positive and significant impact on corruption. Similarly, government effectiveness and education had a positive and significant influence on corruption. However, press freedom and the economy showed a negative and insignificant impact on corruption. This study further found the robustness of the results through sensitivity analysis. Overall, it was concluded that e-government plays a significant role to reduce corruption.

Originality/value

The governments should implement the e-governance system and provide a transparent and accountable environment to eliminate corruption.
Pandemic and the performing arts in New Zealand
Authors: Ramachandra Suresh
Published: May 2021

Purpose

This paper aims to document the narratives that emerged in favour of and against the austerity measures proposed by the Auckland Council, with specific reference to performing arts organisations (PAOs) in the aftermath of the pandemic 2020.

Design/methodology/approach

Written submissions from stakeholders received in response to austerity measures were analysed to identify the arguments presented to support/oppose funding cuts to PAOs. These narratives were thematically grouped into accounting, political, artistic and social categories to deliberate on the tensions that exist between these when funding PAOs.

Findings

This study identifies the arguments presented by grass-root PAOs on the rationale of their existence from a Pacific perspective. The analysis suggests that accounting, hitherto considered as a “sword” can also be used as a “shield” if PAOs direct their research accordingly and offers future research directions.

Originality/value

Prior studies concerning funding difficulties of PAOs have relied on opinions obtained ex-post from selected stakeholders. There are no known studies, which factor the opinions of grass-root PAOs, captured “during” funding deliberations. This study bridges this gap in the New Zealand setting by providing an analysis of grass-root opinions from the Pacific perspective, conducted during a funding deliberation.
Postal or electronic voting? The analysis of the preferred voting methods in the context of failed electoral reform in Poland
Authors: Musiał-Karg Magdalena , Kapsa Izabela
Published: May 2021

Purpose

This paper aims to discuss reasons for the failure of the 2020 postal-vote election reform in Poland and examine opinions of Poles on voting methods. The main goal is to answer the following research question: Which of the alternative voting methods – postal or electronic – would Poles prefer?

Design/methodology/approach

The approach is quantitative and based on the statistical analysis of voters’ attitudes toward alternative voting methods, in particular postal voting.

Findings

The main finding is that out of all voting methods available, most Poles favor electronic voting as a potential alternative to voting in person. On a general level, the conclusions from the Polish case highlight the need to establish special requirements and standards for democratic elections during emergency situations. The unsuccessful implementation of all-postal voting in Poland is an example of how changes to the law should not be made, especially when public health and democratic standards are at stake.

Practical implications

The paper presents practical implications and recommendations for state authorities and electoral administration while implementing electoral reforms, extending the list of available voting channels, and running elections – especially in extraordinary situations.

Originality/value

This paper adds to the knowledge on alternative voting channels, including their implementation during a pandemic. The Polish case is also relevant for other countries as regards safe and democratic elections during emergency situations. Policymakers are expected to benefit from the insight, as the results originate in public opinion polls and identify voting channels favored by citizens
Disturbance by invasive pathogenic fungus alters arthropod predator–prey food‐webs in ash plantations
Authors: Michalko Radek , Košulič Ondřej , Martinek Petr , Birkhofer Klaus
Published: May 2021

According to the disturbance‐succession theory, natural disturbances support biodiversity and are expected to increase the complexity of food‐webs in forest ecosystems by opening canopies and creating a heterogeneous environment. However, a limited number of studies have investigated the impact of disturbance by invasive pathogenic species and succession on arthropod predator–prey food‐webs in forest ecosystems.

Hymenoscyphus fraxineus is a pathogenic fungus of ash trees that is invasive in Europe and causes massive dieback, mainly of the common ash Fraxinus excelsior across its native range. Here we investigated how this pathogenic fungus affects food‐webs of web‐building spiders and their prey in understorey vegetation of ash plantations.

In 23 young and middle‐aged ash plantations that were distributed along a gradient of infestation by H. fraxineus (29%–86% infestation), we measured the vegetation structure (canopy openness, shrub coverage, herb/grass coverage), the trait composition of local spider communities (web type, body size), the prey availability and the prey intercepted by spider webs. We then evaluated the multivariate prey composition (prey type, body size) and network properties.

Hymenoscyphus fraxineus opened the ash tree canopy, which resulted in denser shrub coverage. The dense shrub vegetation changed the composition of web types in local spider communities and increasing fungus infestation resulted in reduced mean body size of spiders. Infestation by H. fraxineus reduced the availability of predaceous Coleoptera and increased the availability of herbivorous Coleoptera as potential prey. The mean body size of captured prey and the per capita capture rates of most prey groups decreased with increasing fungus infestation. Hymenoscyphus fraxineus infestation indirectly reduced the complexity in bipartite networks and the trophic functional complementarity in local web‐building spider communities. The plantation age affected the vegetation structure but did not affect the studied food‐webs.

Forest disturbance by the invasive pathogen affected four trophic levels (plant–herbivore–coleopteran intermediate predator–top predator web‐building spiders) and, contrary to the disturbance‐succession theory, disturbance by the fungus simplified the web‐building spider‐prey food‐webs. The results support the view that H. fraxineus represents a threat to the biodiversity and ecosystem functioning in the simplified ecosystems of ash plantations.
Reciprocal transplant gardens as gold standard to detect local adaptation in grassland species: New opportunities moving into the 21st century
Authors: Johnson Loretta C. , Galliart Matthew B. , Alsdurf Jacob D. , Maricle Brian R. , Baer Sara G. , Bello Nora M. , Gibson David J. , Smith Adam B.
Published: May 2021

Local adaptation is a fundamental phenomenon in evolutionary biology, with relevance to formation of ecotypes, and ultimately new species, and application to restoration and species’ response to climate change. Reciprocal transplant gardens, a common garden in which ecotypes are planted among home and away habitats, are the gold standard to detect local adaptation in populations.

This review focuses on reciprocal transplant gardens to detect local adaptation, especially in grassland species beginning with early seminal studies of grass ecotypes. Fast forward more than half a century, reciprocal gardens have moved into the genomic era, in which the genetic underpinnings of ecotypic variation can now be uncovered. Opportunities to combine genomic and reciprocal garden approaches offer great potential to shed light on genetic and environmental control of phenotypic variation. Our decadal study of adaptation in a dominant grass across the precipitation gradient of the US Great Plains combined genomic approaches and realistic community settings to shed light on controls over phenotype.

Common gardens are not without limitations and challenges. A survey of recent studies indicated the modal study uses a tree species, three source sites and one growing site, focuses on one species growing in a monoculture, lasts 3 years, and does not use other experimental manipulations and rarely employs population genetic tools. Reciprocal transplant gardens are even more uncommon, accounting for only 39% of the studies in the literature survey with the rest occurring at a single common site. Reciprocal transplant gardens offer powerful windows into local adaptation when (a) placed across wide environmental gradients to encompass the species’ range; (b) conducted across timespans adequate for detecting responses; (c) employing selection studies among competing ecotypes in community settings and (d) combined with measurements of form and function which ultimately determine success in home and away environments.

Synthesis. Reciprocal transplant gardens have been one of the foundations in evolutionary biology for the study of adaptation for the last century, and even longer in Europe. Moving forward, reciprocal gardens of foundational non‐model species, combined with genomic analyses and incorporation of biotic factors, have the potential to further revolutionize evolutionary biology. These field experiments will help to predict and model response to climate change and inform restoration practices.
Using identity calls to detect structure in acoustic datasets
Authors: Hersh Taylor A. , Gero Shane , Rendell Luke , Whitehead Hal
Published: May 2021

Acoustic analyses can be powerful tools for illuminating structure within and between populations, especially for cryptic or difficult to access taxa. Acoustic repertoires are often compared using aggregate similarity measures across all calls of a particular type, but specific group identity calls may more clearly delineate structure in some taxa.

We present a new method—the identity call method—that estimates the number of acoustically distinct subdivisions in a set of repertoires and identifies call types that characterize those subdivisions. The method uses contaminated mixture models to identify call types, assigning each call a probability of belonging to each type. Repertoires are hierarchically clustered based on similarities in call type usage, producing a dendrogram with ‘identity clades’ of repertoires and the ‘identity calls’ that best characterize each clade. We validated this approach using acoustic data from sperm whales, grey‐breasted wood‐wrens and Australian field crickets, and ran a suite of tests to assess parameter sensitivity.

For all taxa, the method detected diagnostic signals (identity calls) and structure (identity clades; sperm whale subpopulations, wren subspecies and cricket species) that were consistent with past research. Some datasets were more sensitive to parameter variation than others, which may reflect real uncertainty or biological variability in the taxa examined. We recommend that users perform comparative analyses of different parameter combinations to determine which portions of the dendrogram warrant careful versus confident interpretation.

The presence of group‐characteristic identity calls does not necessarily mean animals perceive them as such. Fine‐scale experiments like playbacks are a key next step to understand call perception and function. This method can help inform such studies by identifying calls that may be salient to animals and are good candidates for investigation or playback stimuli. For cryptic or difficult to access taxa with group‐specific calls, the identity call method can aid managers in quantifying behavioural diversity and/or identifying putative structure within and between populations, given that acoustic data can be inexpensive and minimally invasive to collect.

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Biological evaluation the 2‐aryl‐2,3‐dihydrobenzodiazaborinin‐4(1H)‐ones as potential dual α‐glucosidase and α‐amylase inhibitors with antioxidant properties
Authors: Mphahlele Malose J. , Magwaza Nontokozo M. , Malindisa Sibusiso T. , Choong Yee Siew
Published: May 2021

The 2‐aryl‐2,3‐dihydrobenzodiazaborinin‐4(1H)‐ones (azaborininone) were synthesized as analogues of the 2‐arylquinazoline‐4‐ones and screened through enzymatic assay in vitro for inhibitory effect against α‐glucosidase and α‐amylase activities. These azaborininones exhibited moderate to good inhibitory effect against these enzymes compared to acarbose used as a reference standard. The results are supported by the enzyme‐ligand interactions through kinetics (in vitro) and molecular docking (in silico) studies. The test compounds also exhibited significant antioxidant activity through the 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) and nitric oxide (NO) free radical scavenging assays. These azaborininone derivatives exhibited no effect on the viability of the human lung cancer (A549) cell line after 24 hr and were also not toxic towards the Vero cells.
Inflammatory factors, genetic variants, and predisposition for preterm birth
Authors: Couceiro Joana , Matos Irina , Mendes José João , Baptista Pedro V. , Fernandes Alexandra R. , Quintas Alexandre
Published: May 2021

Preterm birth is a major clinical and public health challenge, with a prevalence of 11% worldwide. It is the leading cause of death in children younger than 5 years old and represents 70% of neonatal deaths and 75% of neonatal morbidity. Despite the clinical and public health significance, this condition's etiology is still unclear, and most of the cases are spontaneous. There are several known preterm birth risk factors, including inflammatory diseases and the genetic background, although the underlying molecular mechanisms are far from understood. The present review highlights the research advances on the association between inflammatory‐related genes and the increased risk for preterm delivery. The most associated genetic variants are the TNFα rs1800629, the IL1α rs17561, and the IL1RN rs2234663. Moreover, many of the genes discussed in this review are also implicated in pathologies involving inflammatory or autoimmune systems, such as periodontal disease, bowel inflammatory disease, and autoimmune rheumatic diseases. This review presents evidence suggesting a common genetic background to preterm birth, autoimmune and inflammatory diseases susceptibility.
The impact of late‐night alcohol restrictions on ambulance call‐outs in entertainment precincts
Authors: de Andrade Dominique , Coomber Kerri , Livingston Michael , Taylor Nicholas , Moayeri Foruhar , Miller Peter G. , Ferris Jason , Puljević Cheneal , Mayshak Richelle , Scott Debbie
Published: May 2021

Introduction

In July 2016, the Queensland Government introduced the Tackling Alcohol‐Fuelled Violence (TAFV) policy to address alcohol‐related harm in entertainment precincts [safe night precincts (SNP)]. Additional measures were introduced in February and July 2017. We aim to examine the impact of the policy on Queensland Ambulance Service call‐outs in Fortitude Valley, Surfers Paradise, all 15 SNP suburbs combined and statewide.

Methods

Auto‐regressive integrated moving average (ARIMA) models and seasonal ARIMA (SARIMA) models were developed to test the impact of TAFV policy stages on monthly number of ambulance call‐outs during high alcohol hours (HAH; Friday and Saturday nights, 20:00–05:59) over an 8‐year period (July 2011–June 2019).

Results

The average number of monthly call‐outs in HAH reduced by 26.2% in Fortitude Valley, 21.1% in Surfers Paradise and 4.3% in all 15 SNP suburbs combined. In Fortitude Valley, there was a significant decline in the monthly number of call‐outs between 00:00 and 02:59 and across all HAH combined when examining the cumulative effect of the policy stages; and significant declines between 03:00 and 05:59 after each stage and cumulatively. Across the 15 SNP suburbs combined, there was a significant decline in call‐outs between 03:00 and 05:59 after the third policy stage (July 2017). There were no significant declines in Surfers Paradise or statewide.

Discussion and Conclusions

Overall, the introduction of the TAFV policy stages in Queensland had a limited effect on ambulance call‐outs during HAH. However, there were some notable declines in HAH ambulance call‐outs in some of the state's key nightlife suburbs.
Hygiene recommendations for outpatient dermatosurgery
Authors: Löser Christoph R. , Dirschka Thomas , Felcht Moritz , Dippel Edgar , Kevekordes Sebastian
Published: May 2021

The German Infection Protection Act and country‐specific laws demand appropriate measures to prevent nosocomial infections and propagation of pathogens, especially those with resistances. This also concerns outpatient surgery of the skin. Special focus is placed on hand hygiene, antiseptics, hygienic modes of operation and professional instrument reprocessing. Every dermatological institution that operates on an outpatient basis is obliged to organize and be responsible for its hygiene. The legal framework is regulated by various laws and regulations and must be observed.
Pseudoaneurysm of Ascending Aorta induced by Brucella Endocarditis In bicuspid Aortic Valve
Authors: Liu Shuo , Ju Hui , Feng Yi , Mahmood Feroze , Dai Tian , Chen Yu , Chen Shenglong , Han Zengqiang , Fan Guangpu
Published: May 2021

Brucellosis is endemic in the Mediterranean region, South American countries, and Asia. In China, it is frequently diagnosed in herdsmen who often have contact with livestock. Brucella endocarditis (BE) is a rare complication, but it is the leading reason for mortality. We report a rare case of BE of bicuspid aortic valve with consequent pseudoaneurysm of ascending aorta, which has never been reported before. The major educational value lies in acknowledging a novel presentation of BE which happened in a patient in remission of BE and appreciation of the role of echocardiography in early diagnosis and definitive surgical therapy.
Bioinformatic analysis of the human brain extracellular matrix proteome in neurodegenerative disorders
Authors: Freitas Ana , Aroso Miguel , Rocha Sara , Ferreira Rita , Vitorino Rui , Gomez‐Lazaro Maria
Published: May 2021

Alzheimer's, Parkinson's, and Huntington's diseases are characterized by selective degeneration of specific brain areas. Although increasing number of studies report alteration of the extracellular matrix on these diseases, an exhaustive characterization at the brain's matrix level might contribute to the development of more efficient cell restoration therapies. In that regard, proteomics‐based studies are a powerful approach to uncover matrix changes. However, to date, the majority of proteomics studies report no or only a few brain matrix proteins with altered expression. This study aims to reveal the changes in the brain extracellular matrix by integrating several proteomics‐based studies performed with postmortem tissue. In total, 67 matrix proteins with altered expression were collected. By applying a bioinformatic approach, we were able to reveal the dysregulated biological processes. Among them are processes related to the organization of the extracellular matrix, glycosaminoglycans and proteoglycans’ metabolism, blood coagulation, and response to injury and oxidative stress. In addition, a protein was found altered in all three diseases—collagen type I alpha 2—and its binding partners further identified. A ClueGO network was created, depicting the GO groups associated with these binding partners, uncovering the processes that may consequently be affected. These include cellular adhesion, cell signaling through membrane receptors, inflammatory processes, and apoptotic cell death in response to oxidative stress. Overall, we were able to associate the contribution of the modification of extracellular matrix components to essential biological processes, highlighting the investment needed on proteomics studies with specific focus on the extracellular matrix in neurodegeneration.
Extending grassland age for climate change mitigation and adaptation on clay soils
Authors: Iepema Goaitske , Hoekstra Nyncke J. , de Goede Ron , Bloem Jaap , Brussaard Lijbert , van Eekeren Nick
Published: May 2021

Permanent grassland soils can act as a sink for carbon and may therefore positively contribute to climate change mitigation and adaptation. We compared young (5–15 years since latest grassland renewal) with old (>20 years since latest grassland renewal) permanent grassland soils in terms of carbon stock, carbon sequestration, drought tolerance and flood resistance. The research was carried out on marine clay soil at 10 dairy farms with young and old permanent grassland. As hypothesized, the carbon stock was larger in old grassland (62 Mg C ha−1) topsoil (0–10 cm) than in young grassland topsoil (51 Mg C ha−1). The carbon sequestration rate was greater in young (on average 3.0 Mg C ha−1 year−1) compared with old grassland (1.6 Mg C ha−1 year−1) and determined by initial carbon stock. Regarding potential drought tolerance, we found larger soil moisture and soil organic matter (SOM) contents in old compared with young grassland topsoils. As hypothesized, the old grassland soils were more resistant to heavy rainfall as measured by water infiltration rate and macroporosity (at 20 cm depth) in comparison with the young grassland soils. In contrast to our hypothesis we did not find a difference in rooting between young and old permanent grassland, probably due to large variability in root biomass and root tip density. We conclude that old grasslands at dairy farms on clay soil can contribute more to the ecosystem services climate change mitigation and climate change adaptation than young grasslands. This study shows that under real farm conditions on a clay topsoil, carbon stock increases with grassland age and even after 30 years carbon saturation has not been reached. Further study is warranted to determine by how much extending grassland age can contribute to climate change mitigation and adaptation.

Highlights

We studied the effect of young versus old grassland on a range of soil properties related to climate change mitigation and adaptation.

Old, more than young, grassland soils offer potential to mitigate and adapt to climate change.

This finding gives farmers insight into the merits of extending grassland age on clay soils.

Soil carbon stock determines carbon sequestration rate more than grassland age.
A nationwide participatory programme to measure person‐centred hospital care in Italy: Results and implications for continuous improvement
Authors: Cardinali Flavia , Carzaniga Sara , Duranti Giorgia , Labella Barbara , Lamanna Alessandro , Cerilli Micaela , Caracci Giovanni , Carinci Fabrizio
Published: May 2021

Background

Patient‐centredness has been targeted by the Italian government as a key theme for the future development of health services.

Objective

Measuring patient‐centred health services in partnership with citizens, health professionals and decision makers.

Design

National participatory survey in a large test set of hospitals at national level.

Setting and participants

A total of 387 hospital visits conducted in 16 Italian regions by over 1,500 citizens and health professionals during 2017‐2018.

Main variables and outcome measures

An ad hoc checklist was used to assess person‐centredness in hospital care through 243 items, grouped in 4 main areas, 12 sub‐areas and 29 person‐centred criteria (scored 0‐10). GEE linear multivariate regression was used to explore the relation between hospital characteristics and person‐centredness.

Results

Person‐centred scores were moderately high, with substantial variation overall (median score: 7.0, range: 3.2‐9.5) and by area (Care Processes: 6.8, 2.0‐9.8; Access: 7.4, 2.7‐9.7; Transparency: 6.7, 3.4‐9.5 and Relationship: 7.3, 0.8‐10.0). Multivariate regression found higher scores for increasing volumes of activity (quartile increase: +0.21; 95% CI: 0.13, 0.29) and lower scores in the south and islands (−1.03; −1.62,‐0.45).

Discussion

The checklist has been applied successfully by over 1,500 collaborators who assessed hospitals in 16 distinct Regions and Autonomous Provinces of Italy. Despite an overall positive mark, all scores were highly variable by location and hospital characteristics.

Conclusion and patient or public contribution

A national participatory programme to improve patient‐centredness in Italian hospitals highlighted critical areas with the direct input of citizens.
Success of supportive periodontal therapy in periodontitis patients — A retrospective analysis
Authors: Schoenmakers Max G. P. , Willems Eveline J. S. , Slot Dagmar Else , Van der Weijden G. A. (Fridus)
Published: May 2021

Objective

The aim of this retrospective analysis was to evaluate, in adult patients treated for periodontitis, the periodontal stability during supportive periodontal therapy (SPT).

Methods

Data were collected and analyzed retrospectively for periodontitis patients aged ≥36 years who underwent active periodontal therapy (APT) and were following an SPT programme. The stability of the APT success, defined as a probing pocket depth (PPD) of ≤5 mm, was the main outcome parameter. Analyses were performed in which PPD, tooth loss (TL), bleeding on probing (BOP), periodontal epithelium surface area (PESA), and the effects of age, gender, smoking status, and the number of years in SPT were evaluated. The annual TL and BOP of <10% in addition to a PPD of ≤5 mm were considered to be secondary outcome variables.

Results

In total, 993 patients were included, in 36% of whom a PPD ≤5 mm was found at the evaluation of APT. If the outcome was defined as a BOP of <10% in addition to a PPD of ≤5 mm, this was present in only 16% of the patients. During SPT, a small overall increase in clinical parameters for the total population and an annual average TL of 0.15 per patient was observed. Patients of male gender and smokers negatively affected the success of SPT.

Conclusion

The periodontal clinical status remained ‘fairly’ stable during SPT in chronic periodontitis patients aged ≥36 years. Smoking negatively affects the outcome of APT and periodontal stability during SPT.
Drug survival and predictor factors for discontinuation of methotrexate in psoriasis: a real‐life multicenter study
Authors: Ozkok Akbulut Tugba , Topaloglu Demir Filiz , Oguz Topal Ilteris , Kara Polat Asude , Karadag Ayse Serap , Aslan Kayiran Melek , Ozkur Ezgi , Kıvanc Altunay Ilknur
Published: May 2021

Background

Drug survival is useful to evaluate long‐term drug performance in daily practice. The aim of this study was to evaluate drug survival for methotrexate (MTX) monotherapy in patients with plaque‐type psoriasis.

Methods

We reviewed 3,512 follow‐up charts of patients with psoriasis at five tertiary referral centers between January 2012 and January 2020. We analyzed baseline data and treatment outcomes of patients under MTX monotherapy. Drug survival was analyzed using Kaplan‐Meier and Cox regression analyses.

Results

Patients with psoriasis who were treated with MTX monotherapy were enrolled (N = 649). The median duration of drug survival was 15 months (95% CI: 13.2–16.8). The overall drug survival rate was 54.7%, 17.4%, and 8% after 1, 3, and 5 years, respectively. The main reasons for discontinuation were adverse effects (n = 209, 32.2%) and inefficacy (n = 105, 15.6%). Based on multivariate Cox regression analysis, the presence of nausea/vomiting (HR: 2.01, 95% CI: 1.49–2.71; P < 0.001) was observed as a statistically significant risk factor for drug discontinuation. Age over 50 years (HR: 0.68, 95% CI: 0.48–0.97; P = 0.03) and using MTX dose ≥15 mg/weekly were positive predictors for drug survival (HR: 0.72, 95% CI: 0.54–0.95; P = 0.02).

Conclusions

The average drug survival of MTX was 15 months. MTX is still the first‐line treatment of moderate‐to‐severe plaque psoriasis, as highlighted in guidelines. To prevent premature discontinuation, physicians need to look at the response time of at least 16–24 weeks, especially when a stepwise dose increment is used. The presence of nausea/vomiting seemed to be associated with an approximately twofold risk of discontinuation.
The influence of Ohmic‐vacuum heating on phenol, ascorbic acid and engineering factors of kiwifruit juice concentration process
Authors: Darvishi Hosain , Behroozi‐Khazaei Nasser , Koushesh Saba Mahmoud , Alimohammadi Zakaria , Nourbakhsh Himan
Published: May 2021

The antioxidant, phenol, ascorbic acid, electrode corrosion and engineering factors of concentration process of kiwifruit juice by ohmic heating‐vacuum conditions (OHVC) were evaluated and compared with ohmic heating under atmospheric conditions (OHAC). Results showed that the total phenol content was decreased with an increasing voltage gradient for both heating modes. The OHVC can better save the antioxidant capacity and ascorbic acid of concentrated samples than the OHAC. The processing time of OHVC was significantly higher than the OHAC at the same voltage gradient (P < 0.05). The electrode corrosion rate at the vacuum mode was 7‐ to 40‐fold higher than the atmospheric mode. The energy efficiency at OHAC was lower than the OHVC. The energy consumption was found in the range of 3.37 to 3.75 MJ kg−1 water for OHAC and 4.08 to 11.09 MJ kg−1 water for OHVC. The electrical conductivity under the vacuum mode was lower than the atmospheric mode.
Training teacher‐researchers through online collective academic supervision: Evidence from a postgraduate teacher education programme
Authors: Yang Weipeng , Huang Runke , Li Yongyan , Li Hui
Published: May 2021

Collective academic supervision (CAS) is a collective model for students' academic supervision to reduce their isolation and as a measure to establish a congenial culture and to develop networks with their peers. Most studies focus on the benefits of online CAS, leaving the pedagogical process and students' learning experiences understudied. This research examines the participation and learning experience of a cohort of Master of Education (MEd) students in online supervision that took place on a Moodle platform. This article reports a case study of Moodle‐based CAS in Hong Kong that aims to train postgraduate students into teacher‐researchers. A class of MEd students and their supervisors were observed, and their online dialogues were analysed. The bio‐ecological student engagement model was used to explain the online supervision process. The results indicated that the students' learning was situated and embodied in the online social processes facilitated by peers' and supervisors' replies. The online interaction behaviours mainly included proposing questions or problems, providing information or solutions, and making comments. The findings have provided an exemplary case regarding the application of the online learning environment in supporting CAS and active research‐based learning. The productive online CAS seems to benefit both teacher candidates and their supervisors by promoting the co‐construction of the knowledge and skills of educational research, although more evidence is needed.
The bright vessel sign on arterial spin labeling MRI for heralding and localizing large vessel occlusions
Authors: McCullough‐Hicks Margy E. , Yu Yannan , Mlynash Michael , Albers Gregory W. , Zaharchuk Greg
Published: May 2021

Background and Purpose

The significance of a bright vessel sign (BVS) at the site of a large vessel occlusion (LVO) on MR arterial spin labeling (ASL) sequence is not widely reported. We compared the utility of the ASL BVS to the gradient echo (GRE) susceptibility vessel sign (SVS) in heralding and localizing LVOs in a large cohort; most underwent digital subtraction angiography (DSA) and endovascular therapy for acute stroke.

Methods

A total of 171 patients with large hemispheric stroke symptoms had baseline and follow‐up MRIs with ASL, GRE, and MR angiogram (MRA). Scans were evaluated for (1) presence versus absence and (2) location of ASL BVS and GRE SVS. For patients who underwent DSA, data comparing presence and location of ASL BVS and GRE SVS to occlusions found on angiography, as well as resolution of the signs after successful recanalization, were also evaluated.

Results

Compared to MRA, the sensitivity of the ASL BVS for an LVO was .83, significantly better than .67 for GRE SVS (p = .001). Localization of vessel occlusion was correct 60.4% of the time by ASL compared to 64.4% by GRE (p = .502). For the 107 patients who underwent DSA, the sensitivity of ASL BVS was .80 compared to .64 for GRE SVS (p = .009). Localization of LVO found on DSA was correct 63.5% of the time by ASL BVS compared to 72.9% by GRE SVS (p = .251).

Conclusion

ASL BVS is significantly more sensitive than GRE SVS for identification of LVO on both MRA and DSA.
Inherent tolerance of extreme seasonal variability in light and salinity in an Arctic endemic kelp (Laminaria solidungula)
Authors: Muth Arley F. , Bonsell Christina , Dunton Kenneth H.
Published: May 2021

The kelp Laminaria solidungula is an important foundation species in the circumpolar Arctic. One of the largest populations of L. solidungula in the Beaufort Sea occurs in Stefansson Sound, off the north coast of Alaska. We surveyed kelp populations in the Stefansson Sound Boulder Patch and found that inshore sites in close proximity (3.5 km) to river input and increased turbidity exhibited lower sporophyte densities (0.36 ± 0.44 · m−2) than more offshore sites (>7 km) to the west (0.72 ± 0.48 · m−2) and east (4.72 ± 1.51 · m−2). We performed culture experiments to examine the possible combined effects of salinity and light on microscopic sporophyte production. Gametophytes cultured in the low salinity treatment (10) were unable to produce sporophytes regardless of light level. The highest light level tested (40 µmol photons · m−2 · s−1) produced the greatest sporophyte densities (0.037 ± 0.08 · mm−2) at a salinity of 30. Subsequent experimental work on the effect of salinity on microscopic stages revealed that haploid stages were not capable of producing sporophytes at a salinity of 10, but 3‐month‐old microscopic sporophytes were able to persist in the lower (10 and 20) salinity treatments. Although L. solidungula sporophytes have apparently acclimated to extreme salinity (<5–33) and light variations, the vulnerability of haploid microscopic stages to reduced salinity has the potential to affect future populations as the timing and magnitude of freshwater input to the Arctic Ocean changes.
Rural hospitals are not associated with worse postoperative outcomes for colon cancer surgery
Authors: Lansing Shan S. , Diaz Adrian , Hyer Madison , Tsilimigras Diamantis , Pawlik Timothy M.
Published: May 2021

Purpose

We sought to determine whether colorectal cancer surgery can be done safely at rural hospitals. The current study compared outcomes among rural patients who underwent colon resection at rural and nonrural hospitals.

Methods

Medicare beneficiaries who underwent colon resection for cancer between 2013 and 2017 were identified using the Medicare Inpatient Standard Analytic Files. Patients and hospitals were designated as rural based on rural‐urban continuum codes. Risk‐adjusted postoperative outcomes and hospitalization spending were compared among patients undergoing resection at rural versus nonrural hospitals.

Results

Among 3,937 patients who resided in a rural county and underwent colon resection for cancer, mean age was 76.3 (SD: 7.1) years and 1,432 (36.4%) patients underwent operative procedure at a rural hospital. On multivariable analyses, no differences in postoperative outcomes were noted among Medicare beneficiaries undergoing colon resection for cancer at nonrural versus rural hospitals. Specifically, the risk‐adjusted probability of experiencing a postoperative complication at a nonrural hospital was 15.4% (95% CI: 14.1%‐16.8%) versus 16.3% (95% CI: 14.2%‐18.3%) at a rural hospital (OR 1.08, 95% CI: 0.85‐1.38); 30‐day mortality (nonrural: 2.9%, 95% CI: 2.2‐3.6 vs rural: 3.5%, 95% CI: 2.4‐4.5) was also comparable. In addition, price standardized, risk‐adjusted expenditures were similar at nonrural ($18,610, 95% CI: $18,037‐$19,183) and rural ($19,010, 95% CI: $18,630‐$19,390) hospitals.

Conclusion

Among rural Medicare beneficiaries who underwent a colon resection for cancer, there were no differences in postoperative outcomes among nonrural versus rural hospitals. These findings serve to highlight the importance of policies and practice guidelines that secure safe, local surgical care, allowing rural clinicians to accommodate strong patient preferences while delivering high‐quality surgical care.
Coronary microvascular dysfunction pathophysiology in COVID‐19
Authors: Yin Jie , Wang Shaoshen , Liu Yang , Chen Junhong , Li Dongye , Xu Tongda
Published: May 2021

Recently, accumulating evidence has highlighted the role of endothelial dysfunction in COVID‐19 progression. Coronary microvascular dysfunction (CMD) plays a pivotal role in cardiovascular disease (CVD) and CVD‐related risk factors (eg, age, gender, hypertension, diabetes mellitus, and obesity). Equally, these are also risk factors for COVID‐19. The purpose of this review was to explore CMD pathophysiology in COVID‐19, based on recent evidence. COVID‐19 mechanisms were reviewed in terms of imbalanced renin‐angiotensin‐aldosterone‐systems (RAAS), systemic inflammation and immune responses, endothelial dysfunction, and coagulatory disorders. Based on these mechanisms, we addressed CMD pathophysiology within the context of COVID‐19, from five perspectives. The first was the disarrangement of local RAAS and Kallikrein‐kinin‐systems attributable to SARS‐Cov‐2 entry, and the concomitant decrease in coronary microvascular endothelial angiotensin I converting enzyme 2 (ACE2) levels. The second was related to coronary microvascular obstruction, induced by COVID‐19‐associated systemic hyper‐inflammation and pro‐thrombotic state. The third was focused on how pneumonia/acute respiratory distress syndrome (ARDS)‐related systemic hypoxia elicited oxidative stress in coronary microvessels and cardiac sympathetic nerve activation. Fourthly, we discussed how autonomic nerve dysfunction mediated by COVID‐19‐associated mental, physical, or physiological factors could elicit changes in coronary blood flow, resulting in CMD in COVID‐19 patients. Finally, we analyzed reciprocity between the coronary microvascular endothelium and perivascular cellular structures due to viremia, SARS‐CoV‐2 dissemination, and systemic inflammation. These mechanisms may function either consecutively or intermittently, finally culminating in CMD‐mediated cardiovascular symptoms in COVID‐19 patients. However, the underlying molecular pathogenesis remains to be clarified.
Diagnostic performance of real‐time polymerase chain reaction assay on blood for invasive aspergillosis and mucormycosis
Authors: Seo Hyeonji , Kim Ji Yeun , Son Hyo‐Ju , Jung Jiwon , Kim Min Jae , Chong Yong Pil , Lee Sang‐Oh , Choi Sang‐Ho , Kim Yang Soo , Kim Sung‐Han
Published: May 2021

Objectives

This study aimed to evaluate the diagnostic usefulness of real‐time (RT) polymerase chain reaction (PCR) on blood samples for diagnosis of invasive aspergillosis and mucormycosis in patients with suspected invasive mould infection.

Methods

Adult patients with suspected invasive mould infection were prospectively enrolled at a tertiary referral hospital in Seoul, South Korea between 2017 and 2020. Standard tests for diagnosis of invasive mould infection and RT‐PCR for Aspergillus, Mucor and Rhizopus using blood samples were performed. We evaluated the diagnostic performance of RT‐PCR tests in patients diagnosed with proven and probable invasive aspergillosis or mucormycosis infection, according to the modified definitions of the EORTC/MSG 2019.

Results

A total of 102 patients with suspected invasive mould infection were enrolled. Of these patients, 46 (45%) were classified as having proven (n = 13) or probable (n = 33) invasive aspergillosis, 21 (21%) as proven (n = 17) or probable (n = 4) invasive mucormycosis and 18 (18%) as possible invasive mould infection. The remaining 13 (13%) were classified as not having invasive mould infection. Patients with possible invasive mould infection (n = 18) and coinfection of aspergillosis and mucormycosis (n = 4) were excluded from the final analysis. The sensitivity and specificity of the Aspergillus PCR were 54.3% ([25/46], 95% confidence interval [CI]: 40.2–67.9%) and 94.1% ([32/34], 95% CI: 80.9–98.4%), respectively. The sensitivity and specificity of the Mucor or Rhizopus PCR were 57.1% ([12/21], 95% CI: 36.6–75.5%) and 76.3% ([45/59], 95% CI: 64.0–85.3), respectively.

Conclusions

Our study suggests that blood PCR can be a useful adjunct test for diagnosing patients with suspected invasive mould infection.
Soil fertility relates to fungal‐mediated decomposition and organic matter turnover in a temperate mountain forest
Authors: Mayer Mathias , Rewald Boris , Matthews Bradley , Sandén Hans , Rosinger Christoph , Katzensteiner Klaus , Gorfer Markus , Berger Harald , Tallian Claudia , Berger Torsten W. , Godbold Douglas L.
Published: May 2021

Fungi are known to exert a significant influence over soil organic matter (SOM) turnover, however understanding of the effects of fungal community structure on SOM dynamics and its consequences for ecosystem fertility is fragmentary.

Here we studied soil fungal guilds and SOM decomposition processes along a fertility gradient in a temperate mountain beech forest. High‐throughput sequencing was used to investigate fungal communities. Carbon and nitrogen stocks, enzymatic activity and microbial respiration were measured.

While ectomycorrhizal fungal abundance was not related to fertility, saprotrophic ascomycetes showed higher relative abundances under more fertile conditions. The activity of oxidising enzymes and respiration rates in mineral soil were related positively to fertility and saprotrophic fungi. In addition, organic layer carbon and nitrogen stocks were lower on the more fertile plots, although tree biomass and litter input were higher. Together, the results indicated a faster SOM turnover at the fertile end of the gradient.

We suggest that there is a positive feedback mechanism between SOM turnover and fertility that is mediated by soil fungi to a significant extent. By underlining the importance of fungi for soil fertility and plant growth, these findings furthermore emphasise the dependency of carbon cycling on fungal communities below ground.