bluuebunny/crossref_metadata_2025 huggingface dataset:
Multipath optical thermometry realized in CaSc2O4: Yb3+/Er3+ with high sensitivity and superior resolution
Authors: Xiang Guotao , Xia Qing , Xu Su , Liu Xiuchong , Jiang Sha , Wang Yongjie , Zhou Xianju , Li Li , Ma Li , Wang Xiaojun , Zhang Jiahua
Published: January 2021

Design and fabrication of contactless optical thermometer with rapid and accurate performance has become a research hotspot in recent years. Herein, CaSc2O4: Yb3+/Er3+ is employed as the intermediary for temperature sensing under the excitation of 980 nm, which is proven to afford an ultra‐sensitive and high‐resolution optical thermometry in multiple ways based on the fluorescence intensity ratio (FIR) technology. The optimal thermal sensing behaviors are realized by the FIR of Er3+:2H11/2 → 4I15/2 to 4S3/2 → 4I15/2 transition, which has a relative sensitivity of 1184/T2 and a minimal resolution of 0.03 K along with a maximal absolute error of 0.96 K. Besides that, the FIR between the thermally coupled Stark sublevels of Er3+:4F9/2 manifold (FIRR) as well as that of Er3+: 4I13/2 manifold (FIRN) can also provide excellent optical thermometry. The relative sensitivity of FIRR‐based and FIRN‐based optical thermometers are calculated to be 402/T2 and 366/T2, respectively, with a same minimal resolution of 0.09 K, which possess the potential to be used for biomedicine due to the inherent advantage of their operating wavelengths located in the biological window. The results demonstrate that CaSc2O4: Yb3+/Er3+ is a promising candidate for temperature sensing with multipath, high sensitivity, and superior resolution.
Features and diversity of symptoms of moyamoya disease in adolescents: A cluster analysis
Authors: Oh Won‐Oak , Shim Kyu Won , Yeom Insun , Park Il Tae , Heo YooJin
Published: January 2021

Aims

The purpose of this study is to explore the symptoms experienced by adolescents with moyamoya disease and to identify the characteristics of each symptom cluster associated with moyamoya disease.

Design

A retrospective and descriptive design, which is a secondary data analysis study based on electronic medical record data from hospitals.

Methods

To assess the symptoms associated with moyamoya disease, a qualitative study was conducted on 12 adolescents, 12 caregivers and 12 experts on moyamoya disease. According to a qualitative study, 12 main symptoms (limb weakness, numbness, pins and needles, difficulty in speech, blurred vision, facial paralysis, hand tremors, involuntary movements, convulsions, dizziness, nausea/vomiting and headaches) were selected. Data were collected around these symptoms. The data collection was carried out through the Electronic Medical Record (EMR) data of 303 adolescents aged 13–19 who were diagnosed with moyamoya disease (ICD 10 Code: I67.5) between January 2010–December 2019 in a hospital in Seoul, South Korea. Cluster analysis was applied to identify symptom clusters with the hierarchical cluster agglomerative approach. We used the log‐likelihood distance to measure the similarity of variables. Proximity between groups of variables was measured using the two‐step method.

Results

The physical symptoms experienced by adolescents with moyamoya disease were ‘limb weakness’ – the most common – followed by a ‘headache,’ ‘difficulty in speech,’ and ‘nausea/vomiting.’ A total of five symptom clusters were derived: cluster 1 was characterized by ‘limb weakness’; cluster 2 participants were asymptomatic or experienced ‘convulsions’; cluster 3 experienced ‘difficulty in speech’ and ‘facial paralysis’; cluster 4 is prone to ‘dizziness’ and ‘pins and needles’; and cluster 5 displays ‘headaches’ and ‘nausea/vomiting’.

Conclusion

This study offers a multidimensional approach for identifying differences in clinical symptoms of moyamoya disease among adolescents.

Impact

These results will help provide interventions concerning the characteristics of the symptoms of moyamoya disease among adolescents.
The family transition experience when living with childhood neuromuscular disease: A grounded theory study
Authors: Waldboth Veronika , Patch Christine , Mahrer‐Imhof Romy , Metcalfe Alison
Published: January 2021

Aims

Neuromuscular diseases are rare conditions that present with progressive muscular weakness. As affected children transition into adulthood, they become more physically dependent on their families for support. There is little evidence on the family transition experience, which this study explored to identify experiences, challenges, and strategies of coping.

Design

Informed by family systems theory, a constructivist grounded theory study was conducted (2014–2017).

Methods

Data were collected by one‐on‐one interviews with a purposive sample of affected Swiss individuals and their families from 2015 to 2016. Data analysis used coding, memo writing, theoretical sampling, and constant comparison techniques.

Results

The analysis of 31 interviews with 10 affected individuals and 21 family members resulted in an interpretive theory constituted of four categories: (a) living with physical dependence, while striving for independence; (b) balancing proximity; (c) conforming and challenging social standards and expectations; and (d) grieving for loss, while joining forces for life.

Conclusion

Family functioning and well‐being were threatened by recurring tension from stress, physical and emotional difficulties, strained relationships, and conflict. The families’ strategies of coping and adaptation and their relationships and communication shaped their transition experience.

Impact

Families that experience threats to their well‐being and functioning would benefit from: needs assessment and monitoring; planning of appropriate family interventions; support of family relationships and communication, effective coping, and mastery; and positive adaptation to change.
Digitalization and its Impact on the Future Role of SCM Executives in Talent Management – An International Cross‐Industry Delphi Study
Authors: Wehrle Manuel , Lechler Sabrina , von der Gracht Heiko A. , Hartmann Evi
Published: January 2021

In the field of supply chain management (SCM), attracting and developing appropriate talent is critical for achieving most SCM goals, as extensive skills are necessary to do the job properly. In order to ensure that future‐proof talent can continue to emerge in this discipline, the role of SCM executives is extremely important. Although many studies have been conducted in the field of talent management (TM), the future role of SCM executives has been mostly neglected in research. The present empirical study addresses this gap, taking into consideration the fourth industrial revolution, as innovation in technology continues to drive significant changes in the SCM field. Aiming to investigate the extent to which increasing digitalization is influencing the future role of SCM executives, a Delphi study with 103 experts from industry, academics, and politics/associations was carried out. In order to identify meaningful topic clusters from the data, fuzzy c‐means clustering was used. From an actor‐network theory perspective, our results show that in some areas of TM, digitalization is leading to a strong fusion of SCM executives and digital technologies, as well as to a clear division of roles, in which either SCM leaders or technology will dominate in the future.
Transcatheter ablation for atrial fibrillation in patients with hypertrophic cardiomyopathy: Long‐term results and clinical outcomes
Authors: Castagno Davide , Di Donna Paolo , Olivotto Iacopo , Frontera Antonio , Calò Leonardo , Scaglione Marco , Arretini Anna , Anselmino Matteo , Giustetto Carla , De Ferrari Gaetano Maria , Cecchi Franco , Haissaguerre Michel , Gaita Fiorenzo
Published: January 2021

Introduction

Radiofrequency transcatheter ablation (RFCA) for atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM) has been proven feasible. However, the long‐term results of RFCA and its impact on clinical course of HCM are unknown. The aim of this study was to analyse clinical outcomes and long‐term efficacy of RFCA in a multicentre cohort of patients with HCM and concomitant AF.

Methods

Patients with HCM and AF consecutively undergoing RFCA were included. Ablation failure was defined as recurrence of AF, atrial tachycardia, or flutter lasting more than 3 min and occurring after the blanking period.

Results

Overall, 116 patients with symptomatic AF refractory to antiarrhythmic drugs were included. Over a median follow‐up of 6.0 years (interquartile range: 3.0–8.9 years) recurrence rate after a single RFCA was 32.3 per 100 patient/years with 26% of patients free from AF relapses at 6‐year follow‐up. Among patients experiencing AF recurrence, 51 (66%) underwent at least one redo‐procedure. The overall recurrence rate considering redo‐procedures was 12.6 per 100 patients/years with 53% of patients free from AF relapses at 6 years. At last follow‐up, with an average of 1.6 procedures, 67 (61%) patients were in sinus rhythm (SR). Patients remaining in SR showed better functional status compared with those experiencing arrhythmic recurrences (NYHA Class 1.6 ± 0.1 vs. 2.0 ± 0.1, p = .009).

Conclusions

RFCA of AF in HCM patients is an effective and safe strategy favoring long‐term SR maintenance, reduction of atrial arrhythmic events, and improved functional status. However, most patients need repeat procedures and continuation of antiarrhythmic drugs.
Neferine suppresses autophagy‐induced inflammation, oxidative stress and adipocyte differentiation in Graves' orbitopathy
Authors: Li Hong , Gao Long , Min Jie , Yang Yucheng , Zhang Ren
Published: January 2021

Previous studies in Graves’ orbitopathy (GO) patient‐derived fibroblasts showed that inhibition of autophagy suppresses adipogenic differentiation. Autophagy activation is associated with inflammation, production of reactive oxygen species and fibrosis. Neferine is an alkaloid extracted from Nelumbo nucifera, which induces Nrf2 expression and inhibits autophagy. Here, we have elucidated the role of neferine on interleukin (IL)‐13‐induced autophagy using patient‐derived orbital fibroblasts as an in vitro model of GO. GO patient‐derived orbital fibroblasts were isolated and cultured to generate an in vitro model of GO. Autophagy was determined by Western blot detection of the markers such as Beclin‐1, Atg‐5 and LC3 and by immunofluorescence detection of autophagosome formation. Analysis of differentiation towards an adipogenic lineage was performed by Oil red O staining. The expression of inflammatory factors was detected by ELISA and semiquantitative RT‐PCR. Neferine inhibited autophagy in GO orbital fibroblasts, as indicated by the suppression of IL‐13‐induced autophagosome formation, overexpression of autophagy markers, increased LC3‐II/LC3‐I levels and finally down‐regulation of p62. Neferine suppressed IL‐13‐induced inflammation, ROS generation, fibrosis and adipogenic differentiation in GO patient‐derived orbital fibroblasts. The anti‐inflammatory, antioxidant and antiadipogenic effects of neferine were accompanied by the up‐regulation of Nrf2. These results indicated that orbital tissue remodelling and inflammation in GO may be mediated by autophagy, and neferine suppressed autophagy‐related inflammation and adipogenesis through a mechanism involving Nrf2.
PPARγ/NF‐κB and TGF‐β1/Smad pathway are involved in the anti‐fibrotic effects of levo‐tetrahydropalmatine on liver fibrosis
Authors: Yu Qiang , Cheng Ping , Wu Jianye , Guo Chuanyong
Published: January 2021

Liver fibrosis is a necessary stage in the development of chronic liver diseases to liver cirrhosis. This study aims to investigate the anti‐fibrotic effects of levo‐tetrahydropalmatine (L‐THP) on hepatic fibrosis in mice and cell models and its underlying mechanisms. Two mouse hepatic fibrosis models were generated in male C57 mice by intraperitoneal injection of carbon tetrachloride (CCl4) for 2 months and bile duct ligation (BDL) for 14 days. Levo‐tetrahydropalmatine was administered orally at doses of 20 and 40 mg/kg. An activated LX2 cell model induced by TGF‐β1 was also generated. The results showed that levo‐tetrahydropalmatine alleviated liver fibrosis by inhibiting the formation of extracellular matrix (ECM) and regulating the balance between TIMP1 and MMP2 in the two mice liver fibrosis models and cell model. Levo‐tetrahydropalmatine inhibited activation and autophagy of hepatic stellate cells (HSCs) by modulating PPARγ/NF‐κB and TGF‐β1/Smad pathway in vivo and in vitro. In conclusion, levo‐tetrahydropalmatine attenuated liver fibrosis by inhibiting ECM deposition and HSCs autophagy via modulation of PPARγ/NF‐κB and TGF‐β1/Smad pathway.
Xanthatin synergizes with cisplatin to suppress homologous recombination through JAK2/STAT4/BARD1 axis in human NSCLC cells
Authors: Zhang Jian , Yang Sheng , Guan Hongmei , Zhou Jueyu , Gao Yuan
Published: January 2021

Xanthatin (Xa) is a bicyclic sesquiterpene lactone identified from the plant Xanthium L. with impressive antitumor activity, but the role of Xa in non‐small cell lung cancer (NSCLC) is not known. Here we found that Xa inhibits proliferation, migration, invasion and induces apoptosis in NSCLC cells. RNA sequencing and Gene set enrichment analysis revealed that Xa significantly activates p53 pathway and suppresses E2F targets, G2M checkpoint and MYC targets in A549 cells. Among these changed genes, the down‐regulated gene BARD1 triggered by Xa was identified as a candidate involved in Xa’s antitumor effect because of its vital role in homologous recombination (HR). Further studies demonstrated that Xa inhibits HR through the BARD1/BRCA1/RAD51 axis, which enhances cell sensitivity to cisplatin. Mechanistic studies showed that Xa inhibits BARD1 through the JAK2/STAT4 pathway. Our study revealed that Xa is a promising drug to treat NSCLC, especially in combination with conventional chemotherapy.
Electronic dashboard‐based remote glycemic management program reduces length of stay and readmission rate among hospitalized adults
Authors: Sheen Yi‐Jing , Huang Chien‐Chung , Huang Shih‐Che , Lin Ching‐Heng , Lee I‐Te , H‐H Sheu Wayne
Published: January 2021

Aims/Introduction

Currently, the impact of hospital‐wide glycemic control interventions on length of hospital stay (LOS) and readmission rates are largely unknown. We investigated the impact of a 4‐year hospital‐wide remote glycemic management program on LOS and 30‐day readmission rates among hospitalized adults who received glucose monitoring.

Materials and Methods

In this retrospective study, hospitalized patients who received glucose monitoring were classified into groups 1 (high glucose variability), 2 (hypoglycemia), 3 (hyperglycemia) and 4 (relatively stable). The monthly percentage changes, and average monthly percentage changes of hyperglycemia, hypoglycemia and treat to target were determined using joinpoint regression analysis.

Results

A total of 106,528 hospitalized patients (mean age 60.9 ± 18.5 years, 57% men) were enrolled. We observed a significant reduction in the percentage of inpatients in poor glycemic control groups (groups 1, 2 and 3, all P < 0.001), and a reciprocal increase in the relatively stable group (group 4) from 2016 to 2019. We found a significant reduction in LOS by 11.4% (10.5–9.3 days, P = 0.002, after adjustment for age, sex, and admission department). The 30‐day readmission rate decreased from 29.9% to 29.3%, mainly among those in group 4 in 2019 (P < 0.001 after adjustment of sex, age, admission department and LOS).

Conclusions

Improved glycemic control through a hospital‐wide electronic remote glycemic management system reduced LOS and 30‐day readmission rates. Findings observed in this study might be associated with the reduction in cost of avoidable hospitalizations.
On‐label use of sodium–glucose cotransporter 2 inhibitors might increase the risk of diabetic ketoacidosis in patients with type 1 diabetes
Authors: Horii Takeshi , Oikawa Yoichi , Atsuda Koichiro , Shimada Akira
Published: January 2021

Aims/Introduction

This study aimed to investigate the risk of diabetic ketoacidosis (DKA) in insulin‐treated type 1 diabetes patients administered sodium–glucose cotransporter 2 (SGLT2) inhibitors in real‐world clinical practice.

Materials and Methods

We carried out a real‐world, retrospective, observational cohort study using Japanese Medical Data Vision, a diagnosis procedure combination database. We identified insulin‐treated adult type 1 diabetes patients enrolled from December 2018 to October 2019. We assessed the incidence and risk of DKA in type 1 diabetes patients using SGLT2 inhibitors in an ‘on‐label’ manner. Cox multivariate regression analyses were carried out to determine clinical factors linked to SGLT2 inhibitor‐associated DKA.

Results

Of 11,475 type 1 diabetes patients, 1,898 (16.5%) were prescribed SGLT2 inhibitors. DKA occurred in 139 (7.3%) of these patients, with 20.2 incidences per 100 person‐years. These patients also showed significantly higher DKA rates than did those not receiving SGLT2 inhibitors (hazard ratio 1.66, 95% confidence interval 1.33–2.06; P < 0.001). The mean time until DKA onset in SGLT2 inhibitor‐treated type 1 diabetes patients was 30.6 ± 30.1 days. The risk of SGLT2 inhibitor‐associated DKA increased in type 1 diabetes patients irrespective of sex, age or body mass index. However, the risk did not increase in type 1 diabetes patients receiving continuous subcutaneous insulin infusion, which warrants further investigation because of the small number of type 1 diabetes patients receiving continuous subcutaneous insulin infusion.

Conclusions

‘On‐label’ SGLT2 inhibitor use might increase DKA risk among insulin‐treated type 1 diabetes patients irrespective of sex, age or body mass index. Both type 1 diabetes patients and healthcare providers should be wary of DKA, especially during the first month of initiating SGLT2 inhibitors.
Incidence of pemphigoid diseases in Northern Germany in 2016 – first data from the Schleswig‐Holstein Registry of Autoimmune Bullous Diseases
Authors: van Beek N. , Weidinger A. , Schneider S.W. , Kleinheinz A. , Gläser R. , Holtsche M.M. , von Georg A. , Hammers C.M. , Hübner F. , Lima A.‐L. , Gola D. , Sadik C.D. , Zillikens D. , Katalinic A. , Schmidt E. , König I.R.
Published: January 2021

Background

Autoimmune bullous diseases (AIBD) are rare disorders characterized by autoantibody formation against components of adhesion molecules; in pemphigoid diseases (PD), these are proteins of hemidesmosomes and basement membrane, important for cell‐matrix adhesion in skin and/or mucous membranes. Incidences of these diseases vary considerably between different populations.

Objectives

To establish a registry prospectively recruiting all AIBD patients in a geographically well‐defined region in Northern Germany (Schleswig‐Holstein).

Methods

Only patients with verified disease (by clinical presentation, histology, direct and/or indirect immunofluorescence and /or ELISA) living in Schleswig‐Holstein were included. Incidences of PD were estimated based on the total number of inhabitants in Schleswig‐Holstein, stratified by birth year and sex.

Results

Of 67 patients with PD [35 male, 32 female, mean age 75 (standard deviation 14.3 years)], 83% were patients with bullous pemphigoid [n = 56, 28 male, 28 female, mean age 78 (SD 9.9)]. The resulting crude incidences were 23.4 patients/million/year for all pemphigoid patients, 19.6 patients/million/year for bullous pemphigoid (age‐standardized 16.9 patients/million/year) with a strong increase in bullous pemphigoid patients in the age group of 85–90 years with 262 patients/million/year. Incidences for bullous pemphigoid were higher in urban compared to rural areas. Other PD (mucous membrane pemphigoid, linear IgA disease, anti‐p200 pemphigoid) were less frequent with crude incidences of 2.1, 1.0 and 0.7 patients/million/year, respectively.

Conclusions

This study prospectively analyses the incidence of PD in a carefully defined geographical area. The highest incidence among PD patients was found for bullous pemphigoid. The incidence of bullous pemphigoid is considerably increased compared to previous reports and reveals regional differences. Further studies are needed in order to clarify these findings.
Debt covenants and asset versus equity acquisitions
Authors: Jory Surendranath Rakesh , Ngo Thanh , Nguyen Ca
Published: January 2021

We examine whether the presence of loan covenants leads firms to choose either an asset or equity acquisitions. Asset acquisitions involve the selective purchase of a target company's assets, and equity acquisitions involve acquisitions of common stocks. We document that firms with loan covenants are more likely to engage in asset acquisitions as opposed to equity acquisitions. Our results are robust to alternative measures of loan covenants and to endogeneity concerns. Furthermore, the association between loan covenants and asset acquisitions is stronger among firms with greater debt covenant intensity, more severe agency problems, and lower profitability. Acquirers facing more intense competition within their industries are also likely to choose asset acquisitions. Our findings suggest that acquirers' incentives to avoid wealth transfer at the expense of debtholders drive the relation between debt covenants and choice of acquisition structure.
Diachronous collision in the Seve Nappe Complex: Evidence from Lu–Hf geochronology of eclogites (Norrbotten, North Sweden)
Authors: Fassmer Kathrin , Froitzheim Nikolaus , Janák Marian , Strohmeyer Merle , Bukała Michał , Lagos Markus , Münker Carsten
Published: January 2021

The collision of Baltica and Laurentia during the Caledonian Orogeny happened atc. 400–420 Ma. However, subduction and collision processes also took place before this main collisional phase and the tectonic history of these is still not fully resolved. The Seve Nappe Complex in Sweden has recorded these earlier phases. The Seve Nappe Complex in Norrbotten (North Swedish Caledonides) comprises four superimposed nappes emplaced by eastward thrusting (from base to top according to the conventional structural interpretation): Lower Seve Nappe, Vaimok, Sarek, and Tsäkkok Lenses. Eclogites occur in the Vaimok and Tsäkkok Lenses. The Vaimok Lens represents rocks of the Baltican continental margin intruded by Neoproterozoic dolerite dikes which were later eclogitized and boudinaged. By contrast, eclogites of the Tsäkkok Lens are former oceanic basalts associated with calcschists, possibly representing the ocean–continent transition between Baltica and Iapetus. Previous age determinations for eclogitization yielded various ages betweenc. 500 and 480 Ma, in contrast to younger (460–450 Ma) ages of ultra high‐Pmetamorphism in the Seve Nappe Complex further south in Jämtland. Eclogites from the Vaimok (one sample) and Tsäkkok (three samples) lenses were dated using Lu–Hf garnet geochronology. Garnet from all samples shows prograde zoning of major element and Lu contents and yielded well‐defined isochrons of the following ages: 480.4 ± 1.2 Ma (Vaimok); 487.7 ± 4.6 Ma, 486.2 ± 3.2, 484.6 ± 4.6 Ma (Tsäkkok). The ages from Tsäkkok are interpreted to date the burial of the Iapetus–Baltica ocean–continent transition in a west‐dipping subduction zone aroundc. 485 Ma, and the age from the structurally deeper Vaimok Nappe the following subduction of the continental margin. Previously reported ages of 500 Ma and older are not supported by this study. The age difference between eclogites in the Seve Nappe Complex in Jämtland (c. 460–450 Ma) and Norrbotten (c. 488–480 Ma) may reflect the collision of an island arc with an irregularly shaped passive continental margin of Baltica or alternatively the collision of a straight margin with a microcontinent (Sarek Lens) accreted to the upper plate.
Oxytocin receptor expression in the midbrain dorsal raphe is dynamic across female reproduction in rats
Authors: Grieb Zachary A. , Lonstein Joseph S.
Published: January 2021

Central oxytocin receptor (OTR) expression is extremely sensitive to circulating steroid hormones and OTRs influence many of the neurobehavioural adaptations associated with female reproduction (e.g., postpartum caregiving, aggression, cognition, affective responses). Changes in central OTR expression across female reproduction have often been studied, but almost all of such research has focused on the forebrain, ignoring hormone‐sensitive midbrain sites such as the serotonergic dorsal raphe (DR) that are also critical for postpartum behaviours. To investigate the effects of female reproductive state on OTRs in the DR, we first used autoradiography to examine OTR binding across four female reproductive states in laboratory rats: dioestrous virgin, pregnancy day 10, the day of parturition and postpartum day 7. OTR binding in the rostral DR (but not other DR subregions) was approximately 250% higher in parturient rats compared to dioestrous virgins and dropped back down to virgin levels by postpartum day 7. Given the chemical heterogeneity of the DR, we then examined OTR expression in the three most abundant neuronal phenotypes of the DR (i.e., serotonin, GABA and dopamine) in dioestrous virgins and recently parturient females. Using dual‐label immunohistochemistry and in situ hybridisation, we found that twice as many dopaminergic cells in the parturient rostral DR contained OTR immunoreactivity compared to that found in virgins. On the other hand, mothers had fewer rostral DR GABAergic cells expressing OTRs than did virgins. OTR expression in serotonin cells did not differ between the two groups. Overall, these results suggest that the rostral subregion of the midbrain DR is uniquely sensitive to oxytocin around the time of parturition, with subpopulations of cells that become more sensitive (i.e., dopamine), less sensitive (i.e., GABA) and show no change (i.e., serotonin) to this neuropeptide. This dynamic OTR signalling in the female DR may help drive the numerous behavioural changes across female reproduction that are necessary for successful motherhood.
Resisting the coastal squeeze through village associations? Comparing environmental, organizational, and political challenges in Philippine seaweed‐growing communities
Authors: Andriesse Edo , Lee Zack
Published: January 2021

This article investigates collective action dynamics and local politics amidst Philippine seaweed‐growing communities. Government agencies and civil society organizations generally encourage collaboration at village level through the formation of cooperatives and associations, often on the assumption that it facilitates the translation of economic growth into rural poverty reduction. Here, we explain how the formation of associations is entangled with the local and central state politics. We argue that civil society initiatives cannot be analysed separately from local and community‐level politics. This contribution reveals a gap between the objectives of rural, coastal associations, and the organizational capacities of communities to sustain such initiatives. Utilizing community support as a means to compensate for market and government failures does not only depend on a facilitative policy environment and start‐up support but also on household‐level capabilities. It also demonstrates that in addition to the interests of big business and national‐level politics, village‐level politics can obstruct effective and sustained implementation of value chain interventions.
The effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients: A randomised controlled trial
Authors: Hassan Eman Arafa , Baraka Azza Abd Elrazek
Published: January 2021

Aims and objectives

To investigate the effect of reverse Trendelenburg position versus semi‐recumbent position on respiratory parameters of obese critically ill patients.

Background

Reverse Trendelenburg position is recommended for obese patients; however, the effect among critically ill patients, especially those on mechanical ventilation, has limited study.

Design

Randomised, controlled pretest, repeated post‐test trial with two parallel groups.

Methods

The study started from 13 January 2020–12 March 2020. Adult critically ill patients with a body mass index ≥30 were randomly assigned by computer‐generated randomisation to either reverse Trendelenburg position group (intervention) or semi‐recumbent position group (active comparator control). Outcome measures were ventilation parameters (dynamic compliance, partial pressure of arterial carbon dioxide and minute volume) and oxygenation parameters (hypoxaemic index and partial pressure of arterial oxygen). Measures were assessed immediately before positioning and after positioning in 10 minutes, 20 minutes and 30 minutes. CONSORT checklist was used to report the current study.

Settings

Four general intensive care units.

Results

One hundred and ten patients (55 patients in each group) completed the study. The reverse Trendelenburg position group had a higher improvement than the semi‐recumbent position group as estimated by mean differences in their dynamic compliance, minute volume, partial pressure of carbon dioxide, partial pressure of oxygen and hypoxaemic index.

Conclusion

Reverse Trendelenburg position improves obese patients’ respiratory parameters more than semi‐recumbent position.

Relevance to clinical practice

This study directs nurses to use the reverse Trendelenburg position, which is an important position for enhancing the parameters of ventilation and oxygenation of obese mechanically ventilated patients.
Learning to be a doctoral supervisor: Experiences and views of nurse supervisors of higher degree research students
Authors: Jackson Debra , Power Tamara , Usher Kim
Published: January 2021

Aims and objectives

Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like.

Background

Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence.

Design

Qualitative storytelling, semi‐structured interviews were conducted via a videoconferencing programme, audio‐recorded and thematically analysed with twenty‐one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines.

Results

Thematic analysis revealed four themes:‘I had a great mentor’: the importance of mentorship and role modelling; ‘Sometimes it's just trial and error’: learning through experience;‘It's like tick a box’: strengths and limitations of formal supervisor training; and‘The training should be more holistic’: what should be in supervisor training.

Conclusions

We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline‐based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training.

Relevance to clinical practice

Further development of clinical nursing is inextricably linked to quality nurse‐led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence‐informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing.
Degree of intrapartum fever and associated factors: Three group analysis of no fever, borderline and overt fever
Authors: Kim Seo‐Yeon , Hong Sir‐Yeon , Kwon Do Youn , Park Hyea , Choi Suk‐Joo , Oh Soo‐Young , Kim Jung‐Sun , Choi Duck Hwan , Roh Cheong‐Rae
Published: January 2021

Aim

Previous studies analyzing intrapartum fever by dichotomization of fever just above 38.0°C or not may lead to overlook clinical significance of borderline fever. We aimed to investigate the maternal baseline and intrapartum characteristics, neonatal outcomes, and inflammatory placental pathology in relation to the degree of intrapartum fever by three group analysis.

Methods

We performed a retrospective analysis of consecutive singleton deliveries between 370/7 to 410/7 weeks divided into three groups based on the peak body temperature during labor: No fever (< 37.5°C), borderline fever (≥ 37.5°C and < 38.0°C), and overt fever (≥ 38.0°C). Maternal and intrapartum characteristics, neonatal outcomes, and inflammatory placental pathology were compared by trend analysis, intergroup difference analysis, and multivariable analysis.

Results

The degree of intrapartum fever was significantly associated with younger maternal age, nulliparity, longer duration of rupture of membrane, and epidural analgesia (p < 0.001). And the incidence of neonatal proven sepsis and mortality were not significantly different among the groups. The degree of intrapartum fever was associated with the stage of acute chorioamnionitis and funisitis (p < 0.001). Multivariate analysis revealed that the association with epidural analgesia was stronger in borderline fever than overt fever (adjusted odds ratio [95% confidence interval], borderline fever = 18.487 [11.447–29.857]; overt fever = 11.068 [4.874–25.133]) after controlling for maternal age, parity, induction or augmentation, duration of ROM, birth weight, and meconium staining.

Conclusion

Our data support that both epidural analgesia and inflammation of the placenta may contribute to the development of intrapartum fever at term.
Seasonality in catastrophe bonds and market‐implied catastrophe arrival frequencies
Authors: Herrmann Markus , Hibbeln Martin
Published: January 2021

We develop a conceptual framework to model the seasonality in the probability of catastrophe bonds being triggered. This seasonality causes strong seasonal fluctuations in spreads. For example, the spread on a hurricane bond is highest at the start of the hurricane season and declines as time goes by without a hurricane. The spread is lowest at the end of the hurricane season assuming the bond was not triggered, and then gradually increases as the next hurricane season approaches. The model also implies that the magnitude of the seasonality effect increases with the expected loss and the approaching maturity of the bond. The model is supported by an empirical analysis that indicates that up to 47% of market fluctuations in the yield spreads on single‐peril hurricane bonds can be explained by seasonality. In addition, we provide a method to obtain market‐implied distributions of arrival frequencies from secondary market spreads.
A meta‐analysis of the effect of values affirmation on academic achievement
Authors: Wu Zezhen , Spreckelsen Thees F. , Cohen Geoffrey L.
Published: January 2021

This meta‐analysis assessed the impact of values affirmation on the academic achievement of students under social identity threats in actual classrooms. After a systematic search yielded 58 relevant studies, multilevel analyses identified an overall affirmation effect for identity‐threatened students (Hedges’ g = .15), not for identity‐nonthreatened students (Hedges’ g = .01). Heterogeneity in the affirmation effect was moderate to high for identity‐threatened students, with effect sizes associated with (1) a larger covariate‐controlled achievement gap between nonthreatened and threatened students in the control condition, suggestive of psychological underperformance, (2) the availability of financial resources in school, (3) more distal performance outcomes, and (4) the presentation of values affirmation as a normal classroom activity rather than a research study or a nonnormal classroom activity. Affirmation appears to work best when it is delivered as a normal classroom activity and where identity threat co‐occurs with resources for improvement and time to await cumulative benefits.
The 48‐week safety and therapeutic effects of tenofovir alafenamide in hbv‐related acute‐on‐chronic liver failure: A prospective cohort study
Authors: Zhang Yeqiong , Xu Wenxiong , Zhu Xiang , Li Xuejun , Li Jianguo , Shu Xin , Lai Jing , Xie Junqiang , Xie Chan , Peng Liang
Published: January 2021

Tenofovir alafenamide (TAF) has been available in China for a short time, little is known about its safety and efficacy in patients with hepatitis B virus (HBV)–related acute‐on‐chronic liver failure (HBV‐ACLF). We conducted this study to further verify the safety and efficacy of TAF in these patients. Eighty‐eight eligible subjects were included and divided into three groups: TAF group, TDF group and ETV group. Clinical and laboratory test results were collected and the survival status, virus suppression status and liver and renal function improvement were observed during follow‐up. No drug‐related adverse events were observed within a 48‐week observation period. At week 48, the survival rates of the three groups were 56.5%, 78.3% and 59.5% (p = 0.262). HBV DNA undetectable rates were similar (80.0% vs.75.0% vs.84.6%, respectively, p = 0.863). Liver function improved in all the three groups over time. Compared with the other two groups, patients in the TAF group had a greater decrease in serum creatinine (CR) and an increase in estimated glomerular filtration rate (eGFR), especially at week 12. At week 48, the median changes of CR were −0.7 (IQR −3.0, 13.0) vs. 15.0 (IQR −3.0, 21.0) vs. 5.0 (IQR −9.0, 14.0), respectively (p = 0.334), while the median changes of eGFR were −2.12 (IQR −13.87, 1.44) vs. −10.43 (IQR −20.21, 3.18) vs. −5.31 (IQR −14.72, 5.44) ml/min/1.73 m2, respectively (p = 0.592). In this real‐world clinical study, TAF is as effective as TDF and ETV, and may be more beneficial in protecting renal function in the early stages of antiviral therapy.
The oestrous cycle of the Damaraland mole‐rat revisited: evidence for induced ovulation
Authors: Voigt C. , Medger K. , Bennett N. C.
Published: January 2021

African mole‐rats (family Bathyergidae) show a wide variety of social organization, from strictly solitary to highly social. Within the family, both modes of ovulation, spontaneous and induced, have been found and are thought to relate to seasonality of reproduction and opportunities for dispersal. Damaraland mole‐rats (Fukomys damarensis) are cooperative breeders, which breed year‐round and exhibit high reproductive skew. Reproduction is monopolized by a single female (queen) in each group, and non‐reproductive females in the presence of the queen are anovulatory. The species was previously described as being a spontaneous ovulator; however, subsequent attempts to determine the length of the oestrous cycle have failed. Therefore, we revisited this subject by studying the urinary progesterone and oestradiol profiles over a period of 7 weeks and the ovarian histology of females kept under different social conditions. The first experiment shows that average urinary progesterone concentrations of breeder females paired with a vasectomized male (full physical contact) are significantly higher than those of breeder females kept singly, non‐breeder females kept singly and non‐breeder females kept within their natal group. In the second experiment, we subjected females consecutively to different experimental conditions: full physical contact (stage 1), isolation (stage 2), non‐physical contact (stage 3) and measured their steroid hormone profiles. The females showed elevated concentrations of urinary progesterone during the phase of full physical contact and basal concentrations during the subsequent single housing phase. Correspondingly, no corpora lutea of ovulation were found in the ovaries of these females in the latter phase. During stage 3, in which females were separated from a male by wire mesh (non‐physical contact), one of three females showed elevated progesterone and oestradiol concentrations throughout the sampling period and analysis of ovarian histology revealed a corpus luteum. Together, these results support the view that Damaraland mole‐rats are induced ovulators, in which non‐coital male cues are able to induce ovulation.
Psychopathic traits predict moral judgements in five moral domains: The mediating effect of unpleasantness
Authors: Ye Shuer , Yang Qun , Lan Tianxiang , Wang Yuchao , Zhu Bing , Dong Yijun , Krueger Frank
Published: January 2021

Purpose

The relationship between psychopathic traits and moral judgements has evoked passionate debates among researchers. Psychopathic traits have been characterized as risk factors for immoral behaviours in both non‐forensic and forensic populations; however, whether individuals with elevated psychopathic traits display atypical moral judgements has been controversial. Here, we aim to examine how psychopathic traits are related to moral judgements in five moral foundations (Care, Fairness, Loyalty, Authority, and Sanctity) and further explore how unpleasantness mediates the relationship in non‐forensic and forensic samples.

Methods

Two hundred and twenty five college students and 219 detainees were recruited in two separate surveys. All the participants were asked to complete the moral judgement task in everyday moral scenarios, the unpleasantness ratings for the immoral behaviours and the Levenson Self‐Report Psychopathy Scale (LSRP).

Results

Psychopathic traits predicted the binary moral distinction (moral vs. immoral category) in the Care foundation in the non‐forensic sample. Moreover, psychopathic traits predicted moral acceptability ratings (continuous category) in all of the moral foundations in the non‐forensic sample but only for the Care and Loyalty foundations in the forensic sample. Finally, unpleasantness fully mediated the relationship between psychopathic traits and moral judgements in both samples.

Conclusions

Our findings provide further evidence that individuals with elevated psychopathic traits have atypical moral judgements – emphasizing the role of unpleasantness in contributing to this phenomenon. Our study has implications for understanding and treating various deviant behaviours in psychopathic individuals.
Two ways to be endemic. Alps and Apennines are different functional refugia during climatic cycles
Authors: Menchetti Mattia , Talavera Gerard , Cini Alessandro , Salvati Vania , Dincă Vlad , Platania Leonardo , Bonelli Simona , Balletto Emilio , Vila Roger , Dapporto Leonardo
Published: January 2021

Endemics co‐occur because they evolved in situ and persist regionally or because they evolved ex situ and later dispersed to shared habitats, generating evolutionary or ecological endemicity centres, respectively. We investigate whether different endemicity centres can intertwine in the region ranging from Alps to Sicily, by studying their butterfly fauna. We gathered an extensive occurrence data set for butterflies of the study area (27,123 records, 269 species, in cells of 0.5 × 0.5 degrees of latitude‐longitude). We applied molecular‐based delimitation methods (GMYC model) to 26,557 cytochrome c oxidase subunit 1 (COI) sequences of Western Palearctic butterflies. We identified entities based on molecular delimitations and/or the checklist of European butterflies and objectively attributed occurrences to their most probable entity. We obtained a zoogeographic regionalisation based on the 69 endemics of the area. Using phylogenetic ANOVA we tested if endemics from different centres differ from each other and from nonendemics for key ecological traits and divergence time. Endemicity showed high incidence in the Alps and Southern Italy. The regionalisation separated the Alps from the Italian Peninsula and Sicily. The endemics of different centres showed a high turnover and differed in phylogenetic distances, phenology and distribution traits. Endemics are on average younger than nonendemics and the Peninsula‐Sicily endemics also have lower variance in divergence than those from the Alps. The observed variation identifies Alpine endemics as paleoendemics, now occupying an ecological centre, and the Peninsula‐Sicily ones as neoendemics, that diverged in the region since the Pleistocene. The results challenge the common view of the Alpine‐Apennine area as a single “Italian refugium”.
Decade‐scale stability and change in a marine bivalve microbiome
Authors: Neu Alexander T. , Hughes Ian V. , Allen Eric E. , Roy Kaustuv
Published: January 2021

Predicting how populations and communities of organisms will respond to anthropogenic change is of paramount concern in ecology today. For communities of microorganisms, however, these predictions remain challenging, primarily due to data limitations. Information about long‐term dynamics of host‐associated microbial communities, in particular, is lacking. In this study, we use well‐preserved and freshly collected samples of soft tissue from a marine bivalve host, Donax gouldii, at a single site to quantify the diversity and composition of its microbiome over a decadal timescale. Site‐level measurements of temperature, salinity and chlorophyll a allowed us to test how the microbiome of this species responded to two natural experiments: a seasonal increase in temperature and a phytoplankton bloom. Our results show that ethanol‐preserved tissue can provide high‐resolution information about temporal trends in compositions of host‐associated microbial communities. Specifically, we found that the richness of amplicon sequence variants (ASVs) associated with D.gouldii did not change significantly over time despite increases in water temperature (+1.6°C due to seasonal change) and chlorophyll a concentration (more than ninefold). The phylogenetic composition of the communities, on the other hand, varied significantly between all collection years, with only six ASVs persisting over our sampling period. Overall, these results suggest that the diversity of microbial taxa associated with D.gouldii has remained stable over time and in response to seasonal environmental change over the course of more than a decade, but such stability is underlain by substantial turnover in the composition of the microbiome.
Longitudinal integrated clerkships are ok, but do they prepare students for reality?
Authors: O’Leary Noreen , Cantillon Peter
Published: January 2021

O'Leary and Cantillon outline how longitudinal integrated clerkships can evolve to facilitate interprofessional learning and prepare students for the collaborative practice needed to deliver modern healthcare.
Dual role of a (p)ppGpp‐ and (p)ppApp‐degrading enzyme in biofilm formation and interbacterial antagonism
Authors: Steinchen Wieland , Ahmad Shehryar , Valentini Martina , Eilers Kira , Majkini Mohamad , Altegoer Florian , Lechner Marcus , Filloux Alain , Whitney John C. , Bange Gert
Published: January 2021

The guanosine nucleotide‐based second messengers ppGpp and pppGpp (collectively: (p)ppGpp) enable adaptation of microorganisms to environmental changes and stress conditions. In contrast, the closely related adenosine nucleotides (p)ppApp are involved in type VI secretion system (T6SS)‐mediated killing during bacterial competition. Long RelA‐SpoT Homolog (RSH) enzymes regulate synthesis and degradation of (p)ppGpp (and potentially also (p)ppApp) through their synthetase and hydrolase domains, respectively. Small alarmone hydrolases (SAH) that consist of only a hydrolase domain are found in a variety of bacterial species, including the opportunistic human pathogen Pseudomonas aeruginosa. Here, we present the structure and mechanism of P. aeruginosa SAH showing that the enzyme promiscuously hydrolyses (p)ppGpp and (p)ppApp in a strictly manganese‐dependent manner. While being dispensable for P. aeruginosa growth or swimming, swarming, and twitching motilities, its enzymatic activity is required for biofilm formation. Moreover, (p)ppApp‐degradation by SAH provides protection against the T6SS (p)ppApp synthetase effector Tas1, suggesting that SAH enzymes can also serve as defense proteins during interbacterial competition.