bluuebunny/crossref_metadata_2025 huggingface dataset:
1115 Does the Published Evidence Support Cell Transplantation in Liver Disease?
Authors: Larkin E H , Armstrong E
Published: October 2021

Introduction

Although a significant body of evidence proposes a role for cell transplantation as a bridge or alternative to orthotopic liver transplantation for a range of liver disorders, this therapy is not performed in the United Kingdom. Several cell types, including human hepatocytes and mesenchymal stem cells, have been assessed for safety and efficacy, with numerous transfusion protocols. In this review we critically evaluated published human studies of hepatocyte transplantation in respect of (i) methods used to evaluate efficacy of therapy, particularly the use of validated prognostic scores for liver disease (MELD or Child-Pugh), and (ii) discrepancies in patient outcomes between studies using different cell types and transfusion protocols.

Method

We reviewed 20 studies on cell transplantation as an alternative to orthotopic liver transplantation. Patient demographics, study design and outcome measures were compared. Outcome measures were post-cell transplant patient survival to (i) the end of the follow-up window, (ii) receipt of a liver transplant, or (iii) death.

Results

Inconsistencies found in study protocols included strategies for cell transfusion, post-transplant immunosuppression and follow-up interval and duration. Comparison of results was complicated by the outcome measures themselves, as neither receipt of a graft nor mortality can be represented in the prognostic scores used. Furthermore, many studies reported biochemistry data which could not be incorporated into MELD/Child-Pugh score format.

Conclusions

Meta-analysis of hepatocyte transplant studies is not possible on account of methodological inconsistencies and lack of large, controlled trials. These may be important factors preventing wider adoption of this intervention.
11 Understanding the Clinical Performance of Ceramic Coated Femoral Components in Knee Arthroplasty Surgery
Authors: Khatkar H , Prokopenko M
Published: October 2021

Aim

In vitro knee simulation has demonstrated favourable wear properties and decreased metal ion release of ceramic coated metal femoral components in total knee arthroplasty surgery. Femoral implants coated with ceramic have been used in patients, however the subsequent clinical performance and time-to-revision of these implants is largely unknown. The scope of this study was to review the current available clinical literature, focusing on retrieval studies of Ceramic-Coated TKAs.

Method

Literature review of PubMed and MEDLINE. All studies included demonstrated clinical evaluation of implant performance, either in vivo or at revision.

Results

9 studies were identified and included for analysis in this study. Retrieval analysis has illustrated microscopic defects in coatings of revised implants, with associated abrasion and 3rd body wear of the polyethylene component. Evidence suggests that coating femoral components with ceramic can prevent effective cement bonding, leading to aseptic loosening and thus earlier implant failure. Despite these problems, high volume centres have been able to demonstrate comparable results when compared with traditional bearing surface combinations. The mechanism behind metal ion hypersensitivity is currently poorly understood; however, the use of ceramic coated knee replacements is demonstrating a reduction in metal ion release.

Conclusions

Whilst conferring favourable clinical properties in certain instances, the lack of surgical, implant and patient data surrounding the use of this coated implants remains concerning. The literature base remains limited, and meaningful clinical conclusions cannot be drawn. Recommendations include performing robust clinical trials in order to delineate the clinical efficacy of ceramic coatings in knee arthroplasty.
77 Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital
Authors: Patel B , Green S , Hennessy C , Adamu-Biu F , Ghani Y , Kankate R
Published: October 2021

Background

The Coronavirus disease (COVID-19) pandemic has contributed to over 900,000 deaths worldwide. Hospitals responded by expanding services to accommodate the forecasted rise in COVID-19-related admissions. We describe the effects these changes had on management of orthopaedic trauma and patient outcomes at a district general hospital in Southern England.

Method

Data were extrapolated retrospectively from two separate six-week periods in 2019 and 2020 (1st April - 13th May) using electronic records of patients referred to the orthopaedic team. Soft tissue injuries were included where a confirmed diagnosis was made with radiological evidence. Patients were excluded if no orthopaedic intervention was required. Data were compared between the two time periods.

Results

There were fewer attendances to hospital in 2020 compared with 2019 (178 vs 328), but time from presentation to surgery significantly increased in 2020 (2.94 days vs 4.91 days, p = 0.009). There were fewer operative complications in 2020 (36/145 vs 11/88, p < 0.001). However, ordinal logistic regression analysis found a significantly greater complication severity in 2020 including death (p = 0.039). Complication severity was unrelated to COVID-19 status.

Conclusions

Restructuring of orthopaedic services in response to the COVID-19 pandemic has been associated with significant delays to surgery and higher post-operative complication severity. Our results demonstrate the need for fast-track emergency operative orthopaedic services in UK district general hospitals whilst the COVID-19 pandemic continues.
93 The Effects of Kinesiophobia on Outcome following Total Knee Replacement: A Systematic Review
Authors: Brown O , Hu L , Demetriou C , Smith T , Hing C
Published: October 2021

Aim

Kinesiophobia, the fear of physical movement and activity related to injury vulnerability, has been linked to sub-optimal outcomes following total knee replacement (TKR). This systematic review has two aims: to define the relationship between kinesiophobia and functional outcomes, pain and range of motion following TKR, and to evaluate published treatments for kinesiophobia following TKR.

Method

A primary search was performed in March 2020. English-language studies recruiting adult primary TKR patients, using the Tampa Scale of Kinesiophobia (TSK) were included. Study quality was assessed using the Newcastle Ottawa Scale for cohort or case control studies, and the Cochrane Collaboration Risk of Bias tool for randomised controlled trials.

Results

All thirteen included papers (82 identified) showed adequately low risk of methodological bias. TSK1 (activity avoidance) correlated with WOMAC functional score at 12 months in three studies (r = 0.20 p < 0.05, R = 0.317 p = 0.001, and correlation coefficient 0.197 p = 0.005). TSK score significantly correlated with mean active range of motion (ROM) at six months (105.33 (SD = 12.34) vs 85.53 (SD = 14.77) p = 0.000) post-operation. Three post-operative interventions improved TSK score vs control following TKR: a home-based functional exercise programme (TSK -14.30 (SD = 0.80) vs -2.10 (SD = 0.80) p < 0.001)), an outpatient CBT programme (TSK 27.76 (SD = 4.56) vs 36.54 (SD = 3.58), and video-based psychological treatment (TSK 24 (SD = 5) vs 29 (SD = 5) p < 0.01).

Conclusions

Kinesiophobia negatively affects functional outcomes up until one year post-operatively, while active ROM is reduced up to six months post procedure. Post-operative functional and psychological interventions can improve kinesiophobia following TKR.
224 A 5-Year Observational Study on Distal Femoral Periprosthetic Fractures in Elderly Patients in a Single Institution: Distal Femoral Replacement vs. Internal Fixation
Authors: Ang K L , Cheah W , Jesani H , Ooi R , Agarwal S
Published: October 2021

Aim

To evaluate the outcome of distal femoral replacements versus internal fixation for elderly patients with distal femoral periprosthetic fracture in a single institution.

Method

A five-year retrospective observational study was conducted of a consecutive series of patients with distal femoral periprosthetic fracture who underwent either distal femoral replacement (DFR) or internal fixation (IF) in a tertiary referral centre. Clinical information analysed included patient demographics, co-morbidities, interval between primary total knee arthroplasty (TKA) to distal femoral periprosthetic fracture, type of fracture, operative technique, preoperative ASA grade, post-operative complications, intensive therapy unit (ITU) stay, length of hospital stay (LOS), re-fixation and mortality.

Results

Study included 27 patients of which fourteen patients underwent a DFR while 13 underwent an IF. 89% of the patients were females. Mean age of the patients at the time of fracture was 85 versus 80 (DFR vs IF). The mean interval from the primary TKA to the fracture were 80 months (range 0-181). There were no intraoperative complications in either group. Three patients required ITU stay from the DFR group while one patient from the IF group required re-fixation. Median LOS was 56 days (range 9-144) after DFR and 55 days (range 4-83) after IF. There was one 30-day mortality in the DFR group. One-year mortality for the DFR group was 7% vs 15% for the IF group.

Conclusions

In our study, DFR and IF were observed to have similar LOS with a higher mortality in the IF group at one year. There was one re-fixation in the IF group.
341 Alder Hey Experience of Paediatric Virtual Fracture Clinic During The COVID-19 Pandemic
Authors: Stead L , Ashraf M , Gandham S , Khattak M , Talbot C
Published: October 2021

Introduction

The SARS-CoV2/COVID-19 pandemic represented an unprecedented emergency prompting a drive to minimise non-essential patient contact and the need for a virtual fracture clinic (VFC); an uncommon practice in paediatric units. Management of paediatric fractures requires a greater degree of vigilance to safeguard children. The current climate has created social challenges that theoretically increase the risk of harm and exploitation to children. This study investigates VFC in the management of paediatric fractures to determine the efficiency of such a process and the risk of safeguarding.

Method

A protocol was devised in affiliation with BSCOS for the immediate management and streamlining of paediatric fractures into VFC. We retrospectively audited 235 VFC consults over a 1-month period. Patient sex was roughly evenly distributed, and age ranged from 9 months to 16 years (mean 8.4 years).

Results

42% of patients were recalled for a face-to-face (F2F) review (26% expedited), primarily for clinical assessment, plaster complaints and imaging requirements. 33% were discharged and 15% continued follow-up in VFC. All clavicle fractures were discharged. Forearm, hand, foot and elbow injuries were more likely to be discharged. Lower leg, upper arm and knee presentations more frequently required a F2F review. 2.3% of cases required safeguarding reviews.

Conclusions

Given the rapid transition to VFC without the use of triage we have determined a number of non-complex fractures safely managed and discharged via VFC. The low percentage of recall due to safeguarding concern highlights this may not be a barrier to the continuation of virtual care outside of the context of a pandemic.
470 Financial and Efficacy Analysis of a Centralised Neck of Femur Fracture Service
Authors: Ngo V , Chan G , Edmondson M
Published: October 2021

Aim

Osteoporotic fractures are rising in incidence, costing the National Health Service up to £1.1 billion for hospital care. The implementation of the Best Practice Tariff (BPT) of fragility fractures in 2010 created a financial incentive to achieve standards of best practice. In June 2015, a dedicated hip fracture unit (HFU) was set up at Princess Royal Hospital (PRH). The aim of this study is (A) to assess changes in performance to the BPT after the introduction of a dedicated HFU, and (B) whether the performance of a HFU is affected by direct/indirect presentation to the HFU.

Method

The performance of Brighton and Sussex University Hospitals (BSUH) to BPT pre and post HFU was assessed by a retrospective review of BPT performance data between 2015 and 2016. 870 patients who were treated for NOFF at BSUH were reviewed to assess whether the performance of the HFU was impacted by patients presenting either directly (PRH) to the HFU or indirectly (presentation to Royal Sussex County Hospital). Appropriate statistical tests were used to analyse the significant differences between these outcome measures.

Results

The comparison between pre and post HFU showed there was a significant increase in the time between A&E admission to ward, theatre or orthogeriatric (OG) assessment (P < 0.001) in patients presenting indirectly to HFU compared to direct presentations.

Conclusions

Having a HFU is cost neutral, and advantages of HFU include focusing NOFF care which improves in patient care. BPT achievements could be improved by increasing the direct admission of NOFF to the HFU.
502 Benefits of Rivaroxaban over Enoxaparin in Trauma and Orthopaedics
Authors: Baig N , Nasim-Mohi M , Lukaszewicz A
Published: October 2021

Aim

Our Aim was to show what the benefits of Rivaroxaban over Enoxaparin post-operatively in trauma and orthopaedics. Doing a meta-analysis of previous studies and comparing post-op thrombotic risk in both rivaroxaban and Enoxaparin. To compare costs of using Enoxaparin vs Rivaroxaban in the major trauma centre.

Method

Meta-analysis of four studies conducted;Lassen 2008, Turpie 2005, Turpie 2009, Xie 2017 and Zou 2014. Gathered data from the British national formulary about Rivaroxaban cost and enoxaparin cost.

Results

This illustrated that rivaroxaban after TKA(Total knee Arthroplasty) had a significantly lower rate of symptomatic VTE, symptomatic DVT, asymptomatic DVT, distal DVT, and proximal DVT (shown in figure 1). The study shows that rivaroxaban after TKA is more effective than enoxaparin and did not increase major bleeding or cause increased mortality Major venous thromboembolism occurred in 9 of 908 patients (1.0%) given rivaroxaban and 24 of 925 (2.6%) given enoxaparin in a study done by Lassen et al Rivaroxaban requires less training for the patient, enoxaparin requires the patient to be taught proper administration. Rivaroxaban is considerably cheaper compared to enoxaparin. Enoxaparin provided by both Inhixa and Clexane cost £30.27 for a batch of 10 pre-filled disposable injections of 40mg, whilst rivaroxaban costs £18 for 10 tablets of the dose 10mg.

Conclusions

Rivaroxaban is cheaper to use for post-op anticoagulation, less resource intensive as patient is not required to be taught optimal administration method. Rivaroxaban has significantly reduced occurrence of thrombus compared to that of enoxaparin (based of the meta-analysis).
535 Are Routine Post-Operative Blood Tests Necessary Following Hip or Knee Arthroplasty in Fit and Well Patients?
Authors: Mullen J , Moulder E
Published: October 2021

Introduction

Enhanced recovery protocols in hip and knee arthroplasty have achieved same-day discharge in selected patients. However, abnormal serum sodium, haemoglobin and creatinine may affect postoperative management. In particular, Serum creatinine guides dosage of prophylactic direct oral anticoagulants (DOAC). In this study we aim to establish if post-operative blood tests following arthroplasty might affect management.

Method

Patients undergoing primary hip and knee arthroplasty surgery at our unit between April 2018 and March 2019 were included. National Joint Registry input forms were used to identify the patients and their American Society for Anaesthesiologists (ASA) grade. Patients with an ASA grade of 1 or 2 were included. The incidence of AKI, hyponatraemia, drop in haemoglobin below 80g/L (the threshold for consideration of transfusion) and altered DOAC dose were recorded. For statistical analysis, the z-test of single proportion was used to compare results to a hypothesised expected population proportion of 1% for group sizes greater than 10. The p-value was set to 0.05.

Results

Results leading to a change in management were seen in 19 of the 218 patients (8.7%) (p < 0.0001). Twelve patients (5.5%) developed stage 1 or 2 AKI (p < 0.0001). Three patients required a reduction in the DOAC dose in response to their post-operative creatinine result. Post-operative haemoglobin level was below 80 g/L in two patients. Hyponatraemia was observed in one fifth of the patients and required intervention in two patients.

Conclusions

Post-operative blood tests are essential prior to discharge for all patients following hip and knee arthroplasty, regardless of pre-operative status.
Cortical origin of the successive cambia in the stems of the charismatic temperate lianescent genusWisteria(Fabaceae) and its systematic importance
Authors: Nejapa Rosa , Cabanillas Pablo A , Pace Marcelo R
Published: October 2021

Successive cambia are not commonly reported in lianas from temperate zones, but previous studies have pointed to their presence in Wisteria, albeit with controversy concerning their origin. The aim of this work was to elucidate the origin and development of the successive cambia in stems of Wisteria and to check whether this cambial variant is shared by the entire genus. We use detailed anatomical analyses to identify the anatomical ontogeny of the successive cambia. Our results reveal that all species studied share the presence of successive cambia. For several years, the secondary growth is regular; with the development of the cambial variant occurring outside from the pericyclic fibres in the cortical parenchyma. This occurs in patches, which commonly merge, resulting in many different configurations of this cambial variant in the stem. Successive cambia are probably a synapomorphy of Wisteria, and here we highlight the importance of the topological position of the pericyclic fibres in identifying the origin of this cambial variant in the genus.
Quantifying and mapping angiosperm endemism in theAraucariaForest
Authors: Dornelles Mariane Paludette , Heiden Gustavo , Nic Lughadha Eimear , Iganci João
Published: October 2021

Neotropical forests are home to exceptional biodiversity, especially along the eastern coast of tropical and subtropical South America. In the Atlantic Forest, the subtropical Araucaria Forest harbours both tropical and temperate plant lineages. Is the presence of Araucaria angustifolia the only attribute characterizing the south-eastern South American Araucaria Forest, or is this formation also defined by the co-occurrence of other endemic species? To answer this question, we revisited the history of this vegetation from published lists and from the current distribution data of angiosperm species. We aimed to identify species endemic to the Araucaria Forest, and to analyse areas of endemism, species richness and occurrence records across the study area. The taxa reported were classified as endemic, near-endemic or non-endemic. A list of 52 endemic taxa and 28 near-endemics was built from public databases and refined. Our results indicate that the eastern region of the southern plateau between the states of Rio Grande do Sul and Santa Catarina has the highest endemism diversity. We suggest that complex interactions are involved in the origin of endemism and that lineages represented in the list of endemic species may contain key taxa for future understanding these drivers in space and time.
Reduced global longitudinal strain as a marker for early detection of Fabry cardiomyopathy
Authors: Lu Dai-Yin , Huang Wei-Ming , Wang Wei-Ting , Hung Sheng-Che , Sung Shih-Hsien , Chen Chen-Huan , Yang Yu-Jou , Niu Dau-Ming , Yu Wen-Chung
Published: October 2021

Aims

Fabry cardiomyopathy (FC) is characterized by progressive left ventricular hypertrophy (LVH). Conventional echocardiography is not sensitive in detecting preclinical FC before the development of LVH. We aim to investigate whether myocardial deformation analysis is useful to detect preclinical FC before LVH.

Methods and results

One hundred and sixty patients carrying mutated gene were prospectively enrolled, including 86 patients without LVH and 74 patients with LVH. Another 33 healthy individuals were also included for comparison. Standard transthoracic two-dimensional, Doppler, tissue Doppler echocardiography and deformation analysis were performed. The mean age of the overall 193 subjects was 48 ± 15 years, with 51% men. Fabry patients with LVH were older, more often to be men. They also had the worst diastolic function as evidenced by the largest left atrium, lowest E/A, and highest E/e′ ratio. The global longitudinal strain (GLS) deteriorated with the development of LVH (control vs. LVH− patients vs. LVH+ patients = −21.2 ± 2.7 vs. −19.0 ± 2.9 vs. −16.5 ± 4.2%, P < 0.001). Despite similar LV systolic, diastolic function, and LV mass, LVH− Fabry patients still had a reduced GLS as well as regional longitudinal strains at mid-to-apical, anterior, and inferolateral wall when compared to healthy subjects. The basal longitudinal strain was consistently worse in male patients than in female patients, irrespective of LVH.

Conclusion

Reduced GLS could be a marker of early FC before the development of LVH.
Treatment of ocean tide background model errors in the context of GRACE/GRACE-FO data processing
Authors: Abrykosov Petro , Sulzbach Roman , Pail Roland , Dobslaw Henryk , Thomas Maik
Published: October 2021

Ocean tide (OT) background models (BMs) used for a priori de-aliasing of GRACE/GRACE-FO observations feature distinct spatial uncertainties (primarily in coastal proximity and in latitudes above ±60°), and therefore pose one of the largest contributors to the overall retrieval error. The retrieval performance can be expected to increase if this underlying spatial error distribution is stochastically modelled and incorporated into the data processing chain. In this contribution, we derive realistic error variance-covariance matrices (VCM) based on a set of five state-of-the-art OT models. The additional value of using such VCMs is assessed through numerical closed-loop simulations, where they are rigorously propagated from model to observation level. Further, different approximations of the resulting VCM of observations are assumed, that is full, block-diagonal and diagonal, in order to evaluate the trade-off between computational efficiency and accuracy. It is asserted that correctly weighting the OT BM error can improve the gravity retrieval performance by up to three orders of magnitude, provided no further error contributors are considered. In comparison, the overall gain in retrieval performance is reduced to 75 per cent once instrument noise is taken into account. Here, it is shown that simultaneously modelling the OT BM and the instrument errors is critical, as each effect induces different types of correlations between observations, and exclusively considering covariance information based on the sensor noise may degrade the solution. We further demonstrate that the additional benefit of incorporating OT error VCMs is primarily limited by the de-aliasing performance for non-tidal mass variations of atmosphere (A) and oceans (O). This emphasizes the necessity of best-possible AO-de-aliasing (e.g. through optimized processing techniques and/or improved BMs) in order to optimally exploit the OT BM weighting.
Regulating platforms and ecosystems: an introduction
Authors: Jacobides Michael G , Lianos Ioannis
Published: October 2021

Digital technologies and modular production methods have led to the emergence of a new generation of global leaders which cement their market position by orchestrating digital platforms and ecosystems of complementors, which offer them new ways to create and capture value that often transcend the boundaries of existing sectors. Their business models, built on intangibles such as software code and access to data, support expansion that is both breathtakingly rapid and effectively costless. With capital markets all too willing to invest in these firms’ growth, and regulators unable to rein them in, these firms have been able to accumulate unprecedented power and wealth, with profound implications for competition, the economy, and society itself. This special issue confronts the challenge of regulating platforms and ecosystems head-on, revisiting the economic, strategic, and legal foundations that enable us to detect and redress issues of dominance and competition and address questions of the appropriate conception of and limits of the law. The papers included cover topics including the true nature of competition with an emphasis on dynamics and innovation, new approaches for legal and economic analysis including the alternatives for the “welfare criterion” and the protection of sunk investments, the approaches to take on tech mergers and acquisitions, the virtues and limits of self-regulation, the potential for radical breakups of Big Tech, and the issues of data, when privacy protection and competition steer us in different directions. Contributors also weigh up the case for regulatory intervention, the practical challenges involved, and the future state that we hope such actions will bring about.
Robust multigrid methods for nearly incompressible elasticity using macro elements
Authors: Farrell Patrick E , Mitchell Lawrence , Scott L Ridgway , Wechsung Florian
Published: October 2021

We present a mesh-independent and parameter-robust multigrid solver for the Scott–Vogelius discretisation of the nearly incompressible linear elasticity equations on meshes with a macro element structure. The discretisation achieves exact representation of the limiting divergence constraint at moderate polynomial degree. Both the relaxation and multigrid transfer operators exploit the macro structure for robustness and efficiency. For the relaxation we use the existence of local Fortin operators on each macro cell to construct a local space decomposition with parameter-robust convergence. For the transfer we construct a robust prolongation operator by performing small local solves over each coarse macro cell. The necessity of both components of the algorithm is confirmed by numerical experiments.
International Prosecutors as Cause Lawyers
Authors: Batesmith Alex
Published: October 2021

This article contributes to the developing socio-legal perspectives on the practical realities, power dynamics, and external perceptions of international criminal law (ICL) by exploring the professional sense of self among international prosecutors. Drawing upon original interviews with ‘everyday’ practitioners, the article uses the prism of ‘cause lawyering’ — the practice of law primarily for a lawyer’s moral, political or ideological commitments — to illustrate the struggle between ICL’s legal professionals within Bourdieu’s concept of the juridical field. As a majoritarian practice among international prosecutors, cause lawyering evidences the position-taking of actors who look to assert their authority over and distinction from others within the field, while also exemplifying the strong correlation between professional role and personal identity. Identifying some of the consequences of cause lawyering for ICL, the article concludes by considering the broader implications of a relational study of the discipline’s legal professionals.
Sensitivity to habitable planets in the Roman microlensing survey
Authors: Sajadian Sedighe
Published: October 2021

We study the Roman sensitivity to exoplanets in the Habitable Zone (HZ). The Roman efficiency for detecting habitable planets is maximized for three classes of planetary microlensing events with close caustic topologies. (a) The events with the lens distances of Dl ≳ 7 kpc, the host lens masses of $M_{\rm h}\gtrsim 0.6\, {\rm M}_{\odot }$. By assuming Jupiter-mass planets in the HZs, these events have q ≲ 0.001 and d ≳ 0.17 (q is their mass ratio and d is the projected planet-host distance on the sky plane normalized to the Einstein radius). The events with primary lenses, $M_{\rm h} \lesssim 0.1 \, {\rm M}_{\odot }$, while their lens systems are either (b) close to the observer with Dl ≲ 1 kpc or (c) close to the Galactic bulge, Dl ≳ 7 kpc. For Jupiter-mass planets in the HZs of the primary lenses, the events in these two classes have q ≳ 0.01, d ≲ 0.04. The events in the class (a) make larger caustics. By simulating planetary microlensing events detectable by Roman, we conclude that the Roman efficiencies for detecting Earth- and Jupiter-mass planets in the Optimistic HZs (OHZs, which is the region between [0.5, 2] au around a Sun-like star) are 0.01 and $5{{\ \rm per\ cent}}$, respectively. If we assume that one exoplanet orbits each microlens in microlensing events detectable by Roman (i.e. ∼27 000), this telescope has the potential to detect 35 exoplanets with the projected planet-host distances in the OHZs with only one having a mass ≲10M⊕. According to the simulation, 27 of these exoplanets are actually in the OHZs.
Reducing the use of sleep-inducing drugs during hospitalization by a multi-faceted intervention – a pilot study
Authors: Heinemann Stephanie , Klemperer Jonas , Hummers Eva , Nau Roland , Himmel Wolfgang
Published: October 2021

Objectives

Many patients receive benzodiazepines or Z-drugs during hospitalization due to sleeping problems. In a pilot study, we aimed to find out whether, and to what degree, a multi-faceted intervention can reduce the use of these drugs, especially in older patients and those without a psychiatric or neurological disorder. The results of this pilot study should inform the design of a randomised controlled trial (RCT).

Methods

In a quasi-experimental design, we implemented the intervention in a German hospital with the support of the hospital director, medical and nursing staff and employee representatives. We compared prescription data for sleep-inducing drugs before and after the intervention by Fisher’s exact test and used Odds-Ratios (ORs) with their 95 % confidence intervals (CI) as measure of effect size.

Results

The data from 960 patients aged 65 and older before intervention and 1049 patients after intervention were analysed. Before intervention, 483 (50.3%) of the patients received sleep-inducing drugs at some time during their hospital stay. After the intervention, 381 (36.3%) patients received a sleep-inducing drug, resulting in an OR of 0.56 (95% CI: 0.47 to 0.68; p <0.001). The reduction was particularly pronounced in patients without a psychiatric or neurological disorder (from 45.0% to 28.8%). Especially benzodiazepines were significantly reduced (from 24.3% to 8.5%; OR: 0.31 (0.23-0.4); <0.001).

Conclusions

A multi-faceted intervention to change the practice of the use of sleep-inducing drugs in one hospital was successful in terms of drug reduction, particularly for benzodiazepines. The intervention was effective especially for target persons, i.e. those without a psychiatric or neurological disease. Being aware of the magnitude of the change and the role of important stakeholders could help researchers, hospital physicians and hospital pharmacists to design a large RCT, including control hospitals, to evaluate the success of a multi-faceted intervention on a scientifically sound basis.

KEY MESSAGES

What is already known on this subject

Benzodiazepines and Z-drugs are still too often used for sleep problems in hospitals.

Simple interventions, such as training seminars to reduce the use of benzodiazepines, Z-drugs, and other drugs for insomnia treatment are limited in their effect.

What this study adds

The intervention significantly reduced the rate of sleep-inducing drugs by 14 percentage points.

The results of this pilot study give a first impression of the possible impact of the interventions and provide essential information for the design of a randomized controlled study.
Global and Local Head Direction Coding in the Human Brain
Authors: Shine J. P. , Wolbers T.
Published: October 2021

Orientation-specific head direction (HD) cells increase their firing rate to indicate one’s facing direction in the environment. Rodent studies suggest HD cells in distinct areas of thalamus and retrosplenial cortex (RSC) code either for global (relative to the wider environment) or local (e.g., room-specific) reference frames. To investigate whether similar neuroanatomical dissociations exist in humans, we reanalysed functional magnetic resonance imaging data in which participants learned the orientation of unique images in separate local environments relative to distinct global landmarks (Shine, Valdés-Herrera, Hegarty, & Wolbers, 2016). The environment layout meant that we could establish two separate multivariate analysis models in which the HD on individual trials was coded relative either to global (North, South, East, West) or local (Front, Back, Right, Left) reference frames. Examining the data first in key regions of interest (ROI) for HD coding, we replicated our previous results and found that global HD was decodable in the thalamus and precuneus; the RSC, however, was sensitive only to local HD. Extending recent findings in both humans and rodents, V1 was sensitive to both HD reference frames. Additional small volume-corrected searchlight analyses supported the ROI results and indicated that the anatomical locus of the thalamic global HD coding was located in the medial thalamus, bordering the anterior thalamus, a region critical for global HD coding in rodents. Our findings elucidate further the putative neural basis of HD coding in humans, and suggest that distinct brain regions code for different frames of reference in HD.

Significance statement

Head direction (HD) cells provide a neural signal as to one’s orientation in the environment. HD can be coded relative to global or local (e.g., room-specific) reference frames, with studies suggesting that distinct areas of thalamus and retrosplenial cortex (RSC) code for this information. We reanalysed fMRI data where human participants associated images with global HDs before undergoing scanning. The design enabled us to examine both global and local HD coding. Supporting previous findings, global HD was decodable in thalamus, however the RSC coded only for local HD. We found evidence also for both reference frames in V1. These findings elucidate the putative neural basis of HD coding in humans, with distinct brain regions coding for different HD reference frames.
Cryo-electron microscopy revealed TACAN is extensively and specifically associated with membrane lipids
Authors: Wang Zhen , Fan Fengying , Dong Lili , Wang Qingxia , Zhou Yue , Gao Rongchao , Yu Xuekui
Published: October 2021

TACAN is not a mechanosensitive ion channel but significantly linked to the mechanical hyperalgesia. In this study, we show that the human TACAN is a homodimer with each monomer consisting of a body, a spring and a blade domains. The body domain contains six transmembrane helices that forms an independent channel. The spring domain adapts a loop-helix-loop configuration with the helix running within and parallel to the membrane. The blade domain is composed of two cytoplasmic helices. In addition, we found that all the helices of the body and the spring domains are specifically associated with membrane lipids. Particularly, a lipid core, residing within a cavity formed by the two body and spring domains, contacts with the helices from the body and spring domains and extends to reach two symmetrically arranged lipid clusters. These results extremely imply that the membrane lipids coordinate with the membrane-embedded protein to sense and transduce the mechanic signal.
Serine/arginine-rich splicing factor 7 plays oncogenic roles through specific regulation of m6A RNA modification
Authors: Cun Yixian , An Sanqi , Zheng Haiqing , Lan Jing , Chen Wenfang , Luo Wanjun , Yao Chengguo , Li Xincheng , Huang Xiang , Sun Xiang , Wu Zehong , Hu Yameng , Li Ziwen , Zhang Shuxia , Wu Geyan , Yang Meisongzhu , Tang Miaoling , Yu Ruyuan , Liao Xinyi , Gao Guicheng , Zhao Wei , Wang Jinkai , Li Jun
Published: October 2021

Serine/Arginine-Rich Splicing Factor 7 (SRSF7), which is previously recognized as a splicing factor, has been revealed to play oncogenic roles in multiple cancers. However, the mechanisms underlying its oncogenic roles have not been well addressed. Here, based on N6-methyladenosine (m6A) co-methylation network analysis across diverse cell lines, we found SRSF7 positively correlated with glioblastoma cell-specific m6A methylation. We then proved SRSF7 is a novel m6A regulator that specifically facilitates the m6A methylation near its binding sites on the mRNAs involved in cell proliferation and migration through recruiting methyltransferase complex. Moreover, SRSF7 promotes the proliferation and migration of glioblastoma cells largely dependent on the m6A methyltransferase. The two single-nucleotide m6A sites on PBK are regulated by SRSF7 and partially mediate the effects of SRSF7 on glioblastoma cells through recognition by IGF2BP2. Together, our discovery revealed a novel role of SRSF7 in regulating m6A and timely confirmed the existence and functional importance of RNA binding protein (RBP) mediated specific regulation of m6A.
Resting brain activity emerges from wave propagating along spatiotemporal varying hyper-structural connectome
Authors: Wang Yanjiang , Ma Jichao , Meng Qingwei , Chen Xue , Du Chunyu
Published: October 2021

How spontaneous brain activities emerge from the structural connectivity (SC) has puzzled researchers for a long time. The underlying mechanism still remains largely unknown. Previous studies on modeling the resting-state human brain functional connectivity (FC) are normally based on the relatively static structural connectome directly and very few of them concern about the dynamic spatiotemporal variability of FC. Here we establish an explicit wave equation to describe the spontaneous cortical neural activities based on the high-order hypergraph representation of SC. Theoretical solution shows that the dynamic couplings between brain regions fluctuates in the form of an exponential wave regulated by the spatiotemporal varying Laplacian of the hyper-structural connectome (hSC), which orchestrates the cortical activities propagating in both space and time. Ultimately, we present a possible mechanism of how negative correlations emerge during the fluctuation of the hypergraph Laplacian of SC, which helps to further understand the fundamental role of SC in shaping the entire pattern of FC with a new perspective. Comprehensive tests on four connectome datasets with different resolutions confirm our theory and findings.
Fifty years of the UK Misuse of Drugs Act 1971: the legislative contexts
Authors: Stothard Blaine
Published: October 2021

Purpose

The purpose of this paper is to illustrate the history of relevant legislation before and after the 1971 Misuse of Drugs Act (MDA).

Design/methodology/approach

A chronological narrative of laws and reports with concluding discussion.

Findings

That UK legislators have not made use of the evidence base available to them and have favoured enforcement rather than treatment approaches. That current UK practice has exacerbated not contain the use of and harms caused by illegal drugs.

Research limitations/implications

The paper does not cover all relevant documents, especially those from non-governmental sources.

Practical implications

The practical implications centre on the failure of consecutive governments to reflect on and review the impact of current legislation, especially on people who use drugs.

Social implications

That the situations of people who use drugs are currently ignored by the government and those proven responses which save lives and reduce harm are rejected.

Originality/value

The paper attempts to show the historical contexts of control and dangerousness of which the MDA is one instrument.
Marketing the past over the long run: uses of the past in French accounting textbooks, 17th-19th c.
Authors: Labardin Pierre , Gervais Pierre
Published: October 2021

Purpose

A growing share of the literature in the fields of marketing and organizational theory is focusing on the uses of the past. This paper aims to propose an analysis of these uses over the long run and concludes that these uses of the past may themselves be historicized.

Design/methodology/approach

The paper uses accounting textbooks published in French from the seventeenth to the nineteenth century. This study uses historical and organizational literature to account for observed variations.

Findings

Two conceptualizations of the past can be found in the sources from the period studied, depending on the period one considers, each of them leading to a different marketing strategy. In the first one, the past is presented as providing most or even all the value of what is offered in the present, as past experience serves as a stepping stone to a better product. The second conception breaks with these mostly positive views and presents the past as a dangerous routine, from which one must be freed to innovate.

Originality/value

Studying marketing uses of the past over the long run allows us to identify a limited set of possible sales pitches using the past to promote work and to identify the constraints orienting these pitches at any given time.
The impact COVID-19 has had on diverse talent
Authors: Reichwald Simon
Published: October 2021

Purpose

The purpose of this paper is to explain the impact COVID-19 has had on diverse talent across the UK and explores how HR teams can now better support individuals of all backgrounds in the workplace.

Design/methodology/approach

The author draws on his experience as Strategic Lead for Talent at MyKindaFuture, as well as being former Honorary Vice President of the Institute of Student Employers.

Findings

While COVID-19 has posed huge challenges to many underrepresented groups and put D&I initiatives on hold across the country, the past 18 months have also brought with it some positive progress, with many new opportunities beginning to open up for diverse talent.

Originality/value

Readers can benefit from the author’s unique perspective and experience of working with organisations to develop, implement and deliver talent strategies, with a focus on tapping into overlooked talent pools and then improving the diversity of that talent.
The impact of Medicaid expansion on emergency department wait times
Authors: Allen Lindsay , Gian Cong T. , Simon Kosali
Published: October 2021

Objective

To estimate the impact of Medicaid expansion on emergency department (ED) wait times.

Data sources

We used 2012–2017 hospital‐level secondary data from the CMS Hospital Compare data warehouse.

Study design

We used a state‐level difference‐in‐differences approach to identify the impact of Medicaid expansion on four measures of ED wait times: time before being seen by a provider; time before being sent home after being seen by a provider; boarding time spent in the ED waiting to be discharged to an inpatient room; and the percentage of patients who left without being seen. We compared outcomes in states that expanded Medicaid with those in states that did not expand Medicaid.

Data collection/extraction methods

Our sample included all US acute care hospitals with EDs in states that did not ever expand Medicaid or that fully expanded Medicaid in January of 2014.

Principal findings

Medicaid expansion was associated with a 3.1‐min increase (SE: 0.994, baseline mean: 30.8 min) in the time spent waiting to see an ED provider, a relative increase of 10%. Patients who were eventually sent home after being seen by a provider experienced a 7.5‐min increase (SE: 1.8, baseline mean 142.1 min) in wait time. Boarding time rose by 3.8 min (SE 1.9, baseline mean 111.4 min). The percentage of patients who left without being seen rose by 0.3 percentage points (SE: 0.09, baseline mean 2.0), a relative increase of 15.3%.

Conclusions

This study provides multistate evidence that Medicaid expansion increased ED wait times for patients, indicating that ED crowding may have worsened post‐expansion. Future work should aim to uncover the mechanisms through which insurance expansion increased ED wait times to provide policy direction.
Intraguild interference of spiders and ladybirds in a cotton field: Evidence from their active time and aphid control efficiency
Authors: Wang Guifeng , Dong Zhaoke , Li Lili , Lu Zengbin , Li Chao , Men Xingyuan
Published: October 2021

In field crop systems, biocontrol efficiency supported by various predators is not always enhanced with occurring simultaneously but can be reduced by predator interference, i.e., competition between predator individuals over access to their prey. Such interference may be related to the active time of each predator. In this study, predator exclusion experiments were used to selectively exclude either one or both predators and to examine the impact of the two predator groups on the suppression of cotton aphid (Aphis gossypii Glover) populations in a cotton field. Main predator species included Propylaea japonica (Thunberg) and Harmonia axyridis Pallas in the ladybird group, and Lycosa spp. and Erigone spp in the spider group. A greater number of spiders was observed in the morning and evening, while ladybird densities did not vary during the day. Removing all predators led to an increase in aphid numbers compared to the other treatments where predators were present. Removing either spiders or ladybirds had similar impacts on aphid control. It is likely that spiders provide an equal level of aphid mortality as ladybirds. When both spiders and ladybirds were present, aphid abundance did not differ from those treatments where only one predator group was present. The presence of both predators did not lead to more aphid suppression, indicating that interference between these predators may have occurred in the cotton field. Although these two predators partly diverged in their activity rhythms, interference may still have occurred and could be common in cotton fields.
The Perceptions on Digital Citizenship Among Prospective Teachers: A Survey-Explorative Study in Westkalimantan-Indonesia
Authors: Djudin Tomo , Kartono Kartono
Published: October 2021

Digital citizenship has become a priority in education almost all over the world. This study aims to explore the level of perception of prospective teacher students regarding digital citizenship and analyze differences in the level of perception of digital citizenship in terms of gender, educational background, and various regional geographical characteristics. This research applies descriptive method with survey-explorative study. A total of 345 student teacher candidates in the sixth semester of the 2020/2021 Academic Year at Westkalimantan of Educational Personnel Education Institute (LPTK) were involved as samples. To explore the level of perceptions of digital citizenship of prospective teachers, this study adopted a questionnaire of Likert scale. Based on data analysis, it was found; (1) the perception profile of students (prospective teachers) about digital citizenship is quite varied; (2) there is no significant difference in the level of perceptions between female and male students; (3) there are significant differences in the level of student perception in terms of various educational backgrounds and geographical conditions from the area where they live. Prospective teachers  need to be trained on the knowledge, skills, and values of digital citizenship before they provide learning services in schools.