bluuebunny/crossref_metadata_2025 huggingface dataset:
High diversity of pathogenic Escherichia coli clones carrying mcr‐1 among gulls underlines the need for strategies at the environment–livestock–human interface
Authors: Ribeiro‐Almeida Marisa , Mourão Joana , Novais Ângela , Pereira Sofia , Freitas‐Silva Joana , Ribeiro Sofia , Martins da Costa Paulo , Peixe Luísa , Antunes Patrícia
Published: June 2022

The expansion of mcr‐carrying bacteria is a well‐recognized public health problem. Measures to contain mcr spread have mainly been focused on the food–animal production sector. Nevertheless, the spread of MCR producers at the environmental interface particularly driven by the increasing population of gulls in coastal cities has been less explored. Occurrence of mcr‐carrying Escherichia coli in gull's colonies faeces on a Portuguese beach was screened over 7 months. Cultural, molecular and genomic approaches were used to characterize their diversity, mcr plasmids and adaptive features. Multidrug‐resistant mcr‐1‐carrying E. coli were detected for 3 consecutive months. Over time, multiple strains were recovered, including zoonotic‐related pathogenic E. coli clones (e.g. B2‐ST131‐H22, A‐ST10 and B1‐ST162). Diverse mcr‐1 genetic environments were mainly associated with ST2/ST4‐HI2 (ST10, ST131, ST162, ST354 and ST4204) but also IncI2 (ST12990) plasmids or in the chromosome (ST656). Whole‐genome sequencing revealed enrichment of these strains on antibiotic resistance, virulence and metal tolerance genes. Our results underscore gulls as important spreaders of high‐priority bacteria and genes that may affect the environment, food–animals and/or humans, potentially undermining One‐Health strategies to reduce colistin resistance.
Trouble with autonomy in behavioral insurance
Authors: Tanninen Maiju , Lehtonen Turo‐Kimmo , Ruckenstein Minna
Published: June 2022

In this article, we study how people define, negotiate, and perform autonomy in relation to digital technologies, specifically in connection with behavioral insurance policies that involve forms of data tracking and health services. The article builds on focus group discussions, which we treat as a dynamic site of ethico‐political deliberation to test ideas, talk about boundaries of acceptable control, and envision future scenarios. The ethico‐political deliberations assess the legitimacy and usability of new behavioral tools. Concern over the nature and limits of autonomy is activated when people discuss how wellbeing‐related decisions are delegated to algorithmically controlled systems. We argue for appreciating autonomy as a relational and ambiguous notion that is sensed and enacted in collaborations with devices in the form of distributed autonomy. Moreover, as reflected by the experiences of the insured, “autonomy” cannot be analyzed solely in the form transmitted by the liberal tradition; that is, as a clear‐cut entity that can simply be “had”, “exerted”, or “controlled”. Consequently, research, ethical considerations, and governance initiatives should pay attention to how values are “done” in the affect‐laden technologically mediated relations and practices.
Analytical strategies for the determination of biogenic amines in dairy products
Authors: Moniente Marta , Botello‐Morte Laura , García‐Gonzalo Diego , Pagán Rafael , Ontañón Ignacio
Published: June 2022

Biogenic amines (BA) are mainly produced by the decarboxylation of amino acids by enzymes from microorganisms that emerge during food fermentation or due to incorrectly applied preservation processes. The presence of these compounds in food can lead to a series of negative effects on human health. To prevent the ingestion of high amounts of BA, their concentration in certain foods needs to be controlled. Although maximum legal levels have not yet been established for dairy products, potential adverse effects have given rise to a substantial number of analytical and microbiological studies: they report concentrations ranging from a few mg/kg to several g/kg. This article provides an overview of the analytical methods for the determination of biogenic amines in dairy products, with particular focus on the most recent and/or most promising advances in this field. We not only provide a summary of analytical techniques but also list the required sample pretreatments. Since high performance liquid chromatography with derivatization is the most widely used method, we describe it in greater detail, including a comparison of derivatizing agents. Further alternative techniques for the determination of BA are likewise described. The use of biosensors for BA in dairy products is emerging, and current results are promising; this paper thus also features a section on the subject. This review can serve as a helpful guideline for choosing the best option to determine BA in dairy products, especially for beginners in the field.
Identification of Milankovitch Cycles and Calculation of Net Primary Productivity of Paleo‐peatlands using Geophysical Logs of Coal Seams
Authors: SHAO Longyi , WEN He , GAO Xiangyu , SPIRO Baruch , WANG Xuetian , YAN Zhiming , LARGE David J.
Published: June 2022

Individual coal seams formed in paleo‐peatlands represent sustained periods of terrestrial carbon accumulation and a key environmental indicator attributed to this record is the rate of carbon accumulation. Determining the rate of carbon accumulation requires a measure of time contained within the coal. This study aimed to determine this rate via the identification of Milankovitch orbital cycles in the coals. The geophysical log is an ideal paleoclimate proxy and has been widely used in the study of sedimentary records using spectral analysis. Spectral analyses of geophysical log from thick coal seams can be used to identify the Milankovitch cycles and to calculate the period of the coal deposition. By considering the carbon loss during coalification, the long‐term average carbon accumulation rate and net primary productivity (NPP) of paleo‐peatlands in coal seams can be obtained. This review paper presents the procedures of analysis, assessment of results and interpretation of geophysical logs in determining the NPP of paleo‐peatlands.
Spain: Political Developments and Data in 2021
Authors: SOTILLOS IRENE DELGADO , FERNÁNDEZ‐PASARÍN ANA MAR , BOHIGUES ASBEL
Published: June 2022

During 2021, Spain faced problems arising from the COVID‐19 pandemic, including high‐risk public health situations in some regions. A vaccination campaign was carried out for the entire Spanish population, constrained by the arrival of doses and their distribution among regions. Several precepts of the legislation framing the COVID‐19 state of alarm were declared unconstitutional by the Constitutional Court. The Cabinet underwent successive reshuffles prompted by the regional electoral processes held in Catalonia and Madrid, and by the balance of power between the two parties that formed the coalition government. In 2021, the labour market began to improve thanks to the arrival of European funds aimed at implementing programmes to mitigate the economic and social damage of the pandemic.
Disparities in the emergency department management of pediatric migraine by race, ethnicity, and language preference
Authors: Hartford Emily A. , Blume Heidi , Barry Dwight , Hauser Chatterjee Jessica , Law Emily
Published: June 2022

Background

There are disparities in pain management for children presenting to the emergency department (ED) according to their racial and ethnic backgrounds. It is not known if there are differences in the treatment of pain associated with pediatric migraines by race, ethnicity, and language for care (REaL).

Methods

We analyzed treatment patterns and outcomes in our ED for acute migraine in pediatric patients by REaL. Retrospective data on treatments, length of stay (LOS), and charges were collected from the electronic medical record for pediatric patients on the ED migraine pathway from October 2016 to February 2020. Patient race/ethnicity and language for care were self‐reported at registration. We analyzed two treatment groups: receipt of oral (PO) or intranasal (IN) medications only or intravenous (IV) ± IN/PO medications. A total of 833 patients (median age 14.8 years, interquartile range [IQR] 12.3–16.5 years; 67% female, 51% non‐Hispanic White (nHW), 23% Hispanic, 8.3% Black or African American, 4.3% Asian) were included. A total of 287 received PO/IN medications only and 546 received IV medications.

Results

Initial pain scores in the two groups were similar. Patients who were Asian, Black or African American, and Hispanic or had a language for care other than English (LOE) had significantly lower odds of receiving IV treatment, while patients who were nHW and preferred English had higher odds of receiving IV treatment. The IV treatment group had longer LOS and ED charges. Pediatric ED patients with migraine who were Black, Asian, and Hispanic or had a LOE had a decreased likelihood of receiving IV therapies while patients who were nHW were more likely to receive IV treatments, despite similar initial pain scores.

Conclusions

These data align with previous studies on pain management disparities and highlight another area where we must improve equity for patients in the ED.
Why language matters in alcohol research: Reducing stigma
Authors: Shi Hannah D. , McKee Sherry A. , Cosgrove Kelly P.
Published: June 2022

Background

The use of pejorative or stigmatizing language to describe individuals with alcohol and drug use disorders adversely affects treatment seeking, quality of care, and treatment outcomes. In 2015, the International Society of Addiction Journal Editors released terminology guidelines that recommended against the use of words that contribute to stigma against individuals with an addictive disorder. This study examined the use of stigmatizing language in National Institutes of Health (NIH)‐funded research and reviews published by the journal, Alcoholism: Clinical and Experimental Research (ACER) from 2010 to 2020, with the goal of sharing the results with the alcohol research community to enhance awareness.

Methods

The search for stigmatizing language in ACER was limited to NIH‐funded articles made publicly available on PubMed Central (PMC). Though ACER is not an open‐access journal, original research and reviews directly funded by NIH are published to PMC for open access to the public as required by the conditions of NIH funding. ACER articles published on PMC were searched from 2010 to 2020 with specific queries for individual terms of interest including those considered pejorative (“alcoholic,” “addict,” and “abuser”) and outdated (“alcohol dependent,” “alcohol abuse,” and “alcoholism”). The number of articles containing a term of interest for a given year was divided by the total number of articles published in that year to determine the percent use of each term per year.

Results

Our search of research and reviews (n = 1903) published in ACER on PMC determined that although the use of pejorative and outdated terminology has decreased over time, there is continued use of the term “alcoholic” over the last decade. Specifically, in 2020, over 40% of articles searched for in PMC still included “alcoholic.” The results of a separate manual search (n = 110) on the Wiley Online Database showed that approximately 30% of articles used the term “alcoholic” in a stigmatizing manner.

Conclusions

Stigmatizing language can perpetuate negative biases against people with alcohol use disorder. We encourage researchers to shift away from language that maintains discriminatory conceptions of alcohol use disorder. Reducing stigma has the potential to increase rates of treatment seeking and improve treatment outcomes for individuals with alcohol use disorder.
The c.612A>G mutation of MC4R affects constitutive activity and signaling in domestic goats
Authors: Yan Yinan , Chi Shaxuan , Liu Guiqiong , Huang Yongjie , Pan Dongmei , Jiang Xunping
Published: June 2022

As a key gene for balancing energy and regulating feeding behavior, MC4R is relevant to the growth of ruminants. In this presentation, a highly conserved c.612A>G site in the coding sequence (CDS) of MC4R has been selected during a selective sweep analysis of 35 Yiling goats and 20 other wild goats. This site mutation results in an amino acid change from Ile to Met. The genotyping analysis of the c.612A>G site revealed that the A allele was the dominant allele in the domestic goat populations, while the wild goat individuals only had the G allele. For a better understanding of the biological significance of this site, we examined the protein localization and signal detection to explain the function of the two MC4R receptors. The results showed that both the M204 and I204 receptors can normally localize on the membrane. When stimulating the M204 type without α‐MSH, it was defective at the level of basal cAMP and decreased significantly against the I204 type. In contrast, the signaling capacity of the M204 receptor was also lower than that of I204 under the stimulation of α‐MSH. In the ERK1/2 pathway, stimulating MC4R with NDP‐α‐MSH, both the M204 and I204 receptors had normal pERK1/2 levels. These results indicate that the p.I204M mutation may change the function by damaging the constitutive activity and signaling, and thus may regulate goats’ appetite. This study has potential application for rearing domestic goats.
Colorimetric evaluation of cross‐sectional silicone plastination of the Total head region of sheep and Deplastination of the histological sections of brain tissue
Authors: Baygeldi Saime Betül , Güzel Barış Can , Şeker Uğur
Published: June 2022

The aim of the study is to protect and preserve the cross‐sectional diagnostic characteristics of the anatomy samples by using silicone plastination method, to examine them both macroscopically and microscopically, and to use them as an educational material. After the dissection procedures of 10 total sheep heads obtained from the slaughterhouse were completed, they were freshly frozen and sliced to prepare cross‐sectional samples. Then, statistical analysis was performed after the colorimetric measurements. For microscopic examination, 30 brain samples were divided into three groups (Fresh–F, plastination–P, plastination/deplastination–P/D). Of the total brain samples, 20 were subject to routine plastination protocol. After the plastination/deplastination procedure, the changes occurring in cerebral histology were compared. In terms of tissue preservation, the effect of plastination and deplastination was examined using a light microscope. Plastinates subject to silicone plastination under room temperature were very similar to their natural appearance, and it was observed that they preserved their morphological features. Colour changes in the tissues were statistically evaluated. Volumetric shrinkages were observed as qualitative, especially in the brain. As a result of the evaluation done, it was seen that deplastination with toluene is not possible for the brain tissues. In addition, it was not possible to take cross sections of the plastinated tissues that were not deplastinated. On the contrary, findings regarding that deplastination with 5% sodium methoxide dissolved in methanol can allow microscopic examination in long‐term preserved plastinated brain tissues were obtained.
Unemployment benefits, food insecurity, and supplemental nutrition assistance program spending
Authors: Fu Wei , Huang Chen , Liu Feng
Published: June 2022

This paper examines the effects of unemployment insurance (UI) expansions on household food insecurity in the United States using the Food Security Supplement to the Current Population Survey for 1999–2017. We exploit the plausibly exogenous variation in state maximum weekly UI benefits across states and over time. The two‐part model demonstrates that a $100 increase in state weekly UI benefits reduces the likelihood of food insecurity among UI‐eligible families by 5.6% and the severity of food insecurity conditional on being food insecure by 6.3%. We further present strong evidence of program substitution between UI and the Supplemental Nutrition Assistance Program (SNAP), which is the largest food assistance program with the stated goal of reducing food insecurity. Specifically, for every dollar spent on UI, 4–11 cents can be saved on SNAP, thereby reinforcing the social benefits of an UI expansion.
Facemask ventilation and vocal cord angle following neuromuscular blockade: a prospective observational study#
Authors: Lee M. K. , Kim K. N. , Jeong M. A. , Kim S. Y. , Oh M. S. , Kwon B. S.
Published: June 2022

Numerous studies support the idea that neuromuscular blockade facilitates facemask ventilation after induction of anaesthesia. Although improved airway patency or pulmonary compliance and a resolution of laryngospasm have been suggested as possible causes, the exact mechanism remains unclear. We aimed to assess whether neuromuscular blockade improves facemask ventilation and to clarify whether this phenomenon is associated with the vocal cord angle. This prospective observational study included patients aged between 20 and 65 years scheduled for elective surgery under general anaesthesia. After induction of anaesthesia, patients' lungs were ventilated with pressure‐controlled ventilation using a facemask. During facemask ventilation, a flexible bronchoscope was inserted through a self‐sealing diaphragm at the elbow connector attached to the facemask and breathing circuit and positioned to allow a continuous view of the vocal cords. The mean tidal volume and vocal cord angle were measured before and after administration of neuromuscular blocking drugs. Of 108 patients, 100 completed the study. Mean (SD) tidal volume ((11.0 (3.9) ml.kg‐1 vs. 13.6 (2.6) ml.kg‐1; p < 0.001) and mean (SD) vocal cord angle (17° (10°) vs. 26° (5°); p < 0.001) increased significantly after neuromuscular blockade. The proportional increase in mean tidal volume after neuromuscular blockade was positively correlated with vocal cord angle (Spearman's ρ = 0.803; p < 0.001). In conclusion, neuromuscular blockade facilitated facemask ventilation, and the improvement was correlated with further opening of the vocal cords.
Expression of membrane fusion proteins in spermatozoa and total fertilisation failure during in vitro fertilisation
Authors: Enoiu Simona Ioana , Nygaard Marie Berg , Bungum Mona , Ziebe Søren , Petersen Morten Rønn , Almstrup Kristian
Published: June 2022

Background

Couples increasingly experience infertility and seek help from assisted reproductive techniques to become pregnant. However, 5%–15% of the couples that are selected for in vitro fertilisation (IVF) experience a total fertilisation failure (TFF), where no zygotes develop despite oocytes and semen parameters appear to be normal. We hypothesise that TFF during IVF could be related to improper membrane fusion of gametes.

Objective

To investigate the membrane integrity and fusion proteins in spermatozoa from men in couples experiencing TFF.

Materials and methods

A total of 33 infertile couples, 17 of which experienced TFF during IVF and 16 matched control couples with normal IVF fertilisation rates, were selected and the men re‐called to deliver an additional semen sample. Proteins involved in gamete membrane fusion on spermatozoa (IZUMO1, SPESP1 and Syncytin‐1) as well as O‐glycosylation patterns (Tn and GALNT3), were investigated by immunofluorescence. The DNA fragmentation index, acrosomal integrity and viability of spermatozoa were determined by flow and image cytometry.

Results

No significant changes in the expression of GALNT3, Tn and Syncytin‐1 were observed between the TFF and control groups. The fraction of spermatozoa expressing SPESP1, the median IZUMO1 staining intensity, and the percentage of viable acrosome‐intact spermatozoa were significantly lower in the TFF group compared to controls. Furthermore, following progesterone‐induced acrosomal exocytosis, a significant difference in the fraction of spermatozoa expressing SPESP1 and the median IZUMO1 staining intensity were observed between the control and TFF group.

Discussion and conclusion

Our results indicate that acrosomal exocytosis, IZUMO1 and SPESP1 expression in spermatozoa could play a crucial role in achieving fertilisation during IVF. However, the size of our cohort was quite small, and our results need to be validated with quantitative methods in larger cohorts.
The complication profile of low Hartmann's in rectal cancer: a systematic review and meta‐analysis
Authors: Choy Kay Tai , Lee Dewei Jordan , Prabhakaran Swetha , Warrier Satish , Heriot Alexander , Kong Joseph C.
Published: June 2022

Background

Non‐restorative options for low rectal cancer not invading the sphincter includes low Hartmann's procedure (LH) and inter‐sphincteric abdominoperineal resection (ISAPR). There is currently little comparative data to differentiate these options.

Objectives

The aim of this review was to assess the peri‐operative morbidity of LH, and then to compare it to that of ISAPR.

Data Sources

An up‐to‐date systematic review was performed on the available literature between 2000–2020 on PubMed, EMBASE, Medline, and Cochrane Library databases.

Study Selection

All studies reporting on non‐restorative surgeries for rectal cancer were analysed. Outcomes were firstly analysed between LH and non‐LH groups, with further sub‐analysis comparing the LH and ISAPR groups.

Main outcome measure

The main outcome measures were the rates of pelvic sepsis, rates of overall post‐operative complication rates, oncological outcomes, and survival.

Results

A total of 12 observational studies were included. There were 3526 patients (61.1%) in the LH group, and 2238 patients (38.9%) in the non‐LH group, which included 461 patients who underwent ISAPR. The LH group had a higher rate of pelvic sepsis as compared to the non‐LH group (OR: 1.79, 95% CI: 1.39–2.29, P < 0.001). The difference is more marked in the sub‐analysis comparing LH and ISAPR alone (OR: 3.94, 95% CI: 1.88–7.84, P < 0.01) corresponding to a higher rate of unplanned re‐intervention. LH was associated with a higher rate of short‐term post‐operative mortality as compared to the non‐LH group.

Conclusion

ISAPR is the preferred option for non‐restorative rectal surgery, with a more favourable peri‐operative morbidity and short‐term mortality profile as compared to LH.
High insertion of the right diaphragm complicated with congenital diaphragmatic hernia: A case report of rare thoracoscopic findings
Authors: Ishimoto Kenta , Hayashida Makoto , Ueda Michiko , Okamura Kaori , Ieiri Satoshi
Published: June 2022

We encountered a case of high insertion of the right diaphragm complicated with congenital diaphragmatic hernia that was diagnosed based on thoracoscopic findings. A full‐term male baby was suspected of having right congenital diaphragmatic hernia or diaphragmatic eventration on postnatal imaging. He only had episodes of mild but prolonged symptoms following upper respiratory tract infection and his course was otherwise uneventful during outpatient monitoring. At 1 year old, the elevated liver volume remained large, which might eventually interfere with his lung growth, so thoracoscopic exploration was planned. Thoracoscopy revealed liver prolapse from a diaphragmatic defect. In addition, the anterior to lateral inserted part of the diaphragm was high, with the anterior part reaching the fourth rib. We repaired only the diaphragmatic defect without repositioning the diaphragm, and the postoperative course was uneventful. High insertion of the diaphragm should be considered as a differential diagnosis of congenital diaphragmatic eventration.
Economies of Coworking: Sharing, Exchanging, and Buying as Acts of Commoning
Authors: Nielsen Gritt B. , Mangor Ida
Published: June 2022

The past fifteen years have seen a rapid growth in the number of coworking spaces worldwide. In the research literature, these spaces, in which start‐up entrepreneurs and other self‐employed people form professional and social networks, are often understood either as a manifestation of increasingly precarious forms of work within neoliberal capitalism or as a solidary alternative to this form of individualizing and competitive economy. Drawing on ethnographic research from a coworking space in Barcelona, we identify three forms of sharing—demand sharing, passion sharing, and public sharing—which simultaneously carry the potential for communal and passionate work and for instrumental and exploitative forms of collaboration in coworking. We show how coworkers balance acts of sharing, exchanging, and buying/selling their skills and knowledge in different ways, depending on their personal situations, experiences, and professional skills. Accordingly, we argue, in this setting coworking also involves forms of “differential commoning” through which coworkers can obtain—even if it is only momentary—a sense of being part of an intentional community that operates according to values of solidarity, care and passion, which intersects with yet differs from what they perceive as individualist capitalist work life.
Blinatumomab as bridging therapy in paediatric B‐cell acute lymphoblastic leukaemia complicated by invasive fungal disease
Authors: Yeoh Daniel K. , Blyth Christopher C. , Kotecha Rishi S.
Published: June 2022

Invasive fungal disease (IFD) remains a challenging complication of treatment for paediatric acute leukaemia. Consensus fungal treatment guidelines recommend withholding chemotherapy to facilitate immune recovery in this setting, yet prolonged delays in leukaemia therapy increase risk of relapse. Blinatumomab, a bispecific T‐cell engager targeting cells expressing CD19, has shown promise for treatment of relapsed/refractory B‐cell acute lymphoblastic leukaemia (B‐ALL) and is associated with reduced toxicity compared to conventional chemotherapy. With close monitoring of minimal residual disease, we demonstrate that children with B‐ALL can receive repeated cycles of bridging blinatumomab whilst conventional chemotherapy is withheld during treatment and recovery from IFD.
Practical management of the haemorrhagic complications of myeloproliferative neoplasms
Authors: Jones Edward , Dillon Bryan , Swan Dawn , Thachil Jecko
Published: June 2022

Myeloproliferative neoplasms can be associated with bleeding manifestations which can cause significant morbidities. Although haematologists are aware of the likelihood of this complication in the setting of myeloproliferative neoplasms, it may often be overlooked especially in patients with no extreme elevation of blood counts and those with myelofibrosis. Acquired von Willebrand syndrome and platelet dysfunction are the two common diagnoses to be considered in this regard. In this review article, we discuss the mechanisms for the development of these rare bleeding disorders, their diagnosis and practical management.
Male urethral stricture disease: why management guidelines are challenging in low‐income countries
Authors: Payne Stephen R. , Anderson Paul , Spasojević Nenad , Demilow Tilaneh L. , Teferi Getaneh , Dickerson David
Published: June 2022

Urethral stricture disease (USD) is one of the commonest urological pathologies in adult men in low‐ or low–middle‐income countries, providing a significant work burden for the small number of specialist surgeons who are able to provide appropriate treatment. The underlying causes of anterior urethral stricture relate to urethral fibrosis from sexually transmitted infection, with posterior urethral disruption secondary to pelvic trauma being an equally common cause of USD in many countries in sub‐Saharan Africa. Anterior urethral strictures are often long, and multifocal, and bulbo‐prostatic disruptions are usually due to relatively low‐velocity pelvic trauma. The management options available in resource‐poor settings are often severely limited by the individual's ability to pay for care, the availability of a specialist surgeon and, importantly, a shortage of functioning endoscopic equipment for less‐invasive treatments. Consequently, reconstructive surgery is often regarded by the patient, and surgeon, as the most cost‐effective and, therefore, primary means of treating a urethral stricture once urethral dilatation has failed. Regional anaesthetic techniques have limited the adoption of free‐graft augmentation as an alternative to pedicled flaps of locally available skin for reconstruction, whilst an inability to provide tension‐free bulbo‐prostatic anastomoses has negatively impacted the outcome from the treatment of pelvic fracture disruption injuries in much of sub‐Saharan Africa. However, Urolink has found that local surgeons can be taught sustainable skills required for successful complex urethroplasty when supported by longitudinal mentorship in the management of difficult clinical issues. Evidence‐based practice is known to improve the standard of care in specific conditions in high‐income countries, including the management of male USD. However, guidelines developed in high‐income countries are not necessarily appropriate for stricture management in less well‐resourced healthcare environments but could be adapted to help improve the delivery of stricture care for men in low‐ or low–middle income countries.
Preoperative medical treatments and surgical approaches for acromegaly: A systematic review
Authors: Papaioannou Christos , Druce Maralyn
Published: June 2022

Objective

Acromegaly is a condition characterized by an overproduction of growth hormone which infers high morbidity and mortality if left untreated. The objective of this review is to analyse and appraise the current evidence for the generalized use of preoperative medications and the various surgical approaches as described in the literature.

Design

A thorough search from MEDLINE via PubMed, EMBASE, and Cochrane Library has been performed which identified a total of 37 papers.

Conclusion

The preoperative use of somatostatin receptor agonists (SAs) in acromegaly is a controversial topic with current guidelines suggesting against their generalized routine use. Most authors noticed an insignificant long‐term remission of acromegaly when given SAs compared with nil preoperative therapy, except for invasive macroadenomas as SAs have been found to reduce the tumour volume and aid towards the total resection of the adenoma. Furthermore, according to the evidence available, endoscopic transsphenoidal surgery is the optimum method for hypophysectomy in terms of its remission and safety profile.
Ethical analysis of cadaver supply and usage processes for research within the scope of the Helsinki Declaration
Authors: Buruk Banu , Aytaç Güneş
Published: June 2022

Recent technological developments have considerably transformed the supply, storage, and transportation processes of cadavers, creating new and previously unforeseen ethical challenges regarding cadaver usage. In this study, we analyzed two aspects of the cadaver processing system—cadaver supply and its use in research. Thereafter, we highlighted the major ethical concerns underlying these stages and correlated our search results with the ethical principles outlined in the Declaration of Helsinki (DoH), or Helsinki Declaration. To ensure the reliability and continuity of medical progress, human—especially cadaver—research depends on the ethical priorities as outlined in the DoH: respect for autonomy, privacy/confidentiality, risks/burdens/benefits, and the protection of vulnerable groups. According to our ethics analysis, which also corresponds with the ethics guidelines of the Consensus Panel on Research with the Recently Dead, the most ignored values were respect for autonomy and privacy/confidentiality issues. Based on these ethical concerns, we provide recommendations to address these challenges in anatomy research.
Explosive networking: The role of adaptive host radiations and ecological opportunity in a species‐rich host–parasite assembly
Authors: Cruz‐Laufer Armando J. , Artois Tom , Koblmüller Stephan , Pariselle Antoine , Smeets Karen , Van Steenberge Maarten , Vanhove Maarten P. M.
Published: June 2022

Many species‐rich ecological communities emerge from adaptive radiation events. Yet the effects of adaptive radiation on community assembly remain poorly understood. Here, we explore the well‐documented radiations of African cichlid fishes and their interactions with the flatworm gill parasites Cichlidogyrus spp., including 10,529 reported infections and 477 different host–parasite combinations collected through a survey of peer‐reviewed literature. We assess how evolutionary, ecological, and morphological parameters determine host–parasite meta‐communities affected by adaptive radiation events through network metrics, host repertoire measures, and network link prediction. The hosts' evolutionary history mostly determined host repertoires of the parasites. Ecological and evolutionary parameters predicted host–parasite interactions. Generally, ecological opportunity and fitting have shaped cichlid‐Cichlidogyrus meta‐communities suggesting an invasive potential for hosts used in aquaculture. Meta‐communities affected by adaptive radiations are increasingly specialised with higher environmental stability. These trends should be verified across other systems to infer generalities in the evolution of species‐rich host–parasite networks.
Aneurysmal subarachnoid hemorrhage in Germany between 2005 and 2018: A nationwide observational study
Authors: Uhl Christian , Huscher Doerte , Sommerfeld Jenny , Schönberg Benn , Vajkoczy Peter , Dengler Nora F.
Published: June 2022

Background and purpose

In recent decades, the global incidence of aneurysmal subarachnoid hemorrhage (aSAH) has declined. However, significant regional differences exist. We present the first comprehensive analysis of time trends in the incidence of aSAH and case fatality in Germany.

Methods

All patients hospitalized with aSAH in Germany between 2005 and 2018 were identified using International Classification of Disease, 10th Revision codes I60.0–I60.7.

Results

A total of 101,105 cases were included. The incidence of aSAH in Germany decreased at a mean annual rate of 0.5% (p = 0.003) from 8.9 per 100,000 population in 2005 to 8.2 in 2018. Over time, incidences of aSAH declined among patients younger than 55 years and patients aged 70–79 years, increased among ages 60–64 years, and remained stable in age groups 65–69 and 85–89 years. This corresponded to an increase in the mean age of aSAH onset from 55.6 (±14.3) to 59.0 (±14.0) years. Throughout the study period, the mean age of aSAH onset was higher in women compared to men (58.3 ± 14.4 years vs. 56.1 ± 14.1 years). There were no changes in in‐hospital case fatality (16.2 vs. 16.6%, p = 0.18), but the duration of hospital stay increased significantly from 19.7 to 24.8 days (p < 0.001). The most frequent aSAH‐associated aneurysm location was the anterior circulation throughout the entire study period.

Conclusions

In Germany, the incidence of aSAH decreased between 2005 and 2018, especially in younger parts of the population. This may reflect effects of lifestyle adjustments most pronounced in younger age groups.
The intestinal immune system and gut barrier function in obesity and ageing
Authors: Shemtov Sarah J. , Emani Rohini , Bielska Olga , Covarrubias Anthony J. , Verdin Eric , Andersen Julie K. , Winer Daniel A.
Published: June 2022

Obesity and ageing predispose to numerous, yet overlapping chronic diseases. For example, metabolic abnormalities, including insulin resistance (IR) and type 2 diabetes (T2D) are important causes of morbidity and mortality. Low‐grade chronic inflammation of tissues, such as the liver, visceral adipose tissue and neurological tissues, is considered a significant contributor to these chronic diseases. Thus, it is becoming increasingly important to understand what drives this inflammation in affected tissues. Recent evidence, especially in the context of obesity, suggests that the intestine plays an important role as the gatekeeper of inflammatory stimuli that ultimately fuels low‐grade chronic tissue inflammation. In addition to metabolic diseases, abnormalities in the intestinal mucosal barrier have been linked to a range of other chronic inflammatory conditions, such as neurodegeneration and ageing. The flow of inflammatory stimuli from the gut is in part controlled by local immunological inputs impacting the intestinal barrier. Here, we will review the impact of obesity and ageing on the intestinal immune system and its downstream consequences on gut barrier function, which is strongly implicated in the pathogenesis of obesity and age‐related diseases. In particular, we will discuss the effects of age‐related intestinal dysfunction on neurodegenerative diseases.
Ecosystem CO2 release driven by wind occurs in drylands at global scale
Authors: Moya María Rosario , López‐Ballesteros Ana , Sánchez‐Cañete Enrique P. , Serrano‐Ortiz Penélope , Oyonarte Cecilio , Domingo Francisco , Kowalski Andrew S.
Published: June 2022

Subterranean ventilation is a non‐diffusive transport process that provokes the abrupt transfer of CO2‐rich air (previously stored) through water‐free soil pores and cracks from the vadose zone to the atmosphere, under high‐turbulence conditions. In dryland ecosystems, whose biological carbon exchanges are poorly characterized, it can strongly determine eddy‐covariance CO2 fluxes that are used to validate remote sensing products and constrain models of gross primary productivity. Although subterranean ventilation episodes (VE) may occur in arid and semi‐arid regions, which are unsung players in the global carbon cycle, little research has focused on the role of VE CO2 emissions in land–atmosphere CO2 exchange. This study shows clear empirical evidence of globally occurring VE. To identify VE, we used in situ quality‐controlled eddy‐covariance open data of carbon fluxes and ancillary variables from 145 sites in different open land covers (grassland, cropland, shrubland, savanna, and barren) across the globe. We selected the analyzed database from the FLUXNET2015, AmeriFlux, OzFlux, and AsiaFlux networks. To standardize the analysis, we designed an algorithm to detect CO2 emissions produced by VE at all sites considered in this study. Its main requirement is the presence of considerable and non‐spurious correlation between the friction velocity (i.e., turbulence) and CO2 emissions. Of the sites analyzed, 34% exhibited the occurrence of VE. This vented CO2 emerged mainly from arid ecosystems (84%) and sites with hot and dry periods. Despite some limitations in data availability, this research demonstrates that VE‐driven CO2 emissions occur globally. Future research should seek a better understanding of its drivers and the improvement of partitioning models, to reduce uncertainties in estimated biological CO2 exchanges and infer their contribution to the global net ecosystem carbon balance.
Designing democracy: How does institutional structure affect civic participation?
Authors: Abbott Jared , Touchton Michael
Published: June 2022

How does the structure of democratic institutions affect citizen engagement? This study employs conjoint analysis to assess the effects of institutional design on political participation in participatory budgeting (PB) programs. We find evidence that PB program design strongly affects citizens' interest in participation. Participation appeals more to citizens when PB programs offer participants meaningful control over decision‐making outcomes, when barriers to participation are low, and when resources allocated through PB are targeted diffusely to communities rather than individual beneficiaries. We also find that focusing PB on issues specific to marginalized communities does not necessarily boost interest in participation among members of those communities. Finally, we observe few systematic differences in preferences for participation between demographic groups traditionally associated with low rates of civic engagement compared to other groups. We then use the results surrounding PB to discuss broad implications for citizen participation in participatory institutions and democratic governance.
Prevalence and risk factors for hepatocellular carcinoma in individuals with haemophilia in the era of direct‐acting antiviral agents: A national inpatient sample study
Authors: Yang Xi , Jeong Kwonho , Yabes Jonathan G. , Ragni Margaret V.
Published: June 2022

Background

Hepatocellular carcinoma (HCC) is a major complication of chronic hepatitis C virus (HCV) infection. Among haemophilic (H) men, HCV is the leading cause of liver disease. Direct‐acting antiviral agents (DAA) reduce HCV viral load, but impact on HCC is unknown.

Methods

This was a retrospective study of adult H and nonhaemophilic (NH) male discharges, with and without HCC, identified by ICD‐10 codes in the National Inpatient Sample (NIS) database, 2016–2018, with DAA availability. Analyses included discharge‐level weights to reflect national estimates. Categorical variables were assessed by Rao‐Scott chi‐square and continuous variables by weighted simple linear regression. HCC correlates were determined by weighted multivariable logistic regression.

Results

Among 7,674,969 adult male discharges, 3730 H (.04%) were identified in 2016–2018, of whom 10.06% had HCV and 1.07% had HCC, significantly higher than NH (1.22% and .27%, respectively) all P < .001. Annual HCC rates were similar during the 3‐year period (2016–2018) in H and NH. Among H, HCC is associated with older age and higher rates of HCV, HBV, NASH, end‐stage liver disease, and Charlson comorbidity (CCI), each P < .001. Among HCC, H were younger and more likely HIV+, each P < .001, but less likely alcoholic (P = .018) or hyperlipidaemic (P = .008) compared to NH. In multivariable regression, risk factors for HCC among H included NASH (OR 21.6), HCV (OR 3.96), CCI (OR1.54), all P < .001, while HIV and hyperlipidaemia were protective.

Conclusion

From 2016 to 2018, HCC rates did not change significantly in haemophilia discharges. NASH, HCV, and CCI are significant risks for HCC in haemophilia during the DAA‐era.
Possible prediction of obesity‐related liver disease in children and adolescents using indices of body composition
Authors: Johansen Magnus Jung , Vonsild Lund Morten Asp , Ängquist Lars , Fonvig Cilius Esmann , Holm Louise Aas , Chabanova Elizaveta , Thomsen Henrik S. , Hansen Torben , Holm Jens‐Christian
Published: June 2022

Background

Diagnosis of nonalcoholic fatty liver disease in children and adolescents currently requires advanced or invasive technologies.

Objectives

We aimed to develop a method to improve diagnosis, using body composition indices and liver biochemical markers.

Methods

To diagnose non‐alcoholic fatty liver disease, 767 Danish children and adolescents underwent clinical examination, blood sampling, whole‐body dual‐energy X‐ray absorptiometry scanning and proton magnetic resonance spectroscopy for liver fat quantification. Fourteen variables were selected as a starting point to construct models, narrowed by stepwise selection. Individuals were split into a training set for model construction and a validation test set. The final models were applied to 2120 Danish children and adolescents to estimate the prevalence.

Results

The final models included five variables in different combinations: body mass index–standard deviation score, android‐to‐gynoid‐fat ratio, android‐regional fat percent, trunk‐regional fat percent and alanine transaminase. When validated, the sensitivity and specificity ranged from 38.6% to 51.7% and 87.6% to 91.9%, respectively. The estimated prevalence was 24.2%–35.3%. Models including alanine transaminase alongside body composition measurements displayed higher sensitivity.

Conclusions

Body composition indices and alanine transaminase can be used to estimate non‐alcoholic fatty liver disease, with 38.6%–51.7% sensitivity and 87.6%–91.9%, specificity, in children and adolescents with overweight (including obesity). These estimated a 24.2%–35.3% prevalence in 2120 patients.
Nursing perspectives about the critical gaps in public health emergency response during the COVID‐19 pandemic
Authors: Norful Allison A. , Tucker Sharon , Miller Pamela S. , Roberts Haley , Kelley Marjorie M. , Monturo Cheryl , O'Mathúna Dónal , Smith Julia , Zadvinskis Inga M. , Zellefrow Cindy , Chipps Esther
Published: June 2022

Introduction

The purpose of this qualitative study was to synthesize frontline U.S. nursing perspectives about the current state of U.S. public health emergency preparedness and response. The study findings may inform public health policy change and improve future national pandemic planning and responses.

Design

We conducted a secondary thematic qualitative analysis using grounded theory methodology.

Methods

Data collection occurred through semi‐structured, in‐depth focus groups between July and December 2020, from 43 frontline nurses working in hospitals in four states (Ohio, California, Pennsylvania, and New York). Data were analyzed deductively, aligned with Khan et al.’s Public Health Emergency Preparedness Framework and inductively for emergent themes.

Results

Three themes emerged: (1) Validation of the presence of health disparities and inequities across populations; (2) Perceived lack of consistency and coordination of messaging about pandemic policies and plans across all levels; and (3) challenges securing and allocating nursing workforce resources to areas of need.

Conclusion

From a frontline nursing perspective, this study demonstrates the critical need to address health inequities and inequalities across populations, a consistent national vehicle for communication, and national plan for securing and allocating nursing workforce resources.
Anti‐racism structures in academic dentistry: Supporting underrepresented racially/ethnically diverse faculty
Authors: Smith Sonya G. , Banks Pamela Berry , Istrate Emilia C. , Davis Alysha J. , Johnson Kelli R. , West Karen P.
Published: June 2022

Objectives

The purpose of this paper is to describe the racialized barriers to recruiting and retaining historically underrepresented racially/ethnically diverse (HURE) faculty at U.S. dental schools and the linkages of these barriers to structural racism to assist dental schools in eliminating these hurdles through an antiracism framework.

Methods

Data is used to describe the trends in the racial/ethnic composition of dental school faculty and the parity gaps by race/ethnicity between dentists and the U.S. population. Literature on the recruitment and retention of faculty of color at higher education institutions is reviewed to identify challenges and best practices. Barriers to the full participation of HURE faculty, outlined in the American Dental Education Association's Faculty Diversity Toolkit, are also identified. Research on antiracism frameworks is also investigated to denote their uses and key components.

Results

There is a critical shortage of HURE faculty at dental schools and active HURE dentists in the U.S. A history of racism and its legacy reinforce biases, stereotypes, and power structures that harm HURE faculty at U.S. dental schools. An anti‐racism framework is needed to holistically eliminate inequities and racialized policies and practices that persists as barriers for HURE faculty.

Conclusions

Increasing the representation of HURE dentists in the workforce and dental school faculty requires a major disruption to culture and institutional practices that mask centuries of structural racism embedded within complex academic systems. Dental schools must use antiracism models to create strategic initiatives that support a humanistic, equitable, and antiracism environment where HURE faculty can thrive.