bluuebunny/crossref_metadata_2025 huggingface dataset:
Does GHRM spur business performance via green corporate citizenship, green corporate reputation and environmental performance?
Authors: Opoku Mensah Abigail , Afum Ebenezer , Sam Evelyn Ama
Published: May 2021

Purpose

This study investigates the effect of green human resource management (GHRM) on green corporate citizenship (GCC), green corporate reputation (GCR), environmental performance (EP) and business performance (BP). The study further examines the mediation roles of GCC, GCR and EP between the direct paths.

Design/methodology/approach

Data for the study is solicited from 185 managers from Ghanaian oil and gas companies. Partial least squares-structural equation modeling (PLS-SEM) is applied to test all hypotheses.

Findings

The results suggest that GHRM has a significant positive effect on GCC, green reputation, environmental and BPs. The mediation analysis further shows that, unlike EP which plays no mediation role, GCC and green reputation play complementary partial mediation role between GHRM and BP. Moreover, GCC mediates the relationship between GHRM and EP.

Originality/value

Aside from magnifying environmental management and the GHRM literature, this study is among the few that investigates the connection role between GHRM, GCC, green reputation, environmental and BPs, especially from direct effects and mediation analysis standpoint.
Comparative analysis of anti-reflection coatings on solar PV cells through TiO2and SiO2nanoparticles
Authors: Sivakumar Rajkamal , Gopalakrishnan Prabhakaran , Abdul Razak Mohamed Sikkander
Published: May 2021

Purpose

Photon absorbance and reflectance are the most important parameters for the recombination of electron-hole pairs. Bandgap energy plays a vital role in photon absorption. That is, the photons with energy greater than band gap energy are absorbed. Also, the refractive index of semiconductors is responsible for photon reflection, as the surface with the highest refractive index will reflect more photons than a surface with have a low refractive index. The purpose of this paper is to improvise the absorbance and reduce the reflectance of photons on the front surface of solar cells.

Design/methodology/approach

Photon reflection is results in reduction in electron-hole pair generation due to the high refractive index of semiconductive materials. To overcome this problem, an Anti-reflection (AR) coating of TiO2and SiO2is undertaken on solar cells through the Sol-spin coating method. Finally, the effectiveness of the Anti-Reflection coating is scrutinized through UV Vis-Spectroscopy, which provides details regarding reflectance, absorbance and bandgap energy characteristics.

Findings

UV–visible spectroscopy was used to measure the responses from the samples. The samples responded to the ultraviolet and visible range of electromagnetic radiation perfectly. UV spectroscopy was done before and after the antireflection coating of TiO2and SiO2over the solar cell to find their corresponding extreme reflectance and absorbance values. The effects of TiO2and SiO2were evaluated from the results.

Originality/value

In this research work, the authors have done anti-reflection coating over solar cells with nanoparticles derived from sol-gel process. Absorbance of photons observed through diffuse reflection method.
Proteomic profiling and glycomic analysis of the yeast cell wall in strains with Aflatoxin B1 elimination ability
Authors: García‐Béjar Beatriz , Owens Rebecca A. , Briones Ana , Arévalo‐Villena María
Published: May 2021

The use of microorganisms for Aflatoxin B1 elimination has been studied as a new alternative tool and it is known that cell wall carried out a critical role. For that reason, cell wall and soluble intracellular fraction of eight yeasts with AFB1 detoxification capability were analysed. The quantitative and qualitative comparative label‐free proteomic allowed the identification of diverse common constituent proteins, which revealed that putative cell wall proteins entailed less than 10% of the total proteome. It was possible to characterize different enzymes linked to cell wall polysaccharides biosynthesis as well as other proteins related with the cell wall organization and regulation. Additionally, the concentration of the principal polysaccharides was determined which permitted us to observe that β‐glucans concentration was higher than mannans in most of the samples. In order to better understand the biosorption role of the cell wall against the AFB1, an antimycotic (Caspofungin) was used to damage the cell wall structure. This assay allowed the observation of an effect on the normal growth of those yeasts with damaged cell walls that were exposed to AFB1. This effect was not observed in yeast with intact cell walls, which may reveal a protective role of this structure against mycotoxins.
Estimating health care delivery system value for each US state and testing key associations
Authors: Dieleman Joseph L , Kaldjian Alexander S , Sahu Maitreyi , Chen Carina , Liu Angela , Chapin Abby , Scott Kirstin Woody , Aravkin Aleksandr , Zheng Peng , Mokdad Ali , Murray Christopher JL , Schulman Kevin , Milstein Arnold
Published: May 2021

Objective

To estimate health care systems' value in treating major illnesses for each US state and identify system characteristics associated with value.

Data sources

Annual condition‐specific death and incidence estimates for each US state from the Global Burden Disease 2019 Study and annual health care spending per person for each state from the National Health Expenditure Accounts.

Study design

Using non‐linear meta‐stochastic frontier analysis, mortality incidence ratios for 136 major treatable illnesses were regressed separately on per capita health care spending and key covariates such as age, obesity, smoking, and educational attainment. State‐ and year‐specific inefficiency estimates were extracted for each health condition and combined to create a single estimate of health care delivery system value for each US state for each year, 1991–2014. The association between changes in health care value and changes in 23 key health care system characteristics and state policies was measured.

Data collection/extraction methods

Not applicable.

Principal findings

US state with relatively high spending per person or relatively poor health‐outcomes were shown to have low health care delivery system value. New Jersey, Maryland, Florida, Arizona, and New York attained the highest value scores in 2014 (81 [95% uncertainty interval 72‐88], 80 [72‐87], 80 [71‐86], 77 [69‐84], and 77 [66‐85], respectively), after controlling for health care spending, age, obesity, smoking, physical activity, race, and educational attainment. Greater market concentration of hospitals and of insurers were associated with worse health care value (p‐value ranging from <0.01 to 0.02). Higher hospital geographic density and use were also associated with worse health care value (p‐value ranging from 0.03 to 0.05). Enrollment in Medicare Advantage HMOs was associated with better value, as was more generous Medicaid income eligibility (p‐value 0.04 and 0.01).

Conclusions

Substantial variation in the value of health care exists across states. Key health system characteristics such as market concentration and provider density were associated with value.
Effects of different pesticides treatments on the nutritional quality of kiwifruit
Authors: Shan Tingting , Wei Jianping , Wang Yuan , Zhao Xubo , Zhao Yuyao , Ge Qian , Yuan Yahong , Yue Tianli
Published: May 2021

Pesticides are widely used in the process of kiwifruit growth to promote fruit expansion. This study was aimed to assess the effects of pesticides on the quality of kiwifruit by applying high and normal concentrations of forchlorfenuron (CPPU) and thidiazuron (TDZ) to “Xuxiang” (XX) green kiwifruit and “Jinyan” (JY) gold kiwifruit. Sixty kiwifruit trees were used to comprehensively evaluate the effects on the pulp and whole kiwifruit. In addition to the weight gain effect and basic physical‐chemical properties (vitamin C, total protein, glucose and fructose, organic acids), the main nutritional qualities (in vitro and cellular antioxidant activity (CAA), and dietary minerals) were also evaluated. The vitamin C content of XX was not affected by pesticides, but the use of CPPU reduced vitamin C of JY pulp by 23% (p < 0.05). Pesticides did not reduce the antioxidant values of XX pulp in vitro but significantly reduced CAA values (32%–47%). In JY pulp, pesticides treatments had no significant effect on antioxidant values in vitro except that CPPU treatments significantly reduced the ferric reducing antioxidant power (FRAP) value by 21% (p < 0.05). Reasonable use of pesticides can effectively improve taste of kiwifruit, increasing kiwifruit weight and the content of certain nutrients.

Practical Application

Based on observed changes in nutritional components, CPPU may be more suitable for XX while TDZ may be more suitable for JY. The significance of this study may affect kiwifruit farmers and ultimately help improve the sensory quality of kiwifruit.
Clinical outcomes and resource utilization after surgical resection with curative intent among patients with non‐small cell lung cancer treated with adjuvant therapies in a community oncology setting: A real‐world retrospective observational study
Authors: Cai Beilei , Fulcher Nicole , Boyd Marley , Spira Alexander
Published: May 2021

Aims

Adjuvant chemotherapy has been shown to improve survival in patients with completely resected early‐stage non‐small cell lung cancer (NSCLC). This study evaluated real‐world relapse rates and healthcare resource utilization in patients with stage II–IIIB NSCLC receiving adjuvant therapy in a community oncology setting after complete resection.

Patients and Methods

The study included patients with stage II–IIIB NSCLC and complete resection receiving any adjuvant therapy during 06/2008–04/2017 at US Oncology Network clinics, with follow‐up through 04/2019. Primary endpoints were rate of relapse, time to relapse (TTR), disease‐free survival (DFS), overall survival (OS), and monthly emergency department (ED) visits and hospitalizations before and after relapse.

Results

The study identified 456 patients; median age was 66 years, 50% were male. In patients with relapse (45.2%), median follow‐up was 31.7 months and median TTR was 13.7 months. Median DFS in the overall population was 42.9 months. Median OS was 82.4 months in the overall population and shorter in patients with relapse than without relapse (41.6 months vs. not reached, p < 0.0001). Patients with relapse had significantly more monthly ED visits (mean [SD] 0.10 [0.24] vs. 0.03 [0.08], p < 0.0001) and hospitalizations (mean [SD] 0.20 [0.43] vs. 0.05 [0.10], p < 0.0001) following relapse than before relapse.

Conclusions

Patients with stage II–IIIB NSCLC treated with adjuvant therapy after complete resection had high relapse rates, reduced survival, and significantly increased healthcare resource use when relapse occurred. New therapeutic options to reduce relapse rates in patients with early‐stage NSCLC could reduce healthcare utilization and costs.
Optimal radiotherapy dose in cervical esophageal squamous cell carcinoma patients treated with definitive concurrent chemoradiotherapy: A population based study
Authors: Li Chia‐Chin , Chen Chih‐Yi , Chou Ying‐Hsiang , Huang Chih‐Jen , Ku Hsiu‐Ying , Chien Chun‐Ru
Published: May 2021

Background

The optimal radiotherapy dose for locally advanced cervical esophageal squamous cell carcinoma (C‐ESqCC) treated with definitive concurrent chemoradiotherapy (dCCRT) is unclear. Here, we aimed to compare the survival of those treated with high dose versus standard dose via a population based approach.

Methods

Eligible C‐ESqCC patients diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance observable potential confounders between groups. The hazard ratio (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between high (60–70 Gy) and standard dose (50–50.4 Gy). We also evaluated the outcome in supplementary analyses via alternative approaches.

Results

Our primary analysis consisted of 141 patients in whom covariates were well balanced after PS weighting. The HR of death when high dose was compared with standard dose was 0.65 (95% confidence interval [CI]: 0.4–1.03, p = 0.07). The HR of IECM was 0.74 (p = 0.45). The HR of OS remained similarly insignificant in supplementary analyses.

Conclusions

We observed a trend in favor of high radiotherapy dose versus standard dose for C‐ESqCC treated with dCCRT in this population‐based nonrandomized study. Further studies are needed to confirm the findings of the study.
A kernel‐based change detection method to map shifts in phytoplankton communities measured by flow cytometry
Authors: Jones Corinne , Clayton Sophie , Ribalet François , Armbrust E. Virginia , Harchaoui Zaid
Published: May 2021

Automated, ship‐board flow cytometers provide high‐resolution maps of phytoplankton composition over large swaths of the world's oceans. They therefore pave the way for understanding how environmental conditions shape community structure. Identification of community changes along a cruise transect commonly segments the data into distinct regions. However, existing segmentation methods are generally not applicable to flow cytometry data, as these data are recorded as ‘point cloud’ data, with hundreds or thousands of particles measured during each time interval. Moreover, nonparametric segmentation methods that do not rely on prior knowledge of the number of species are desirable to map community shifts.

We present CytoSegmenter, a kernel‐based change‐point estimation method for segmenting point cloud data. Our method allows us to represent and summarize a point cloud of data points by a single element in a Hilbert space. The change‐point locations can be found using a fast dynamic programming algorithm.

Through an analysis of 12 cruises, we demonstrate that CytoSegmenter allows us to locate abrupt changes in phytoplankton community structure. We show that the changes in community structure generally coincide with changes in the temperature and salinity of the ocean. We also illustrate how the main parameter of CytoSegmenter can be easily calibrated using limited auxiliary annotated data.

CytoSegmenter is generally applicable for segmenting series of point cloud data from any domain. Moreover, it readily scales to thousands of point clouds, each containing thousands of points. In the context of flow cytometry data collected during research cruises, it does not require prior clustering of particles to define taxa labels, eliminating a potential source of error. This represents an important advance in automating the analysis of large datasets now emerging in biological oceanography and other fields. It also allows for the approach to be applied during research cruises.
Patient perceptive focus on recovery: An exploratory study on follow‐up after major emergency abdominal surgery
Authors: Kristiansen Puk , Oreskov Jakob Ohm , Ekeloef Sarah , Gögenur Ismail , Burcharth Jakob
Published: May 2021

Background

Optimal recovery can be defined as the adequate in‐hospital length of stay with minimal postoperative complications and readmissions. The quality of recovery beyond the immediate postoperative period after major emergency abdominal surgery is yet to be fully described. We hypothesized that long‐term measures of overall recovery were affected after surgery. The study aimed to investigate patient‐focused recovery‐related parameters 1 year after major emergency abdominal surgery.

Method

This is a prospective study including patients undergoing major emergency abdominal surgery at a Danish secondary referral center. Three questionnaires were answered regarding the recovery following the procedure; Activities Assessment Scale (AAS); Quality of Recovery‐15 (QoR‐15), and Self‐complete Leeds Assessment of Neuropathic Symptoms and Signs (S‐LANSS). All questionnaires were answered at postoperative days (PODs) 14, 30, 90, and 365.

Results

Eighty‐two patients were included, and 68 were available for follow‐up until 1 year after surgery. The response rates differed between the follow‐up time points, with a response rate of 85% (n = 59) at POD30 and 50% (n = 36) at POD365. A decrease in the level of physical function following surgery was observed in 60% of the patients at POD14, which improved to 36% at POD365. Twenty‐four patients (48%) reported postoperative pain at POD14, which declined to 9 (26%) at POD365. The maximum overall recovery was reached at POD30, which remained stable throughout the study period.

Conclusion

One in three patients reported physical functional impairment, and one in four patients reported pain 1 year after their surgical procedure.
Associations between psychosis and visual acuity impairment: A systematic review and meta‐analysis
Authors: Shoham Natalie , Eskinazi Michelle , Hayes Joseph F. , Lewis Gemma , Theodorsson Magnus , Cooper Claudia
Published: May 2021

Objectives

Several theories propose that visual acuity impairment is associated with psychosis. Visual impairment could lead to psychosis or the converse, or they may share underlying pathology or risk factors. In the first evidence synthesis in this area for over 25 years, we collated studies measuring the association between visual acuity impairment and psychosis.

Methods

We searched the MEDLINE, EMBASE, PsycINFO, and Web of Science databases for studies published from 1992 to 2020, using the Newcastle Ottawa Scale to assess risk of bias. We narratively synthesized findings and meta‐analyzed sufficiently homogenous results.

Results

We included 40 papers, which reported on 31 studies. Evidence from seven cohort studies was inconsistent, which precluded meta‐analysis of this study design. These contradictory results also made it difficult to draw conclusions regarding a temporal association. We found evidence for an association from eight cross‐sectional studies treating visual acuity impairment as the exposure and psychosis as the outcome [pooled odds ratio (OR) =1.76, 95% confidence interval (CI): 1.34–2.31], and four with the reverse exposure and outcome (OR: 1.85, 95% CI: 1.17–2.92). Seven case–control studies with mixed findings were found, but only two primarily addressed our research question, and these findings were mixed.

Conclusions

Although evidence supports a cross‐sectional association between visual acuity impairment and psychosis, further research is needed to clarify the temporal direction, given the mixed findings in cohort studies. Understanding the association may give insights into prevention strategies for people at risk of visual acuity impairment and psychosis.
Targeted sequencing reveals candidate causal variants for dairy bull subfertility
Authors: Abdollahi‐Arpanahi R. , Pacheco H. A. , Peñagaricano F.
Published: May 2021

Bull fertility is a key factor for successful reproductive performance in dairy cattle. Since the semen from a single bull can be used to inseminate hundreds of cows, one subfertile bull could have a major impact on herd reproductive efficiency. We have previously identified five genomic regions, located on BTA8 (72.2 Mb), BTA9 (43.7 Mb), BTA13 (60.2 Mb), BTA17 (63.3 Mb), and BTA27 (34.7 Mb), that show large dominance effects on bull fertility. Each of these regions explained about 5–8% of the observed differences in sire conception rate between Holstein bulls. Here, we aimed to identify candidate causal variants responsible for this variation using targeted sequencing (10 Mb per region). For each genomic region, two DNA pools were constructed from high‐fertility and low‐fertility Holstein bulls. The DNA‐sequencing analysis included reads quality control (using FastQC), genome alignment (using BWA and ARS‐UCD1.2), variant calling (using GATK) and variant annotation (using Ensembl). The sequencing depth per pool varied from 39× to 51×. We identified a set of nonsense mutations, missense mutations, and frameshift variants carried by low‐fertility bulls. Notably, some of these variants were classified as strong candidate causal variants, i.e., mutations with deleterious effects located on genes exclusively/highly expressed in testis. Genes affected by these candidate causal variants include AK9, TTLL9, TCHP, and FOXN4. These results could aid in the development of novel genomic tools that allow early detection and culling of subfertile bull calves.
Comparative analysis of swine leukocyte antigen gene diversity in European farmed pigs
Authors: Hammer S. E. , Duckova T. , Groiss S. , Stadler M. , Jensen‐Waern M. , Golde W. T. , Gimsa U. , Saalmueller A.
Published: May 2021

In Europe, swine represent economically important farm animals and furthermore have become a preferred preclinical large animal model for biomedical studies, transplantation and regenerative medicine research. The need for typing of the swine leukocyte antigen (SLA) is increasing with the expanded use of pigs as models for human diseases and organ‐transplantation experiments and their use in infection studies and for design of veterinary vaccines. In this study, we characterised the SLA class I (SLA‐1, SLA‐2, SLA‐3) and class II (DRB1, DQB1, DQA) genes of 549 farmed pigs representing nine commercial pig lines by low‐resolution (Lr) SLA haplotyping. In total, 50 class I and 37 class II haplotypes were identified in the studied cohort. The most common SLA class I haplotypes Lr‐04.0 (SLA‐1*04XX‐SLA‐3*04XX(04:04)‐SLA‐2*04XX) and Lr‐32.0 (SLA‐1*07XX‐SLA‐3*04XX(04:04)‐SLA‐2*02XX) occurred at frequencies of 11.02 and 8.20% respectively. For SLA class II, the most prevalent haplotypes Lr‐0.15b (DRB1*04XX(04:05/04:06)‐DQB1*02XX(02:02)‐DQA*02XX) and Lr‐0.12 (DRB1*06XX‐DQB1*07XX‐DQA*01XX) occurred at frequencies of 14.37 and 12.46% respectively. Meanwhile, our laboratory has contributed to several vaccine correlation studies (e.g. Porcine Reproductive and Respiratory Syndrome Virus, Classical Swine Fever Virus, Foot‐and‐Mouth Disease Virus and Swine Influenza A Virus) elucidating the immunodominance in the T‐cell response with antigen specificity dependent on certain SLA‐I and SLA‐II haplotypes. Moreover, these SLA–immune response correlations could facilitate tailored vaccine development, as SLA‐I Lr‐04.0 and Lr‐32.0 as well as SLA‐II Lr‐0.15b and Lr‐0.12 are highly abundant haplotypes in European farmed pigs.
Ultrasound‐guided de‐roofing of epithelialised tunnels of hidradenitis suppurativa
Authors: Der Sarkissian Sam , Frew John W
Published: May 2021

Hidradenitis Suppurativa is a chronic inflammatory disease manifesting in painful nodules, abscesses and malodorous draining tunnels with a pre‐disposition to flexural regions of skin. Traditional surgical interventions include excision of clinically visible lesions and in severe cases – excision down to fascia of entire anatomical regions (axilla, groin) and repair with split‐thickness grafting or skin substitutes. However, such techniques are plagued by long healing times (up to several months), extensive tissue loss and high recurrence rates given that a large proportion of disease is not clinically visible. Deroofing is a tissue‐saving surgical technique, ideal for Hurley Stage 2 disease, which when combined with bedside pre‐operative sonography can allow for the accurate identification and removal of occult dermal tunnels whilst minimising the risks of pain, infection, minimising healing times and can be safely conducted in the setting of immunomodulatory therapy.
The prenatal phase of retinopathy of prematurity
Authors: Dammann Olaf , Rivera José Carlos , Chemtob Sylvain
Published: May 2021

Aim

To explore the current literature on prenatal inflammation‐associated risk factors for retinopathy of prematurity (ROP).

Methods

Subjective summary of selected experimental and epidemiological publications that support the authors’ central hypothesis that the aetiology of ROP begins before birth.

Results

Based on current evidence we suggest that, contrary to current aetiological models, the process of ROP development begins with a prephase in utero. This beginning is likely initiated by inflammatory responses that are associated with intrauterine infection.

Conclusion

We propose a novel aetio‐pathogenetic model of ROP and suggest that the effects of postnatal exposure to inflammatory stressors (resulting from infection or hyperoxia or both) as well as those of other pre‐ and postnatal contributors to the complex pathogenesis of ROP might be modified by the prenatal phase of the disease.
Amelioration of sperm fertilizability, thyroid activity, oxidative stress, and inflammatory cytokines in rabbit bucks treated with phytogenic extracts
Authors: El‐Ratel Ibrahim T. , Wafa Wael M. , El‐Nagar Hamdy A. , Aboelmagd Abdelrhman M. , El‐Kholy Khaled H.
Published: May 2021

This study investigated the beneficial effect of phytogenic extracts on semen quality, reproductive hormones, thyroid activity, immunity, hepatic antioxidant activity, and fertility in rabbit bucks. We divided 70 bucks into seven groups (10 in each). Group 1 was fed a basal diet (control); groups 2, 3, and 4 were fed the control diet with 30, 60, and 90 mg/kg of turmeric, respectively; and groups 5, 6, and 7 were fed the control diet with 50, 75, and 100 mg/kg of garlic extract, respectively, for 8 weeks. Rectal and skin temperatures decreased, while follicle‐stimulating hormone, luteinizing hormone, triiodothyronine, thyroxine, testosterone, immunoglobulin M, tumor necrosis factor‐alpha, and interleukin‐6 in blood serum and glutathione peroxidase in the liver increased in all groups (p < .05). Garlic extract (100 mg/kg diet) increased adenosine triphosphate and glutathione in the liver tissues. All treatments significantly increased net semen volume, percentages of progressive motility, livability, curled tail, and intact acrosomes of spermatozoa, sperm cell concentration, and outputs of total and motile spermatozoa, while significantly decreased percentage of sperm abnormality. In conclusion, dietary supplementation of turmeric or garlic extract can be used as a suitable tool for enhancing the hepatic antioxidant activity, immunity, and semen quality in rabbit bucks.
Designing personalised instruction: A research and design framework
Authors: Kucirkova Natalia , Gerard Libby , Linn Marcia C.
Published: May 2021

Advances in technology have increased the opportunities for designers to personalise instruction based on student actions. We conducted semi‐structured interviews with an international sample of educational professionals including researchers, teachers and designers, and reviewed interdisciplinary literature on personalisation to propose a framework for personalisation research and design. Thematic analysis of the interviews revealed that professionals value each type of personalisation opportunity (eg, customising for age‐appropriate content, supports for student choice, automated guidance based on learner responses) and identify challenges (eg, trade‐offs between adaptive and standardised instruction). Three research/design dilemmas emerged: individualisation and equity; group customisation and individual benefit; and adaptation and validity of measurement. We discuss these dilemmas in relation to three categories of personalisation: customisation by designers or teachers to support a specific audience (grade level, course, community); individualisation to support user choice (of book to read, project topic); and adaptation of instructional activities based on automated analysis of logged user performance (performance metrics, natural language processing, cumulative indicators). We suggest some guiding questions for a generative agenda for future research on personalised instruction.

Practitioner notes

What is already known about this topic

Personalised learning is popular among educational professionals.

Personalised design has multiple and inconsistent definitions.

A shared framework for personalised instruction would facilitate research and design.

What this paper adds

A succinct but comprehensive definition of personalised education.

Perspectives on personalisation from an international group of practitioners and designers.

A framework including three dilemmas to guide future research on the design and practice of personalised instruction.

Implications for practice and/or policy

A shared definition of personalisation can support communication across diverse stakeholders.

The framework can guide future design and instruction with personalised educational technology.

The framework identifies dilemmas that illustrate ethical pathways for policy‐makers responsible for personalised education.
Gender‐related differences in the outcomes and genomic landscape of patients with myelodysplastic syndrome/myeloproliferative neoplasm overlap syndromes
Authors: Karantanos Theodoros , Gondek Lukasz P. , Varadhan Ravi , Moliterno Alison R. , DeZern Amy E. , Jones Richard J. , Jain Tania
Published: May 2021

Myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) overlap syndromes show a male predominance and men with MDS/MPN have worse outcomes, but it is unknown if the mutational burden differs between genders. We reviewed 167 patients with MDS/MPN and found that men had worse overall survival [hazard ratio (HR) 2·09, 95% confidence interval (CI) 1·16–3·75; P = 0·013] independent of subtype, Revised International Prognostic Scoring System score and age at diagnosis. We analysed the genomic data of a subset of 100 patients. Men had 0·88 more somatic mutations on average (95% CI 0·20–1·56, P = 0·011) independent of subtype, sample source and blast percentage. More somatic mutations was associated with a higher incidence of transformation to acute myeloid leukaemia (subdistribution HR 1·30, 95% CI 1·01–1·70; P = 0·046). Men had 0·70 more mutations in high‐risk genes [additional sex combs like‐1 (ASXL1), enhancer of zeste homolog 2 (EZH2), Runt‐related transcription factor 1 (RUNX1), SET binding protein 1 (SETBP1), NRAS proto‐oncogene, GTPase (NRAS), stromal antigen 2 (STAG2)] on average (95% CI 0·11–1·29, P = 0·021), and 13‐times higher odds of harbouring an EZH2 mutation (95% CI 1·64–102·94, P = 0·015). The presence of an EZH2 mutation was associated with worse survival among men (HR 2·98, 95% CI 1·1–8·0; P = 0·031). Our present findings suggest that the worse outcomes in men with MDS/MPN are associated with a higher number of somatic mutations, especially in high‐risk genes. These results warrant validation in larger cohorts and investigation of the underlying mechanisms.
ENZA‐p trial protocol: a randomized phase II trial using prostate‐specific membrane antigen as a therapeutic target and prognostic indicator in men with metastatic castration‐resistant prostate cancer treated with enzalutamide (ANZUP 1901)
Authors: Emmett Louise , Subramaniam Shalini , Joshua Anthony M. , Crumbaker Megan , Martin Andrew , Zhang Alison Y. , Rana Nisha , Langford Ailsa , Mitchell Jenna , Yip Sonia , Francis Roslyn , Hofman Michael S. , Sandhu Shahneen , Azad Arun , Gedye Craig , McJannett Margaret , Stockler Martin R. , Davis Ian D. ,   the Australian, New Zealand Urogenital, Prostate Cancer Trials Group (ANZUP), the ENZA‐p investigators
Published: May 2021

Objectives

To determine the activity and safety of lutetium‐177 (177Lu)‐prostate‐specific membrane antigen (PSMA)‐617 in men with metastatic castration‐resistant prostate cancer (mCRPC) commencing enzalutamide, who are at high risk of early progression, and to identify potential prognostic and predictive biomarkers from imaging, blood and tissue.

Participants and Methods

ENZA‐p (ANZUP 1901) is an open‐label, randomized, two‐arm, multicentre, phase 2 trial. Participants are randomly assigned (1:1) to treatment with enzalutamide 160 mg daily alone or enzalutamide plus 177Lu‐PSMA‐617 7.5 GBq on Days 15 and 57. Two additional 177Lu‐PSMA‐617 doses are allowed, informed by Day‐92 Gallium‐68 (68Ga)‐PSMA positron emission tomography (PET; up to four doses in total). The primary endpoint is prostate‐specific antigen (PSA) progression‐free survival (PFS). Other major endpoints include radiological PFS, PSA response rate, overall survival, health‐related quality of life, adverse events and cost‐effectiveness. Key eligibility criteria include: biochemical and/or clinical progression; 68Ga‐PSMA PET‐avid disease; no prior androgen signalling inhibitor, excepting abiraterone; no prior chemotherapy for mCRPC; and ≥2 high‐risk features for early enzalutamide failure. Assessments are 4 weekly during study treatment, then 6 weekly until radiographic progression. Response Evaluation Criteria in Solid Tumours (RECIST) are used to assess imaging conducted every 12 weeks, 68Ga‐PSMA PET at baseline, Days 15 and 92, and at progression, and 18F‐fluorine deoxyglucose (18F‐FDG) PET at baseline and progression. Translational samples include blood (and optional biopsies) at baseline, Day 92, and first progression. Correlative studies include identification of prognostic and predictive biomarkers from 68Ga‐PSMA and 18F‐FDG PET/CT, circulating tumour cells and circulating tumour DNA. The trial will enrol 160 participants, providing 80% power with a two‐sided type‐1 error rate of 5% to detect a hazard ratio of 0.625 assuming a median PSA‐PFS of 5 months with enzalutamide alone.

Results and Conclusion

The combination of 177Lu‐PSMA‐617 and enzalutamide may be synergistic. ENZA‐p will determine the safety and efficacy of the combination in addition to developing predictive and prognostic biomarkers to better guide treatment decisions.
The cancer multidisciplinary team meeting: in need of change? History, challenges and future perspectives
Authors: Winters David A. , Soukup Tayana , Sevdalis Nick , Green James S.A. , Lamb Benjamin W.
Published: May 2021

Two decades since their inception, multidisciplinary teams (MDTs) are widely regarded as the ‘gold standard’ of cancer care delivery. Benefits of MDT working include improved patient outcomes, adherence to guidelines, and even economic benefits. Benefits to MDT members have also been demonstrated. An increasing body of evidence supports the use of MDTs and provides guidance on best practise. The system of MDTs in cancer care has come under increasing pressure of late, due to the increasing incidence of cancer, the popularity of MDT working, and financial pressures. This pressure has resulted in recommendations by national bodies to implement streamlining to reduce workload and improve efficiency. In the present review we examine the historical evidence for MDT working, and the scientific developments that dictate best practise. We also explore how streamlining can be safely and effectively undertaken. Finally, we discuss the future of MDT working including the integration of artificial intelligence and decision support systems and propose a new model for improving patient centredness.
Mesenchymal stem cells and extracellular vesicles for the treatment of pain: Current status and perspectives
Authors: Bryk Marta , Karnas Elżbieta , Mlost Jakub , Zuba‐Surma Ewa , Starowicz Katarzyna
Published: May 2021

Mesenchymal stem/stromal cells (MSCs) are multipotent progenitor cells of mesodermal origin. Due to their capacity for self‐renewal and differentiation into several cell types, MSCs have been extensively studied in experimental biology and regenerative medicine in recent years. Moreover, MSCs release extracellular vesicles (EVs), which might be partly responsible for their regenerative properties. MSCs regulate several processes in target cells via paracrine signalling, such as immunomodulation, anti‐apoptotic signalling, tissue remodelling, angiogenesis and anti‐fibrotic signalling. The aim of this review is to provide a detailed description of the functional properties of MSCs and EVs and their potential clinical applications, with a special focus on pain treatment. The analgesic, anti‐inflammatory and regenerative properties of MSCs and EVs will be discussed for several diseases, such as neuropathic pain, osteoarthritis and spinal cord injury.

LINKED ARTICLES

This article is part of a themed issue on New discoveries and perspectives in mental and pain disorders. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.17/issuetoc
Cytology of a mass in the hard palate: A diagnostic pitfall
Authors: Mohamedali Rasheeda , Nath Nayantrishna , Mishra Pritinanda , Mitra Suvradeep
Published: May 2021

This is a case of pleomorphic adenoma, misdiagnosed as basal cell adenoma on cytology. The histopathology showed predominantly basal cell adenoma‐like areas with focal changes representing the stroma of pleomorphic adenoma.
Optimal treatment policies for pelvic organ prolapse in women
Authors: Zhuo Yueran , Solak Senay , Harmanli Oz , Jones Keisha A.
Published: May 2021

Pelvic organ prolapse (POP) is a very common gynecological disorder greatly affecting the quality of life (QoL) of females in the society. Studies have shown that approximately 40% of women in the United States have POP that requires medical intervention. In clinical practice, there are four treatment options for POP: watchful waiting, conservative treatment, reconstructive surgery, and obliterative surgery. In this study, we utilize practical data obtained through surveys and clinical literature and develop a model to help physicians and POP patients dynamically select treatment options in order to maximize a patient's expected future QoL. Results from the model are presented in the form of optimal policy tables, which can be used by physicians and patients by entering several attributes as inputs, such as the patient's age, current observed QoL defined by the severity of POP symptoms, preferences over preserving coital function, and other potential restrictive conditions. The results show significant socioeconomic incentives for potential utilization of optimal treatment policies in POP treatment. We estimate based on QoL to dollar conversions that the expected value of improved QoL for an individual POP patient is around $10,000. When aggregated over the entire POP population seeking treatment, the total annual expected value for the society is at least $675 million under medium‐level valuations of QoL. Although the optimization‐based policies imply an overall increase of about $200 million in annual POP treatment costs, the net positive gains can make this trade‐off an acceptable one.
Drivers of change in the realised climatic niche of terrestrial mammals
Authors: Di Marco Moreno , Pacifici Michela , Maiorano Luigi , Rondinini Carlo
Published: May 2021

The breadth of a species' climatic niche is an important ecological trait that allows adaptation to climate change, but human activities often reduce realised niche breadth by impacting species distributions. Some life‐history traits, such as dispersal ability and reproductive speed, allow species to cope with both human impact and climate change. But how do these traits interact with human pressure to determine niche change? Here we investigate the patterns and drivers of change in the realised climatic niche of 258 terrestrial mammal species. Our goal is to disentangle the impacts of human land use, climate change and life history. We quantified the past and present climatic niches of each species by considering past climatic conditions (Mid Holocene) within their pre‐human impact distributions, and current climatic conditions within the current distributions. Depending on the difference between past and current niche, we defined four categories of change: ‘shrink', ‘shift', ‘stable' and ‘expand'. We found over half of the species in our sample have undergone niche shrink, while only one in six retained a stable niche. Climate change and distribution change were the strongest correlates of species niche change, followed by biogeography, anthropogenic land use and life‐history traits. Factors that increased the probability of niche shrink included: overall climatic instability, reduction in distribution range, historical land use, large body mass and long weaning age. Species with these characteristics might require interventions that facilitate natural dispersal or assisted colonisation to survive rapidly changing climates.
Behavioural heat‐stress compensation in a cold‐adapted ungulate: Forage‐mediated responses to warming Alpine summers
Authors: Semenzato Paola , Cagnacci Francesca , Ossi Federico , Eccel Emanuele , Morellet Nicolas , Hewison A. J. Mark , Sturaro Enrico , Ramanzin Maurizio
Published: May 2021

Alpine large herbivores have developed physiological and behavioural mechanisms to cope with fluctuations in climate and resource availability that may become maladaptive under climate warming. We tested this hypothesis in female Alpine ibex (Capra ibex) by modelling annual and daily movement and activity patterns in relation to temperature, vegetation productivity and reproductive status based on bio‐logging data and climate change projections. In summer, ibex moved upslope, tracking the green wave. Ibex decreased diel activity sharply above a threshold temperature of 13–14°C, indicating thermal stress, but compensated behaviourally by foraging both earlier and later in the day, and by moving further upslope than on cooler days, especially reproductive females. This critical temperature will be exceeded three times as often under climate change projections. Under such scenarios, the altitudinal extent of the area will limit the available habitat providing thermal shelter, potentially impacting performance and population distribution of this emblematic mountain ungulate.
Are Fourth‐Year College Students Better Critical Thinkers than Their First‐Year Peers? Not So Much, and College Major and Ethnicity Matter
Authors: Liu Ou Lydia , Roohr Katrina Crotts , Seybert Jacob M. , Fishtein Daniel
Published: May 2021

Critical thinking has become an essential skill required by both higher education and the workforce. Research to date has reported moderate cross‐sectional learning differences in critical thinking as students progress through a 4‐year college. However, retention, differential participation, and students’ low test‐taking motivation possibly confounded conclusions from prior studies. Controlling for such factors, we found a cross‐sectional difference of .24 SDs after 4 years in college (n = 2,381 students, 46 institutions), considerably smaller than what's reported in prior studies. Natural science majors performed the highest and business majors performed the lowest. Minority students achieved only half of the cross‐sectional difference (.18 SDs) of white students (.39 SDs), and only 6% of them scored at the Advanced level, compared to 24% of white students.
Defining dipeptidyl peptidase‐4 inhibitors‐related bullous pemphigoid: A single‐centre retrospective study
Authors: Nieto‐Benito Lula María , Bergón‐Sendín Marta , Pulido‐Pérez Ana , Rosell‐Díaz Ángel Manuel , Parra‐Blanco Verónica , Suárez‐Fernández Ricardo
Published: May 2021

Background

Many studies have corroborated the association of dipeptidyl peptidase‐4 inhibitors (DPP4i) use with bullous pemphigoid (BP). It has been speculated that this drug‐induced variant presents with a different clinical spectrum than conventional BP.

Objective

To determine the prevalence of DPP4i‐induced cases of BP and to evaluate whether gliptin‐related BP has specific clinicopathological and immunological features.

Methods

We conducted a retrospective, observational study of BP cases attended at our centre between January 2000 and June 2020. Epidemiological, clinical, histopathological and laboratory data were collected.

Results

A total of 257 cases of BP were collected; 51 (24.3%) were on treatment with DPP4i. When analysing DPP4i‐induced BP cases, generalized BP was the predominant pattern and scalp/mucosal involvement was found in 13 patients. Gliptin‐related BP cases were associated to a decrease in the eosinophilic infiltrate (p = 0.000) and both the detection rate and concentration of anti‐BP180 IgG were lower (p = 0.004, p = 0.001, respectively) than non‐DPP4i cases.

Limitations

Retrospective, single‐centre study.

Conclusion

Our large DPP4i‐induced BP case series has highlighted that DPP4i‐induced BP is characterized by generalized lesions and scalp involvement. Lower titres of anti‐BP180 antibodies and a decrease in eosinophils infiltrating into the skin may be distinct features of DPP4i‐related BP.
Protein phosphatase 1: life‐course regulation by SDS22 and Inhibitor‐3
Authors: Cao Xinyu , Lemaire Sarah , Bollen Mathieu
Published: May 2021

Protein phosphatase 1 (PP1) is expressed in all eukaryotic cells and catalyzes a sizable fraction of protein Ser/Thr dephosphorylation events. It is tightly regulated in space and time through association with a wide array of regulatory interactors of protein phosphatase one (RIPPOs). Suppressor‐of‐Dis2‐number 2 (SDS22) and Inhibitor‐3 (I3), which form a ternary complex with PP1, are the first two evolved and most widely expressed RIPPOs. Their deletion causes mitotic‐arrest phenotypes and is lethal in some organisms. The role of SDS22 and I3 in PP1 regulation has been a mystery for decades as they were independently identified as both activators and inhibitors of PP1. This conundrum has largely been solved by recent reports showing that SDS22 and I3 control multiple steps of the life course of PP1. Indeed, they contribute to (a) the stabilization and activation of newly translated PP1, (b) the translocation of PP1 to the nucleus, and (c) the storage of PP1 as a reserve for holoenzyme assembly. Preliminary evidence suggests that SDS22 and I3 may also function as scavengers of released or aged PP1 for re‐use in holoenzyme assembly or proteolytical degradation, respectively. Hence, SDS22 and I3 are emerging as master regulators of the life course of PP1.
Impacts of invasive Amur honeysuckle, Lonicera maackii, leaf litter on multiple trophic levels of detritus‐based experimental wetlands
Authors: Robison Alexis L. , Berta Josey L. , Mott Cy L. , Regester Kurt J.
Published: May 2021

Wetlands are especially vulnerable to invasive plants because seasonal movements of sediments, water, nutrients, and debris from adjacent terrestrial habitats create ecological conditions suitable for invasion. Lonicera maackii is a relatively abundant and broadly distributed invasive shrub in the eastern U.S.A., yet few studies have simultaneously tested for effects of its leaf litter on multiple trophic levels within wetland food webs.

Hatching success, hatchling survival, and hatchling size of tadpoles (Acris crepitans) were assessed using a laboratory mesocosm experiment with no‐leaf, native‐leaf, and L. maackii‐leaf treatments. In the field, short‐term (c. 3 week) and long‐term (c. 2 years) mesocosm experiments assessed the initial and persistent impacts, respectively, of L. maackii on measures of primary productivity, invertebrate abundance and community structure, and oviposition preference and larval survival of Cope's gray treefrog (Hyla chrysoscelis).

Exposure of eggs to L. maackii leaves reduced body size at hatching and larval survival of newly hatched A. crepitans. In short‐term experiments, L. maackii leaves reduced dissolved oxygen levels, filamentous algal biomass, and macroinvertebrate abundance, and altered macroinvertebrate community structure. In long‐term experiments, duckweed cover was 15× times greater in mesocosms with L. maackii leaf additions. Oviposition by a local population of H. chrysoscelis was 10× lower in both short‐ and long‐term mesocosms with L. maackii present.

Although ecological impacts of L. maackii have been reported for terrestrial systems, our study is the first to demonstrate the simultaneous effects of its leaves on multiple trophic levels within replicated experimental wetlands. The relatively rapid decomposition of L. maackii leaves, and associated pulse of phenolic compounds, is the most likely proximate mechanism of the bottom‐up effects we observed. The mechanisms, timing, and significance of effects is predicted to vary among natural wetlands.

Our study demonstrates multiple ecological impacts of a terrestrial invasive shrub within experimental wetlands. Detailed studies on the specific mechanisms, and their spatial and temporal variability in natural systems, will elucidate management strategies and improve the efficiency of wetland conservation efforts.