bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome
Authors: Park Sungwon , Jang Min Kyeong , Park Chang Gi , Hong Oi Saeng
Published: February 2022

Background

Metabolic syndrome has a high global prevalence, affecting 26% of South Koreans. Lifestyle modifications have shown benefits in studies involving health behavior enhancement, specifically through workplace eating and exercise interventions. However, workplace interventions focusing on health behaviors have been inadequately explored.

Objectives

This study examined factors affecting health promotion behaviors of workers at high risk of metabolic syndrome by applying Theory of Planned Behavior constructs (attitude, subjective norm, perceived behavioral control, and intention).

Methods

This correlational cross-sectional study collected survey data from 164 hotel workers in South Korea. The study applied factor analysis and structural equation modeling for the data analysis.

Results

Analysis revealed five health promotion behaviors: exercise, making healthy food choices, avoiding fatty foods, eating a nutritious and balanced diet, and eating regular moderate meals. Participants were grouped as total participants, those with one risk factor, and those with two risk factors. In the “total” group, four behaviors were influenced by perceived behavioral control: exercise, making healthy food choices, eating a nutritious and balanced diet, and eating regular moderate meals. In the “one risk factor” group, intention and attitude influenced the eating regular moderate meals behavior, and two other behaviors were influenced by perceived behavioral control: exercise and eating a nutritious and balanced diet; in the “two risk factor” group, only perceived behavioral control directly affected exercise.

Discussion

Perceived behavioral control was a key predictor of health behaviors, and theory constructs partially explained behaviors. Perceived behavioral control influenced four behaviors and influenced exercise in all three groups. Also, theory constructs showed a greater effect on behaviors in the one risk factor group than in the two risk factor group, indicating that participants with one risk factor more effectively managed their behaviors on their own and with healthcare providers’ support. Occupational health providers should conduct early assessments of workers showing metabolic syndrome risk factors to identify their particular risks, intention, and behaviors. As the number of risk factors affects behaviors and perceived behavioral control primarily influences exercise, these findings should be incorporated in metabolic syndrome interventions.
Energetic dissociation of individual and species ranges
Authors: Enriquez-Urzelai Urtzi , Boratyński Zbyszek
Published: February 2022

The use of energy is universal to all life forms and all levels of biological organization, potentially linking processes operating at variable scales. Individual and species ranges might be energetically constrained, yet divergent metabolic limitations at both scales can disassociate these individual and species traits. We analysed comparative energetic and range data to unravel the mechanistic basis of the dissociation between individual and species range sizes observed among mammalian species. Our results demonstrate that basal, or maintenance, metabolism negatively correlates with individual ranges, but, at the same time, it positively correlates with species ranges. High aerobic capacity, i.e. maximum metabolic rate, positively correlates with individual ranges, but it is weakly related to species range size. These antagonistic energetic constraints on both ranges could lead to a disassociation between individual and species traits and to a low covariation between home and species range sizes. We show that important organismal functions, such as basal and maximum metabolic rates, have the potential to unravel mechanisms operating at different levels of biological organization and to expose links between energy-dependent processes at different scales.
Global pleiotropic effects in adaptively evolved
Escherichia coli
lacking CRP reveal molecular mechanisms that define the growth physiology
Authors: Pal Ankita , Iyer Mahesh S. , Srinivasan Sumana , Narain Seshasayee Aswin Sai , Venkatesh K. V.
Published: February 2022

Evolution facilitates emergence of fitter phenotypes by efficient allocation of cellular resources in conjunction with beneficial mutations. However, system-wide pleiotropic effects that redress the perturbations to the apex node of the transcriptional regulatory networks remain unclear. Here, we elucidate that absence of global transcriptional regulator CRP in
Escherichia coli
results in alterations in key metabolic pathways under glucose respiratory conditions, favouring stress- or hedging-related functions over growth-enhancing functions. Further, we disentangle the growth-mediated effects from the CRP regulation-specific effects on these metabolic pathways. We quantitatively illustrate that the loss of CRP perturbs proteome efficiency, as evident from metabolic as well as ribosomal proteome fractions, that corroborated with intracellular metabolite profiles. To address how
E. coli
copes with such systemic defect, we evolved
Δcrp
mutant in the presence of glucose. Besides acquiring mutations in the promoter of glucose transporter
ptsG
, the evolved populations recovered the metabolic pathways to their pre-perturbed state coupled with metabolite re-adjustments, which altogether enabled increased growth. By contrast to
Δcrp
mutant, the evolved strains remodelled their proteome efficiency towards biomass synthesis, albeit at the expense of carbon efficiency. Overall, we comprehensively illustrate the genetic and metabolic basis of pleiotropic effects, fundamental for understanding the growth physiology.
Lyme disease transmission by severely impaired ticks
Authors: Perner Jan , Kucera Matej , Frantova Helena , Urbanova Veronika , Kopacek Petr , Sima Radek
Published: February 2022

It has been demonstrated that impairing protein synthesis using drugs targeted against tRNA amino acid synthetases presents a promising strategy for the treatment of a wide variety of parasitic diseases, including malaria and toxoplasmosis. This is the first study evaluating tRNA synthetases as potential drug targets in ticks. RNAi knock-down of all tested tRNA synthetases had a strong deleterious phenotype on
Ixodes ricinus
feeding. Our data indicate that tRNA synthetases represent attractive, anti-tick targets warranting the design of selective inhibitors. Further, we tested whether these severely impaired ticks were capable of transmitting
Borrelia afzelii
spirochaetes. Interestingly, biologically handicapped
I. ricinus
nymphs transmitted
B. afzelii
in a manner quantitatively sufficient to develop a systemic infection in mice. These data suggest that initial blood-feeding, despite the incapability of ticks to fully feed and salivate, is sufficient for activating
B. afzelii
from a dormant to an infectious mode, enabling transmission and dissemination in host tissues.
Biochemical analysis challenging Western blot analysis as validation step for antibodies intended for ELISA and Immunohistochemistry use
Authors: Zhang Yunyun , Zhang Wenfeng , Yang Maozhou , Zhang Jiandi
Published: February 2022

The relative contributions of the conformation and primary structure of an epitope to overall antigen-antibody interaction (AAI) at denatured, native or formalin fixed (FF) state were compared using six randomly chosen commercial antibodies using Quantitative Dot Blot (QDB) method. AAIs at native and FF states were found ranged 1.3 ∼ 10.2 and 0.5 ∼ 45.4 folds, respectively, over those at denatured state in cellular and tissue lysates. Using two antibodies against different epitopes of PYGL protein, we showed that PYGL levels in several types of tissues and cell lines were highly correlated (r=0.99 from Pearson, p<0.0001, n=25) when measured with these two antibodies at native state. Yet, one antibody was found to be nonspecific with one type of these tissues using Western blot analysis. These observations suggested that the conformation of an epitope may serve as dominant contributor of overall AAI at native state in general, regardless of linear or conformational epitopes. In many cases, it would override nonspecific interactions formed at denatured state to challenge Western blot analysis as a validation tool for antibodies intended for immunohistochemistry (IHC) and ELISA.
Sexual identity management of working lesbian women
Authors: Khachatryan Kristine , Graml Regine , Hagen Tobias , Ziegler Yvonne , Herman Ricky Astrida
Published: February 2022

Purpose

The purpose of this study is to provide a closer look at being out in the work environment. What are the characteristics that distinguish lesbian women who are out at work from those who are not? What role do companies play with their diversity-related measures?

Design/methodology/approach

This paper investigates characteristics that distinguish lesbian women who were out at work and analyzes the use of various sexual identity management strategies in relation to specific reference groups within a company. Furthermore, the method of multiple correspondence analysis is used to visually map the associations between company-specific characteristics and being out.

Findings

Results show that being out in the work environment is subject to a complex interplay of several factors, from personal resources to the diversity-friendliness of the company. A company’s lesbian, gay, bisexual, transgender, and intersexual (LGBTI)-related measures, such as in-house LGBTI networks or diversity workshops, can not only promote the coming out of lesbian employees, and thereby help to increase their overall satisfaction with life, but can also reduce their experiences of discrimination.

Originality/value

In this paper, the method of multiple correspondence analysis is used to examine the relationships between several diversity-related measures of the company and being out at the workplace. A visualization of these relationships in a two-dimensional space allows a more comprehensive view of these features and their possible effect on being out at the workplace.
Unexpected role of electron‐transfer hub in direct degradation of pollutants by exoelectrogenic bacteria
Authors: Zhu Ting‐Ting , Cheng Zhou‐Hua , Yu Sheng‐Song , Li Wen‐Wei , Liu Dong‐Feng , Yu Han‐Qing
Published: February 2022

Exoelectrogenic bacteria (EEB) are capable of anaerobic respiration with diverse extracellular electron acceptors including insoluble minerals, electrodes and flavins, but the detailed electron transfer pathways and reaction mechanisms remain elusive. Here, we discover that CymA, which is usually considered to solely serve as an inner‐membrane electron transfer hub in Shewanella oneidensis MR‐1 (a model EEB), might also function as a reductase for direct reducing diverse nitroaromatic compounds (e.g. 2,4‐dichloronitrobenzene) and azo dyes. Such a process can be accelerated by dosing anthraquinone‐2,6‐disulfonate. The CymA‐based reduction pathways in S. oneidensis MR‐1 for different contaminants could be functionally reconstructed and strengthened in Escherichia coli. The direct reduction of lowly polar contaminants by quinol oxidases like CymA homologues might be universal in diverse microbes. This work offers new insights into the pollutant reduction mechanisms of EEB and unveils a new function of CymA to act as a terminal reductase.
LIFE AFTER RESETTLEMENT IN URBAN CHINA: State‐led Community Building as a Reterritorialization Strategy
Authors: Wang Zheng
Published: February 2022

Resettlement thus far has been conceptualized as a large‐scale form of displacement taking place within a short timeframe. In this article I attempt to reinterpret resettlement as a two‐stage process involving both the deterritorialization and reterritorialization of residents by shedding light on the processes and challenges involved in rebuilding the sense of community of residents after resettlement. I draw on the case of a relocation settlement in Shanghai and find that the Chinese state is heavily involved in reterritorializing residents because it needs to consolidate its influence at the grassroots level and address the practical necessity of assisting tens of millions of resettled residents who lack access to essential amenities and services. The state uses a mechanism I describe as state‐led community building in its attempt to rebuild the sense of community of resettled residents in a way that also renders residents more governable. In practice, this involves increasing the number and power of resettlement committees and promoting resident volunteering and participation through community organizations and events. State‐led community building works relatively well in the case of retired urban residents, but fails to attract other resident groups, including rural and working migrant residents.
The association between recreational cannabis legalization, commercialization and cannabis‐attributable emergency department visits in Ontario, Canada: an interrupted time–series analysis
Authors: Myran Daniel T. , Pugliese Michael , Tanuseputro Peter , Cantor Nathan , Rhodes Emily , Taljaard Monica
Published: February 2022

Background and aims

Recreational cannabis was legalized in Canada in October 2018. Initially, the Government of Ontario (Canada’s largest province) placed strict limits on the number of cannabis retail stores before later removing these limits. This study measured changes in cannabis‐attributable emergency department (ED) visits over time, corresponding to different regulatory periods.

Design

Interrupted time–series design using population‐level data. Two policy periods were considered; recreational cannabis legalization with strict store restrictions (RCL, 17 months) and legalization with no store restrictions [recreational cannabis commercialization (RCC), 15 months] which coincided with the COVID‐19 pandemic. Segmented Poisson regression models were used to examine immediate and gradual effects in each policy period.

Setting

Ontario, Canada.

Participants

All individuals aged 15–105 years (n = 13.8 million) between January 2016 and May 2021.

Measurements

Monthly counts of cannabis‐attributable ED visits per capita and per all‐cause ED visits in individuals aged 15+ (adults) and 15–24 (young adults) years.

Findings

We observed a significant trend of increasing cannabis‐attributable ED visits pre‐legalization. RCL was associated with a significant immediate increase of 12% [incident rate ratio (IRR) = 1.12, 95% confidence interval (CI) = 1.02–1.23] in rates of cannabis‐attributable ED visits followed by significant attenuation of the pre‐legalization slope (monthly slope change IRR = 0.98, 95% CI = 0.97–0.99). RCC and COVID‐19 were associated with immediate significant increases of 22% (IRR = 1.22, 95% CI = 1.09–1.37) and 17% (IRR = 1.17, 95% CI = 1.00–1.37) in rates of cannabis‐attributable visits and the proportion of all‐cause ED visits attributable to cannabis, respectively, with insignificant increases in monthly slopes. Similar patterns were observed in young adults.

Conclusions

In Ontario, Canada, cannabis‐attributable emergency department visits stopped increasing over time following recreational cannabis legalization with strict retail controls but then increased during a period coinciding with cannabis commercialization and the COVID‐19 pandemic.
Fragmented QRS as a risk marker for the occurrence of ventricular fibrillation in patients with variant angina
Authors: Shinohara Tetsuji , Yonezu Keisuke , Hirota Kei , Kondo Hidekazu , Fukui Akira , Akioka Hidefumi , Teshima Yasushi , Yufu Kunio , Nakagawa Mikiko , Takahashi Naohiko
Published: February 2022

Background

Variant angina (VA) is caused by reversible coronary artery spasm, which is characterized by chest pain with ST‐segment elevations on standard 12‐lead electrocardiogram (ECG) at rest. Ventricular fibrillation (VF) is often caused by VA attack, but the risk stratification is not well understood. The purpose of this study was to evaluate the impact of fragmented QRS (fQRS) on VF occurrence in VA patients.

Methods

Ninety‐four patients who showed ST elevation on 12‐lead ECGs with total or nearly total occlusion in response to coronary spasm provocation test were enrolled. Among them, 16 patients had documented VF before hospital admission (n = 12) or experienced VF during provocation test (n = 4) (VF occurrence group). The fQRS was defined as the presence of spikes within the QRS complex of two or more consecutive leads.

Results

The prevalence of fQRS was more often observed in the VF occurrence group than in the non‐VF occurrence group (63% [10/16] vs. 27% [21/78], p = 0.009). Univariate analyses revealed that age, history of syncope, QTc, and the presence of fQRS were associated with VF occurrence (p = 0.004, 0.005, 0.029, and 0.008, respectively). Furthermore, upon multivariate analyses using those risk factors, age, QTc, and fQRS predicted VF occurrence independently (p = 0.007, 0.041, and 0.014, respectively).

Conclusions

The present study demonstrated that fQRS in VA patients is a risk factor for VF. The fQRS may be a useful factor for the risk stratification of VF occurrence in VA patients.
How do zombie firms affect innovation: from the perspective of credit resources distortion
Authors: Qiao Xiaole , Song Lin , Fan Xiaomin
Published: February 2022

Excessive support from banks and governments to poorly‐performing firms, making them zombie firms, distorts financial resources—a common factor in firm innovation. Using a large sample of Chinese industrial firms, this paper investigates the impact of zombie firms on the innovation of healthy firms. The results indicate that the prevalence of zombie firms reduces the patent output of healthy firms and seriously jeopardises innovation. Endogeneity analyses and robustness checks validate the results. Further analysis reveals that zombie firms distort the credit resources of healthy firms, especially those that are state‐owned or in high‐tech industries, thereby reducing innovation output. However, the higher financial marketisation of provinces can alleviate this negative effect. This study contributes to an understanding of the negative consequences of zombie firms due to the distortion of credit and provides some policy implications for the disposal of zombies to promote high‐quality economic development.
Trait resilience instigates innovative behaviour at work? A cross‐lagged study
Authors: Caniëls Marjolein C. J. , Hatak Isabella , Kuijpers Koen J. C. , de Weerd‐Nederhof Petra C.
Published: February 2022

Being able to deal with change and setbacks at work is a major reason why many people generate, promote and implement new ideas at work, supporting organizations in their strive for success including innovation outcomes. Yet, surprisingly little research has examined the underlying mechanisms through which trait resilience influences innovative behaviour at work. Drawing upon control theory in conjunction with the affect‐as‐information perspective, we theorize why resilience as a core personality trait affects innovative behaviour at work. Performing cross‐lagged analyses on two‐wave data, our analyses demonstrate that resilience positively relates to employees' innovative work behaviour due to increased levels of positive emotions. We conclude that being able to deal with change and setbacks at work generates a powerful pool of emotions that can boost innovative behaviour at work, offering meaningful implications for research on innovation and the dynamics of personality and emotions at work.
First evidence of SOX2 mutations in Peters' anomaly: Lessons from molecular screening of 95 patients
Authors: Chesneau Bertrand , Aubert‐Mucca Marion , Fremont Félix , Pechmeja Jacmine , Soler Vincent , Isidor Bertrand , Nizon Mathilde , Dollfus Hélène , Kaplan Josseline , Fares‐Taie Lucas , Rozet Jean‐Michel , Busa Tiffany , Lacombe Didier , Naudion Sophie , Amiel Jeanne , Rio Marlène , Attie‐Bitach Tania , Lesage Cécile , Thouvenin Dominique , Odent Sylvie , Morel Godelieve , Vincent‐Delorme Catherine , Boute Odile , Vanlerberghe Clémence , Dieux Anne , Boussion Simon , Faivre Laurence , Pinson Lucile , Laffargue Fanny , Le Guyader Gwenaël , Le Meur Guylène , Prieur Fabienne , Lambert Victor , Laudier Beatrice , Cottereau Edouard , Ayuso Carmen , Corton‐Pérez Marta , Bouneau Laurence , Le Caignec Cédric , Gaston Véronique , Jeanton‐Scaramouche Claire , Dupin‐Deguine Delphine , Calvas Patrick , Chassaing Nicolas , Plaisancié Julie
Published: February 2022

Peters' anomaly (PA) is a rare anterior segment dysgenesis characterized by central corneal opacity and irido‐lenticulo‐corneal adhesions. Several genes are involved in syndromic or isolated PA (B3GLCT, PAX6, PITX3, FOXE3, CYP1B1). Some copy number variations (CNVs) have also been occasionally reported. Despite this genetic heterogeneity, most of patients remain without genetic diagnosis. We retrieved a cohort of 95 individuals with PA and performed genotyping using a combination of comparative genomic hybridization, whole genome, exome and targeted sequencing of 119 genes associated with ocular development anomalies. Causative genetic defects involving 12 genes and CNVs were identified for 1/3 of patients. Unsurprisingly, B3GLCT and PAX6 were the most frequently implicated genes, respectively in syndromic and isolated PA. Unexpectedly, the third gene involved in our cohort was SOX2, the major gene of micro‐anophthalmia. Four unrelated patients with PA (isolated or with microphthalmia) were carrying pathogenic variants in this gene that was never associated with PA before. Here we described the largest cohort of PA patients ever reported. The genetic bases of PA are still to be explored as genetic diagnosis was unavailable for 2/3 of patients. Nevertheless, we showed here for the first time the involvement of SOX2 in PA, offering new evidence for its role in corneal transparency and anterior segment development.
Motor skills and intelligence in children with fetal alcohol spectrum disorder
Authors: Branton Erin , Thompson‐Hodgetts Sandy , Johnston Danielle , Gross Douglas P. , Pritchard Lesley
Published: February 2022

Aim

To determine the relationship between motor abilities and intelligence in children and young people with prenatal alcohol exposure (PAE) being assessed for fetal alcohol spectrum disorder (FASD).

Method

This was a cross‐sectional correlational study of children and young people with PAE being assessed for FASD. The relationship between motor abilities (Movement Assessment Battery for Children, Second Edition) and intelligence (Wechsler Intelligence Scale for Children, Fourth or Fifth Edition) was calculated using correlation and regression analyses. Attention and executive function were considered as potential confounding variables.

Results

The relationship between motor abilities and intelligence in 73 children and young people (48 males, 25 females; aged 6–17y, mean age 10y 5mo [SD 2y 9mo]) assessed for FASD was small and statistically non‐significant (r=0.05, p=0.67).

Interpretation

The findings confirm that motor abilities and intelligence should be assessed separately when investigating an FASD diagnosis. Intelligence scores should not be used to estimate motor abilities, nor should they dictate when motor testing be completed. Assessing intelligence and motor domains separately will enhance diagnostic accuracy, identify the need for strategies or interventions to address functional motor skills, and further define the role of physiotherapy and occupational therapy in FASD assessment and intervention.
Effect of bremelanotide on body weight of obese women: Data from two phase 1 randomized controlled trials
Authors: Spana Carl , Jordan Robert , Fischkoff Steven
Published: February 2022

Aims

The melanocortin 4 receptor (MC4R) plays a central role in appetite regulation, and agonistic activity at this receptor promotes satiety. Results from two randomized controlled clinical trials examine the effects of bremelanotide's agonism at MC4R on caloric intake and body weight.

Methods

Premenopausal women with a body mass index >30 kg/m2 were studied in two phase 1, single‐centre, randomized, double‐blind, placebo‐controlled trials. Study A matched subjects 1:1 to receive subcutaneous placebo or bremelanotide three times daily for days 1‐15. Study B was a crossover trial with six distinct treatment sequences consisting of three 4‐day treatment periods, investigating once‐a‐day and twice‐a‐day exposure to bremelanotide versus placebo. Subjects received one of the three treatments twice‐daily during each period: 0 mg/0 mg, 2.5 mg/0 mg or 2.5 mg/2.0 mg bremelanotide. Body weight and food intake were recorded in detail daily. Adverse events were recorded throughout both studies.

Results

In Study A, 27 of 30 bremelanotide subjects (90.0%) completed the trial and exhibited a significantly greater reduction in body weight after 16 days versus placebo [least squares mean difference (95% CI), −1.3 (−1.9 to −0.8) kg; p < .0001]. Mean caloric intake in bremelanotide subjects was decreased versus placebo, with a magnitude of reduction of approximately 400 kcal/day throughout Study A (p < .01). In Study B, 15 of 27 subjects (55.6%) completed all three phases. Significantly greater reduction of mean body weight occurred in twice‐daily bremelanotide subjects versus placebo (1.7 vs. 0.9 kg, respectively, p < .001). Total caloric intake reduction was significantly greater in the bremelanotide groups versus placebo (mean difference range: 398‐469 kcal; p < .0001).

Conclusions

Agonist activity at the MC4R may aid in reducing caloric intake and weight loss in obese women.
What prevents women from reaching the top?
Authors: Keloharju Matti , Knüpfer Samuli , Tåg Joacim
Published: February 2022

We use rich data on all business, economics, and engineering graduates in Sweden to study the lack of women among chief executive officers (CEOs). A comprehensive battery of graduates’ characteristics explains 40% of the gender gaps in CEO appointments and 60% among graduates with children. The explanatory power mostly comes from absences and unemployment, which are about twice as likely for women as men. These gender differences increase following childbirth, and they persist in the long run. We present and discuss potential explanations to the explained and remaining gaps. Although the large unexplained share makes it hard to pinpoint the exact reason for the gender gap in CEO appointments, the large contribution of labor market attachment to the explained share suggests work–family trade‐offs are an important part of the story.
The Belgian mental health reform: When a combination of soft instruments hampers structural change
Authors: Darcis Coralie , Schoenaers Frédéric , Thunus Sophie
Published: February 2022

In Europe, the mental health field is undergoing a paradigm shift from a hospital‐centered, institutionalized and segmented model toward a community‐based, patient‐centered and more integrated model. From 2010 onwards, Belgian policymakers availed themselves of new policy instruments to complete this shift, having been hampered by strong professional and cultural barriers over the four previous decades. However, the reform objectives have only partially been achieved. Assuming that an instrument perspective on policy implementation would illustrate why the reform does not achieve its priority objectives, the article questions the relationship between the types of instruments used and the type of change induced. Drawing on the analysis of three policy implementation processes, we argue that these “soft” instruments are by nature not suitable for initiating any type of change and may have limited effects when used in certain contexts and under certain conditions. The article ends with a discussion of the three limitations of these instruments.
HLA‐identical living related kidney transplantation: Outcomes of a national multicenter study
Authors: Bentata Yassamine , ElKabbaj Driss , Bahadi Abdelaali , Rhou Hakima , Laouad Inass , Sqalli Tarik , Bouattar Tarik , Ouzeddoun Naima , Bayahia Rabia , Ramdani Benyouns
Published: February 2022

Objectives

The kidney prognosis of HLA‐identical seems theoretically very interesting with the lowest risk of acute rejection after that of identical twins. Objectives were to determine the prevalence of acute rejection and various complications in a cohort of HLA‐identical living‐related kidney transplant.

Methods

A retrospective, multicenter study was conducted in seven university centers in Morocco, which included all recipients of an HLA‐identical living‐related kidney transplant performed between 1990 and 2019.

Results

Data on 68 HLA‐identical living‐related kidney transplants were collected. The donors were siblings in 89.7%, the parents in 7.3%, and identical twins in 3% of cases. 53.6% of all recipients were under 35 years old, and 59.4% of them were male. 39.7% of all donors were under 35 years old, and 47% of them were male. 48.5% of HLA‐identical living‐related kidney transplants were performed before the year 2000. 18 kidney transplant biopsies were performed on 16 kidney transplant recipients. Seven episodes of acute rejection occurred in six patients, 8.8% of the whole cohort (n = 68). Two cases of acute rejection among the seven were related to poor adherence, cessation of immunosuppressive therapy, and loss of medical follow‐up by these patients. These two patients were 20 years old at the time of kidney transplantation. The global kidney transplant survival was 66.7% versus 91.9% (P = 0.04) in the two patient groups having developed acute rejection and not having developed acute rejection, respectively.

Conclusions

Acute rejection is a real threat to HLA‐identical kidney transplant recipients. Therefore, it seems very important to codify the immunosuppressive regimen and to adopt a minimal and effective treatment.
Health care workers' experience of personal protective equipment use and associated adverse effects during the COVID‐19 pandemic response in Singapore
Authors: Aloweni Fazila , Bouchoucha Stéphane L. , Hutchinson Ana , Ang Shin Yuh , Toh Hui Xian , Bte Suhari Nur' Azzah , Bte Sunari Raden Nurheryany , Lim Siew Hoon
Published: February 2022

Aim

One of the greatest challenges in responding to the COVID‐19 pandemic is preventing staff exposure and infection by ensuring consistent and effective use of personal protective equipment (PPE). This study explored health care workers' experience of prolonged PPE use in clinical practice settings and their concerns regarding PPE supply, effectiveness and training needs.

Design

A descriptive cross‐sectional design was adopted in this study.

Methods

Health care workers (N = 592) from an acute care hospital completed an online survey from July to September 2020 assessing: (i) usage frequencies, side effects and interference with patient care; and (ii) perceptions of access to PPE, likelihood of exposure to infection and adequacy of PPE training.

Results

PPE‐related side effects were reported by 319 (53.8%) participants, the majority being nurses (88.4%) and those working in high‐risk areas such as the emergency department (39.5%), respiratory wards (acute 22.3% and non‐acute 23.8%) and COVID‐19 isolation ward (13.8%). The average time wearing PPE per shift was 6.8 h (SD0.39). The most commonly reported symptoms were from donning N95 masks and included: pressure injuries (45.5%), mask‐induced acne (40.4%) and burning/pain (24.5%). Some 31.3% expressed that PPE‐related side effects had negatively affected their work. The odds of having PPE‐associated side effects was higher in women (OR 2.10, 95% CI [1.29–03.42],p = .003) and those working in high‐risk wards (OR 3.12, 95% CI [2.17–4.60],p < .001]. Most (90.1%) agreed that PPE supplies were readily available, sufficient for all (86.1%) and there was sufficient training in correct PPE use (93.6%). Only 13.7% of participants reported being ‘highly confident’ of overall PPE protection.

Conclusions

Prevention and management of PPE‐related adverse effects is vital to: preserve the integrity of PPE, improve adherence and minimize viral transmission.

Impact

The high incidence of PPE‐associated pressure injuries and perception that PPE use can interfere with clinical care should inform future development of PPE products, and strategies to better equip health care workers to prevent and manage PPE‐related side effects.
Intramural mapping of intramural septal ventricular arrhythmias
Authors: Tam Tsz‐kin , Ghannam Michael , Liang Jackson J. , Attili Anil , Cochet Hubert , Jais Pierre , Juhoor Mehdi , Latchamsetty Rakesh , Jongnarangsin Krit , Morady Fred , Bogun Frank
Published: February 2022

Background

Intramural ventricular arrhythmias (VAs) can originate in patients with or without structural heart disease. Electrogram (EGM) recordings from intramural sources of VA have not been described thoroughly.

Objective

We hypothesized that the presence of scar may be linked to the site of origin (SOO) of focal, intramural VAs.

Methods

In a series of 21 patients (age: 55 ± 11 years, 12 women, mean ejection fraction 43 ± 14%) in whom the SOO of intramural VAs was identified, we analyzed bipolar EGM characteristics at the SOO and compared the findings with the endocardial breakout site. The patients were from a pool of 86 patients with intramural VAs referred for ablation.

Results

In 16/21 patients intramural scarring was detected by cardiac magnetic resonance (CMR) imaging In patients in whom the intramural SOO was reached, intramural bipolar EGMs showed a lower voltage and had broader EGMs compared to the endocardial breakout sites (0.97 ± 0.56 vs. 2.28 ± 0.15 mV, p = .001; and 122.3 ± 31.6 vs. 96.5 ± 26.3 ms, p < .01). All intramural sampled sites at the SOO had either low voltage or broad abnormal EGMs. The activation time was significantly earlier at the intramural SOO than at breakout sites (−36.2 ± 11.8 vs. −23.2 ± 9.1 ms, p < .0001).

Conclusions

Sites of origin of intramural VAs with scar by CMR display EGM characteristics of scarring, supporting that scar tissue localizes to the SOO of intramural outflow tract arrhythmias in some patients. Scarring identified by CMR may be helpful in planning ablation procedures in patients with suspected intramural VAs.
Maternal sleep during pregnancy and adverse pregnancy outcomes: A systematic review and meta‐analysis
Authors: Wang Ruiqi , Xu Mengmeng , Yang Wenfang , Xie Guilan , Yang Liren , Shang Li , Zhang Boxing , Guo Leqian , Yue Jie , Zeng Lingxia , Chung Mei Chun
Published: February 2022

Aims/Introduction

Sleep problems are important public health concern worldwide. We carried out a meta‐analysis to quantitatively evaluate whether sleep duration was associated with pregnancy outcomes, and the associations were modified by important characteristics of studies.

Materials and Methods

Based on PubMed, Embase and the Cochrane Central Register of Controlled Trials databases, we searched for published literature related to maternal sleep duration and adverse pregnancy outcomes before 30 June 2021. We carried out risk of bias assessment, subgroup analyses and sensitivity analysis. The relative risks or odds ratios with 95% confidence intervals (CI) were used to estimate the pooled effects.

Results

A total of 5,246 references were identified through a database search, and 41 studies were included in the study. Pregnant women with short sleep duration had 1.81‐fold (95% CI 1.35–2.44,P < 0.001) the risk of developing gestational diabetes mellitus. The association between short sleep duration and the risk of gestational hypertension, cesarean section, low birthweight, preterm birth and small for gestational age were not significant (P > 0.05). Furthermore, long sleep duration was significantly correlated with gestational diabetes mellitus (odds ratio1.24. 95% CI 1.12–1.36,P < 0.001) and CS (odds ratio 1.13. 95% CI 1.04–1.22,P = 0.004), whereas long sleep duration was not linked with gestational hypertension, low birthweight, preterm birth and small for gestational age (P > 0.05).

Conclusions

Short/long sleep duration appeared to be associated with adverse pregnancy outcomes, specifically with an increased risk of gestational diabetes mellitus. Sleep should be systematically screened in the obstetric population.
Classifying atopic dermatitis: a systematic review of phenotypes and associated characteristics
Authors: Bosma A.L. , Ascott A. , Iskandar R. , Farquhar K. , Matthewman J. , Langendam M.W. , Mulick A. , Abuabara K. , Williams H.C. , Spuls P.I. , Langan S.M. , Middelkamp‐Hup M.A.
Published: February 2022

Atopic dermatitis is a heterogeneous disease, accompanied by a wide variation in disease presentation and the potential to identify many phenotypes that may be relevant for prognosis and treatment. We aimed to systematically review previously reported phenotypes of atopic dermatitis and any characteristics associated with them. Ovid EMBASE, Ovid MEDLINE and Web of Science were searched from inception till 12 February 2021 for studies attempting to classify atopic dermatitis. Primary outcomes are atopic dermatitis phenotypes and characteristics associated with them in subsequent analyses. A secondary outcome is the methodological approach used to derive them. In total, 8511 records were found. By focussing only on certain clinical phenotypes, 186 studies were eligible for inclusion. The majority of studies were hospital‐based (59%, 109/186) and cross‐sectional (76%, 141/186). The number of included patients ranged from seven to 526 808. Data‐driven approaches to identify phenotypes were only used in a minority of studies (7%, 13/186). Ninety‐one studies (49%) investigated a phenotype based on disease severity. A phenotype based on disease trajectory, morphology and eczema herpeticum was investigated in 56 (30%), 22 (12%) and 11 (6%) studies respectively. Thirty‐six studies (19%) investigated morphological characteristics in other phenotypes. Investigated associated characteristics differed between studies. In conclusion, we present an overview of phenotype definitions used in literature for severity, trajectory, morphology and eczema herpeticum, including associated characteristics. There is a lack of uniform and consistent use of atopic dermatitis phenotypes across studies.
Interactions between microenvironment, selection and genetic architecture drive multiscale adaptation in a simulation experiment
Authors: Cubry Philippe , Oddou‐Muratorio Sylvie , Scotti Ivan , Lefèvre François
Published: February 2022

When environmental conditions differ both within and among populations, multiscale adaptation results from processes at both scales and interference across scales. We hypothesize that within‐population environmental heterogeneity influences the chance of success of migration events, both within and among populations, and maintains within‐population adaptive differentiation. We used a simulation approach to analyse the joint effects of environmental heterogeneity patterns, selection intensity and number of QTL controlling a selected trait on local adaptation in a hierarchical metapopulation design. We show the general effects of within‐population environmental heterogeneity: (i) it increases occupancy rate at the margins of distribution ranges, under extreme environments and high levels of selection; (ii) it increases the adaptation lag in all environments; (iii) it impacts the genetic variance in each environment, depending on the ratio of within‐ to between‐populations environmental heterogeneity; (iv) it reduces the selection‐induced erosion of adaptive gene diversity. Most often, the smaller the number of QTL involved, the stronger are these effects. We also show that both within‐ and between‐populations phenotypic differentiation (Q
ST) mainly results from covariance of QTL effects rather than QTL differentiation (F
STq), that within‐population QTL differentiation is negligible, and that stronger divergent selection is required to produce adaptive differentiation within populations than among populations. With a high number of QTL, when the difference between environments within populations exceeds the smallest difference between environments across populations, high levels of within‐population differentiation can be reached, reducing differentiation among populations. Our study stresses the need to account for within‐population environmental heterogeneity when investigating local adaptation.
Comparison of postoperative laparoscopic and open total mesorectal excision on lower urinary tract function in men with rectal cancer
Authors: Fei Zhenglei , Yu Jiazi , Huang Bin , Jin Liangbin
Published: February 2022

Objectives

This study investigated male voiding dysfunction (VD) or lower urinary tract function in rectal cancer (RC) patients after laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP).

Methods

One hundred and eighty‐seven male RC patients admitted between January 2016 and May 2019 were enrolled in this study, 112 of whom underwent laparoscopic total mesorectal excision (LTME) and 75 underwent open total mesorectal excision (OTME). The International Prostatic Symptom Score (IPSS) was compared between the two groups.

Results

The postoperative IPSS in patients with RC was elevated on day 7 and gradually decreased during the first month after surgery. Compared with the OTME group, the IPSS scores decreased less in the LTME group at week 1, and months 1 and 3 postoperatively (6.82 ± 2.13 vs 10.15 ± 3.86, 5.70 ± 2.45 vs 7.21 ± 2.0, and 5.01 ± 2.09 vs 5.75 ± 2.55, respectively; P < 0.05). The VD rate was significantly lower in the LTME group than the OTME group at 1, 2, and 3 weeks postoperatively (21.4% vs 26.8%,13.4% vs 25.3%, and 9.8% vs18.6%, respectively; P < 0.05); however, there was no major difference in the incidence of VD 6 months postoperatively between the two groups (P > 0.05). VD was more frequent in the OTME group than the LTME group 6 months postoperatively, but the difference was not statistically significant (odds ratio = 1.857, 95% CI, 0.964‐3.645, P = 0.064).

Conclusions

LTME may be superior to OTME with respect to PANP of lower urinary tract function in males with RC.
Parentage analysis across age cohorts reveals sex differences in reproductive skew in a group‐living cichlid fish,Neolamprologus multifasciatus
Authors: Bose Aneesh P. H. , Dabernig‐Heinz Johanna , Koch Lukas , Grimm Jacqueline , Lang Sebastian , Hegedűs Bernadett , Banda Taylor , Makasa Lawrence , Jordan Alex , Sefc Kristina M.
Published: February 2022

Group‐living animals are often faced with complex reproductive decisions, namely how to partition within‐group reproduction, how to obtain extra‐group reproduction and how these two means of reproduction should be balanced. The solutions to these questions can be difficult to predict because ecological conditions can affect the scopes for within‐group and extra‐group reproduction in complex ways. For example, individuals that are restricted from moving freely around their habitats may have limited extra‐group reproductive opportunities, but at the same time, groups may live in close proximity to one another, which could potentially have the opposite effect. The group‐living cichlid fishNeolamprologus multifasciatusexperiences such ecological conditions, and we conducted an intensive genetic parentage analysis to investigate how reproduction is distributed within and among groups for both males and females. We found that cohabiting males live in “high‐skew” societies, where dominant males monopolize the majority of within‐group reproduction, while females live in “low‐skew” societies, where multiple females can produce offspring concurrently. Despite extremely short distances separating groups, we inferred only very low levels of extra‐group reproduction, suggesting that subordinate males have very limited reproductive opportunities. A strength of our parentage analysis lies in its inclusion of individuals that spanned a wide age range, from young fry to adults. We outline the logistical circumstances when very young offspring may not always be accessible to parentage researchers, and present strategies to overcome the challenges of inferring mating patterns from a wide age range of offspring.
Epistemic contestation and interagency conflict: The challenge of regulating investment funds
Authors: James Scott , Quaglia Lucia
Published: February 2022

Scholarship on regulating global finance emphasizes the importance of national and bureaucratic interests, but less attention has been devoted to epistemic sources of regulatory conflict. We address this by analyzing the failure of regulators to agree tougher rules for large investment funds after the 2008 crisis. The article suggests this outcome was the result of epistemic contestation between prudential regulators and securities regulators, rooted in divergent interpretive “frames.” We show that US and EU prudential regulators pushed for entity‐based regulation of investment funds by escalating the issue to global standard‐setting bodies. But this was successfully resisted by securities regulators that exercised epistemic authority through recursive practices—appeals to expertise, jurisdictional claims, and alliance building—to defend their transaction‐based approach. The article demonstrates how an interpretivist perspective can provide new insights into inter‐agency conflict and regulatory disputes in other policy fields.
Cost‐effectiveness of noninvasive fetal RhD blood group genotyping in nonalloimmunized and alloimmunized pregnancies
Authors: Gajic‐Veljanoski Olga , Li Chunmei , Schaink Alexis K. , Guo Jennifer , Shehata Nadine , Charames George S. , de Vrijer Barbra , Clarke Gwen , Pechlivanoglou Petros , Okun Nanette , Kandel Rita , Dooley Joseph , Higgins Caroline , Ng Vivian , Sikich Nancy
Published: February 2022

Background

We sought to determine the cost‐effectiveness of noninvasive fetal RhD blood group genotyping in nonalloimmunized and alloimmunized pregnancies in Canada.

Study design and methods

We developed two probabilistic state‐transition (Markov) microsimulation models to compare fetal genotyping followed by targeted management versus usual care (i.e., universal Rh immunoglobulin [RhIG] prophylaxis in nonalloimmunized RhD‐negative pregnancies, or universal intensive monitoring in alloimmunized pregnancies). The reference case considered a healthcare payer perspective and a 10‐year time horizon. Sensitivity analysis examined assumptions related to test cost, paternal screening, subsequent pregnancies, other alloantibodies (e.g., K, Rh c/C/E), societal perspective, and lifetime horizon.

Results

Fetal genotyping in nonalloimmunized pregnancies (at per‐sample test cost of C$247/US$311) was associated with a slightly higher probability of maternal alloimmunization (22 vs. 21 per 10,000) and a reduced number of RhIG injections (1.427 vs. 1.795) than usual care. It was more expensive (C$154/US$194, 95% Credible Interval [CrI]: C$139/US$175‐C$169/US$213) and had little impact on QALYs (0.0007, 95%CrI: −0.01–0.01). These results were sensitive to the test cost (threshold achieved at C$88/US$111), and inclusion of paternal screening. Fetal genotyping in alloimmunized pregnancies (at test cost of C$328/US$413) was less expensive (‐C$6280/US$7903, 95% CrI: ‐C$6325/US$7959 to ‐C$6229/US$7838) and more effective (0.19 QALYs, 95% CrI 0.17–0.20) than usual care. These cost savings remained robust in sensitivity analyses.

Discussion

Noninvasive fetal RhD genotyping saves resources and represents good value for the management of alloimmunized pregnancies. If the cost of genotyping is substantially decreased, the targeted intervention can become a viable option for nonalloimmunized pregnancies.