bluuebunny/crossref_metadata_2025 huggingface dataset:
Restoration of portal flow with varix in liver transplantation for patients with total portal vein thrombosis: An effective strategy in the largest center experience
Authors: Ravaioli Matteo , Prosperi Enrico , Pinna Antonio , Siniscalchi Antonio , Fallani Guido , Frascaroli Giacomo , Maroni Lorenzo , Odaldi Federica , Serenari Matteo , Cescon Matteo
Published: April 2021

Introduction

Postoperative complications and worse prognosis still burden liver transplantations (LT) with complex portal vein thrombosis (CPVT). When an engorged left gastric vein (LGV) is present, the portal inflow is restorable with an anastomosis between the graft portal vein and the LGV of the recipient. We analyzed short‐ and long‐term results of this procedure in 12 LT with CPVT.

Methods

Between 2005 and 2019, 55 patients with CPVT underwent LT. We applied this technique in 12 patients. In six cases, we placed a vascular graft to obtain a tension‐free structure. We evaluated patency, short‐ and long‐term results.

Results

No intraoperative complication was observed. The median duration of LT, blood transfusion, deceased donor age, and MELD score of the recipients were 7 h, 1250 mL, 72 years, and 19. Seven patients were affected by hepatocellular carcinoma. No major complications or PVT recurrence were observed. One patient required a liver re‐transplantation for primary non‐functioning syndrome. The mean hospital stay was 20 days. The actuarial patient survival was 85% with a mean FU of 4 years. The two late deaths were due to hepatocellular carcinoma recurrence and sepsis for cholangitis.

Conclusions

This technique in presence of both CPVT and engorged LGV is feasible and safe for patients, with good short‐ and long‐term results.
Distal allograft pancreatectomy for graft salvage after pancreas transplantation
Authors: Soma Daiki , Nikumbh Tejas , Mangus Richard S , Lutz Andrew J. , Powelson John A. , Fridell Jonathan A
Published: April 2021

Early pancreas allograft failure most commonly results from vascular thrombosis. Immediate surgical intervention may permit pancreas allograft salvage, typically requiring thrombectomy. In cases of partial allograft necrosis secondary to splenic arterial thrombosis, distal allograft pancreatectomy may allow salvage of at least half of the pancreas allograft with retention of function. We retrospectively reviewed four cases of simultaneous pancreas and kidney recipients who required distal allograft pancreatectomy for splenic artery thrombosis with necrosis of the distal pancreas. Three of the four maintained long‐term allograft function with euglycemia independent of insulin at six months to six years of follow‐up, and all patients continue to maintain normal renal allograft function. Early diagnosis and early intervention are essential in order to salvage the pancreas allograft in the case of thrombosis. Distal allograft pancreatectomy can be performed safely and result in excellent long‐term outcomes in select patients.
Neural substrates of the executive function construct, age‐related changes, and task materials in adolescents and adults: ALE meta‐analyses of 408 fMRI studies
Authors: Zhang Zheng , Peng Peng , Eickhoff Simon B. , Lin Xin , Zhang Delong , Wang Yingying
Published: April 2021

To explore the neural substrates of executive function (EF), we conducted an activation likelihood estimation meta‐analysis of 408 functional magnetic resonance imaging studies (9639 participants, 7587 activation foci, 518 experimental contrasts) covering three fundamental EF subcomponents: inhibition, switching, and working memory. Our results found that activation common to all three EF subcomponents converged in the multiple‐demand network across adolescence and adulthood. The function of EF with the multiple‐demand network involved, especially for the prefrontal cortex and the parietal regions, could not be mature until adulthood. In adolescents, only working memory could be separable from common EF, whereas in adults, the three EF subcomponents could be separable from common EF. However, findings of switching in adolescents should be treated with substantial caution and may be exploratory due to limited data available on switching tasks. For task materials, inhibition and working memory showed both domain generality and domain specificity, undergirded by the multiple‐demand network, as well as different brain regions in response to verbal and nonverbal task materials, respectively. In contrast, switching showed only domain generality with no activation specialized for either verbal or nonverbal task materials. These findings, taken together, support and contribute to the unitary–diverse nature of EF such that EF should be interpreted in an integrative model that relies on the integration of the EF construct, development, and task materials.
The light from the North—voyaging towards the west. Grundtvig and the Folk High School movement from Scandinavia to United States
Authors: Ohrem Sigurd
Published: April 2021

N.F. S. Grundtvig is the Danish founding father of the Folk High Schools. In this article, I first describe Grundtvig's original idea and the application of the Folk High School in Norway as an alternative popular school for adults from a rural context, children of farmers, fishermen, and sailors. I further reflect upon this unique arena's cultural importance as well as the socio‐political implications of the Folk High School pedagogy. In particular, I consider the methods behind the desired empowerment of the participants towards active citizenship and the close interaction with some of the strong social movements of the varying time periods. Next, I discuss how this idea was exported before and after World War II, and thereby underwent an important modernization and transformation. Grundtvig's seminal ideas spread across the Atlantic. In the United States, they disseminated in the establishment of so‐called Folk Schools, amongst them the national and politically important Highlander Folk School. In this way, Grundtvig's vision gained new importance as an incubator for the integration of people of different ethnic backgrounds, supporting the emergence of local and national Trade Unions and facilitating the Civil Rights Movement.
Vertical distribution of Bemisia tabaci on soybean and attractiveness of cultivars
Authors: Rodrigues Raimundo Henrique Ferreira , Silva Luciana Barboza , Almeida Lorrana Francisca Oliveira , da Silva Sandra Ribeiro , Sobrinho Neurandir , Maggioni Kellen , Rodrigues Thiago Ferreira , Pavan Bruno Ettore
Published: April 2021

The reduction in the number and frequency of insecticide applications in transgenic crops has favored population outbreaks of Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae) in various Bt (Bacillus thuringiensis Berliner) soybean cultivars [Glycine max (L.) Merrill; Fabaceae], reflecting the fact that plants have different levels of attractiveness to insects. The identification of Bt soybean cultivars resistant to whitefly represents a viable and effective control alternative. The objective of this study was to characterize the vertical distribution of insects on the plant and to identify Bt soybean cultivars less attractive to B. tabaci. The insects used were collected in tomato crops, and the whitefly population was maintained on leaf cabbage plants. Fifteen soybean cultivars were evaluated to determine attractiveness to whitefly. Soybean plants were stratified into upper, middle, and lower thirds. Multiple‐choice and no‐choice bioassays were carried out with the 15 cultivars. Subsequently, 10 cultivars were selected for a new multiple‐choice assay. The parameters evaluated were the number of adults per leaflet and number of eggs cm−2; the degree of colonization by nymphs was determined only in the multiple‐choice assay. The density and length of trichomes of the 15 cultivars were also characterized. It was shown that the upper third of the plant was the most attractive, having the largest number of adults and colonizing nymphs. The cultivars BRS 9280RR, M 8808, and M 8644IPRO showed low levels of B. tabaci infestation by adults, eggs, and nymphs in the bioassays performed. There was a negative correlation between trichome length and density with the number of adults, eggs, and degree of colonization by nymphs. The vertical distribution and attractiveness of soybean cultivars to whitefly are discussed.
Building and sustaining mentor interactions as a mentee
Authors: Sarabipour Sarvenaz , Hainer Sarah J. , Arslan Feyza Nur , de Winde Charlotte M. , Furlong Emily , Bielczyk Natalia , Jadavji Nafisa M. , Shah Aparna P. , Davla Sejal
Published: April 2021

Mentorship is experience and/or knowledge‐based guidance. Mentors support, sponsor and advocate for mentees. Having one or more mentors when you seek advice can significantly influence and improve your research endeavours, well‐being and career development. Positive mentee–mentor relationships are vital for maintaining work–life balance and success in careers. Early‐career researchers (ECRs), in particular, can benefit from mentorship to navigate challenges in academic and nonacademic life and careers. Yet, strategies for selecting mentors and maintaining interactions with them are often underdiscussed within research environments. In this Words of Advice, we provide recommendations for ECRs to seek and manage mentorship interactions. Our article draws from our experiences as ECRs and published work, to provide suggestions for mentees to proactively promote beneficial mentorship interactions. The recommended practices highlight the importance of identifying mentorship needs, planning and selecting multiple and diverse mentors, setting goals, and maintaining constructive, and mutually beneficial working relationships with mentors.
A modification of Matake criterion for considering the effect of mean shear stress under high cycle fatigue loading
Authors: Li Jing , Wang Xin , Li Kui , Qiu Yuan‐ying
Published: April 2021

In the present paper, a brief review for some existing critical plane‐based life prediction models is presented, and limitations of these models in reflecting the influence of mean stress on fatigue life are discussed. It is found that the effect of mean normal stress on fatigue damage has been well taken into account for most of the critical plane‐based fatigue life prediction models, while mean shear stress effect is not well considered in these models. Therefore, a new critical plane‐based multiaxial high cycle fatigue life prediction model is proposed in this paper to account for the effects of both mean shear and normal stresses. The shear Walker factor and mean normal stress sensitivity index are introduced in the developed criterion to consider the effects of mean shear and normal stresses, respectively. Procedures to determine the damage parameters acting on the critical plane and to calculate the material constants contained in the proposed model are all presented. Experimental validations by using six different materials show that most of the predictions are within a factor of 3 in fatigue life.
Pharmacokinetics and safety of ubrogepant when coadministered with calcitonin gene‒related peptide‐targeted monoclonal antibody migraine preventives in participants with migraine: A randomized phase 1b drug–drug interaction study
Authors: Jakate Abhijeet , Blumenfeld Andrew M. , Boinpally Ramesh , Butler Matthew , Borbridge Lisa , Contreras‐De Lama Janette , McGeeney Danielle , Periclou Antonia , Lipton Richard B.
Published: April 2021

Objective

To evaluate the impact of two calcitonin gene–related peptide (CGRP)‐targeted monoclonal antibodies (mAbs), erenumab and galcanezumab, on the pharmacokinetic (PK) profile, safety, and tolerability of ubrogepant.

Background

People taking CGRP‐targeted mAbs for migraine prevention sometimes take ubrogepant, an oral small‐molecule CGRP receptor antagonist, for acute treatment of breakthrough migraine attacks.

Design

In this two‐arm, multicenter, open‐label, phase 1b trial, adults with migraine were randomized to arm 1 (ubrogepant ± erenumab) or arm 2 (ubrogepant ± galcanezumab). The PK profile of ubrogepant was characterized for administration before and 4 days after CGRP‐targeted mAb injection. Participants received single‐dose ubrogepant 100 mg on day 1, subcutaneous erenumab 140 mg (arm 1) or galcanezumab 240 mg (arm 2) on day 8, and ubrogepant 100 mg once daily on days 12–15. In each study arm, serial blood samples were drawn on days 1 and 12 for measurement of plasma ubrogepant concentrations. The primary outcomes were area under the plasma ubrogepant concentration–time curve (AUC) from time 0 to t post‐dose (AUC0–t) and from time 0 to infinity (AUC0–inf), and maximum plasma concentration (Cmax) of ubrogepant when ubrogepant was administered before or after a single dose of erenumab or galcanezumab. Vital signs and laboratory parameters were monitored.

Results

Forty participants enrolled (20 per arm; mean [standard deviation] ages, 32.2 [8.9] and 38.4 [8.8] years; 50% [10/20] and 60% [12/20] female in arms 1 and 2, respectively). There were no significant differences in ubrogepant Cmax after versus before erenumab administration (geometric least‐squares mean [LSM] ratio, 1.04 [90% CI, 0.93–1.16]), and no significant differences in AUC0–t (1.06 [0.96–1.16]) or AUC0–inf (1.05 [0.96–1.15]). Similarly, ubrogepant Cmax (1.00 [90% CI, 0.82–1.20]), AUC0–t (1.05 [0.90–1.23]), and AUC0–inf (1.05 [0.90–1.22]) geometric LSM ratios were statistically equivalent after galcanezumab versus ubrogepant alone. Treatment‐emergent adverse events (TEAEs) were similar to those reported with each treatment alone. No serious TEAEs, TEAEs leading to discontinuation, or clinically relevant changes in laboratory parameters or vital signs were reported.

Conclusions

The PK profile of ubrogepant was not significantly changed and no safety concerns were identified when ubrogepant was coadministered with erenumab or galcanezumab.
Prevalence and association of lifestyle and medical‐, psychiatric‐, and pain‐related comorbidities in patients with migraine: A cross‐sectional study
Authors: Yin Jiu‐Haw , Lin Yu‐Kai , Yang Chun‐Pai , Liang Chih‐Sung , Lee Jiunn‐Tay , Lee Meei‐Shyuan , Tsai Chia‐Lin , Lin Guan‐Yu , Ho Tsung‐Han , Yang Fu‐Chi
Published: April 2021

Background and Objectives

Migraine has been associated with many comorbidities. However, lifestyle factors and the presence of comorbid diseases have not previously been extensively studied in the same sample. This study aimed to compare the prevalence of unhealthy lifestyle factors and comorbid diseases between patients with migraine and migraine‐free controls with subgroup analyses to determine the pathophysiology and possible consequences.

Methods

This cross‐sectional study recruited 1257 patients with migraine between the ages of 20 and 65 years from a headache outpatient clinic in Taiwan and 496 non‐migraine controls. All participants completed questionnaires regarding demographics, migraine diagnosis, sleep, headache burden, and medical, pain, and psychiatric conditions. Participants also underwent a structured interview. The associations between comorbidities and migraine were investigated and further stratified by sex and aura.

Results

Patients with migraine with aura had an unhealthier lifestyle compared with controls in the form of current smoking status (15.5% [67/431] vs. 11.5% [57/496], p = 0.013). Furthermore, medical‐ (e.g., thyroid disease; 7.2% [91/1257 vs. 2.8% [14/496]; p = 0.006), psychiatric‐ (e.g., depression; 6% [76/1257 vs. 2.6% [13/496]; p = 0.031), and pain‐related (e.g., fibromyalgia; 8% [101/1257 vs. 3.2% [16/496]; p = 0.006) comorbidities were more prevalent in patients compared with controls. Subgroup analyses revealed that chronic migraine, migraine with aura, and female sex were associated with a greater number of significant comorbidities than episodic migraine, migraine without aura, and male patients with migraine, respectively.

Conclusion

Individuals seeking treatment for migraine reported greater levels of smoking and medical, psychiatric, and pain conditions than non‐treatment‐seeking healthy controls who were recruited from the community. Understanding the relationship between migraine and comorbid diseases may improve medical care as well as the quality of life.
The efficacy of rituximab treatment for antibody‐mediated rejection in liver transplantation: A retrospective Japanese nationwide study
Authors: Sakamoto Seisuke , Akamatsu Nobuhisa , Hasegawa Kiyoshi , Ohdan Hideki , Nakagawa Ken , Egawa Hiroto
Published: April 2021

Aim

Antibody‐mediated rejection (AMR) has been consistently elucidated in liver transplantation (LT); however, the treatment for AMR, including rituximab, has not been indicated as a strongly recommended therapeutic protocol.

Methods

This study was conducted as the Japanese multicenter retrospective study to accumulate data on the use of rituximab for AMR among patients undergoing LT between August 2001 and December 2016. Thirteen patients (five children and eight adults) were enrolled.

Results

The types of AMR in the pediatric cases were chronic AMR in four cases and indeterminate AMR in one case. Among the pediatric cases, rituximab treatment only showed therapeutic efficacy in two patients with chronic AMR. Among the adult patients, five patients had chronic AMR, and three had acute AMR. Although two patients with chronic AMR died due to graft failure, liver function tests revealed improvement after rituximab treatment in the other patients. Two of the three patients with acute AMR died due to graft failure; rituximab treatment showed no therapeutic efficacy in these cases. Although bacterial infections occurred within 3 months after rituximab administration in three patients, rituximab treatment could be safely administered without any direct adverse effects.

Conclusions

The indication of rituximab therapy as an additional treatment for mild acute AMR and chronic AMR may be feasible; however, a prospective randomized control study is needed to evaluate the therapeutic efficacy of rituximab treatment for AMR.
Potential application of immunotherapy for modulation of pulp inflammation: opportunities for vital pulp treatment
Authors: Arora S. , Cooper P. R. , Friedlander L. T. , Rizwan S. , Seo B. , Rich A. M. , Hussaini H. M.
Published: April 2021

Caries results in the demineralization and destruction of enamel and dentine, and as the disease progresses, irreversible pulpitis can occur. Vital pulp therapy (VPT) is directed towards pulp preservation and the prevention of the progression of inflammation. The outcomes of VPT are not always predictable, and there is often a poor correlation between clinical signs and symptoms, and the events occurring at a molecular level. The inflamed pulp expresses increased levels of cytokines, including tumour necrosis factor (TNF)‐α, interleukin (IL)‐1α, IL‐1β, IL‐4, IL‐6, IL‐8, IL‐17 and IL‐23, which recruit and drive a complex cellular immune response. Chronic inflammation and sustained cytokine release can result in irreversible pulp damage and a decreased capacity for tissue healing. Other chronic inflammatory diseases, such as psoriasis, inflammatory bowel diseases and rheumatoid arthritis, are also characterized by an dysregulated immune response composed of relatively high cytokine levels and increased numbers of immune cells along with microbial and hard–soft tissue destructive pathologies. Whilst anti‐cytokine therapies have been successfully applied in the treatment of these diseases, this approach is yet to be attempted in cases of pulp inflammation. This review therefore focuses on the similarities in the aetiology between chronic inflammatory diseases and pulpitis, and explores how anti‐cytokine therapies could be applied to manage an inflamed pulp and facilitate healing. Further proof‐of‐concept studies and clinical trials are justified to determine the effectiveness of these treatments to enable more predictable outcomes in VPT.
Investigation of alumina doped 45S5 glass as a bioactive filler for experimental dental composites
Authors: Basaran Elalmis Yeliz , Karakuzu Ikizler Burcu , Kilic Depren Serpil , Yucel Sevil , Aydin Ismail
Published: April 2021

This study aimed to investigate the effects of inclusion of Al2O3‐doped bioactive glass (BG) and silane treatment on physical properties and bioactivity behavior of resin‐based experimental dental composites (EDCs). Melt‐derived 45S5 BG and alumina doped 45S5 BG were prepared and incorporated into EDCs with and without silanization. EDCs prepared were subjected to three‐point bending, microhardness, water sorption (WS), solubility (S), and bioactivity tests. Using non‐silanized Al2O3‐doped BG in EDCs resulted in improved flexural strength (FS), flexural modulus (FM), and microhardness and decreased bioactivity compared to EDCs containing non‐silanized BG. There was no significant difference (p < 0.05) between WS and S results of non‐silanized glass containing EDCs. Using silanized BG and Al2O3‐doped BG resulted in improved FS and FM, decreased WS, S, and bioactivity. Addition of Al2O3‐doped BG as a possible bioactive filler to EDCs improved mechanical performance while slightly decreasing bioactivity compared to BG containing EDCs.
The interaction among religiosity, moral intensity and moral certainty in predicting ethical consumption: A study of Muslim consumers
Authors: Alsaad Abdallah , Elrehail Hamzah , Saif‐Alyousfi Abdulazeez Y. H.
Published: April 2021

Prior research has paid little attention to the cognitive mechanisms by which religiosity influences ethical consumption. The aim of this study is to explore when and how religiosity might be related to the development of ethical consumption. The study develops an interactionist model describing how religiosity and moral intensity might interact and be linked to the sense of certainty and conviction about the morality of ethical consumption. Data from 333 Muslim participants in Saudi Arabia is analysed using structural equation modelling; it reveals that religiosity and moral intensity are significantly associated with moral certainty which, in turn, predicts ethical consumption intention. Even though religiosity and moral intensity are crucial predictors of moral certainty, the interaction between them has not been proven, indicating that the association between religiosity and moral certainty does not depend on moral intensity. This implies that religiosity is a strong predictor of moral certainty even when recognition of aspects of ethical consumption is minimal.
Family expectations of inpatient mental health services for adults with suicidal ideation: a qualitative study
Authors: Vandewalle Joeri , Debyser Bart , Deproost Eddy , Verhaeghe Sofie
Published: April 2021

Involvement of family members of adults with suicidal ideation is a key area of improvement in inpatient mental health services. To support family involvement in this context, it is crucial to understand what care and treatment family members expect for their relative. This qualitative study based on grounded theory involved interviews with 14 family members, including partners, parents, adult children and siblings. The family members’ expectations of care and treatment in inpatient mental health services were captured by the core element ‘Struggling to remain hopeful while looking through the lens of uncertainty’. This core element interacted with four sub‐elements: assuming safety as a priority, looking for a healing approach and environment, counting on continuity of care and wanting to be involved and supported. The family members fluctuated between hope and uncertainty depending on whether their expectations were met or unmet. Unmet expectations were common and underpinned by a sense of being marginalized during the admission of their relative with suicidal ideation. Mental health professionals, including nurses, can be more empathetic towards the family members and attuned to their expectations. This can underpin partnerships that help families to deal with their feelings of uncertainty and disempowerment. Such partnerships can flourish in recovery‐oriented mental health services that allow meaningful family involvement.
Point‐of‐care testing for influenza in a university emergency department: A prospective study
Authors: Perlitz Benjamin , Slagman Anna , Hitzek Jennifer , Riedlinger Dorothee , Möckel Martin
Published: April 2021

Background

Seasonal influenza is a burden for emergency departments (ED). The aim of this study was to investigate whether point‐of‐care (POC) PCR testing can be used to reduce staff sick days and improve diagnostic and therapeutic procedures.

Objectives

The aim of this study was to investigate whether point‐of‐care (POC) PCR testing can be used to reduce staff sick days and improve diagnostic and therapeutic procedures.

Methods

Using a cross‐over design, the cobas® Liat® Influenza A/B POC PCR test (Liat) was compared with standard clinical practice during the 2019/2020 influenza season. All adult patients (aged ≥ 18 years) with fever (≥38°C) and respiratory symptoms were included. Primary end points were the prevalence of influenza infections in the ED and staff sick days. Secondary end points were frequency of antiviral and antibacterial therapy, time between admission and test result or treatment initiation, patient disposition, ED length of stay (LOS), and for inpatients mortality and LOS. Nurses were interviewed about handling and integration of POC testing. The occurrence of SARS‐CoV‐2 infections coincided with the second half of the study.

Results

A total of 828 patients were enrolled in the study. All 375 patients of the intervention group were tested with Liat, and 103 patients of them (27.6%) tested positive. During the intervention period, staff sick days were reduced by 34.4% (P = .023). Significantly, more patients in the intervention group received antiviral therapy with neuraminidase inhibitors (7.2% vs 3.8%, P = .028) and tested patients received antibiotics more frequently (40.0% vs 31.6%, P = .033). Patients with POC test were transferred to external hospitals significantly more often (5.6% vs 1.3%, P = .01).

Conclusion

We conclude that POC testing for influenza is useful in the ED, especially if it is heavily frequented by patients with respiratory symptoms.
Design of two‐stage quick chilling refrigeration system for pig processing in an engineering application
Authors: Xue Lianzheng , Zhang Junrong
Published: April 2021

The two‐stage chilling technology has been widely used in pig slaughtering and processing, and has achieved good results in reducing weight loss and improving meat quality. The design ideas of very quick intensive chilling (VQIC) system are proposed in this article, such as the cooling load calculation, air cooler arrangement, air supply mode and defrosting system. VQIC temperature is −20°C and chilling time is 1.5 hr at first stage, second‐stage temperature is 0–4°C and chilling time is 16–20 hr. Two‐stage compressor unit with variable frequency, evaporative condenser and ceiling air cooler are preferred to applied in VQIC refrigeration system. In order to defrost air cooler without stopping refrigeration system, there should be redundant air cooler with variable fin pitch in the chilling room. Consideration to the effect of the defrosting and machine oil back to the compressor, water defrosting and hot gas defrosting are shared.

Practical Applications

Quick chilling is used to pre‐chilling the pig carcass before it enters the cooling room to mature. Two‐stage cooling technology has been widely used in the slaughter and processing of pigs, and has achieved good results in reducing weight loss, inhibiting bacterial reproduction and improving meat quality. The very quick intensive chilling technology has merits in reducing energy consumption and protecting meat quality. Based on practical applications in meat processing plant, the design points of the very quick intensive chilling refrigeration system were explained in the article.
“What Next?”: Toward telebehavioral health sustainability in couple and family therapy
Authors: Hertlein Katherine M. , Drude Kenneth , Jordan Sara S.
Published: April 2021

As a response to the COVID‐19 global crisis, many in the couple/marital and family therapy (CMFT) professional community quickly met the challenge of providing services to clients via telebehavioral health (TBH) services. As this public health emergency endures, family therapists must continue to engage in TBH practice professionally and ethically. The rapid adoption of TBH with minimal training and experience during this public health emergency can result in crises for both individual therapists as well as for the profession in implementing electronic record‐keeping, conducting virtual sessions, and communicating online with various clinical populations. The risk of insufficient training and supervision create a challenge to new and experienced family therapists. This article summarizes the work done by the profession thus far to respond to this public health emergency and presents a roadmap of recommendations for navigating those challenges into the future and offers ideas about how to sustain quality TBH practice.
Multiband diffusion tensor imaging for presurgical mapping of motor and language pathways in patients with brain tumors
Authors: Jenabi Mehrnaz , Young Robert J , Moreno Raquel , Gene Madeleine , Cho Nicholas , Otazo Ricardo , Holodny Andrei I. , Peck Kyung K.
Published: April 2021

Background and Purpose

Assessment of the essential white matter fibers of arcuate fasciculus and corticospinal tract (CST), required for preoperative planning in brain tumor patients, relies on the reliability of diffusion tensor imaging (DTI). The recent development of multiband DTI (mb‐DTI) based on simultaneous multislice excitation could maintain the overall quality of tractography while not exceeding standard clinical care time. To address this potential, we performed quantitative analyses to evaluate tractography results of arcuate fasciculus and CST acquired by mb‐DTI in brain tumor patients.

Methods

We retrospectively analyzed 44 patients with brain lesions who underwent presurgical single‐shot DTI (s‐DTI) and mb‐DTI. We measured DTI parameters: fractional anisotropy (FA) and mean diffusivity (MD [mm2 s–1]) in whole brain and tumor regions; and the tractography parameters: fiber FA, MD (mm2 s–1), volume (mm3), and length (mm) in the whole brain, arcuate fasciculus, and CST. Additionally, three neuroradiologists performed a blinded visual assessment comparing s‐DTI with mb‐DTI.

Results

The mb‐DTI showed higher mean FA and lower MD (r > .95, p < .002) in whole brain and tumor regions of interest; slightly higher fiber FA, volume, and length; and slightly lower fiber MD in whole brain, arcuate fasciculus, and CST than in s‐DTI. These differences were significant for fiber FA in all tracts; length (mm) in arcuate fasciculus; and fiber MD (mm2 s–1) and volume (mm3) in all patients with tumor involved in the arcuate fasciculus, CST, and whole brain tracts (p = .001). Visual assessment demonstrated that both techniques produced visually similar tracts.

Conclusions

This study demonstrated the clinical potential and significant advantages of preoperative mb‐DTI in brain tumor patients.
The effect of group cognitive behavioural therapy for insomnia in postmenopausal women
Authors: Moradi Farsani Hadis , Afshari Poorandokht , Sadeghniiat Haghighi Khosro , Gholamzadeh Jefreh Maryam , Abedi Parvin , Haghighizadeh Mohammad Hossein
Published: April 2021

The menopausal period is associated with several complications in women. One of these complications is sleep disorders including insomnia disorder that can affect all aspects of personal life. The present study aimed to evaluate the effectiveness of cognitive behavioural therapy for insomnia (CBT‐I) on insomnia severity and sleep quality among postmenopausal women. This was a randomised clinical trial in which 46 women were recruited and randomly allocated into two groups, one receiving CBT‐I and a control group. The CBT‐I group received six sessions of training, while the control group received only usual care. A demographic questionnaire, Insomnia Severity Index (ISI), and Pittsburgh Sleep Quality Index (PSQI), were used to collect the data. The ISI and PSQI were measured at baseline, 3 and 6 weeks after intervention, and in a 4‐week follow‐up. The Independent t test, the chi‐square test, generalised estimating equation models, and Bonferroni correction were applied to analyse the data. According to our results, in the CBT‐I group compared to the control group, the mean ISI, PSQI, sleep onset latency, sleep time, and sleep quality score reduced continuously from baseline to week 3 and from week 3 to week 6, and remained constant from week 6 to week 10. The mean sleep efficiency score improved significantly from baseline to week 3 in the CBT‐I group and remained unchanged until the end of the study. CBT‐I could significantly improve insomnia severity and sleep quality in postmenopausal women. Therefore, using this method is recommended for menopausal women with insomnia.
Progress on the elimination of viral hepatitis in Zimbabwe: A review of the policies, strategies and challenges
Authors: Dzingirai Blessing , Katsidzira Leolin , Matyanga Celia Moffat Joel , Postma Maarten Jacobus , van Hulst Marinus , Mafirakureva Nyashadzaishe
Published: April 2021

Very few low‐income countries have developed national plans to achieve the viral hepatitis elimination targets set in the World Health Organization (WHO) strategy. We reviewed the policy environment, strategies and challenges on the fight against viral hepatitis in Zimbabwe. The review focussed on the Ministry of Health and Child Care (MoHCC) policy documents, strategic plans and reports. We performed key informant interviews to enhance evidence generated from the document review. Twelve documents were reviewed and interviews with 10 key informants were completed. The MoHCC established a technical working group to work towards elimination of viral hepatitis. The technical working group drafted a strategic plan for elimination of viral hepatitis; however, it is still awaiting implementation. Key strategies that are working well include screening of donated blood for transfusion, safe injection practices and hepatitis B virus (HBV) three‐dose vaccination. Current challenges in the drive towards elimination of viral hepatitis include poor to non‐existent surveillance systems, lack of epidemiological data, absence of the HBV vaccine birth dose and lack of systematic screening and treatment services for viral hepatitis. In conclusion, despite political will demonstrated towards achieving viral hepatitis elimination, substantial investment and work are required to implement the strategic plan and realize significant success.
The use of linguistic and world knowledge in language processing
Authors: Warren Tessa , Dickey Michael Walsh
Published: April 2021

There has been considerable investigation of the roles that linguistic and world knowledge play during language comprehension. This investigation is important because its results have ramifications for both basic questions about how the mature intact language comprehension system functions and for applied questions regarding how comprehension systems that are impaired by aphasia might function. In the current paper, we review debates and research related to the representation and use of linguistic and world knowledge in language comprehension and then describe a recent computational model that takes both world and linguistic knowledge into account in predicting language comprehension difficulty. We then review empirical work that attempts to characterize the interactions and potential trade‐offs between world and linguistic knowledge during language comprehension, and relate this work to the computational model previously described. We conclude with a brief overview of a few open questions regarding the representation of linguistic and world knowledge.
Two ABC transport systems carry out peptide uptake in Enterococcus faecalis: Their roles in growth and in uptake of sex pheromones
Authors: Segawa Takaya , Johnson Christopher M. , Berntsson Ronnie P‐A. , Dunny Gary M.
Published: April 2021

Enterococcal pheromone‐inducible plasmids encode a predicted OppA‐family secreted lipoprotein. In the case of plasmid pCF10, the protein is PrgZ, which enhances the mating response to cCF10 pheromone. OppA proteins generally function with associated OppBCDF ABC transporters to import peptides. In this study, we analyzed the potential interactions of PrgZ with two host‐encoded Opp transporters using two pheromone‐inducible fluorescent reporter constructs. Based on our results, we propose renaming these loci opp1 (OG1RF_10634‐10639) and opp2 (OG1RF_12366‐12370). We also examined the ability of the Opp1 and Opp2 systems to mediate import in the absence of PrgZ. Cells expressing PrgZ were able to import pheromone if either opp1 or opp2 was functional, but not if both opp loci were disrupted. In the absence of PrgZ, pheromone import was dependent on a functional opp2 system, including opp2A. Comparative structural analysis of the peptide‐binding pockets of PrgZ, Opp1A, Opp2A, and the related Lactococcus lactis OppA protein, suggested that the robust pheromone‐binding ability of PrgZ relates to a nearly optimal fit of the hydrophobic peptide, whereas binding ability of Opp2A likely results from a more open, promiscuous peptide‐binding pocket similar to L. lactis OppA.
Three LysM effectors of Zymoseptoria tritici collectively disarm chitin‐triggered plant immunity
Authors: Tian Hui , MacKenzie Craig I. , Rodriguez‐Moreno Luis , van den Berg Grardy C. M. , Chen Hongxin , Rudd Jason J. , Mesters Jeroen R. , Thomma Bart P. H. J.
Published: April 2021

Chitin is a major structural component of fungal cell walls and acts as a microbe‐associated molecular pattern (MAMP) that, on recognition by a plant host, triggers the activation of immune responses. To avoid the activation of these responses, the Septoria tritici blotch (STB) pathogen of wheat, Zymoseptoria tritici, secretes LysM effector proteins. Previously, the LysM effectors Mg1LysM and Mg3LysM were shown to protect fungal hyphae against host chitinases. Furthermore, Mg3LysM, but not Mg1LysM, was shown to suppress chitin‐induced reactive oxygen species (ROS) production. Whereas initially a third LysM effector gene was disregarded as a presumed pseudogene, we now provide functional data to show that this gene also encodes a LysM effector, named Mgx1LysM, that is functional during wheat colonization. While Mg3LysM confers a major contribution to Z. tritici virulence, Mgx1LysM and Mg1LysM contribute to Z. tritici virulence with smaller effects. All three LysM effectors display partial functional redundancy. We furthermore demonstrate that Mgx1LysM binds chitin, suppresses the chitin‐induced ROS burst, and is able to protect fungal hyphae against chitinase hydrolysis. Finally, we demonstrate that Mgx1LysM is able to undergo chitin‐induced polymerization. Collectively, our data show that Z. tritici utilizes three LysM effectors to disarm chitin‐triggered wheat immunity.
Effects of a Brazil nut‐enriched diet on oxidative stress and inflammation markers in coronary artery disease patients: A small and preliminary randomised clinical trial
Authors: Cardozo Ludmila Ferreira Medeiros de França , Mafra Denise , Tavares da Silva Ana Carla , Ermida Barbosa Jaqueline , Oliveira da Cruz Beatriz , Tinoco Mesquita Cláudio , Barcza Stockler‐Pinto Milena
Published: April 2021

Nutritional interventions can reduce complications associated with coronary artery disease (CAD) such as inflammation and oxidative stress. This small, preliminary study aimed to evaluate a Brazil nut‐enriched diet's effects on markers of oxidative stress and inflammation in CAD patients. Twenty‐five CAD patients (13 male, 63.3 ± 6.7 years, BMI of 29.3 ± 5.6 kg/m2) were randomised to receive one unit of Brazil nut (5 g) per day for 3 months and were compared to 17 CAD patients (8 male, 63.3 ± 8 years, BMI of 28.6 ± 4.8 kg/m2) who served as control. Peripheral blood mononuclear cells were isolated, processed and analysed for expression of the transcription factors nuclear factor kappa B (NF‐κB) and nuclear factor E2‐related factor 2 (Nrf2), which is involved with antioxidant synthesis, and the antioxidant enzyme NAD(P)H: quinone oxidoreductase 1 (NQO1) by quantitative real‐time polymerase chain reaction (PCR). Plasma thiobarbituric acid‐reactive substances (TBARS) and clinical parameters were also measured before and after supplementation. No significant differences were found in any of the analysed parameters. Supplementing the diet with one Brazil nut a day for 3 months did not mitigate inflammation and oxidative stress in CAD patients. A longer period of supplementation may be required for positive effects to be seen.
Translating evidence‐based nursing clinical handover practice in an acute care setting: A quasi‐experimental study
Authors: Hada Adriana , Jones Lee V. , Jack Leanne C. , Coyer Fiona
Published: April 2021

Effective transfer of information during the nursing handover contributes to patient safety. This study aimed to translate the best practice nursing shift handover recommendations in an acute care setting using the Ottawa Model for Research Use and to explore its effect on patient adverse outcomes (falls, pressure injuries, and medication errors). Using a quasi‐experimental design, the study was conducted in four internal medicine wards in a major tertiary hospital. A total of 88 nurses and 110 patients participated in 152 handover observations. The findings showed clinically important increases in percentages and odds of nurses' compliance with shift handover recommendations after the intervention. The patient adverse outcomes after the intervention were compared to the corresponding period of previous year. A reduction was observed for all adverse patient outcomes with incident rate ratios of 0.762 (p = 0.027) for falls, 0.624 for pressure injuries (p = 0.010), and 0.782 for medication errors (p = 0.023). Replicating this study's methodology across multiple clinical settings will increase the generalizability of findings and provide further evidence to inform nursing practice and policy.
Asymmetric effects of oil revenue on government expenditure: insights from oil‐exporting developing countries
Authors: Hassan Adewale Samuel
Published: April 2021

This study was aimed at investigating the asymmetric effect of oil revenue on government expenditures in developing oil‐exporting countries, as most previous studies on the subject had presumed a symmetric oil revenue–government expenditure nexus. Thus, a non‐linear panel ARDL was employed to determine how government expenditures respond to positive and negative shocks to oil revenue. Regression estimates indicated that both total and health government expenditures respond asymmetrically to positive and negative changes in oil revenue in the long run, while the responses are symmetric in the short run. The results bespeak the limitation in modelling long‐run oil revenue–government expenditure nexus models symmetrically and the need to consider asymmetry when modelling the relationship between the two variables. The findings also bring to the fore the need for developing oil‐exporting countries to diversify their economies in order to extend their revenue sources, as such would greatly reduce the susceptibility of government expenditure, especially health expenditure to oil revenue busts. Furthermore, stabilisation funds from oil revenue booms if used and properly managed can help to moderate the negative impact of oil revenue busts in these countries.
The Mechanisms and Functions of GDF‐5 in Intervertebral Disc Degeneration
Authors: Guo Sheng , Cui Liqiang , Xiao Changming , Wang Chenglong , Zhu Bin , Liu Xueli , Li Yujie , Liu Xinyue , Wang Dingxuan , Li Sen
Published: April 2021

Intervertebral disc degeneration (IDD) is widely recognized as the main cause of low back pain, which leads to disability in aging populations and induces great losses both socially and economically worldwide. Unfortunately, current treatments for IDD are aimed at relieving symptoms instead of preserving disc structure and function. Researchers are forged to find new promising biological therapeutics to stop, and even reverse, IVD degeneration. Recently, the injection of growth factors has been shown to be a promising biological therapy for IDD. A number of growth factors have been investigated to modulate the synthesis of the extracellular matrix (ECM) through a variety of pathogenetic biological mechanisms, including suppressing inflammatory process and down‐regulating degrading enzymes. However, growth factors, including Transforming Growth Factor‐β (TGF‐β), Fibroblast Growth Factor (FGF), and Insulin‐like Growth Factor‐1 (IGF‐1), may induce unwanted blood vessel in‐growth, which accelerates the process of IDD. On the contrary, studies have demonstrated that injection of GDF‐5 into the intervertebral disc of mice can effectively alleviate the degeneration of the intervertebral disc, which elicits their response via BMPRII and will not induce blood vessel in‐growth. This finding suggests that GDF‐5 is more suitable for use in IDD treatment compared with the three other growth factors. Substantial evidence has suggested that GDF‐5 may maintain the structure and function of the intervertebral disc (IVD). GDF‐5 plays an important role in IDD and is a very promising therapeutic agent for IDD. This review is focused on the mechanisms and functions of GDF‐5 in IDD.
Bionic Tiger‐Bone Powder Improves Bone Microstructure and Bone Biomechanical Strength of Ovariectomized Rats
Authors: Ren Shanwu , Jiao Guangjun , Zhang Lu , You Yunhao , Chen Yunzhen
Published: April 2021

Objective

To study the curative effect of bionic tiger‐bone powder on osteoporosis in ovariectomized rats and investigate its mechanism.

Methods

Overall, a 120 female Wistar rats were randomly divided into Sham (sham‐operated group), ovariectomy (OVX, ovariectomized group), TB (bionic tiger‐bone powder treatment group after ovariectomy) and TB + VD groups (bionic tiger‐bone powder + vitamin D treatment group after ovariectomy). The osteoporotic rat model was established 3 months after ovariectomy, and rats were intragastrically administrated with the corresponding drugs. Serum and bone tissue samples were collected from 10 rats in each group at weeks 4, 12 and 24 after intragastric administration. The bone microstructure of L6 vertebrae was analyzed by MicroCT, the biomechanical strength of left femurs was measured by the three‐point bending test, and serum bone metabolism markers (P1NP and CTX) were detected by ELISA. Changes in bone collagen were analyzed by Masson's trichrome staining and hydroxyproline detection, and members of the BMP2/SMAD/RUNX2 and OPG/RANKL/RANK signal pathways were detected by immunoblotting.

Results

Compared with the OVX group, the serum level of P1NP in the TB and TB + VD groups was higher (P < 0.05), while the CTX level was lower (P < 0.05). Bone collagen fiber structures in the TB and TB + VD groups were repaired, and the collagen content was significantly higher than that in the OVX group (P < 0.05). In the TB group, BMP‐2, P‐SMAD1/5, RUNX2 and OPG levels were increased in bone tissue (P < 0.01), RANKL levels were decreased (P < 0.01), and the bone microstructure and biomechanical strength were improved.

Conclusion

Bionic tiger‐bone powder promotes osteogenesis by activating the BMP2/SMAD/RUNX2 signaling pathway, suppresses osteoclasts by downregulating the OPG/RANK/RANKL signaling pathway, increases bone collagen content, and improves bone microstructure and bone biomechanical strength.