bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of a novel bubble ultra‐wide field viewing system for vitreoretinal surgery
Authors: Pan Qin‐tuo , Gao Zhi‐qiang , Chen Xu‐hao , Yang Zheng‐wei , Huang Sheng‐hai , Hu Xu‐ting , Zheng Jing‐wei , Zhang Zong‐duan
Published: August 2021

Purpose

To report the clinical outcomes and evaluate the efficacy of a novel bubble ultra‐wide field viewing system for vitreoretinal surgery.

Design

Prospective, noncomparative, interventional case series.

Participants

One hundred and fifty‐one eyes of 146 consecutive patients with proliferative diabetic retinopathy (PDR), vitreous haemorrhage originating from retinal vein occlusion (VH‐RVO), epiretinal membrane (EM), macular hole (MH) or retinal detachment (RD) who underwent vitreoretinal surgery using the bubble ultra‐wide field viewing system were included.

Methods

A standard phacoemulsification was performed on each patient. Core humour and mid‐peripheral vitreous humour were removed using a planoconcave lens. A suitably sized bubble was infused to attach to the posterior capsule or the anterior chamber depending on the integrity of the posterior capsule. The planoconcave lens and the air bubble formed the wide‐angle viewing system, through which peripheral vitrectomy was performed.

Main Outcome Measures

Range of applications, field of view, model validation and complications were recorded.

Results

The new ultra‐wide field viewing system was successfully applied in all eyes, including 34 with PDR, 28 VH‐RVO, 28 EM, 25 MH and 36 RD. Peripheral vitrectomy, local or panretinal laser photocoagulation, and removal of the peripheral proliferative membrane were successfully performed while viewing through this system. Maximum peripheral retinal area observable during the procedure was positively correlated with pupil diameter. Model analysis results showed that when the pupil diameter was 6 mm, the maximum field of view was approximately 128.1‐ 148.0 degrees with this system. Of 142 eyes, the main intraoperative complication was iatrogenic retinal breaks (IRBs) in 8 eyes (5.3%) and posterior capsule injury by vitreous cutter during bubble removal in 6 eyes (4.2%). The postsurgery mean best‐corrected visual acuity (BCVA) (0.48 ± 0.39 logMAR) was significantly improved compared with the preoperative mean BCVA (1.60 ± 1.08 logMAR, p < 0.001). No incidents of postoperative choroidal detachment, secondary glaucoma or endophthalmitis were recorded.

Conclusions

For patients with lens excision or absence, vitreoretinal surgery can be successfully performed using the novel viewing system described here. The system is a safe, convenient and economical ultra‐wide field viewing system with a wide range of applications.
Prediction of anti‐VEGF efficacy in diabetic macular oedema using intraocular cytokines and macular optical coherence tomography
Authors: Mao Jianbo , Zhang Shian , Zheng Zicheng , Deng Xinyi , Liu Chenyi , Chen Yiqi , Zhao Shixin , Zhang Yun , Shen Lijun
Published: August 2021

Purpose

In eyes with diabetic macular oedema (DME), aqueous humour (AH) cytokine levels before and after anti‐vascular endothelial growth factor (VEGF) treatment were compared and correlated with optical coherence tomography structural parameters.

Methods

This prospective study included 56 control patients with cataracts and 83 patients with DME manifesting as diffuse retinal thickening (DRT), cystoid macular oedema and serous retinal detachment (SRD). AH samples were obtained before intravitreal injection of anti‐VEGF or cataract surgery. VEGF, interleukin (IL)‐6, IL‐8, IL‐10, interferon‐inducible protein 10 (IP‐10) and monocyte chemotactic protein 1 (MCP‐1) levels were measured by multiplex bead assay. AH cytokine levels, central macular thickness (CMT), number of hyper‐reflective foci (HF), continuity of external limiting membrane and ellipsoid zone (EZ) and best‐corrected visual acuity were evaluated.

Results

In SRD, IL‐6 and MCP‐1 levels and HF were increased (all p < 0.05) compared to DRT. At baseline, the number of HF was correlated with VEGF, IL‐6, IL‐8, IP‐10 and MCP‐1 (all p < 0.05). Eyes sensitive to anti‐VEGF treatment had high baseline levels of VEGF, MCP‐1, HF and many EZ disruptions (all p < 0.05). DME patients with normal VEGF levels but with high levels of IL‐8, IP‐10 and MCP‐1 (all p < 0.05) had little change in CMT after anti‐VEGF treatment (p = 0.678).

Conclusions

AH concentrations of some inflammatory cytokines in DME were differentially expressed among the three DME morphologies. HF was associated with VEGF and other inflammatory cytokine levels. Multiple HF at baseline predicted a significant decrease in CMT, and eyes with normal VEGF but increased inflammatory cytokines may be insensitive to anti‐VEGF treatment.
Luminescence dating of sand wedges constrains the Late Wisconsin (MIS 2) permafrost interval in the upper Midwest, USA
Authors: Schaetzl Randall J. , Running Garry , Larson Phillip , Rittenour Tammy , Yansa Catherine , Faulkner Douglas
Published: August 2021

Large parts of the upper Midwest, USA were impacted by permafrost during the Last Glacial Maximum (LGM). Even though permafrost persisted as the Laurentide Ice Sheet began to recede, direct age control of this interval is largely lacking. To better temporally constrain the permafrost interval in western Wisconsin, we identified two sites, outside the Late Wisconsin (MIS 2) glacial limit, that contain relict, ice‐wedge pseudomorphs, initially interpreted to be sand wedges, hosted within well‐drained outwash deposits. The pre‐Wisconsin (>MIS 5) host material commonly displays up‐turned bedding near the contact with the wedges, indicative of well‐formed features. The wedges are filled with well‐sorted, gravel‐free, medium and fine sands, and lack evidence of post‐formational disturbance, pointing to an aeolian sand infill and confirming them as sand wedges. Ventifacts on nearby uplands attest to windy conditions here in the past. Optically stimulated luminescence (OSL) ages on five sand wedges indicate that they filled with sand between c. 19.3 and 18.3 ka at the southerly site and between c. 15.1 and 14.7 ka at the northerly site, which is closer to the LGM margin. Sand wedges at the latter site were wider and had more complex morphologies, possibly suggesting a longer interval of formation and/or more intense permafrost. We also examined a site along a ridge crest, between the two wedge sites, which displayed interbedded loess and sand, dated by OSL to 12.7 ka. Together, these results point to dry, cold, windy conditions in west‐central Wisconsin, within 100 km of the LGM limit. At this time, aeolian sands were being transported across a landscape with (at least scattered) permafrost. The OSL results suggest multiple phases, or perhaps time‐transgressive, sand‐wedge formation, associated with permafrost between c. 19 and 15 ka, with dry, windy (and likely, cold) conditions persisting until at least 12.7 ka.
Chemokine C‐C motif ligand 21 synergized with programmed death‐ligand 1 blockade restrains tumor growth
Authors: Chen Qiangda , Yin Hanlin , Pu Ning , Zhang Jicheng , Zhao Guochao , Lou Wenhui , Wu Wenchuan
Published: August 2021

Programmed death‐ligand 1 (PD‐L1) blockade has revolutionized the prognosis of several cancers, but shows a weak effect on pancreatic cancer (PC) due to poor effective immune infiltration. Chemokine C‐C motif ligand 21 (CCL21), a chemokine promoting T cell immunity by recruiting and colocalizing dendritic cells (DCs) and T cells, serves as a potential antitumor agent in many cancers. However, its antitumor response and mechanism combined with PD‐L1 blockade in PC remain unclear. In our study, we found CCL21 played an important role in leukocyte chemotaxis, inflammatory response, and positive regulation of PI3K‐AKT signaling in PC using Metascape and gene set enrichment analysis. The CCL21 level was verified to be positively correlated with infiltration of CD8+ T cells by the CIBERSORT algorithm, but no significant difference in survival was observed in either The Cancer Genome Atlas or the International Cancer Genome Consortium cohort when stratified by CCL21 expression. Additionally, we found the growth rate of allograft tumors was reduced and T cell infiltration was increased, but tumor PD‐L1 abundance elevated simultaneously in the CCL21‐overexpressed tumors. Then, CCL21 was further verified to increase tumor PD‐L1 level through the AKT‐glycogen synthase kinase‐3β axis in human PC cells, which partly impaired the antitumor T cell immunity. Finally, the combination of CCL21 and PD‐L1 blockade showed superior synergistic tumor suppression in vitro and in vivo. Together, our findings suggested that CCL21 in combination with PD‐L1 blockade might be an efficient and promising option for the treatment of PC.
Reasons for hospitalizations in patients with type 2 diabetes in the CANVAS programme: A secondary analysis
Authors: Feng Kent Y. , Li JingWei , Ianus Juliana , de Zeeuw Dick , Fulcher Greg R. , Pfeifer Michael , Matthews David R. , Jardine Meg J. , Perkovic Vlado , Neal Bruce , Mahaffey Kenneth W.
Published: August 2021

Aim

To determine the reasons for hospitalizations in the CANagliflozin cardioVascular Assessment Study (CANVAS) programme and the effects of the sodium‐glucose co‐transporter‐2 inhibitor canagliflozin on hospitalization.

Materials and Methods

A secondary analysis was performed on the CANVAS programme that included 10 142 participants with type 2 diabetes randomized to canagliflozin or placebo. The primary outcome was the rate of total (first plus all recurrent) all‐cause hospitalizations (ACH). Secondary outcomes were total hospitalizations categorized by the Medical Dictionary for Regulatory Activities hierarchy at the system organ class level, reported by investigators at each centre. Outcomes were assessed using negative binomial models.

Results

Of the 7115 hospitalizations reported, the most common reasons were cardiac disorders (23.7%), infections and infestations (15.0%), and nervous system disorders (9.0%). The rate of total ACH was lower in the canagliflozin group (n = 5795) compared with the placebo group (n = 4347): 197.9 versus 215.8 participants per 1000 patient‐years, respectively (rate ratio [RR] 0.92; 95% confidence interval [CI] 0.86, 0.98). Canagliflozin reduced the rate of total hospitalizations because of cardiac disorders (RR 0.81; 95% CI 0.75, 0.88). There was no significant difference between the canagliflozin and placebo groups in the rates of total hospitalizations because of infections and infestations (RR 0.96; 95% CI 0.86, 1.02) or nervous system disorders (RR 0.96; 95% CI 0.88, 1.05).

Conclusions

In the CANVAS programme, the most common reasons for hospitalization were cardiac disorders, infections and infestations, and nervous system disorders. Canagliflozin, compared with placebo, reduced the rate of total ACH.
Glucose control using fast‐acting insulin aspart in a real‐world setting: A 1‐year, two‐centre study in people with type 1 diabetes using continuous glucose monitoring
Authors: Billion Lisa , Charleer Sara , Verbraeken Laurens , Sterckx Mira , Vangelabbeek Kato , De Block Nathalie , Janssen Charlien , Van Dessel Kristof , Dirinck Eveline , Peiffer Frida , Bolsens Nancy , Mathieu Chantal , Gillard Pieter , De Block Christophe
Published: August 2021

Aim

To evaluate the efficacy and safety of switching from traditional mealtime insulins to fast‐acting insulin aspart (Fiasp) in a “real‐world” clinical practice setting in adult people with type 1 diabetes (PWD1) who were using intermittently scanned or real‐time continuous glucose monitoring (isCGM or rtCGM, respectively).

Materials and Methods

Data from 438 adult PWD1 (60% men, age 44.6 ± 16.2 years, diabetes duration 21.5 ± 14.0 years, isCGM/rtCGM: 391/47, multiple daily injections/continuous subcutaneous insulin infusion: 409/29), who initiated Fiasp from January 2018 to May 2020, were analysed. The primary objective was the evolution of time in range (TIR; 70‐180 mg/dL) at 6 and 12 months. Secondary objectives included change in HbA1c, body mass index (BMI), insulin doses, time below range (<70 and <54 mg/dL), and time above range (>180 and >250 mg/dL).

Results

TIR improved from 50.3% ± 15.6% to 54.3% ± 15.1% at 6 months (n = 425) and to 55.5% ± 15.2% at 12 months (n = 385) (P < .001), corresponding to 57 min/d at 6 months and 75 min/d at 12 months. Time spent below 54 mg/dL evolved from 3.1% ± 3.3% to 3.1% ± 3.7% and 2.5% ± 3.0% at 6 and 12 months, respectively (P = .011). Also, time spent above 180 mg/dL decreased from 42.3% ± 16.7% at start by 4.2% at 6 months and by 4.6% at 12 months (P < .001). The proportion of people reaching TIR more than 70% increased from 11.0% to 14.8% (P = .002), and those spending less than 4% at time less than 70 mg/dL increased from 36.1% to 42.1% (P = .002). After 12 months, HbA1c, insulin doses, and BMI did not change significantly.

Conclusions

In a Belgian real‐world setting of adult PWD1, switching to Fiasp was associated with a 5% increased TIR after 12 months, corresponding to 75 min/d, in combination with less time spent below and above range.
European Federation of Periodontology Survey of Postgraduate and Specialist Training in Europe in 2020
Authors: Eaton Kenneth A. , West Nicola X. , Wilson Nairn H. F. , Sanz Mariano
Published: August 2021

Aims

The survey's aim was to establish which universities and other educational organisations deliver postgraduate and specialist training in Periodontology in the 31 countries who are members of the European Federation of Periodontology (EFP) and to obtain details of how these programmes are organised, funded, regulated and evaluated.

Methods

A questionnaire and covering letter were emailed to all national periodontal societies. The questions were on the name of country, official recognition, training programmes, entry to specialist training, specialist training assessment and recognition after completion of training.

Results

Twenty‐nine (93%) of national periodontal societies responded. Key findings included the following: Periodontology was reported as being recognised at a national level in 17 countries, there was a three‐year full‐time programme in 12 countries, no fees were charged for specialist training in 10 countries, in 14 countries trainees received annual salaries, end of training (summative) assessments varied from country to country, 12 countries reported that they had a requirement for specialists in Periodontology to complete continuing education to maintain registration as specialists.

Conclusions

This survey has established which universities and other educational organisations deliver postgraduate and specialist training in Periodontology and how these programmes are organised, funded, regulated and evaluated. To provide uniformly high‐quality periodontal care for patients in all European countries, further harmonisation of postgraduate and specialty training in Periodontology would be advantageous.
Breast hamartoma: reassessment of an under‐recognised breast lesion
Authors: Alran Léonie , Chamming’s Foucauld , Auriol‐Leizagoyen Sophie , Velasco Valérie , Deleau Florian , Brouste Véronique , Bonhomme Benjamin , Ben Rejeb Houda , Marty Marion , MacGrogan Gaëtan
Published: August 2021

Aims

Breast hamartomas are an under‐recognised lesion because they lack a distinctive microscopic appearance. Microscopic diagnosis can often conclude ‘no significant lesion’ or ‘normal breast tissue’, leading to repeated biopsies and diagnostic delay. We describe the histological, immunohistochemical and radiological features of breast hamartomas with the aim of identifying specific signs to facilitate their diagnosis and to differentiate them from normal breast and fibroepithelial lesions.

Methods and results

Forty‐seven breast hamartomas were reassessed (histological diagnosis and imaging features). An immunohistochemical study [oestrogen receptor (ER), progesterone receptor (PR), CD34, high‐mobility group A2 (HMGA2)] was performed. On breast imaging, hamartomas most often presented as probably benign solid masses with circumscribed margins and variable densities. Histologically, breast hamartomas resembled normal breast, although their stromal component was predominant, separating randomly scattered epithelial elements with areas of pure collagenous stroma. Pseudoangiomatous stromal hyperplasia (PASH) was present in 93.6% of cases and CD34 antibody highlighted intralobular, perilobular and interlobular distribution of CD34‐positive fibroblasts. By comparison, CD34 was mainly expressed in the intralobular normal breast tissue stroma. Hamartoma stromal cells expressed HMGA2, ER and PR in 79%, 66% and 76.3% of our cases, respectively, compared to 7.7%, 23% and 19% in normal breast tissue, respectively (P < 0.0001; P = 0.0005; P < 0.0001).

Conclusions

After ascertaining that core needle biopsy is effectively intralesional, breast hamartomas can be diagnosed with confidence by taking into account the presence of stromal changes, PASH, interlobular distribution of CD34‐positive fibroblasts, HMGA2 and hormonal receptor stromal expression.
Alterations in mental health and quality of life in patients with skin disorders: a narrative review
Authors: Cortés Hernán , Rojas‐Márquez Martín , Del Prado‐Audelo María L. , Reyes‐Hernández Octavio D. , González‐Del Carmen Manuel , Leyva‐Gómez Gerardo
Published: August 2021

The presence of lesions in visible areas of skin may cause emotional troubles in patients, including low self‐worth, embarrassment, sorrow, and social isolation. Those alterations may predispose to psychiatric disorders such as anxiety, depression, and even suicidal ideation, severely affecting patients' health state and quality of life (QoL). In this article, we focus on dermatologic patients that present with secondary mental health alterations. Thus, we offer a detailed description of mental disorders observed in patients with acne vulgaris, atopic dermatitis, psoriasis, ichthyosis, vitiligo, and hidradenitis suppurativa. Moreover, we point out the relationship between the severity of the cutaneous symptoms with mental illnesses and QoL decline. Our objective was to highlight the importance of mental health care for patients with skin diseases. The impact of skin alterations on the mental health of dermatological patients should be a central concern. Likewise, the timely identification and treatment of mental disorders are essential for the comprehensive management of these skin diseases.
The effect of an instant message‐based lifestyle and stress management intervention on the reduction of cardiovascular disease risk
Authors: Lu Ya‐Ting , Wu Ying
Published: August 2021

Aim

This study investigated the effectiveness of an instant message‐based lifestyle and stress management intervention delivered by nurses on cardiovascular disease risk reduction.

Methods

In this nonrandomized concurrent controlled trial conducted from March 2013 to September 2013, 164 eligible employees in two companies were assigned to the intervention (n = 83) and control (n = 81) groups based on their worksites. Only participants were blinded to group assignment. All participants received two education sessions during 1 month, and the intervention group also received an instant message‐based lifestyle and stress management intervention for 5 months. The primary outcome was the Framingham Risk Score, and the data were collected at the first month and the sixth month.

Results

The final analysis included 80 participants in the intervention group and 76 in the control group. After the intervention, significant intervention effects were found for the mean value and the changes of the Framingham Risk Score and the proportion of participants who improved their diet and exercise (P < 0.05). There were trends for improvement in the proportion of smoking and levels of stress, but statistically significant levels (P > 0.05) were not met.

Conclusion

An instant message‐based lifestyle and stress management intervention can reduce cardiovascular disease risk in high‐risk individuals.
Food insecurity is associated with higher food responsiveness in low‐income children: The moderating role of parent stress and family functioning
Authors: Eagleton Sally G. , Na Muzi , Savage Jennifer S.
Published: August 2021

Background

Food insecurity (FI) may increase the odds for childhood obesity, yet little is known about the mechanism explaining this relationship. Parents experience greater psychosocial stress in the context of FI. In these environments, children from FI households may exhibit different appetitive behaviours.

Objectives

To examine associations between FI and appetitive behaviours in children (3–5 years) and to explore whether social, emotional and structural properties of the home environment moderate this relationship.

Methods

In a low‐income sample of 504 parent–child dyads, parents completed the household food security module and the Children's Eating Behavior Questionnaire. A subsample (n = 361) self‐reported perceived stress, depressive symptoms, household chaos and family functioning. Children were categorized as food secure, household FI and child FI.

Results

Food responsiveness (LSmeans ± SE; child FI: 2.56 ± 0.13; food secure: 2.31 ± 0.10, p < 0.05) and emotional overeating (LSmeans ± SE; child FI: 1.69 ± 0.10; food secure: 1.48 ± 0.08, p < 0.05) were higher among children in the child FI group compared to the food secure group. Child FI was only associated with higher food responsiveness among children of parents reporting high levels of perceived stress (p = 0.04) and low levels of family functioning (p = 0.01). There were no differences in food responsiveness by food security status at mean or low levels of perceived stress or at mean or high levels of family functioning (p > 0.05).

Conclusions

Child FI may contribute to obesity risk through differences in appetitive behaviours. For low‐income families, stress management and improving family dynamics may be important factors for interventions designed to improve children's appetitive behaviours.
Orthodontic treatment demand in young adolescents – Are parents familiar with their children's desires and reasons?
Authors: Uhac Mia , Zibar Belasic Tihana , Perkovic Vjera , Matijevic Marko , Spalj Stjepan
Published: August 2021

Aim

To assess the levels of agreement between parents and adolescents about young adolescents' orthodontic treatment demand and to what extent is treatment demand conditioned by family and psychosocial impacts and oral function.

Design

This cross‐sectional study included 221 adolescents (11–14 years, 54% female) and their parents. A 5‐point scale was used to assess orthodontic treatment demand. Adolescents self‐administered the Child Perceptions Questionnaire, and parents self‐administered the Parental‐Caregivers Perceptions Questionnaire and Family Impact Scale. The Index of Orthodontic Treatment Need Dental Health Component (IOTN DHC) was used for determining malocclusion severity. Intraclass correlation coefficient and Cohen's kappa coefficient were used for the assessment of agreement between two informants.

Results

The parent‐child agreement on children's orthodontic treatment demand was weak, concording in 67.4% of cases. The most common reasons for seeking orthodontic treatment derive from the emotional (EW) and social well‐being domains for both informants. In linear regression, the adolescent's reporting of impaired EW and IOTN DHC was the only significant linear predictor of orthodontic treatment demand.

Conclusion

Parents cannot correctly assess the orthodontic treatment demand of their children. Impaired EW is the most significant self‐reported determinant of adolescents' demand for orthodontic treatment. Family relationships and parental perspective have a low influence.
Evaluation of facial tissue stresses under medical devices post application of a cyanoacrylate liquid skin protectant: An integrated experimental‐computational study
Authors: Margi Raz , Gefen Amit
Published: August 2021

Medical device‐related pressure ulcers (PUs) (injuries) are a subclass of PUs, associated with pressure and/or shear applied by a medical device onto the skin. Clinical application of a cyanoacrylate liquid skin protectant (CLSP) under the contours of skin‐contacting medical devices to shield an intact skin from the sustained mechanical loads that are applied by medical devices is a preventative option, but no computer modelling work has been reported to assess the biomechanical efficacy of such interventions. Here, we investigated the biomechanical protective effect of a polymerised cyanoacrylate coating using three‐dimensional, anatomically realistic finite element models of the ear with oxygen cannula and the mouth with endotracheal attachment device, informed by experimental studies. We have compared tissue stress exposures under the devices at these facial sites between conditions where the cyanoacrylate skin protectant has been applied or where the device was contacting the skin directly, without the shielding of the cyanoacrylate coating. The CLSP considerably reduced the skin stress concentration levels and overall tissue stress exposures under the aforementioned medical devices. This demonstrates strong biomechanical effectiveness of the studied cyanoacrylate‐based skin protectant in prevention of facial medical device‐related injuries at small, curved and thereby difficult to protect facial sites.
Making the planet green again: The interplay of attitudes and group norms in the conversion to organic farming
Authors: Khamzina Kamilla , Huet Sylvie , Deffuant Guillaume , Streith Michel , Guimond Serge
Published: August 2021

Attitudes and social norms are key social psychological concepts that have often been considered as independent determinants of human behavior. However, questions about the interplay between the two are somewhat of a blind spot in social psychology. In the present research, we test the hypothesis that when an important change in norms is involved, behavioral intentions will be shaped by a discrepancy between personal attitudes and the perceived group norm, that is the perception of other group members’ attitudes. This proposition is tested and supported across three studies in a context of the conversion to organic farming, a behavior indicative of a significant societal and behavioral change. Farmers who did convert to organic farming were those who perceive other farmers to hold less positive attitudes toward this environmentally‐friendly practice compared to their own (Study 1a & 1b, N = 1,023). Among conventional farmers, the intention to convert to organic farming is also predicted by a discrepancy between personal attitudes and the perceived group norm (Study 1b). Finally, among agricultural colleges’ students (Study 2, N = 280), the intention to become an organic farmer was influenced by an interaction between attitudes and perceived group norm and not only by independent effects of these two variables. The theoretical and practical implications of these findings for a better understanding of behavioral adaptation in times of social change are discussed.
Measuring systematic risk from managerial organization capital
Authors: Yildirim Alev , Allen Linda
Published: August 2021

Organization capital (OC) constitutes a firm's unique, hard‐to‐mimic, hard‐to‐transfer culture, internal knowledge and language, policies and procedures, growth opportunities and information technology, brand name and any other aspects that are not directly related to the production process. In order to disentangle value enhancement from agency costs inherent in the OC, we calibrate systematic risk premiums from the loss of managerial OC rents by decomposing OC into: (1) portable economic rents in the form of disclosed executive compensation and (2) a strategic component that comprised undisclosed, non‐portable OC rents mixed with agency costs. Shareholders in firms with high strategic component (not the portable component) earn an annual systematic risk premium of 4.6%. Disclosures revealing the breakdown between OC and agency costs in the strategic component (earnings surprises, managerial obfuscation and stock mispricing) as well as corporate governance eliminate this risk premium by revealing the OC rents in strategic component and increasing OC portability.
Hydrogen gas inhalation ameliorates cardiac remodelling and fibrosis by regulating NLRP3 inflammasome in myocardial infarction rats
Authors: Nie Chaoqun , Zou Rentong , Pan Shuang , A Rong , Gao Yunan , Yang Hongxiao , Bai Juncai , Xi Shuiqing , Wang Xue , Hong Xiaojian , Yang Wei
Published: August 2021

It is noteworthy that prolonged cardiac structural changes and excessive fibrosis caused by myocardial infarction (MI) seriously interfere with the treatment of heart failure in clinical practice. Currently, there are no effective and practical means of either prevention or treatment. Thus, novel therapeutic approaches are critical for the long‐term quality of life of individuals with myocardial ischaemia. Herein, we aimed to explore the protective effect of H2, a novel gas signal molecule with anti‐oxidative stress and anti‐inflammatory effects, on cardiac remodelling and fibrosis in MI rats, and to explore its possible mechanism. First, we successfully established MI model rats, which were then exposed to H2 inhalation with 2% concentration for 28 days (3 hours/day). The results showed that hydrogen gas can significantly improve cardiac function and reduce the area of cardiac fibrosis. In vitro experiments further proved that H2 can reduce the hypoxia‐induced damage to cardiomyocytes and alleviate angiotensin II‐induced migration and activation of cardiac fibroblasts. In conclusion, herein, we illustrated for the first time that inhalation of H2 ameliorates myocardial infarction‐induced cardiac remodelling and fibrosis in MI rats and exert its protective effect mainly through inhibiting NLRP3‐mediated pyroptosis.
Editorial: COVID‐19: lessons learned for suicide prevention
Authors: Asarnow Joan R. , Chung Bowen
Published: August 2021

This editorial discusses lessons learned from the COVID‐19 public health emergency as they relate to the prevention of suicide, the second leading cause of death in adolescents and young adults globally. Recognizing that COVID‐19 impact and response varied across nations, we offer a US perspective, addressing two questions: (a) what have we learned from this pandemic and mitigation strategies used to reduce cases of COVID‐19 illness and deaths; and (b) how can our research advance knowledge and be advanced by work aimed at understanding the impact of this ‘unusual’ period? Provisional data indicate that during the pandemic and lockdown period, there were some declines in suicide rates for the total US population and no change in youth. However, data also indicate increases in reported suicidal ideation and behavior, mental health‐related ED visits, and ED visits for suicidal ideation and behavior in youth. Heterogeneity of pandemic effects is noteworthy, with ethnic and racial minority populations suffering the most from COVID‐19, COVID‐19‐related risk factors, and possibly suicide deaths. As vaccinations can prevent severe COVID‐19 cases and deaths, we also have demonstrations of effective ‘psychological inoculations’ such as community‐based interventions for reducing suicide attempts and deaths. During COVID‐19, we mobilized to provide clinical care through telehealth and digital interventions. The challenge now is to continue to put our science to work to mitigate the adverse impacts of the pandemic on suicide and suicide risk factors, our children’s mental health, and enhance mental health and well‐being in our communities.
Cognitive, psychosocial, and behaviour gains at age 31 years from the Jamaica early childhood stimulation trial
Authors: Walker Susan P. , Chang Susan M. , Wright Amika S. , Pinto Rodrigo , Heckman James J. , Grantham‐McGregor Sally M.
Published: August 2021

Background

There is little evidence on adult benefits from early childhood interventions in low and middle‐income countries. We assessed adult cognition, psychosocial skills and behaviour from a stimulation trial conducted in Jamaica.

Methods

Children with stunted growth (height‐for age <−2SD of references) aged 9–24 months were enrolled in a two‐year randomised‐controlled trial of nutritional supplementation and/or stimulation. At mean age 31.79 (SD 0.40) years, 95 of 127 participants (74.8%; 53.7% male) were assessed. Children without stunted growth were also followed as a comparison group (64 of 84 participants, 76.2%). Measurements included IQ, executive function, mental health, psychosocial skills, personality traits and risk behaviours. A block permutation test, valid for small sample sizes, was used. Analyses accounted for the randomisation protocol, multiple hypothesis testing and attrition.

Results

Treatment group participants (stimulation intervention with or without supplementation, n = 48) had significantly greater IQ (Hedges g effect size 0. 57; 95%CI 0.20, 0.95) and cognitive flexibility (0.61; 0.25, 0.98) compared with no‐treatment (no‐intervention and supplementation only, n = 47). They also had reduced depressive symptoms (0.61; 0.28, 1.00), increased grit (0.53; 0.16, 0.92) and conscientiousness (0.66; 0.31, 1.07), lower substance use (rank mean score, 0.45; 0.08, 0.81) and risk taking related to health and work (0.64; 0.27, 1.00). There were 18 significant outcomes of 33 assessed. Comparison participants had higher IQ than no‐treatment (1.17; 0.81, 1.54) and treatment groups (0.62; 0.18, 1.07); and better executive function, lower social inhibition and risk taking than the no‐treatment group.

Conclusions

The wide‐ranging benefits at 31 years from the stimulation intervention supports investment in larger scale programmes to promote early childhood development in disadvantaged children. The lower IQ in the treatment group compared with comparison participants, emphasises the need for continued efforts to prevent early childhood growth retardation.
Vertical integration and capacity investment in the electricity sector
Authors: Brown David P. , Sappington David E. M.
Published: August 2021

We examine the incentives for and the effects of vertical integration in the electricity sector. We find that vertical integration often reduces retail prices and increases industry capacity investment, consumer surplus, and total welfare. Unilateral vertical integration often is profitable, and so arises in equilibrium. However, ubiquitous vertical integration can reduce aggregate industry profit.
A safe haven for potential reproductive aggregations of the critically endangered Brazilian guitarfish (Pseudobatos horkelii)
Authors: Anderson Antônio B. , Fiuza Thiago M. J. , Araujo Gabriel S. , Canterle Angela M. , Canto Luiza M. C. , Freitas Renato H. A. , Gadig Otto B. F. , Floeter Sergio R.
Published: August 2021

Brazilian endemic batoid elasmobranch populations have declined dramatically in the past 40 years due to anthropic activities (e.g., overfishing). The Brazilian guitarfish, Pseudobatos horkelii, included in the IUCN red list of endangered species [Critically Endangered (CR)], has been captured as by‐catch by trawling fishing boats to the edge of extinction. Despite governmental conservation initiatives, the species is still caught and commercialized along the Brazilian coast. In this study, the authors report three rare aggregation events for the Brazilian coast of P. horkelii, inside the only nearshore no‐entry Brazilian marine protected area. Strategies for its protection are also discussed.
Gastroenterology hospital outpatients report high rates of satisfaction with a Telehealth model of care
Authors: Bensted Karen , Kim Christy , Freiman John , Hall Matthew , Zekry Amany
Published: August 2021

Aims

This study aimed to capture patient satisfaction with a Telehealth model of care in a tertiary hospital gastroenterology outpatient setting. An in‐depth patient questionnaire addressed patients' experience with telephone based consultations, as well as capturing demographic data to predict patients who may benefit from a Telehealth model of care.

Methods

Patients aged ≥ 18 years who had a telephone appointment from 1st March 2020 to 1st September 2020 at the St George Hospital and Sutherland Hospital Gastroenterology Clinics in Sydney, Australia, were invited to complete an anonymous online survey detailing their experience. Clinics included general gastroenterology, inflammatory bowel disease, hepatology and swallow disorders. Chi squared analysis was used to investigate if demographic data (age, gender, educational status, English‐spoken at home, and presence of IBD or cirrhosis) impacted on a patients rating of care they received.

Results

1894 patients were invited to complete with survey, with 302 responses. 294 respondents (88.4%) rated the care they received as “very good” or “good”. 254 (84.1%) stated the main reason for attending the clinic was dealt with to their satisfaction. There was no statistical relationship between age, gender, educational status and the rating of care received. 49.7% preferred their telephone appointment, and 63.6% would like the option of a telephone appointment in the future.

Conclusion

Gastroenterology outpatients reported a very high satisfaction with Telehealth, demonstrating a potential for Telehealth to be incorporated into usual care.
Estimating stocks and flows of electric passenger vehicle batteries in the Norwegian fleet from 2011 to 2030
Authors: Thorne Rebecca , Aguilar Lopez Fernando , Figenbaum Erik , Fridstrøm Lasse , Müller Daniel Beat
Published: August 2021

Retired passenger battery electric vehicles (BEVs) are expected to generate significant volumes of lithium‐ion batteries (LIBs), opening business opportunities for second life and recycling. In order to evaluate these, robust estimates of the future quantity and composition of LIBs are imperative. Here, we analyzed BEV fate in the Norwegian passenger vehicle fleet and estimated the corresponding battery capacity in retired vehicles from 2011 to 2030, using a stock‐flow vehicle cohort model linked to analysis of the battery types and sizes contained in different BEVs. Results based on this combination of modeled and highly disaggregated technical data show that (i) the LIB energy capacity available for second use or recycling from end‐of‐life vehicles is expected to reach 0.6 GWh in 2025 and 2.1 GWh in 2030 (not accounting for any losses); (ii) most LIBs are currently contained within the weight segment 1500–1599 kg followed by 2000+ kg; (iii) highest sales currently exist for BEVs containing lithium nickel manganese cobalt oxide (NMC) batteries; and (iv) lithium nickel cobalt aluminum oxide batteries initially constitute the largest overall capacity in retired vehicles, but will later be surpassed by NMCs. The results demonstrate rapidly growing opportunities for businesses to make use of retired batteries and a necessity to adapt to changing battery types and sizes.
Critiques of the circular economy
Authors: Corvellec Hervé , Stowell Alison F. , Johansson Nils
Published: August 2021

This paper presents a reasoned account of the critiques addressed to the circular economy and circular business models. These critiques claim that the circular economy has diffused limits, unclear theoretical grounds, and that its implementation faces structural obstacles. Circular economy is based on an ideological agenda dominated by technical and economic accounts, which brings uncertain contributions to sustainability and depoliticizes sustainable growth. Bringing together these critiques demonstrates that the circular economy is far from being as promising as its advocates claim it to be. Circularity emerges instead as a theoretically, practically, and ideologically questionable notion. The paper concludes by proposing critical issues that need to be addressed if the circular economy and its business models are to open routes for more sustainable economic development.
Digital polycentricity and diasporic connectivity: A Norwegian‐Senegalese case study
Authors: Androutsopoulos Jannis , Lexander Kristin Vold
Published: August 2021

Digital communication remains largely unexplored in sociolinguistic research on diaspora and language. In this paper, ethnographically collected data from Norway‐based families of Senegalese heritage are explored to identify how family members use digital media to engage with diaspora concerns and projects, and how this engagement shapes their multilingual practices online. We re‐contextualize the concept of polycentricity (Blommaert et al.) from the physical setting of a neighbourhood or region to complex ecologies of digital media, and identify four ‘centres’, that is, distinct orientations for participants’ digital language and literacy practices, in which linguistic choices are associated with diaspora discourses, genres, and imagery. Each centre constrains the deployment of linguistic and semiotic resources in ways that are related both to historically rooted sociolinguistic hierarchies and affordances of digital media. The findings support a key claim in language and diaspora research, that is, the fine‐grained patterning of linguistic resources in diaspora communities. They also underscore the need to extend the empirical scope of a sociolinguistics of diaspora from co‐present to mediated interaction, and to explore the interplay between the two.
Population genetic structure of the yellow catfish (Pelteobagrus fulvidraco) in China inferred from microsatellite analyses: implications for fisheries management and breeding
Authors: Guo Xiang‐Zhao , Chen Hui‐Min , Wang Ai‐Bo , Qian Xue‐Qiao
Published: August 2021

Analysis of genetic diversity and population structure of the yellow catfish (Pelteobagrus fulvidraco), an important commercial aquaculture species that is widely distributed throughout China's fresh waters, could contribute to scientific management and sustainable utilization of this species. To characterize the population genetic structure of yellow catfish across China, 448 individuals from 10 locations across North, Central, and South China were analyzed using 15 microsatellite loci. Moderate to high genetic diversity was determined in all nine natural populations, while genetic diversity was slightly lower in the cultured populations. Two subgroups were detected, indicating clear genetic differences among the natural populations in China. This research represents the first comprehensive study of the genetic diversity of yellow catfish throughout its entire Chinese range, and the results may inform effective fisheries management and systematic selective breeding of the yellow catfish.
Seladelpar improved measures of pruritus, sleep, and fatigue and decreased serum bile acids in patients with primary biliary cholangitis
Authors: Kremer Andreas E. , Mayo Marlyn J. , Hirschfield Gideon , Levy Cynthia , Bowlus Christopher L. , Jones David E. , Steinberg Alexandra , McWherter Charles A. , Choi Yun‐Jung
Published: August 2021

Background & Aims

Primary biliary cholangitis (PBC) can result in life‐altering cholestatic pruritus and fatigue, but treatment options are limited. Seladelpar, a peroxisome proliferator‐activated receptor‐delta (PPARδ) agonist, has demonstrated potent anti‐cholestatic effects in clinical studies. This open‐label, uncontrolled phase 2 study in PBC patients evaluated the effects of 1‐year of seladelpar treatment on measures of pruritus and quality of life.

Methods

Self‐reported experiences of 101 PBC patients were collected at baseline and after 1 year of seladelpar treatment using the pruritus visual analog scale (VAS), 5D‐itch scale, and PBC‐40 questionnaires along with bile acid profiles.

Results

In patients with moderate–to‐severe pruritus, substantial improvement in pruritus was seen in 58% and 93% of patients in 5/10 mg and 10 mg treatment groups, respectively. After 1 year, patients reporting improvement substantially outnumbered those who worsened in the total 5‐D itch (including individual domains) and PBC‐40 (itch and fatigue domains) questionnaires. Improvement in sleep disturbance at 1‐year was reported in 81% (5/10 mg) and 78% (10 mg) of the patients with baseline itch‐related sleep disturbance by 5‐D itch score with similar results using the PBC‐40 sleep questionnaire. Seladelpar‐treated patients had significant reductions of 46% (5/10 mg) and 31% (10 mg) in the serum bile acid precursor C4 and reductions of up to 38% in serum bile acids.

Conclusions

Seladelpar treatment for 1 year led to consistent improvement in both symptom burden and biochemical response, suggesting its potential as a single agent to address two key unmet needs in PBC patients.
An LRR‐only protein promotes NLP‐triggered cell death and disease susceptibility by facilitating oligomerization of NLP in Arabidopsis
Authors: Chen Jun‐Bin , Bao Shu‐Wen , Fang Ya‐Li , Wei Lu‐Yang , Zhu Wang‐Sheng , Peng You‐Liang , Fan Jun
Published: August 2021

Necrosis‐ and ethylene‐inducing peptide 1 (Nep1)‐like proteins (NLPs) constitute a superfamily of proteins toxic to dicot plants, but the molecular basis of this toxicity remains obscure.

Using quantitative trait locus (QTL) analysis we investigated the genetic variation underlying ion leakage in Arabidopsis plants elicited with MoNLP1 derived from Magnaporthe oryzae. The QTL conditioning MoNLP1 toxicity was positionally cloned and further characterized to elucidate its mode of action.

MoNLP1‐triggered cell death varied significantly across > 250 Arabidopsis accessions and three QTLs were identified conferring the observed variation. The QTL on chromosome 4 was uncovered to encode a leucine‐rich repeat (LRR)‐only protein designated as NTCD4, which shares high sequence identity with a set of nucleotide‐binding LRR proteins. NTCD4 was secreted into the apoplast and physically interacted with multiple NLPs. Apoplastic NTCD4 facilitated the oligomerization of NLP, which was closely associated with toxicity in planta. The natural genetic variation causing D3N change in NTCD4 reduced the secretion efficiency of NTCD4 and the infection of Botrytis cinerea on Arabidopsis plants.

These observations demonstrate that the plant‐derived NTCD4 is recruited by NLPs to promote toxicity via facilitating their oligomerization, which extends our understanding of a key step in the toxic mode of action of NLPs.
The lived experience of patients with obesity: A systematic review and qualitative synthesis
Authors: Farrell Emma , Hollmann Eva , le Roux Carel W. , Bustillo Marta , Nadglowski Joe , McGillicuddy Deirdre
Published: August 2021

Although the deleterious effects of obesity have been well documented in terms of morbidity and mortality, less is known about what it is like to live with this complex and chronic disease. This study systematically reviewed and synthesized peer‐reviewed studies relating to the lived experience of patients with obesity. A total of 12,388 records were screened, resulting in the inclusion of 32 final studies. Meta‐ethnographic synthesis of these 32 studies generated five “third‐order constructs” or themes: the development of obesity; a life limited; stigma, judgment, shame, and blame; treatment and; experiences of specific or minority groups. These constructs describe, from the patient's perspective, the factors associated with the development and maintenance of obesity; the effects of the disease on their day‐to‐day lives; the impact of the stigma and judgment many patients are subjected to; and their experience of accessing, or trying to access, treatment for their healthcare needs. This synthesis reveals the dearth of studies that focus solely on the experience of the patient and highlights the tendency for participant‐informed, rather than participatory, methods in obesity research. It concludes with a call for further participatory research into the experiences of people living with obesity.