bluuebunny/crossref_metadata_2025 huggingface dataset:
Advancing leadership in Australasian emergency medicine: Taking stock and looking ahead
Authors: Rixon Andrew , Wilson Samuel , Judkins Simon , Bonning John , Skinner Clare , White Peter
Published: June 2021

Since 2018, the Australasian College for Emergency Medicine has collaborated with the Swinburne University of Technology on a research project to understand and enhance the leadership capacity of emergency physicians, beginning with Australasian Directors of Emergency Medicine (DEMs). Over the last 3 years, this research programme has revealed the complexity of leadership in emergency medicine, illuminating the strengths and limitations of extant research and suggesting promising new directions for emergency medicine leadership and leadership development research. This programme has also shed new light on the knowledge, skills and abilities that DEMs need to develop to catalyse change in the systems where DEMs practice both medicine and leadership. We propose that an approach to leadership development that reflects the diversity of DEMs' leadership challenges and the complexity of leadership in emergency medicine would go a long way to enhancing the sophistication, effectiveness and impact of the leadership in emergency medicine.
Linking high‐performance work systems and employee well‐being: A multilevel examination of the roles of organisation‐based self‐esteem and departmental formalisation
Authors: Wang Honglei , Zhang Yejun , Wan Min (Maggie)
Published: June 2021

Prior research has suggested that the relationship between high‐performance work systems (HPWS) and employee well‐being has been inconclusive, and particularly less is known about the underlying mechanisms and the boundary conditions between them. Integrating signalling theory with uncertainty reduction theory, we propose a cross‐level model linking department‐level HPWS to employee job burnout. Specifically, we propose the mediating role of organisation‐based self‐esteem (OBSE) in the effect of department HPWS on employee job burnout, as well as the moderating role of departmental formalisation. Using a sample of 366 employees and 60 managers from 60 departments, we found that department‐level HPWS was associated with reduced employee job burnout both directly and indirectly through OBSE. In addition, the mitigating influence of department‐level HPWS on employee job burnout was significant only when departmental formalisation was high. The findings of this study contribute to resolving the inconclusive relationship between HPWS and employee well‐being.
Unique phage–bacterium interplay in sponge holobionts from the southern Okinawa Trough hydrothermal vent
Authors: Zhou Kun , Qian Pei‐Yuan , Zhang Ting , Xu Ying , Zhang Rui
Published: June 2021

Deep‐sea hydrothermal vents harbour diverse and abundant animals and their symbiotic microorganisms, which together comprise holobionts. The interplay between bacterial members of holobionts and their viruses (phages) is important for maintaining these symbiotic systems; however, phage–bacterium interactions in deep‐sea vent holobionts are not well understood. Marine sponges serve as good models for such studies and are used to unveil phage–bacterium interplay via metagenomic analysis. In three demosponges from deep‐sea hydrothermal vent fields in the southern Okinawa Trough, the genomes of a diverse array of symbiotic bacteria, including 10 bacterial phyla, were found to lack intact prophages. Genes related to diverse anti‐viral defence systems, for example, the restriction–modification and toxin–antitoxin systems, were abundant in the bacterial communities. We also detected phage genes that could complement or compensate host bacterial metabolism, indicating beneficial roles of phage infection. Our findings provide insight into phage–bacterium interplay in sponges from deep‐sea hydrothermal vents.
Neoantigen load as a prognostic and predictive marker for stage II/III non‐small cell lung cancer in Chinese patients
Authors: Gong Lei , He Ronghui , Xu Yanjun , Luo Taobo , Jin Kaixiu , Yuan Wuzhou , Zheng Zengguang , Liu Lanxuan , Liang Zebin , Li Ao , Zheng Zhiguo , Li Hui
Published: June 2021

Background

The prognosis for patients with stage II/III non–small cell lung cancer (NSCLC) is unsatisfactory, even after complete tumor resection and adjuvant chemotherapy. Here, we assessed the prognostic and predictive value of immunogenomic signatures for stage II/III NSCLC in Chinese patients.

Methods

A total of 91 paired resected stage II/III NSCLC and normal tissues, including 47 squamous cell lung carcinomas (SCC) and 44 lung adenocarcinomas (ADC), were collected and analyzed using whole exome sequencing (WES) to identify immunogenomic signatures for association with clinicopathological variables and disease‐free survival (DFS).

Results

Higher neoantigen load (NAL, >2 neoantigens/Mb) exhibited better DFS for SCC patients (p = 0.021) but not ADC patients. A benefit from adjuvant chemotherapy was correlated with lower NAL (≤2 neoantigens/Mb) (p = 0.009). However, tumor mutation burden (TMB), mutations of individual gene, oncogene pathways, and antigen presentation machinery genes, and human leukocyte antigen (HLA)‐I number and HLA‐I loss of heterozygosity (LOH) had no prognostic or predictive value for DFS of SCC or ADC patients.

Conclusions

NAL is a useful biomarker for lung SCC prognosis and prediction of chemotherapy responses in Chinese patients. The predictive value of NAL for adjuvant immunotherapy should be further explored in patients with resected NSCLC.
Circulating microRNA profile in humans and mice with congenital GH deficiency
Authors: Saccon Tatiana D. , Schneider Augusto , Marinho Cindi G. , Nunes Allancer D. C. , Noureddine Sarah , Dhahbi Joseph , Nunez Lopez Yury O. , LeMunyan Gage , Salvatori Roberto , Oliveira Carla R. P. , Oliveira‐Santos Alécia A. , Musi Nicolas , Bartke Andrzej , Aguiar‐Oliveira Manuel H. , Masternak Michal M.
Published: June 2021

Reduced inflammation, increased insulin sensitivity, and protection against cancer are shared between humans and mice with GH/IGF1 deficiency. Beyond hormone levels, miRNAs are important regulators of metabolic changes associated with healthy aging. We hypothesized that GH deficiency in humans alters the abundance of circulating miRNAs and that a subset of those miRNAs may overlap with those found in GH‐deficient mice. In this study, subjects with untreated congenital isolated GH deficiency (IGHD; n = 23) and control subjects matched by age and sex (n = 23) were recruited and serum was collected for miRNA sequencing. Serum miRNAs from young (6 month) and old (22 month) Ames dwarf (df/df) mice with GH deficiency and their WT littermates (n = 5/age/genotype group) were used for comparison. We observed 14 miRNAs regulated with a genotype by age effect and 19 miRNAs regulated with a genotype effect independent of age in serum of IGHD subjects. These regulated miRNAs are known for targeting pathways associated with longevity such as mTOR, insulin signaling, and FoxO. The aging function was overrepresented in IGHD individuals, mediated by hsa‐miR‐31, hsa‐miR‐146b, hsa‐miR‐30e, hsa‐miR‐100, hsa‐miR‐181b‐2, hsa‐miR‐195, and hsa‐miR‐181b‐1, which target the FoxO and mTOR pathways. Intriguingly, miR‐181b‐5p, miR‐361‐3p, miR‐144‐3p, and miR‐155‐5p were commonly regulated in the serum of humans and GH‐deficient mice. In vitro assays confirmed target genes for the main up‐regulated miRNAs, suggesting miRNAs regulated in IGHD individuals can regulate the expression of age‐related genes. These findings indicate that systemic miRNAs regulated in IGHD individuals target pathways involved in aging in both humans and mice.
Distribution and morphology of ventricular bands in the hearts of ringed seals
Authors: Laakkonen Juha
Published: June 2021

In contrast to studies on domestic animals, few reports describe ventricular bands in wildlife, and none in aquatic mammals. Ventricular bands in the endangered Saimaa ringed seal (Pusa hispida saimensis) and the Baltic ringed seal (Pusa hispida botnica) were examined as part of an ongoing research on the comparative anatomy of ringed seal subspecies. The dissections illustrated that a varying number of thin or thick ventricular bands from the papillary muscles to the ventricular walls were visible in the ventricles of all ringed seal specimens examined. The histological appearance of the ventricular bands was characterized by a fibromuscular pattern.
Botulinum toxin A (Botox) injection into muscles of pelvic floor as a treatment for persistent pelvic pain secondary to pelvic floor muscular spasm: A pilot study
Authors: Mooney Samantha S. , Readman Emma , Hiscock Richard J. , Francis Alaina , Fraser Elise , Ellett Lenore
Published: June 2021

Background

Persistent pelvic pain (PPP) remains an important cause of morbidity. Pelvic floor muscle spasm is an important contributor to PPP.

Aims

The study’s primary aim was to assess if botulinum toxin (BoNT) injection to pelvic floor muscles altered pain scores or quality of life (QoL) at six, 12 and 26 weeks. Secondary aims included investigating the impact of BoNT on opiate usage, examining the role of pain catastrophising, and assessing for complications.

Materials and Methods

A single‐centre prospective cohort study enrolled 21 patients with PPP who had failed physiotherapy techniques. Each participant underwent BoNT injection to muscles of the pelvic floor and pudendal nerve block. Questionnaires and digital vaginal examinations were conducted at baseline, six, 12 and 26 weeks. Pain score quantification used visual analogue scales (VAS) and numerical rating scales (NRS). Other outcome assessments included The World Health Organization Quality of Life instrument (WHOQoL‐BREF), Pain Catastrophising Scale (PCS), and modified Australian Pelvic Floor Questionnaire (APFQ). ACTRN12620000067976.

Results

Following BoNT injection, median VAS scores decreased for all domains at six and 12 weeks, with VAS for dyspareunia significant at six weeks (P = 0.026). Scores returned to baseline by 26 weeks. Opiate usage was significantly less following BoNT injection, with a percentage reduction of 23.8% (95% CI −48.3 to 0.7, P = 0.06). Sexual function improved significantly (P < 0.01), and at six months, four previously apareunic participants reported successful penetrative vaginal intercourse. Health‐related QoL and PCS demonstrated sustained improvement (P = 0.02–0.05). NRS for muscle tenderness decreased for all assessed muscle groups (P < 0.001).

Conclusions

BoNT requires further assessment as a treatment modality for select women with PPP.
Boosting the oral bioavailability of anticancer drugs through intentional drug–drug interactions
Authors: Eisenmann Eric D. , Talebi Zahra , Sparreboom Alex , Baker Sharyn D.
Published: June 2021

Oral anticancer drugs suffer from significant variability in pharmacokinetics and pharmacodynamics partially due to limited bioavailability. The limited bioavailability of anticancer drugs is due to both pharmaceutical limitations and physiological barriers. Pharmacokinetic boosting is a strategy to enhance the oral bioavailability of a therapeutic drug by inhibiting physiological barriers through an intentional drug–drug interaction (DDI). This type of strategy has proven effective across several therapeutic indications including anticancer treatment. Pharmacokinetic boosting could improve anticancer drugs lacking or with otherwise unacceptable oral formulations through logistic, economic, pharmacodynamic and pharmacokinetic benefits. Despite these benefits, pharmacokinetic boosting strategies could result in unintended DDIs and are only likely to benefit a limited number of targets. Highlighting this concern, pharmacokinetic boosting has mixed results depending on the boosted drug. While pharmacokinetic boosting did not significantly improve certain drugs, it has resulted in the commercial approval of boosted oral formulations for other drugs. Pharmacokinetic boosting to improve oral anticancer therapy is an expanding area of research that is likely to improve treatment options for cancer patients.
Exploring digital transformation through pretend play in kindergarten
Authors: Vogt Franziska , Hollenstein Lena
Published: June 2021

Digitalisation and the accompanying transformation processes, involving data, technology and people, are part of children's life and will shape their future. Competences, such as digital skills, as well as creativity, communication, collaboration, critical thinking and problem solving are crucial to these transformation processes. In early childhood, these competences are essentially acquired through play, especially pretend play. The project ‘we play the future’ draws on the potential of pretend play to enable young children to be actively engaged in imagining themselves shaping digital transformation in the roles of inventors, developers and users. Drawing on an analysis of fields currently undergoing digital transformation, eight inputs for pretend play were developed to areas of digital transformation (eg, robotics, autonomous vehicles and Internet of things). Fifteen kindergarten teachers implemented the pretend play on digital transformation in their kindergarten after taking a half‐day introductory professional development course. The children's play was filmed and analysed using qualitative multimodal interaction analysis in order to examine the ways in which the pretend play encourages the exploration of digital transformation amongst the children. The results reveal the potential of pretend play for children to explore digital transformation and to acquire the digital competences needed in the future.

Practitioner notes

What is already known about this topic?

Children integrate imaginative digital technology in their play.

Guided pretend play is important for children's learning in kindergarten.

What this paper adds

Ideas for pretend play in kindergarten to enable children developing an understanding of digital transformation in a playful way

The paper presents findings from video analysis which indicate that children are using competences needed for the digital future during pretend play

Implications for practice

Digital education should not just be focused on using and programming digital devices but include pretend play to explore digital transformation; through the inputs for pretend play suggested in the project, the kindergarten teachers support the children developing an understanding of digital technology.

The inputs for pretend play enable children to develop competences such as technical and digital skills, as well as creativity, communication, collaboration, critical thinking and problem solving.
Fine‐tuning multiciliated cell differentiation at the post‐transcriptional level: contribution of miR‐34/449 family members
Authors: Loukas Ioannis , Skamnelou Margarita , Tsaridou Stavroula , Bournaka Spyridoula , Grigoriadis Sokratis , Taraviras Stavros , Lygerou Zoi , Arbi Marina
Published: June 2021

Cell differentiation is a process that must be precisely regulated for the maintenance of tissue homeostasis. Differentiation towards a multiciliated cell fate is characterized by well‐defined stages, where a transcriptional cascade is activated leading to the formation of multiple centrioles and cilia. Centrioles migrate and dock to the apical cell surface and, acting as basal bodies, give rise to multiple motile cilia. The concerted movement of cilia ensures directional fluid flow across epithelia and defects either in their number or structure can lead to disease phenotypes. Micro‐RNAs (miRNAs; miRs) are small, non‐coding RNA molecules that play an important role in post‐transcriptional regulation of gene expression. miR‐34b/c and miR‐449a/b/c specifically function throughout the differentiation of multiciliated cells, fine‐tuning the expression of many different centriole‐ and cilia‐related genes. They strictly regulate the expression levels of genes that are required both for commitment towards the multiciliated cell fate (e.g. Notch) and for the establishment and maintenance of this fate by regulating the expression of transcription factors and structural components of the pathway. Herein we review miR‐34 and miR‐449 spatiotemporal regulation along with their roles during the different stages of multiciliogenesis.
Review: Unaccompanied refugee minors’ perception of mental health services and professionals: a systematic review of qualitative studies
Authors: Demazure Gwladys , Baeyens Céline , Pinsault Nicolas
Published: June 2021

Background

Unaccompanied refugee minors (URMs) are a population at risk of mental health problems and a population with whom the therapeutic alliance can be difficult to set up. The therapeutic alliance’s quality can impact the result and effectiveness of psychotherapeutic interventions. The aim of the present study was to gather URMs’ points of view about mental health services and mental health professionals (MHP) in the host country. A summary of interviews conducted with URMs will allow a better understanding of their perception and expectations.

Methods

Seven databases were searched with English and French keywords. In the end, nine studies were selected.

Results

The review of the interviews shows that URMs do not have a clear perception of MHP – it seems difficult for them to trust MHP, but also to understand the value of sharing past painful experiences to reduce current symptoms. They can have a negative perception of mental health and consider that this is not a priority. URMs prefer to focus on day‐to‐day problems, do activity‐based interventions and do group sessions to value social interactions.

Conclusions

Clinical and methodological implications are discussed. The development of an instrument to evaluate therapeutic care for URMs could be interesting for future research and for clinicians.
Retracted: Overexpression of dopamine receptor D2 promotes colorectal cancer progression by activating the β‐catenin/ZEB1 axis
Authors: Lee Hyunjung , Shim Sehwan , Kong Joon Seog , Kim Min‐Jung , Park Sunhoo , Lee Seung‐Sook , Kim Areumnuri
Published: June 2021

Colorectal cancer (CRC) is a recurring cancer that is often resistant to conventional therapies and therefore requires the development of molecular‐based therapeutic approaches. Dopamine receptor D2 (DRD2) is associated with the growth of many types of tumors, but its oncogenic role in CRC is unclear. Here, we observed that elevated DRD2 expression was associated with a poor survival rate among patients with CRC. Depletion of DRD2 suppressed CRC cell growth and motility by downregulating β‐catenin/ZEB signaling in vitro and in vivo, whereas overexpression of DRD2 promoted CRC cell progression. Inhibition of DRD2 by the antagonist pimozide inhibited tumor growth and lymph node metastasis in vivo and enhanced the cytotoxic effects of conventional agents in vitro. Taken together, our findings indicate that targeting the DRD2/β‐catenin/ZEB1 signaling axis is a potentially promising therapeutic strategy for patients with CRC.
Allergen extract‐ and component‐based diagnostics in children of the ALLIANCE asthma cohort
Authors: Skevaki Chrysanthi , Tafo Pavel , Eiringhaus Kathrin , Timmesfeld Nina , Weckmann Markus , Happle Christine , Nelson Philipp P. , Maison Nicole , Schaub Bianca , Ricklefs Isabell , Fuchs Oliver , von Mutius Erika , Kopp Matthias Volkmar , Renz Harald , Hansen Gesine , Dittrich Anna‐Maria ,   the ALLIANCE Study Group
Published: June 2021

Background

Current in vitro allergen‐specific IgE (sIgE) detection assays measure IgE against allergen extracts or molecules in a single‐ or multiplex approach. Direct comparisons of the performance of such assays among young children with common presentations of allergic diseases regardless of sensitization status are largely missing.

Objectives

The aim of this study was a comparison of the analytical and diagnostic performance for common clinical questions of three commonly used technologies which rely upon different laboratory methodologies among children of the All Age Asthma (ALLIANCE) cohort (clinicaltrials.gov: NCT02496468).

Methods

Sera from 106 paediatric study participants (mean age 4 years) were assessed for the presence of sIgE by means of the ImmunoCAP™ sx1 and fx5 mixes, the ImmunoCAP ISAC™ 112 microarray and a Euroline™ panel.

Results

Total and negative concordance was high (>82%–>89%), while positive concordance varied considerably (0%–100%) but was also >50% for the most common sensitizations analysed (house dust mite and birch). All three test systems showed good sensitivity and specificity (AUC consistently > 0.7). However, no significant differences with regard to identifying sIgE sensitizations associated with symptoms in children with suspected pollen‐ or dust‐triggered wheeze or presenting with symptoms of allergic rhinoconjunctivitis or food allergy were detected. Extending the number of allergens did not change the similar performance of the three assay systems.

Conclusion and Clinical Relevance

Among young children, the three sIgE assays showed good analytical and diagnostic concordance. Our results caution that the identification of larger numbers of sensitizations by more comprehensive multiplex approaches may not improve the clinical utility of sIgE testing in this age group.
A new method for broad‐scale modeling and projection of plant assemblages under climatic, biotic, and environmental cofiltering
Authors: Ferrarini Alessandro , Bai Yang , Dai Junhu , Alatalo Juha M.
Published: June 2021

There is increasing interestin broad‐scale analysis, modeling, and prediction of the distribution and composition of plant species assemblages under climatic, environmental, and biotic change, particularly for conservation purposes. We devised a method to reliably predict the impact of climate change on large assemblages of plant communities, while also considering competing biotic and environmental factors. To this purpose, we first used multilabel algorithms in order to convert the task of explaining a large assemblage of plant communities into a classification framework able to capture with high cross‐validated accuracy the pattern of species distributions under a composite set of biotic and abiotic factors. We applied our model to a large set of plant communities in the Swiss Alps. Our model explained presences and absences of 175 plant species in 608 plots with >87% cross‐validated accuracy, predicted decreases in α, β, and γ diversity by 2040 under both moderate and extreme climate scenarios, and identified likely advantaged and disadvantaged plant species under climate change. Multilabel variable selection revealed the overriding importance of topography, soils, and temperature extremes (rather than averages) in determining the distribution of plant species in the study area and their response to climate change. Our method addressed a number of challenging research problems, such as scaling to large numbers of species, considering species relationships and rarity, and addressing an overwhelming proportion of absences in presence–absence matrices. By handling hundreds to thousands of plants and plots simultaneously over large areas, our method can inform broad‐scale conservation of plant species under climate change because it allows species that require urgent conservation action (assisted migration, seed conservation, and ex situ conservation) to be detected and prioritized. Our method also increases the practicality of assisted colonization of plant species by helping to prevent ill‐advised introduction of plant species with limited future survival probability.
Predicting species and community responses to global change using structured expert judgement: An Australian mountain ecosystems case study
Authors: Camac James S. , Umbers Kate D. L. , Morgan John W. , Geange Sonya R. , Hanea Anca , Slatyer Rachel A. , McDougall Keith L. , Venn Susanna E. , Vesk Peter A. , Hoffmann Ary A. , Nicotra Adrienne B.
Published: June 2021

Conservation managers are under increasing pressure to make decisions about the allocation of finite resources to protect biodiversity under a changing climate. However, the impacts of climate and global change drivers on species are outpacing our capacity to collect the empirical data necessary to inform these decisions. This is particularly the case in the Australian Alps which have already undergone recent changes in climate and experienced more frequent large‐scale bushfires. In lieu of empirical data, we use a structured expert elicitation method (the IDEA protocol) to estimate the change in abundance and distribution of nine vegetation groups and 89 Australian alpine and subalpine species by the year 2050. Experts predicted that most alpine vegetation communities would decline in extent by 2050; only woodlands and heathlands are predicted to increase in extent. Predicted species‐level responses for alpine plants and animals were highly variable and uncertain. In general, alpine plants spanned the range of possible responses, with some expected to increase, decrease or not change in cover. By contrast, almost all animal species are predicted to decline or not change in abundance or elevation range; more species with water‐centric life‐cycles are expected to decline in abundance than other species. While long‐term ecological data will always be the gold standard for informing the future of biodiversity, the method and outcomes outlined here provide a pragmatic and coherent basis upon which to start informing conservation policy and management in the face of rapid change and a paucity of data.
Inhibiting effect of heterogeneous cations aggregation enhanced by oxygen deficiency on glass formation of BaTi2O5 melts
Authors: Ge Xuan , Xu Jun , Hu Qiaodan , Qiu Ren , Lai Pingsheng , Han Yanfeng , Yang Fan , Zhou Yongquan , Qin Jingyu , Yu Pengfei , Lu Wenquan , Li Jianguo
Published: June 2021

Although remarkable development of titanate‐based glasses has been achieved, challenge remains to elucidate the correlation between structure and glass‐forming properties in these systems due to their complex structure that is inconsistent with the classic Zachariasen's model. In this work, we aim to correlate the structural evolution of titanate melts to their glass‐forming ability (GFA). The prototypical material barium dititanate (BaTi2O5, BT2) melts with different GFA were rendered by controlled melting atmospheres, and the corresponding structural changes were determined using in situ high‐energy synchrotron X‐ray diffraction combined with empirical potential structure refinement and ab initio molecular dynamics. The results show that BT2 melt in reducing atmosphere shows poor GFA but that in oxidizing atmosphere presents good GFA. Structural analysis demonstrates the mean coordination number of [TiOm] polyhedra is analogous in the melt under two different atmospheres but an enhanced heterogeneous cations aggregation takes place in the melt under reducing atmosphere, which is closely related to oxygen‐deficiencies. Furthermore, we reveal that the enhanced heterogeneous cations aggregation promotes crystallization (and therefore hinders glass formation) through disordering the distribution of [TiOm] and [BaOn] polyhedra, changing the connectivity between these polyhedra, creating more crystal‐like Ti‐Ti clusters, and decreasing topological disorder of BT2 melt. Our work provides a new viewpoint to understand the GFA of titanates melt from structural heterogeneity beyond the previous perspectives that only focus on [TiOm] polyhedra.
The effectiveness of digital self‐management interventions on health outcomes among childhood cancer survivors: A systematic review and meta‐analysis
Authors: Hong Hye Chong , Min Ari , Kim Young Man
Published: June 2021

Aims

The study aimed to review the evidence about existing digital interventions for childhood cancer survivors and examine their effectiveness on health outcomes.

Design

Systematic review and meta‐analysis.

Data sources

PUBMED, EMBASE, Cochrane, CINAHL, Web of Science, PsycArticles, SCOPUS and PQDT Global databases were searched, and the date last searched was 16 September 2019.

Review methods

This systematic review followed PRISMA guidelines. Randomized and nonrandomized controlled trials, as well as before‐and‐after studies, were included. The main outcomes were health‐related quality of life and moderate‐to‐vigorous physical activity. Two authors independently reviewed included studies and assessed methodological quality. Meta‐analysis was conducted using statistical software STATA 16.0.

Results

Out of the eight eligible studies, four were included in the meta‐analysis. The digital self‐management interventions were not effective on health‐related quality of life and moderate‐to‐vigorous physical activity. Additionally, the digital self‐management interventions increased the moderate‐to‐vigorous physical activity over time but was not statistically significant.

Conclusions

There is insufficient evidence on the effectiveness of digital self‐management interventions in improving health outcomes among childhood cancer survivors. Future randomized controlled trials should be conducted from multiple locations and should include objective measures and means to encourage interaction with health care providers.

Impact

Digital interventions are increasingly implemented to improve health outcomes among childhood cancer survivors, but their results are inconsistent. Well‐designed digital interventions may be beneficial for this population over time. The recommendations proposed in the current review may be useful for developing digital interventions and designing related studies in the future, thereby reducing late effects and improving healthy behaviours among this population.
Trends in the prevalence of hypertension according to severity and phenotype in Chinese adults over two decades (1991‐2015)
Authors: Yi Qian , Zha Mingming , Yang Qingwen , Zhang Yan , Hou Leying , Ye Xinxin , Chen Ge , Shao Jing , Xia Wei , Song Peige
Published: June 2021

Until recently, few studies have reported the secular trend and associated factors of hypertension severities and phenotypes in China. In this study, the authors aimed to assess the trend in the prevalence of hypertension according to severity and phenotype in Chinese adults from 1991 to 2015 and to explore potential cardiometabolic factors. From the China Health and Nutrition Survey (CHNS), the authors included 164 682 records of adults (≥18 years). The prevalence of hypertension by severity (stage 1 and stage 2 hypertension) and by phenotype (isolated systolic hypertension [ISH], isolated diastolic hypertension [IDH], and systolic‐diastolic hypertension [SDH]), during 1991‐2015 was explored. The potential effects of demographic, socioeconomic, geographic, and cardiometabolic factors on hypertension severities and phenotypes were assessed by multivariable logistic regression. During 1991‐2015, the overall prevalence of hypertension increased dramatically from 15.7% to 23.3%. For stage 1 and stage 2 hypertension, the age‐standardized prevalence increased from 10.1% to 15.6% and from 5.5% to 7.4%, respectively. For ISH and SDH, the age‐standardized prevalence rates rose from 3.6% to 6.4% and from 6.9% to 10.4%, respectively. Advanced age and medium/high urbanization were positively associated factors, whereas females, higher educational attainments, and residing in Southern China were negatively associated factors. Additionally, general obesity, central obesity, diabetes, and elevated triglyceride levels were linked to ISH, IDH, and SDH. The present study documents an increasing trend in the prevalence of hypertension, including different severities and phenotypes, among Chinese adults over more than two decades. Efforts for the prevention and management of hypertension are in urgent need in China.
Identification of a prognostic metabolic gene signature in diffuse large B‐cell lymphoma
Authors: Wang Huizhong , Shao Ruonan , Liu Wenjian , Tang Hailin , Lu Yue
Published: June 2021

Diffuse large B‐cell lymphoma (DLBCL) is a clinically diverse disease. Given the numerous genetic mutations and variations associated with it, a prognostic gene signature that can be related to the overall survival (OS) is a clinical implication. We used the mRNA expression profiles and clinicopathological data of patients with DLBCL from the Gene Expression Omnibus (GEO) database to identify a metabolism‐related gene signature. Using LASSO regression analysis, a novel 13‐metabolic gene signature was identified to evaluate prognosis. The information gathered was used to construct the nomogram model to improve risk stratification and quantify risk factors for individual patients. We performed gene set enrichment analysis to identify the enriched signalling axes to further understand the underlying biological pathways. The receiver operating characteristic (ROC) curve revealed a satisfactory performance in the training cohorts. The model also showed clinical benefit when compared to the standard prognostic factors (P < .05) in validation cohorts. This study aimed to combine metabolic dysregulation with clinical features of patients with DLBCL to generate a prognostic model that might not only indicate the value of the metabolic microenvironment for prognostic stratification but also improve the decision‐making during individual therapy.
Alopecia areata severity index (AASI): A reliable scoring system to assess the severity of alopecia areata on face and scalp—a pilot study
Authors: Majid Imran , Sameem Farah , Sultan Javeed , Aleem Samia
Published: June 2021

Background

All scoring systems used in Alopecia Areata (AA) focus mainly on scalp and cannot assess the severity or treatment response when AA involves the beard hair, eyebrows, or eyelashes.

Aim

This study describes and assesses the reliability of a new scoring system “Alopecia Areata Severity Index” (AASI) for measuring the severity of AA of scalp, beard, and upper face.

Methods

Scalp hair, beard hair, upper face (eyebrows and eyelashes) were individually assessed and the severity of AA was scored from 0 to 100 (0–50 in case of upper face). AASI score was then calculated as a sum of all these individual scores as AASI = AASI (scalp) + AASI (upper face) + AASI (beard)+. To test the inter‐observer reliability of AASI score, 25 patients with varying severity of AA were scored by 4 trained dermatologists. Repeat scoring was performed after one week to test for intra‐observer reliability.

Results

Excellent inter‐rater, as well as intra‐observer reliability, was observed with Chronbach's alpha value of 0.999 (CI = 0.989–1.000). The intra‐observer correlation coefficient with average measure was 0.999 (CI = 0.990–1.000) with statistically significant F test <0.005.

Conclusion

AASI score is a reliable scoring system to assess the severity of AA in patients with involvement of one or more areas of the body.

Limitations

Sample population belonged to single ethnic group.
Hero or villain? The financial system in the 21st century
Authors: Libich Jan , Lenten Liam
Published: June 2021

The paper reviews the literature and data on the role of finance in socioeconomic development. The evidence suggests that a well‐developed financial system can certainly enhance people's prosperity, but an excessively large and poorly regulated financial system can do more harm than good. We start by making the important distinction between traditional finance (retail banking, insurance, etc.) and modern finance (financial “innovation” and asset trading). We then document that the financialization trend of the past four decades has largely transformed modern finance from “hero” into “villain.” We discuss the driving forces behind this, as well as some policy reform proposals that could in principle make modern finance a hero once again.
Sleep timing and consistency are associated with the standardised test performance of Icelandic adolescents
Authors: Stefansdottir Runa , Rognvaldsdottir Vaka , Chen Kong Y. , Johannsson Erlingur , Brychta Robert J.
Published: June 2021

Sleep has been shown to affect cognitive function in laboratory studies; however, its association to the academic performance of adolescents has largely been demonstrated using self‐reported measures. Studies with objective measures of both sleep and academic performance are limited. The aim of the present study was to determine whether the free‐living sleep quantity, quality, and timing of 15‐year‐old adolescents measured with wrist actiography are associated with their scores on national standardised examinations as an objective measure of academic achievement. We measured sleep with wrist actiography for 1 week in 253 (150 girls) Icelandic adolescents with a mean (SD) age of 15.9 (0.3) years. Multiple linear regression was used to assess associations between sleep parameters and combined standardised examination scores in mathematics, English, and Icelandic obtained from the Icelandic Directorate of Education. We found that students went to bed at 00:49 hours (± 51.8 min) and slept for a mean (SD) of 6.6 (0.7) hr/night, with a median (interquartile range) night‐to‐night variation in sleep duration of 1.2 (0.7) hr and an efficiency of 88.1 (5.3)%. Combined analyses adjusted for sex, demonstrated that both bedtime and night‐to‐night variability in total sleep time were negatively associated with the average score across all topics. Sex‐specific associations did not indicate clear differences between boys and girls. These findings suggest that, in addition to appropriate sleep duration, public health guidance should also highlight the importance of early and consistent sleep schedules to academic achievement for both boys and girls.
Duality for optimal consumption with randomly terminating income
Authors: Davey Ashley , Monoyios Michael , Zheng Harry
Published: June 2021

We establish a rigorous duality theory, under No Unbounded Profit with Bounded Risk, for an infinite horizon problem of optimal consumption in the presence of an income stream that can terminate randomly at an exponentially distributed time, independent of the asset prices. We thus close a duality gap encountered in the Davis‐Vellekoop example in a version of this problem in a Black‐Scholes market. Many of the classical tenets of duality theory hold, with the notable exception that marginal utility at zero initial wealth is finite. We use as dual variables a class of supermartingale deflators such that deflated wealth plus cumulative deflated consumption in excess of income is a supermartingale. We show that the space of discounted local martingale deflators is dense in our dual domain, so that the dual problem can also be expressed as an infimum over the discounted local martingale deflators. We characterize the optimal wealth process, showing that optimal deflated wealth is a potential decaying to zero, while deflated wealth plus cumulative deflated consumption over income is a uniformly integrable martingale at the optimum. We apply the analysis to the Davis‐Vellekoop example and give a numerical solution.
Fragmentation and logical omniscience
Authors: Elga Adam , Rayo Agustín
Published: June 2021

It would be good to have a Bayesian decision theory that assesses our decisions and thinking according to everyday standards of rationality—standards that do not require logical omniscience (Garber, 1983; Hacking, 1967). To that end we develop a “fragmented” decision theory in which a single state of mind is represented by a family of credence functions, each associated with a distinct choice condition (Lewis, 1982; Stalnaker, 1984). The theory imposes a local coherence assumption guaranteeing that as an agent's attention shifts, successive batches of “obvious” logical information become available to her. A rule of expected utility maximization can then be applied to the decision of what to attend to next during a train of thought. On the resulting theory, rationality requires ordinary agents to be logically competent and to often engage in trains of thought that increase the unification of their states of mind. But rationality does not require ordinary agents to be logically omniscient.
Improving Outcomes in Child Care Subsidy Voucher Programs under Regional Asymmetries
Authors: Arora Priyank , Wei Wei , Solak Senay
Published: June 2021

Related to several efforts by governments to attain United Nations Sustainable Development Goals, subsidy vouchers are used to provide monetary support to income‐eligible (IE) families who cannot afford child care. However, IE families are often unable to accept an offered voucher due to an inadequate supply of voucher‐accepting child care providers that best suit their needs. Child Care Resource and Referral agencies (CCR&Rs), which administer these programs, can influence the family's propensity to accept a voucher by investing funds both in outreach to increase the number of voucher‐accepting providers in each region, and in provider services to improve the service delivery to families. This study analyzes how a CCR&R should allocate its limited funds between these two types of activities to ensure equitable access to child care across the different regions of its service area. We show that it might be optimal for the CCR&R to invest more funds in outreach in the region with a lower proportion of IE families. This is especially true when: the external considerations (e.g., public transportation and infrastructure) in that region have a greater impact on a family's acceptance propensity; the marginal return of investment in outreach in that region is higher and abundant funds are available; the socioeconomic distress experienced by families in that region is significantly higher; or a large amount of funds is earmarked for outreach in that region. We contextualize our study for a CCR&R in Massachusetts and conclude that the proposed investment decisions can improve equity outcomes by 7.0%.
Roxadustat on anti‐erythropoietin antibody‐related pure red cell aplasia in the patient with end‐stage renal disease
Authors: Wu Rui , Peng Yanqiang
Published: June 2021

Anti‐erythropoietin antibody‐related pure red cell aplasia (anti‐EPO PRCA) is a severe complication in patients who receive erythropoiesis‐stimulating agents for nephrogenic anemia. The standard therapy is withdrawl of EPO and immunosuppression. Here, we present successful treatment of anti‐EPO PRCA with roxadustat, a hypoxia‐inducible factor prolyl hydroxylase inhibitor. A 39‐year‐old woman with end‐stage renal disease received recombinant human erythropoietin (rhEPO) subcutaneously. Unfortunately, she developed anti‐EPO PRCA and her hemoglobin dropped continuously, whereas she rejected immunosuppressive therapy. The patient failed to achieve spontaneous hematologic recovery with cessation of rhEPO alone, and she became transfusion dependent. Thus, she accepted our advice to try roxadustat for nephrogenic anemia. Surprisingly, after starting roxadustat treatment, her reticulocyte and hemoglobin improved gradually. Four months later, the bone marrow aspiration smear demonstrated a return to normal in erythroid cells. Besides, her anti‐erythropoietin antibody converted to negative. All in all, this case reveals the potential effect of roxadustat on anti‐EPO PRCA.
Similarities between Cognitive Models of Language Production and Everyday Functioning: Implications for Development of Interventions for Functional Difficulties
Authors: Mis Rachel , Giovannetti Tania
Published: June 2021

The loss of the ability to independently complete activities of daily living, such as meal preparation and household chores, is a defining characteristic of clinical dementia; however, minor difficulties in completing everyday activities emerge in the mild cognitive impairment stage, and even healthy older adults exhibit subtle functional difficulties compared to younger adults. These functional difficulties are associated with an array of negative outcomes, including decreased quality of life, higher costs of care, and increased frustration, depression, caregiver burden, and institutionalization. While cognitive models have been proposed to explain the functional deficits seen in dementia and subtler forms of cognitive decline, in contrast to other cognitive disorders such as aphasia, there are essentially no theoretically motivated interventions to address difficulties in everyday functioning. Proposed models of functional impairment share features with cognitive processing models of language, including hierarchical organization of representations and interactive, spreading activation; thus, an examination of aphasia interventions has the potential to inform the development of theoretically motivated interventions for everyday activities. This review first addresses the shared characteristics of cognitive models of everyday function and language, with a focus on linguistic production. Next, we will present aphasia interventions that target single‐word production, sentence production, short‐term memory, and semantics, and discuss their implications for everyday functioning interventions. We conclude with a discussion of limitations of the language‐everyday functioning comparison as well as areas of future research.
Suction and Injection Impacts on Casson Nanofluid With Gyrotactic Micro-organisms Over a Moving Wedge
Authors: Jabeen K. , Mushtaq M. , Akram Muntazir R. M.
Published: June 2021

This work deals with the effects of suction and injection on Casson nanofluid around a moving wedge under the influence of gyrotactic micro-organisms along with viscous and ohmic dissipation. The governing system of highly coupled nonlinear partial differential equations together with assisting boundary conditions is converted by applying suitable similarity transformations, into a set of nonlinear ordinary differential equations. The obtained flow model is solved numerically by bvp4c (matlab) procedure. The accuracy of the flow model under consideration is validated by employing another well-known mathematical technique Runge–Kutta-Fehlberg (RKF) having good agreement while comparing the numerical results obtained by bvp4c for both suction and injection cases. Impacts of various pertinent parameters active in the flow model such as thermophoresis and Brownian motion, moving wedge, magnetic field, viscous and ohmic dissipation are numerically calculated for both suction and injection flow situations and also presented graphically. It is observed that the increase in casson parameter enhances the velocity but declines the density of motile organism, concentration and temperature for suction as well as injection flow case. The impacts of mass transfer rate of gyrotactic micro-organisms, Nusselt and Sherwood numbers for various fluid parameters are numerically presented in tabular form, separately for both suction and injection. One of the important observations of this study is that the suction or injection plays a key role in controlling boundary layer flow and brings stability in the flow. Moreover, rate of heat and mass transfer get enhanced in the existence of gyrotactic micro-organisms. Further, it would be worth mentioning that physical behavior of this flow problem coincides very well with already published literature either graphically or in tabular representation.