bluuebunny/crossref_metadata_2025 huggingface dataset:
The early association of water irrigation with negative pressure wound therapy does not more efficiently reduce the depth of the alkali infiltration progress into the burn
Authors: Wang Xiaoyan , He Jinqing , Li Zhibin , Zhu Jiayuan , Wu Jun
Published: July 2022

Water irrigation is an efficacious decontaminating method for dermis exposures to corrosive agents and hence has been widely applied to treat especially alkali burns. Nevertheless, once alkali has infiltrated the deep subcutaneous tissue, washing the tissue surface with water irrigation does not attenuate the damage progress. Therefore, significant efforts have been devoted to promising strategies aimed at removing the deeply infiltrated lye. According to a recent report, the negative pressure wound therapy (NPWT) reduces the pH value of the exudate from alkali‐provoked burns thus accelerating wound healing. However, it remains to be ascertained whether or not NPWT coupled with water irrigation, that is, iNPWT, more effectively hinders the alkali injury deepening. In this study, we compared the effectiveness of an early application of water irrigation with or without NPWT in preventing the progressive deepening of the alkali burn in an animal model. Our histological examination results showed no appreciable difference in tissue injury depth, dermal retention, inflammatory cell infiltration, re‐epithelization, and cellular function between iNPWT and water irrigation alone treatments. Thus, our results prove that the more expensive NPWT coupled with water irrigation does not more effectively hinder the alkali's injury deepening. Hence, iNPWT use should be more cautious in clinical practice.
High‐temperature reactive synthesis of the Zr–Ta multiboride with a supercomposite structure
Authors: Demirskyi Dmytro , Suzuki Tohru S. , Yoshimi Kyosuke , Vasylkiv Oleg
Published: July 2022

This study reports the formation of a ceramic composite consisting only of boride phases with an artificially created hierarchical superstructure. Such a composite was formed during the reaction‐driven consolidation process using a mixture of ZrB2, tantalum, and amorphous boron powders. The homogeneity of the reaction among these powders at 1900°C allowed the forming of a highly reproducible and repetitive superstructure where Ta3B4 forms a chain‐like mesh that entraps the ZrB2, ZrB, TaB, and (Zr,Ta)B2 phases. The multiboride ceramic composite exhibited extremely high hardness: 28.6 ± 3.2 or 22.6 ± 0.6 GPa. These were estimated using 98‐ and 196‐N loads, respectively. At 2000°C, the multiboride composite showed a strength of nearly 400 MPa and fractured in an elastic manner at the loading rate of 2.5 mm/min. This level of strength is usually observed for the bulk zirconium diboride at room temperature. The main factors leading to the improvement of the mechanical properties were considered to be the formation of the (Zr,Ta)B2 solid solution as well the composite structure.
Electromechanical properties of paper‐derived potassium sodium niobate piezoelectric ceramics
Authors: Wahl Larissa , Maier Juliana Gabriele , Schmiedeke Samuel , Pham The‐An , Fey Tobias , Webber Kyle Grant , Travitzky Nahum , Khansur Neamul Hayet
Published: July 2022

The small‐signal dielectric and piezoelectric coefficients of paper‐derived sodium potassium niobate, K0.5Na0.5NbO3 (KNN), were compared with those of conventionally prepared samples. Results show similar functional properties of paper‐derived KNN without significantly decreasing the small‐signal piezoelectric coefficient. The structure and microstructure analysis of conventional KNN and paper‐derived KNN did not reveal any significant difference in the crystal structure and grain size. However, the temperature‐dependent inter‐ferroelectric phase transition temperature estimated from the temperature‐dependent dielectric permittivity data revealed a decrease of approximately 18°C for the paper‐derived KNN and is possibly associated with the structural and microstructural defects. This work indicates that optimizing suspension chemistry and sintering conditions will be critical to enhance the functional response of paper‐derived KNN further. Moreover, paper‐derived ceramic processing, a novel and cost‐effective additive manufacturing technology, can be potentially used to fabricate other electroceramics with a wide range of porosities and sizes as well as complex geometries and multilayer structures.
Pragmatism as a philosophical foundation to integrate education, practice, research and policy across the nursing profession
Authors: Dolan Sara , Nowell Lorelli , McCaffrey Graham
Published: July 2022

Aim

A discussion of the philosophy of pragmatism and how it can underpin and integrate nursing education, practice, research and policy across the nursing profession.

Background

Although the concepts of plurality, truth, fallibilism, subjectivity and meliorism have been discussed across foundational philosophical literature, the relation of these concepts across various facets of the nursing profession have not been thoroughly articulated in the nursing literature.

Design

Critical theoretical reflection.

Data sources

In this article, we draw from literature written on the philosophy of pragmatism from 1907 through to 2021.

Implications for nursing

We propose an integrative approach for the nursing profession where education, practice, research and policy speak and contribute to each other through a lens of pragmatism. In this approach, education has a relationship with practice and practice has a direct line to research where nurses on the front lines can engage with pragmatic inquiry. Researchers in return can inform frontline nurses and policymakers of evidence emerging in areas pertinent to practice. These relationships are made possible through integrated knowledge translation by including all stakeholders at every point of knowledge generation. Each facet of the nursing profession is filled with stakeholders of nursing knowledge, who are invested in its utility. Although it requires focused effort to integrate knowledge across the profession, pragmatism calls for action in the face of challenges in hope for a stronger body of nursing knowledge and ultimately profession.

Conclusion

Pragmatism is an apt philosophy to underpin and integrate nursing education, practice, research and policy across the nursing profession.
Slurs and Freedom of Speech
Authors: Rinner Stefan
Published: July 2022

A very common argument against restrictions on hate speech says that since such restrictions curtail freedom of speech, they cause more harm than they prevent. A no less common reply has it that the harms caused by hate speech are sufficiently great to justify legal restrictions on free speech. In ‘Freedom of Expression and Derogatory Words’, West questions a common assumption of both arguments concerning the use of slurs, i.e. that restricting the use of slurs necessarily curtails freedom of speech. According to West, everything that can be said with a slur can be said with its neutral counterpart. Given the psychological and social harms of slurs, this would give us a compelling reason to put legal restrictions on their use. However, in this article, I will argue that, according to the main theories of slurs, slurs can be used to express derogatory information which cannot be expressed by their neutral counterparts. This will leave us with two options when it comes to avoiding the negative effects of slurs: (i) to restrict freedom of speech or (ii) to argue that the derogatory information expressed by slurs is not covered by free speech. Both options will depart significantly from West's argument.
From minimally to maximally invasive; VT ablation in the setting of mechanical aortic and mitral valves
Authors: Hawson Joshua , Kalman Jonathan , Goldblatt John , Anderson Robert D. , Watts Troy , Hardcastle Nick , Siva Shankar , Kumar Saurabh , Lee Geoffrey
Published: July 2022

Double mitral and aortic mechanical valves present an access challenge when planning a ventricular tachycardia (VT) ablation. In this case report, we describe a patient who was considered for stereotactic ablative radiotherapy but was unable to proceed due to unfavorable anatomy making them at high risk of fistula formation. The patient went on to have an endocardial VT ablation via mini‐thoracotomy and transapical access without complication. This case highlights the need for careful consideration when planning treatment for patients with double mechanical valves.
A 15‐year follow‐up study of radiofrequency catheter ablation for atrial fibrillation in patients with tachycardia‐bradycardia syndrome
Authors: Tokuda Michifumi , Yamashita Seigo , Hachisuka Eri , Sato Hidenori , Oseto Hirotsuna , Yokoyama Masaaki , Tokutake Kenichi , Yokoyama Kenichi , Kato Mika , Narui Ryohsuke , Tanigawa Shinichi , Yoshimura Michihiro , Yamane Teiichi
Published: July 2022

Introduction

Catheter ablation for atrial fibrillation (AF) in patients with tachycardia‐bradycardia syndrome (TBS) can be a major therapeutic option to replace permanent pacemaker implantation (PMI). However, the very long‐term outcome of more than 15 years in these patients has not been elucidated.

Methods

From 2002 to 2008, 25 consecutive TBS patients (62 ± 7.9 years old, 68% male) with both AF and symptomatic sinus pauses (>3.0 s) were performed radiofrequency AF ablation. These patients were followed for 15 ± 2.7 years.

Results

The median longest sinus pause before the ablation procedure was 6.0 s (4.4–8.0). Following 1.6± 0.8 ablation procedures, 18 (72%) patients remained free from AF. Three (12%) patients died due to noncardiovascular causes, and seven (28%) patients underwent PMI due to symptomatic sinus pause after recurrent AF in five patients and progression of sinus node dysfunction in two patients. The median duration from the first AF ablation to PMI was 6.3 years (range: 9 days to 11.0 years). Five and two patients required PMI more than 5 and 10 years after the first ablation procedure, respectively.

Conclusion

AF ablation prevented PMI in 72% of TBS patients for a 15‐year follow‐up. However, in consideration of the long duration of PMI, a continuous careful long‐term follow‐up was warranted.
Keloid therapy: A neoteric comparative study
Authors: Khattab Fathia M. , Bessar Hagar , Khater Elsayed M.
Published: July 2022

Background

Keloids are considered disorders of fibroproliferation characterized by accumulation of collagen fibers in hypodermis and dermis, caused by inflammation, surgery, and trauma.

Objectives

The main goal of the study was to approach a better modality for the treatment of keloids by comparing the effects and the side effects of intralesional cryotherapy and intralesional injection of bleomycin.

Methods

This interventional, comparative clinical trial was conducted on 60 cases and was divided equally into the group (A), combined group who were subjected to intralesional bleomycin followed by cryotherapy in the same session, group (B) who were subjected to intralesional injection of bleomycin, and group (C) intralesional cryotherapy. All cases were subjected to clinical examination, complete history taking, dermatological examination, examination, and evaluation of scar lesion using the Vancouver scar scale.

Results

There was a statistically significant decrease in pliability among the combined group. Also, pliability decreased in the bleomycin group and cryotherapy, but this decrease wasn't statistically significant. Our results revealed that there was a statistically significant decrease in lesion height among all the studied groups, but the decrease was more among the combined group.

Conclusion

Intralesional cryotherapy was effective as intralesional bleomycin. Combined therapy was a valid and more effective technique with few adverse effects than either alone for keloids as it achieved a decrease in volumes of scars or accompanied symptoms.
Deep learning in periodontology and oral implantology: A scoping review
Authors: Mohammad‐Rahimi Hossein , Motamedian Saeed Reza , Pirayesh Zeynab , Haiat Anahita , Zahedrozegar Samira , Mahmoudinia Erfan , Rohban Mohammad Hossein , Krois Joachim , Lee Jae‐Hong , Schwendicke Falk
Published: July 2022

Deep learning (DL) has been employed for a wide range of tasks in dentistry. We aimed to systematically review studies employing DL for periodontal and implantological purposes. A systematic electronic search was conducted on four databases (Medline via PubMed, Google Scholar, Scopus, and Embase) and a repository (ArXiv) for publications after 2010, without any limitation on language. In the present review, we included studies that reported deep learning models' performance on periodontal or oral implantological tasks. Given the heterogeneities in the included studies, no meta‐analysis was performed. The risk of bias was assessed using the QUADAS‐2 tool. We included 47 studies: focusing on imaging data (n = 20) and non‐imaging data in periodontology (n = 12), or dental implantology (n = 15). The detection of periodontitis and gingivitis or periodontal bone loss, the classification of dental implant systems, or the prediction of treatment outcomes in periodontology and implantology were major use cases. The performance of the models was generally high. However, it varied given the employed methods (which includes various types of convolutional neural networks (CNN) and multi‐layered perceptron (MLP)), the variety in specific modeling tasks, as well as the chosen and reported outcomes, outcome measures and outcome level. Only a few studies (n = 7) showed a low risk of bias across all assessed domains. A growing number of studies evaluated DL for periodontal or implantological objectives. Heterogeneity in study design, poor reporting and a high risk of bias severely limit the comparability of studies and the robustness of the overall evidence.
Evaluation of sources cited by an exotic animal formulary for supporting drug dosages and reference intervals in mammals
Authors: Golden O. , Kline S. , Tarpalechee L. , Brandão J. , Di Girolamo N.
Published: July 2022

Objectives

Formularies are intended to simplify clinical decision‐making by collecting evidence‐based information on drugs and their dosages. This study assessed the characteristics of sources used to support drug dosages and reference intervals for mammals in a specific exotic animal formulary, and how the sources had changed over five editions.

Methods

Each reference supporting drug dosages and reference intervals in the sections for ferrets, rabbits, rodents, hedgehogs and miniature pigs in all five editions of the formulary was evaluated and classified by two independent investigators in terms of the type of source cited. Univariable and multi‐variable logistic regression models were built to evaluate changes between editions and sections.

Results

In total, 1338 references supporting drug dosages and 180 references supporting reference intervals were included from all editions of the formulary. Primary sources were cited by 525 (39.2%) and 39 (21.7%) of the drug and reference interval references, respectively. For drug dosages, the current edition of the formulary (2018) cited a higher proportion of primary rather than secondary sources compared with the first edition (odds ratios 3.4, 95% confidence interval 2.1 to 5.6), while for reference intervals there were no significant changes between editions. In the current edition of the formulary, the 168 secondary sources cited for drug dosages included 78 (46.4%) textbooks, 63 (37.5%) reviews, 14 (8.3%) personal communications and 7 (4.2%) other formularies.

Clinical Significance

A large proportion of references supporting drug dosages and reference intervals in the evaluated sections cited secondary sources. Although modest improvements have been observed over time, practitioners should be aware that the evidence supporting several drugs and dosages was limited, and assess the information within the formulary critically.
Dynamics of dwarf shrubs in Mediterranean high‐mountain ecosystems
Authors: De Toma Andrea , Carboni Marta , Bazzichetto Manuele , Malavasi Marco , Cutini Maurizio
Published: July 2022

Question

Vegetation around the alpine–treeline ecotone faces changes in both climate and land use (i.e. grazing abandonment). Broad‐scale shrub encroachment is considered an effect of these changes, but it remains unclear how this process is mediated by local‐scale environmental heterogeneity. Our goal is to determine which local‐scale environmental factors shape the spatial distribution and temporal trends of alpine dwarf shrub vegetation dominated by Juniperus communis in Mediterranean mountains.

Location

Three sites in the Central Apennine Mountain Range (Italy): Mt. Terminillo, Mt. Duchessa and Mt. Ernici.

Methods

Combining a set of environmental variables obtained at a fine scale (25‐m resolution) from multi‐year remote sensing imagery and field‐collected vegetation data, we modelled the occurrence and cover of Juniperus communis‐dominated dwarf shrubland, as well as its change over time, as a function of local climate, topography and land use, using linear and generalized mixed effects models.

Results

Over a period of almost 60 years (1954–2012) shrubland occurrence increased by 12% and shrubland cover by 10% in our study sites. Its current distribution and change over time appear to be strongly shaped by the joint influences of fine‐scale topography, above‐ground biomass, land use and microclimate. Shrublands have been favoured locally in areas with harsher alpine environmental constraints and stronger resource limitations.

Conclusions

Our study shows that in the Mediterranean high‐mountain environment J. communis dwarf shrubland acts as a stress‐tolerant pioneer vegetation, occurring in areas that are otherwise sparsely vegetated. Contrary to our expectations, at fine scales, warmer temperatures and the regional decline in grazing did not favour shrub encroachment. Despite increasing overall, J. communis shrubs have little competitive ability to successfully encroach grasslands, and remain restricted to less‐productive areas. Our results confirm that fine‐scale environmental heterogeneity can strongly influence shrub distribution and dynamics, thereby modulating future responses in evolving alpine ecosystems.
The illusion of choice: Organizational dependency and the neutralization of university sexual assault complaints
Authors: Bedera Nicole
Published: July 2022

In response to new regulations, universities have created multiple options for managing sexual misconduct complaints. These options are described as maximizing survivors' autonomy through feminist paradigms of choice. This study uses data from ethnographic observation and 76 interviews with survivors, perpetrators, and administrators to examine whether providing options gave survivors control over their complaints. The findings indicate that survivors found the complicated and vague sexual misconduct policies overwhelming and confusing. As a result, they became dependent on university actors in decision‐making, giving the university more control over survivors' complaints as institutional actors guided survivors to options that required minimal university action.
A reactive oxygen species Ca2+ signalling pathway identified from a chemical screen for modifiers of sugar‐activated circadian gene expression
Authors: Li Xiang , Deng Dongjing , Cataltepe Gizem , Román Ángela , Buckley Christopher R. , Cassano Monte‐Bello Carolina , Skirycz Aleksandra , Caldana Camila , Haydon Michael J.
Published: July 2022

Sugars are essential metabolites for energy and anabolism that can also act as signals to regulate plant physiology and development. Experimental tools to disrupt major sugar signalling pathways are limited. We performed a chemical screen for modifiers of activation of circadian gene expression by sugars to discover pharmacological tools to investigate and manipulate plant sugar signalling.

Using a library of commercially available bioactive compounds, we identified 75 confident hits that modified the response of a circadian luciferase reporter to sucrose in dark‐adapted Arabidopsis thaliana seedlings. We validated the transcriptional effect on a subset of the hits and measured their effects on a range of sugar‐dependent phenotypes for 13 of these chemicals. Chemicals were identified that appear to influence known and unknown sugar signalling pathways.

Pentamidine isethionate was identified as a modifier of a sugar‐activated Ca2+ signal that acts as a calmodulin inhibitor downstream of superoxide in a metabolic signalling pathway affecting circadian rhythms, primary metabolism and plant growth.

Our data provide a resource of new experimental tools to manipulate plant sugar signalling and identify novel components of these pathways.
The Arabidopsis IDD14 transcription factor interacts with bZIP‐type ABFs/AREBs and cooperatively regulates ABA‐mediated drought tolerance
Authors: Liu Jing , Shu Defeng , Tan Zilong , Ma Mei , Guo Ning , Gao Shan , Duan Guangyou , Kuai Benke , Hu Yuxin , Li Shipeng , Cui Dayong
Published: July 2022

The INDETERMINATE DOMAIN (IDD) transcription factors mediate various aspects of plant growth and development. We previously reported that an Arabidopsis IDD subfamily regulates spatial auxin accumulation, and thus organ morphogenesis and gravitropic responses. However, its functions in stress responses are not well defined.

Here, we use a combination of physiological, biochemical, molecular, and genetic approaches to provide evidence that the IDD14 cooperates with basic leucine zipper‐type binding factors/ABA‐responsive element (ABRE)‐binding proteins (ABRE‐binding factors (ABFs)/AREBs) in ABA‐mediated drought tolerance.

idd14‐1D, a gain‐of‐function mutant of IDD14, exhibits decreased leaf water loss and improved drought tolerance, whereas inactivation of IDD14 in idd14‐1 results in increased transpiration and reduced drought tolerance. Altered IDD14 expression affects ABA sensitivity and ABA‐mediated stomatal closure. IDD14 can physically interact with ABF1–4 and subsequently promote their transcriptional activities. Moreover, ectopic expression and mutation of ABFs could, respectively, suppress and enhance plant sensitivity to drought stress in the idd14‐1 mutant.

Our results demonstrate that IDD14 forms a functional complex with ABFs and positively regulates drought‐stress responses, thus revealing a previously unidentified role of IDD14 in ABA signaling and drought responses.
Interactions of the protease inhibitor, ritonavir, with common anesthesia drugs
Authors: Svedmyr Anders , Hack Henrik , Anderson Brian J.
Published: July 2022

The protease inhibitor, ritonavir, is a strong inhibitor of CYP 3A. The drug is used for management of the human immunovirus and is currently part of an oral antiviral drug combination (nirmatrelvir–ritonavir) for the early treatment of SARS‐2 COVID‐19‐positive patients aged 12 years and over who have recognized comorbidities. The CYP 3A enzyme system is responsible for clearance of numerous drugs used in anesthesia (e.g., alfentanil, fentanyl, methadone, rocuronium, bupivacaine, midazolam, ketamine). Ritonavir will have an impact on drug clearances that are dependent on ritonavir concentration, anesthesia drug intrinsic hepatic clearance, metabolic pathways, concentration‐response relationship, and route of administration. Drugs with a steep concentration‐response relationship (ketamine, midazolam, rocuronium) are mostly affected because small changes in concentration have major changes in effect response. An increase in midazolam concentration is observed after oral administration because CYP 3A in the gastrointestinal wall is inhibited, causing a large increase in relative bioavailability. Fentanyl infusion may be associated with a modest increase in plasma concentration and effect, but the large between subject variability of pharmacokinetic and pharmacodynamic concentration changes suggests it will have little impact on an individual patient, especially when used with adverse effect monitoring. It has been proposed that drugs that have no or only a small metabolic pathway involving the CYP 3A enzyme be used during anesthesia, for example, propofol, atracurium, remifentanil, and the volatile agents. That anesthesia approach denies children of drugs with considerable value. It is better that the inhibitory changes in clearance of these drugs are understood so that rational drug choices can be made to tailor drug use to the individual patient. Altered drug dose, anticipation of duration of effect, timing of administration, use of reversal agents and perioperative monitoring would better behoove children undergoing anesthesia.
Political consensus, economic reforms, and democratic transitions in the Middle East: Evidence from voting on Tunisian reform bills
Authors: Jouini Nizar , Ben Akal Manel
Published: July 2022

This study investigates the role of political consensus in accelerating economic reforms and finds a significant negative effect of political consensus on the speed of reform votes in the parliament in Tunisia. We analyze the number of days until a reform bill was adopted in parliament to identify the causal effect of the consensus on accelerating reforms. Using an endogenous treatment effect model and an original database of reforms between 2012 and 2019 in Tunisia, we compare economic and social reforms with political reforms before and after the consensus. We find that political consensus is more likely to delay economic and social reforms than political reforms. This effect is driven mainly by informal mechanisms created by consensus and political instability that prevailed after the agreement. The findings indicate that consensus had a subversive effect on democratic institutions in Tunisia by creating informal processes that reduced public oversight, transparency, and law enforcement.

Related Articles

Gazdar, Kaouthar, Rihab Grassa, and M. Kabir Hassan. 2021. “The Development of Islamic Finance in Tunisia after the Arab Spring: Does Political Islam Matter?” Politics & Policy 49(3): 682–707. https://doi.org/10.1111/polp.12408.

Khodair, Amany Ahmed, Mostafa E. AboElsoud, and Mahmoud Khalifa. 2019. “The Role of Regional Media in Shaping Political Awareness of Youth: Evidence from Egypt.” Politics & Policy 47(6): 1095–24. https://doi.org/10.1111/polp.12335.

Sarquís, David J. 2012. “Democratization after the Arab Spring: The Case of Egypt's Political Transition.” Politics & Policy 40(5): 871–903. https://doi.org/10.1111/j.1747‐1346.2012.00381.x.
Cypress canker: An important disease discovered for the first time on a native South African tree
Authors: Wingfield Michael J. , Marincowitz Seonju , Pham Nam Q. , Roets Francois , Paap Trudy , Wingfield Brenda D. , Aylward Janneke
Published: July 2022

Cypress canker is a branch and stem canker disease of Cupressaceae trees, particularly those in the genera Cupressus and Hesperocyparis. These trees have been planted in many parts of the world as ornamentals and the Seiridium species that cause the disease, consequently, also have an almost global distribution. The taxonomy of Seiridium species causing cypress canker has recently been revised and numerous species are now believed to cause the disease. This study describes, for the first time, cypress canker on the native South African Cupressaceae tree, Widdringtonia nodiflora. The aim was to identify the causal agent and confirm its pathogenicity. Phylogenetic analyses of sequence data for four regions identified the fungus as Seiridium neocupressi, a species previously known only from Australia, New Zealand and Italy. Field inoculations of W. nodiflora branches resulted in distinct cankers within 6 weeks and the fungus could be reisolated from the treated trees. Cypress canker has been known in South Africa for many decades, where it causes a serious disease on nonnative species of Cupressus, but it has never been found on native Cupressaceae. The newly discovered disease caused by a probable alien pathogen is of particular concern because only three species of Widdringtonia occur in South Africa and are important components of the native flora. The two other species, W. wallichii and W. schwartzii, occur in small endemic and threatened populations. The origin of S. neocupressi in South Africa and the relative susceptibility of the three Widdringtonia species, consequently, requires urgent attention.
Fact‐value framework for adjudicating public health policy debates
Authors: Choi Yongjin , Fox Ashley M.
Published: July 2022

That policy should be evidence‐based has become a widely accepted dictum, especially in public health, where evidence‐based policy is strongly emphasized. Yet, most public health controversies arise because there is a conflict over values, which facts alone cannot resolve. Moreover, promoting population‐based health interventions requires the art of political actors to arouse public support. In discussing this tension in public health, studies often frame value conflicts as a barrier to rational decision‐making rather than viewing value considerations as an inherent part of democratic policymaking. We argue that by failing to engage value‐conflicts directly, public health professionals actually stymie evidence translation, which requires public and political buy‐in. We suggest a two‐by‐two framework that seeks to make value concerns more explicit in public health policymaking by breaking out policy controversies and alternatives along two dimensions—factual debates and value debates, creating four categories: uncontested alternatives, value debates, fact debates, and contested alternatives. We demonstrate that the policies that are most likely to be contested are those with a strong value conflict and where the evidence‐base is less solid. We also show that the framework is dynamic: fact and value conflicts are neither static nor inevitable. Rather, interested actors use both fact and value to try to push issues from contested to uncontested and vice‐versa. We conclude by demonstrating how the framework can help specify the role of both value and fact debates in public health policymaking through examples from U.S. public health policy controversies, including during the present COVID‐19 crisis.
Secure attachment and social and personality outcomes: The moderating role of emerging adults’ autobiographical memories of parents
Authors: McGinley Meredith , Muzzy Brieanna M. , Hermann Miracle , Thompson Ross A.
Published: July 2022

Schema‐congruent positive autobiographical memories of past experiences with parents, a legacy of secure attachment, may operate jointly with secure attachment to predict social and personality outcomes. The current study examines the moderating role of emerging adults’ autobiographical memories of parents on the relations between maternal and paternal attachment and self‐regulation, personal distress, and pathological narcissism. Undergraduates (N = 156, 66.7% female, 53.2% White, Mage = 19.3) completed a battery of measures assessing secure attachment, self‐regulation, personal distress, and pathological narcissism (vulnerable and grandiose). Participants were instructed to recall brief autobiographical memories of experiences with their parental figures. Later, they were asked to name the primary emotion associated with each memory. These emotions were coded as positive, negative, or neutral in valence. For the final analysis, a positive emotion index was constructed by subtracting the number of negative memories from the number of positive memories. Regression models simultaneously examining four outcomes (self‐regulation, personal distress, and vulnerable and grandiose narcissism) were examined for both female and male parental figures. Interactions between secure attachment and positive memories were only significant for maternal model outcomes. Secure attachment was positively related to self‐regulation, and negatively related to personal distress and vulnerable narcissism, when more relative positive memories were recalled. Taken together, this study provides support for the continued influence of secure attachment on social and personality outcomes in emerging adulthood. Further, this influence of secure attachment appears buttressed by readily accessible positive (relative to negative) memories of female attachment figures.
Lower Quadrant Swing Biomechanics Identifies Golfers With Increased Risk of Low Back Pain: A Prospective Longitudinal Cohort Study
Authors: Quinn Samantha-lynn , Olivier Benita , McKinon Warrick
Published: July 2022

Context: Elite golfers have a high incidence of low back pain. Recent reviews have emphasized the need for investigation into how to prevent low back pain in golfers, prompting the current study. Design: Prospective longitudinal cohort study. Methods: Forty-one injury-free golfers were included in this study. At baseline, lower quadrant joint angles and club and ball performance were measured while each golfer performed 10 drives. The golfers were then monitored for 6 months and were allocated into 2 groups depending on whether or not they developed low back pain. The initial, baseline kinematic variables of the low back pain group and the uninjured group were then compared. Results: Over the 6-month monitoring period, 17 (41%) of the golfers developed low back pain. At baseline assessment, the low back pain group had 4° less lead ankle dorsiflexion at setup (P = .01; effect size = 0.82), 6° less lead knee flexion at the top of the backswing (P = .05; effect size = 0.64), 6° less lead ankle dorsiflexion at the top of the backswing (P = .01; effect size = 0.82), 6° more trail hip adduction at the top of the backswing (P = .02; effect size = 0.79), 9° more trail knee flexion at impact (P = .05; effect size = −0.64), and 6° more trail hip adduction at the end of follow through (P < .00; effect size = 1.00). Conclusion: Golfers who developed low back pain during the 6-month monitoring period displayed distinct differences in biomechanics at baseline when all golfers were injury free. These biomechanical differences may be considered a precursor to injury. Three-dimensional motion analysis may indicate whether elite golfers are at risk of developing low back pain. Research is needed to assess whether targeted exercise and sports drills aimed at addressing the biomechanical risk factors identified may prevent low back pain in elite golfers.
Heart Rate Variability as a Reliable Biomarker Following Concussion: A Critically Appraised Topic
Authors: Harper Brent A. , Miner Daniel G. , Parcetich Kevin , Price Jamie
Published: July 2022

Clinical Scenario: Recent systematic reviews show conflicting information regarding the effect of concussion on cardiac autonomic function. Controlled aerobic exercise is the most popular intervention for those recovering from a concussion. There is a gap in the literature supporting the utility of objective metrics during exertional return to play protocols and rehabilitation. Clinical Question: Can heart rate variability (HRV) during physical exertion be a reliable biomarker over time for those who suffered a sport-related concussion? Summary of Key Findings: A literature search produced 3 studies relevant to the clinical question. One, a prospective-matched control group cohort study, reported disturbances in HRV during physical exertion in those with a history of concussion, and identified persistent HRV dysfunction after resolution of subjective complaints, return to play, and with multiple concussive events. Second, a cross-sectional cohort study found an HRV difference in those with and without a history of concussion and in HRV related to age and sex. Finally, the prospective longitudinal case–control cohort study did not find sex or age differences in HRV and concluded that, although postconcussion HRV improved as time passed, resting HRV was not as clinically meaningful as HRV during exertional activities. Clinical Bottom Line: There is emerging evidence to support the use of HRV as an observable biomarker, over time, of autonomic function during physical exertion following a sport-related concussion. However, the meaningfulness of HRV data is not fully understood and the utility seems individualized to the level of athlete, age, and sex and, therefore, cannot be generalizable. In order to be more clinically meaningful and to assist with current clinical decision making regarding RTP, a preinjury baseline assessment would be beneficial as an individualized reference for baseline comparison. Strength of Recommendation: Although HRV is not fully understood, currently, there is grade B evidence to support the use of individualized baseline exertional HRV data as comparative objective metric to assess the autonomic nervous system function, over time, following a concussive event.
Multiepitope supramolecular peptide nanofibers eliciting coordinated humoral and cellular antitumor immune responses
Authors: Wu Yaoying , Wen Hanning , Bernstein Zachary J. , Hainline Kelly M. , Blakney Tykia S. , Congdon Kendra L. , Snyder David J. , Sampson John H. , Sanchez-Perez Luis , Collier Joel H.
Published: July 2022

Subunit vaccines inducing antibodies against tumor-specific antigens have yet to be clinically successful. Here, we use a supramolecular α-helical peptide nanofiber approach to design epitope-specific vaccines raising simultaneous B cell, CD8
+
T cell, and CD4
+
T cell responses against combinations of selected epitopes and show that the concurrent induction of these responses generates strong antitumor effects in mice, with significant improvements over antibody or CD8
+
T cell–based vaccines alone, in both prophylactic and therapeutic subcutaneous melanoma models. Nanofiber vaccine–induced antibodies mediated in vitro tumoricidal antibody-dependent cellular cytotoxicity (ADCC) and antibody-dependent cellular phagocytosis (ADCP). The addition of immune checkpoint and phagocytosis checkpoint blockade antibodies further improved the therapeutic effect of the nanofiber vaccines against murine melanoma. These findings highlight the potential clinical benefit of vaccine-induced antibody responses for tumor treatments, provided that they are accompanied by simultaneous CD8
+
and CD4
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responses, and they illustrate a multiepitope cancer vaccine design approach using supramolecular nanomaterials.
Tunneling nanotubes provide a route for SARS-CoV-2 spreading
Authors: Pepe Anna , Pietropaoli Stefano , Vos Matthijn , Barba-Spaeth Giovanna , Zurzolo Chiara
Published: July 2022

Neurological manifestations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represent a major issue in long coronavirus disease. How SARS-CoV-2 gains access to the brain and how infection leads to neurological symptoms are not clear because the principal means of viral entry by endocytosis, the angiotensin-converting enzyme 2 receptor, are barely detectable in the brain. We report that human neuronal cells, nonpermissive to infection through the endocytic pathway, can be infected when cocultured with permissive infected epithelial cells. SARS-CoV-2 induces the formation of tunneling nanotubes (TNTs) and exploits this route to spread to uninfected cells. In cellulo correlative fluorescence and cryo–electron tomography reveal that SARS-CoV-2 is associated with TNTs between permissive cells. Furthermore, multiple vesicular structures such as double-membrane vesicles, sites of viral replication, are observed inside TNTs between permissive and nonpermissive cells. Our data highlight a previously unknown mechanism of SARS-CoV-2 spreading, likely used as a route to invade nonpermissive cells and potentiate infection in permissive cells.
Interleukin-6–dependent epithelial fluidization initiates fibrotic lung remodeling
Authors: Stancil Ian T. , Michalski Jacob E. , Hennessy Corinne E. , Hatakka Kristina L. , Yang Ivana V. , Kurche Jonathan S. , Rincon Mercedes , Schwartz David A.
Published: July 2022

Chronic disease results from the failure of tissues to maintain homeostasis. In the lung, coordinated repair of the epithelium is essential for preserving homeostasis. In animal models and human lung disease, airway epithelial cells mobilize in response to lung injury, resulting in the formation of airway-like cysts with persistent loss of functional cell types and parenchymal architecture. Using live-cell imaging of human lung epithelial cultures and mouse precision-cut lung slices, we demonstrated that distal airway epithelia are aberrantly fluidized both after injury and in fibrotic lung disease. Through transcriptomic profiling and pharmacologic stimulation of epithelial cultures, we identified interleukin-6 (IL-6) signaling as a driver of tissue fluidization. This signaling cascade occurred independently of canonical Janus kinase (JAK)–signal transducer and activator of transcription (STAT) signaling but instead was dependent on a downstream SRC family kinase (SFK)–yes-associated protein (YAP) axis. Airway epithelial-fibroblast cocultures revealed that the fibrotic mesenchyme acts as a source of IL-6 family cytokines, which drive airway fluidization. Inhibition of the IL-6–SFK–YAP cascade was sufficient to prevent fluidization in both in vitro and ex vivo models. Last, we demonstrated a reduction in fibrotic lung remodeling in mice through genetic or pharmacologic targeting of IL-6–related signaling. Together, our findings illustrate the critical role of airway epithelial fluidization in coordinating the balance between homeostatic lung repair and fibrotic airspace remodeling.
Ubiquitination of SARS-CoV-2 NSP6 and ORF7a Facilitates NF-κB Activation
Authors: Nishitsuji Hironori , Iwahori Satoko , Ohmori Mariko , Shimotohno Kunitada , Murata Takayuki
Published: July 2022

The detailed molecular basis of the induction of proinflammatory cytokines and chemokines by SARS-CoV-2 is unclear, although such induction is clearly related to the severity of COVID-19. Here, we show that SARS-CoV-2 NSP6 and ORF7a lead to NF-κB activation through associations with TAK1.
The Effects of Quinone Imine, a New Potent Nitrification Inhibitor, Dicyandiamide, and Nitrapyrin on Target and Off-Target Soil Microbiota
Authors: Papadopoulou Evangelia S. , Bachtsevani Eleftheria , Papazlatani Christina V. , Rousidou Constantina , Brouziotis Antonios , Lampronikou Eleni , Tsiknia Myrto , Vasileiadis Sotirios , Ipsilantis Ioannis , Menkissoglu-Spiroudi Urania , Ehaliotis Constantinos , Philippot Laurent , Nicol Graeme W. , Karpouzas Dimitrios G.
Published: July 2022

NIs could improve N use efficiency and decelerate N cycling. Still, we know little about their activity on the distinct AOM groups and about their effects on off-target soil microorganisms.
Incipient collision of the Rae and Slave cratons at ca. 1.95 Ga
Authors: Cutts Jamie , Dyck Brendan
Published: July 2022

Incipient collision between the Rae and Slave cratons represents a critical initial stage in the final assembly of the composite Laurentian craton. However, the timing and kinematics of this event remain poorly constrained. Here, we integrate phase equilibria modeling and Lu-Hf garnet and U-Pb monazite and zircon petrochronology to precisely date the timing of peak metamorphism along the Great Slave Lake shear zone, the central segment of the western Rae cratonic margin that was the locus of terminal Rae-Slave collision. Zircon and monazite U-Pb ages broadly constrain prograde-to-peak metamorphism to 1933–1913 Ma, whereas the timing of upperamphibolite facies peak metamorphism (0.8–1.0 GPa and 750–800 °C) is best constrained by two garnet Lu-Hf ages of 1931 ± 12 and 1917 ± 6 Ma. Our results highlight the inherent strengths and limitations of garnet, monazite, and zircon petrochronology in the context of dating Paleoproterozoic-aged metamorphism. Based on the timing of crustal thickening constrained by Lu-Hf garnet geochronology, we posit that the Slave craton first collided with the western Rae margin at ca. 1950 Ma. Taken together with prior constraints on the timing of metamorphism elsewhere along the western Rae margin, we propose incipient collision was followed by the northwards zippering of the margins and the eventual ~500 km of dextral translation of the Slave craton along the Great Slave Lake shear zone.
Instabilities, Bifurcations, and Nonlinear Dynamics in Two-Dimensional Generalizations of Kolmogorov Flow
Authors: Wertgeim I. I. , Zaks M. A. , Sagitov R. V. , Sharifulin A. N.
Published: July 2022

A family of two-dimensional flows of viscous incompressible fluid in a plane rectangular region with periodic boundary conditions (two-dimensional torus) is considered. The flows are induced by a force, periodic in the two spatial variables and independent of time. In the particular case of the harmonic dependence of the force on one coordinate and in the absence of average flow the well-known Kolmogorov flow is realized. In the general two-dimensional case restructurings of the stationary solutions of the Navier–Stokes equations are investigated numerically and the stability domains are determined in the space of governing physical and geometric parameters, namely, Reynolds numbers, force amplitudes, and spatial dimensions of periodicity cells. It is found that in a square region, whose side is equal to the spatial period of the external force, the main stationary flow preserves its stability against variation in the force amplitude and the Reynolds number. Contrariwise, in the cells, whose sides include several force periods, the variation in the parameters destabilizes the stationary flow. Stationary and self-oscillatory nonlinear secondary flows are considered. The effect of nonstationarity on the Lagrangian dynamics is discussed: the mechanisms of transition to the chaotic advection of passive particles depend on the commensurability of the Reynolds numbers characterizing the average flow in mutually perpendicular directions.
Reconstruction of a knee defect in a morbidly obese patient with a pedicled reverse anterolateral thigh flap
Authors: Bøkset Mari Irgens , Söderman Martin , Thomsen Jørn Bo , Sørensen Jens Ahm
Published: July 2022

The anterolateral thigh (ALT) flap is widely used in the reconstruction of a variety of soft tissue defects. Descriptions of patients with severe obesity in the literature are scarce. We report a case where a reverse pedicled fasciocutaneous ALT flap was successfully used for resurfacing of a knee defect measuring 12×6 cm in a patient with a body mass index (BMI) of 47.3. The flap was supercharged to the greater saphenous vein to optimise flap survival. Reconstruction of the soft tissue of the knee was achieved as planned. There were no flap or donor site complications.
Space Medicine: Inspiring a new generation of physicians
Authors: Mian Areeb , Aamir Mian Minahel
Published: July 2022

Space medicine is critical in enabling safe human exploration of space. The discipline focuses on supporting human survival, health, and performance in the austere environment of space. It is set to grow ever more important as significant transitions in the standard of space operations in the suborbital, low earth orbit (LEO) and beyond LEO domains will take place in the coming years. NASA along with their international and commercial partners have committed to returning to the Moon through the Artemis missions in this decade with the aim of achieving a permanent sustainable human presence on the lunar surface. Additionally, the development of reusable rockets is set to increase the number and frequency of humans going to space by making space travel more accessible. Commercial spaceflight and missions beyond LEO present many new challenges which space medicine physicians and researchers will need to address. Space medicine operates at the frontier of exploration, engineering, science and medicine. Aviation and Space Medicine (ASM) is the latest specialty to be recognised by the Royal College of Physicians and the General Medical Council in the UK. In this paper, we provide an introduction to space medicine, review the effects of spaceflight on human physiology and health along with countermeasures, medical and surgical issues in space, the varied roles of the ASM physician, challenges to UK space medicine practice and related research, and finally we explore the current representation of space medicine within the undergraduate curriculum.

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