bluuebunny/crossref_metadata_2025 huggingface dataset:
NaCl Triggers the Sessile-to-Motile Transition of Bacillus subtilis
Authors: Murugan Prem Anand , Gupta Manish Kumar , Sankar T. Sabari , Chandran Sivasurender , Matheshwaran Saravanan
Published: February 2022

Various chemical cues are known to alter the motile and sessile states of bacteria differentially and, in turn, the formation of biofilms. However, the underlying mechanisms at the cellular and molecular level remain less understood, which severely limits our ability to control biofilms. Here, we systematically studied the effects of NaCl on the dynamics of biofilm formation across various length scales and the associated changes in the regulation of gene expression in an undomesticated natural isolate of Bacillus subtilis. Interestingly, NaCl induced significant changes in the architecture of pellicles and yielded systematic increase in lateral expansion rates of biofilms when grown on an agar surface. At the microscopic level, both in the presence and absence of NaCl, bacteria displayed super-diffusive motion at times lesser than a second. However, at larger delay times, we observed an intriguing NaCl-induced transition from sub-diffusion behavior of individual bacterial cells to rapid diffusion behavior. In addition, NaCl reduced the dynamical heterogeneity of the bacterial cells within the biofilm. The reduced heterogeneity and the increased flagellation in a subpopulation of cells in the presence of NaCl corroborates well with the observed higher motility of the cells. Further, the cellular uptake of NaCl resulted in the downregulation of several genes underlying the formation of biofilms, revealing the role of chemical cues like NaCl in controlling the gene regulatory circuit underlying the sessile to motile transition. Our study opens a new avenue to decipher the competitive advantage provided to the subcellular populations by NaCl due to lifestyle switch in Bacillus subtilis.
Recombinant production of growth factors for application in cell culture
Authors: Venkatesan Meenakshi , Semper Cameron , DiLeo Rosa , Mesa Nathalie , Stogios Peter J , Savchenko Alexei
Published: February 2022

Culturing eukaryotic cells has widespread applications in research and industry, including the emerging field of cell-cultured meat production colloquially referred to as “cellular agriculture”. These applications are often restricted by the high cost of growth medium necessary for cell growth. Mitogenic protein growth factors (GFs) are essential components of growth medium and account for upwards of 90% of the total costs. Here, we present a set of expression constructs and a simplified protocol for recombinant production of functionally active GFs, including FGF-2, IGF-1, PDGF-BB and TGF-β1 in Escherichia coli. Using this expression system, we produced soluble GFs from species including bovine, chicken, and fish. Bioactivity analysis revealed orthologs with improved performance compared to commercially available alternatives. We estimated that the production cost of GFs using our methodology will significantly reduce the cost of cell culture medium, facilitating low-cost protocols tailored for cultured meat production and tissue engineering.
Effect of corporate environmental strategies on firms’ competitiveness, the mediating role of supply chain collaboration
Authors: Owusu Kwateng Kwame , Tetteh Francis Kamewor , Atchulo Hunaisu Ben , Opoku-Mensah Shirley
Published: February 2022

Purpose

The purpose of this is to test the relationship between corporate environmental strategies (CES) and firms’ competitiveness (FC) through collaboration.

Design/methodology/approach

Selected companies from Ghana Club 100 were used as the sample for this study. This study used regression to test the hypothesized paths.

Findings

The results indicated that a unit change in CES results in a 42.7% alteration in FC – all things being equal. Also, as revealed by the study, supply chain collaboration (SCC) is not a significant predictor of FC. However, SCC plays an indirect role in enhancing the relationship between CES and FC. The results showed that CES act as a significant predictor of a company’s collaboration in its supply chain.

Practical implications

The findings will enlighten firms to outline and implement appropriate environmental strategies to sustain their competitive advantage.

Originality/value

This study is very rare in the African context; hence, it adds to the extant literature by providing a contemporary perspective of CES and FC.
Maternities: Dorothea Tanning's Aesthetics of Touch
Authors: Watz Anna
Published: February 2022

This essay explores the concern in Dorothea Tanning's work of the late 1960s and early 1970s with touch, contiguity, and the concept of maternity. In addition to a series of paintings and drawings that connote intimacy and whose titles allude to maternity, during this period Tanning also gave form to a group of soft sculptures, which similarly evince a preoccupation with closeness and touch, and indicate a form of intimacy that challenges the limits of the individual subject. Tanning's engagement with these themes, the essay argues, resonates closely with the feminist poetics developed around the same time by poststructuralist theorists such as Hélène Cixous, Julia Kristeva, and Luce Irigaray. I propose that Irigaray's theories of maternity, subjectivity, and non‐phallocentric language offer a particularly rich set of analytical tools with which to understand Tanning's work. Through establishing the affinities between Tanning and Irigaray, I suggest, we can better understand the intellectual currents that flowed between poststructuralist feminism and surrealist women's work of this period.
Ipriflavone as a non‐steroidal glucocorticoid receptor antagonist ameliorates diabetic cognitive impairment in mice
Authors: Nie Ruifang , Lu Jian , Xu Rui , Yang Juanzhen , Shen Xingyi , Ouyang Xingnan , Zhu Danyang , Huang Yujie , Zhao Tong , Zhao Xuejian , Lu Yin , Qian Minyi , Wang Jiaying , Shen Xu
Published: February 2022

Diabetic cognitive impairment (DCI) is a common diabetic complication with hallmarks of loss of learning ability and disorders of memory and behavior. Glucocorticoid receptor (GR) dysfunction is a main reason for neuronal impairment in brain of diabetic patients. Here, we determined that ipriflavone (IP) a clinical anti‐osteoporosis drug functioned as a non‐steroidal GR antagonist and efficiently ameliorated learning and memory dysfunction in both type 1 and 2 diabetic mice. The underlying mechanism has been intensively investigated by assay against the diabetic mice with GR‐specific knockdown in the brain by injection of adeno‐associated virus (AAV)‐ePHP‐si‐GR. IP suppressed tau hyperphosphorylation through GR/PI3K/AKT/GSK3β pathway, alleviated neuronal inflammation through GR/NF‐κB/NLRP3/ASC/Caspase‐1 pathway, and protected against synaptic impairment through GR/CREB/BDNF pathway. To our knowledge, our work might be the first to expound the detailed mechanism underlying the amelioration of non‐steroidal GR antagonist on DCI‐like pathology in mice and report the potential of IP in treatment of DCI.
The utility of routine screening for anaemia at 36 weeks gestation
Authors: Purcell Samuel , Beckmann Michael
Published: February 2022

Anaemia is a global disease, affecting over 1 billion people worldwide; 12% of Australian women experience anaemia in pregnancy. Professional bodies/institutions recommend screening for and treating anaemia in pregnancy but there is inconsistency in recommendations for when to screen. A ten‐year retrospective analysis was undertaken of 10 518 pregnancies where there was not a specific indication for repeat blood tests. Using a 28‐week haemoglobin (Hb) threshold of ≥110 g/L, seven out of ten could safely forego a routine 36‐week full blood count. Less than 2.5% would then be anaemic at 36 weeks, none of whom would have had a Hb < 90 g/L.
Has EVAR changed the outcomes of ruptured abdominal aortic aneurysms? A decades worth of experience in an Australian Teaching Hospital
Authors: de Boer Madeleine , Shiraev Timothy , Waller Jacob , Qasabian Raffi
Published: February 2022

Background

Ruptured abdominal aortic aneurysms (rAAA) are associated with significant mortality, and equipoise remains as to whether patients managed with endovascular stent grafts (rEVAR) demonstrate better outcomes when compared to traditional open repair (OR). This study sought to examine the outcomes of patients presenting with rAAA to our institution and assess the perioperative outcomes and outpatient mortality of patients over the past decade.

Methods

A retrospective analysis was conducted. Patients treated for rAAA between 2010 and 2019 were identified from a search of the hospital database for ACHI and ICD‐10 codes for repair of AAA. Demographic, operative and post‐operative variables were collected from electronic medical records of identified patients.

Results

Eighty patients were identified, 51 of whom presented with a rAAA. The majority of repairs were rEVARs (59%). Median age was 76 years. Median length of admission to ICU was 3 days, and median length of hospital admission was 10 days. Overall in‐patient mortality was 26%, with rates of 39% at 3 years and 47% at 5 years. No significant difference in outpatient mortality was found in patients undergoing rEVAR compared to OR, with rates of 61% at 5 years compared to 65% at 5 years, respectively (p = 0.8).

Conclusion

Perioperative outcomes of our cohort of patients undergoing endovascular repair compared to open repair for ruptured and symptomatic AAAs are comparable over the past decade. Given equipoise remains between repair methods, further observational studies are required to quantify benefits of OR and endovascular repairs for ruptured and symptomatic AAAs.
Association between ultrasound quality and test performance for HCC surveillance in patients with cirrhosis: a retrospective cohort study
Authors: Chong Nicolas , Schoenberger Haley , Yekkaluri Sruthi , Fetzer David T. , Rich Nicole E. , Yokoo Takeshi , Gopal Purva , Manwaring Carrie , Quirk Lisa , Singal Amit G.
Published: February 2022

Background

Ultrasound visualisation is limited in approximately 20% of patients with cirrhosis undergoing hepatocellular carcinoma (HCC) surveillance; however, it is unknown if impaired visualisation directly impacts test performance. We aimed to evaluate the association between ultrasound visualisation and surveillance test performance.

Methods

We performed a retrospective cohort study among patients with cirrhosis, with or without HCC, who underwent ultrasound‐based surveillance at two large health systems between July 2016 and July 2019. Ultrasound visualisation assessment was recorded by interpreting radiologists using the ultrasound LI‐RADS Visualisation score. We performed logistic regression analyses to evaluate the association between ultrasound visualisation and diagnostic test performance. We assessed sensitivity for HCC detection among ultrasounds performed in the year prior to HCC diagnoses and specificity using ultrasounds in those without HCC.

Results

Among 186 patients with HCC, severely limited visualisation (Vis Score C) on ultrasound prior to HCC diagnosis was associated with increased odds of false‐negative results, that is lower sensitivity (OR 7.94, 95% CI 1.23‐51.16) in multivariable analysis. Ultrasound sensitivity with visualisation scores A or B exceeded 75%, compared to only 27.3% with visualisation score C. Among 2052 cirrhosis patients without HCC, moderate visualisation limitations (Vis score B) were associated with increased odds of false‐positive results (OR 1.60, 1.13‐2.27), although specificity exceeded 95% across all visualisation scores.

Conclusions

Impaired ultrasound visualisation is associated with worse surveillance test performance. Alternative blood‐based biomarkers and imaging strategies are needed for patients at risk for ultrasound‐based surveillance failure.
Investigation of the manufacture development of early Chinese ink in the Western Han dynasty
Authors: Ren Meng , Guan Li , Wang Na , Xu Changqing , Cui Yaping , He Donghong , Wang Changsui , Yang Yimin
Published: February 2022

Chinese ink, generally produced in a stick form, was often like pellets before the Western Han dynasty (202 bce–8 ce) according to literary records and a few archaeological discoveries. However, their composition and manufacture have not been scientifically analysed to date. In this study, the ink pellets roughly dated to 2000 years ago from two royal tombs of the Han dynasty (the Nanyue King's tomb and the Marquis of Haihun's tomb) were analyzed by micro‐/non‐destructive methods, including synchrotron radiation‐based micro‐computed tomography (SR‐μCT), Fourier‐transform infrared spectroscopy (FTIR) and pyrolysis gas chromatography mass spectrometry (Py‐GC/MS). The results reveal that they were made from pine soot, and the production technology of the later Haihun ink was more complex than that of the earlier Nanyue King ink. The microstructure of the ink pellets indicated that some kind of glue should be used in the Haihun ink, which is the earliest case of glue addition. Moreover, plant extracts, including borneol and cedar oil, were detected in the Haihun ink, reflecting another aspect of progress in ink production history. These technical breakthroughs imply that the Western Han dynasty is a critical period for the development of traditional ink manufacture, and the shape transformation of Chinese ink is closely related to the evolution of ink production technology during this specific period.
Measuring the gig economy in Canada using administrative data
Authors: Jeon Sung‐Hee , Liu Huju , Ostrovsky Yuri
Published: February 2022

A rapidly growing literature on informal work increasingly turns to administrative data to document changes in the size of informal economy and to learn more about the characteristics of freelancers, on‐demand/platform workers and similar types of workers commonly referred to as “gig workers.” These studies have established a conceptual link between the work arrangements of gig workers and how these are reported in tax data. We contribute to this literature by introducing a method of identifying gig workers specific to the way work arrangements are reported in the Canadian tax system and estimating the size of the gig economy in Canada using administrative data. Based on our definition, the share of gig workers among all workers rose from 5.5% in 2005 to 8.2% in 2016. Some of this increase coincided with the introduction and proliferation of online platforms. Our analysis highlights gender differences in the trends and characteristics of gig workers. By linking administrative data to 2016 census microdata, we are also able to examine educational and occupational differences in the prevalence of gig workers.
Optimised minus lens overcorrection for paediatric intermittent exotropia: A randomised clinical trial
Authors: Ale Magar Jit B. , Shah Shaheen P. , Webber Ann , Sleep Michael G. , Dai Shuan H.
Published: February 2022

Background

Aim of this study was to evaluate the efficacy of a novel algorithm to customise overminus lens therapy in intermittent exotropia (IXT) based on clinical factors associated with control of the deviation.

Methods

Clinical parameters in IXT vary among individuals. Based on individual's physiological factors, an algorithm was developed. Children aged between 4 and 15 years with IXT were randomised into OML and observation groups. Participants in the observation group were corrected for any significant refractive error. IXT control score, angle of deviation, refraction, axial length and stereopsis were examined at baseline and follow up ranging between 6 and 15 months and compared. Compliance and tolerance to OML was determined by a symptom survey.

Results

The OML power ranged between −1.00D and − 6.25D. Of the total 141 participants (mean age 6.8 ± 2.5 year), 77 were in the OML and 66 were in observation group. IXT control score improved (mean difference − 2.5 ± 1.1; p < 0.001) and angle of deviation reduced (6.9 ± 7.2pd; p < 0.001) significantly in the OML group only. Compliance rate to OML wear was 80%; 90% never or rarely experienced asthenopia symptoms. Slightly greater myopic shift (−0.36 ± 0.53D vs. −0.18 ± 0.55D) and change in axial length (0.17 vs. 0.14 mm) were observed in the OML group, but these differences were not statistically significant.

Conclusions

A customised OML, calculated using this novel algorithm was effective in improving distance control, angle of deviation and stereopsis. Glasses wear was highly tolerable.
Running a paediatric ambulatory sleep service in a pandemic and beyond
Authors: Johnson Jo‐Anne , Burrows Katrina , Trinidade Aaron
Published: February 2022

Objectives

In response COVID‐19, re‐establishing safe elective services was prioritised in the UK. We assess the impact on face‐to‐face hospital attendance, cost and efficiency of implementing a virtual sleep clinic (intervention 1) to screen for children requiring level 3 ambulatory sleep studies using newly implemented ENT‐UK guidelines for obstructive sleep apnoea (OSA) investigation (intervention 2). Objectives: (1) compare the proportion of children attending sleep clinic undertaking a sleep study before and after implementation of these interventions; (2) compare clinic cancellations and first‐time success rates of sleep studies before and after intervention.

Design

Retrospective analysis.

Setting

District general hospital paediatric sleep clinic.

Participants

Children aged 3 months to 16 years referred to sleep clinic by ENT for investigation of OSA over 3 months immediately following interventions (1 June 2020 – 1 September 2020) to the same period in the previous year (1 June 2019 – 1 September 2019).

Main outcome measures

Number of children attending sleep clinic, date of birth/age of children attending sleep clinic, number of children undergoing sleep study, diagnostic outcomes, number of appointment cancellations, number of first‐time sleep study failures.

Results

Post intervention, there was a significant reduction in the proportion of children undertaking ambulatory sleep studies, and nonsignificant reductions in appointment cancellations and in first‐time sleep study failures.

Conclusions

The introduction of the virtual sleep clinic meant that only those children requiring a sleep study attended a face‐to‐face appointment, which led to reduced face‐to‐face attendance. There were also unintended cost‐effectiveness and efficiency benefits, with potential longer‐term learning implications for the wider sleep community and other diagnostic services.
Enhancer RNA: What we know and what we can achieve
Authors: Han Zhenzhen , Li Wei
Published: February 2022

Enhancers are important cis‐acting elements that can regulate gene transcription and cell fate alongside promoters. In fact, many human cancers and diseases are associated with the malfunction of enhancers. Recent studies have shown that enhancers can produce enhancer RNAs (eRNAs) by RNA polymerase II. In this review, we discuss eRNA production, characteristics, functions and mechanics. eRNAs can determine chromatin accessibility, histone modification and gene expression by constructing a ‘chromatin loop’, thereby bringing enhancers to their target gene. eRNA can also be involved in the phase separation with enhancers and other proteins. eRNAs are abundant, and importantly, tissue‐specific in tumours, various diseases and stem cells; thus, eRNAs can be a potential target for disease diagnosis and treatment. As eRNA is produced from the active transcription of enhancers and is involved in the regulation of cell fate, its manipulation will influence cell function, and therefore, it can be a new target for biological therapy.
Impact of race on pancreas transplant outcomes in the current era: It is not all Black and White
Authors: McElroy Lisa , Fridell Jonathan A.
Published: February 2022

The growth in pancreas transplant is driven in part by expansion of indications to include an increasing number of select patients with type 2 diabetes. Two papers in this month's issue of Clinical transplantation specifically investigate this association, and in parallel illustrate the complexity of defining the association of race with pancreas transplant outcomes from different perspectives and illustrate several important concepts related to health equity in organ transplantation.
Governance of organic cocoa production: An analysis of EU regulation through the framework of multilevel governance
Authors: Obeng Godfred Adduow
Published: February 2022

Motivation

While organic agriculture is seen as the best way to achieve sustainable agriculture, the question of how actors in the sector can help remains unresolved. This article seeks to contribute to the global determination to resolve environmental challenges through sustainable agricultural practices grounded in multilevel governance.

Purpose

The article examines existing regulations governing the production and importation of organic cocoa.

Methods and approach

Multilevel governance is used as a theoretical and methodological tool to examine the discursive and material struggles which challenge the promotion of organic cocoa, using a content analysis of European Union (EU) regulations governing the production and importation of organic agricultural produce, including cocoa.

Findings

The article finds that the EU regulations on the production and importation of organic cocoa take a vertical approach to multilevel governance. Organic cocoa farmers, who come lower down in the governance hierarchy, have no role in policy‐making and have simply to follow these regulations.

Policy implications

The regulations seem to ignore the inputs of actors at the lower level in the hierarchy. The absence of organic producers' (farmers) participation in the governance architecture may inhibit conventional farmers from venturing into organic cocoa production.
Sinus venosus defect of the pulmonary vein‐type: An easily missed diagnosis
Authors: Metcalf Meghan K. , Ghosh Reena M. , Harris Matthew A. , Savla Jill J. , Cohen Meryl S.
Published: February 2022

Atrial septal defects are one of the most common forms of congenital heart disease, however sinus venosus communications, particularly pulmonary vein‐type defects, are rare and are easily misdiagnosed. Patients with pulmonary vein‐type sinus venosus defects often present earlier than those with ostium secundum defects with significant right heart dilation. Correct diagnosis has important implications for management. We discuss the clinical courses and review multimodality imaging of three patients correctly diagnosed with pulmonary vein‐type defects after an initial diagnosis of an ostium secundum atrial septal defect, in order to promote understanding of the unique anatomy of this entity.
Emulating a target trial of proton pump inhibitors and dementia risk using claims data
Authors: Ahn Nayeon , Nolde Michael , Günter Alexander , Güntner Florian , Gerlach Roman , Tauscher Martin , Amann Ute , Linseisen Jakob , Meisinger Christa , Rückert‐Eheberg Ina‐Maria , Baumeister Sebastian‐Edgar
Published: February 2022

Background and purpose

Understanding the adverse effects of proton pump inhibitors (PPIs) is important due to their widespread use, but the available evidence for an increased dementia risk amongst patients taking PPIs is inconclusive. The present study aimed to estimate the causal effect of PPIs on the risk of dementia by target trial emulation and time‐varying exposure modeling.

Methods

Using claims data of 2,698,176 insured people of a large German statutory health insurer, a target trial was conceptualized in which individuals aged 40 years and older were classified as PPI initiators or non‐initiators between 2008 and 2018, and were followed until diagnosis of dementia, death, loss to follow‐up or end of study. Incidence of dementia (International Classification of Diseases 10 codes F00, F01, F03, F05.1, G30, G31.0, G31.1, G31.9 and F02.8+G31.82) was defined applying a 1‐year lag window. Weighted Cox models were used to estimate the effect of PPI initiation versus non‐initiation on dementia risk and weighted pooled logistic regression was used to estimate the effect of time‐varying use versus non‐use.

Results

In all, 29,746 PPI initiators (4.4%) and 26,830 non‐initiators (1.3%) were diagnosed with dementia. Comparing PPI initiation with no initiation, the hazard ratio for dementia was 1.54 (95% confidence interval 1.51–1.58). The hazard ratio for time‐dependent PPI use versus non‐use was 1.56 (95% confidence interval 1.50–1.63). Differentiated subtypes, including unspecified dementia, Alzheimer's disease and vascular dementia, showed increased risk by PPI initiation and time‐varying PPI use.

Conclusions

This study suggests that PPI initiation and time‐varying PPI use may increase overall dementia risk.
A vision‐based clinical analysis for classification of knee osteoarthritis, Parkinson's disease and normal gait with severity based on k‐nearest neighbour
Authors: Kour Navleen , Gupta Sunanda , Arora Sakshi
Published: February 2022

The prevalence of musculoskeletal and neurological diseases such as knee osteoarthritis (KOA) and Parkinson's disease (PD) has grown speedily in recent years. The direct impact of these disorders on a person's gait has evoked many researchers to perform their analysis using gait because of its greater feasibility. In this paper, we proposed a framework to accurately classify abnormal considering KOA and PD and normal (NM) gait using a vision‐based (VB) approach. The aim of this study is four‐fold: firstly, a novel VB gait dataset is created and presented; secondly, the segmentation of the region of interest (ROIs) is performed using an improved technique; thirdly gait parameters, that is, spatiotemporal (SPT), linear kinematic (KNM) and additional body motion features are evaluated using statistical methods; fourthly, the classification of KOA, PD and NM subjects has been done based on artificial intelligence or a machine learning technique (MLT), that is, k‐nearest neighbour (KNN) at three severity levels and a comparison is performed with other methods namely support vector machine (SVM), random forest (RF) and linear regression (LR). The results reveal the relevance of considered gait features in this investigation. For classification purposes, the highest results are obtained by our proposed method in classifying the subjects with severity also, achieving an overall accuracy = 0.9006, sensitivity = 0.8554, specificity = 0.9044, and precision = 0.8966 respectively. This study thus successfully presents KOA, PD, and NM gait classification method based on the MLT which may be beneficial for clinicians to perform early diagnosis of such disorders objectively.
Diverging patterns at the forest edge: Soil respiration dynamics of fragmented forests in urban and rural areas
Authors: Garvey Sarah M. , Templer Pamela H. , Pierce Erin A. , Reinmann Andrew B. , Hutyra Lucy R.
Published: February 2022

As urbanization and forest fragmentation increase around the globe, it is critical to understand how rates of respiration and carbon losses from soil carbon pools are affected by these processes. This study characterizes soils in fragmented forests along an urban to rural gradient, evaluating the sensitivity of soil respiration to changes in soil temperature and moisture near the forest edge. While previous studies found elevated rates of soil respiration at temperate forest edges in rural areas compared to the forest interior, we find that soil respiration is suppressed at the forest edge in urban areas. At urban sites, respiration rates are 25% lower at the forest edge relative to the interior, likely due to high temperature and aridity conditions near urban edges. While rural soils continue to respire with increasing temperatures, urban soil respiration rates asymptote as temperatures climb and soils dry. Soil temperature‐ and moisture‐sensitivity modeling shows that respiration rates in urban soils are less sensitive to rising temperatures than those in rural soils. Scaling these results to Massachusetts (MA), which encompasses 0.25 Mha of the urban forest, we find that failure to account for decreases in soil respiration rates near urban forest edges leads to an overestimate of growing‐season soil carbon fluxes of >350,000 Mg C. This difference is almost 2.5 times that for rural soils in the analogous comparison (underestimate of <143,000 Mg C), even though rural forest area is more than four times greater than urban forest area in MA. While a changing climate may stimulate carbon losses from rural forest edge soils, urban forests may experience enhanced soil carbon sequestration near the forest edge. These findings highlight the need to capture the effects of forest fragmentation and land use context when making projections about soil behavior and carbon cycling in a warming and increasingly urbanized world.
Will forest dynamics continue to accelerate throughout the 21st century in the Northern Alps?
Authors: Thom Dominik , Rammer Werner , Laux Patrick , Smiatek Gerhard , Kunstmann Harald , Seibold Sebastian , Seidl Rupert
Published: February 2022

Observational evidence suggests that forests in the Northern Alps are changing at an increasing rate as a consequence of climate change. Yet, it remains unclear whether the acceleration of forest change will continue in the future, or whether downregulating feedbacks will eventually decouple forest dynamics from climate change. Here we studied future forest dynamics at Berchtesgaden National Park, Germany by means of a process‐based forest landscape model, simulating an ensemble of 22 climate projections until the end of the 21st century. Our objectives were (i) to assess whether the observed acceleration of forest dynamics will continue in the future, (ii) to analyze how uncertainty in future climate translates to variation in future forest disturbance, structure, and composition, and (iii) to determine the main drivers of future forest dynamics. We found that forest dynamics continue to accelerate in the coming decades, with a trend towards denser, structurally more complex and more species rich forests. However, changes in forest structure leveled off in the second half of the 21st century regardless of climate scenario. In contrast, climate scenarios caused trajectories of tree species change to diverge in the second half of the 21st century, with stabilization under RCP 2.6 and RCP 4.5 scenarios and accelerated loss of conifers under RCP 8.5. Disturbance projections were 3 to 20 times more variable than future climate, whereas projected future forest structure and composition varied considerably less than climate. Indirect effects of climate change via alterations of the disturbance regime had a stronger impact on future forest dynamics than direct effects. Our findings suggest that dampening feedbacks within forest dynamics will decelerate forest change in the second half of the 21st century. However, warming beyond the levels projected under RCP 4.5 might profoundly alter future forest disturbance and composition, challenging conservation efforts and ecosystem service supply.
Effectiveness of a nurse‐led smartphone‐based self‐management programme for people with poorly controlled type 2 diabetes: A randomized controlled trial
Authors: Jiang Ying , Ramachandran Hadassah Joann , Teo Jun Yi Claire , Leong Foon Leng , Lim Suan Tee , Nguyen Hoang D. , Wang Wenru
Published: February 2022

Aim

To evaluate the effectiveness of a nurse‐led smartphone‐based self‐management programme (NSSMP) on improving self‐efficacy, promoting diabetes self‐care, increasing health‐related quality of life (HRQoL) and decreasing HbA1c, acute complications and unplanned medical consultation for people with poorly controlled type 2 diabetes compared with a nurse‐led diabetic service (NDS).

Design

A two‐arm randomized controlled trial with repeated measures was conducted.

Methods

Participants were recruited from June 2018 to September 2020. Eligible participants were assigned to either the intervention or control group randomly. Participants assigned to intervention group received the 6‐month NSSMP, while those in the control group received existing NDS provided by the study hospital. Outcomes were measured at baseline, and at 3 and 6 months from baseline.

Results

A total of 114 participants were recruited. There were no significant interactions between group and time for all the outcomes except for blood glucose testing activities (F = 4.742, p = .015). Both groups had reduced HbA1c over 6 months. The intervention group had a lower HbA1c than the control group at follow‐ups, but the differences were not statistically significant. None of the participants had acute diabetes complications at follow‐up. Similarly, the differences in the number of unplanned medical consultation at 6‐month follow‐up between two groups were statistically insignificant.

Conclusion

The NSSMP is as effective as existing NDS provided by the study hospital in improving most of the outcomes. NSSMP can liberate valuable time for nurses to provide care to critically ill patients and supports healthcare resource constraints in the current COVID‐19 pandemic.

Impact

The existing diabetes service is labour intensive as nurses are required to deliver education, follow‐up telephone calls to trace blood sugar monitoring and provide therapeutic consultations and necessary referrals. The outbreak of COVID‐19 pandemic has added further strain on the overworked professionals. NSSMP provides an alternative programme that is just as effective, to reduce nurses' workload by delegating them back to the individuals through self‐management strategies. This enables nurses to increase contact time with patients, and individuals to take onus of their disease through increased self‐efficacy, facilitated by technology.

Clinical Trial

This study is registered under clinical registration number NCT03088475.
Addressing the contributions of electricity from biomass in Brazil in the context of the Sustainable Development Goals using life cycle assessment methods
Authors: Souza Nariê Rinke Dias de , Souza Alexandre , Ferreira Chagas Mateus , Hernandes Thayse Aparecida Dourado , Cavalett Otávio
Published: February 2022

The implications of bioenergy deployment for sustainable development goals (SDGs) have been gaining importance worldwide, as bioenergy may contribute to other sustainability impacts besides climate change. Decarbonization of the energy sector can promote major co‐benefits between Climate Action and other SDGs and lead to important tradeoffs. Life cycle assessment (LCA) methods have been proposed to monitor the SDGs as many of them are closely interconnected but often separately studied. A harmonized application of environmental and social LCA can reveal additional relevant aspects of SDGs. This work proposes an interpretation of combined environmental and socioeconomic LCA impacts by comparing the SDG impacts of electricity from sugarcane biomass with other technological options, which altogether represent 96% of the Brazilian electricity matrix. Our analysis indicates that sugarcane electricity has a higher SDGs score (58 points) compared to coal and oil electricity (42 and 47 points, respectively); however, it is lower than natural gas (78). Sugarcane SDG internal normalization related to the biosphere is very close to natural gas, varying only 3–4 points. On the Economy and Society SDG score, sugarcane electricity is also lower than natural gas. Key areas in sugarcane electricity production that need to be enhanced to better contribute to achieving the SDGs include improving its awareness levels, increasing wages and women representation on the workforce, and promoting measures to decrease work accidents as well as the use of fertilizers and pesticides. This approach may help design specific measures for different value chains for them to significantly contribute to the achievement of SDGs.
Porous diaphragm syndrome presenting as hemothorax secondary to hemoperitoneum after laparoscopic myomectomy: A case report and literature review
Authors: Ota Kuniaki , Katagiri Yukiko , Katakura Masafumi , Maemura Toshimitsu , Takahashi Toshifumi , Morita Mineto
Published: February 2022

Porous diaphragm syndrome includes all pleural cavity conditions, including pleural effusion, hemothorax, or pneumothorax, that occur secondary to peritoneal cavity disorders through defects in the diaphragm. In this report, we describe the first known case of porous diaphragm syndrome presenting as hemothorax after laparoscopic myomectomy. A 46‐year‐old nulliparous woman underwent laparoscopic myomectomy for multiple fibroids. Eight hours after surgery, the patient developed exertional dyspnea followed by hemoptysis. Radiological diagnosis revealed massive hemothorax in the right thoracic cavity. Thoracoscopic findings showed the presence of small fenestrae at the center of the right diaphragm, which were repaired thoracoscopically. Hence, quick postoperative diagnosis resulted in successful treatment. In this case, porous diaphragm syndrome is believed to be caused by retention of intraoperative bleed and saline from intra‐abdominal lavage, in the abdominal cavity. Porous diaphragm syndrome is a potential life‐threatening condition that gynecological surgeons should consider in this era of laparoscopic surgery.
Acute odynophagia: A new symptom of COVID‐19 during the SARS‐CoV‐2 Omicron variant wave in Sweden
Authors: Piersiala Krzysztof , Kakabas Lara , Bruckova Anna , Starkhammar Magnus , Cardell Lars Olaf
Published: February 2022

Objective

The objective of this study is to present a novel clinical manifestation of infection with the Omicron variant of the SARS‐CoV‐2 virus affecting mainly young, vaccinated, and healthy adults. We describe a new group of COVID‐19 patients seeking emergency care with symptoms similar to the life‐threatening condition epiglottitis. Here, we present a case series and discuss management.

Methods

We performed a retrospective single‐center case study of patients diagnosed with COVID‐19 who were referred to the Ear, Nose, and Throat Emergency Department (ENT ED) between January 1 and January 23, 2022 with clinical symptoms such as acute odynophagia, severe sore throat, and fever. Ethical approval was obtained from the Swedish Ethical Review Authority (2020‐02579). Informed consent was obtained from all patients included in the study.

Results

Twenty patients meeting inclusion criteria were identified. Fifteen patients were fully vaccinated against COVID‐19. Four patients needed a short hospitalization for their symptoms. The most common diagnoses were COVID‐19‐associated acute viral laryngotracheitis and/or viral pharyngitis. Six patients presented with signs of secondary bacterial infection and were put on antibiotics.

Conclusion

Previous variants of SARS‐CoV‐2 infection affected predominantly the lower respiratory tract and were associated with loss of smell and taste in many patients. The Omicron variant seems to affect predominantly the upper airways and cause acute laryngitis without olfactory dysfunction. In some patients, the clinical manifestation is similar to the symptoms of epiglottitis. In such a case, a prompt examination of the larynx is the gold standard to exclude inflammatory edema in the upper airways. None of the patients described in this study developed epiglottitis. In this study, we discuss the management of acute odynophagia in COVID‐19 patients.
Rurality impacts pain care for female veterans similarly to male veterans
Authors: Hadlandsmyth Katherine , Driscoll Mary A. , Mares Jasmine G. , Au Vanessa , Miell Kelly Richardson , Lund Brian C.
Published: February 2022

Purpose

Rural disparities exist in access to multidisciplinary pain care with higher rates of opioid prescribing in rural regions. Among Veterans, who have prevalent rates of chronic pain, women often evidence complex presentations, multiple comorbidities, and dissatisfaction with care. This study investigates the impact of rurality on pain care for women specifically, and whether this varies from the impact of rurality for men.

Methods

A cohort of Veterans with chronic pain in 2018 was built utilizing VA administrative data. Variables of interest included: demographic, comorbidities, medications, and health care utilization for chronic pain.

Findings

The cohort included 2,261,030 Veterans; 11% (n = 248,977) were women. Significantly fewer women (7%) compared to men (10.7%) received long‐term opioids (adjusted OR = 0.77, 95% CI: 0.75‐0.78). Men, relative to women, were also more likely to receive gabapentinoids and nonsteroidal ant‐inflammatory drugs, whereas women, relative to men, were more likely to receive muscle relaxants and duloxetine. Women were more likely to receive most psychiatric medications. Rural women received more primary care visits compared to urban women (adjusted OR = 1.19, 95% CI: 1.15‐1.22), but fewer women's clinic visits (a subset of primary care visits: adjusted OR = 0.69, 95% CI:0.67‐0.71) and fewer pain specialty care visits (physical therapy, pain clinic, and mental health visits with pain codes). Rural effects did not vary substantially between women and men.

Conclusions

Rural‐dwelling Veterans received more pain and psychiatric medications compared to urban Veterans and fewer specialty care visits. Rural Veterans may benefit from increased access to specialty chronic pain care.
Menstrual cycle length and adverse pregnancy outcomes among women in Project Viva
Authors: Soria‐Contreras Diana C. , Perng Wei , Rifas‐Shiman Sheryl L. , Hivert Marie‐France , Chavarro Jorge E. , Oken Emily
Published: February 2022

Background

Retrospective studies suggest that menstrual cycle length may be a risk marker of adverse pregnancy outcomes, but this evidence is susceptible to recall bias.

Objective

To evaluate the prospective association between menstrual cycle length and the risk of adverse pregnancy outcomes.

Methods

Secondary analysis of 2046 women enrolled in Project Viva at ~10 weeks of gestation and followed through delivery. The exposure was menstrual cycle length. The outcomes included gestational glucose tolerance (gestational diabetes/impaired glucose tolerance [GDM/IGT] and isolated hyperglycaemia), hypertensive disorders of pregnancy (gestational hypertension/preeclampsia), gestational weight gain, birthweight‐for‐gestational age z‐scores (BWZ) categorised in tertiles, preterm birth and birth outcome (live birth and pregnancy loss). We used modified Poisson and multinomial logistic regression adjusted for age, race/ethnicity, parity, age at menarche and pre‐pregnancy body mass index.

Results

Mean (SD) age at enrolment was 32.1 (4.9) years. Most women (74.3%) had a cycle length of 26–34 days (reference group), 16.2% reported short cycles (≤25 days), and 9.5% reported long/irregular cycles (≥35 days/too irregular to estimate). Compared with the reference group, women with short cycles had lower odds of GDM/IGT (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28, 0.89), whereas women with long/irregular cycles had higher odds (OR 1.72, 95% CI 1.04, 2.83). Additionally, women with short cycles had higher odds of having a newborn in the lowest tertile of BWZ (OR 1.45, 95% CI 1.06, 1.98). There was a U‐shaped relation between cycle length and preterm birth with both short (relative risk [RR] 1.49, 95% CI 0.98, 2.27) and long/irregular (RR 2.04, 95% CI 1.30, 3.20) cycles, associated with a higher risk.

Conclusions

Variation in menstrual cycle length may be a risk marker of GDM/IGT, lower birth size and preterm birth and flag women who may benefit from targeted monitoring and care before and during pregnancy.
Parent‐recorded videos of infant spontaneous movement: Comparisons at 3–4 months and relationships with 2‐year developmental outcomes in extremely preterm, extremely low birthweight and term‐born infants
Authors: Kwong Amanda K. L. , Doyle Lex W. , Olsen Joy E. , Eeles Abbey L. , Zannino Diana , Mainzer Rheanna M. , Cheong Jeanie L. Y. , Spittle Alicia J.
Published: February 2022

Background

Infants born extremely preterm (EP, <28‐week gestational age) or extremely low birthweight (ELBW, <1000 g) are at risk of developmental delay and cerebral palsy (CP). The General Movements Assessment (GMA) and its extension, the Motor Optimality Score, revised (MOS‐R) (assesses movement patterns and posture), may help to identify early delays.

Objectives

To compare differences in the MOS‐R scored from parent‐recorded videos between infants born EP/ELBW and term‐born infants, to determine relationships between the MOS‐R and 2‐year cognitive, language and motor outcomes and if any relationships differ between birth groups and the association of the GMA (fidgety) with CP.

Methods

A geographical cohort (EP/ELBW and term‐control infants) was assessed using the MOS‐R inclusive of the GMA at 3‐ to 4‐month corrected age (CA), and the Bayley Scales of Infant and Toddler Development, 3rd edition (Bayley‐III) at 2‐year CA. Differences in mean total MOS‐R between groups, relationships between MOS‐R and 2‐year outcomes and relationships between GMA (fidgety) and CP in infants born EP/ELBW were estimated using linear/logistic regression.

Results

Three hundred and twelve infants (147 EP/ELBW; 165 term) had complete MOS‐R and Bayley‐III assessments. Mean MOS‐R was lower in infants born EP/ELBW than controls (mean difference −3.2, 95% confidence interval [CI] −4.2, −2.3). MOS‐R was positively related to cognitive (β [regression coefficient] = 0.71, 95% CI 0.27, 1.15), language (β = 0.96, 95% CI 0.38, 1.54) and motor outcomes (β = .89, 95% CI 0.45, 1.34). There was little evidence for interaction effects between birth groups for any outcome. Absent/abnormal fidgety movements were related to CP in children born EP/ELBW (risk ratio 5.91, 95% CI 1.48, 23.7).

Conclusions

Infants born EP/ELBW have lower MOS‐R than infants born at term. A higher MOS‐R is related to better outcomes for 2‐year development, with similar relationships in both birth groups. Absent/abnormal fidgety movements are related to CP in EP/ELBW survivors.
Does geographic distance benefit or harm cooperative NPD creativity? A contingency model
Authors: Zhang Feng , Zhu Lei , Lyu Chongchong
Published: February 2022

Existing research widely assumes that geographic distance between partners exerts a negative influence on cooperative outcomes. However, empirical evidence yields contradictory results. To reconcile the current inconsistencies, this study builds on the relational view to develop a conceptual model proposing that geographic distance has a curvilinear relationship with NPD creativity, which is moderated by technical‐level and relational‐level governance mechanisms. The results of hierarchical regressions on a sample of 209 Chinese manufacturing firms show that geographic distance of a firm’s cooperative relationship has a U‐shaped influence on NPD creativity, which is moderated by high levels of IT usage, trust, and shared goals. These findings help to explain the conflicting views on the influence of geographic distance on NPD creativity by demonstrating a curvilinear influence of distance and providing a nuanced understanding of the contingent roles of technical and relational factors as collaborative governance mechanisms affecting the influence of distance. This study contributes to a better understanding of how and under what conditions distance between cooperating firms can confer specific benefits to innovation.