bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered neurovascular coupling in thyroid‐associated ophthalmopathy: A combined resting‐state fMRI and arterial spin labeling study
Authors: Chen Wen , Hu Hao , Chen Huan‐Huan , Liu Hu , Wu Qian , Chen Lu , Zhou Jiang , Jiang Wen‐Hao , Xu Xiao‐Quan , Wu Fei‐Yun
Published: September 2022

Besides the well‐documented ophthalmic manifestations, thyroid‐associated ophthalmopathy (TAO) is believed to be related to emotional and psychological abnormalities. Given the previous neuroimaging evidence, we hypothesized that TAO patients would have altered neurovascular coupling associated with clinical‐psychiatric disturbances. This study was to investigate neurovascular coupling changes in TAO by combining resting‐state functional magnetic resonance imaging (rs‐fMRI) and arterial spin labeling (ASL) techniques. Amplitude of low‐frequency fluctuation (ALFF) was calculated from rs‐fMRI, and cerebral blood flow (CBF) was computed from ASL in 37 TAO patients and 21 healthy controls (HCs). Global neurovascular coupling was assessed by across‐voxel CBF‐ALFF correlation, and regional neurovascular coupling was evaluated by CBF/ALFF ratio. Auxiliary analyses were performed using fractional ALFF (fALFF) and regional homogeneity (ReHo) as rs‐fMRI measures. Compared with HCs, TAO patients showed significantly reduced global CBF‐ALFF coupling. Moreover, TAO patients exhibited decreased CBF/ALFF ratio in the left lingual gyrus (LG)/fusiform gyrus (FFG), and increased CBF/ALFF ratio in the bilateral precuneus (PCu). In TAOs, CBF/ALFF ratio in the left LG/FFG was positively correlated with visual acuity, while CBF/ALFF ratio in the bilateral PCu was negatively correlated with Montreal Cognitive Assessment score. The auxiliary analyses showed trends of reduced global neurovascular coupling (i.e., CBF‐fALFF correlation and CBF‐ReHo correlation), as well as significant altered regional neurovascular coupling (i.e., CBF/fALFF ratio and CBF/ReHo ratio) in several brain regions. These findings indicated that TAO patients had altered neurovascular coupling in the visual and higher‐order cognitive cortices. The neurovascular decoupling might be a possible neuropathological mechanism of TAO.
Molecular examination of the endogenous opioid system in rhesus macaque monkeys with self‐injurious behavior
Authors: Jackson Marques , Foret Brittany L. , Fontenot Jane , Hasselschwert Dana , Smith Josh , Romero Emily , Smith Karen Müller
Published: September 2022

Self‐injurious behavior (SIB) can lead to serious injury and occurs in approximately 1%–4% of the adult population, with higher incidences in adolescent and institutionalized populations, as well as in children with developmental disorders such as Autism. SIB also spontaneously occurs in a low percentage of captive monkeys. Rhesus macaque (Macaca mulatta) monkeys are evolutionarily and physiologically similar to humans, share 93% genetic sequence similarity to humans, and have long been used as testing subjects for vaccine and clinical trials. Previous studies hypothesized that altered endogenous opioid expression occurs in the brains of individuals and animals that self‐injure. We examined the regional mRNA expression of opioid signaling genes in sixteen rhesus macaques that exhibited SIB and eight sex‐ and age‐ matched controls. The brain regions examined are linked to reward reinforcement and stress adaptation including the hypothalamus, orbital frontal cortex, nucleus accumbens, hippocampus, caudate, and the amygdala. We found decreased μ‐opioid receptor (OPRM1) in the amygdala of monkeys with SIB, and reduced prodynorphin (PDYN) in the hypothalamus. Our data suggest dysfunction in the regulation of opioid peptide precursors and calls for further investigation of the endogenous opioid system in SIB.
Dipole response of early‐summer rainfall in eastern China to 1.5 and 2.0°C global warming
Authors: Lei Yadong , Yue Xu , Liu Zhengyu
Published: September 2022

The 2015 Paris Agreement set the goal of pursuing efforts to keep global warming to 1.5°C above the pre‐industrial level. It remains unclear how the early‐summer rainfall in China responds to moderate warming. Here, we investigate the changes in June rainfall in eastern China by 1.5 and 2.0°C warming using the ensemble projection from Half a degree Additional warming, Prognosis and Projected Impacts (HAPPI) dataset. Results reveal a dipole response in the June rainfall with the significant increase in southeastern China but a slight decrease in northeastern China at 1.5 and 2.0°C warming compared to the present day. The moisture budget analysis indicates that the dipole rainfall response is caused predominantly by the dynamic response in the anomalous circulation and in turn moisture transport. Compared to the present day, the upper‐tropospheric temperature is significantly enhanced in the tropics but decreased in middle latitudes at the 1.5 and 2.0°C warming. The enhanced poleward temperature gradient strengthens zonal wind on the south of the East Asian westerly jet, leading to a southward displacement of jet. As a result, an anomalous upward motion is reinforced over the north of 30°N with an anomalous downward motion over the south of 30°N, leading to a dipole rainfall anomaly in eastern China. In addition, the warming also induces a thermodynamic response with increased moisture and in turn rainfall across eastern China, further enhancing rainfall in southeastern China, but weakening the decreased rainfall in northeastern China.
Textbook oncologic outcomes and regionalization among patients undergoing hepatic resection for intrahepatic cholangiocarcinoma
Authors: Munir Muhammad M. , Alaimo Laura , Moazzam Zorays , Endo Yutaka , Lima Henrique A. , Shaikh Chanza , Ejaz Aslam , Beane Joal , Dillhoff Mary , Cloyd Jordan , Pawlik Timothy M.
Published: September 2022

Background and Objectives

Textbook oncologic outcome (TOO) and its association with regionalization of care for intrahepatic cholangiocarcinoma (ICC) have not been evaluated.

Methods

We identified patients who underwent hepatic resection for ICC between 2004 and 2018 from the National Cancer Database. Facilities were categorized by annual hepatectomy volume for ICC. TOO was defined as no 90‐day mortality, margin‐negative resection, no prolonged hospitalization, no 30‐day readmission, receipt of appropriate adjuvant therapy, and adequate lymphadenectomy. Multivariable regression was used to evaluate the association between annual hepatectomy volume and TOO.

Results

A total of 5359 patients underwent liver resection for ICC. TOO was achieved in 11.2% (n = 599) of patients. Inadequate lymphadenectomy was the largest impediment to achieving TOO. After adjusting for patient, pathologic, and facility characteristics, high volume facilities had 67% increased odds of achieving TOO (Ref.: low volume; high volume: odds ratio 1.67, 95% confidence interval: 1.24–2.25; p < 0.001). Patients treated at high‐volume centers who achieved a TOO had better overall survival (OS) versus patients treated at low‐volume facilities (low volume vs. high volume; median OS, 47.3 vs. 71.1 months, p < 0.05).

Conclusions

A composite oncologic measure, TOO, provides a comprehensive insight into the performance of liver resection and regionalization of surgical care for ICC.
Managing for red‐cockaded woodpeckers is more complicated under climate change
Authors: Lucash Melissa S. , Weiss Shelby , Duveneck Matthew J. , Scheller Robert M.
Published: September 2022

Open pine (Pinusspp.) savannas are home to the federally endangered red‐cockaded woodpecker (Leuconotopicus borealis). Frequent fires are essential for maintaining the open canopy and wiregrass (Aristida stricta) groundcover preferred by these woodpeckers, which face ongoing threats from climate change, hurricanes, and land use change. Our objective was to project future changes in habitat for red‐cockaded woodpeckers at the Fort Bragg military installation in North Carolina, USA, under different scenarios of climate and disturbances from 2000 to 2050. We used a spatially explicit, forest simulation model (LANDIS‐II) to simulate climate change, hurricanes, and forest management (prescribed fire, thinning, harvesting). We examined the relative risks of climate change and hurricanes to red‐cockaded woodpecker habitat and quantified the capacity of management practices to promote their habitat, given hurricanes and projected changes in climate. Climate change had little direct effect on red‐cockaded woodpecker habitat, but it reduced the capacity of managers to use prescribed fire, as currently practiced. This effect became more pronounced in the scenario with low prescribed fire frequency, which caused a 10% decline in habitat under climate change. Hurricanes had a more substantial impact on red‐cockaded woodpecker habitat than climate change or management, causing an average decline in extent by 41% compared to scenarios without hurricanes. Our work suggests that hurricanes pose a greater threat to red‐cockaded woodpecker habitat than climate change, but despite these threats, overall habitat will likely still increase until 2050, which bodes well for this endangered species. Deployment of prescribed burning became more challenging under climate warming, and if this trend continues, it may threaten red‐cockaded woodpecker conservation efforts over the next century.
Local differences in maximum temperature determine water use among desert bighorn sheep populations
Authors: Glass Danielle M. , Prentice Paige R. , Evans Ashley D. , Schmitz Oswald J.
Published: September 2022

The availability of surface water is assumed by many wildlife managers to be important to desert bighorn sheep (Ovis canadensis nelsoni). Yet scientific evidence suggests bighorn sheep populations can sometimes fulfill their water requirements from forage alone. To investigate how water use changes with environmental conditions, we analyzed the surface water use and movement patterns of 4 desert bighorn populations across a range of meteorological conditions in the Mojave Desert in California, USA. We compared ground‐based weather data to the daily use of surface water sources for 65 known individuals, and examined the movement patterns of 18 of these individuals with global positioning system collars in relation to visitation to surface water sources. Maximum daily temperature most closely predicted the percent of bighorn visiting water daily, with visitation increasing approximately 30% between 30°C and 40°C. Individual animals switched from a tortuous foraging movement to directed movement when accessing surface water. Day length, maximum daily temperature, minimum daily temperature, solar radiation, and the interaction between day length and minimum temperature explained the distance desert bighorn were located from the nearest water source. Our results indicate that local meteorological conditions are important determinants of desert bighorn surface water use, and that managers should monitor water sources when the maximum daily temperature exceeds 35°C. Individual animals meet their water requirements with surface water under hot and dry conditions, likely because it is temporally or energetically efficient given their other resource needs.
Geobacter sulfurreducens metabolism at different donor/acceptor ratios
Authors: Frühauf‐Wyllie Hanna Marianne , Holtmann Dirk
Published: September 2022

Geobacter species have great application potential in remediation processes and electrobiotechnology. In all applications, understanding the metabolism will enable target‐oriented optimization of the processes. The typical electron donor and carbon source of the Geobacter species is acetate, while fumarate is the usual electron acceptor. Here, we could show that depending on the donor/acceptor ratio in batch cultivation of Geobacter sulfurreducens different product patterns occur. With a donor/acceptor ratio of 1:2.5 malate accumulated as an intermediate product but was metabolized to succinate subsequently. At the end of the cultivation, the ratio of fumarate consumed and succinate produced was approximately 1:1. When fumarate was added in excess, malate accumulated in the fermentation broth without further metabolization. After the addition of acetate to stationary cells, malate concentration decreased immediately and additional succinate was synthesized. Finally, it was shown that also resting cells of G. sulfurreducens could efficiently convert fumarate to malate without an additional electron donor. Overall, it was demonstrated that by altering the donor/acceptor ratio, targeted optimization of the metabolite conversion by G. sulfurreducens can be realized.
Upstream collusion and corporate social responsibility in downstream competition
Authors: Ying Bin , Wang Leonard F. S. , Zhang Qidi
Published: September 2022

This paper analyzes the impacts of downstream CSR on upstream tacit collusion. Considering an infinitely repeated game with trigger strategy punishment, we find that how consumer‐oriented CSR affects the stability of upstream collusion basically hinges on the downstream competition modes. Specifically, CSR behavior facilitates (hinders) upstream collusion under downstream quantity (price) competition. For given degree of CSR and product substitutability, upstream collusion is always less stable under downstream price competition. In addition, higher degree of product substitutability obstructs collusion, regardless of downstream competition mode.
Muscle/musculocutaneous versus fasciocutaneous free flap reconstruction in the lower extremity: A systematic review and meta‐analysis
Authors: Shimbo Keisuke , Kawamoto Haruka , Koshima Isao
Published: September 2022

Background

Free flaps for soft tissue coverage of the lower extremity can be broadly divided into muscle/musculocutaneous and fasciocutaneous flaps. The purpose of this systematic review and meta‐analysis was to assess their different post‐operative outcomes.

Methods

A systematic search was performed in PubMed, Scopus, and the Web of Science from their inception to February 2022. Non‐randomized comparative studies, which describe any post‐operative outcome of muscle/musculocutaneous and fasciocutaneous free flaps reconstruction in the lower extremity were included. Articles with duplicate titles, editorials, review articles, case series, case reports, and publications lacking an abstract, those reporting pediatric patients, those describing only muscle/musculocutaneous or fasciocutaneous free flaps, those with incomplete or incomparable post‐operative outcomes, and studies involving <10 muscle/musculocutaneous or fasciocutaneous free flaps were excluded. A comparative meta‐analysis was conducted on muscle/musculocutaneous and fasciocutaneous free flaps outcomes, comprising vascular thrombosis, partial or complete flap necrosis, infection, donor‐site complications, non‐union, and primary or recurrent osteomyelitis. The fixed‐effects meta‐analysis model was used when low heterogeneity (I2 < 50%) was identified.

Results

Twenty‐two articles with a total of 2711 flaps (1584 muscle/musculocutaneous flaps and 1127 fasciocutaneous flaps) were included in the qualitative and quantitative assessment. The rates of any flap necrosis (12.0% vs. 7.4%; p = 0.007) and donor‐site complications (16.7% vs. 6.7%; p < 0.0001) were significantly higher for muscle/musculocutaneous flaps than for fasciocutaneous flaps. There were no significant differences in the rates of vascular thrombosis (10.5% vs. 10.7%; p = 0.98), complete flap necrosis (6.2% vs. 4.7%; p = 0.30), infection (19.4% vs. 14.7%; p = 0.18), non‐union (18.9% vs. 14.8%; p = 0.33), and primary or recurrent osteomyelitis (14.7% vs. 12.4%; p = 0.69).

Conclusion

This meta‐analysis revealed no significant difference in long‐term post‐operative outcomes, but suggested that fasciocutaneous flaps should be preferred to avoid flap necrosis and donor‐site complications.
An eco‐epidemiological model with general functional response of predator to prey
Authors: de Jesus Lopo F. , Silva César Marques , Vilarinho Helder
Published: September 2022

We consider a nonautonomous eco‐epidemiological model with general functions for predation on infected and uninfected preys as well as general functions associated to the vital dynamics of the susceptible prey and predator populations. We obtain persistence and extinction results for the infected prey based on assumptions on auxiliary systems constructed from the disease‐free system. We moreover consider an iterative process that can improve the extinction results. We apply our results to general eco‐epidemiological models that include several examples existent in the literature.
LiSNet: An artificial intelligence ‐based tool for liver imaging staging of hepatocellular carcinoma aggressiveness
Authors: Sun Shu Wen , Xu Xun , Liu Qiu Ping , Chen Jie Neng , Zhu Fei Peng , Liu Xi Sheng , Zhang Yu Dong , Wang Jie
Published: September 2022

Background

Presurgical assessment of hepatocellular carcinoma (HCC) aggressiveness can benefit patients’ treatment options and prognosis.

Purpose

To develop an artificial intelligence (AI) tool, namely, LiSNet, in the task of scoring and interpreting HCC aggressiveness with computed tomography (CT) imaging.

Methods

A total of 358 patients with HCC undergoing curative liver resection were retrospectively included. Three subspecialists were recruited to pixel‐wise annotate and grade tumor aggressiveness based on CT imaging. LiSNet was trained and validated in 193 and 61 patients with a deep neural network to emulate the diagnostic acumen of subspecialists for staging HCC. The test set comprised 104 independent patients. We subsequently compared LiSNet with an experience‐based binary diagnosis scheme and human–AI partnership that combined binary diagnosis and LiSNet for assessing tumor aggressiveness. We also assessed the efficiency of LiSNet for predicting survival outcomes.

Results

At the pixel‐wise level, the agreement rate of LiSNet with subspecialists was 0.658 (95% confidence interval [CI]: 0.490–0.779), 0.595 (95% CI: 0.406–0.734), and 0.369 (95% CI: 0.134–0.566), for scoring HCC aggressiveness grades I, II, and III, respectively. Additionally, LiSNet was comparable to subspecialists for predicting histopathological microvascular invasion (area under the curve: LiSNet: 0.668 [95% CI: 0.559–0.776] versus subspecialists: 0.699 [95% CI: 0.591–0.806], p > 0.05). In a human–AI partnered diagnosis, combining LiSNet and experience‐based binary diagnosis can achieve the best predictive ability for microvascular invasion (area under the curve: 0.705 [95% CI: 0.589–0.820]). Furthermore, LiSNet was able to indicate overall survival after surgery.

Conclusion

The designed LiSNet tool warrants evaluation as an alternative tool for radiologists to conduct automatic staging of HCC aggressiveness at the pixel‐wise level with CT imaging. Its prognostic value might benefit patients’ treatment options and survival prediction.
Perception of nursing students from the Middle East about caring: A descriptive, comparative, cross‐sectional study
Authors: Allari Rabia S. , Hamdan Khaldoun , Zahran Zainab , Alabdullah Amany , Salem Safaa G. , Saifan Ahmad Rajeh , Abu‐El‐Noor Nasser Ibrahim , Abu‐El‐Noor Mysoon Khalil , Al Omari Omar
Published: September 2022

Aim

To investigate the perception of undergraduate nursing students in different countries in the Middle East about caring.

Design

A cross‐sectional, descriptive, comparative design.

Methods

A total of 1,582 nursing students from six different countries in the Middle East completed the Caring Dimensions Inventory.

Results

The total mean score of caring was 138.8 (± 15.8), indicating a high level of caring. The highest mean score was for nursing students from Egypt (M = 145.37 ± 15.97), whereas the lowest was for nursing students from Palestine (M = 135.36 ± 13.48). The caring perception was more significant for female students than male students, and no significant correlation was found between students' ages and caring scores.

Conclusions

The high level of caring among nursing students reflects the involvement of caring behaviour in the nursing curricula, which motivates nursing schools to continue stressing the importance of caring and to enhance this behaviour among their graduates.

Patient or Public Contribution

Improving the students' caring competencies as recommended by the study will influence the caregiving quality in the future that will be reflected in nurse–patient caring relationships and raise the patients' and public satisfaction with nursing care.
Resistivity imaging of river embankments: 3D effects due to varying water levels in tidal rivers
Authors: Ball John , Chambers Jonathan , Wilkinson Paul , Binley Andrew
Published: September 2022

Electrical resistivity tomography (ERT) has seen increased use in the monitoring the condition of river embankments, due to its spatial subsurface coverage, sensitivity to changes in internal states, such as moisture content, and ability to identify seepage and other erosional process with time‐lapse ERT. Two‐dimensional ERT surveys are commonly used due to time and site constraints, but they are often sensitive to features of anomalous resistivity proximal to the survey line, which can distort the resultant inversion as a three‐dimensional (3D) effect. In a tidal embankment, these 3D effects may result from changing water levels and river water salinities. ERT monitoring data at Hadleigh Marsh, UK, showed potential evidence of 3D effects from local water bodies. Synthetic modelling was used to quantify potential 3D effects on tidal embankments. The modelling shows that a 3D effect in a tidal environment occurs (for the geometries studied) when surveys are undertaken at high water levels and at distances less than 4.5 m from the electrode array with 1 m spacing. The 3D effect in the modelling is enhanced in brackish waters, which are common in tidal environments, and with larger electrode spacing. Different geologies, river water compositions, and proximities to the model parameters are expected to induce a varied 3D effect on the ERT data in terms of magnitude, and these should be considered when surveying to minimize artefacts in the data. This research highlights the importance of appropriate geoelectrical measurement design for tidal embankment characterization, particularly with proximal and saline water bodies.
Two‐order superconvergence for a weak Galerkin method on rectangular and cuboid grids
Authors: Wang Junping , Wang Xiaoshen , Ye Xiu , Zhang Shangyou , Zhu Peng
Published: September 2022

This article introduces a particular weak Galerkin (WG) element on rectangular/cuboid partitions that uses th order polynomial for weak finite element functions and th order polynomials for weak derivatives. This WG element is highly accurate with convergence two orders higher than the optimal order in an energy norm and the norm. The superconvergence is verified analytically and numerically. Furthermore, the usual stabilizer in the standard weak Galerkin formulation is no longer needed for this element.
Feasibility of treating pediatric intracranial germ cell tumors in a middle‐income country: The Jordanian experience
Authors: Amayiri Nisreen , Sarhan Nasim , Yousef Yacoub , Ibrahimi Ahmed Kh. , Abu‐Shanab Sobuh , Al‐Zebin Zebin , Al‐Hussaini Maysa , Musharbash Awni , Tawalbeh Ahmed , Bouffet Eric , Bartels Ute
Published: September 2022

Background

Pediatric intracranial germ cell tumors (iGCT) are rare, with limited data available from Arabic countries.

Methods

We retrospectively reviewed the medical charts of children <18 years diagnosed with iGCT at King Hussein Cancer Center/Jordan (January 2003 to December 2020) for clinical characteristics, treatment, and morbidities.

Results

Sixteen patients had germinoma; median age was 6.9 years and median symptoms duration 8 months. Nine tumors were suprasellar, five pineal, and two bifocal. Four were metastatic. Eight patients had slightly elevated beta subunit human chorionic gonadotropin and 11 patients had resection/biopsy. Fifteen patients received chemotherapy; mostly carboplatin (450 mg/m2)/etoposide, which had low toxicity. All patients received radiotherapy (different doses and fields). At median follow‐up of 7.7 years, one tumor recurred (progression‐free survival: 91% ± 8%). Twelve patients who continued follow‐up had stable visual and endocrine deficits to their initial presentation. Five finished or are finishing diploma and seven had poor school performance (four left school). Six patients were diagnosed with nongerminomatous germ cell tumor; median symptom duration was 1 month. Three tumors were pineal, two suprasellar, and one at quadrigeminal plate. Three were metastatic. Five tested patients had high tumor markers and four had resection/biopsy. All patients received chemotherapy, and then five received craniospinal radiation. Two patients are alive, two died with tumor progression, one died in remission with electrolyte imbalance, and one developed leukemia and died with septic shock.

Conclusions

We achieved excellent survival in treating germinoma using a feasible protocol for low middle‐income countries. However, patients encountered significant morbidities exacerbated by delayed diagnosis and unnecessary surgical interventions despite abnormal tumor markers. Raising awareness on iGCT symptomatology and diagnosis may help limit these morbidities.
Chromatographic fingerprint combined with quantitative analysis of multi‐components by single‐marker for quality control of total lignans from Fructus arctii by high‐performance liquid chromatography
Authors: Zhang Jing‐yun , Mei Jin‐wang , Wang Hai‐ying , Xu Zhao‐hui
Published: September 2022

Introduction

The total lignans from Fructus arctii (TLFA) is a mixture of a series of lignans isolated from dried ripe fruit of Arctium lappa L. We previously reported on the pharmacological activity of TLFA that is related to diabetes. An accurate and practical TLFA quantitative analysis method for utilising it needs to be established.

Objective

This study aimed to develop an effective quantitative analysis method for assessing the TLFA quality.

Methods

A total of 11 marker components were confirmed by analysing the high‐performance liquid chromatography fingerprints of 24 batches of TLFA samples. The samples were prepared from TLFA and structurally identified as lappaol H, lappaol C, arctiin, arctignan D, arctignan E, matairesinol, arctignan G, isolappaol A, lappaol A, arctigenin, and lappaol F. In the quantitative analysis of multi‐components by the single‐marker (QAMS) method and with arctiin as an internal reference substance, the content of these lignans in TLFA was simultaneously determined according to their relative correction factors with arctiin.

Results

There was no significant difference between results measured by the QAMS and traditional external standard methods. Hierarchical cluster and principal component analyses were performed to evaluate 24 TLFA batches based on the contents of 10 marker components. The results revealed that QAMS method combined with chemometric analyses could accurately measure and clearly distinguish the different quality samples of TLFA.

Conclusion

The QAMS method is a reliable and promising quality control method for TLFA. It can provide a reference for promoting quality control of complex multi‐component systems, especially for traditional Chinese medicine.
Identification of the most important factors related to people with cancer starting a palliative care conversation: A survey study
Authors: Scherrens Anne‐Lore , Beernaert Kim , Deliens Luc , Lapeire Lore , De Laat Martine , Biebuyck Christine , Geboes Karen , Van Praet Charles , Moors Ine , Deforche Benedicte , Cohen Joachim
Published: September 2022

Objective

A late conversation about palliative care needs can lead to suboptimal care in the final months/weeks of life. Insight into factors related to patients' communication about palliative care is needed. This study aims to identify the factors associated with starting/intending to start a conversation about palliative care with the physician.

Methods

We performed a cross‐sectional interviewer‐administered survey among people with incurable cancer. Purposive sampling was used, taking into account theoretically relevant heterogeneity. The questionnaire was developed based on the theory of planned behavior. Uni‐ and multivariable logistic regression analyses were performed.

Results

Out of 80 participants, ten (13%) started the palliative care conversation and 18 (23%) intended to do so. People holding a positive attitude towards starting/intending to start the conversation (odds ratio [OR] 4.74; 95% CI 2.35–9.54), perceiving more benefits of it (OR 2.60; 95% CI 1.37–4.96) and perceiving a positive attitude towards the behavior in family/friends (OR 2.07; 95% CI 1.26–3.41) and the physician (OR 2.19; 95% CI 1.39–3.45) were more likely to start/intend to start a palliative care conversation; people perceiving more disadvantages (OR 0.53; 95% CI 0.32–0.87) and barriers (OR 0.31; 95% CI 0.15–0.63) were less likely to do so. These factors explained 64% of the variance.

Conclusions

Our findings show that psychological and perceived socio‐environmental factors, particularly patients' attitudes, are associated with starting a conversation about palliative care. Theory‐based interventions targeting these strong associations might have a high potential to empower people with cancer to take the initiative in communication about palliative care and to improve timely initiation of palliative care.
Plant awareness is linked to plant relevance: A review of educational and ethnobiological literature (1998–2020)
Authors: Stagg Bethan C. , Dillon Justin
Published: September 2022

Societal Impact Statement

This research attempts to provide novel insights into plant awareness disparity (plant blindness), through a systematic and critical examination of the educational and ethnobiological literature. The low interest and awareness for plants is well documented in urban societies and has serious implications for biodiversity conservation and sustainable land‐use. This study is significant because it provides a comprehensive analysis of the characteristics of human‐plant relations in different societies, which does not currently exist in the academic literature. The findings suggest that people's plant awareness develops where they have frequent interactions with plants that have direct relevance to their lives.

The inattention to plants, known as ‘plant blindness’ or ‘plant awareness disparity’, is an established concern amongst biologists, but there has been no comprehensive and critical examination of the investigative literature to date. This study aims to address this, with a narrative review of experimental studies published in indexed journals from 1998 to 2020. Data were extracted using a suite of relevant search terms, characterised using key words and subjected to a thematic content analysis; 326 studies were shortlisted for review, with the majority in the subject areas of biological education, ethnobiology and biological conservation. The prevalent research methods were interviews and free‐listing exercises (ethnobiology) and questionnaires and tests (education). The most common characteristics of plant awareness disparity were a deficit of knowledge or identification skills, followed by an attention or memory advantage for animals compared to plants, preference for animals and low interest in plants. There was no concrete evidence of innate plant awareness disparity; instead, diminished experience of nature in urbanised societies appeared to be the cause. Virtually, all the 87 studies that found evidence of plant awareness disparity were undertaken in urban populations in high‐income countries. By contrast, there were 109 studies of extensive botanical knowledge based on rural communities dependent on biological resources, where individual expertise was found to be proportionate to the extent of wild plant collecting. We conclude that a decline in relevant experience with plants leads to a cyclical process of inattention that could be addressed through first‐hand experiences of edible and useful plants in local environments.
Controllable N Doped in Carbon Nanolayers@Mo2C Nanodots as Electrocatalyst Boosts High‐Efficient Hydrogen Production
Authors: Mao Ziyao , Wang Yating , Liu Rui , Sun Jingjing , Liu Bichan , Zhao Ruihua , Du Jianping
Published: September 2022

Mo2C is one of the promising alternatives to the precious metal catalyst for hydrogen evolution reaction (HER). However, it is still challenging to prepare highly dispersed Mo2C and prevent nanoparticles (NPs) from sintering during high‐temperature carbonization. Herein, a strategy is proposed to realize dual purposes that confine the coalescence of Mo2C NPs and redistribute charge density by regulating N‐doped contents. As‐synthesized molybdenum carbide nanodots are well dispersed on the N‐doped carbon nanolayers, and the size of Mo2C is uniform and less than 5 nm. The HER tests reveal that as‐prepared Mo2C nanodots exhibit excellent electrocatalytic activity for HER and long‐term stability. Theory calculation proves that optimizing N doping amount can tune hydrogen adsorption free energies and redistribute charge density. The present study provides insight into the impact of nitrogen doped in C/Mo2C and also a synthetic route to achieve heteroatom doping and size control for the synthesis of nanocatalysts beyond Mo2C.
Mechanistic basis of GPCR activation explored by ensemble refinement of crystallographic structures
Authors: Madsen Jesper J. , Ye Libin , Frimurer Thomas M. , Olsen Ole H.
Published: September 2022

G protein‐coupled receptors (GPCRs) are important drug targets characterized by a canonical seven transmembrane (TM) helix architecture. Recent advances in X‐ray crystallography and cryo‐EM have resulted in a wealth of GPCR structures that have been used in drug design and formed the basis for mechanistic activation hypotheses. Here, ensemble refinement (ER) of crystallographic structures is applied to explore the impact of binding of agonists and antagonist/inverse agonists to selected structures of cannabinoid receptor 1 (CB1R), β2 adrenergic receptor (β2AR), and A2A adenosine receptor (A2AAR). To assess the conformational flexibility and its role in GPCR activation, hydrogen bond (H‐bond) networks are analyzed by calculating and comparing H‐bond propensities. Mapping pairwise propensity differences between agonist‐ and inverse agonist/antagonist‐bound structures for CB1R and β2AR shows that agonist binding destabilizes H‐bonds in the intracellular parts of TM 5–7, forming the G protein binding cavity, while H‐bonds of the extracellular segment of TMs surrounding the orthosteric site are conversely stabilized. Certain class A GPCRs, for example, A2AAR, bind an allosteric sodium ion that negatively modulates agonist binding. The impact of sodium‐excluding mutants (D522.50N, S913.39A) of A2AAR on agonist binding is examined by applying ER analysis to structures of wildtype and the two mutants in complex with a full agonist. While S913.39A exhibits normal activity, D522.50N quenches the downstream signaling. The mainchain H‐bond pattern of the latter is stabilized in the intracellular part of TM 7 containing the NPxxY motif, indicating that an induced rigidity of the mutation prevents conformational selection of G proteins resulting in receptor inactivation.
Assessment of dose‐volume histogram statistics using three‐dimensional conformal techniques in breast cancer adjuvant radiotherapy treatment
Authors: Alwan Aula Fadhil , Al‐Naqqash Manwar Abdulelah , Al‐Nuami Hasan Saad Abbood , Mousa Nawres Ali , Ezzulddin Sura Yousif , Al‐shewered Ahmed Salih , Al‐Nuami Dalya
Published: September 2022

Objective

Breast cancer (BC) is first of the top 10 malignancies in Iraq. Dose‐volume histograms (DVHs) are most commonly used as a plan evaluation tool. This study aimed to assess DVH statistics using three‐dimensional conformal radiotherapies in BC in an adjuvant setting.

Methods

A retrospective study of 70 histologically confirmed women diagnosed with BC was reviewed. The study was conducted between November 2020 and May 2021, planning for treatment with adjuvant three‐dimensional conformal radiotherapies. The treatment plan used for each woman was based on an analysis of the volumetric dose, including DVH analysis.

Results

The planning target volume and clinical target volume coverage for tumors at V85% was better than V90% and V95%, with highly significant differences (p < 0.0001). The planning target volume and clinical target volume coverage for lymph nodes at V85% was higher than V90% and V95%, with no significant differences.

Conclusions

This is the only study that has been carried out in Iraq that we are aware of that addresses the evaluation of DVH statistics in BC. V85% produced the best chest wall coverage, and V95% made the worst. With little significance, higher lymph nodes coverage was attained at V85%, whereas the lowest coverage was at V95%.
Efficiency and clinical outcomes of Moses technology for holmium laser enucleation of the prostate: An evidence‐based analysis
Authors: Li Kangsen , Meng Chunyang , Li Jinze , Gan Lijian , Peng Lei , Li Yunxiang , Wu Ji
Published: September 2022

Background

To compare the safety and clinical efficacy of Moses laser enucleation of the prostate (MoLEP) with those of holmium laser enucleation of the prostate (HoLEP) for treating benign prostatic hyperplasia (BPH).

Methods

We systematically searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang databases, and SinoMed databases. The retrieval period was from the establishment of the database to March 2022. Stata17.0 was used for calculations and statistical analyses.

Results

This study included 12 articles comprising 1160 patients for meta‐analysis. Compared with those of the HoLEP group, the hemostasis time (weighted mean difference [WMD] = −4.66, 95% confidence interval [CI] [−6.47, −2.84], p < 0.001), enucleation time (WMD = −7.23, 95% CI [−10.67, −3.79], p < 0.001), operative time (WMD = −15.02, 95% CI [−20.50, −9.53], p< 0.001), length of hospital stay (WMD = −15.02, 95% CI [−20.50, −9.53], p< 0.001), intraoperative blood loss (WMD = −11.19, 95% CI [−12.94, −9.44], p< 0.001), and total postoperative complications rate (OR = 0.51, 95% CI [0.32, 0.81], p = 0.004) were shorter in the MoLEP group. Postoperative quality of life (WMD = 0.30, 95% CI [0.00, 0.59], p = 0.047) was lower in the HoLEP group, and there were no statistically significant differences in the International Prostate Symptom Score, postoperative maximum urinary flow rate, and postoperative residual urine (p > 0.05).

Conclusion

MoLEP has more advantages than HoLEP in terms of safety, shorter operation time and hospital stay, and fewer complications. However, this conclusion needs to be verified with a larger sample size, longer follow‐up time, and multicenter randomized controlled trial data.
Analysis of CheW‐like domains provides insights into organization of prokaryotic chemotaxis systems
Authors: Vass Luke R. , Bourret Robert B. , Foster Clay A.
Published: September 2022

The ability to control locomotion in a dynamic environment provides a competitive advantage for microorganisms, thus driving the evolution of sophisticated regulatory systems. In total, 19 known categories of chemotaxis systems control motility mediated by flagella or Type IV pili, plus other cellular functions. A key feature that distinguishes chemotaxis systems from generic two‐component regulatory systems is separation of receptor and kinase functions into distinct proteins, linked by CheW scaffold proteins. This arrangement allows for formation of varied arrays with remarkable signaling properties. We recently analyzed sequences of CheW‐like domains found in CheA kinases and CheW and CheV scaffold proteins. In total, 16 Architectures of CheA, CheW, and CheV proteins contain ~94% of all CheW‐like domains and form six Classes with likely functional specializations. We surveyed chemotaxis system categories and proteins containing CheW‐like domains in ~1900 prokaryotic species, the most comprehensive analysis to date, revealing new insights. Co‐occurrence analyses suggested that many chemotaxis systems occur in non‐random combinations within species, implying synergy or antagonism. Furthermore, many Architectures of proteins containing CheW‐like domains occurred predominantly with specific categories of chemotaxis systems, suggesting specialized functional interactions. We propose Class 1 (~80%) and Class 6 (~20%) CheW proteins exhibit preferences for distinct chemoreceptor structures. Furthermore, rare (~1%) Class 2 CheW proteins frequently co‐occurred with methyl‐accepting coiled coil proteins, which contain both receptor and kinase functions and so do not require connection via a CheW scaffold but may benefit from arrays. Last, rare multidomain CheW proteins may interact with different receptors than single‐domain CheW proteins.
Prevalence and survival associated with pulmonary hypertension after mitral valve replacement: National echocardiography database of Australia study
Authors: Collins Nicholas , Sugito Stuart , Davies Allan , Boyle Andrew , Sverdlov Aaron , Attia John , Stewart Simon , Playford David , Strange Geoff
Published: September 2022

The specific prevalence and outcome of pulmonary hypertension after mitral valve replacement (MVR) is not well documented. The aim of the study was to determine the prevalence and prognostic impact of pulmonary hypertension after MVR. In addition, we sought to determine the threshold of mortality risk according to echocardiography derived pulmonary pressures and those echocardiographic characteristics that are associated with increased mortality. Using the National Echocardiography Database of Australia, patients who had undergone MVR were identified with estimated right ventricular systolic pressure (eRVSP) assessed and linked to patient mortality during mean follow up of 1917 days. Classification and regression tree analysis was used to identify the most powerful predictors of mortality. A total of 10,994 patients who had undergone echocardiography following MVR (mean age 65.2 ± 16, 44.8% women) were studied (mean follow‐up 1917 days). The prevalence of PH (defined as eRSVP ≥40 mmHg) was 64.1% (7042/10,994). Severe PH (eRVSP ≥60 mmHg) was seen in 42.3% (4671/10,994). Mortality in individuals with PH was greater than amongst individuals without PH (41.1% vs. 26.3%). Age, tricuspid regurgitation and left ventricular dysfunction were also associated with mortality. There is a high prevalence of PH after MVR which confers an adverse prognosis. Improved therapeutic approaches to mitral valve disease and the subsequent development of PH are essential.
Atomistic simulations of ∑3 [110](111) grain boundary in diamond: Structure, stability, and properties
Authors: Pooja  , Pawar Ravinder
Published: September 2022

Grain boundaries play a pivotal role to influence the stability and mechanical properties of the diamond derived from chemical vapor deposition; therefore, the scrutiny of grain boundaries has aroused intensive research attention. In the present study, the structure, stability, mechanical, electronic properties, and concentration effect of the ∑3 [110](111) grain boundary in diamond has been investigated using density functional theory calculations. The grain boundary energy (), phonon dispersion relation, and charge density distribution clearly indicate that the ∑3 [110](111) grain boundary in diamond is stable. The elasticity and electronic properties of the diamond with the ∑3 [110](111) grain boundary closely resemble the pristine diamond. En route to determining the thermal stability of the grain boundary, molecular dynamics simulations using ReaxFF were performed at various temperatures. In addition, Young's modulus was calculated by applying an increasing 5.6% uniaxial strain along the z‐direction during the molecular dynamics simulations using ReaxFF. The ReaxFF simulations further demonstrate that the grain boundary is found to be thermally stable even at 1773.15 K.
Robust tracking control with reinforcement learning for nonlinear‐constrained systems
Authors: Tang Yuhong , Yang Xiong
Published: September 2022

This article considers the robust tracking control problem of uncertain nonlinear systems with asymmetric input constraints. Initially, the tracking error dynamics and the desired trajectory dynamics are constructed as an augmented system. Then, with a discounted value function being introduced for the nominal augmented system, the original tracking control problem is transformed into a constrained optimal control problem. To solve the constrained optimal control problem, its related Hamilton–Jacobi–Bellman equation (HJBE) is developed. After that, a critic approximator is constructed to solve the HJBE in the reinforcement learning framework. To tune the parameters used in the critic approximator, a novel concurrent learning technique is introduced, which could remove the persistence of excitation condition. Moreover, the uniform ultimate boundedness of the tracking error and the parameters' estimation error of the critic approximator is assured via the Lyapunov's approach. Finally, a spring‐mass‐damper mechanical system and a robot manipulator system are given to validate the theoretical claims.
Using unoccupied aerial vehicles to map and monitor changes in emergent kelp canopy after an ecological regime shift
Authors: Saccomanno Vienna R. , Bell Tom , Pawlak Camille , Stanley Charlotte K. , Cavanaugh Katherine C. , Hohman Rietta , Klausmeyer Kirk R. , Cavanaugh Kyle , Nickels Abby , Hewerdine Waz , Garza Corey , Fleener Gary , Gleason Mary
Published: September 2022

Kelp forests are complex underwater habitats that form the foundation of many nearshore marine environments and provide valuable services for coastal communities. Despite their ecological and economic importance, increasingly severe stressors have resulted in declines in kelp abundance in many regions over the past few decades, including the North Coast of California, USA. Given the significant and sustained loss of kelp in this region, management intervention is likely a necessary tool to reset the ecosystem and geospatial data on kelp dynamics are needed to strategically implement restoration projects. Because canopy‐forming kelp forests are distinguishable in aerial imagery, remote sensing is an important tool for documenting changes in canopy area and abundance to meet these data needs. We used small unoccupied aerial vehicles (UAVs) to survey emergent kelp canopy in priority sites along the North Coast in 2019 and 2020 to fill a key data gap for kelp restoration practitioners working at local scales. With over 4,300 hectares surveyed between 2019 and 2020, these surveys represent the two largest marine resource‐focused UAV surveys conducted in California to our knowledge. We present remote sensing methods using UAVs and a repeatable workflow for conducting consistent surveys, creating orthomosaics, georeferencing data, classifying emergent kelp and creating kelp canopy maps that can be used to assess trends in kelp canopy dynamics over space and time. We illustrate the impacts of spatial resolution on emergent kelp canopy classification between different sensors to help practitioners decide which data stream to select when asking restoration and management questions at varying spatial scales. Our results suggest that high spatial resolution data of emergent kelp canopy from UAVs have the potential to advance strategic kelp restoration and adaptive management.