bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid approach with laparoscopic wall‐inversion surgery and single‐incision intragastric surgery for intraluminal gastrointestinal stromal tumor: A case report
Authors: Kusunoki Chikako , Hamakawa Takuya , Nishikawa Kazuhiro , Sato Hiromichi , Imamura Sayumi , Miyahara Satoru , Sakano Yu , Miyazaki Hazuki , Seto Hiroto , Ueda Ryuta , Toshiyama Reishi , Miyo Masaaki , Takahashi Yusuke , Sakai Kenji , Miyake Masakazu , Miyamoto Atsushi , Kato Takeshi , Mori Kiyoshi , Hirao Motohiro
Published: February 2021

Laparoscopic wedge resection (LWR) for intraluminal gastrointestinal stromal tumor (GIST) leads to excessive resection of normal gastric wall. We report a case of GIST around the cardia successfully treated with full‐thickness partial resection using a hybrid approach of laparoscopic surgery and single‐incision intragastric surgery (SIIGS). A 69‐year‐old woman had a 5 cm intraluminal GIST at the posterior wall around the cardia. Submucosal injection of glycerin and indigo carmine was performed with transoral endoscopy. Circumferential seromuscular incision followed by placement of seromuscular sutures to invert the lesion into the stomach was performed under laparoscopy. By SIIGS, resection of the inverted mucosa and retrieval of the tumor were completed. A hybrid approach consisting of laparoscopic wall‐inversion surgery and SIIGS was useful for intraluminal GIST and may expand the indications for laparoscopic wall‐inversion surgery by removing size limitations.
Using the faecal immunochemical test in patients with rectal bleeding: evidence from the NICE FIT study
Authors: Hicks Georgina , D’Souza Nigel , Georgiou Delisle Theo , Chen Michelle , Benton Sally C. , Abulafi Muti ,   the NICE FIT steering group
Published: February 2021

Aim

The aim of this work was to investigate whether the faecal immunochemical test (FIT) could safely rule out colorectal cancer (CRC) in patients with rectal bleeding (RB).

Method

This was a multicentre, double‐blinded diagnostic accuracy study in 50 National Health Service hospitals. Patients referred from primary care with suspected CRC on an urgent 2‐week‐wait pathway were asked to perform a FIT prior to colonoscopy. The primary outcome measure was the sensitivity of the FIT for CRC in patients with RB versus nonrectal bleeding symptoms (NRB). The secondary outcome measures included the diagnostic accuracy of the FIT for CRC and other serious bowel disease.

Results

Of 9822 patients included in the study, 3143 (32.0%) were referred with RB. CRC was present in 4.7% of patients with RB versus 2.7% of patients with NRB (p < 0.05). Faecal haemoglobin (f‐Hb) was detectable (>2 µg/g) in 44.1% of patients with RB and 33.9% with NRB (p < 0.05). In RB patients, CRC was present in 10.4% when f‐Hb was >2 µg/g compared with 0.1% when f‐Hb was not detected. Flexible sigmoidoscopy in this group would further reduce the risk of CRC to 0.03%. The sensitivity of the FIT for CRC in RB versus NRB groups was 98.6% (95% CI 95.2%–99.8%) vs 95.6% (91.5%–98.1%) for f‐Hb >2 µg/g and 96.6% (92.2%–98.9%) vs 86.3 (80.4%–90.9%) for f‐Hb >10 µg/g.

Conclusion

Faecal haemoglobin is not always detectable in patients with RB; 56% of patients had undetectable f‐Hb (<2 µg/g) and CRC was present in 0.1%. The high sensitivity of the FIT can be used to rule out CRC in patients with RB and triage them more appropriately for investigation.
Time‐varying impact of global, region‐, and country‐specific uncertainties on the volatility of international trade
Authors: Gül Selçuk , Gupta Rangan
Published: February 2021

We use a dynamic factor model with time‐varying parameters and stochastic volatility to decompose the variance of exports and imports over time for 22 Organization for Economic Co‐operation and Development countries spanning the quarterly period of 1960:01–2016:04 into contributions from country‐ and region‐specific uncertainties and uncertainty common to all countries. We find that, while idiosyncratic uncertainty has a dominant role in explaining the volatility of international trade, global, country‐, and region‐specific uncertainties drive around 40% of the volatility of real exports and imports, with the impact of the latter three uncertainties rising in explanatory power during episodes of crises. Our results have important policy implications.
Global distribution and conservation of avian diet specialization
Authors: Morelli Federico , Benedetti Yanina , Hanson Jeffrey O. , Fuller Richard A.
Published: February 2021

Ecologically specialist species are more prone to extinction than generalist species, yet the global distribution and conservation of ecological specialism is poorly understood. Here, we show that the global distribution of avian dietary specialization is roughly congruent with overall bird species richness for resident and breeding species, as well as for non‐breeding species. However, some areas harbour a higher number of diet specialist birds than expected given overall species richness (e.g. the Amazon, Gabon and Cameroon in Central Africa, extensive parts of Indonesia and some parts of northern Eurasia, Baltic cost and Mediterranean areas for resident and breeding birds, and tropical zone and south part of subtropical zone in South America for non‐breeding birds). These areas represent hotspots of avian specialization that need to carefully be considered in conservation strategies. We found that overall, 49.6% of resident and breeding species and 45.5% of non‐breeding diet specialist species are adequately represented by the global protected area system, but that this percentage is lower for the most threatened species. Policies that modify conservation planning approaches to include measures of specialization alongside other more traditional metrics of biodiversity could improve the protection of biodiversity in the face of rapidly accelerating anthropogenic threats.
Bimonthly viral monitoring for late‐onset cytomegalovirus infection in kidney transplant recipients
Authors: Melgarejo Ivy , Jorgensen Dana , Hariharan Sundaram , Puttarajappa Chethan M.
Published: February 2021

Kidney transplant recipients with high‐risk cytomegalovirus (CMV) serostatus (seropositive donor to seronegative recipient) are at risk for late‐onset CMV after cessation of antiviral prophylaxis. We report findings from a strategy of bimonthly (every 2 weeks) CMV screening for late‐onset CMV. This is a single‐center retrospective cohort study of 70 high‐risk CMV kidney transplant recipients transplanted between June 2016 and September 2018. Patients were monitored at 6–12 months post‐transplantation for late‐onset CMV using bimonthly CMV nucleic acid testing (NAT). Adherence to screening and its correlation with CMV‐related hospitalizations were assessed. Failure to prevent CMV‐related hospitalization was classified into three categories (non‐adherence to CMV testing, rapid CMV progression, and health system failure). Twenty‐one (30%) patients developed CMV DNAemia, of whom 10 (14%) required hospitalization. Reasons for CMV‐related hospitalization despite screening were (i) screening non‐adherence (50%), (ii) rapid progression (40%), and (iii) health system failure (10%). Adherence to screening was associated with lower viral counts at diagnosis (r = ‐.44, p = .049) and a trend towards lower risk of CMV‐related hospitalization (OR: 0.97 per 1% increase in adherence; 95% CI: 0.94–1.00; p = .06). Bimonthly monitoring for late‐onset CMV allows for early CMV detection and may lower CMV‐related hospitalization.
Rapid onsite evaluation uses a very small proportion of total material aspirated at endobronchial or endoscopic ultrasound in the investigation of suspected thoracic malignancy
Authors: Tang Winnie , Plank Claire , Kiepura Claire , Bunting Sharon , Waugh Jodie , Coates Matthew , Spencer Neil , Barlow Andrew , Mogal Rahul , Maddox Anthony
Published: February 2021

Introduction

The objectives were: to measure the proportion of aspirated material used to make direct slides for rapid onsite evaluation (ROSE) at endobronchial (EBUS) and endoscopic ultrasound (EUS) in suspected thoracic malignancy; and to correlate pass weights with ROSE category and needle size.

Method

All EBUS and EUS cases for possible thoracic malignancy October 2018‐May 2019 were included. All material from each pass was expelled into a Petri dish. One drop of material was placed on each of two slides; one used for ROSE, the other fixed and remaining material processed to cell block. Dish and slides were weighed before and after this procedure on a sensitive balance and weight of aspirate and slide material calculated. When ROSE identified malignancy, slide production ceased but target sampling for ancillary studies continued.

Results

ROSE accuracy was 96.8%. Mean percentage by target of aspirated material used to make direct slides for ROSE was 1.9% in malignant cases and 3.6% in non‐malignant cases (P = .027 for difference). Mean percentage by pass was 5.9%. Mean weight of a single aspirate was 128.8 mg. Mean weight of aspirates insufficient on ROSE (175.7 mg) was significantly higher than the mean weight of benign or malignant aspirates (117.1 and 114.0 mg, respectively). Mean weight of aspirates using 22G needles (132.6 mg) was significantly higher than that for 25G needles (87.1 mg).

Conclusion

Material made into direct slides at EBUS and EUS and used in part for ROSE uses a tiny proportion of aspirated material with over 98% processed to cell block and available for ancillary testing in malignant cases.
Predictive models of distribution and abundance of a threatened mountain species show that impacts of climate change overrule those of land use change
Authors: Barras Arnaud G. , Braunisch Veronika , Arlettaz Raphaël
Published: February 2021

Aim

Climate is often the sole focus of global change research in mountain ecosystems although concomitant changes in land use might represent an equally important threat. As mountain species typically depend on fine‐scale environmental characteristics, integrating land use change in predictive models is crucial to properly assess their vulnerability. Here, we present a modelling framework that aims at providing more comprehensive projections of both species’ distribution and abundance under realistic scenarios of land use and climate change, and at disentangling their relative effects.

Location

Switzerland.

Methods

We used the ring ouzel (Turdus torquatus), a red‐listed and declining mountain bird species, as a study model. Based on standardized monitoring data collected across the whole country, we fitted high‐resolution ensemble species distribution models to predict current occurrence probability, while spatially explicit density estimates were obtained from N‐mixture models. We then tested for the effects of realistic scenarios of land use (land abandonment versus farming intensification) and climate change on future species distribution and abundance.

Results

Occurrence probability was mostly explained by climatic conditions, so that climate change was predicted to have larger impacts on distribution and abundance than any scenarios of land use change. In the mid‐term (2030–2050), predicted effects of environmental change show a high spatial heterogeneity due to regional differences in climate and dominant land use, with farming intensification identified as an important threat locally. In the long term (2080–2100), climate models forecast a marked upward range shift (up to +560 m) and further population decline (up to −35%).

Main conclusions

Our innovative approach highlights the spatio‐temporal heterogeneity in the relative effects of different environmental drivers on species distribution and abundance. The proposed framework thus provides a useful tool not only for better assessing species’ vulnerability in the face of global change, but also for identifying key areas for conservation interventions at a meaningful scale.
Advancing therapy with iGlarLixi versus premix BIAsp 30 in basal insulin‐treated type 2 diabetes: Design and baseline characteristics of the SoliMix randomized controlled trial
Authors: McCrimmon Rory J. , Al Sifri Saud , Emral Rifat , Mohan Viswanathan , Sauque‐Reyna Leobardo , Trescolí Carlos , Lalic Nebojsa , Alvarez Agustina , Demil Nacima , Coudert Mathieu , Shaunik Alka , Bonnemaire Mireille , Rosenstock Julio ,   SoliMix Trial investigators
Published: February 2021

Aim

Premix insulin is commonly used in some regions of the world, despite the higher risk of hypoglycaemia and weight gain compared with basal insulin, based on the premise that it offers a simplified insulin regimen. iGlarLixi is a once‐daily titratable fixed‐ratio formulation that combines basal insulin glargine 100 units/mL (iGlar) and the GLP‐1 RA, lixisenatide, which offers a single‐injection option for treatment intensification, with improved HbA1c reductions, similar hypoglycaemia risk and more favourable bodyweight profiles over iGlar alone. This randomized controlled study directly compares, for the first time, treatment intensification with iGlarLixi versus premix insulin analogue biphasic insulin aspart 30 (BIAsp 30) in adults with T2D inadequately controlled on basal insulin in combination with one or two oral antihyperglycaemic drugs.

Materials and Methods

This was an open‐label, active‐controlled, comparative, parallel‐group, multicentre, phase 3b study. In total, 887 adults with T2D uncontrolled on basal insulin were randomized to switch to either iGlarLixi once daily, or BIAsp 30 twice daily, for 26 weeks.

Results

Overall, 887 participants were enrolled (mean age 59.8 years, 50.2% female) from 89 centres in 17 countries. At baseline, 65.6% had a duration of T2D of 10 years or longer, and the mean HbA1c at baseline was 8.6%.

Conclusions

The study directly compared the efficacy and safety of iGlarLixi versus BIAsp 30 in people with T2D uncontrolled on basal insulin and one or more oral antihyperglycaemic agents. These results provide robust clinical data that may inform clinicians in their therapeutic management of people with T2D uncontrolled on basal insulin requiring additional therapy.
Hybrid closed‐loop glucose control with faster insulin aspart compared with standard insulin aspart in adults with type 1 diabetes: A double‐blind, multicentre, multinational, randomized, crossover study
Authors: Boughton Charlotte K. , Hartnell Sara , Thabit Hood , Poettler Tina , Herzig David , Wilinska Malgorzata E. , Ashcroft Nicole L. , Sibayan Judy , Cohen Nathan , Calhoun Peter , Bally Lia , Mader Julia K. , Evans Mark , Leelarathna Lalantha , Hovorka Roman
Published: February 2021

Aim

To evaluate the use of hybrid closed‐loop glucose control with faster‐acting insulin aspart (Fiasp) in adults with type 1 diabetes (T1D).

Research Design and Methods

In a double‐blind, multinational, randomized, crossover study, 25 adults with T1D using insulin pump therapy (mean ± SD, age 38 ± 9 years, HbA1c 7.4% ± 0.8% [57 ± 8 mmol/mol]) underwent two 8‐week periods of unrestricted living comparing hybrid closed‐loop with Fiasp and hybrid closed‐loop with standard insulin aspart in random order. During both interventions the CamAPS FX closed‐loop system incorporating the Cambridge model predictive control algorithm was used.

Results

In an intention‐to‐treat analysis, the proportion of time sensor glucose was in the target range (3.9–10.0 mmol/L; primary endpoint) was not different between interventions (75% ± 8% vs. 75% ± 8% for hybrid closed‐loop with Fiasp vs. hybrid closed‐loop with standard insulin aspart; mean‐adjusted difference −0.6% [95% CI −1.8% to 0.7%]; p < .001 for non‐inferiority [non‐inferiority margin 5%]). The proportion of time with sensor glucose less than 3.9 mmol/L (median [IQR] 2.4% [1.2%–3.2%] vs. 2.9% [1.7%–4.0%]; p = .01) and less than 3.0 mmol/L (median [IQR] 0.4% [0.2%–0.7%] vs. 0.7% [0.2%–0.9%]; p = .03) was reduced with Fiasp versus standard insulin aspart. There was no difference in mean glucose (8.1 ± 0.8 vs. 8.0 ± 0.8 mmol/L; p = .13) or glucose variability (SD of sensor glucose 2.9 ± 0.5 vs. 2.9 ± 0.5 mmol/L; p = .90). Total daily insulin requirements did not differ (49 ± 15 vs. 49 ± 15 units/day; p = .45). No severe hypoglycaemia or ketoacidosis occurred.

Conclusions

The use of Fiasp in the CamAPS FX closed‐loop system may reduce hypoglycaemia without compromising glucose control compared with standard insulin aspart in adults with T1D.
Not Settling for Certainty in Uncertain Times
Authors: Morrell Thomas
Published: February 2021

I had a great job at a well‐respected company. But I was also bored, stagnating, and ready to move on to something new.

A UX designer found new work, better mental health, and greater job satisfaction during the pandemic after realizing there is no such thing as job security.
Changing One's View of Interior Design: an Educator's Perspective from the Pandemic
Authors: Barron Danielle L.
Published: February 2021

Like most other educators, my world was rocked when my university was directed to transition to teaching fully online last March.

The pandemic may have upended life as she knew it, but this educator found ways to keep her life, as well as those of her family and students, moving in the right direction.
When Will I Return to the Uni Workshop? Studying Industrial Design in Colombia during the Pandemic
Authors: Casasbuenas Laura
Published: February 2021

My university affords an education for students who come from remote areas of the country, indigenous people, and those with scarce financial resources. For these reasons, distance education has been a real challenge for us, but not the only one.

Lockdowns thrust students into new realities devoid of the normal hard work and hard‐won joys of college life. But such times can also present new opportunities for learning.
Innovation and Creativity in Times of Crisis
Authors: Munro‐Smith Nigel
Published: February 2021

I want to tell the story of what happened when I applied to myself the methodology I recommend to others.

What happens when a designer applies the principles of design thinking to his own future after his life has been turned upside down by the pandemic?
Finding New Structure in Pandemic Life
Authors: Hopson Jordan
Published: February 2021

Looking back, I can see how the pandemic has entwined my personal life with professional life, provided more structure to my weeks, and helped me strike deeper connections with unexpected people.

Working from home has been a challenge, even for those accustomed to disruption. One designer finds surprising silver linings while constructing new routines.
The end of currency manipulation? Global production networks and exchange rate outcomes
Authors: Weldzius Ryan M.
Published: February 2021

Between 2000 and 2017, eight major exporting countries engaged in currency manipulation in order to increase their trade surpluses with the rest of the world. As of 2018, however, no currency manipulators remained. This change in policy is puzzling given the past successes of this export‐led growth model. I argue that the state‐level decision to stop depreciating its exchange rate stems from the reduced benefits and increased costs of currency manipulation. As production becomes more global, an increase in tradable inputs decreases the traditional benefits of a depreciated currency, in particular an increase in exports. Utilizing panel data across 63 countries between 2000 and 2018, I demonstrate that global production networks moderate the traditional relationship between export dependence and currency manipulation. I further discuss how this relationship may reverse given the reshoring of production networks in response to the novel coronavirus pandemic.
Computed tomographic and magnetic resonance imaging of a coup contrecoup traumatic brain injury in a horse
Authors: Morgan R. E. , Dunkel B. , Spiro S. , Beltran E.
Published: February 2021

A 3‐year‐old Thoroughbred mare found recumbent in the field was referred for further assessment with suspicion of a skull fracture. Neurological examination identified compulsive tight circling to the left, and hypermetria in all four limbs. The mare was obtunded, with a mild head tilt to the right, absent menace response of the right eye and decreased facial sensation on the right. Standing computed tomographic examination revealed a subtle depression fracture of the dorsal calvarium and moderate intra‐axial midline shift consistent with a traumatic brain injury (TBI). Despite supportive treatment, the mare deteriorated and was subjected to euthanasia. Post‐mortem high field magnetic resonance imaging revealed findings consistent with a small cerebral contusion adjacent to the fracture site, and moderate to severe ipsilateral cerebral oedema within the caudal cerebrum and rostral brainstem, consistent with a coup contrecoup TBI. Brainstem lesions indicate a poor prognosis and support the decision for euthanasia. This is the first report of the imaging findings of a coup contrecoup TBI in a horse.
Biserrula pelecinus L. is a promising forage legume for the central Ethiopian highlands
Authors: Bekuma Amanuel A. , Terpolilli Jason J. , Tiwari Ravi P. , O'Hara Graham W. , Howieson John G.
Published: February 2021

The availability of effective inoculant rhizobia is often critical to the successful development of productive forage legumes. Biserrula pelecinus L. is a legume with potential as forage in Ethiopia to improve livestock feed quality and soil fertility. B. pelecinus can form N2‐fixing symbiosis with rhizobia in the genus Mesorhizobium. This study investigated the N2 fixation effectiveness of 15 B. pelecinus‐nodulating Mesorhizobium strains on two subspecies of B. pelecinus (B. pelecinus ssp. leiocarpa, native to Ethiopia, and the introduced B. pelecinus ssp. pelecinus). The most effective strain (WSM3873) on both subspecies was assessed at two sites; one with pre‐existing populations of B. pelecinus‐nodulating rhizobia (Modjo), and one without (Holeta). No inoculation response was observed at Modjo when B. pelecinus ssp. pelecinus was inoculated with WSM3873 alone, however, biomass yield was greatest (11.5 tonne DM/ha) following inoculation along with co‐application of phosphorus and nitrogen. At Holeta, a strong inoculation response was achieved with WSM3873 alone on B. pelecinus ssp. pelecinus. In contrast, B. pelecinus ssp. leiocarpa did not show any response at Modjo and failed to emerge after sowing at Holeta. While the native legume B. pelecinus ssp. leiocarpa appears poorly suited to development as a forage, B. pelecinus ssp. pelecinus and WSM3873 represents a promising legume‐rhizobia symbiosis that could benefit farming systems of the central Ethiopian highlands.
Personal network analysis from an intersectional perspective: How to overcome ethnicity bias in migration research
Authors: Bilecen Başak
Published: February 2021

Through qualitative personal network analysis from an intersectional perspective, this article contributes to the debate on the salience of ethnicity as a defining, yet essentialized, category in transnational migration research. The article includes a theoretical and methodological discussion of qualitative personal network analysis as a means to alleviate the risks of overemphasizing ethnicity over other categories, which provides the background to the empirical analysis. Drawing on 20 personal networks and qualitative interviews with Chinese international students who were studying in the United States, the findings of this study indicate that ethnicity, as a precursor to culture, along with gender and class, is important in friendship formations but not necessarily for job‐relevant issues. Moreover, through an intersectional personal network analysis, transnational family ties were problematized based not on their ethnicity but on gendered expectations and social norms.
Impedance spectroscopy of Na0.5Bi4.50+xTi4Oy (x = ‐0.02, 0, 0.02) ceramics with excellent dielectric properties
Authors: Du Yi Ke , Qi Yi , Liu Kang Hui , Chen Ye , Zuo Yuan Dong , Qin Lu , Jiang Chao Bin , Chen Yong , Shen Meng , Xiang Huang Zhao
Published: February 2021

The electric and dielectric properties of Na0.5Bi4.50+xTi4Oy (x = −0.02, 0, 0.02) prepared by conventional mixed oxide route have been investigated by impedance spectroscopy (IS) over a wide temperature range. Single‐phase bismuth layer‐structured perovskite patterns were observed through X‐ray diffraction of the three samples Na0.5Bi4.5Ti4O15, Na0.5Bi4.48Ti4Oy, and Na0.5Bi4.52Ti4Oy. The results show that the relative permittivity (εr) increases with the increase in temperature and reaches its maximum at about 675℃. With the continuous increase in temperature, the permittivity decreases gradually. Both relative permittivity and dielectric loss show great stability at the low‐temperature zone. The ceramic of x = 0.02 with Ea of 1.09 eV has the maximum oxygen ionic transport number between 600 and 800℃ for all samples. And at this time, it has the maximum electrical conductivity. All the results indicated that Na0.5Bi4.50+xTi4Oy (x = −0.02, 0, 0.02) ceramics were promising base materials for high‐temperature capacitor because of their high dielectric properties.
The role of elaboration likelihood model in consumer behaviour research and its extension to new technologies: A review and future research agenda
Authors: Shahab Muhammad Hamza , Ghazali Ezlika , Mohtar Mozard
Published: February 2021

During the last decade, research on new technologies such as virtual reality and augmented reality in the context of marketing has gained notable attention from the marketing researchers. Researchers are trying to understand consumer behaviour with the aid of new technologies, but only a few consumer behaviour theories are being used in the context of marketing, for example, theory of planned behaviour, self‐determination theory, technology acceptance model, uses & gratification theory and innovation diffusion theory. These theories can successfully predict consumer's motivation, behavioural intentions and technology adoption. However, they are unable to explicate the effectiveness of promotional messages and content marketing on consumer's change in attitude and decision making. Surprisingly, theories that are actually capable to do so, for example, elaboration likelihood model (ELM), have been overlooked by the researchers. This could be because classical theories are unable to comprehend the new technologies, and hence, it is pertinent to enhance the spectrum of the classical theories. Therefore, the goal of this theory‐based systematic literature review is to assess the ELM literature to address the existing research gaps in the marketing literature. The research string used in this study was developed by using Boolean operators to search databases, and Preferred Reporting Items for Systematic Reviews and Meta‐Analyses framework was adopted to increase the efficiency of the searching process. A total of 762 suitable articles were considered for the initial screening, however, only 68 articles met the inclusion criteria and were included in the study. These articles were analysed to propose future research agenda by including the under‐looked constructs and theories.
Robot‐assisted partial nephrectomy for high‐complexity tumors (PADUA score ≥10): Perioperative, long‐term functional and oncologic outcomes
Authors: Koukourikis Periklis , Alqahtani Ali Abdullah , Almujalhem Ahmad , Lee Jongsoo , Han Woong Kyu , Rha Koon Ho
Published: February 2021

Objectives

To evaluate the safety and efficacy, and long‐term functional and oncologic outcomes of robot‐assisted partial nephrectomy in high‐complexity tumors.

Methods

Data of 155 patients with a high‐complexity tumor (PADUA score ≥10) were reviewed. Trifecta achievement, intra‐, perioperative, functional, and oncologic outcomes were analyzed and compared between patients with increasing complexity.

Results

Of the 155 patients, 65 (41.9%) patients had a PADUA score of 10, 55 (35.5%) had a PADUA score of 11, and 35 (22.6%) had a PADUA score of 12–13, respectively. The median (interquartile range) operative time, warm ischemia time and estimated blood loss were 150 min (112–186 min), 26 min (23–32 min) and 250 mL (100–500 mL), respectively. Postoperatively, complications occurred in 25 (16.1%) patients, and positive surgical margins in 15 (10.5%) patients. Trifecta was achieved in 67 (43.2%) patients. At a median follow‐up period of 58 months, the median estimated glomerular filtration rate preservation was 87% (78–110), and 12 (7.7%) patients developed new‐onset chronic kidney disease. Recurrence‐free survival and overall survival rates were 93.6% and 96.7%, respectively. Positive surgical margins were statistically different between the groups of PADUA score 10, 11 and 12–13 (P = 0.017), whereas functional and oncologic outcomes were similar. In multivariate logistic regression analysis, increasing tumor size (odds ratio 1.48, 95% confidence interval 1.21–1.87; P < 0.001) and the American Society of Anesthesiologists score 2/3 (odds ratio 0.48, 95% confidence interval 0.24–0.96; P = 0.041) were independent predictors of trifecta failure.

Conclusions

Robot‐assisted partial nephrectomy is a safe and effective treatment for high‐complexity tumors providing excellent long‐term functional and oncologic outcomes.
Mössbauer spectroscopy, XRPD, and SEM study of iron‐containing Na2O‐B2O3‐SiO2 glasses
Authors: Konon Marina , Polyakova Irina , Stolyar Sergey , Simonenko Nikolay , Simonenko Tatiana , Zolotov Nikita , Semenova Ekaterina , Antropova Tatiana
Published: February 2021

Glasses in the Na2O‐B2O3‐SiO2‐Fe2O3 system are suitable for producing magnetic porous glasses—host matrices for multiferroic composite materials for spintronics applications. Successful synthesis of such materials is dependent on the knowledge of crystallization and immiscibility areas in this system. Here, we report new findings for such glasses with a constant SiO2 concentration of 70 mol %, containing 7‐12 mol % Fe2O3, whose compositions lie in the low (2 mol % Na2O) and higher (8‐12 mol % Na2O) alkali regions, heat‐treated at 550°C. Glasses were studied using analytical chemistry methods and investigated by means of Mössbauer spectroscopy, XRPD and SEM. We outlined the immiscibility area boundary in the chosen silica cross‐section for 550°C, indicating the region of interconnected morphology and the crystallization fields of magnetite and FeSiO3, and correlated them with data on the valence and coordination state of iron in glasses. We find that both Fe3+ and Fe2+ ions in the low‐alkali region are octahedrally coordinated, in higher alkali area Fe3+ and Fe2+ are tetrahedrally and octahedrally coordinated, respectively. A significant amount of Fe2+ in the low‐alkali region can be the cause of the FeSiO3 formation. The usual crystalline phase in non‐X‐Ray amorphous glasses is magnetite, precipitating at the annealing stage.
Mountains, climate and niche heterogeneity explain global patterns of fern diversity
Authors: Suissa Jacob S. , Sundue Michael A. , Testo Weston L.
Published: February 2021

Aim

It is well known that the distribution of species diversity is spatially heterogeneous, but understanding the factors contributing to this heterogeneity and to the formation of biodiversity hotspots remains a challenge. Here, we seek to improve our understanding of how historical, ecological and evolutionary processes contribute to current patterns of global fern diversity.

Location

Worldwide.

Taxon

Ferns.

Methods

To evaluate the drivers of global fern diversity, we integrate over 800,000 georeferenced species occurrence records of nearly 8000 species, a time‐calibrated phylogeny and seven climate and environmental layers. We use these data to summarize diversity and evolutionary patterns at a resolution of 100 × 100 km, and identify hotspots of fern species richness and endemism. We compare these hotspots to neighbouring non‐hotspot regions to provide insight into the factors controlling global patterns of fern diversity.

Results

Tropical and subtropical mountains harbour a disproportionate amount of species relative to the land area they occupy; 58% of global species richness occur in eight principally montane hotspots together comprising just 7% of Earth’s land area. We identify hotspots of fern species richness and endemism that are universally characterized by disproportionately high ecological variation. We demonstrate that total fern species richness scales linearly with available climate space at regional and global scales.

Main Conclusions

Areas of high environmental heterogeneity harbour a disproportionate amount of fern species, and global patterns of extant fern diversity reflect the distribution of these areas, especially in mountains at lower latitudes. Persistence of ancient lineages in areas with long‐term climatic stability helps explain exceptional endemism in regions such as Malesia.
Clinical significance of nocturnal home blood pressure monitoring and nocturnal hypertension in Asia
Authors: Fujiwara Takeshi , Hoshide Satoshi , Tomitani Naoko , Cheng Hao‐min , Soenarta Arieska Ann , Turana Yuda , Chen Chen‐Huan , Minh Huynh Van , Sogunuru Guru Prasad , Tay Jam Chin , Wang Tzung‐Dau , Chia Yook‐Chin , Verma Narsingh , Li Yan , Wang Ji‐Guang , Kario Kazuomi
Published: February 2021

Nocturnal home blood pressure (BP) monitoring has been used in clinical practice for ~20 years. The authors recently showed that nocturnal systolic BP (SBP) measured by a home BP monitoring (HBPM) device in a Japanese general practice population was a significant predictor of incident cardiovascular disease (CVD) events, independent of office and morning home SBP levels, and that masked nocturnal hypertension obtained by HBPM (defined as nocturnal home BP ≥ 120/70 mmHg and average morning and evening BP < 135/85 mmHg) was associated with an increased risk of CVD events compared with controlled BP (nocturnal home BP < 120/70 mmHg and average morning and evening BP < 135/85 mmHg). This evidence revealed that (a) it is feasible to use a nocturnal HBPM device for monitoring nocturnal BP levels, and (b) such a device may offer an alternative to ambulatory BP monitoring, which has been the gold standard for the measurement of nocturnal BP. However, many unresolved clinical problems remain, such as the measurement schedule and conditions for the use of nocturnal HBPM. Further investigation of the measurement of nocturnal BP using an HBPM device and assessments of the prognostic value are thus warranted. Asians are at high risk of developing nocturnal hypertension due to high salt sensitivity and salt intake, and the precise management of their nocturnal BP levels is important. Information and communication technology‐based monitoring devices are expected to facilitate the management of nocturnal hypertension in Asian populations.
Carp edema virus‐related mortality in wild adult common carp (cyprinus carpio) in Italy
Authors: Marsella Andrea , Pretto Tobia , Abbadi Miriam , Quartesan Rosita , Cortinovis Luana , Fiocchi Eleonora , Manfrin Amedeo , Toffan Anna
Published: February 2021

Mortality in wild fish populations represents a challenging issue for public fish health inspectors. When a single fish species is involved, an infective aetiology is frequently suspected, with focus on viral notifiable diseases. However, other viral agents not subjected to regulation and causing mortality in common carp have been reported such as carp edema virus (CEV). In mid‐June 2020, a severe common carp mortality was observed in an artificial lake in north‐east of Italy. Sleepy fish were noted some days before the beginning of the mortality itself, which lasted several days and involved over 340 adult specimens. During the outbreak, water temperature was around 15°C, water quality was normal, and no adverse meteorological events were reported in the area. Four specimens, which showed severe cutaneous hyperaemia and increased mucus production on skin and gills, were tested by bacteriological methods and virological analysis targeting the main carp pathogens. Molecular analysis performed on gills, kidney and brains from all the fish analysed resulted positive for CEV, which, based on anamnestic information and laboratory findings, was considered the responsible for the mortality event herein described.
Ethylene‐induced stomatal closure is mediated via MKK1/3–MPK3/6 cascade to EIN2 and EIN3
Authors: Zhang Teng‐Yue , Li Zhong‐Qi , Zhao Yu‐Dong , Shen Wen‐Jie , Chen Meng‐Shu , Gao Hai‐Quan , Ge Xiao‐Min , Wang Hui‐Qin , Li Xue , He Jun‐Min
Published: February 2021

Mitogen‐activated protein kinases (MPKs) play essential roles in guard cell signaling, but whether MPK cascades participate in guard cell ethylene signaling and interact with hydrogen peroxide (H2O2), nitric oxide (NO), and ethylene‐signaling components remain unclear. Here, we report that ethylene activated MPK3 and MPK6 in the leaves of wild‐type Arabidopsis thaliana as well as ethylene insensitive2 (ein2), ein3, nitrate reductase1 (nia1), and nia2 mutants, but this effect was impaired in ethylene response1 (etr1), nicotinamide adenine dinucleotide phosphate oxidase AtrbohF, mpk kinase1 (mkk1), and mkk3 mutants. By contrast, the constitutive triple response1 (ctr1) mutant had constitutively active MPK3 and MPK6. Yeast two‐hybrid, bimolecular fluorescence complementation, and pull‐down assays indicated that MPK3 and MPK6 physically interacted with MKK1, MKK3, and the C‐terminal region of EIN2 (EIN2 CEND). mkk1, mkk3, mpk3, and mpk6 mutants had typical levels of ethylene‐induced H2O2 generation but impaired ethylene‐induced EIN2 CEND cleavage and nuclear translocation, EIN3 protein accumulation, NO production in guard cells, and stomatal closure. These results show that the MKK1/3–MPK3/6 cascade mediates ethylene‐induced stomatal closure by functioning downstream of ETR1, CTR1, and H2O2 to interact with EIN2, thereby promoting EIN3 accumulation and EIN3‐dependent NO production in guard cells.
An x‐ray microanalytical method for measuring in vivo element and water concentrations, relating to osmoregulation, in cells and tissues of the posterior eye
Authors: Marshall Alan T. , Crewther Sheila G.
Published: February 2021

Osmoregulation is critical for cell and tissue survival yet there are relatively few methods available to determine osmotic gradients from water and elemental concentration either in single cells or across multiple cellular layers of tissue. X‐ray microanalysis of frozen‐hydrated preparations in a scanning electron microscope is one such powerful, sensitive, nondestructive technique. Here we use x‐ray microanalysis to quantitatively analyse intracellular element concentrations and oxygen concentrations, as a proxy for water concentrations, in selected individual cells of the posterior eye. Using frozen‐hydrated preparations of the retinal complex of chicken eyes, it is shown that structural preservation is sufficient to identify cell layers and individual cells. The quantitative analysis of selected areas in the photoreceptor layer, inner nuclear layer and ganglion cell layer, where specific cell types were known to be present, provided measurements of intracellular element concentrations comparable with the analysis of individual cells. It is also shown that in the cells of the retinal pigment epithelium and outer photoreceptor segments elemental analyses were reasonably consistent at the cellular level in different depth levels of the same sample. Comparison of oxygen concentrations, as a proxy for water concentration, at two accelerating voltages (15 and 5 kV) indicated that at 15 kV oxygen concentration was largely derived from intracellular water. Water concentrations could be calculated and concentrations of diffusible elements (Na, K) could be defined in mmol/L. From the latter it is possible to calculate osmotic concentrations of individual cells and osmotic gradients across the tissue.

Lay Description

Understanding many cellular processes, in both healthy and diseased states, depends on knowing how the water content of cells and their surrounding fluids is controlled. The transport of water is generally down its concentration gradient or against the osmotic concentration gradient defined by solutes such as sodium, potassium and chloride dissolved in the water. We have refined a microanalytical method, that detects the x‐rays emitted from specific elements when they are bombarded by electrons in a scanning electron microscope, to apply it to the analysis of the retina of the eye. The method facilitates the measurement of the elemental composition, water and osmotic concentration gradients of cells and tissues in the eye, that may be involved in the development of myopia, or short sightedness, a condition that afflicts many people including some 80 ‐ 90% of children in Asia.
Effects of leukoreduction on storage lesions in whole blood and blood components of dogs
Authors: Stefani Annalisa , Capello Katia , Carminato Antonio , Wurzburger Wendy , Furlanello Tommaso , Bertazzo Valentina , Marsilio Elisabetta , Albertin Elena , La Pietra Giacomo , Bozzato Elisa , Mutinelli Franco , Vascellari Marta
Published: February 2021

Background

Leukoreduction is a routine procedure in human transfusion medicine but is uncommon in veterinary.

Objectives

To evaluate the effect of leukoreduction on the quality of canine whole blood (WB) and blood products during storage.

Animals

Ten canine blood donors.

Methods

This is a case series study. An amount of 450 mL of blood was collected from each dog. Five WB and 5 packed red blood cells (pRBC) bags were divided into 2 units each: leukoreduced (LR) and non‐leukoreduced (nLR). RBC count, erythrocytes' mean osmotic fragility (MOF), 2,3‐diphosphoglycerate (2,3‐DPG), adenosine triphosphate (ATP), percentage of hemolysis, potassium (K), lactate, glucose, and cytokines were measured weekly from day of donation (T0) to day 35 (T35); pH, coagulation times, and clotting factors were evaluated at T0 and T35 from WB and in fresh frozen plasma after 1 year of storage.

Results

Leukoreduction showed positive effects on lactate (T35: LR WB 14.42 mmol/L SD 2.71, nLR WB 22.42 mmol/L SD 1.86, LR pRBC 20.88 mmol/L SD 2.65, nLR pRBC 36.81 mmol/L SD 2.34; P < .0001), pH (T35: LR WB 6.88 SD 0.16, nLR WB 6.69 SD 0.20, P = .02; LR pRBC 6.57 SD 0.23, nLR pRBC 6.22 SD 0.11; P < .001), and K (LR pRBC 4.08 mmol/L SD 0.88, nLR pRBC 5.48 mmol/L SD 0.90; P < .001). Increasing values of IL8 were observed in nLR units during storage (T0: 4167 ± 11 888 pg/mL; T35: 6367 ± 11 612 pg/mL).

Conclusion and Clinical Importance

LR blood units are recommended to critically ill dogs with marked inflammatory conditions.
Who Succeeds in the Competition for Regional Dominance in the Contemporary Middle East?
Authors: Honig Or Arthur , Arsenault Joshua T.
Published: February 2021

Since the end of World War II, several local actors have tried to gain regional dominance in the Middle East. These attempts have met with varying levels of success. This study seeks to explain this variation. We will not address the equally important question of when and why specific states decide to make bids for regional dominance. We maintain that while realism is a useful theoretical lens for explaining this variation, it is necessary to adjust some realist assumptions slightly to make realism work well in the Middle Eastern context. This is so because realism was developed based on modern European and American experiences. Specifically, our adjustments of realism's assumptions produced the following three preconditions that must be met for a local actor's bid to succeed. First, one must pursue those types of power which are the most potent at a specific time given the Middle Eastern environment. Second, while traditional realists recommend forging large coalitions by reducing threat perception and making bargains through traditional diplomacy or Realpolitik, we argue that domination through subversion or intimidation is more effective. Third, one must not only avoid counterproductive intervention by the great powers, but also have them actively on one's side.
Democrats’ Attitudes toward the Israeli‐Palestinian Conflict
Authors: Rynhold Jonathan
Published: February 2021

Since 2015, there has been a sharp turnaround in US Democrats’ sympathies for Israel and the Palestinians. The percentage of Democrats with a preference for Israel is more or less tied with those preferring the Palestinians, wiping out Israel's historic advantage. Long‐term processes of liberalization and secularization have generated a more difficult environment for Israel and a more favorable one for the Palestinians, but they alone do not account for the shift. Rather, the fusing of these trends with changes in Israel triggered the change. The formation of a narrow right‐wing government in 2015 played a significant role. However, the primary cause of the collapse in sympathy for Israel was the way in which Prime Minister Benjamin Netanyahu's Republican‐first strategy to block the Iran nuclear deal turned Israel into a highly salient motif of partisanship at a time of unparalleled hostility between the two major US parties. While the fall in sympathy for Israel spans both wings of the Democratic Party, the sharp increase in sympathy for the Palestinians has occurred primarily among liberal Democrats. It is intertwined with the growing political salience of Black Lives Matter, which helps to generate a narrative associating racial discrimination in America with the plight of the Palestinians.
Syria‐Russia and the “Arab Spring“: A Reassessment
Authors: Blanga Udi
Published: February 2021

After a decade of civil war, hundreds of thousands of casualties and immense destruction is now clear that Bashar al‐Assad won the war in Syria. Assad's victory in the war is the result of a variety of reasons, one of them is the military and economic assistance he received from Russia, his close ally. The present article follows the Russian involvement in Syria and examines what are Russia's interests in Syria? Has the Kremlin taken a uniform and consistent diplomatic position towards Syria and the Middle East, both in the Soviet era and after the fall of the USSR, or has its policy changed over the years? Why did Moscow see fit to intervene in the internal Syrian conflict in 2015, considering that until then the United States seemed to have been dominant in the Middle East? Finally, did Russia take this action out of global motives that go beyond the regional context? In this context, the main argument of this article is that the Syrian civil war gave Moscow a one‐time opportunity to penetrate the Middle East more deeply and further its ambitions in the region. Moscow identified an outstanding opportunity to restore its status as a superpower and promote its regional and global objectives, at the expense of the United States.
Resisting Change: Tunisia and Algeria Manage Islamism
Authors: Zhang Chuchu , Zoubir Yahia H.
Published: February 2021

Abtstract

A recurrent question is whether Islamist parties surreptitiously capitalize on political change to weaken or establish their own authoritarianism. In this article, we contend that the answer to this question depends largely on how ruling elites in authoritarian systems structure and manage the Islamist marketplace, thus affecting the position of Islam in politics and society. In our comparative analysis of Tunisia and Algeria, we distinguish between a state‐dominated Islamist marketplace and a managed, open, pluralist Islamist marketplace. We postulate that Islamist parties in monopolized Islamist marketplaces are more likely to gain ground when they challenge authoritarianism. Thus, the marginalization/repression of Islamist political parties cannot, nor should it, seek to eliminate Islamist sentiments, while the opening of an Islamist pluralist marketplace is less likely to produce a hegemonic Islamist political party. The analysis of the trajectories of the Islamist movements informs on the management of Islamism and provides lessons for the Middle East and North Africa (MENA) and, conceivably, Islamic States elsewhere. Therefore, both policy makers and academics should renounce “de‐Islamizing” an Islamic society and focus instead on judicious approaches to managing Islamism in Muslim‐dominated societies and integrating Islamist parties into a democratic polity.