bluuebunny/crossref_metadata_2025 huggingface dataset:
Differential coexistence of multiple genotypes ofOphiocordyceps sinensisin the stromata, ascocarps and ascospores of naturalCordyceps sinensis
Authors: Li Yu-Ling , Li Xiu-Zhang , Yao Yi-Sang , Wu Zi-Mei , Gao Ling , Tan Ning-Zhi , Luo Zhou-Qing , Xie Wei-Dong , Wu Jian-Yong , Zhu Jia-Shi
Published: June 2022

Objective

To examine the differential occurrence ofOphiocordyceps sinensisgenotypes in the stroma, stromal fertile portion (SFP) densely covered with numerous ascocarps, and ascospores of naturalCordyceps sinensis.

Methods

Immature and matureC. sinensisspecimens were harvested. MatureC. sinensisspecimens were continuously cultivated in our laboratory (altitude 2,200 m). The SFPs (with ascocarps) and ascospores ofC. sinensiswere collected for microscopic and molecular analyses using species-/genotype-specific primers. Sequences of mutant genotypes ofO. sinensiswere aligned with that of Genotype #1Hirsutella sinensisand compared phylogenetically using a Bayesian majority-rule method.

Results

Fully and semiejected ascospores were collected from the same specimens. The semiejected ascospores tightly adhered to the surface of the asci as observed by the naked eye and under optical and confocal microscopies. The multicellular heterokaryotic ascospores showed uneven staining of nuclei. The immature and mature stromata, SFPs (with ascocarps) and ascospores were found to differentially contain several GC- and AT-biased genotypes ofO. sinensis, Samsoniella hepiali, and an AB067719-type fungus. The genotypes within AT-biased Cluster-A in the Bayesian tree occurred in all compartments ofC. sinensis, but those within AT-biased Cluster-B were present in immature and mature stromata and SPFs but absent in the ascospores. Genotype #13 ofO. sinensiswas present in semi-ejected ascospores and Genotype #14 in fully ejected ascospores. GC-biased Genotypes #13-14 featured large DNA segment substitutions and genetic material recombination between the genomes of the parental fungi (H. sinensisand the AB067719-type fungus). These ascosporic offspring genotypes combined with varying abundances ofS. hepialiin the 2 types of ascospores participated in the control of the development, maturation and ejection of the ascospores.

Conclusion

Multiple genotypes ofO. sinensiscoexist differentially in the stromata, SFPs and 2 types ofC. sinensisascospores, along withS. hepialiand the AB067719-type fungus. The fungal components in different combinations and their dynamic alterations in the compartments ofC. sinensisduring maturation play symbiotic roles in the lifecycle of naturalC. sinensis.
The cohesin subunit RAD21.2 functions as a recombination silencer of ribosomal DNA arrays
Authors: Kuttig Viola , Sims Jason , Hamamura Yuki , Komaki Shinichiro , Köhler Maren , Stolze Sara Christina , De Jaeger-Braet Joke , Tuncay Elbasy Hasibe , Nakagami Hirofumi , Failla Antonio Virgilio , Schlögelhofer Peter , Schnittger Arp
Published: June 2022

Introductory Paragraph

In many species, including Arabidopsis, heterochromatin often comprises repetitive DNA elements, such as arrays of ribosomal DNA (rDNA). Repetitive regions pose a risk in meiosis since recombination between them can lead to gross genomic rearrangements. However, meiotic recombination at rDNA arrays and other heterochromatic repeat regions is blocked by not well understood mechanisms. Here, we have identified RAD21.2, an α-kleisin subunit of cohesin, as a repressor of meiotic recombination at the rDNA regions in Arabidopsis. We show that RAD21.2 co-localizes with heterochromatic factors and is specifically enriched at rDNA repeats, which are devoid of the meiosis specific α-kleisin REC8, needed for recombination. Knocking down RAD21.2, we find that REC8 moves into the nucleolus organizing regions (NORs), where we see an increase of RAD51 recombinase foci numbers. Concomitantly, we find extensive rearrangements of the NORs and the offspring of these plants have large variation in rDNA copy numbers demonstrating that RAD21.2 is necessary for transgenerational genome stability.

One-Sentence Summary

The cohesin component RAD21.2 represses meiotic recombination and by that contributes to genome stability over generations.
Novel strains of Campylobacter cause diarrheal outbreak in Rhesus macaques (Macaca mulatta) of Kathmandu Valley
Authors: Napit Rajindra , Manandhar Prajwol , Poudel Ajit , Rajbhandari Pragun G. , Watson Sarah , Shakya Sapana , Pradhan Saman M. , Sharma Ajay N. , Chaudhary Ashok , Johnson Christine K. , Mazet Jonna K. , Karmacharya Dibesh
Published: June 2022

Campylobacter spp. is often underreported and underrated bacteria that present real health risks to both humans and animals, including non-human primates. It is a commensal microorganism of gastrointestinal tract known to cause gastroenteritis in humans. Commonly found in many wild animals including non-human primates (monkeys-Rhesus macaques) these pathogens are known to be a common cause of diarrhea in humans in many parts of developing and under developed countries.

Rhesus macaques from the two holy sites in Kathmandu (Pashupati and Swoyambhu) were included in this cross-sectional study. Opportunistic diarrheal samples of monkeys were analyzed to detect and characterize the pathogen using 16S rRNA-based PCR screening, followed by DNA sequencing and phylogenetic analysis.

Out of a total 67 collected diarrheal samples, Campylobacter spp. were detected in the majority of the samples (n=64; 96%). DNA sequences of the amplified PCR products were successfully obtained from 13 samples. Phylogenetic analysis identified Candidatus Campylobacter infans (n=10, Kimura-2 parameter (K2P) pairwise distance values of 0.002287). Remaining three sequences might potentially belong to a novel Campylobacter species/sub-species-closely relating to known species of C. helviticus (K2P pairwise distance of 0.0267). Both Candidatus Campylobacter infans and C. helvitucus are known to infect humans and animals. Additionally, we also detected the bacteria in water and soil samples from the sites. Campylobacter spp. caused the 2018 diarrhea outbreak in Rhesus macaques in the Kathmandu valley. Campylobacter might be one of the important contributing pathogens in diarrheal outbreaks-both in humans and animals (monkeys) in Nepal. Due to close interactions of these animals with humans and other animals, One Health approach might be the most effective way to prevent and mitigate the threat posed by this pathogen.
Oxygen concentration modulates colibactin production
Authors: Bossuet Nadège , Guyonnet Cécile , Chagneau Camille V , Tang-Fichaux Min , Penary Marie , Loubet Dorian , Branchu Priscilla , Oswald Eric , Nougayrede Jean-Philippe
Published: June 2022

Up to 25% of theE. colistrains isolated from the feces of healthy humans harbor thepksgenomic island encoding the synthesis of colibactin, a genotoxic metabolite. Evidence is accumulating for an etiologic role of colibactin in colorectal cancer. Little is known about the conditions of expression of colibactin in the gut. The intestine is characterized by a unique oxygenation profile, with a steep gradient between the physiological hypoxic epithelial surface and the anaerobic lumen, which favors the dominance of obligate anaerobes. Here, we report that colibactin production is maximal under anoxic conditions and decreases with increased oxygen concentration. We show that the aerobic respiration control (ArcA) positively regulates colibactin production and genotoxicity ofpks+ E. coliin response to oxygen availability. Thus, colibactin synthesis is inhibited by oxygen, indicating that thepksbiosynthetic pathway is adapted to the anoxic intestinal lumen and to the hypoxic infected or tumor tissue.
Derivation of closed-form ellipsoidal X-ray mirror shapes from Fermat's principle
Authors: Goldberg Kenneth A.
Published: June 2022

Ellipsoidal and plane-elliptical surfaces are widely used as reflective, point-to-point focusing elements in many optical systems, including X-ray optics. Here the classical optical path function approach of Fermat is applied to derive a closed-form expression for these surfaces that are uniquely described by the object and image distances and the angle of incidence at a point on a mirror surface. A compact description facilitates design, modeling, fabrication, and testing to arbitrary accuracy. Congruent surfaces in two useful coordinate systems — a system centered on the ellipsoid's axes of symmetry and a mirror-centered or `vertex' system with the surface tangent to the xy plane at the mirror's center — are presented. Expressions for the local slope and radii of curvature are derived from the result, and the first several terms of the Maclauren series expansion are provided about the mirror center.
Financial inclusion using corporate social responsibility: a socio-economic demand–supply analysis
Authors: Ibne Afzal Munshi Naser , Nayeem Sadi Md Abu , Siddiqui Shamim Ahmad
Published: June 2022

Purpose

Corporate social responsibility (CSR) aims at upholding socio-economic condition of deprived communities prevailing in society as well as bringing profitability for corporate companies themselves. This study investigates to what extent the CSR initiatives of financial institutions in Bangladesh have been able to reach out to deprived communities and support various dimensions of financial inclusion (FI) in the country.

Design/methodology/approach

In this study, both supply-side and demand-side data are included and discussed rigorously as tools to cross-check the result. Both qualitative and quantitative data are incorporated, and graphs and tables are used to represent the critical information better. A triangulation of in-depth interviews with secondary data is used to ensure rigor and trustworthiness. The triangulation approach works as a method to verify secondary data by interviewees in this study.

Findings

The result shows a positive geographical and demographical penetration of CSR activities, but it does not necessarily bring FI in all cases. This study identifies some key issues that prevail in the current context of Bangladesh, such as usage, distance, quality and cost of financial products.

Originality/value

This study makes use of both supply-side and demand-side information and thus explain the reasons behind the involuntary exclusion of financial services.
Relationship of green human resource management with environmental performance: mediating effect of green organizational culture
Authors: Aggarwal Priyanka , Agarwala Tanuja
Published: June 2022

Purpose

Environment concerns and climate changes have led organizations to reorient their processes with a focus toward sustainability. Organizations recognize that incorporating greening in HR practices has the potential to address environmental concerns. The present study aims to focus on investigating the relationship between green human resource management (GHRM) practices and environmental performance (EP). It is premised that the adoption of green human resource practices facilitates the development of a green organizational culture (GOC) that helps the organization to gain strategic business advantage with respect to the competitors. The literature suggests that the adoption of green human resource practices among organizations is at a nascent stage. The present study focusses on understanding the mediating role of three dimensions of GOC, that is, degree, diffusion and depth in the relationship between green human resource practices and EP that has not been addressed in the empirical literature.

Design/methodology/approach

The present study developed a model consisting of GHRM practices as an independent variable, the three dimensions of culture (degree, diffusion and depth) as mediators, and EP as the dependent variable. The study followed a quantitative exploratory research approach. The sample consisted of 278 employees from private and public sector organizations located in India. The hypothesized model was analyzed using structural equation modeling (SEM).

Findings

The study found the green human resource practices to be significantly related with EP of the organization. Results of parallel mediation confirmed that the “degree” dimension of GOC played a significant mediating role in the relationship between green human resource practices and EP of the organization. The other two dimensions of GOC, diffusion and depth, did not have a significant mediating role in this relationship. The findings of the study have been explained in the context of social identity theory, resource based view and ability–motivation–opportunity theory.

Practical implications

The study provides practical insights for researchers and managers who seek to adopt sustainability objectives in the organization. The findings have the potential to encourage human resource managers to adopt green human resource management practices toward promoting a culture of greening in the organization. The importance of developing and measuring EP targets for industry leadership is also emphasized.

Originality/value

The originality of the study lies in classifying and understanding GOC in terms of three dimensions, that is, degree, diffusion and depth, following the model proposed by Harris and Crane (2002). The three dimensions help in assessing the current level of GOC. This assessment promotes the judicious application of resources by the organization and adopts green practices to foster the organizational EP.
Exploring relationships between service quality dimensions and customers satisfaction: empirical study in context to Indian logistics service providers
Authors: Gupta Anchal , Singh Rajesh Kumar , Mathiyazhagan K. , Suri Pradeep Kumar , Dwivedi Yogesh K.
Published: June 2022

Purpose

This study aims to identify service quality dimensions for logistics service providers (LSPs) and to examine their relationships with customer satisfaction and customer loyalty.

Design/methodology/approach

Service quality dimensions are identified from vast literature review. Customers who take services from LSPs were surveyed to collect data on basis of developed survey instrument. Structural Equation Modelling (SEM) is applied to test the proposed research hypotheses.

Findings

The study shows that all the five service quality constructs, i.e. “Operational Quality”, “Resource Quality”, “Information Quality”, “Personnel Contact Quality” and “Customization and Innovation Quality” have direct relationship with customer satisfaction. They also have indirect relationship with customer loyalty, implying the full mediation of customer satisfaction.

Practical implications

The results of the study suggest that the logistics service quality (LSQ) can be measured multi-dimensionally. It provides clear implications to LSPs for improvement of service quality. The present research work is expected to be useful for both, logistics service providers and the customer organizations, which take services from LSPs. LSPs can develop strategies to improve their service quality on basis of findings from this study.

Originality/value

The present research will help in extending the existing literature on service quality in context to LSPs.
Attitude towards pharmaceutical promotional tools and its influence on physicians’ prescribing behaviour in Sudan
Authors: Eldrwish May Alowi , Aigbogun Osaro , Kani Yusuf , Sambasivan Murali
Published: June 2022

Purpose

Due to the proliferation of generic medicines, pharmaceutical marketing has become increasingly competitive, and marketing executives are now focusing their attention on understanding the prescribing behaviour of physicians to enable them to devise marketing strategies that would put them at a superior business position relative to their competitors. Previous studies carried out either lack a sound theoretical foundation, or report contrasting results, making generalizations sketchy. Thus, a better understanding of attitude-prescribing axiom is needed. Underpinned by the theory of reasoned action (TRA), this study aims to empirically examine the factors that predict the prescribing behaviour of physicians.

Design/methodology/approach

A conceptual model was developed and tested on a sample of 355 respondents drawn from 76 private and 50 public hospitals in Sudan. The data set from the questionnaire survey included both general practitioners (N = 200) and specialists (N = 155). Primary data gathered were analysed using partial least squares structural equation modelling (PLS-SEM).

Findings

The findings reveal that the prescribing behaviour of physicians is positively influenced by the physician’s attitude towards direct marketing, personal selling, educational travel and public relations, but negatively influenced by gifts. Besides, the moderating effect of subjective norms showed no significant influence on the relationship between attitude and prescribing behaviour. However, gender seems to moderate the attitude towards health sector-related charity on prescribing behaviour and the attitude towards scientific conferences on prescribing behaviour.

Research limitations/implications

The findings gathered from this study offers a significant contribution to the ongoing debate on the essential factors that influence the prescribing behaviour of physicians in the hospital setting.

Originality/value

By examining the essential factors that predict physicians’ prescribing behaviour, pharmaceutical companies can improve their understanding of physicians’ attitudes towards the pharmaceutical promotional tools. This is an aspect that is ill reflected in the literature.
Mediating effect of firm’s customer centricity and market orientation on the relationship between the knowledge management and business performance
Authors: Dash Ajitabh
Published: June 2022

Purpose

The purpose of this paper is to examine the mediating effect of a firm’s customer centricity and market orientation on the relationship between the knowledge management and business performance.

Design/methodology/approach

The hypotheses proposed for this study were tested on the data collected from 274 sample firms using partial least square-based structural equation modeling.

Findings

According to the findings of this study, a firm’s customer-centricity fully mediates the relationship between explicit and tacit knowledge management and a firm’s business performance, whereas a firm’s market orientation partially mediates the relationship between tacit and implicit knowledge management systems and a firm’s business performance.

Originality/value

This study can be considered as a pioneer work that investigates how explicit and tacit knowledge can be transformed into business performance with the mediating effect of a firm’s customer centricity and market orientation on this relationship.
Specific detection of viable Cronobacter sakazakii in powdered infant formula by phage amplification combined with qPCR (PAA‐qPCR) assay
Authors: Zhang Yuan‐Song , Yuan Lei , Chen Cao‐Wei , Mgomi Fedrick C , Yang Zhen‐Quan , Jiao Xin‐an
Published: June 2022

Cronobacter sakazakii is a foodborne pathogen that has become a significant challenge to public health and poses a serious risk to food safety, especially in powdered infant formula. This study applied a novel approach combining the Phage Amplification Assay with qPCR (PAA‐qPCR), amplifying the C. sakazakii phage EspYZU12 coupled with phage‐specific qPCR to detect viable C. sakazakii in milk samples. Results showed that the limit of detection of 6.58 × 102 CFU/mL of C. sakazakii could be assayed in less than 5.5 h with phage EspYZU12 (103 PFU/mL). Additionally, compared with plate counting, the accuracy factor value (Af), the bias factor value (Bf) and the root mean square error (RMSE) of the PAA‐qPCR method were 1.029, 1.026 and 1.808 respectively. The PAA‐qPCR method exhibited high sensitivity, rapidity and specificity for detecting live C. sakazakii in dairy products.
Chromosome‐scale genomes reveal genomic consequences of inbreeding in the South China tiger: A comparative study with the Amur tiger
Authors: Zhang Le , Lan Tianming , Lin Chuyu , Fu Wenyuan , Yuan Yaohua , Lin Kaixiong , Li Haimeng , Sahu Sunil Kumar , Liu Zhaoyang , Chen Daqing , Liu Qunxiu , Wang Aishan , Wang Xiaohong , Ma Yue , Li Shizhou , Zhu Yixin , Wang Xingzhuo , Ren Xiaotong , Lu Haorong , Huang Yunting , Yu Jieyao , Liu Boyang , Wang Qing , Zhang Shaofang , Xu Xun , Yang Huanming , Liu Dan , Liu Huan , Xu Yanchun
Published: June 2022

The South China tiger (Panthera tigris amoyensis, SCT) is the most critically endangered subspecies of tiger due to functional extinction in the wild. Inbreeding depression is observed among the captive population descended from six wild ancestors, resulting in high juvenile mortality and low reproduction. We assembled and characterized the first SCT genome and an improved Amur tiger (P. t. altaica, AT) genome named AmyTig1.0 and PanTig2.0. The two genomes are the most continuous and comprehensive among any tiger genomes yet reported at the chromosomal level. By using the two genomes and resequencing data of 15 SCT and 13 AT individuals, we investigated the genomic signature of inbreeding depression of the SCT. The results indicated that the effective population size of SCT experienced three phases of decline, ~5.0–1.0 thousand years ago, 100 years ago, and since captive breeding in 1963. We found 43 long runs of homozygosity fragments that were shared by all individuals in the SCT population and covered a total length of 20.63% in the SCT genome. We also detected a large proportion of identical‐by‐descent segments across the genome in the SCT population, especially on ChrB4. Deleterious nonsynonymous single nucleotide polymorphic sites and loss‐of‐function mutations were found across genomes with extensive potential influences, despite a proportion of these loads having been purged by inbreeding depression. Our research provides an invaluable resource for the formulation of genetic management policies for the South China tiger such as developing genome‐based breeding and genetic rescue strategy.
Alcohol consumption at age 18–25 and number of children at a 33‐year follow‐up: Individual and within‐pair analyses of Finnish twins
Authors: Rose Richard J. , Latvala Antti , Silventoinen Karri , Kaprio Jaakko
Published: June 2022

Background

Do drinking patterns in late adolescence/early adulthood predict lifetime childlessness and number of children? Research on this question has been only tangentially relevant and the results inconsistent. The designs used to date have been compromised by genetic and environmental confounds that are poorly controlled; covariate effects of smoking and education that are often ignored; males being understudied; population‐based sampling rare, and long‐term prospective studies with genetically informative designs yet to be reported.

Method

In a 33‐year follow‐up, we linked the drinking patterns of >3500 Finnish twin pairs, assessed at ages 18–25, to registry data on their eventual number of children. Analyses distinguished associations of early drinking patterns with lifetime childlessness from those predictive of family size. Within‐twin pair analyses used fixed‐effects regression models to account for shared familial confounds and genetic liabilities. Childlessness was analyzed with Cox proportional hazards models and family size with Poisson regression. Analyses within‐pairs and of twins as individuals were run before and after adjustment for smoking and education, and for oral contraceptive (OC) use in individual‐level analyses of female twins.

Results

Baseline abstinence and heavier drinking both significantly predicted lifetime childlessness in individual‐level analyses. Few abstinent women used OCs, but they were nonetheless more often eventually childless; adjusting for smoking and education did not affect this finding. Excluding childless twins, Poisson models of family size showed heavier drinking at 18–25 to be predictive of fewer children in both men and women. Those associations were replicated in within‐pair analyses of dizygotic twins, each level of heavier drinking being associated with smaller families. Among monozygotic twins, associations of drinking with completed family size yielded effects of similar magnitude, reaching significance at the highest levels of consumption, ruling out familial confounds.

Conclusions

Compared to moderate levels of drinking, both abstinence and heavier drinking in late adolescence/early adulthood predicted a greater likelihood of lifetime childlessness and eventual number of children. Familial confounds do not fully explain these associations.
Efficacy of insecticide aerial spraying programs to reduce tree mortality during a spruce budworm outbreak (1967–1992) in the province of Quebec
Authors: Fuentealba Alvaro , Dupont Alain , Quezada‐García Roberto , Bauce Éric
Published: June 2022

Spruce budworm (Choristoneura fumiferana) is the most important pest of conifer forests in eastern North America. The main approach for protecting forests against this defoliator is aerial spraying of insecticides. Despite the crucial role of aerial insecticide applications in the global forest protection strategy, little is known about its real effects on tree mortality or the stand characteristics that may affect its long‐term efficacy.

We evaluated the efficacy of the protection program that was implemented during the 1967–1992 outbreak in Quebec (Canada) in tree mortality reduction. We established 422 plots in eastern Quebec based upon the following parameters: insecticide application; stand composition; drainage quality; and stand age.

Unprotected plots exhibited 18 to 44% greater tree mortality than protected plots. Insecticide efficacy was affected by drainage condition. Protected plots that established on sites with poor quality drainage exhibited 67.53% lower balsam fir (Abies balsamea) mortality than did unprotected plots. Stand age did not affect tree mortality. Insecticide application had no substantial effect on spruce mortality. Our study also found that the return on protection investment in terms of mortality reduction may decline after 7 years of aerial spraying, and that it is not necessary to achieve the target protection goal (50% foliage protection) every year to reduce host tree mortality.

Our results may be useful for decision‐makers to decide where and when to apply insecticides during a spruce budworm outbreak and may help to determine the appropriateness of treating the forest on an annual basis depending upon the protection goals.
Lipiodol flushing under ultrasound guidance at time of hystero‐salpingo contrast sonography (HyCoSy): A retrospective observational study
Authors: Hu Hillary , Kirby Adrienne , Dowthwaite Sarah , Mizia Karen , Zen Monica
Published: June 2022

Background

Up to 30% of female infertility can be attributed to tubal abnormalities. Assessment of fallopian tube patency forms a component of the basic assessment of infertility. Tubal patency can be checked through hysterosalpingogram (HSG) under radiologic guidance with oil‐ or water‐based contrast medium (OBCM or WBCM), or hystero‐salpingo contrast sonography (HyCoSy) under ultrasound guidance with WBCM. Tubal flushing with OBCM has been shown to improve fertility rates.

Objectives

To study the feasibility and tolerability of performing Lipiodol (ethiodised oil) flush concurrently with HyCoSy. To examine the in vivo sonographic visibility of Lipiodol vs normal saline.

Materials and Methods

Retrospective observational study of patients with subfertility referred for Lipiodol flushing under ultrasound guidance between August 2017–September 2020 at six private ultrasound practices in Sydney, Australia.

Results

There were 412 patients who were referred for Lipiodol flushing. Of these, 86 patients did not have concurrent Lipiodol flush at HyCoSy performed due to strict exclusion criteria. Of the 326 patients who proceeded with Lipiodol flushing at HyCoSy, all cases were successful, with no cases of extravasation. There were no major complications. In vivo sonographic visualisation of Lipiodol was similar to that of the commonly used agitated 0.9% saline (n = 20; mean visibility score 4.3 ± 0.9 vs 4.0 ± 1.2).

Conclusion

Our study has shown that Lipiodol flushing at time of HyCoSy as a single procedure is feasible and tolerable to patients. Flushing with Lipioidol during HyCoSy is likely as sonographically visible as 0.9% saline.
Starting with us: Imagining relational, co‐designed policy approaches to improve healthcare access for rural people with disability
Authors: Quilliam Claire , O'Shea Amie , Holgate Nadine , Alston Laura
Published: June 2022

Context

Access to healthcare for rural Australians is a wicked problem, particularly for rural people with disability. Contemporary healthcare access frameworks in Australia tend to overlook geography, use a ‘one‐size‐fits‐all approach’, and disregard the valuable relationships between key rural healthcare stakeholders, including rural people with disability, rural health services and health professionals. The United Nation's Convention on the Rights of Persons with Disabilities requires the Australian Government to engage people with disability in the design of policies that will shape their day‐to‐day lives, including their access to healthcare. However, the nature and extent to which rural people with disability, rural health professionals and other key rural stakeholders are involved in the design of Australian policies impacting the health of rural people with disability are unknown.

Aim

This paper examines approaches taken to engage rural people with disability and health professionals in the design of Australian disability policy impacting healthcare access, and reimagines future processes which can improve healthcare access for rural people with disability.

Approach

Co‐design and ethics of care lenses are applied to policy design approaches in this paper. We approach this work as rural disability and health academics, rural health professionals, and as rural people with disability, neurodivergence and family members of people with disability.

Conclusion

We argue future co‐designed policy approaches could focus on driving change towards equity in healthcare access for rural people with disability by harnessing the relational nature of rural healthcare.
Does the distance between residency and implanting center affect the outcome of patients supported by left ventricular assist devices? A multicenter Italian study on radial mechanically assisted circulatory support (MIRAMACS) analysis
Authors: Lechiancole Andrea , Loforte Antonio , Scandroglio Mara , Comisso Marina , Iacovoni Attilio , Maiani Massimo , Gliozzi Gregorio , De Bonis Michele , Musumeci Francesco , Terzi Amedeo , Pacini Davide , Livi Ugolino
Published: June 2022

Background

Patients with LVAD require continuous monitoring and care, and since Implanting Centers (ICs) are more experienced in managing LVAD patients than other healthcare facilities, the distance between patient residency and IC could negatively affect the outcomes.

Methods

Data of patients discharged after receiving an LVAD implantation between 2010 and 2021 collected from the MIRAMACS database were retrospectively analyzed. The population was divided into two groups: A (n = 175) and B (n = 141), according to the distance between patient residency and IC ≤ or >90 miles.

The primary endpoint was freedom from Adverse Events (AEs), a composite outcome composed of death, cerebrovascular accident, hospital admission because of GI bleeding, infection, pump thrombosis, and right ventricular failure. Secondary endpoints were incidences of mortality and complications. All patients were followed‐up regularly, according to participating center protocols.

Results

Baseline clinical characteristics and indications for LVAD did not differ between the two groups. The mean duration of support was 25.5 ± 21 months for Group A and 25.7 ± 20 months for Group B (p = 0.79). At 3 years, freedom from AEs was similar between Group A and Group B (p = 0.36), and there were no differences in rates of mortality and LVAD‐related complications.

Conclusions

Distance from the IC does not represent a barrier to successful outcomes as long as regular and continuous follow‐up is provided.
Assessment of adjuvant chemotherapy benefits after complete mesocolic excision in patients with colon cancer: Reanalysis of data from the ESCME trial
Authors: Wang Chao , Gan Lin , Shen Zhanlong , Jiang Kewei , Gao Zhidong , Ye Yingjiang
Published: June 2022

Aim

The benefits of adjuvant chemotherapy (AC) in colon cancer after complete mesocolic excision (CME) have not been evaluated sufficiently. We reanalysed the ESCME trial data to investigate the survival benefits and establish AC stratified indications.

Methods

The data of Stage II and III colon cancer patients who received CME in the ESCME trial were reanalysed. Patients were divided into AC and non‐AC (NAC) groups. The primary outcomes measured were differences in 5‐year cancer‐specific survival and disease‐free survival (DFS) between the groups.

Results

Of the 206 patients enrolled in the study, 125 patients (AC, 49; NAC, 76) had Stage II cancer and 111 (AC, 86; NAC, 25) had Stage III cancer. There were no significant differences in the adjusted 5‐year cancer‐specific survival and DFS between the AC and NAC groups. Poor differentiation (hazard ratio [HR] 2.947; 95% CI 1.218–7.131) and RAS mutation (HR 3.140; 95% CI 1.363–7.234) affected the 5‐year DFS significantly in multivariate Cox regression analysis for Stage II and III cancer, respectively. In subgroup analysis, AC significantly improved 5‐year DFS (HR 0.369; 95% CI 0.140–0.978) for Stage III cancer with lymphovascular/perineural invasion compared to NAC.

Conclusion

The current indication and benefits of AC for colon cancer patients after CME should be re‐evaluated. AC is more appropriate for Stage III cancer with lymphovascular/perineural invasion.
Metagenomic next‐generation sequencing for the diagnosis of Chlamydia psittaci pneumonia
Authors: Li Hu , Hao Binwei , Wang Yongxue , Yu Dinghong , Chen Zhonghua , Du Duanlin , Xiong Jian , Li Kang , Zhang Hengping , Liu Xu , Liu Kai , Xiao Fanrong , Cheng Xiaosan , Huang Lingmei
Published: June 2022

The aim of this study was to investigate the clinical characteristics of Chlamydia psittaci pneumonia and evaluate the diagnostic value of Metagenomic Next‐Generation Sequencing (mNGS). A total of 44 patients diagnosed with Chlamydia psittaci pneumonia using mNGS were retrospectively analysed. The demographic and clinical features, laboratory data, imaging findings and clinical outcomes were collected. Results showed that 65.91% of the patients had a history of exposure to poultry or birds. All patients presented with fever. Apart from systemic and respiratory symptoms, some patients also presented with digestive and neurological symptoms. Respiratory failure was common among patients. The key laboratory tests were normal white blood cell counts, slightly elevated PCT, changes in levels of cardiac enzymes, liver enzymes and hyponatremia. Chest imaging revealed that most of the lesions contained patchy exudation or lobar consolidation of one lobe, especially in the lower lobe. Consolidation of both lungs was seen in critically ill patients. Although quinolones were effective in most patients, tetracyclines should be the first choice of treatment. The overall prognosis was good; however, patients who developed severe pneumonia had poor prognosis. The incidence of chlamydia psittaci pneumonia may be underestimated due to the nonspecific clinical manifestations and lack of confirmatory testing methods. The use of mNGS has increased the number of patients diagnosed with chlamydia psittaci pneumonia. mNGS is an effective diagnostic method for chlamydia psittaci pneumonia.
Alternatives to rifampicin: A review and perspectives on the choice of strong CYP3A inducers for clinical drug–drug interaction studies
Authors: Bolleddula Jayaprakasam , Gopalakrishnan Sathej , Hu Ping , Dong Jennifer , Venkatakrishnan Karthik
Published: June 2022

N‐Nitrosamine (NA) impurities are considered genotoxic and have gained attention due to the recall of several marketed drug products associated with higher‐than‐permitted limits of these impurities. Rifampicin is an index inducer of multiple cytochrome P450s (CYPs) including CYP2B6, 2C8, 2C9, 2C19, and 3A4/5 and an inhibitor of OATP1B transporters (single dose). Hence, rifampicin is used extensively in clinical studies to assess drug–drug interactions (DDIs). Despite NA impurities being reported in rifampicin and rifapentine above the acceptable limits, these critical anti‐infective drugs are available for therapeutic use considering their benefit–risk profile. Reports of NA impurities in rifampicin products have created uncertainty around using rifampicin in clinical DDI studies, especially in healthy volunteers. Hence, a systematic investigation through a literature search was performed to determine possible alternative index inducer(s) to rifampicin. The available strong CYP3A inducers were selected from the University of Washington DDI Database and their in vivo DDI potential assessed using the data from clinical DDI studies with sensitive CYP3A substrates. To propose potential alternative CYP3A inducers, factors including lack of genotoxic potential, adequate safety, feasibility of multiple dose administration to healthy volunteers, and robust in vivo evidence of induction of CYP3A were considered. Based on the qualifying criteria, carbamazepine, phenytoin, and lumacaftor were identified to be the most promising alternatives to rifampicin for conducting CYP3A induction DDI studies. Strengths and limitations of the proposed alternative CYP3A inducers, the magnitude of in vivo CYP3A induction, appropriate study designs for each alternative inducer, and future perspectives are presented in this paper.
Confirmation of a rubber band as the stone nuclei within common bile duct stones using cholangioscopy
Authors: Soga Koichi , Majima Atsushi , Kitae Hiroaki
Published: June 2022

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Religion's Role in a Martian War of Independence
Authors: Rappaport Margaret Boone , Corbally Christopher J.
Published: June 2022

Astrotheologians and Astroethicists must be futurists at the same time that they articulate theological issues and moral quandaries in future settlement programs. One methodology used to recommend solutions is the construction of a scenario, a story that extrapolates from what is known to what is yet unknown, following models in international planning and operations research. In anticipation of the roles of religion and the clergy in an off‐Earth settlement on Mars, we offer this dramatic story, which takes place during a long, 10‐year Martian War of Independence. Issues framed on Earth (as in the 1962 UN Principles) take on new importance in a multi‐national, multi‐ethic, Martian society, where political and religious leadership based essentially on future versions of ancient Judeo‐Christian principles is key to survival.
Early recognition of SGCE‐myoclonus–dystonia in children
Authors: Correa‐Vela Marta , Carvalho Joao , Ferrero‐Turrion Julia , Cazurro‐Gutiérrez Ana , Vanegas Maria , Gonzalez Victoria , Alvárez Ramiro , Marcé‐Grau Anna , Moreno Antonio , Macaya‐Ruiz Alfons , Pérez‐Dueñas Belén
Published: June 2022

Aim

To evaluate early dystonic features in children and adolescents with SGCE‐myoclonus–dystonia.

Method

In this cross‐sectional study, 49 patients (26 females and 23 males) with SGCE‐myoclonus–dystonia (aged 15y 2mo, SD 12y) with childhood‐onset (2y 10mo, SD 1y 10mo) dystonia were examined using a standardized video recorded protocol. Dystonia was rated using the Writer's Cramp and Gait Dystonia Rating Scales. Disability and impairment for handwriting and walking were also rated.

Results

Dystonia was present at rest (n=1), posture (n=12), and during specific motor tasks (n=45) such as writing (n=35), walking (n=23), and running (n=20). Most children reported disability while performing these tasks. Early dystonic patterns were identified for writer's cramp and gait dystonia, the latter named the ‘circular shaking leg’, ‘dragging leg’, and ‘hobby‐horse gait’ patterns. Sensory tricks were used by five and eight children to improve dystonia and myoclonus during writing and walking respectively. The rating scales accurately measured the severity of action dystonia and correlated with self‐reported disability.

Interpretation

Children with SGCE‐myoclonus–dystonia show recognizable dystonic patterns and sensory tricks that may lead to an early diagnosis and timely therapeutic approach. Isolated writer's cramp is a key feature in childhood and should prompt SCGE analysis. The proposed action dystonia scales could be used to monitor disease course and response to treatment.

What this paper adds

Most children with SGCE‐myoclonus–dystonia got writer's cramp and had walking and running dystonia.

Writer's cramp was a key feature and should prompt SGCE genetic investigation.

‘Circular shaking leg’, ‘dragging leg’, and ‘hobby‐horse gait’ were recognized as early gait patterns.

Children used sensory tricks to improve myoclonus and dystonia, suggesting common pathophysiological mechanisms.

Action dystonia rating scales are valid tools to assess severity in children.
The autism spectrum disorder phenotype in children with tuberous sclerosis complex: A systematic review and meta‐analysis
Authors: Mitchell Rebecca A. , Mitchell Marijke , Williams Katrina
Published: June 2022

Aim

To investigate the phenotype in autistic children with tuberous sclerosis complex (TSC), specifically autism spectrum disorder (ASD) severity and characteristics, intellectual ability, adaptive and executive function, language skills, attention‐deficit/hyperactivity disorder features, and internalizing and externalizing behaviours.

Method

MEDLINE, Embase, and the Cochrane Library were searched up to March 2021. Studies that investigated predefined phenotypic factors in children with TSC‐ASD were included according to the Preferred Reporting Items for Systematic review and Meta‐Analysis Protocols (PRISMA‐P) guidelines. Two authors independently reviewed titles, abstracts, full texts, and extracted the data. Risk of bias and GRADE assessments were completed.

Results

Thirty‐four studies with 3160 children with TSC, 30% with ASD, were included. Meta‐analysis found that 90% (95% confidence interval 86%–94%) of children with TSC‐ASD have an intellectual disability. There was some evidence to suggest that young children with TSC‐ASD and idiopathic ASD have a similar pattern of severity and behaviour. Overall, data about phenotypic characteristics were limited.

Interpretation

A greater proportion of children with TSC‐ASD are reported to have an intellectual disability than children with idiopathic ASD. Early intervention should consider the needs of children with a high likelihood of intellectual disability. Research is needed to better understand the impacts of intellectual disability and other co‐occurring difficulties on adaptive function, participation, and quality of life in TSC‐ASD.

What this paper adds

Most children with tuberous sclerosis complex (TSC) and autism spectrum disorder (ASD) have an intellectual disability.

TSC‐ASD early intervention planning should consider the high likelihood of intellectual disability.

Quality of life and the functional impact of intellectual disability in TSC‐ASD are not understood.

Little is known about co‐occurring difficulties in TSC‐ASD.
The Harry Keen Rank Nutrition Lecture 2022. Nutritional guidelines for diabetes management: Where do they come from and do they work?
Authors: Dyson Pamela
Published: June 2022

Nutritional guidelines for diabetes are designed to support those living with diabetes in achieving optimal glycaemic control, reducing the risk of cardiovascular disease and maintaining quality of life. Historically, guidelines reflected current opinion and clinical practice and only relatively recently have evidence‐based recommendations been published. Current nutritional guidelines for type 1 and type 2 diabetes are based on high‐quality evidence including data from randomised controlled trials and prospective cohort studies and are graded by the strength of evidence. There is no evidence to support one specific dietary strategy for people with diabetes, and this is particularly true for weight reduction in those with type 2 diabetes living with overweight or obesity, where the evidence suggests that different strategies are equally successful. As a result, the emphasis of modern guidelines is on individualised, person‐centred approaches. Some barriers to successful implementation include lack of dietary education and knowledge in health professionals supporting people with diabetes, and a so‐called obesogenic environment that impedes dietary change. Initiatives such as education and training programmes for health professionals, and population‐based interventions that promote both structural and policy change are recommended to enable those with diabetes to support dietary change and improve health.
Early‐ and late‐onset posttransplant lymphoproliferative disorders among adult kidney and liver transplant recipients
Authors: Abdulovski Ranya , Møller Dina L. , Knudsen Andreas D. , Sørensen Søren S. , Rasmussen Allan , Nielsen Susanne D. , Wareham Neval E.
Published: June 2022

Objectives

Posttransplant lymphoproliferative disorder (PTLD) in solid organ transplant recipients has a high mortality and may present early (<2 years) or late (≥2 years) posttransplantation. We investigated the clinical characteristics of early and late PTLD among kidney and liver transplant recipients.

Methods

Recipients, transplanted at Rigshospitalet, with PTLD development as adults from January 2010 to August 2020, were included. Clinical characteristics, laboratory parameters, and pathology of early and late PTLD were compared.

Results

Thirty‐one PTLD cases were detected where 10 (32%) were early and 21 (68%) were late PTLD. EBV DNA in plasma was detected in 78% versus 28% in early and late PTLD (p = .037). None of the recipients with early PTLD and nine recipients with late PTLD (47%) had Ann Arbor stage IV at the time of their diagnosis (p = .006). Cyclophosphamid–Hydroxyrubicin–Oncovin–Prednisolon was used for treatment in 10 (48%) recipients with late PTLD (p = 0.032) only. There was no difference in mortality between the two groups.

Conclusions

Recipients with late PTLD had a lower prevalence of detectable EBV DNA in plasma, were diagnosed with more advanced disease, and were more frequently treated with chemotherapy compared to recipients with early PTLD.
Millimetre scale aeration of the rhizosphere and drilosphere
Authors: Uteau Daniel , Horn Rainer , Peth Stephan
Published: June 2022

Soil aeration is a critical factor for oxygen‐limited subsoil processes, as transport by diffusion and advection is restricted by the long distance to the free atmosphere. Oxygen transport into the soil matrix is highly dependent on its connectivity to larger pore channels like earthworm and root colonised biopores. Here we hypothesize that the soil matrix around biopores represents different connectivity depending on biopore genesis and actual coloniser. We analysed the soil pore system of undisturbed soil core samples around biopores generated or colonised by roots and earthworms and compared them with the pore system of soil, not in the immediacy of a biopore. Oxygen partial pressure profiles and gas relative diffusion was measured in the rhizosphere and drilosphere from the biopore wall into the bulk soil with microelectrodes. The measurements were linked with structural features such as porosity and connectivity obtained from X‐ray tomography and image analysis. Aeration was enhanced in the soil matrix surrounding biopores in comparison to the bulk soil, shown by higher oxygen concentrations and higher relative diffusion coefficients. Biopores colonised by roots presented more connected lateral pores than earthworm colonised ones, which resulted in enhanced aeration of the rhizosphere compared to the drilosphere. This has influenced biotic processes (microbial turnover/mineralization or root respiration) at biopore interfaces and highlights the importance of microstructural features for soil processes and their dependency on the biopore's coloniser.