bluuebunny/crossref_metadata_2025 huggingface dataset:
Methods to perform risk‐based inspections of food companies
Authors: van Asselt E.D. , Hoffmans Y. , Hoek‐ van den Hil E.F. , van der Fels‐Klerx H.J.
Published: November 2021

Risk‐based monitoring programs are increasingly applied for cost‐effective monitoring of food safety. Such programs ideally consist of three steps: risk‐ranking, risk‐based inspections, and cost‐effective monitoring. Various methods have been described to perform the first step of risk‐based monitoring. However, once the risk‐ranking has been completed, identifying the hazard‐food combinations to monitor, the frequency of inspection needs to be established based on a prioritization of food business operators (FBOs). The aim of this paper is to provide an overview of methods available for risk‐based inspections. Literature shows that FBO's food safety compliance can be assessed based on company size, historical monitoring data, and socio‐economic factors influencing compliance behavior. Non‐compliance can either be intentional or unintentional. The latter can be assessed by evaluating the food safety culture of a company. Various models—ranging from qualitative (e.g., focus groups) to quantitative (e.g., scoring)—can be used for this purpose. These models usually include an evaluation of the organizational structure (e.g., management control, communication, commitment), the technical food safety environment (e.g., hygienic design, zoning), and employee characteristics (e.g., knowledge, risk awareness). Intentional non‐compliance can be assessed using food fraud vulnerability tools. These tools incorporate factors influencing the likelihood of food fraud at the company, that is, opportunity, motivation, and (lack of) control measures. The literature indicates that either self‐assessment tools or risk matrices are applied. There is no global consensus on the methods to apply for risk‐based inspections. Depending on time and budget available as well as preferred output, one of the presented methods may be applied for prioritizing FBOs.
Electroacupuncture modulates the intestinal microecology to improve intestinal motility in spinal cord injury rats
Authors: Cheng Jie , Li Weimin , Wang Ying , Cao Qing , Ni Ying , Zhang Wenyi , Guo Jiabao , Chen Binglin , Zang Yaning , Zhu Yi
Published: November 2021

Spinal cord injury (SCI) is a disease involving gastrointestinal disorders. The underlying mechanisms of the potential protective effects of electroacupuncture (EA) and 5‐hydroxytryptamine (5‐HT) system on SCI remain unknown. We investigated whether EA improves gut microbial dysbiosis in SCI and regulates the 5‐HT system. 16S rDNA gene sequencing was applied to investigate alterations in the gut microbiome of the rats. Faecal metabolites and the expression of the 5‐HT system were detected. EA and faecal microbiota transplantation (FMT) treatment facilitated intestinal transmission functional recovery and restored the colon morphology of SCI rats. The composition of the intestinal microbiota, including numbers of phylum Proteobacteria, class Clostridia, order Bacteroidales, and genus Dorea, were amplified in SCI rats, and EA and FMT significantly reshaped the intestinal microbiota. SCI resulted in disturbed metabolic conditions in rats, and the EA and FMT group showed increased amounts of catechin compared with SCI rats. SCI inhibited 5‐HT system expression in the colon, which was significantly reversed by EA and FMT treatment. Therefore, EA may ameliorate SCI by modulating microbiota and metabolites and regulate the 5‐HT system. Our study provides new insights into the pathogenesis and therapy of SCI from the perspective of microbiota and 5‐HT regulation.
Regular pre‐admission urate‐lowering therapy and serum urate testing are associated with a shorter hospital length of stay in people with gout: A nation‐wide population‐based cohort study
Authors: Jatuworapruk Kanon , Grainger Rebecca , Dalbeth Nicola , Taylor William J.
Published: November 2021

Objective

This study aims to explore the association between inpatient gout flare‐related variables and the length of stay (LOS) in hospitalized people with comorbid gout.

Methods

Using data from the Aotearoa/New Zealand national data collections, this cohort study included adults with comorbid gout who were admitted to publicly funded hospitals during 2017 for reasons other than gout. The primary outcome was LOS. Association between 20 variables and the LOS was explored using two generalized linear models. Directed acyclic graph (DAG) was constructed to evaluate the causal relationship between pre‐admission urate lowering therapy (ULT) and LOS.

Results

The cohort included 36 047 admissions. We identified five variables associated with shorter LOS (pre‐admission regular urate‐lowering therapy (ULT), serum urate testing, male gender, Māori ethnicity and low‐dose aspirin) and seven variables associated with longer LOS (M3 multimorbidity index, acute admission, operation, loop diuretics, potassium‐sparing diuretics, NSAIDs, and age). Regular ULT had the strongest impact on shorter LOS (10% shorter). The model estimated an additional four days of hospitalization if the patient had multiple variables associated with longer LOS. DAG suggested a causal relationship between regular ULT and LOS under the condition that all unobserved confounders affected only ULT use, with no impact on in‐hospital gout flares and/or LOS except through its influence on ULT use or as mediator of confounders that were observed.

Conclusion

We have identified a set of gout flare‐related variables found to be associated with LOS in hospitalized people with comorbid gout. Pre‐admission ULT may help reduce the LOS in such patients.
Sex‐specific accelerated decay in time/activity‐dependent plasticity and associative memory in an animal model of Alzheimer's disease
Authors: Navakkode Sheeja , Gaunt Jessica Ruth , Pavon Maria Vazquez , Bansal Vibhavari Aysha , Abraham Riya Prasad , Chong Yee Song , Ch'ng Toh Hean , Sajikumar Sreedharan
Published: November 2021

Clinical studies have shown that female brains are more predisposed to neurodegenerative diseases such as Alzheimer's disease (AD), but the cellular and molecular mechanisms behind this disparity remain unknown. In several mouse models of AD, synaptic plasticity dysfunction is an early event and appears before significant accumulation of amyloid plaques and neuronal degeneration. However, it is unclear whether sexual dimorphism at the synaptic level contributes to the higher risk and prevalence of AD in females. Our studies on APP/PS1 (APPSwe/PS1dE9) mouse model show that AD impacts hippocampal long‐term plasticity in a sex‐specific manner. Long‐term potentiation (LTP) induced by strong tetanic stimulation (STET), theta burst stimulation (TBS) and population spike timing‐dependent plasticity (pSTDP) show a faster decay in AD females compared with age‐matched AD males. In addition, behavioural tagging (BT), a model of associative memory, is specifically impaired in AD females with a faster decay in memory compared with males. Together with the plasticity and behavioural data, we also observed an upregulation of neuroinflammatory markers, along with downregulation of transcripts that regulate cellular processes associated with synaptic plasticity and memory in females. Immunohistochemistry of AD brains confirms that female APP/PS1 mice carry a higher amyloid plaque burden and have enhanced microglial activation compared with male APP/PS1 mice. Their presence in the diseased mice also suggests a link between the impairment of LTP and the upregulation of the inflammatory response. Overall, our data show that synaptic plasticity and associative memory impairments are more prominent in females and this might account for the faster progression of AD in females.
FGF2 is an endogenous regulator of alcohol reward and consumption
Authors: Even‐Chen Oren , Herburg Leonie , Kefalakes Ekaterini , Urshansky Nataly , Grothe Claudia , Barak Segev
Published: November 2021

Alcohol use disorder (AUD) is a chronic, relapsing disorder, characterized by escalating alcohol drinking and loss of control, with very limited available treatments. We recently reported that the expression of fibroblast growth factor 2 (Fgf2) is increased in the striatum of rodents following long‐term excessive alcohol drinking and that the systemic or intra‐striatal administration of recombinant FGF2 increases alcohol consumption. Here, we set out to determine whether the endogenous FGF2 plays a role in alcohol drinking and reward, by testing the behavioural phenotype of Fgf2 knockout mice. We found that Fgf2 deficiency resulted in decreased alcohol consumption when tested in two‐bottle choice procedures with various alcohol concentrations. Importantly, these effects were specific for alcohol, as a natural reward (sucrose) or water consumption was not affected by Fgf2 deficiency. In addition, Fgf2 knockout mice failed to show alcohol‐conditioned place preference (CPP) but showed normal fear conditioning, suggesting that deletion of the growth factor reduces alcohol's rewarding properties. Finally, Fgf2 knockout mice took longer to recover from the loss of righting reflex and showed higher blood alcohol concentrations when challenged with an intoxicating alcohol dose, suggesting that their ethanol metabolism might be affected. Together, our results show that the endogenous FGF2 plays a critical role in alcohol drinking and reward and indicate that FGF2 is a positive regulator of alcohol‐drinking behaviours. Our findings suggest that FGF2 is a potential biomarker for problem alcohol drinking and is a potential target for pharmacotherapy development for AUD.
Target‐group backgrounds prove effective at correcting sampling bias in Maxent models
Authors: Barber Robert A. , Ball Stuart G. , Morris Roger K. A. , Gilbert Francis
Published: November 2021

Aim

Accounting for sampling bias is the greatest challenge facing presence‐only and presence‐background species distribution models; no matter what type of model is chosen, using biased data will mask the true relationship between occurrences and environmental predictors. To address this issue, we review four established bias correction techniques, using empirical occurrences with known sampling effort, and virtual species with known distributions.

Innovation

Occurrence data come from a national recording scheme of hoverflies (Syrphidae) in Great Britain, spanning 1983–2002. Target‐group backgrounds, distance‐restricted backgrounds, travel time to cities and human population density were used to account for sampling bias in 58 species of hoverfly. Distributions generated by bias correction techniques were compared in geographical space to the distribution produced accounting for known sampling effort, using Schoener's distance, centroid shifts and range size changes. To validate our results, we performed the same comparisons using 50 randomly generated virtual species. We used sampling effort from the hoverfly recording scheme to structure our biased sampling regime, emulating complex real‐life sampling bias.

Main conclusions

Models made without any correction typically produced distributions that mapped sampling effort rather than the underlying habitat suitability. Target‐group backgrounds performed the best at emulating sampling effort and unbiased virtual occurrences, but also showed signs of overcompensation in places. Other methods performed better than no‐correction, but often differences were difficult to visually detect. In line with previous studies, when sampling effort is unknown, target‐group backgrounds provide a useful tool for reducing the effect of sampling bias. Models should be visually inspected for biological realism to identify any areas of potential overcompensation. Given the disparity between corrected and un‐corrected models, sampling bias constitutes a major source of error in species distribution modelling, and more research is needed to confidently address the issue.
Should bone mineral content be part of the equation for assessing fracture risk in patients with cerebral palsy?
Authors: Szlachetka Weronika Agnieszka , Myint Phyo Kyaw
Published: November 2021

This commentary is on the original article by Whitney et al. on pages 469–475 of this issue.
Region‐of‐interest analysis approaches in neuroimaging studies of body ownership: An activation likelihood estimation meta‐analysis
Authors: Nilsson Martin , Kalckert Andreas
Published: November 2021

How do we feel that we own our body? By manipulating the integration of multisensory signals and creating the illusory experience of owning external body parts and entire bodies, researchers have investigated the neurofunctional correlates of body ownership. Recent attempts to synthesize the neuroimaging literature of body ownership through meta‐analysis have shown partly inconsistent results. A large proportion of functional magnetic resonance imaging (fMRI) findings on body ownership include analyses based on regions of interest (ROIs). This approach can produce inflated findings when results are synthesized in meta‐analyses. We conducted a systematic search of the fMRI literature of ownership of body parts and entire bodies. Three activation likelihood estimation (ALE) meta‐analyses were conducted, testing the impact of including ROI‐based findings. When both whole‐brain and ROI‐based results were included, frontal and posterior parietal multisensory areas were associated with body ownership. When only ROI‐based results were included, larger areas of the frontal and posterior parietal cortices and the middle occipital gyrus were associated with body ownership. A whole‐brain meta‐analysis, excluding ROI‐based results, found no significant convergence of activation across the brain. These findings highlight the difficulty of quantitatively synthesizing a neuroimaging field where a large part of the literature is based on findings from ROI‐based analyses. We discuss these findings in the light of current practices within this field of research and highlight current problems of meta‐analytic approaches of body ownership. We recommend the sharing of unthresholded data as a means to facilitate future meta‐analyses of the neuroimaging literature of body ownership.
Low‐beta repetitive transcranial magnetic stimulation to human dorsolateral prefrontal cortex during object recognition memory sample presentation, at a task‐related frequency observed in local field potentials in homologous macaque cortex, impairs subsequent recollection but not familiarity
Authors: Wu Zhemeng , Kavanova Martina , Hickman Lydia , Boschin Erica A. , Galeazzi Juan M. , Verhagen Lennart , Ainsworth Matthew , Pedreira Carlos , Buckley Mark J.
Published: November 2021

According to dual‐process signal‐detection (DPSD) theories, short‐ and long‐term recognition memory draws upon both familiarity and recollection. It remains unclear how primate prefrontal cortex (PFC) contributes to these processes, but frequency‐specific neuronal activities are considered to play a key role. In Experiment 1, nonhuman primate (NHP) local field potential (LFP) electrophysiological recordings in macaque left dorsolateral PFC (dlPFC) revealed performance‐related differences in a low‐beta frequency range during the sample presentation phase of a visual object recognition memory task. Experiment 2 employed a similar task in humans and targeted left dlPFC (and vertex as a control) with repetitive transcranial magnetic stimulation (rTMS) at 12.5 Hz during occasional sample presentations. This low‐beta frequency rTMS to dlPFC decreased DPSD derived indices of recollection, but not familiarity, in subsequent memory tests of the targeted samples after short delays. The same number of rTMS pulses over the same total duration albeit at a random frequency had no effect on either recollection or familiarity. Neither stimulation protocols had any causal effect upon behaviour when targeted to the control site (vertex). In this study, our hypotheses for our human TMS study were derived from our observations in NHPs; this approach might inspire further translational research through investigation of homologous brain regions and tasks across species using similar neuroscientific methodologies to advance the neural mechanism of recognition memory in primates.
Insomnia disorder update: the benefits of screening and treatment for this common presentation
Authors: Ree Melissa J. , Richardson Cele
Published: November 2021

Insomnia is a chronic condition and major healthcare problem for Australians across the lifespan. Insomnia's high prevalence and disease burden render it an important target for treatment. Further, and importantly, there exist established bidirectional links between insomnia and a range of health conditions, with insomnia both contributing to risk, maintenance and relapse of comorbid conditions. Recent clinical research demonstrates that treating insomnia in its own right is important for resolution of insomnia and for optimising treatment outcomes for comorbid presenting problems. Due to its effectiveness and favourable side‐effect profile, Cognitive Behaviour Therapy‐Insomnia (CBT‐I) is the recommended first‐line treatment even when comorbid conditions are present. CBT‐I is a brief treatment often delivered in four to eight consultations. Individual, group and online CBT‐I have each demonstrated effectiveness. Outcomes for online CBT‐I are often stronger when individualised clinician support is provided. Specifically assessing for and treating insomnia in clinical practice may provide an opportunity to optimise treatment outcome in many patients.
Coping strategies and stressors of nursing students in the care of sex trafficking victims
Authors: Gutiérrez‐Puertas Lorena , Márquez‐Hernández Verónica V. , Aguilera‐Manrique Gabriel , Molina‐Torres Guadalupe , Rodriguez‐Arrastia Miguel , Román‐López Pablo , Ropero‐Padilla Carmen , Rodríguez‐García Mª Carmen
Published: November 2021

During their clinical practice, nursing students face a number of complex clinical situations, which may include treating victims of sex trafficking. These clinical experiences can lead to stress for the nursing students, which may hinder their learning process. Nonetheless, there is very little educational training provided in nursing programmes on this topic. The objective of this study was to identify the coping strategies and stressors perceived by nursing students in the care of sex trafficking victims. A pre‐post study of a single group was carried out. The TREND guidelines were followed. The Perceived Stress Scale (PSS) and Coping Behavior Inventory (CBI) were used for data collection. On the PSS, the average scores were lower after the intervention in all dimensions, except related to teachers and nursing staff and peers and daily life. Statistically significant differences were found when comparing the results of the total average score of the PSS and the time of measurement (pre/post‐intervention) (t(106) = 38.811; P < 0.001). Regarding the Coping Behavior Inventory, the average scores in each dimension increased after the intervention, except transference behaviours. Statistically significant differences were found when comparing the total average score of the questionnaire and the time of measurement (Z = −13.357; P < 0.001). The total stress levels and coping strategies of nursing students in caring for victims of sex trafficking improved significantly after the intervention. Nursing educators should promote the training of future nursing professionals as a potential effective strategy for the rapid identification and adequate care of sex trafficking victims.
Financialisation, globalisation, and the industrial labour share: A comparison between Iran and Thailand
Authors: Gouzoulis Giorgos
Published: November 2021

This paper examines Iran and Thailand and shows that the distributional consequences of financialisation and globalisation do not depend exclusively on the extent of financial deepening and exposure to globalisation. Instead, the cultural and legal underpinnings of the creditor–debtor relationship and the form of global integration matter more.
“Brittleworms”: Ultrastructure and arrangement of the calcified chaetae of Euphrosine (Amphinomida, Annelida)
Authors: Müller Julian , Schumacher Anja , Borda Elizabeth , Rouse Greg W. , Bartolomaeus Thomas , Tilic Ekin
Published: November 2021

The annelid clade Amphinomidae, commonly known as “fireworms,” is notorious for causing skin inflammations after physical contact. These injuries are caused by the chaetae of the animals, which are calcified and particularly brittle. The incorporation of calcium carbonate particles and their disintegration cause the chitinous lamellae within a chaeta to break apart and result in a prominent inner cavity. Although the chaetae of Amphinomidae are well studied, data concerning their sister group, Euphrosinidae, are scarce. In this study, we examined the chaetae of two species of Euphrosine for the first time regarding the variety of chaetal types, their ultrastructure, elemental composition, and arrangement. This allows us to get a better understanding of chaetal characteristics in the ground pattern of Amphinomida. We were able to determine bifurcate chaetae as the primary chaetal type in Amphinomida and provide evidence that their aciculae must have evolved secondarily. Calcification is a common feature among amphinomidan chaetae and regarded as autapomorphy of Amphinomida. Finally, a single dorsal formative site in each notopodium and neuropodium, found in Euphrosine foliosa, likely represents the ancestral state in Amphinomida. There is no evidence for venom production or secretory cells associated with the chaetae of Euphrosine, which is in accordance with what was previously observed in Amphinomidae. Our study also complements further studies into chaetal characteristics such as the number and arrangement of formative sites.
Effects of physical activity on behaviour and emotional problems, mental health and psychosocial well‐being in children and adolescents with intellectual disability: A systematic review
Authors: Borland Ross L. , Cameron Lauren A. , Tonge Bruce J. , Gray Kylie M.
Published: November 2021

Background

This systematic review aimed to explore the effects of sport and physical activity on behaviour and emotional problems, mental health and psychosocial well‐being of children and adolescents with intellectual disability.

Method

Five databases were searched systematically (ERIC, MEDLINE, PsycINFO, SportDISCUS and SCOPUS), up to 28 February 2021. Thirty‐two studies met criteria for inclusion.

Results

Studies in this review included case studies (n = 15), treatment trials (n = 14), cross sectional studies (n = 2) and a cohort study (n = 1). Evidence was positive, though high risk of bias in treatment trials (7 of 14 rated high) meant generalisability of results was limited.

Conclusions

The available evidence suggests a positive relationship between physical activity and improved behaviour and emotional problems, mental health and psychosocial well‐being; however, more robust randomised controlled trials are required to confirm this.
Sodium–glucose cotransporter 2 inhibitors and anemia among diabetes patients in real clinical practice
Authors: Murashima Miho , Tanaka Tomohiro , Kasugai Takahisa , Tomonari Tatsuya , Ide Atsuki , Ono Minamo , Mizuno Masashi , Suzuki Taisei , Hamano Takayuki
Published: November 2021

Aims/Introduction

Sodium–glucose cotransporter 2 inhibitors (SGLT2i) were reported to increase hemoglobin levels in short‐term clinical trials. Whether it is also true in real clinical practice is unknown.

Materials and Methods

This is a retrospective cohort study. Inclusion criterion was diabetes patients who visited our outpatient clinic from January 2019 to August 2020. Exposure of interest was the use of SGLT2i. Outcomes were hemoglobin levels. For the cross‐sectional analyses, non‐linear regression models were fitted with restricted cubic splines to investigate the association between hemoglobin levels and estimated glomerular filtration rate (eGFR) for users and non‐users of SGLT2i. For the case–control study, cases (anemia defined as hemoglobin <120 g/L for men, <110 g/L for women or the use of erythropoiesis stimulating agents) and controls were matched by age, sex and eGFR.

Results

Among 2,063 diabetes patients, 723 were taking SGLT2i. In the cross‐sectional analyses, hemoglobin levels were higher among SGLT2i users compared with non‐users at eGFR >15 mL/min/1.73 m2. For the case–control study, 197 cases and controls were matched. Conditional logistic regression showed that the use of SGLT2i was associated with significantly lower prevalence of anemia (odd ratio 0.35, 95% confidence interval 0.21–0.58). Adjusted mean differences in hemoglobin levels between users and propensity score‐matched non‐users of SGLT2i were 7.0 g/L (95% confidence interval 3.0–10.0 g/L) at 6 months. Among SGLT2i users, the odds of an increase in 6‐month hemoglobin were similar across eGFR categories, except for eGFR <15 mL/min/1.73 m2.

Conclusions

The use of SGLT2i was associated with higher hemoglobin levels and lower prevalence of anemia in real clinical practice.
Importance of biotic pollination varies across common bean cultivars
Authors: Franceschinelli Edivani Villaron , Ribeiro Paula Louredo Morais , Mesquita‐Neto José Neiva , Bergamini Leonardo Lima , Madureira de Assis Igor , Elias Marcos Antônio Silva , Fernandes Paulo Marçal , Carvalheiro Luísa Gigante
Published: November 2021

Common bean (Phaseolus vulgaris L.) flowers are morphologically adapted to biotic pollination, although it is partially autogamous. We evaluated the effect of pollinator visits on pod and seed production of 14 local creole cultivars of P. vulgaris, commonly used in organic farming. We collected descriptive data observing the flower visitors and estimating the number and viability of pollen grains, flower size, nectar volume and nectar sugar concentration. Overall, exposure to flower visitors (legitimate pollinators and robbers) improved production in terms of quantity or quality of pods and/or seeds of eight cultivars and reduced production of two other cultivars. We found 10 insect species visiting flowers of the bean cultivars, but only Xylocopa bees behaved as legitimate pollinators. Other flower visitor species either pierced the corolla base to get the nectar or got the nectar without lowering the flower's wings and keels to touch anthers and stigma. Petal length and nectar features showed few variations among the cultivars. Two cultivars produced a larger amount of pollen grains than the remaining cultivars. Despite some variation across cultivars, our results suggest the importance of native bees to pollination and reproductive success of creole beans.
Predictive simulation of concurrent debris flows: How slope failure locations affect predicted damage
Authors: Yamanoi Kazuki , Oishi Satoru , Kawaike Kenji , Nakagawa Hajime
Published: November 2021

Predictive simulation of concurrent debris flows using only pre‐disaster information has been difficult, partly because of problems faced in predicting debris‐flow initiation locations (i.e., slope failure). However, because catchment topography has convergent characteristics with all channels in it joining each other as they flow downstream, damage to downstream areas could be predicted using relatively inaccurate initiation points. Based on this hypothesis, this study uses debris‐flow initiation points generated randomly with statistical slope failure prediction and performs a many‐case simulation across numerous initiation points to quantify the effect of slope‐failure locations in terms of deviations in the predicted water level and topographic change. This paper presents the results of 2D simulations based on a conventional debris‐flow model that was run on a supercomputer to realise simulations of many cases. The obtained relative standard deviation was found to decrease as the debris flow and sediment‐laden flood approached the downstream area, indicating that the predictability of the inundation and topographic change can be decided from the terrain characteristics.
Evaluating older adults with cognitive dysfunction: A qualitative study with emergency clinicians
Authors: Chary Anita N. , Castilla‐Ojo Noelle , Joshi Christopher , Santangelo Ilianna , Carpenter Christopher R. , Ouchi Kei , Naik Aanand D. , Liu Shan W. , Kennedy Maura
Published: November 2021

Background

Evaluating older adults with cognitive dysfunction in emergency departments (EDs) requires obtaining collateral information from sources other than the patient. Understanding the challenges emergency clinicians face in obtaining collateral information can inform development of interventions to improve geriatric emergency care and, more specifically, detection of ED delirium. The objective was to understand emergency clinicians' experiences obtaining collateral information on older adults with cognitive dysfunction, both before and during the COVID‐19 pandemic.

Methods

From February to May 2021, we conducted semi‐structured interviews with a purposive sample of 22 emergency physicians and advanced practice providers from two urban academic hospitals and one community hospital in the Northeast United States. Interviews lasted 10–20 min and were digitally recorded and transcribed. Interview transcripts were analyzed for dominant themes using a combined deductive–inductive approach. Responses regarding experiences before and during the pandemic were compared.

Results

Five major challenges emerged regarding (1) availability of caregivers, (2) reliability of sources, (3) language barriers, (4) time constraints, and (5) incomplete transfer documentation. Participants perceived all challenges, but those relating to transfer documentation were amplified by the COVID‐19 pandemic.

Conclusion

Emergency clinicians' perspectives can inform efforts to support caregiver presence at bedside and develop standardized communication tools to improve recognition of delirium and, more broadly, geriatric emergency care.
Cognitive stimulation has potential for brain activation in individuals with Rett syndrome
Authors: Migliorelli C. , Medina‐Rivera I. , Bachiller A. , Tost A. , Alonso J. F. , López‐Sala A. , Armstrong J. , O'Callahan M. d. M. , Pineda M. , Mañanas M. A. , Romero S. , García‐Cazorla Á.
Published: November 2021

Background

Knowledge regarding neuropsychological training in Rett syndrome (RS) is scarce. The aim of this study was to assess the outcome and the duration of the effect of cognitive stimulation on topographic electroencephalography (EEG) data in RS.

Methods

Twenty female children diagnosed with RS were included in the analysis. Girls with RS conducted a cognitive task using an eye‐tracker designed to evaluate access and choice skills. EEG data were acquired during the experimental procedure including two 10‐min baseline stages before and after the task. Topographical changes of several EEG spectral markers including absolute and relative powers, Brain Symmetry Index and entropy were assessed.

Results

Topographic significance probability maps suggested statistical decreases on delta activity and increases on beta rhythm associated with the cognitive task. Entropy increased during and after the task, likely related to more complex brain activity. A significant positive interaction was obtained between Brain Symmetry Index and age showing that the improvement of interhemispheric symmetry was higher in younger girls (5–10 years).

Conclusions

According to our findings, significant alterations of brain rhythms were observed during and after cognitive stimulation, suggesting that cognitive stimulation may have effects on brain activity beyond the stimulation period. Finally, our promising results also showed an increase brain symmetry that was especially relevant for the younger group. This could suggest an interaction of the eye‐tracking cognitive task; however, further studies in this field are needed to assess the relation between brain asymmetries and age.
Prevalence, association with systemic inflammatory response syndrome and outcome of stress hyperglycaemia in sick cats
Authors: Frezoulis P. S. , Oikonomidis I. L. , Saridomichelakis M. N. , Kasabalis D. , Pappa A. , Bouza‐Rapti P. , Chochlios T. , Tsouloufi T. K. , Kritsepi‐Konstantinou M. , Soubasis N.
Published: November 2021

Objectives

To determine the prevalence of stress hyperglycaemia in sick cats, and to investigate the association of stress hyperglycaemia with systemic inflammatory response syndrome and outcome.

Materials and Methods

Medical records (2004 to 2013) from sick cats admitted to the Medicine Unit of a Veterinary Teaching Hospital were retrospectively reviewed. Cases were enrolled if a serum glucose measurement and a complete medical record were available. Cats that were healthy, hypoglycaemic, diabetic, sedated or had a previous administration of drugs (apart from vaccination and deworming) were excluded.

Results

The study included 647 cats; stress hyperglycaemia (serum glucose >8.3 mmol/L) was found in 194 (30%) cats, while 453 (70%) cats were normoglycaemic. The prevalence of systemic inflammatory response syndrome was significantly higher in cats with stress hyperglycaemia (25/174, 14.4%) compared to normoglycaemic cats (26/399, 6.5%). Significantly, more cats with stress hyperglycaemia were hospitalised [97/194 (50.0%)] compared to normoglycaemic cats [171/453 (37.7%)]. However, the median duration of hospitalisation was not significantly different [4 (1 to 26) days and 4 (1 to 24) days, respectively]. The prevalence of cats with negative outcome was not significantly different between the two groups (cats with stress hyperglycaemia: 37.1%, normoglycaemic cats: 33.9%). Nonetheless, when modelling of outcome prediction included breed, age, stress hyperglycaemia and disease category as factors, cats with stress hyperglycaemia had 2.8 times the odds to have a negative outcome (95% confidence interval: 1.3 to 6.4).

Clinical Significance

Based on the cut‐off employed in this study, Stress hyperglycaemia, as defined by the cut‐off is common in sick cats. Stress hyperglycaemia is associated with systemic inflammatory response syndrome development and seem to be a negative prognostic indicator.
Heard, valued, supported? Doctors' wellbeing during transitions triggered by COVID‐19
Authors: Gordon Lisi , Scanlan Gillian M. , Tooman Tricia R. , Walker Kim A. , Cairns Patrick , Ferguson Julie , Aitken Gillian , Cecil Joanne , Cunningham Kathryn B. , Smith Kathrine Gibson , Johnston Peter W. , Laidlaw Anita , Pope Lindsey M. , Wakeling Judy
Published: November 2021

Introduction

Supporting doctors' wellbeing is crucial for medical education to help minimise negative long‐term impacts on medical workforce retention and ultimately patient care. There is limited study of how doctors' transitions experiences impact wellbeing, particularly socially and culturally. Multiple Multidimensional Transitions (MMT) theory views transitions as dynamic, incorporating multiple contexts and multiple domains. Using MMT as our lens, we report a qualitative analysis of how transitions experienced by doctors during the pandemic impacted on social and cultural aspects of wellbeing.

Methods

Longitudinal narrative inquiry was employed, using interviews and audio‐diaries. Data were collected over 6 months in three phases: (i) interviews with doctors from across the career spectrum (n = 98); (ii) longitudinal audio‐diaries for 2–4 months (n = 71); (iii) second interviews (n = 83). Data were analysed abductively, narrowing focus to factors important to social and cultural wellbeing.

Results

Doctors described experiencing multiple interacting transitions triggered by the pandemic in multiple contexts (workplace, role, homelife and education). Patterns identifiable across the dataset allowed us to explore social and cultural wellbeing crosscutting beyond individual experience. Three critical factors contributed to social and cultural wellbeing both positively and negatively: being heard (e.g., by colleagues asking how they are); being valued (e.g., removal of rest spaces by organisations showing lack of value); and being supported (e.g., through regular briefing by education bodies).

Conclusions

This study is the first to longitudinally explore the multiple‐multidimensional transitions experienced by doctors during the COVID‐19 pandemic. Our data analysis helped us move beyond existing perceptions around wellbeing and articulate multiple factors that contribute to social and cultural wellbeing. It is vital that medical educators consider the learning from these experiences to help pinpoint what aspects of support might be beneficial to trainee doctors and their trainers. This study forms the basis for developing evidenced‐based interventions that ensure doctors are heard, valued and supported.
Psychological profile and α‐amylase levels in oral lichen planus patients: A case–control preliminary study
Authors: Simoura Juliana Araújo da Silva , Pires Alessandra Laís Pinho Valente , Alves Lísia Daltro Borges , Arsati Franco , Lima‐Arsati Ynara Bosco de Oliveira , Santos Jean Nunes dos , Freitas Valéria Souza
Published: November 2021

Objective

To investigate psychological (anxiety, depression, and stress) and salivary (flow and concentration of α‐amylase) profile associated with oral lichen planus.

Materials and methods

A case–control preliminary study with oral lichen planus patients and age–gender matched controls was conducted. The participants underwent psychological tests (Beck depression and anxiety inventories and perceived stress scale) and saliva collection to determine the unstimulated salivary flow and α‐amylase levels at three moments along the day. The data were analyzed statistically using Mann–Whitney, McNemar chi‐square and Friedman tests, and the Spearman correlation coefficient. The significance level adopted was 5%.

Results

A total of 46 case–control pairs were recruited. There was a significant correlation between anxiety, depression, stress, and oral lichen planus, as well as the stress and decline of salivary α‐amylase levels. Higher concentrations of this biomarker were found in the case group thirty minutes post‐awakening.

Conclusion

The applied psychological tests indicated that factors such as anxiety, depression, and stress were associated with oral lichen planus. Salivary analyses demonstrated a higher concentration of α‐amylase thirty minutes post‐awakening on individuals with the disease and its decline correlated with stress, suggesting the role of α‐amylase as a promising biomarker for future studies.
Changes in visual cortical function in moderately myopic patients: a functional near‐infrared spectroscopy study
Authors: Zhang Ying , Lin Xiao , Bi Ailing , Cao Ning , Zhang Tingyu , Wang Sha , Wen Ying , Bi Hongsheng
Published: November 2021

Purpose

To investigate haemoglobin oxygenation in the visual cortex of myopic patients using functional near‐infrared spectroscopy (fNIRS).

Methods

The experiment consisted of two parts. Part 1 examined functional changes in the visual cortex before and after refractive correction in myopic patients. Subjects were divided into normal controls, uncorrected and corrected myopes. Part 2 examined functional changes in the visual cortex caused by lens‐induced myopia in normal subjects, and whether this activity recovered after a period of rest. Here, subjects were divided into three groups: emmetropes, lens‐induced myopia and a rest group. The rest group completed a test with the uncorrected eye following lens removal and 5 min of rest. The visual stimulus was a black and white checkerboard. fNIRS was used to detect changes in oxyhaemoglobin content within the visual cortex. The original fNIRS data were analysed using MATLAB to obtain the β values (the visual cortical activity response caused by the task); these were used to calculate Δβ, which represents the degree of change in oxygenated haemoglobin caused by visual stimulation.

Results

The Δβ value measured in each single channel or only in the region of interest (ROI) was significantly higher in the emmetropic control group than the uncorrected myopic group. After optical correction, the responses of myopic subjects approached those of the emmetropes and were not significantly different. If myopia was induced in emmetropic subjects by imposing defocus with positive lenses, a decline in functional activity was observed similar that observed in uncorrected myopes. Activity recovered after the lenses were removed.

Conclusions

Myopic defocus reduced the level of haemoglobin oxygenation in the visual cortex, but activity could be restored by optical correction.
Collaborating with the competition? A study of interlocal partnership choices
Authors: Rubado Meghan E.
Published: November 2021

In the US system of decentralized federalism, competitive dynamics among local governments are not incompatible with successful interlocal collaboration. Municipalities often collaborate with competing jurisdictions in the same region to provide services and solve problems. Yet, competitive relations among municipalities are expected to complicate collaboration, escalating transaction costs due to divergent goals and lack of trust. This article uses the Institutional Collective Action framework to examine the conditions under which local governments are best able to surmount competition‐related hurdles and successfully partner with their chief municipal competitors. An original survey of mayors and councilors is used to test potential predictors of collaboration among top competitors. Results show that municipalities often collaborate with their chief competitors but are less likely to do so when they are situated in municipally‐fragmented regions, when they are located in a different county from their top competitors, and when they are fiscally strong.
Identifying resistance in wild and ornamental cherry towards bacterial canker caused by Pseudomonas syringae
Authors: Hulin Michelle T. , Vadillo Dieguez Andrea , Cossu Francesca , Lynn Samantha , Russell Karen , Neale Helen C. , Jackson Robert W. , Arnold Dawn L. , Mansfield John W. , Harrison Richard J.
Published: November 2021

Bacterial canker is a major disease of stone fruits and is a critical limiting factor to sweet cherry (Prunus avium) production worldwide. One important strategy for disease control is the development of resistant varieties. Partial varietal resistance in sweet cherry is discernible using shoot or whole tree inoculations; however, these quantitative differences in resistance are not evident in detached leaf assays. To identify novel sources of resistance to canker, we used a rapid leaf pathogenicity test to screen a range of wild cherry, ornamental Prunus species and sweet cherry × ornamental cherry hybrids with the canker pathogens, Pseudomonas syringae pvs syringae, morsprunorum races 1 and 2, and avii. Several Prunus accessions exhibited limited symptom development following inoculation with each of the pathogens, and this resistance extended to 16 P. syringae strains pathogenic on sweet cherry and plum. Resistance was associated with reduced bacterial multiplication after inoculation, a phenotype similar to that of commercial sweet cherry towards nonhost strains of P. syringae. Progeny resulting from a cross of a resistant ornamental species Prunus incisa with susceptible sweet cherry (P. avium) exhibited resistance indicating it is an inherited trait. Identification of accessions with resistance to the major bacterial canker pathogens is the first step towards characterizing the underlying genetic mechanisms of resistance and introducing these traits into commercial germplasm.
Measuring severe neonatal morbidity using hospital discharge data in France
Authors: Lebreton Elodie , Menguy Claudie , Fresson Jeanne , Egorova Natalia N. , Crenn Hebert Catherine , Zeitlin Jennifer
Published: November 2021

Background

Measuring infant health at birth is key for surveillance and research in obstetrics and neonatology, but there is no international consensus on morbidity indicators. The Neonatal Adverse Outcome Indicator (NAOI) is a composite indicator, developed in Australia, which measures the burden of severe neonatal morbidity using hospital discharge data.

Objective

To evaluate the applicability of the NAOI in France for surveillance and research.

Methods

We constituted a cohort of live births ≥24 weeks’ gestational age in Metropolitan France from 2014 to 2015 using hospital discharge, insurance claims and cause of death data. Outlier hospitals were identified using funnel plots of standardised morbidity ratios (SMR), and their coding patterns were assessed. We compared the NAOI and its component codes with published Australian and English data and estimated unadjusted and adjusted risk ratios for known risk factors for neonatal morbidity.

Results

We included 1,459,123 births (511 hospitals). Twenty‐eight hospitals had SMR above funnel plot control limits. Newborns with NAOI morbidities in these hospitals had lower mortality and shorter stays than in other hospitals. Amongst within‐limit hospitals, NAOI prevalence was 4.8%, comparable to Australia (4.6%) and England (5.4%). Most individual components had a similar prevalence, with the exception of respiratory support, intravenous fluid procedures and infection. NAOI was lowest at 39 weeks (2.2%) with higher risks for maternal age ≥40 (relative risk [RR] 1.47, 95% confidence interval [CI] 1.42, 1.51), state medical insurance (RR 1.60, 95% CI 1.52, 1.68), male sex (RR 1.21, 95% CI 1.19, 1.23) and birthweight <3rd percentile (RR 4.60, 95% CI 4.51, 4.69).

Conclusions

The NAOI provides valuable information on population prevalence of severe neonatal morbidity and its risk factors. Whilst the prevalence was similar in high‐income countries with comparable neonatal mortality levels, ensuring valid comparisons between countries and hospitals will require further work to harmonize coding procedures, especially for infection and respiratory morbidity.
Indigenous youth and international conservation law: Five case studies
Authors: Sellheim Nikolas , Ojanperä Otava
Published: November 2021

The principle of intergenerational equity plays a fundamental role in international conservation law. In this article, we analyse in how far the principle is applied with regard to indigenous youth. By scrutinizing the Whaling Convention, the Ramsar Convention on Wetlands, the Convention on International Trade in Endangered Species of Wild Fauna and Flora, the Convention on Conservation of Migratory Species and the Convention on Biological Diversity, we analyse the extent to which key regimes in international conservation law have internalized the principle in relation to a stakeholder group that is not overly prominent. We conclude that there are fundamental differences between the regimes in question. Although the Ramsar Convention and the Biodiversity Convention have either included the principle from the outset or responded to a changing environmental discourse, the others show significant shortcomings in this regard. Therefore, it is important that institutions develop mechanisms to effectively address intergenerational equity, especially with regard to indigenous youth.