bluuebunny/crossref_metadata_2025 huggingface dataset:
Is pyoderma gangrenosum associated with solid malignancies? Insights from a population‐based cohort study
Authors: Kridin Khalaf , Laufer Britva Rimma , Tzur Bitan Dana , Damiani Giovanni , Cohen Arnon D
Published: June 2021

Background

The question of whether solid malignancies (SMs) are associated with pyoderma gangrenosum (PG) remains to be conclusively answered.

Objective

To evaluate the risk of SM among patients with PG and the odds of PG after a diagnosis of SM.

Methods

A population‐based retrospective cohort study was conducted to study the risk for SM in patients with PG (n = 302) as compared with age‐, sex‐ and ethnicity‐matched control subjects (n = 1799). A case–control design was used to estimate the odds of PG in those with a preexisting history of SM.

Results

The prevalence of a preexisting SM was comparable in patients with PG and controls (7.5% vs. 8.8%, respectively; P = 0.490). The odds of having PG following a diagnosis of a SM was not statistically increased (OR, 0.85; 95% CI, 0.53–1.36). The incidence of SM was 6.8 (95% CI, 3.5–12.2) and 7.9 (95% CI, 6.1–10.1) per 1000 person‐years among patients with PG and controls, respectively. Patients with PG were not more likely to develop SM as compared to controls (HR, 0.86; 95% CI, 0.44–1.69). Patients with a dual diagnosis of PG and SM were older and had more frequent comorbid conditions and increased mortality.

Conclusions

SM is not associated with provoking PG, and patients with PG are not at an increased risk of developing SM. A thorough routine screening for SM in patients with new‐onset PG is an unnecessary approach based on the study findings.
Salt tolerance of the African haplotype of Phragmitesaustralis (Poaceae)
Authors: Naidoo Gonasageran
Published: June 2021

We determined the effect of salinity on growth of P. australis in glasshouse and field experiments. In the glasshouse, plants were subjected to 0%, 10%, 20%, 30%, 40% and 50% sea water for 32 weeks. Plant height, biomass and photosynthesis decreased with increase in salinity from 0% to 50% sea water. In the 50% sea water treatment, plant height decreased by 44%, total biomass by 62%, above‐ground biomass by 61% and below‐ground biomass by 62%. CO2 exchange ranged from 9.07 µmol m−2 s−1 in the control to 1.49 µmol m−2 s−1 in the 50% sea water treatment. In the 50% sea water treatment, leaf conductance, CO2 exchange and transpiration decreased by 81%, 84% and 78%, respectively, while quantum yield and electron transport rate decreased by 34%, and 20%, respectively. In the field study, leaf conductance, CO2 exchange and transpiration were higher in the non‐saline site and lower in the saline site by 50%, 46% and 43%, respectively. Quantum yield and electron transport rate were higher in the non‐saline site and reduced in the saline site by 15% and 11%, respectively. The results suggest that although P. australis is tolerant of increasing salinity, growth and productivity are reduced significantly.
Suicide in anaesthetists: a systematic review
Authors: Plunkett E. , Costello A. , Yentis S.M. , Hawton K.
Published: June 2021

Evidence suggests that healthcare professionals are at an increased risk of dying by suicide, with anaesthetists at particularly high risk. However, much of the data on which this is based are historical. With a focus on the epidemiology and methods used, we conducted a systematic review of evidence regarding suicide and suicidal behaviour among anaesthetists to provide a more contemporary summary. The systematic review process was adapted from a previous similar study in veterinary surgeons and was consistent with recommended guidance. We identified 54 articles published in or after 1990 that had anaesthetist‐specific data and met the inclusion criteria. Seven of these reported epidemiological data, of which four were published after 2000. Although none of the more recent studies reported standardised mortality rates specific to suicide in anaesthetists, the proportion of anaesthetists dying by suicide was increased with respect to comparator groups, which is consistent with previous findings. Eleven studies that included information on suicidal behaviour reported suicidal ideation in 3.2–25% of individuals (six studies) and suicide attempts in 0.5–2% (four studies). Studies reporting methods of suicide highlighted the use of anaesthetic drugs, particularly propofol, supporting the suggestion that the increased risk of suicide in anaesthetists may be related to the availability of the means. We discuss our findings in relation to other recently published data and guidance concerning mental health problems in anaesthetists.
Assessing operating theatre efficiency: a prospective cohort study to identify intervention targets to improve efficiency
Authors: Wallace Lauren , Muir Mathew , Romano Linda , Wyllie Tracey , Gyomber Dennis , Hodgson Russell
Published: June 2021

Background

Operating theatre efficiency is critical to providing optimum healthcare and maintaining the financial success of a hospital. This study aims to assess theatre efficiency, with a focus on staff activities, theatre utilisation and case changeover.

Methods

Theatre efficiency data were collected prospectively at a single centre in metropolitan Melbourne, Australia, over two 5‐week periods. Characteristics of each case and various time points were collected, corresponding to either in‐theatre staff activities or patient events.

Results

Two hundred and ninety‐nine cases were prospectively audited over a range of surgical specialties. Setting up represented 42.4% (37.28 min), operating time 40.1% (35.28 min) and finishing up time 17.5% (15.43 min). Theatres were empty (turnover time) for 17.42 min, which was 39.4% of the non‐operative time between operations (44.25 min, turnaround time). Plastic surgery operations required the shortest set‐up and finishing times on most of the measured metrics, with general surgery and obstetrics/gynaecology having longer times. List order made a significant difference, with efficiency improving over the list and over the day for separate am and pm lists. When a patient was not on time to theatre, efficiency in both set up and finishing up metrics was significantly worse.

Conclusions

A large proportion of theatre time was being spent on non‐operative tasks, making staff activities potential targets for operating theatre improvement interventions. Motivation and team familiarity were identified as the major factors behind efficiently run operating theatres, supporting the use of regular operating teams and maintenance of a highly motivated workforce.
The closer the better? Relative influence of forest continuity and distance to water on the taxonomic and functional structure of riparian plant communities along headwater streams
Authors: Janssen Philippe , Chevalier Richard , Evette André , Archaux Frédéric
Published: June 2021

Questions

(a) Is forest temporal continuity an important factor in structuring the riparian plant communities along small alluvial valleys? (b) To what extent can distance from the stream modulate the effect of forest continuity and provide a better understanding of the taxonomic and functional structure of these communities?

Location

Ouanne watershed, France.

Methods

We used a paired‐samples design, involving stands close to and far from the stream, in ancient or recent riparian forests, in which we studied the vegetation. We performed analyses of species richness and cover, as well as mean values of species preferences and functional traits, and measures of species composition, distinguishing between the understorey and overstorey.

Results

Strong differences in richness and mean values, as well as in composition, were found between ancient and recent forests. Ancient forests were characterized by species with a dominant stress‐tolerant strategy, whereas recent forests were dominated by hygrophilous and nitrophilous species with a dominant competitive strategy. Furthermore, we found that ancient and recent stands close to the stream encompassed a larger richness of species, than ancient and recent riparian stands far from the stream, a pattern mostly driven by the greater co‐occurrence of small ruderal species with rapid leaves turnover but also of ancient forest species.

Conclusions

In small riparian forests along headwater streams, we have shown that past human activities leave still detectable traces in contemporary plant communities. In addition, we pointed out that colonization by ancient indicator species was faster in recent forests closer to the stream. This underscores the need to protect remaining ancient riparian forests that are well connected to the stream, even if they are small, and suggests that bank reforestation as well as restoration of hydrological connectivity on rivers fragmented by artificial barriers may be an effective way to increase forest biodiversity in riparian zones.
How environmental enrichment balances out neuroinflammation in chronic pain and comorbid depression and anxiety disorders
Authors: Kimura Louise F. , Novaes Leonardo S. , Picolo Gisele , Munhoz Carolina D. , Cheung Chi W. , Camarini Rosana
Published: June 2021

Depression and anxiety commonly occur in chronic pain states and the coexistence of these diseases worsens outcomes for both disorders and may reduce treatment adherence and response. Despite the advances in the knowledge of chronic pain mechanisms, pharmacological treatment is still unsatisfactory. Research based on exposure to environmental enrichment is currently under investigation and seems to offer a promising low‐cost strategy with no side effects. In this review, we discuss the role of inflammation as a major biological substrate and aetiological factor of chronic pain and depression/anxiety and report a collection of preclinical evidence of the effects and mechanisms of environmental enrichment. As microglia participates in the development of both conditions, we also discuss microglia as a potential target underlying the beneficial actions of environmental enrichment in chronic pain and comorbid depression/anxiety. We also discuss how alternative interventions under clinical guidelines, such as environmental enrichment, may improve treatment compliance and patient outcomes.

LINKED ARTICLES

This article is part of a themed issue on Building Bridges in Neuropharmacology. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.8/issuetoc
High recurrence rate after posterior component separation and keyhole mesh reconstruction for complex parastomal hernia: A case series study
Authors: Robin Valle de Lersundi Alvaro , Rupealta Niccolo , San Miguel Mendez Carlos , Muñoz Rodriguez Joaquin , Pérez Flecha Marina , López Monclús Javier , Blazquez Hernando Luis , García Ureña Miguel Angel
Published: June 2021

Aim

This study aimed to describe the results of complex parastomal hernia repair after posterior component separation and keyhole reconstruction.

Method

We conducted a retrospective review of a prospectively sustained database in one single complex abdominal wall referral centre. We analysed the data of patients who underwent the posterior component separation technique using modified transversus abdominis release for complex parastomal hernia and retromuscular keyhole mesh repair from February 2014 to January 2017. Demographic data, hernia characteristics, operative details and outcomes were analysed. The primary outcome measured was the recurrence rate during the follow‐up.

Results

Twenty patients were included in this study. Among the patients who underwent surgery for parastomal hernia, 17 patients had a colostomy (85%) and three patients had a ureteroileostomy after the Bricker procedure (15%). The mean body mass index was 33.2 kg/m2 (range 25–47). Twelve patients had an expected associated risk according to the Carolinas equation for determining associated risk classification of >60%. Sixty per cent of our patients had contaminated or dirty/infected wounds. The overall complication rate was 60%. Surgical site infection was observed in 25% of the cases. The mortality rate in our study group was 5% (n = 1). We found clinical or radiological evidence of parastomal hernia recurrence in nine out of 20 (45%) patients during follow‐up. No hernia recurrence was detected in the concomitant incisional hernias.

Conclusions

Although posterior component separation in the form of modified transversus abdominis muscle release allows abdominal wall reconstruction, keyhole mesh configuration at the stoma site does not offer satisfactory results in terms of long‐term recurrence rate at the parastomal defect.
Important ecosystem function, low redundancy and high vulnerability: The trifecta argument for protecting the Great Barrier Reef's tabular Acropora
Authors: Ortiz Juan C. , Pears Rachel J. , Beeden Roger , Dryden Jen , Wolff Nicholas H. , Gomez Cabrera Maria del C. , Mumby Peter J
Published: June 2021

Identifying organisms that play an important role in maintaining ecosystem function is a key aspect of resilience‐based management. For Australia's Great Barrier Reef (GBR), we found that the recovery ability of shallow exposed fore‐reefs is more than 14 times higher when tabular Acropora are present. The disproportionate role that tabular Acropora play appears to be driven by a combination of traits including high recruitment, high growth rate and, importantly, large maximum colony sizes. Despite this key role, tabular Acropora are highly sensitive to most pressures. We compile evidence suggesting that if tabular corals were to decline or disappear on the GBR, the potential for reef recovery on exposed fore‐reefs would be considerably slowed. We then consider the merits of placing special emphasis on the protection of tabular Acropora within the management of the GBR. Importantly, we recognise that an analysis of costs and benefits of such recognition is vital before any change is implemented. Actions might include targeted crown‐of‐thorns starfish control, anchoring restrictions and protection for tabular corals on reefs identified as essential for their larval dispersal. In addition, targeted communications about the critical importance of these highly recognisable corals may boost community support and participation in their protection.
Dose selection for intracerebroventricular cerliponase alfa in children with CLN2 disease, translation from animal to human in a rare genetic disease
Authors: Hammon Kevin , de Hart Greg , Vuillemenot Brian R. , Kennedy Derek , Musson Don , O’Neill Charles A. , Katz Martin L. , Henshaw Joshua W.
Published: June 2021

Neuronal ceroid lipofuscinosis type 2 (CLN2 disease) is an ultra‐rare pediatric neurodegenerative disorder characterized by deficiency of the lysosomal enzyme tripeptidyl peptidase‐1 (TPP1). In the absence of adequate TPP1, lysosomal storage material accumulation occurs in the central nervous system (CNS) accompanied by neurodegeneration and neurological decline that culminates in childhood death. Cerliponase alfa is a recombinant human TPP1 enzyme replacement therapy administered via intracerebroventricular infusion and approved for the treatment of CLN2 disease. Here, we describe two allometric methods, calculated by scaling brain mass across species, that informed the human dose selection and exposure prediction of cerliponase alfa from preclinical studies in monkeys and a dog model of CLN2 disease: (1) scaling of dose using a human‐equivalent dose factor; and (2) scaling of compartmental pharmacokinetic (PK) model parameters. Source PK data were obtained from cerebrospinal fluid (CSF) samples from dogs and monkeys, and the human exposure predictions were confirmed with CSF data from the first‐in‐human clinical study. Nonclinical and clinical data were analyzed using noncompartmental analysis and nonlinear mixed‐effect modeling approaches. Both allometric methods produced CSF exposure predictions within twofold of the observed exposure parameters maximum plasma concentration (Cmax) and area under the curve (AUC). Furthermore, cross‐species qualification produced consistent and reasonable PK profile predictions, which supported the allometric scaling of model parameters. The challenges faced in orphan drug development place an increased importance on, and opportunity for, data translation from research and nonclinical development. Our approach to dose translation and human exposure prediction for cerliponase alfa may be applicable to other CNS administered therapies being developed.
Predictors of alcohol use during pregnancy in Australian women
Authors: Tsang Tracey W. , Kingsland Melanie , Doherty Emma , Anderson Amy E. , Tully Belinda , Crooks Kristy , Symonds Ian , Tremain Danika , Dunlop Adrian J. , Wiggers John , Elliott Elizabeth J.
Published: June 2021

Introduction

This paper aimed to document alcohol use during pregnancy and determine predictors of ongoing use, including knowledge and agreement with national alcohol guideline recommendations.

Methods

Pregnant women (n = 1179) attending public antenatal services in a Local Health District in NSW, Australia, were surveyed about their alcohol use before pregnancy and after pregnancy recognition, and awareness of, and agreement with, national alcohol guidelines and health‐related statements. Respondent characteristics, drinking behaviour and predictors of ongoing drinking during pregnancy were assessed.

Results

Most women consumed alcohol before pregnancy (79.3%) but the majority (82.0%) stopped following pregnancy recognition. Half the ongoing drinkers only drank on special occasions. Most (63.6%) women were aware of the national guidelines: 78.1% knew the recommendation that consuming no alcohol in pregnancy is safest, 4.6% thought some alcohol was safe and 17.3% were unsure. Predictors [OR (95%CI)] of ongoing drinking were older age [1.11 (1.07, 1.15)]; medium [2.42 (1.46, 4.00)] or high‐risk drinking pre‐pregnancy [3.93 (2.35, 6.56)]; and agreement that: avoiding alcohol in pregnancy is safest [0.05 (0.006, 0.47)]; avoiding alcohol is important for baby's health [0.14 (0.06, 0.31)] and pregnancy is a good time to change alcohol use for mother's health [0.29 (0.13, 0.63)].

Discussion and Conclusions

Results emphasise the importance of asking about special occasion drinking, the link between pre‐pregnancy drinking and ongoing drinking during pregnancy, and the need to understand why women disagree with the national guideline. To ensure guidelines have their intended benefit, interventions to promote behaviour change relating to alcohol consumption during pregnancy are warranted.
Retroflexed view for reexamination of the right colon after forward view examination: Systematic review and meta‐analysis
Authors: Lv Xiu‐He , Lu Qing , Sun Yi‐Ning , Deng Kai , Yang Jin‐Lin
Published: June 2021

Background

The effect of retroflexed view (RV) for the reexamination of the right colon after forward view (FV) examination has not been fully understood.

Methods

We searched multiple databases including PubMed, Embase, and the Cochrane Library for prospective studies exploring the role of RV for reexamination of the right colon. A meta‐analysis was performed on outcomes including lesion detection rates, lesion miss rates, and withdrawal time.

Results

Four randomized controlled trials aimed to compare the impact of the second withdrawal from the right colon in RV vs. FV following a standard colonoscopy. Both the additional adenoma detection rate (AADR) and additional polyp detection rate (APDR) of the right colon were lower in the RV group compared with the FV group (risk ratio [RR] 0.73 for AADR; RR 0.76 for APDR); similar results were noted in comparisons of the adenoma miss rate and polyp miss rate. Six prospective cohort studies aimed to describe the effect of the RV examination of the right colon after one or two rounds of FV examination. Both the adenoma detection rate (ADR) and polyp detection rate (PDR) of the right colon were slightly higher in combined examinations with RV examination than single FV examination (RR 1.11 for ADR; RR 1.16 for PDR) or two FV examinations (RR 1.21 for ADR; RR 1.22 for PDR).

Conclusions

FV may detect more adenomas and polyps than RV during the second withdrawal from the right colon. RV may detect additional adenomas and polyps in the right colon after two FV examinations.
Transcranial direct current stimulation over the left anterior temporal lobe during memory retrieval differentially affects true and false recognition in the DRM task
Authors: Friehs Maximilian A. , Greene Ciara , Pastötter Bernhard
Published: June 2021

Transcranial direct current stimulation (tDCS) is a form of non‐invasive brain stimulation that has been used to modulate human brain activity and cognition. One area which has not yet been extensively explored using tDCS is the generation of false memories. In this study, we combined the Deese‐Roediger‐McDermott (DRM) task with stimulation of the left anterior temporal lobe (ATL) during retrieval. This area has been shown to be involved in semantic processing in general and retrieval of false memories in the DRM paradigm in particular. During stimulation, 0.7 mA were applied via a 9 cm² electrode over the left ATL, with the 35 cm² return electrode placed over the left deltoid. We contrasted the effects of cathodal, anodal, and sham stimulation, which were applied in the recognition phase of the experiment on a sample of 78 volunteers. Results showed impaired recognition of true memories after both anodal and cathodal stimulation in comparison to sham stimulation, suggesting a reduced signal‐to‐noise ratio. In addition, the results revealed enhanced false recognition of concept lure items during cathodal stimulation compared to anodal stimulation, indicating a polarity‐dependent impact of tDCS on false memories in the DRM task. The pathway by which tDCS modulated false recognition remains unclear: stimulation may have changed the activation of irrelevant lures or affected the weighting and monitoring of lure activations. Nevertheless, these results are a first step towards using brain stimulation to decrease false memories. Practical implications of the findings for real‐life settings, for example, in the courtroom, need to be addressed in future work.
A transient decrease in heart rate with unilateral and bilateral galvanic vestibular stimulation in healthy humans
Authors: Pliego Adriana , Vega Rosario , Gómez Rocío , Reyes‐Lagos José J. , Soto Enrique
Published: June 2021

The study of cardiovascular function with galvanic vestibular stimulation has provided evidence on the neural structures that are involved in the vestibulo‐autonomic reflex. This study determined if the effect on heart rate using galvanic vestibular stimulation persists after provoking a sympathetic response and if this response differs when using unilateral or transmastoid (bilateral) stimulation. We analysed heart rate and heart rate variability using unilateral and transmastoid galvanic vestibular stimulation combined with cardiovascular reflex evoked by postural change in 24 healthy human subjects. Three electrode configurations were selected for unilateral stimulation considering the anatomical location of each semicircular canal. We compared recordings performed in seated and standing positions, and with unilateral and transmastoid stimulation. With subjects seated, a significant transient decrease in heart rate was observed with unilateral stimulation. With transmastoid stimulation, heart rate decreased in both seated and standing positions. Average intervals between normal heartbeats recorded with stimulation resemble parasympathetic cardiac function induced by auricular vagal nerve stimulation. Our results indicate that unilateral stimulation does not eliminate the natural heart rate increase caused by orthostatic hypotension. In contrast, transmastoid stimulation provoked a transient reduction in heart rate, even when subjects were standing. These responses should be considered while performing experiments with galvanic vestibular stimulation and subsequent effects in cardiac regulation mechanisms.
Clinical predictors and neural correlates for compromised swallowing safety in Huntington disease
Authors: Schumann‐Werner Beate , Dogan Imis , Mirzazade Shahram , Mall Bettina , Overbeck Rena , Honrath Philipp , Schulz Jörg B. , Reetz Kathrin , Werner Cornelius J.
Published: June 2021

Background and purpose

Dysphagia is one of the most common and important complications in Huntington disease (HD), frequently leading to aspiration pneumonia and mortality. Objective estimates of prevalence using instrumental diagnostics and data on neural correlates of dysphagia in HD are scarce or lacking entirely. Similarly, its correlation with other clinical markers is still not fully known. We aimed at defining clinical risk factors and neural correlates for compromised swallowing safety in HD more precisely.

Methods

Thirty‐four HD subjects (16 female, Shoulson & Fahn Stage I–IV, two premanifest) underwent a full clinical–neurological examination including the cranial nerves, the Unified Huntington’s Disease Rating Scale total motor score, and the Mini‐Mental State Examination. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed by a trained speech and language therapist. Twenty‐six subjects additionally underwent a high‐resolution anatomical magnetic resonance imaging (MRI) scan (T1, 3‐T Siemens Prisma). Moreover, we correlated clinical and atrophy (MRI) measures with swallowing safety levels as judged by the validated Penetration–Aspiration Scale.

Results

FEES showed penetration or aspiration in 70.6%. Using partial correlation, no significant correlations were found between swallowing safety and any of the clinical markers after correcting for disease duration and CAG repeat length. Voxel‐based morphometry demonstrated atrophy associated with compromised swallowing safety in a network of parietothalamocerebellar areas related to sensorimotor communication, notably excluding striatum.

Conclusions

Our results characterise dysphagia in HD as a disorder of communication between sensory and motor networks involved in swallowing. This finding and high rates of silent aspiration argue in favor of instrumental swallowing evaluation early in the disease.
Sell‐side analyst recommendation revisions and hedge fund trading before and after regulation fair disclosure
Authors: Caglayan Mustafa Onur , Celiker Umut , Lawrence Edward R.
Published: June 2021

We examine institutional trading in relation to changes in consensus recommendations over time. We find that pre‐Reg FD's positive contemporaneous relation between hedge fund trading and change in consensus becomes negative after Reg FD, but the positive relation between nonhedge fund trading and change in consensus continues even after Reg FD. Furthermore, during post‐Reg FD, while the performance of hedge funds’ trades that contradict with analysts improve, nonhedge funds’ trades that agree with analysts significantly deteriorate. Our evidence suggests that hedge funds have better information processing skill and are more cognizant about the role of selective information in analyst recommendations.
Immunological and virological response to initial antiretroviral therapy among older people living with HIV in the Canadian Observational Cohort (CANOC)
Authors: Zhabokritsky A , Szadkowski L , Burchell AN , Cooper C , Hogg RS , Hull M , Kelly DV , Klein M , Loutfy M , McClean A , Montaner J , Walmsley SL ,   for the Canadian Observational Cohort (CANOC) Collaboration
Published: June 2021

Objectives

The aim of this study was to assess the adequacy of immunological recovery and virological suppression in response to antiretroviral therapy (ART) in the growing population of older people living with HIV (PLWH), as treatment regimens become more effective and tolerable.

Methods

An interprovincial Canadian cohort of treatment‐naïve PLWH who initiated ART after 1 January 2000 was used and age assessed in decades. Longitudinal absolute CD4 count response to treatment was modelled using generalized estimating equations. Cumulative incidence functions and proportional hazards models with a competing risk of death were used to estimate time to: (1) CD4 ≥ 200 cells/µL, (2) CD4 ≥ 500 cells/µL, (3) virological suppression (≤ 50 copies/mL), and (4) virological failure (> 200 copies/mL).

Results

In all, 12 489 individuals starting ART between 2000 and 2016 with one or more post‐treatment CD4 count or viral load were included in the analysis. Age > 60 years was associated with lower absolute CD4 recovery (adjusted β = −31 cells/µL) compared with age ≤ 30 years when pre‐treatment CD4 count and other covariates were accounted for. Older age groups were less likely to achieve a CD4 ≥ 500 cells/µL, with the greatest effect in the > 60 group [adjusted hazard ratio (aHR) = 0.69, 95% confidence interval (CI): 0.57–0.84 vs. age ≤ 30). Older age groups were more likely to achieve viral suppression (age > 60, aHR = 1.20, 95% CI: 1.05–1.37) and less likely to have virological failure (age > 60, aHR = 0.46, 95% CI: 0.3–0.71) compared with those aged ≤ 30 years.

Conclusions

Older adults have robust virological responses to ART; however, individuals over the age 60 are more likely to experience blunted CD4 recovery.
Taking the entrepreneur out of entrepreneurship
Authors: Coad Alex , Storey David J.
Published: June 2021

This ‘Debate Essay’ responds to the extensive overview of research on new venture survival provided by Soto‐Simeone et al. (‘New venture survival: A review and extension’, International Journal of Management Reviews, 22(4), 2020, pp. 378–407). The material they reviewed exclusively emphasized the link between the talents, skills, awareness of the business owner and new venture outcomes. Our case is that such a review is incomplete, even misleading, because it omits the key concept of ‘chance’, and all references to the stream of literature demonstrating that new venture performance is best explained by the gambling analogy. We therefore set out the Gambler's Ruin model in which new venture performance is a random walk and exit depends on access to financial resources—chips. This model takes the entrepreneur out of entrepreneurship.
A meta‐analysis of the comparison of phlebitis between midline catheters and peripherally inserted central catheters in infusion therapy
Authors: Lu Huapeng , Yang Qinling , Tian Boyan , Lyu Yi , Zheng Xuemei , Xin Xia
Published: June 2021

Aims

To compare the risk of phlebitis between midline catheters and peripherally inserted central catheters in infusion therapy with a meta‐analysis.

Design

This was a systematic literature review and meta‐analysis.

Data Sources

Web of Science, PubMed, Scopus, Embase, Cochrane Library, ProQuest, CNKI, WanFang, VIP and SinoMed were searched from inception to May 2020.

Review Methods

All studies comparing the risk of phlebitis between midline catheters and peripherally inserted central catheters were included. According to the inclusion and exclusion criteria, two authors independently assessed the literature and extracted the data. Meta‐analyses were conducted to generate estimates of phlebitis risk in patients with midline catheters verse peripherally inserted central catheters, and publication bias was evaluated with RevMan 5.3.

Results

A total of seven studies were collected, involving 1377 participants. The incidence of phlebitis with midline catheters and peripherally inserted central catheters was 1.52% and 3.41%. Meta‐analysis showed that the incidence of phlebitis has no significant difference between midline catheters and peripherally inserted central catheters. The sensitivity analysis shows that the results from this meta‐analysis are fair in overall studies. All studies have no significant publication bias.

Conclusion

This study provides the first systematic assessment of the risk of phlebitis between midline catheters and peripherally inserted central catheters. The incidence of phlebitis has no significant difference between them. There are many factors to consider when choosing vascular access devices.
Courting diaspora for foreign direct investment: The conditional nature of diaspora engagement
Authors: Kulakevich Tatsiana
Published: June 2021

The paper focuses on an understudied aspect of the relationship between states and their diasporas—emigration policies attracting diaspora investment. I find that countries with weaker rule of law face particularly strong incentives to adopt diaspora engagement policies and engage in initiatives attracting diaspora investment as opposed to the countries with stronger rule of law. This argument is illustrated through an investment game between migrant investors and governments with different strengths of rule of law. It is tested by using the data from multiple levels of analysis: original and existing data examining the instances when top government officials reach out to their diasporas for investment and bilateral foreign direct investment and migration data.
Cancer‐associated fibroblasts: Key players in shaping the tumor immune microenvironment
Authors: Desbois Mélanie , Wang Yulei
Published: June 2021

Cancer immunotherapies have rapidly changed the therapeutic landscape for cancer. Nevertheless, most of the patients show innate or acquired resistance to these therapies. Studies conducted in recent years have highlighted an emerging role of cancer‐associated fibroblasts (CAFs) in immune regulation that shapes the tumor immune microenvironment (TIME) and influences response to cancer immunotherapies. In this review, we outline recent advances in the understanding of phenotypic and functional heterogeneity of CAFs. We will focus on emerging roles of CAFs in shaping the TIME, especially under a framework of tumor immunity continuum, and discuss current and future CAF‐targeting therapeutic strategies in particular in the context of optimizing the success of immunotherapies.
Lymphedema rehabilitation: Provision and practice patterns among service providers: National survey
Authors: Omar Mohammed T. A. , Al‐Dhwayan Nouf M. , Gwada Rehab F. M. , Armer Jane M.
Published: June 2021

Information on the current practices and quantification of lymphedema service may be beneficial to promote and improve the current health care system. Therefore, this study aimed to describe the characteristics of lymphedema practitioners, and lymphedema patients' profiles, and provide a comprehensive picture of lymphedema service provision in Saudi Arabia. A cross‐sectional study design used an online survey to gather data. The survey included information about demographic and professional characteristics of lymphedema practitioners, lymphedema profiles, questions on the services provided, and perceived barriers in providing services. Eighteen lymphedema practitioners (38%) responded to the survey. Most of the respondents were physical therapists (94%), who had completed 135 hours of basic training course, and were certified as lymphedema therapists (89%). Most of these practitioners were in Riyadh (58%), Jeddah (25%), and Dammam (17%). About 75% of patients seen by practitioners had secondary lymphedema, predominately breast cancer‐related lymphedema (47%). The average number of lymphedema practitioners per service is three. The perceived barriers reported included an inadequate number of certified therapists (100%), difficulties with transportation and lack of financial support (each; 72%), and limited space for lymphedema practice/management (89%). The results suggest lymphedema practitioners provide reasonable services for lymphedema patients; however, services are still limited and needs are unmet. Therefore, more staffing is required to promote awareness of the condition and related services, to develop and implement appropriate educational strategies, and improve geographical and multidisciplinary coordination of the services in Saudi Arabia.
Prevalence and predictors of medication non‐adherence among older community‐dwelling people with chronic disease in Singapore
Authors: Chew Suet Mei , Lee Jia Hua , Lim Su Fee , Liew Min Jia , Xu Yi , Towle Rachel Marie
Published: June 2021

Aims

To determine the prevalence and predictors of medication non‐adherence among older community‐dwelling people with at least one chronic disease in Singapore.

Design

A single‐centre cross‐sectional study.

Methods

The study was conducted in the largest tertiary public hospital in Singapore between May 2019 and December 2019. The community nurses of the hospital recruited a total of 400 community‐dwelling older people aged ≥60 years old, who were diagnosed with at least one chronic disease and prescribed with at least one long‐term medication. Medication non‐adherence was assessed using the self‐report 5‐item Medication Adherence Report Scale, operationalized as a score of <25. A list of potential factors of medication non‐adherence was structured based on the World Health Organization five‐domain framework and collected using a self‐report questionnaire.

Results

Sixty percent (n = 240) of our participants were non‐adherent to their medication regime. Older people who smoked (OR 2.89, 95% CI 1.14–7.33), perceived their medication regime as being complicated (OR 2.54, 95% CI 1.26–5.13), felt dissatisfied with their regime (OR 2.50, 95% CI 1.17–5.31), did not know the purpose of all their medications (OR 2.56, 95% CI 1.42–4.63) and experienced side effects (OR 3.32, 95% CI 1.14–9.67) were found to be predictive of medication non‐adherence.

Conclusion

Medication adherence was found to be poor in community‐dwelling older people in Singapore. The predictors identified in this study can help guide healthcare professionals in identifying older people who are at risk of medication non‐adherence and inform the development of interventions to improve adherence.

Impact

Medication non‐adherence, especially in the older population with chronic diseases, constitutes a serious problem as it undermines the efforts to reduce morbidity and mortality associated with the underlying chronic diseases. To improve adherence, our findings propose the importance of assessing the older person's treatment satisfaction, which includes examining the aspects of side effects, effectiveness and convenience. Additionally, we highlight the need to address the older person's medication knowledge deficit.
Breeding strategies for improving smallholder dairy cattle productivity in Sub‐Saharan Africa
Authors: Chawala Aluna R. , Sanchez‐Molano Enrique , Dewhurst Richard J. , Peters Andrew , Chagunda Mizeck G. G. , Banos Georgios
Published: June 2021

Breeding strategies for smallholder dairy farming systems in Sub‐Saharan Africa (SSA) were simulated and evaluated considering cow traits identified as priorities by farmers in different agro‐ecological zones. These traits were related to cow milk yield, fertility, temperament, feed intake and disease resistance. The first breeding strategy was based on continuous importation of genetically superior exotic dairy sire semen to SSA and crossing with local females leading to a gradual upgrade of the indigenous population. The second strategy assumed that semen from elite exotic bulls would be imported to SSA and used on indigenous cows to produce F1 animals. Thereafter, elite animals would be selected from within the F1 and each subsequent generation to establish a new synthetic breed. The third strategy was to improve the indigenous population by genetically selecting the best sires available domestically. Results showed positive genetic progress for all breeding goal traits. After 15 generations of selection, the genetic response of the importation strategy exceeded the corresponding genetic response of the synthetic breed strategy by 20%–60%. The former also exceeded the genetic response of the indigenous breed improvement strategy by 43%–75%. Potentially there is an opportunity for breeders to choose an appropriate breeding strategy that fits a specific need of smallholder dairy farmers.
The species–area relationship in ant ecology
Authors: Ohyama Leo , Holt Robert D. , Matthews Thomas J. , Lucky Andrea
Published: June 2021

Aim

The positive relationship between species richness and area—the species–area relationship (SAR)—is a key principle in ecology. Previous studies show large variation in the SAR across taxa collectively indicating the necessity of a taxon‐focused approach to accurately evaluate biodiversity scaling patterns. Ants are ideal for this given their global distribution and role in ecosystem functioning. Using data from insular ant communities, this study quantified and investigated various attributes of ant SARs and reviewed the SAR literature for ant faunas, world‐wide, to identify specific areas for improvement.

Location

Islands around the world.

Taxon

Ants (Hymenoptera: Formicidae).

Methods

We aggregated data on species richness and island characteristics from previous studies on ant SARs to evaluate effects of climate, biogeographic realm, and latitude on slope values from these studies. A multimodel inference approach was used to determine the form of the different SARs, and whether there were any differences between mainland and insular SARs. We also assessed differences between mainland and insular SAR slopes and intercepts. To seek a general slope coefficient for ants, we used a mixed‐effect model. Finally, we tested for potential thresholds in the global insular SAR using piecewise regression models.

Results

There was a negative relationship between SAR slopes and precipitation in both mainland and insular SARs, while SAR slopes and intercept values were higher in mainland compared to insular systems. Strong evidence of thresholds emerged in the global insular SAR. Finally, a general slope of 0.16 was observed for insular systems, which is lower than found in previous studies.

Main Conclusions

A taxon‐focused approach proves to showcase unexpected patterns in the SAR. Ant diversity increases faster across area in mainland areas compared to true islands. The influences of climate and biogeographic realms on the ant SAR warrant deeper study. Our review highlights knowledge gaps in the ant SAR that also extend to other taxa, such as the effects of nonnative species on the SAR.
The impact of adaptive computer assisted instruction on reading comprehension: Identifying the main idea
Authors: Toonder Scott , Sawyer L. Brook
Published: June 2021

Research has demonstrated that computer assisted instruction (CAI) can have positive impacts on various literacy skills, however its impact on specific comprehension skills is currently unclear. This study employed a small‐scale randomized control trial to examine the impact of a researcher‐developed adaptive computer assisted instructional program, Digital Comprehension, on 47 upper elementary struggling readers' comprehension skills, specifically main idea identification. Students were randomly assigned to treatment and control groups, with students in the treatment group engaging in the Digital Comprehension program and students in the control group receiving only business‐as‐usual classroom instruction. Students completed measures assessing main idea and general reading comprehension skills at pre‐ and post‐intervention. Students in the treatment group demonstrated statistically significant greater growth in main idea skills than students in the control group. No main effect for the intervention was found for general reading comprehension skills, although there was a significant interaction between condition and student's pretest scores. Results indicate that adaptive CAI may be an effective means for remediating struggling readers' main idea skills.
CRKL is a critical target of Hh‐GLI2 pathway in lung adenocarcinoma
Authors: Liu Xiaoming , Hu Yan , Yu Bentong , Peng Kai , Gan Xin
Published: June 2021

Lung adenocarcinoma (LUAD) is one of the important components of non‐small‐cell lung cancer (NSCLC) and leads to many deaths every year. During the initiation and progression of the LUAD, the Hh‐GLI2 pathway plays critical roles. Several components of this pathway have been shown to be amplified or overexpressed in LUAD, providing this pathway as an attractive target for therapeutics. However, a gap in our understanding of the Hh‐GLI2 pathway is the identity of transcriptional targets of GLI2 that drive LUAD tumorigenesis. Here, we show that the oncogene CRKL is a direct target of GLI2. GLI2 turns on CRKL transcription through binding its second intron. Furthermore, CRKL is an essential mediator for GLI2‐driven proliferation and migration of LUAD cells. Depletion of CRKL blunts Hh‐GLI2 pathway‐mediated cell proliferation and invasion. Lastly, we find that CRKL knockout cells are more sensitive to EGFR‐TKI and chemotherapeutics. Taken together, our work here identifies a specific target for Hh‐related malignancies and provides CRKL as a promising therapeutic target for LUAD.
Mesenchymal stem cells ameliorate silica‐induced pulmonary fibrosis by inhibition of inflammation and epithelial‐mesenchymal transition
Authors: Wei Jingjing , Zhao Qiuyan , Yang Guo , Huang Ruoxuan , Li Chao , Qi Yuanmeng , Hao Changfu , Yao Wu
Published: June 2021

Silicosis is a devastating occupational disease caused by long‐term inhalation of silica particles, inducing irreversible lung damage and affecting lung function, without effective treatment. Mesenchymal stem cells (MSCs) are a heterogeneous subset of adult stem cells that exhibit excellent self‐renewal capacity, multi‐lineage differentiation potential and immunomodulatory properties. The aim of this study was to explore the effect of bone marrow‐derived mesenchymal stem cells (BMSCs) in a silica‐induced rat model of pulmonary fibrosis. The rats were treated with BMSCs on days 14, 28 and 42 after perfusion with silica. Histological examination and hydroxyproline assays showed that BMSCs alleviated silica‐induced pulmonary fibrosis in rats. Results from ELISA and qRT‐PCR indicated that BMSCs inhibited the expression of inflammatory cytokines TNF‐α, IL‐1β and IL‐6 in lung tissues and bronchoalveolar lavage fluid of rats exposed to silica particles. We also performed qRT‐PCR, Western blot and immunohistochemistry to examine epithelial‐mesenchymal transition (EMT)–related indicators and demonstrated that BMSCs up‐regulate E‐cadherin and down‐regulate vimentin and extracellular
matrix (ECM) components such as fibronectin and collagen Ⅰ. Additionally, BMSCs inhibited the silica‐induced increase in TGF‐β1, p‐Smad2 and p‐Smad3 and decrease in Smad7. These results suggested that BMSCs can inhibit inflammation and reverse EMT through the inhibition of the TGF‐β/Smad signalling pathway to exhibit an anti‐fibrotic effect in the rat silicosis model. Our study provides a new and meaningful perspective for silicosis treatment strategies.
METTL16 promotes cell proliferation by up‐regulating cyclin D1 expression in gastric cancer
Authors: Wang Xiao‐Kun , Zhang Ya‐Wei , Wang Chun‐Ming , Li Bo , Zhang Tian‐Zhi , Zhou Wen‐Jie , Cheng Lyu‐jia , Huo Ming‐Yu , Zhang Chang‐Hua , He Yu‐Long
Published: June 2021

N6‐methyladenosine (m6A) is a well‐known modification of RNA. However, as a key m6A methyltransferase, METTL16 has not been thoroughly studied in gastric cancer (GC). Here, the biological role of METTL16 in GC and its underlying mechanism was studied. Immunohistochemistry was used to detect the expression of METTL16 and relationship between METTL16 level and prognosis of GC was analysed. CCK8, colony formation assay, EdU assay and xenograft mouse model were used to study the effect of METTL16. Regulatory mechanism of METTL16 in the progression of GC was studied through flow cytometry analysis, RNA degradation assay, methyltransferase inhibition assay, RT‐qPCR and Western blotting. METTL16 was highly expressed in GC cells and tissues and was associated with prognosis. In vitro and in vivo experiments confirmed that METTL16 promoted proliferation of GC cells and tumour growth. Furthermore, down‐regulation of METTL16 inhibited proliferation by G1/S blocking. Significantly, we identified cyclin D1 as a downstream effector of METTL16. Knock‐down METTL16 decreased the overall level of m6A and the stability of cyclin D1 mRNA in GC cells. Meanwhile, inhibition of methyltransferase activity reduced the level of cyclin D1. METTL16‐mediated m6A methylation promotes proliferation of GC cells through enhancing cyclin D1 expression.