bluuebunny/crossref_metadata_2025 huggingface dataset:
Associations between liver function parameters and poor clinical outcomes in peritoneal dialysis patients
Authors: Song Xiyu , Zha Yang , Liu Jing , He Peng , He Lijie
Published: September 2022

Patients with end‐stage renal disease (ESRD) have significantly lower survival rates compared with the general population of the same age. Peritoneal dialysis (PD) is an effective treatment for patients with ESRD, but the clinical outcome of PD patients is still not promising. The survival of PD patients is associated with various clinical factors, and exploring some valid risk predictors may be beneficial for this population. In this review, by integrating the latest research, we summarized the association of some common and novel liver function parameters (ALT, AST, ALP, GGT, serum bilirubin, pre‐albumin, albumin, albumin‐globulin ratio [AGR], serum ferritin, and hyaluronic acid) with clinical outcomes in PD patients. It may contribute to a better understanding of potential risk factors and help to develop strategies to prevent the disease progression.
Retrospective cohort analysis comparing changes in blood glucose level and body composition according to changes in thyroid‐stimulating hormone level
Authors: Kim Hyunah , Jung Da Young , Lee Seung‐Hwan , Cho Jae‐Hyoung , Yim Hyeon Woo , Kim Hun‐Sung
Published: September 2022

Background

In the euthyroid state, the risk of developing diabetes according to changes in thyroid‐stimulating hormone (TSH) levels remains controversial. Additionally, the correlation of various body indices affecting blood glucose levels according to changes in TSH levels over a certain period is not well known.

Methods

Patients who underwent health check‐ups twice at a 2 year interval at a tertiary university hospital between 2009 and 2018 were included. By dividing baseline TSH levels into quartiles (TSH_Q1, Q2, Q3, and Q4), various variables were compared, and their changes after 2 years (∆TSH_Q1, Q2, Q3, and Q4) were confirmed.

Results

Among 15 557 patients, the incidence of diabetes mellitus after 2 years was 2.4% (377/15 557 patients). There was no statistically significant difference in the incidence of diabetes according to TSH_Q (p = 0.243) or ∆TSH_Q (p = 0.131). However, as TSH levels increased, skeletal muscle mass decreased (p < 0.001), and body fat mass and percent body fat significantly increased (p < 0.001). As ∆TSH increased, ∆fasting blood glucose and ∆body mass index also significantly increased (all p < 0.001). The incidence of diabetes decreased significantly as skeletal muscle mass increased (odds ratio 0.734, p < 0.001).

Conclusions

Owing to the short study period, it was not possible to prove a statistical relationship between the incidence of diabetes mellitus and TSH levels in the euthyroid state. Significant decreases in skeletal muscle mass and increases in body mass index and body fat mass according to baseline TSH levels were demonstrated. Therefore, a focus on improving physical functions, such as increasing muscle mass and decreasing fat, is required in this case.
Evaluation of pulmonary artery bleeding during thoracoscopic pulmonary resection for lung cancer
Authors: Tomoyasu Makoto , Deguchi Hiroyuki , Kudo Satoshi , Shigeeda Wataru , Kaneko Yuka , Yoshimura Ryuichi , Kanno Hironaga , Saito Hajime
Published: September 2022

Background

Bleeding from the pulmonary artery (PA) can be fatal in video‐assisted thoracoscopic surgery (VATS) for lung cancer. We evaluated intraoperative PA injury and assessed precautions for thoracoscopic anatomic pulmonary resection.

Methods

We retrospectively analyzed a total of 1098 patients who underwent radical surgery for lung cancer utilizing complete VATS from January 2010 to December 2021.

Results

A total of 16 patients (1.5%) had PA injury during VATS, while hemostasis was performed by conversion to thoracotomy in eight patients (50.0%). Although there was a significantly greater operation time and blood loss for patients in the PA injury group (318.4 vs. 264.9 min, p = 0.001; 550.3 vs. 60.5 g, p ≤ 0.001, respectively), there was no significant different for the chest tube insertion duration and length of postoperative hospital stay (4.9 vs. 7.8 days, p = 0.157; 10.6 vs. 9.9 days, p = 0.136, respectively). There was a significant difference observed for the surgical procedure related to the left upper lobectomy in the PA injury group (43.8 vs. 18.8%, p = 0.012), with the primary causative PA determined to be the left anterior segmental PA (A3) (31.3%).

Conclusions

VATS is both feasible and safe for lung cancer treatment provided the surgeon performs appropriate hemostasis, although fatal vascular injury could potentially occur during VATS. Surgeons need to be aware of the pitfalls regarding PA dissection management.
Improving older adults stroke survivors’ decision‐making when selecting a discharge location: A randomized controlled trial protocol
Authors: Aoki Yoriko , Nakayama Kazuhiro
Published: September 2022

Purpose

Due to disability and reduced activities of daily living (ADL), older adult stroke survivors face difficulties deciding whether to receive care at home or move to a facility after discharge. The study aims to evaluate the impact of decision‐aid (DA) use on decision‐making participation and conflict regarding the selection of post‐discharge care locations for older adult stroke survivors and their families.

Data sources

A randomized controlled trial will be conducted among older adult stroke survivors at a medical rehabilitation facility during their recovery period. Randomization units will be blinded and allocated according to the patient's room, and the intervention period will be approximately 2 months, from admission to discharge. The study participants will include (1) people over 65 years of age, (2) stroke survivors, and (3) those facing the need to make decisions regarding the location of post‐discharge care. However, those who have difficulty making their own decisions due to severe dementia, aphasia, or altered consciousness will be excluded. In the intervention group, a DA will be provided with its utilization confirmed approximately 1 month after hospitalization. Similarly, the control group will be provided with an informative brochure, with the provision being confirmed approximately 1 month after hospitalization.

Data synthesis

The primary outcome (decision‐making conflict) and secondary outcome (decision‐making participation) will be evaluated using the decisional conflict scale (DCS) and revised control preference scale (CPS), respectively. Intergroup differences in DCS and CPS will be analyzed using two‐way repeated measures analysis of variance and z‐test, respectively.

Conclusions

Verification using randomized controlled trials is necessary to determine the effectiveness and versatility of DAs.

Implications for nursing practice

By deepening the knowledge of our priority research areas, the results of the proposed study will strengthen our fundamental knowledge by revealing older adult stroke survivors’ care preferences after discharge.
Exploring the relationships between adolescent alcohol misuse and later life health outcomes
Authors: Pascale Angela , Stephenson Mallory , Barr Peter , Latvala Antti , Aaltonen Sari , Piirtola Maarit , Viken Richard , Rose Richard J. , Kaprio Jaakko , Maes Hermine , Dick Danielle M. , Salvatore Jessica E.
Published: September 2022

Background

We sought to clarify the impact of adolescent alcohol misuse on adult physical health and subjective well‐being. To do so, we investigated both the direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction and the indirect effects on these outcomes attributable to subsequent alcohol problems.

Method

The sample included 2733 twin pairs (32% monozygotic; 52% female) from the FinnTwin16 study. Adolescent alcohol misuse was a composite of frequency of drunkenness, frequency of alcohol use, and alcohol problems at ages 16, 17, and 18.5. The early midlife outcomes included somatic symptoms, self‐rated health, and life satisfaction at age 34. The mediators examined as part of the indirect effect analyses included alcohol problems from the Rutgers Alcohol Problem Index at ages 24 and 34. Serial mediation and co‐twin comparison models were applied and included covariates from adolescence and early midlife.

Results

There were weak direct associations between adolescent alcohol misuse and early midlife physical health and life satisfaction. However, there was stronger evidence for indirect effects, whereby young adult and early midlife alcohol problems serially mediated the relationship between adolescent alcohol misuse and early midlife somatic symptoms (β = 0.03, 95% CI [0.03, 0.04]), self‐rated health (β = −0.02, 95% CI [−0.03, −0.01]), and life satisfaction (β = −0.03, CI [−0.04, −0.02]). These serial mediation effects were robust in co‐twin comparison analyses.

Conclusions

These results provide evidence that alcohol problems are a primary driver linking adolescent alcohol misuse and poor health outcomes across the lifespan.
What affects the public healthcare costs of breast cancer in New Zealand?
Authors: Lao Chunhuan , Mondal Mohana , Kuper‐Hommel Marion , Campbell Ian , Lawrenson Ross
Published: September 2022

Backgrounds

The pressure to the healthcare system for providing ongoing monitoring and treatment for breast cancer survivors is increasing. This study aims to identify the factors that affect the public healthcare costs of stage I–III breast cancer and stage IV cancer in New Zealand.

Methods

We identified women diagnosed with invasive breast cancer between July 1, 2010 and June 30, 2018 and who received services in a public hospital. Patients were identified from the National Breast Cancer Register and/or New Zealand Cancer Registry and were linked to the national administrative datasets. A two‐part model was used to identify the factors that affect the public healthcare costs of stage I–III breast cancer and stage IV cancer.

Results

We identified 16,977 stage I–III and 1,093 stage IV breast cancer patients eligible for this study. The costs of stage I–III cancer in the second to fifth year post diagnosis decreased over time, and the costs of stage IV cancer in the first year post diagnosis increased over time. After adjustment for other factors, the costs of stage I–IV cancer decreased with age but increased with cancer stage. HER2+ cancers had the highest costs, followed by triple negative cancers. After adjustment for other factors, Pacific and Asian women had lower costs, and Māori had similar costs compared to others. For stage I–III cancers, women living in nonmajor urban areas had a higher chance of incurring costs in follow‐up years, and screen detected patients and patients having any services in a private hospital had a decreased probability of receiving any public healthcare services.

Conclusions

Pacific women had higher costs than others, but after adjustment for cancer stage, subtype, and other factors, they had lower costs than others. The early detection and better management of stage I–III breast cancer can lead to better outcome and lower costs in follow‐up years.
Real‐world outcomes of cisplatin, capecitabine, and gemcitabine with either epirubicin (PEXG) or docetaxel (PDXG) as first‐line palliative treatment in metastatic or unresectable locally advanced pancreatic adenocarcinoma
Authors: Hitchen Nadia , Waldron Nick R. , Deva Sanjeev , Findlay Michael , Lawrence Benjamin
Published: September 2022

Background

First‐line palliative chemotherapy regimens in advanced pancreatic adenocarcinoma include triplet chemotherapy with 5‐fluorouracil, oxaliplatin, and irinotecan, and the doublet of nab‐paclitaxel plus gemcitabine. Use of triplet chemotherapy in real‐world populations is limited by tolerability and nab‐paclitaxel is not universally available. Regimens using the combination of cisplatin, capecitabine, gemcitabine, and either epirubicin or docetaxel may be better tolerated, more widely available, and similarly effective, but no published real‐world data exist.

Methods

A retrospective cohort review of patients with metastatic or unresectable locally advanced pancreatic adenocarcinoma treated with first‐line palliative cisplatin, capecitabine, gemcitabine, and either epirubicin or docetaxel chemotherapy at Auckland City Hospital between July 1, 2013 and July 30, 2020. The primary outcome was overall survival (OS). Secondary outcomes were rates of grade 3 or 4 hematological toxicity, rate of febrile neutropenia, number of cycles received, and reasons for discontinuation.

Results

Eighty‐eight patients were included. Median age was 66 years (range 39–79), 28.4% had unresectable, locally advanced disease and 71.6% metastatic disease. Median OS was 8.5 months. Patients stopped treatment due to disease progression (53.4%), completing 12 cycles (19.3%), or toxicity (10.2%). Grade 4 neutropenia was experienced by 21.6%; 10.2% had febrile neutropenia. There were four treatment‐related deaths.

Conclusion

This retrospective study in a real‐world population demonstrates that chemotherapy with cisplatin, capecitabine, and gemcitabine with epirubicin (PEXG) or docetaxel (PDXG) had similar effectiveness to more commonly used combination regimens. PDXG/PEXG are viable alternatives to nab‐paclitaxel plus gemcitabine in countries that have restricted drug funding.
Factors predicting successful discontinuation of acute kidney replacement therapy: A retrospective cohort study
Authors: Ohara Cristine Naomi , Suarez Maria Irma , Kitawara Koody Hassemi , Zamoner Welder , Balbi André Luis , Ponce Daniela
Published: September 2022

Background

Treatment for severe acute kidney injury (AKI) typically involves the use of acute kidney replacement therapy (AKRT) to prevent or reverse complications.

Methodology

We aimed to determine the prevalence of successful discontinuation of AKRT and its predictive factors. A retrospective cohort study was performed with 316 patients hospitalized at a public Brazilian university hospital between January 2011 and June 2020.

Results

Success and hospital discharge were achieved for most patients (85% and 74%, respectively). Multivariable logistic regression analysis showed that C‐reactive protein (CRP), urine output, and need mechanical ventilation at the time of interruption were variable associated with discontinuation success (OR 0.969, CI 0.918–0.998, p = 0.031; OR 1.008, CI 1.001–1.012, p = 0.041 and OR 0.919, CI 0.901–0.991, p = 0.030; respectively), while the absence of comorbidities such as chronic kidney disease (OR 0.234, CI 0.08–0.683, p = 0.008), cardiovascular disease (OR 0.353, CI 0.134–0.929, p = 0.035) and hypertension (OR 0.278, CI 0.003–0.882, p = 0.009), as well as pH values at the time of AKRT indication (OR 1.273, CI 1.003–1.882, p = 0.041), mechanical ventilation at the time of interruption (OR 0.19, CI 0.19–0.954, p = 0.038) and successful discontinuation (OR 8.657, CI 3.135–23.906, p < 0.001) were identified as variables associated with hospital discharge.

Conclusion

These results show that clinical conditions such as comorbidities, urine output, and mechanical ventilation, and laboratory variables such as pH and CRP are factors associated with hospital discharge and AKRT discontinuation success, requiring larger studies for confirmation.
Comparison of hemodynamics in biological surgical aortic valve replacement and transcatheter aortic valve implantation: An in‐silico study
Authors: Franke Benedikt , Schlief Adriano , Walczak Lars , Sündermann Simon , Unbehaun Axel , Kempfert Jörg , Solowjowa Natalia , Kühne Titus , Goubergrits Leonid
Published: September 2022

Objectives

In aortic valve replacement (AVR), the treatment strategy as well as the model and size of the implanted prosthesis have a major impact on the postoperative hemodynamics and thus on the clinical outcome. Preinterventional prediction of the hemodynamics could support the treatment decision. Therefore, we performed paired virtual treatment with transcatheter AVR (TAVI) and biological surgical AVR (SAVR) and compared hemodynamic outcomes using numerical simulations.

Methods

10 patients with severe aortic stenosis (AS) undergoing TAVI were virtually treated with both biological SAVR and TAVI to compare post‐interventional hemodynamics using numerical simulations of peak‐systolic flow. Virtual treatment procedure was done using an in‐house developed tool based on position‐based dynamics methodology, which was applied to the patient's anatomy including LVOT, aortic root and aorta. Geometries were automatically segmented from dynamic CT‐scans and patient‐specific flow rates were calculated by volumetric analysis of the left ventricle. Hemodynamics were assessed using the STAR CCM+ software by solving the RANS equations.

Results

Virtual treatment with TAVI resulted in realistic hemodynamics comparable to echocardiographic measurements (median difference in transvalvular pressure gradient [TPG]: −0.33 mm Hg). Virtual TAVI and SAVR showed similar hemodynamic functions with a mean TPG with standard deviation of 8.45 ± 4.60 mm Hg in TAVI and 6.66 ± 3.79 mm Hg in SAVR (p = 0.03) while max. Wall shear stress being 12.6 ± 4.59 vs. 10.2 ± 4.42 Pa (p = 0.001).

Conclusions

Using the presented method for virtual treatment of AS, we were able to reliably predict post‐interventional hemodynamics. TAVI and SAVR show similar hemodynamics in a pairwise comparison.
Clinical characteristics and long‐term outcomes in patients with peripartum cardiomyopathy (PPCM) receiving left ventricular assist devices (LVAD)
Authors: Berliner Dominik , Li Tong , Mariani Silvia , Hamdan Righab , Hanke Jasmin , König Tobias , Pfeffer Tobias Jonathan , Abou‐Moulig Valeska , Dogan Günes , Hilfiker‐Kleiner Denise , Haverich Axel , Bauersachs Johann , Schmitto Jan D.
Published: September 2022

Background

Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure (HF), presenting with left ventricular (LV) systolic dysfunction either at the end of pregnancy or in the months following delivery. In rare cases, PPCM leads to severe impairment of LV function, refractory cardiogenic shock or advanced HF. LV assist devices (LVAD) have been shown to be a feasible treatment option in advanced HF. However, little is known about long‐term outcomes and prognosis of PPCM patients undergoing LVAD implantation.

Methods

A retrospective analysis of data from PPCM patients undergoing LVAD implantation in two tertiary centers with respect to long‐term outcomes was performed.

Results

Twelve patients of median age 30 (18–39) years were included. Eight patients were experiencing cardiogenic shock (INTERMACS 1) at implantation. Seven patients were implanted within 1 month of their PPCM diagnosis. Median duration of LVAD support was 19 (2–92) months with median follow up of 67 (18–136) months (100% complete). In‐hospital and 1‐year mortality were 0% and 8.3%, respectively. Two patients died on LVAD support, four patients were successfully bridged to transplantation, two patients are still on LVAD, and four were successfully weaned due to sufficient LV recovery (one died after LV function deteriorated again).

Conclusion

LVAD treatment of decompensated end‐stage PPCM is feasible. Early LVAD provision led to hemodynamic stabilization in our cohort and facilitated safe LV recovery in one third of these young female patients.
SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern
Authors: Cozzi Giorgio , Tessitore Antimo , Giangreco Manuela , Cogo Paola , Valentini Elena , Salis Simona , Pascolo Paola , Barbi Egidio
Published: September 2022

Aim

According to the Italian national statistical institute, severe bacterial infections (SBI) in Italy are responsible for 1.7% of mortality under 5 years of age and their recognition is often challenging, especially in the first stages of the disease.

We tried to estimate the prevalence of SBI in our target population and to identify signs and symptoms that could guide in the initial evaluation of a child with a possible SBI.

Methods

We designed a prospective, multicentre study and enrolled patients aged 0–14 years at the first evaluation to the emergency department with an acute illness lasting a maximum of 5 days. The presence of variables suggestive of SBI was collected for every enrolled patient. One week after the enrolment, every patient was followed up by telephone.

Results

SBI is more likely to be detected with the ‘gut feeling’ in both univariate and multivariate models (univariate OR: 7.16, 95% CI: 4.08–12.56; multivariate OR: 5.34, 95% CI: 2.78–10.25), while abnormal breathing pattern resulted significative only in univariate model (OR 3.83, 95% CI: 1.98–7.40). Nevertheless, their associated sensitivity is low.

Conclusion

SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern.
Mold‐deteriorated archaeological Egyptian papyri: Biodeteriogens, monitoring the deterioration, and treatment approach
Authors: Saada Hanadi , Othman Moamen , Khaleil Mona
Published: September 2022

Fungi play a critical role in the deterioration of ancient papyri due to their organic and hygroscopic nature. Fourteen fungal species belonging to five genera—Aspergillus,Cladosporium,Penicillium,Talaromyces, andUlocladium—were isolated and identified from 20 Egyptian papyrus artifacts located at the Grand Egyptian Museum—Conservation Center (GEM‐CC). The biodeterioration mechanism was evaluated by two analyses: cellulase enzyme activity and acid production assay. The isolated fungusP. lanosumshowed potent biodeterioration power as it exhibited the highest enzymatic activity and could produce acid as well. Four different analyses were performed to assess the entity of the biodeterioration phenomenon: scanning electron microscopy, Fourier transform infrared spectroscopy, colorimetry, and pH measurements. The analyses demonstrated considerable changes in surface morphology, chemical structure (mainly represented by oxidation and hydrolysis of infected papyrus samples), darkness of the papyrus samples (ΔE3.84–7.33), and pH (which dropped to 5.2 in the case ofA. niger‐infected sample. This article builds a preliminary perception for monitoring the biodeterioration of archaeological papyri and a trial for in vitro treatment to prevent further degradation, which may lead to loss of our valuable artifacts over a prolonged period.
Video‐assisted thoracoscopic surgery for pleuroperitoneal communication
Authors: Tsubouchi Hideki , Nakamura Shota , Fukui Takayuki , Kadomatsu Yuka , Ueno Harushi , Ozeki Naoki , Fukumoto Koichi , Mizuno Masashi , Chen‐Yoshikawa Toyofumi F.
Published: September 2022

Here we report the cases of five patients on continuous ambulatory peritoneal dialysis (CAPD) who developed hydrothorax because of pleuroperitoneal communication. Preoperative computed tomography (CT) peritoneography revealed penetrated sites on the diaphragm in all patients. All patients underwent video‐assisted thoracoscopic surgery (VATS), and a dialysate containing indigo carmine was injected intraperitoneally through a CAPD catheter to confirm the fistula. In all patients, a thinned bleb was found at the center of the diaphragmatic tendon consistent with that noted on preoperative CT peritoneography. The bleb was resected using a surgical stapler in four patients, and the pleuroperitoneal communication did not recur. However, in one patient, the bleb was only covered with reinforcement agents and the hydrothorax recurred after CAPD. This study demonstrates that VATS treatment for pleuroperitoneal communication is safe and effective but that lesion resection would be more useful for preventing hydrothorax recurrence in patients undergoing CAPD.
Exploring the self‐care practices of social workers in China under the COVID‐19 pandemic
Authors: Li Qing , Xu Liying , Wang Yun , Zhu Yun , Huang Yan
Published: September 2022

The self‐care practices of social workers have garnered increasing attention in the literature, yet little is known about the case of China. To explore the self‐care practices of Chinese social workers under the COVID‐19 pandemic, this study uses the Self‐Care Practice Scale (SCPS) to measure the self‐care practices of social workers (N = 1066) in Fujian Province, China. The results indicate that Chinese social workers engage in moderate amounts of self‐care practices under the COVID‐19 pandemic. Significant group differences exist in social workers' self‐care practices by marital status, parenting status, age, health satisfaction, years of practicing social work, average hours of work per day, resignation intention, job satisfaction, number of received supervision services in a year, and self‐care education. Significant predictors of self‐care include marital status, monthly salary, service status, average hours of work per day, number of received supervision services in a year, school self‐care education, job satisfaction, and health satisfaction. This study has practical implications for self‐care education and practice, including workplace health promotion and the development of self‐care practice policies.
The moderating role of socioeconomic status on the relationship between teacher social support and sense of belonging to school
Authors: Bakchich Julien , Carré Arnaud , Claes Nele , Smeding Annique
Published: September 2022

Background

Teacher social support (TSS) has been identified as one of the most important factors of success and well‐being for students. Yet, there is a gap in the literature regarding the impact of students' socioeconomic status (SES) on their perceptions of TSS, and whether SES may impact the strength of the relationship between teacher social support and students' sense of belonging to school (SBS).

Aims

In this preregistered study, we aimed at filling this gap by testing the moderating role of SES on the TSS‐SBS link, along with the direct associations between these variables.

Sample

We used data from the French sample of the Programme for International Student Assessment 2018 (PISA; N = 6308).

Methods

TSS was primarily assessed as a latent construct based on three indicators provided by PISA: teacher support, teacher emotional support and teacher feedback. Regarding SES, we primarily focused on family wealth possessions and parents' highest level of education.

Results

Using structural equation modelling, findings confirmed that the TSS‐SBS link was stronger for high‐SES than low‐SES students. We also found a negative association between teacher support and SES. Importantly, preregistered additional analyses highlight that findings depend on the SES and TSS indicators considered.

Conclusions

Findings support the importance of SES effect on students' perceptions of their interactions with teachers and the extent to which they perceive they belong to the school. The implications and limitations of this research are discussed.
Optimizing decision‐making after ventral onlay buccal mucosa graft urethroplasty failure
Authors: Bandini Marco , Basile Giuseppe , Lazzeri Massimo , Montorsi Francesco , Valli Benedetta , Balò Sofia , Barbagli Guido
Published: September 2022

Objectives

To evaluate factors predicting recurrence after treatment and to assess the best rescue option for patients failing buccal mucosa graft (BMG) urethroplasty.

Materials and methods

We evaluated the data from 575 patients treated with ventral onlay BMG urethroplasty. Multivariable Cox regression analysis was performed to identify predictors of BMG urethroplasty failure, and their effect on failure risk was estimated using the Kaplan–Meier method and compared using log‐rank tests. Then, for those patients who underwent a rescue treatment, namely, direct visual internal urethrotomy (DVIU) vs open urethroplasty, we assessed the probability of success after retreatment using the Kaplan–Meier method and regression tree analyses.

Results

On multivariable Cox regression analysis, only stricture length ≥5 cm (hazard ratio 3.46, 95% confidence interval 1.50–7.94; P = 0.003) was a predictor of failure. A total of 103 patients had at least one re‐intervention. Notably, 12‐month success rates after first rescue DVIU, second rescue DVIU, third rescue DVIU, and fourth rescue DVIU were 66.3%, 62.5%, 37.5% and 25%, respectively. Conversely, for those patients who underwent open urethroplasty retreatment, success rates at 12 months were 83.3%, 79%, 92.3% and 75% after BMG ventral onlay, first rescue DVIU, second rescue DVIU and third rescue DVIU, respectively. These data were confirmed in regression tree analyses.

Conclusion

Ventral BMG urethroplasty fails in approximately one out of five patients. Despite DVIU as a rescue treatment being a good option, its success rate becomes lower as the number of DVIU treatments performed increases. Conversely, open urethroplasty improves patient outcomes in almost three out of four patients, even in the case of previous failed DVIU treatments for stricture recurrence.
Commentary: Using experts by experience to enhance transitional age youth mental health services – a commentary on Adu et al. (2022)
Authors: Wakefield Emma , Wakefield Toni
Published: September 2022

Background

In their article, ‘System Transformation to Enhance Transitional Age Youth Mental Health – A Scoping Review’, Joseph Adu et al. consider how, over the last 15 years, youth mental health and the transitional age from adolescents to young adulthood has received increasing attention, with 1 in 5 living with mental illness reported as being under 25. Their research on the transition to adult mental health services identifies a need for innovative, evidence‐based approaches to TAY mental health care, in response to the emerging and persistent challenges experienced globally in this area of practice.

In responding to this review, the authors support the findings that when youth actively participate in service design, they experience improvements in their own mental health and are able to contribute to the evolution of evidence‐based mental health promotion and care. Examples from personal experience and research reiterate the importance of youth voice through all levels of system design.

Conclusions

The benefits of co‐production are evident, both in this review and from personal experience, recognising that mental health issues have a major impact on individuals, families, and communities. The use of this approach in developing and improving youth mental health transition services is beneficial for all involved.
METTL3‐mediated m6A mRNA contributes to the resistance of carbon‐ion radiotherapy in non‐small‐cell lung cancer
Authors: Xu Xiaofeng , Zhang Peiru , Huang Yangle , Shi Weizhong , Mao Jingfang , Ma Ningyi , Kong Lin , Guo Lin , Liu Jinlong , Chen Jian , Lu Renquan
Published: September 2022

Lung cancer is one of the leading causes of death among cancer patients worldwide. Carbon‐ion radiotherapy is a radical nonsurgical treatment with high local control rates and no serious adverse events. N6‐methyladenosine (m6A) modification is one of the most common chemical modifications in eukaryotic messenger RNA (mRNA) and has important effects on the stability, splicing, and translation of mRNAs. Recently, the regulatory role of m6A in tumorigenesis has been recognized more and more. However, the dysregulation of m6A and its role in carbon‐ion radiotherapy of non‐small‐cell lung cancer (NSCLC) remains unclear. In this study, we found that the level of methyltransferase‐like 3 (METTL3) and its mediated m6A modification were elevated in NSCLC cells with carbon‐ion radiotherapy. Knockdown of METTL3 in NSCLC cells impaired proliferation, migration, and invasion in vitro and in vivo. Moreover, we found that METTL3‐mediated m6A modification of mRNA inhibited the decay of H2A histone family member X (H2AX) mRNA and enhanced its expression, which led to enhanced DNA damage repair and cell survival.
Bucco‐palatal implant position and its impact on soft tissue level in the maxillary esthetic zone
Authors: Fürhauser Rudolf , Fürhauser Lukas , Fürhauser Nikolaus , Pohl Veronika , Pommer Bernhard , Haas Robert
Published: September 2022

Aim

The term “buccal implant position” is commonly used but lacks a precise definition and missing a reference point. Considering its major impact on peri‐implantitis and esthetic failures the purpose of this study was to find a correlation between bucco‐palatal implant positioning and the midfacial soft tissue level of implant crowns using newly defined Emergence‐points.

Materials and Methods

Patients with unilateral single‐tooth implant crowns in the region of the central or lateral maxillary incisor were included in this study. Digital intraoral scans were superimposed over a scan of the master cast or the original digital data set and analyzed in a computer planning program. In relation to the corresponding natural tooth, an ideal Emergence‐point (EIDEAL‐point) was defined from a frontal view. The distance to the real Emergence‐point (EREAL‐point) of the implant crown was correlated to apical displacement (AD) of peri‐implant soft tissue. The distance of the implant shoulder (I‐point) to the real Emergence‐point (EREAL‐point) of the implant crown was also correlated to the AD of peri‐implant soft tissue. In cross sections, the horizontal distance between EREAL‐ and I‐point represents the sagittal implant position (SIP), and the vertical distance represents the vertical implant position (VIP).

Results

Seventy‐three patients met the inclusion criteria. AD ranged from 0 to 3.5 mm (AD = 0.87 ± 1.01), SIP from 0.2 to 5.1 mm (AD = 2.66 ± 1.64). Statistical analysis showed a significant inverse correlation between AD and SIP (ρ = −.55, p < .001). VIP, the implant inclination, time span since implant insertion, and phenotype revealed no significant correlation to AD.

Conclusion

The more palatal the implant was positioned, the less AD was observed. The position of the implant shoulder should preferably be planned more than 2 mm behind the ideal E‐point. This E‐point can be used for implant planning as it defines the ideal crown length for prospective planning.
Anorexia nervosa and autoimmune comorbidities: A bidirectional route?
Authors: Sirufo Maria M. , Magnanimi Lina M. , Ginaldi Lia , De Martinis Massimo
Published: September 2022

Immunological dysfunctions in eating disorders have recently gained increasing scientific attention. Furthermore, the reciprocal association between anorexia and autoimmune diseases is of particular interest and suggests a role of autoimmunity in the pathogenesis of eating disorders. Anorexia nervosa (AN) and autoimmune diseases are linked by a bidirectional relationship based on common immunopathological mechanisms. In this review, in addition to reporting the numerous cases described in which autoimmune disorders are associated with anorexia or vice versa, we summarize the many aspects of this relationship between the immune system (IS) and AN. We describe how the microbiota affects the IS, disrupts gut‐brain communication, and possibly triggers eating disorders. We also describe the shared immunological pathways of autoimmune and eating disorders and in particular the occurrence of disrupted T cell tolerance and autoantibodies in AN. The described observations represent the starting point for possible, future research directions.
Collateral damage from agricultural netting to open‐country bird populations in Thailand
Authors: Angkaew Rongrong , Round Philip D. , Ngoprasert Dusit , Powell Larkin A. , Limparungpatthanakij Wich'yanan , Gale George A.
Published: September 2022

Nets are used across a wide variety of food production landscapes to control avian pests typically resulting in deaths of entangled birds. However, the impact of nets on bird populations is a human–wildlife conflict that remains mostly unquantified. Here, we examined the scale of netting in the central plains of Thailand, a region dominated by ricefields, among which aquaculture ponds are increasingly interspersed. Nets/exclusion types, number of individual birds and species caught were recorded on 1312 road‐survey transects (2‐km length × 0.4‐km width). We also interviewed 104 local farmers. The transect sampling took place in late‐September 2020, and from December 2020 to April 2021. Each survey transect was visited only once. We found 1881 nets and barriers of parallel cords on 196 (15%) of the transects. Counts of nets and barriers were ~13 times higher than expected in aquaculture ponds based on their areal proportion, and vertical nets were the most commonly observed type (n = 1299). We documented 735 individuals of at least 45 bird species caught in the nets and parallel cords, including many species not regarded as pests. Approximately 20% of individuals caught in ricefields and 95% at aquaculture ponds were non‐target bycatch. Our interviews suggested that 55% of respondents thought nets were ineffective while only 6% thought they were effective. We suggest imposing a ban on netting, considering other mitigation strategies to reduce conflicts such as promoting the use of parallel cords, and prioritizing conservation actions with community participation. Further studies should investigate the efficacy of less deleterious deterrents.
Testing the influence of visual framing on engagement and pro‐environmental action
Authors: Salazar Gabby , Monroe Martha C. , Ennes Megan , Jones Jennifer Amanda , Veríssimo Diogo
Published: September 2022

Although images play a significant role in environmental communications, few studies have empirically examined whether positive or negative images are more effective at engaging attention and promoting behavior change. We conducted a 6‐week public experiment at the Florida Museum of Natural History in Gainesville, Florida, to test whether viewing a photography exhibit featuring images of the impacts of marine plastic pollution on ocean ecosystems (negative valence) or images of pristine ocean ecosystems (positive valence) would increase engagement, monetary donations to conservation, and pledges to help protect the ocean from plastic pollution. We tracked 1179 adults while observing the negative exhibit and 1304 adults while observing the positive exhibit. Of the adults tracked, significantly more engaged with the negative exhibit (270; 22.90%) than the positive exhibit (159; 12.19%). The mean number of pledges per visitor for the negative exhibit was significantly higher than for the positive exhibit. However, there was not a significant difference in donations between the two exhibits. These results suggest that environmental organizations that seek to capture attention should consider using images that show the negative impacts of human behavior on the environment.
Restriction of interleukin‐6 alters endothelial cell immunogenicity in an allogenic environment
Authors: Lion Julien , Maitre Mathilde Le , de Truchis Camille , Taupin Jean‐Luc , Poussin Karine , Haziot Alain , Chong Edward , Glotz Denis , Mooney Nuala
Published: September 2022

The microvascular endothelium of the renal transplant is the first site of graft interaction with the host immune system and is often injured in chronic Antibody Mediated Rejection (AMR). Microvascular inflammation is an independent determinant of AMR and heightens endothelial expression of human leukocyte antigen (HLA) molecules thereby increasing the possibility of Donor Specific Antibody (DSA) binding. Endothelial cells (ECs) produce IL‐6 in the steady‐state that is increased by inflammation or by HLA‐DR antibody binding in an allogeneic setting. Because IL‐6 has been implicated in AMR, IL‐6 blockade is currently under investigation as a therapeutic target. To further understand the role of IL‐6 in EC immunogenicity, we have examined whether humanized antibody blockade of IL‐6 altered EC interactions with allogeneic PBMC and after anti‐HLA or DSA binding to ECs in an in vitro human experimental model. Soluble factors, endothelial phenotype, Stat‐3 activation, CD4+‐T differentiation and C4d deposition were examined. Blockade of IL‐6 reduced EC secretion of IL‐6 and of the monocyte chemoattractant MCP‐1. Pre‐activation of ECs by anti‐HLA or DSA binding increased IL‐6 secretion, that was further increased by concurrent binding of both antibodies and this was inhibited by IL‐6 blockade. Activation of Stat‐3 in CD4+‐T mediated by soluble factors produced in endothelial‐PBMC interactions, and endothelial differentiation of CD4+‐T cell subsets (Th1, Treg), were impaired whereas activation of Complement by anti‐HLA antibody binding remained unchanged by IL‐6 blockade. Together, these data identify EC‐mediated pro‐inflammatory responses (T cell expansion, EC auto‐activation, chemokine secretion) targeted by IL‐6 blockade.
Effects of Public Transfers on Income Inequality and Poverty in Rural China
Authors: Hoken Hisatoshi , Sato Hiroshi
Published: September 2022

This study examines the impacts of public transfers on income inequality and poverty reduction in rural China. It uses nationally representative rural household surveys from the China Household Income Project and classifies public transfers into three types – universal, pro‐poor, and reimbursable transfers – to compare the impacts of each type of public transfer in 2013 and 2018. Estimated results show that the contributions of each type of public transfer to reducing income inequality were generally small in both 2013 and 2018. However, the effects of reimbursable transfers were the largest of the three types. We also found that the poverty‐reducing effects were the largest for reimbursable transfers, and their impacts have considerably improved in the western region. The impacts of pro‐poor transfers were intermediate but have developed notably in the central region. These findings suggest that reimbursable and pro‐poor transfers contributed mainly to reducing rural poverty but the impacts were heterogeneous among regions.
An Evaluation of the Regional Comprehensive Economic Partnership Agreement: Market Access and Trading Rules
Authors: Sheng Bin , Jin Chenxin
Published: September 2022

The Regional Comprehensive Economic Partnership (RCEP) agreement was signed on November 15, 2020. This marks the formal conclusion of the world's largest free trade agreement in terms of population and economic scale. The RCEP agreement covers new liberalization commitments in goods, services, investment, and movement of natural persons, and addresses some emerging behind‐the‐border trade issues, to forge more transparent, open, and inclusive trade rules. Its aim is to build a comprehensive, modern, inclusive, and high‐quality free trade agreement. This paper summarizes the framework and highlights of the RCEP agreement, measures the extent of tariff reduction from various perspectives, makes a quantitative assessment of the level of service trade liberalization of the member states adopting positive list commitments, and makes an in‐depth analysis of trade rules and provisions in the RCEP agreement. Furthermore, this paper also makes a comprehensive comparison of main provisions among the Comprehensive and Progressive Agreement for Trans‐Pacific Partnership, RCEP, and US‐Mexico‐Canada Agreement. The paper concludes with policy recommendations for China to promote the implementation of the RCEP agreement.
Inventory Management with Trade Policy Uncertainty
Authors: Zhao Xiaotao , Chen Xiaoping
Published: September 2022

This paper develops a theoretical model to describe how exporting firms manage their inventory stocks in response to an exogenous trade policy uncertainty shock. Using firm‐level data from China Industrial Enterprise Database and China Customs Database on inventory and exports over the period around China's WTO accession, we show that a reduction in trade policy uncertainty significantly increased exporting firms' inventory holdings. The result was robust to various robustness checks. This effect was found to be stronger for private and foreign firms than state‐owned enterprises and mainly driven by firms from the coastal region. We also found that the reduction in trade policy uncertainty increased the frequency and the average volume of export transactions, and that this was the mechanism behind the effect. This paper helps to understand exporting firms' optimal inventory problem arising from trade‐policy uncertainty and shocks.
The Impact of the Pilot Free Trade Zone on Regional Financial Development
Authors: Wang Lihui , Liu Zhihong , Shi Huailong
Published: September 2022

This paper focuses on the Shanghai pilot free trade zone (FTZ). It investigates the effect of the FTZ policy on regional financial development. The synthetic control method employs quarterly data from 2005 to 2019 at the provincial level to investigate counterfactual states before and after the pilot FTZ was set up. First, our results reveal that the Shanghai pilot FTZ had a positive influence on the following four variables proxied for regional financial development: (i) the scale of regional financial development; (ii) the efficiency of indirect financial development; (iii) the efficiency of direct financial development; (iv) the structure of financial development. Second, our results found that the policy effects that began to emerge from 2014 onwards exhibited a steadily increasing trend. As a result, the four proxy variables have increased by (i) 197 percent, (ii) 202 percent, (iii) 9.4 percent, and (iv) 15.2 percent, respectively. That is, the scale of regional financial development and the efficiency of indirect financial development have increased more than the other proxy variables.
The Life‐cycle Dynamics of Zombie Companies amongst Listed Firms in China
Authors: Bowman Joel
Published: September 2022

This paper analyses the life‐cycle dynamics of zombie companies – broadly defined as businesses that are consistently unable to meet their interest expenses from current profits – amongst listed firms in China over the period 2008–2019. A large share of zombie companies subsequently return to nonzombie status. This proportion is higher for firms undergoing a major restructuring event, low leverage levels, and with smaller operating expense ratios. However, zombie firms that return to nonzombie status continue to have lower levels of profitability compared with their industry peers and have a higher probability of relapsing into zombie status compared with firms that have never been classified as zombie. Concerted efforts to revive zombie companies using major restructuring events appear insufficient in overcoming the longer term scarring effects of zombification on firms' profitability. The results highlight the potential benefits of the ongoing efforts by Chinese regulators to improve the delisting process.
Elderly Care Provision and the Impact on Caregiver Health in China
Authors: Ai Jingyi , Feng Jin , Yu Yangyang
Published: September 2022

With the fast pace of population aging, industrialization, and urbanization in China, the main source of elderly care is changing. Using China Health and Retirement Longitudinal Survey data, we investigate the elderly care provision situation and find that spouses are currently the most important elderly care providers in China. We use a model to depict the trade‐off between a caregiver's own health and the care quality obtained by the care recipient. The model predicts that under some conditions, the caregivers will provide care at the cost of their health. Employing a stratified propensity score matching method, we find that spouses' caregivers are more likely to have depression, physical pain, and hypertension than noncaregivers. The negative effects are larger for caregivers with a high level of care intensity or less support from other resources. Female spousal caregivers tend to suffer more from depression and physical pain than male spousal caregivers. Our findings suggest that policies toward “healthy aging” should target not only the disabled elderly but also their spousal caregivers who are also elderly people.