bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of outcomes of remote consultation in ENT
Authors: Gupta Tanya , Gkiousias Vasileios , Bhutta Mahmood F.
Published: March 2021

Aims

Remote or tele‐consultation has become an emerging modality of consultation in many specialities, including ENT. Advantages include increasing accessibility, potential to reduce costs and, during the COVID‐19 pandemic, reduced risk of infection transmission. Here, we systematically collate and synthesise the evidence base on outcomes from remote consultation in adult and paediatric ENT services.

Methods

We performed a review in accordance with PRISMA guidelines. We searched Medline and Embase for relevant articles. Outcomes include specific patient pathway efficiency measures (including number of healthcare visits, lead time, touch time and handoff), patient/clinician satisfaction, cost analysis and safety implications.

Results

From 6325 articles screened, 53 met inclusion criteria. Publications included studies on remote consultation for initial, preoperative and follow‐up assessment (including postoperative). In most instances, remote consultation reduced costs and time from referral to assessment and was associated with high patient satisfaction. However, a face‐to‐face follow‐up appointment was required in 13%‐72% of initial consultations, suggesting that remote consultation is only appropriate in selected cases.

Conclusion

Remote consultation is appropriate and preferable for ENT consultation in specific conditions and circumstances. Future research should look to better define those conditions and circumstances, and report using recognised quality standards and outcome measures.
Peptide‐based therapeutic cancer vaccine: Current trends in clinical application
Authors: Liu Wensi , Tang Haichao , Li Luanfeng , Wang Xiangyi , Yu Zhaojin , Li Jianping
Published: March 2021

The peptide‐based therapeutic cancer vaccines have attracted enormous attention in recent years as one of the effective treatments of tumour immunotherapy. Most of peptide‐based vaccines are based on epitope peptides stimulating CD8+ T cells or CD4+ T helper cells to target tumour‐associated antigens (TAAs) or tumour‐specific antigens (TSAs). Some adjuvants and nanomaterials have been exploited to optimize the efficiency of immune response of the epitope peptide to improve its clinical application. At present, numerous peptide‐based therapeutic cancer vaccines have been developed and achieved significant clinical benefits. Similarly, the combination of peptide‐based vaccines and other therapies has demonstrated a superior efficacy in improving anti‐cancer activity. We delve deeper into the choices of targets, design and screening of epitope peptides, clinical efficacy and adverse events of peptide‐based vaccines, and strategies combination of peptide‐based therapeutic cancer vaccines and other therapies. The review will provide a detailed overview and basis for future clinical application of peptide‐based therapeutic cancer vaccines.
The Bird's Head Seascape Marine Protected Area network—Preventing biodiversity and ecosystem service loss amidst rapid change in Papua, Indonesia
Authors: Purwanto  , Andradi‐Brown Dominic A. , Matualage Dariani , Rumengan Irman , Awaludinnoer  , Pada Defy , Hidayat Nur I. , Amkieltiela  , Fox Helen E. , Fox Matt , Mangubhai Sangeeta , Hamid La , Lazuardi Muhammad E. , Mambrasar Ronald , Maulana Nugraha , Mulyadi  , Tuharea Syafri , Pakiding Fitryanti , Ahmadia Gabby N.
Published: March 2021

The Bird's Head Seascape (BHS), Papua, Indonesia is located within the epicenter of global marine biodiversity and has been the focus of recent conservation efforts to protect marine resources. Here, we provide an overview of Marine Protected Areas (MPAs) progress in the BHS over the past decade, including establishment history, changes in management effectiveness and ecosystem health, as well as examining trends in tourism growth. While generally viewed as a conservation success story, we reflect on both successes and challenges in the BHS, identifying where we need to continue to improve and adapt in response to rapid economic and environmental change. As of 2020, BHS MPAs cover 5.1 million ha across 23 MPAs. As expected, management effectiveness is steadily increasing in BHS MPAs—although newer MPAs face substantial capacity gaps. Tourism is rapidly growing—with an almost 3,000% increase in tourist visits between 2007 and 2018. Overall, hard coral cover in monitored BHS MPAs remained stable at 33% from 2010 to 2019, although trends in reef fish biomass were more variable. Given continued conservation challenges in the region, BHS MPAs are successfully preventing biodiversity loss while providing ecosystem services for local communities.
East Asian buntings: Ongoing illegal trade and encouraging conservation responses
Authors: Heim Wieland , Chan Simba , Hölzel Norbert , Ktitorov Pavel , Mischenko Alexander , Kamp Johannes
Published: March 2021

The dramatic decline in the once superabundant Yellow‐breasted Bunting Emberiza aureola, a widely distributed Eurasian songbird, triggered worldwide media interest. Five years after the initial publication, we set out to give an update on the status of this critically endangered species, the conservation actions that followed, and the lessons that can be learned from this exceptional case for the conservation of migratory land birds in Asia and beyond. While there are signs of possible population recovery in the Yellow‐breasted Bunting, other migratory songbird species were recently observed to be trapped in huge numbers, which could lead to further declines. We argue that the Yellow‐breasted Bunting can be used as a flagship species to promote the conservation of East Asian land bird migrants.
Selecting stimulation intensity in repetitive transcranial magnetic stimulation studies: A systematic review between 1991 and 2020
Authors: Turi Zsolt , Lenz Maximilian , Paulus Walter , Mittner Matthias , Vlachos Andreas
Published: March 2021

Repetitive transcranial magnetic stimulation (rTMS) is an increasingly used, non‐invasive brain stimulation technique in neuroscience research and clinical practice with a broad spectrum of suggested applications. Among other parameters, the choice of stimulus intensity and intracranial electric field strength substantially impacts rTMS outcome. This review provides a systematic overview of the intensity selection approaches and stimulation intensities used in human rTMS studies. We also examined whether studies report sufficient information to reproduce stimulus intensities for basic science research models. We performed a systematic review by focusing on original studies published between 1991 and 2020. We included conventional (e.g., 1 or 10 Hz) and patterned protocols (e.g., continuous or intermittent theta burst stimulation). We identified 3,784 articles in total, and we manually processed a representative portion (20%) of randomly selected articles. The majority of the analyzed studies (90% of entries) used the motor threshold (MT) approach and stimulation intensities from 80% to 120% of the MT. For continuous and intermittent theta burst stimulation, the most frequent stimulation intensity was 80% of the active MT. Most studies (92% of entries) did not report sufficient information to reproduce the stimulation intensity. Only a minority of studies (1.03% of entries) estimated the rTMS‐induced electric field strengths. We formulate easy‐to‐follow recommendations to help scientists and clinicians report relevant information on stimulation intensity. Future standardized reporting guidelines may facilitate the use of basic science approaches aiming at better understanding the molecular, cellular, and neuronal mechanisms of rTMS.
Dysregulated epigenetic modifications in psoriasis
Authors: Zeng Chang , Tsoi Lam C. , Gudjonsson Johann E.
Published: March 2021

The observed incidence of psoriasis has been gradually increasing over time (J Am Acad Dermatol, 03, 2009, 394), but the underlying pathogenic factors have remained unclear. Recent studies suggest the importance of epigenetic modification in the pathogenesis of psoriasis. Aberrant epigenetic patterns including changes in DNA methylation, histone modifications and non‐coding RNA expression are observed in psoriatic skin. Reversing these epigenetic mechanisms has showed improvement in psoriatic phenotypes, making epigenetic therapy a potential avenue for psoriasis treatment. Here, we summarize relevant evidence for epigenetic dysregulation contributing to psoriasis susceptibility and pathogenesis, and the factors responsible for epigenetic modifications, providing directions for potential future clinical avenues.
Non‐optimal codon usage preferences of coronaviruses determine their promiscuity for infecting multiple hosts
Authors: Carmi Gon , Gorohovski Alessandro , Mukherjee Sumit , Frenkel‐Morgenstern Milana
Published: March 2021

Circulating animal coronaviruses occasionally infect humans. The SARS‐CoV‐2 is responsible for the current worldwide outbreak of COVID‐19 that has resulted in 2 112 844 deaths as of late January 2021. We compared genetic code preferences in 496 viruses, including 34 coronaviruses and 242 corresponding hosts, to uncover patterns that distinguish single‐ and ‘promiscuous’ multiple‐host‐infecting viruses. Based on a codon usage preference score, promiscuous viruses were shown to significantly employ nonoptimal codons, namely codons that involve ‘wobble’ binding to anticodons, as compared to single‐host viruses. The codon adaptation index (CAI) and the effective number of codons (ENC) were calculated for all viruses and hosts. Promiscuous viruses were less adapted hosts vs single‐host viruses (P‐value = 4.392e‐11). All coronaviruses exploit nonoptimal codons to infect multiple hosts. We found that nonoptimal codon preferences at the beginning of viral coding sequences enhance the translational efficiency of viral proteins within the host. Finally, coronaviruses lack endogenous RNA degradation motifs to a significant degree, thereby increasing viral mRNA burden and infection load. To conclude, we found that promiscuously infecting coronaviruses prefer nonoptimal codon usage to remove degradation motifs from their RNAs and to dramatically increase their viral RNA production rates.
Design of step‐stress accelerated life tests for estimating the fatigue reliability of structural components based on a finite‐element approach
Authors: Klemenc Jernej , Nagode Marko
Published: March 2021

This article describes how a step‐stress accelerated life test (SSALT) can be designed for testing the fatigue life and reliability of structural components with a dominant failure mode. With simple numerical simulations of the crack's propagation in the notched area of the structural part for different loading levels, the slope of the S–N curve for a structural component is initially estimated. Then, a very few fatigue–life experiments are carried out in the high‐cycle domain to determine the intercept of the structure's S–N curve. By considering the scatter from the material's P–S–N curve, different SSALT designs for the structural component can be composed and checked for their expected acceleration factor. The procedure is experimentally validated for the case of a notched specimen and two different SSALT designs. From the results it can be concluded that the predicted durations of the SSALT experiments correlate well with the real experiments.
Combined effects of wheat gluten and carboxymethylcellulose on dough rheological behaviours and gluten network of potato–wheat flour‐based bread
Authors: Hu Xiaohui , Cheng Li , Hong Yan , Li Zhaofeng , Li Caiming , Gu Zhengbiao
Published: March 2021

Incorporating high level of potato flour into wheat flour enhances nutritional values of bread but induces a series of problems that lead to the decline of the bread quality. To overcome the barrier, wheat gluten and carboxymethylcellulose (CMC) were added into potato–wheat composite flour to improve dough machinability and bread quality. The rheological properties, thermo‐mechanical properties and microstructures of dough were investigated. The results showed that the interaction between gluten and CMC mitigated the discontinuity of gluten matrix and gluten protein aggregation caused by the addition of potato flour, which yielded a more branched and compact gluten network. The compact three‐dimensional viscoelastic structure induced improvements of gas retention capacity and dough stability, making it mimic the machinability properties of wheat flour dough. Bread qualities were apparently improved with the combined use of 4% gluten and 6% CMC, of which specific volume increased by 42.86%, and simultaneously, hardness reduced by 75.93%.
Dynamic sensory profile of mango skyr yoghurt added of prebiotic and natural sweeteners: multiple time‐intensity analysis and temporal dominance of sensations
Authors: Pereira Cecília Teresa Muniz , Pereira Dalva Muniz , Bolini Helena Maria André
Published: March 2021

This study aimed to evaluate the impact of the addition of prebiotics and natural sweeteners on the temporal profile of mango skyr yoghurts. Eight formulations were made with the addition (or not) of prebiotics (FOS) and different sweetening agents (sucrose, stevia, thaumatin and a blend of stevia/thaumatin). The time‐intensity (TI) and temporal dominance of sensations (TDS) analyses were performed with trained assessors (n = 12) and consumers (n = 60). The addition of prebiotics did not affect the temporal profile of the sucrose‐sweetened yoghurt. Thaumatin can be used as a natural sweetener in this type of yoghurt to reduce the perceived bitterness of stevia. The results revealed important data on the use of temporal methods and different panels, contributing to understand major dynamic sensory profile for concentrated yoghurts sweetened with natural sweeteners, especially skyr.
Health literacy and diabetes self‐care activities: The mediating effect of knowledge and patient activation
Authors: Kim Su Hyun
Published: March 2021

Background

An association between health literacy and health outcomes has been widely reported in the literature. However, models exploring the links between health literacy and the outcomes of health literacy need further testing. The purpose of this study was to examine the pathways of health literacy on diabetes self‐care activities amongst patients with Type 2 diabetes.

Methods

A cross‐sectional survey using secondary data analysis was conducted on 155 patients with Type 2 diabetes recruited from the diabetes clinics of two university hospitals in a metropolitan city in South Korea. Structural equation modelling analysis using bootstrapping was carried out using the AMOS software.

Results

Health literacy had no significant direct effect on diabetes self‐care activities. Rather, health literacy had a significant indirect effect on diabetes self‐care activities mediated through diabetes knowledge and patient activation.

Conclusion

These findings indicate that interventions intended to improve self‐care activity amongst older adults with low health literacy should include strategies to enhance patients' knowledge, as well as their activation for diabetes self‐care.
Survey of barriers to adherence to international inflammatory bowel disease guidelines: does gastroenterologists' confidence translate to high adherence?
Authors: Kanazaki Ria , Smith Ben , Girgis Afaf , Descallar Joseph , Connor Susan
Published: March 2021

Background

Despite the availability of evidence‐based inflammatory bowel disease (IBD) guidelines, suboptimal care persists. There is little published research assessing barriers to IBD guideline adherence.

Aim

To identify barriers to IBD guideline adherence including gastroenterologists' knowledge and attitudes towards guidelines.

Methods

An online cross‐sectional survey of 824 Australian gastroenterologists was conducted from April to August 2018, with 198 (24%) responses. A novel survey was developed that was informed by the theoretical domain's framework.

Results

Confidence in guideline recommendations was high; however, referral to them was low. The European Crohn's and Colitis Organisation guidelines were referred to most commonly (43.6%). In multivariate analysis, significant predictors of frequent versus infrequent guideline referral were: high confidence in the guideline (odds ratio (OR) 7.70; 95% confidence interval (CI): 2.43–24.39; P = 0.001), and low (≤10 years) clinical experience (OR 3.62; 95% CI: 1.11–11.79; P = 0.03). The most common barriers to guideline adherence were not having time (62%), followed by guideline specifics being difficult to remember (61%). Low confidence was reported in managing pregnancy and IBD (34%) and loss of response to therapy (29%). High confidence was reported in managing immunomodulators; however, only 43% answered the associated knowledge question correctly.

Conclusion

Although gastroenterologists have high confidence in guidelines, they use them infrequently, primarily due to specifics being difficult to remember and lack of time. Self‐reported confidence in an area of IBD management does not always reflect knowledge. An intervention targeting these barriers, for example, computer‐based clinical decision support tools, might improve adherence and standardise care.
Use of a Victorian statewide surveillance programme to evaluate the burden of healthcare‐associated Staphylococcus aureus bacteraemia and Clostridioides difficile infection in patients with cancer
Authors: Valentine Jake C. , Hall Lisa , Verspoor Karin M. , Gillespie Elizabeth , Worth Leon J.
Published: March 2021

Background

Patients with cancer are at high risk for infection, but the epidemiology of healthcare‐associated Staphylococcus aureus bacteraemia (HA‐SAB) and Clostridioides difficile infection (HA‐CDI) in Australian cancer patients has not previously been reported.

Aims

To compare the cumulative aggregate incidence and time trends of HA‐SAB and HA‐CDI in a predefined cancer cohort with a mixed statewide patient population in Victoria, Australia.

Methods

All SAB and CDI events in patients admitted to Victorian healthcare facilities between 1 July 2010 and 31 December 2018 were submitted to the Victorian Healthcare Associated Infection Surveillance System Coordinating Centre. Descriptive analyses and multilevel mixed‐effects Poisson regression modelling were applied to a standardised data extract.

Results

In total, 10 608 and 13 118 SAB and CDI events were reported across 139 Victorian healthcare facilities, respectively. Of these, 89 (85%) and 279 (88%) were healthcare‐associated in the cancer cohort compared with 34% (3561/10 503) and 66% (8403/12 802) in the statewide cohort. The aggregate incidence was more than twofold higher in the cancer cohort compared with the statewide cohort for HA‐SAB (2.25 (95% confidence interval (CI): 1.74–2.77) vs 1.11 (95% CI: 1.07–1.15) HA‐SAB/10 000 occupied bed‐days) and threefold higher for HA‐CDI (6.26 (95% CI: 5.12–7.41) vs 2.31 (95% CI: 2.21–2.42) HA‐CDI/10 000 occupied bed‐days). Higher quarterly diminishing rates were observed in the cancer cohort than the statewide data for both infections.

Conclusions

Our findings demonstrate a higher burden of HA‐SAB and HA‐CDI in a cancer cohort when compared with state data and highlight the need for cancer‐specific targets and benchmarks to meaningfully support quality improvement.
A graph modeling framework to design and plan the downstream oil supply chain
Authors: Lima Camilo , Relvas Susana , Barbosa‐Póvoa Ana
Published: March 2021

In this paper, a deterministic mixed‐integer linear programming (MILP) model is proposed aiming at designing and planning the downstream oil supply chain. The optimization model defines the strategic network design, and then determines its tactical distribution plan. A multimodal transportation network is considered in which road, maritime, rail, and pipeline resources may be chosen. The network structure is represented through a graph modeling approach, so the diverse network operations, for example, the exchange of products between warehouses, may be readily incorporated into the optimization model. A case study based on the Brazilian oil industry is explored and analyzed to check and demonstrate the adequacy of the MILP model to solve a real‐world problem.
Effects of Holocene climate change, volcanism and mass migration on the ecosystem of a small, dry island (Brava, Cabo Verde)
Authors: Castilla‐Beltrán Alvaro , de Nascimento Lea , Fernández‐Palacios José María , Whittaker Robert J. , Romeiras Maria M. , Cundy Andrew B. , Edwards Mary , Nogué Sandra
Published: March 2021

Aim

Palaeoecological data provide an essential long‐term perspective of ecological change and its drivers in oceanic islands. However, analysing the effects of multi‐scalar and potentially co‐occurring disturbances is particularly challenging in dry islands. Here, we aim to identify the ecological consequences of the integrated impacts of a regional drying trend, volcanic eruptions and human mass migrations in a spatially constrained environment—a small, dry oceanic island in Macaronesia.

Location

Brava Island, Republic of Cabo Verde.

Taxa

Terrestrial vegetation and fungi.

Methods

We use palaeoecological analyses applied to a caldera soil profile that dates back to 9700 cal yr BP (calibrated years before the present). Analyses include pollen (vegetation history), non‐pollen palynomorphs (changes in fern and fungal communities), grain‐size distribution, loss‐on‐ignition and geochemistry (sedimentology and erosion regimes), microscopic tephra shards (volcanic ash deposition) and charcoal (fire regime).

Results

A regional drying trend after c. 4000 cal yr BP caused increased erosion but had limited immediate impacts on highland grassland vegetation. The expansion of fern‐rich woody scrubland was contemporaneous with significant deposition of volcanic ash and erosion between 1800 and 650 cal yr BP. About 300 cal yr BP, exogenous plants expanded, grazing and fires increased, and there was a decrease of native vegetation cover.

Main conclusions

Throughout the Holocene, highland vegetation in Brava was characterized by the presence of open landscapes dominated by herbaceous species (e.g. Poaceae, Forsskaolea), with some presence of woody native taxa (e.g. Ficus, Dodonaea). A regional drying trend was a driver of erosion since the Mid Holocene but did not have an immediate influence on highland vegetation. Tephra deposition is a possible driver of vegetation change. Inter‐island mass migration after volcanic events in Fogo Island c. 1680 CE potentially triggered land use change and intensification, causing a reduction of native vegetation in Brava.
A single‐cell survey of the human glomerulonephritis
Authors: Chen Zhejun , Zhang Ting , Mao Kaiqiong , Shao Xinghua , Xu Yao , Zhu Minyan , Zhou Hang , Wang Qin , Li Zhenyuan , Xie YuanYuan , Yuan Xiaodong , Ying Liang , Zhang Ming , Hu Jiajia , Mou Shan
Published: March 2021

Glomerulonephritis is the one of the major causes of the end‐stage kidney disease, whereas the pathological process of glomerulonephritis is still not completely understood. Single‐cell RNA sequencing (scRNA‐seq) emerges to be a powerful tool to evaluate the full heterogeneity of kidney diseases. To reveal cellular gene expression profiles of glomerulonephritis, we performed scRNA‐seq of 2 human kidney transplantation donor samples, 4 human glomerulonephritis samples, 1 human malignant hypertension (MH) sample and 1 human chronic interstitial nephritis (CIN) sample, all tissues were taken from the biopsy. After filtering the cells with < 200 genes and > 10% mitochondria (MT) genes, the resulting 14 932 cells can be divided into 20 cell clusters, consistently with the previous report, in disease samples dramatic immune cells infiltration was found, among which a proximal tubule (PT) subset characterized by wnt‐β catenin activation and a natural killer T (NKT) subset high expressing LTB were found. Furthermore, in the cluster of the podocyte, three glomerulonephritis related genes named FXYD5, CD74 and B2M were found. Compared with the mesangial of donor, the gene CLIC1 and RPS26 were up‐regulated in mesangial of IgA nephropathy(IgAN), whereas the gene JUNB was up‐regulated in podocyte of IgAN in comparison with that of donor. Meanwhile, some membranous nephropathy (MN) high expressed genes such as HLA‐DRB5, HLA‐DQA2, IFNG, CCL2 and NR4A2, which involve in highest enrichment pathway, display the cellular‐specific expression style, whereas monocyte marker of lupus nephritis (LN) named TNFSF13B was also found and interferon alpha/beta signalling pathway was enriched in B and NKT of LN comparing with donor. By scRNA‐seq, we first defined the podocyte markers of glomerulonephritis and specific markers in IgA, MN and LN were found at cellular level. Furthermore, the critical role of interferon alpha/beta signalling pathway was enriched in B and NKT of LN was declared.
The transition from inquiry to evidence to actionable clinical knowledge: A proposed roadmap
Authors: Kowalski Charles J. , Redman Richard W. , Mrdjenovich Adam J.
Published: March 2021

Rationale, aims, and objectives

We consider the question “What should we do?” in the context of clinical research/practice. There are several steps along the way to providing a satisfactory answer, many of which have received considerable attention in the literature. We aim to provide a unified summary and explication of these “steps along the way”. The result will be an increased appreciation for the meaning and structure of “actionable clinical knowledge”.

Methods

We review the literature to identify pertinent works dealing with evidence production and translation into actionable clinical knowledge. We draw from insights in this literature about various aspects of reasoning relevant to clinical questions and integrate these into a unified approach to the processes that lead to actionable clinical knowledge.

Results

We collect, collate, and integrate some of the work by Bauer, Carper, Goldman, Haack, McHugh and Walker, and Upshur and colleagues and obtain guidelines to aid in the evidence‐to‐actionable‐clinical‐ knowledge transition.

Conclusions

Clinical decision‐making is not infallible, and the steps we can take to minimize error are context dependent. Medical evidence, produced as it is by human effort, can never be perfect. We will be doing well by assuring that the evidence we use has been produced by a reliable process and is relevant to the question posed.
A prediction model of health‐related quality of life in young adult patients with stroke
Authors: Yoon Susie , Kim Hye Young , Kim Sung Reul
Published: March 2021

Aims and objectives

This study aimed to establish and test a predictive model for explaining the health‐related quality of life of young adult patients with stroke.

Background

Individual characteristics, biological and physiological variables, social support, emotional and cognitive symptoms, physical function disability and general health perception may be interrelated and may directly or indirectly affect the health‐related quality of life of young adult patients with stroke.

Design

A cross‐sectional study.

Methods

237 young outpatients with stroke were recruited and surveyed. Data collection used a structured questionnaire from July–November 2018. The collected data were analysed using SPSS version 25.0®and AMOS 23.0. This study is based on STROBE guidelines.

Results

The hypothetical model's fit indices were adequate. Stroke severity, social support, fear of stroke recurrence, physical function disability and general health perceptions directly affected the health‐related quality of life. Additionally, stroke severity, depression and fear of stroke recurrence also indirectly affected it. These variables explained 60.3% of the variance in this quality.

Conclusions

Variables such as severity of stroke, depression, fear of stroke recurrence, social support, physical function disability and general health perception were found to be related to the HRQoL of young adult patients with stroke.

Relevance to clinical practice

A variety of physical, psychological, functional and social factors related to health‐related quality of life should be systematically monitored. Furthermore, nurses need to develop and apply detailed nursing interventions that take into account all these variables.
Hope and symptom burden of women with breast cancer undergoing chemotherapy: A cross‐sectional study
Authors: Li Yuan , Ni Na , Zhou Zijun , Dong Jianyu , Fu Ying , Li Jiaxin , Luan Ze , Peng Xin
Published: March 2021

Aim

This research aimed to explore the level of hope and symptom burden of breast cancer women undergoing chemotherapy, and predictive factors of hope were also investigated.

Background

Chemotherapy brings physical and psychological stress to breast cancer patients. As an effective coping strategy, hope gives them the courage to overcome difficulties and improve prognosis and survival. Therefore, efforts are needed to raise hope.

Design/Methods

A total of 450 women who were undergoing breast cancer chemotherapy participated in this cross‐sectional study. Sociodemographic data, disease characteristics, and measures of hope and symptom burden were collected using questionnaires. Hope was assessed using the validated Herth Hope Index, and the previously validated Memorial Symptom Assessment Scale was used to assess symptom burden. This paper adhered to the STROBE guidelines.

Results

Chinese breast cancer chemotherapy women hope average scores of 30.15 ± 4.82 were in the medium range of the Hearth Hope Index as specified by Herth to be 24–35. Patients with age ≤45, religious beliefs and lighter symptom burden have a higher level of hope. These variables explained a total of 22.9% of the variation in hope.

Conclusions

The level of hope for women undergoing breast cancer chemotherapy still needs to be further improved. Symptom burden can negatively predict hope.

Relevance to clinical practice

If nurses can decrease breast cancer chemotherapy women symptom burden, there is an impact on increasing levels of hope.
Rheological, textural, and technological modifications in wheat unleavened flatbread substituted with extruded finger millet
Authors: Kumar Pankaj , Kaur Charanjit , Jambh Harpreet Kaur
Published: March 2021

Finger millet incorporation in wheat flour increases the nutritional value of flatbread and provides health benefits. However, it also has a detrimental effect on the quality of flatbread. The present study evaluates the effect of extruded finger millet (EFM) over unextruded finger millet (UFM) flour on pasting, textural and rheological properties of composite dough and their impact on the quality of flatbread. EFM modified the dough handling properties leading to higher viscoelastic moduli and elastic share of compliance. In addition, a significant reduction in firmness and increment in extensibility of dough was also observed. The flatbread prepared by substituting 20% of EFM in wheat flour exhibited better puffing and lower resistance, shrinkage, and baking time in comparison to flatbread prepared with UFM at the same level of substitution. The sensory score for the same was at par with the control whole wheat flatbread. Results suggest that the substitution of EFM flour in composite dough maintains the rheological and technological quality of composite wheat flatbread.
Vegetative and reproductive phenology in a tropical grassland–savanna–forest gradient
Authors: Santos de Oliveira Carolina , de Sousa Messeder João Vitor , Lopez Teixido Alberto , Reis Arantes Marcel Rozemberg , Oliveira Silveira Fernando Augusto
Published: March 2021

Question

Climate, particularly precipitation, is the primary factor driving tropical plant phenology because of its relevant role in regulating water availability. However, differences in soil physicochemical properties can also drive resource availability, potentially affecting plant phenology, especially under similar environments in terms of rainfall regime. We determined whether the seasonality and synchrony of the vegetative and reproductive phenophases differ along a grassland–savanna–forest gradient under the same climate regime in a Neotropical seasonal ecosystem. We hypothesized that species growing on shallow, nutrient‐impoverished soils have a higher capacity to respond to precipitation pulses than those on rich soils.

Location

Serra do Cipó, southeastern Brazil.

Methods

We quantified soil physicochemical properties associated with fertility and water retention of the grassland (campo rupestre), savanna (cerrado) and forest, and determined the phenological strategies of 70 species across the three vegetation types by monitoring vegetative and reproductive phenophases over one year. For each phenophase, in each vegetation type, we evaluated the seasonality and synchrony of phenological patterns. We quantified the phylogenetic signal for phenophases to disentangle the relative roles of historical vs ecological drivers of plant phenology.

Results

Soils from campo rupestre were more nutrient‐ and water‐limited than those of cerrado and forest. Cerrado and forest communities had similar phenological strategies, whereas species from campo rupestre showed strategies that maximize resource acquisition and conservation. In the cerrado and forest, leafing and flowering patterns were seasonal, with leaf flushing and flowering peaking at the onset of the rainy season and leaf senescence in the dry season. Conversely, species from campo rupestre showed continuous leafing and flowering patterns, while fruiting was seasonal. Phenophases did not show a phylogenetic signal.

Conclusions

We demonstrated changes in vegetative and reproductive phenology that are likely associated with variations in soil physicochemical properties. We argue that more severe edaphic filters may have shaped different phenological patterns in campo rupestre.
Competence pili in Streptococcus pneumoniae are highly dynamic structures that retract to promote DNA uptake
Authors: Lam Trinh , Ellison Courtney K. , Eddington David T. , Brun Yves V. , Dalia Ankur B. , Morrison Donald A.
Published: March 2021

The competence pili of transformable Gram‐positive species are phylogenetically related to the diverse and widespread class of extracellular filamentous organelles known as type IV pili. In Gram‐negative bacteria, type IV pili act through dynamic cycles of extension and retraction to carry out diverse activities including attachment, motility, protein secretion, and DNA uptake. It remains unclear whether competence pili in Gram‐positive species exhibit similar dynamic activity, and their mechanism of action for DNA uptake remains unclear. They are hypothesized to either (1) leave transient cavities in the cell wall that facilitate DNA passage, (2) form static adhesins to enrich DNA near the cell surface for subsequent uptake by membrane‐embedded transporters, or (3) play an active role in translocating bound DNA via dynamic activity. Here, we use a recently described pilus labeling approach to demonstrate that competence pili in Streptococcus pneumoniae are highly dynamic structures that rapidly extend and retract from the cell surface. By labeling the principal pilus monomer, ComGC, with bulky adducts, we further demonstrate that pilus retraction is essential for natural transformation. Together, our results suggest that Gram‐positive competence pili in other species may also be dynamic and retractile structures that play an active role in DNA uptake.
From convolutional neural networks to models of higher‐level cognition (and back again)
Authors: Battleday Ruairidh M. , Peterson Joshua C. , Griffiths Thomas L.
Published: March 2021

The remarkable successes of convolutional neural networks (CNNs) in modern computer vision are by now well known, and they are increasingly being explored as computational models of the human visual system. In this paper, we ask whether CNNs might also provide a basis for modeling higher‐level cognition, focusing on the core phenomena of similarity and categorization. The most important advance comes from the ability of CNNs to learn high‐dimensional representations of complex naturalistic images, substantially extending the scope of traditional cognitive models that were previously only evaluated with simple artificial stimuli. In all cases, the most successful combinations arise when CNN representations are used with cognitive models that have the capacity to transform them to better fit human behavior. One consequence of these insights is a toolkit for the integration of cognitively motivated constraints back into CNN training paradigms in computer vision and machine learning, and we review cases where this leads to improved performance. A second consequence is a roadmap for how CNNs and cognitive models can be more fully integrated in the future, allowing for flexible end‐to‐end algorithms that can learn representations from data while still retaining the structured behavior characteristic of human cognition.
Sensory and physical characteristics of foods that impact food intake without affecting acceptability: Systematic review and meta‐analyses
Authors: Appleton Katherine M. , Newbury Annie , Almiron‐Roig Eva , Yeomans Martin R. , Brunstrom Jeffrey M. , de Graaf Kees , Geurts Lucie , Kildegaard Heidi , Vinoy Sophie
Published: March 2021

This systematic review with meta‐analyses aimed to identify the sensory and physical characteristics of foods/beverages which increase satiation and/or decrease/delay subsequent consumption without affecting acceptability. Systematic searches were first undertaken to identify review articles investigating the effects of any sensory and physical food characteristic on food intake. These articles provided some evidence that various textural parameters (aeration, hardness, homogeneity, viscosity, physical form, added water) can impact food intake. Individual studies investigating these effects while also investigating acceptability were then assessed. Thirty‐seven individual studies investigated a textural manipulation and provided results on food intake and acceptability, 13 studies (27 comparisons, 898 participants) investigated effects on satiation, and 29 studies (54 comparisons, 916 participants) investigated effects on subsequent intake. Meta‐analyses of within‐subjects comparisons (random‐effects models) demonstrated greater satiation (less weight consumed) from food products that were harder, chunkier, more viscous, voluminous, and/or solid, while demonstrating no effects on acceptability. Textural parameters had limited effects on subsequent consumption. Between‐subjects studies and sensitivity analyses confirmed these results. These findings provide some evidence that textural parameters can increase satiation without affecting acceptability. The development of harder, chunkier, more viscous, voluminous, and/or solid food/beverage products may be of value in reducing overconsumption.
Fluid balance management during continuous renal replacement therapy
Authors: Prowle John , Mehta Ravindra
Published: March 2021

In critically ill patients, particularly in the setting of shock and sepsis volume management frequently results in a fluid overloaded state, requiring diuresis or intervention with renal replacement therapy. Achieving appropriate volume management requires knowledge of the underlying cardiovascular pathophysiology and careful evaluation of intravascular and extravascular volume status. In the presence of a failing kidney, fluid removal is often a challenge. Continuous renal replacement therapy (CRRT) techniques offer a significant advantage over intermittent dialysis for fluid control, however, any form of RRT in the critically ill patient requires careful attention to prescription and monitoring to avoid complications. In order to utilize these therapies for their maximum potential it is necessary to understand which factors influence fluid balance and have an understanding of the principles and kinetics of fluid removal with extra‐corporeal techniques.
Sedimentary processes at the mouth of a tidally‐influenced delta: New insights from submarine observatory measurements, Fraser Delta, Canada
Authors: Hill Philip R. , Lintern D. Gwyn
Published: March 2021

This paper examines particle settling dynamics in a tidally‐influenced delta, including observations of convective settling, strongly modulated by seasonal discharge and tidal cycles. Long time series of Acoustic Doppler Current Profiler backscatter, a proxy for suspended sediment concentration in the water column, current and sediment accumulation measurements from the slope of the Fraser River delta show variability of sedimentary processes over timescales from semi‐diurnal to annual. Acoustic Doppler Current Profiler backscatter shows a lagged response to river discharge and strong diurnal/semi‐diurnal variability. Most of the tidal cycle is characterized by a buoyant effluent plume. During the ebbing phase of diurnal major tides, discrete settling events are observed extending through the entire water column. The pulse‐like nature of these events is the result of downward plunging fingers characteristic of convective settling, similar to those observed in laboratory flume experiments, and appear to be initiated at the interface between the surface buoyant plume and the underlying ambient water. Currents show strong variability in a three‐layer water column. The surface plume shows offshore and southward directed transport of sediments. The remaining water column is influenced by tidal flows, but near surface and intermediate water‐depth currents are out of phase by several hours, indicating a stratification of the basin water and decoupled propagation of surface and internal tides. This phase lag is unlikely to cause discernible facies changes, but may have implications for basin‐fill patterns in restricted basins with strong tidal range. The results of this work will help to better understand river mouth sedimentation processes and dispersal patterns in other modern deltas and in the geological record.
Computing geographical access to services: The design of a client–server solution that incorporates multiple transport modes
Authors: Price Andrew , Langford Mitchel , Higgs Gary
Published: March 2021

This study describes the design and implementation of a web‐based infrastructure built on open‐source components to enable the computation of accessibility scores. It can be adapted to any form of service provision that is represented as geo‐located points. The solution aims to extend previous attempts to measure and analyse geographical accessibility in a web‐based environment. This design integrates a new approach for generating the variables required in calculating accessibility scores, while allowing the whole system to potentially remain as an open‐source and open‐data solution. The design allows accessibility scores to be computed using simultaneously both public and private transport modes, thus presenting a more accurate assessment than that obtained from standard single‐mode solutions. The infrastructure is described through a consideration of each fundamental component, demonstrating how travel distances and alternative journeys are generated and applied to the accessibility model. Results produced by the solution enable the comparison of accessibility scores generated from alternative modes of transport and are illustrated using a case study to investigate access to sports facilities in Wales. This demonstrates how the system can be used to guide further investment and the future management of service infrastructure.
Trade agreements and Latin American trade (creation and diversion) and welfare
Authors: El Dahrawy Sánchez‐Albornoz Ayman , Timini Jacopo
Published: March 2021

This study analyses the process of economic integration in Latin America. Making use of a structural gravity model and including intra‐national trade flows, this paper provides an ex‐post assessment of the effect of the trade agreements (TAs) signed by Latin American countries on international trade. We account for the last wave of TAs proliferation and estimate treaty‐level effects. On average, TAs had a positive effect on Latin American trade. This holds true for both intra‐Latin American agreements and agreements between Latin American countries and the Rest‐of‐the‐World (RoW). However, we unveil that these average estimates cover a substantial degree of heterogeneity across TAs. Additionally, we quantify ex‐ante general equilibrium effects on the trade volumes and welfare of Latin American countries under different scenarios of deeper trade integration and disintegration.
When morphology does not match phylogeny: The puzzling case of two sibling nudibranchs (Gastropoda)
Authors: Furfaro Giulia , Salvi Daniele , Trainito Egidio , Vitale Fabio , Mariottini Paolo
Published: March 2021

Species delimitation is particularly challenging in Mediterranean nudibranchs because morphological distinction between closely related species is subtle and several cryptic species have been discovered. In this study, we apply an integrative approach to investigate taxonomic distinction of Flabellina cavolini and F. gaditana and assess their genetic and morphologic distinction. We combined a comprehensive phylogeographic survey from across their distribution range and compared genetic variation at mitochondrial and nuclear markers with the variation in colour pattern of cerata that is used to discriminate these two species. Phylogenetic, phylogeographic and species delimitation analyses consistently identify two evolutionary and taxonomic units that do not match with the morphospecies, demonstrating that Flabellina cavolini and F. gaditana are indeed two cryptic, closely related, species and that colour pattern of cerata is not a valid diagnostic character. This study emphasizes how the comparison of range‐wide patterns of phylogenetic and morphological variation, with the inclusion of samples from the type localities, is essential for species delimitation of Mediterranean nudibranchs. Moreover, this study demonstrates the occurrence of Flabellina gaditana in the Mediterranean Sea, allowing to extend the known distribution range of the species, that was previously restricted to the eastern Atlantic Ocean, as well as increasing our inventory of Mediterranean nudibranch diversity.
Trayectorias y proyectos intelectuales: el pensamiento social en América Latina y Colombia
Authors: Beltrán Alvarado Jonathan , Celentano Adrián , Cristancho Rojas Juan Sebastián , Gómez Facundo , Gómez Delgado Julián , Jaramillo Jiménez Jaime Eduardo , Luengas Solano Manuela , Mora Granados Diana Constanza , Otavo Jaime , Peña Laura , Riveros Torres Sylvia Juliana , Vanegas Mahecha Samuel , Zapata María Isabel
Published: March 2021

Este libro ha sido pensado como una reconstrucción comparada e las trayectorias que ha tenido el pensamiento social latinoamericano, a través de los ensayistas, el surgimiento de la sociología, la institución de la crítica literaria y la trasformación de ciertos conceptos en relación con coyunturas de la historia social y política colombiana y latinoamericana. El objetivo de esta organización es que el lector pueda conocer el proceso a través del cual el pensamiento social se fue transformando, junto con ciertos hitos que permiten su visión comparada. Los capítulos de esta compilación no comparten un enfoque; sin embargo, es posible seguir cómo, en diferentes países latinoamericanos, se fue configurando una manera de observar la realidad de una región que se ha debatido entre entenderse como una particularidad o asumir el destino de ser una simple variante del proceso de occidentalización. Para superar ese ir y venir, es necesario plantearse el problema de la emancipación cultural como parte del desarrollo cognitivo de los seres humanos a largo plazo. Lo que implica, entonces, es entender la especificidad histórica latinoamericana en términos de la apropiación del ser humano de sí mismo y de su entorno. Los trabajos aquí presentados proponen algunas pistas para avanzar en esa dirección.