bluuebunny/crossref_metadata_2025 huggingface dataset:
Stage‐specific embryonic antigen 4 is a membrane marker for enrichment of porcine spermatogonial stem cells
Authors: Zhang Pengfei , Li Fuyuan , Zhang Lingkai , Lei Peipei , Zheng Yi , Zeng Wenxian
Published: July 2020

Background

Spermatogonial stem cells (SSCs), as tissue‐specific stem cells, are capable of both self‐renewal and differentiation and supporting the continual and robust spermatogenesis for male fertility. As a rare sub‐fraction of undifferentiated spermatogonia, SSCs share most molecular markers with the progenitor spermatogonia. Thus, the heterogeneity of the progenitor cells often obscures the characteristics of stem cells. Distinguishing SSCs from the progenitors is of paramount importance to understand the regulatory mechanisms governing their actions.

Objectives

The present study was designed to reveal that SSEA4 can be a marker for putative porcine SSCs that distinguished it from the progenitors and to build a sorting program for efficient enrichment of porcine SSCs.

Methods

To explore expression of SSEA4 within the undifferentiated spermatogonial population, we performed co‐immunofluorescent staining for SSEA4 and common molecular markers (VASA, DBA, PLZF, c‐KIT, and SOX9) in the 7‐, 90‐, and 150‐day‐old porcine testicular tissues. SSEA4‐positive cells were isolated from the 90‐day‐old porcine testes by flow cytometry. Immunofluorescent, RNA‐sequencing, and transplantation analysis were used to reveal that SSEA4‐positive fraction holds the stem cell capacity.

Results

We found that SSEA4 was expressed in a rare sub‐fraction of porcine undifferentiated spermatogonia, and RNA‐sequencing analysis revealed that the genes for stem cell maintenance and SSC‐specific markers (ID4 and PAX7) were up‐regulated in the SSEA4‐sorted fraction, compared with undifferentiated spermatogonia. In addition, germ cell transplantation assay demonstrated that SSEA4‐positive spermatogonia colonized in the recipient testicular tubules. Sorting of the undifferentiated spermatogonia with anti‐SSEA4 antibody resulted in a 2.5‐fold enrichment of SSCs compared with the germ cell gate group, and 21‐fold enrichment of SSCs compared with the SSEA4‐negative spermatogonia group.

Conclusions

Our findings revealed that SSEA4 is a new surface marker for porcine undifferentiated spermatogonia. This finding helps to elucidate the characteristics of porcine SSCs and facilitates the culture and manipulation of SSCs.
Early outcomes of implanting larger‐sized grafts in deceased donor liver transplantation
Authors: Shen Zhenhua , Wang Zhize , Jiang Yuancong , Wu Tianchun , Zheng Shusen
Published: July 2020

Background

The outcomes of large‐sized graft mismatch in deceased donor liver transplantation (LT) have been rarely studied. The aim of this study was to determine whether a large‐sized graft for recipient influenced the post‐transplant outcomes.

Methods

A total of 273 patients undergoing LT were enrolled and divided into a large and a normal‐sized graft group by graft weight to recipient weight (GWRW) >2.5% (n = 76) or GWRW ≤2.5% (n = 197). Post‐operative complications and outcomes were retrospectively analysed.

Results

The two groups were comparable in demographic characteristics. The rate of complications was significantly higher in the large‐sized graft group including early allograft dysfunction (36.8% versus 17.8%, P = 0.001), hepatic necrosis (26.3% versus 13.7%, P = 0.01) and massive hydrothorax (25% versus 14.7%, P = 0.04). The large‐sized graft group suffered higher early mortality compared with the normal‐sized graft group (30 days: 14.5% versus 5.6%, P = 0.02, 90 days: 21.1% versus 9.6%, P = 0.01). The primary causes of early death were multiple organ failure (10.5% versus 2%, P = 0.002) and sepsis (2.6% versus 1.5%, P = 0.54). Four parameters including donor alanine transaminase, GWRW, estimated blood loss and model for end‐stage liver disease score were significant on multivariate analysis, and indicated significant risk factors for the early mortality of recipients.

Conclusion

In deceased donor LT, GWRW >2.5% is associated with increased liver injury, risk of early mortality and other adverse outcomes. Thus, donor livers should be allocated to recipients with GWRW ≤2.5%.
Early surgical complications of total hip arthroplasty related to surgical approach
Authors: Hoskins Wayne , Dowsey Michelle M. , Spelman Tim , Choong Peter F. M.
Published: July 2020

Background

Total hip arthroplasty (THA) can be performed through a number of surgical approaches. The aim was to compare the incidence of early surgical complications in THA related to approach.

Methods

A retrospective review of prospectively recorded data extracted from St. Vincent's Melbourne Arthroplasty Registry was performed between January 2006 and December 2016. Surgical approach was identified: lateral, posterior, anterior and superior. Primary outcome measure was return to theatre (RTT) for any cause within 1 year. Age, comorbidity, body mass index and femoral fixation were assessed for potential confounding. Secondary outcomes were RTT for revision procedure and for specific complications: intra or post‐operative fracture, dislocation/instability, aseptic loosening and prosthetic joint injection (PJI). Variables were assessed for their association with outcome using unadjusted and adjusted quantile median regression for continuous outcomes and Cox proportional hazards regression for binary time‐to‐event outcomes.

Results

There were a total of 2906 consecutive THA's recorded, 1413 lateral, 1188 posterior, 233 anterior and 72 superior. A total of 140 cases (4.5%) required RTT within 1 year. No approach was associated with RTT on unadjusted analyses or multivariate modelling. There was no association between approach and revision, PJI or periprosthetic fracture. The posterior approach was associated with 2.90 times the rate of dislocation relative to the lateral (P = 0.005).

Conclusions

There was no difference in the RTT rate between surgical approaches for THA. There was no difference in revision rates, PJI or periprosthetic fracture. The posterior approach was associated with a higher rate of dislocation relative to the lateral, but not the anterior.
Impact of postoperative acute kidney injury on predicting the upstaging of chronic kidney disease after robot‐assisted partial nephrectomy
Authors: Teishima Jun , Inoue Shogo , Miyamoto Shunsuke , Fukuoka Kenichiro , Sekino Yohei , Kitano Hiroyuki , Hieda Keisuke , Hayashi Tetsutaro , Matsubara Akio
Published: July 2020

Introduction

The aim of our study was to assess the impact of acute kidney injury (AKI) on postoperative upstaging of chronic kidney disease (CKD) after robot‐assisted partial nephrectomy (RAPN).

Methods

This study consisted of 110 patients who had undergone RAPN and were followed up for at least 6 months after surgery. Patients were classified as AKI or non‐AKI based on their serum creatinine level and estimated glomerular filtration rate within 7 days after surgery. Patient characteristics, outcome of RAPN and estimated glomerular filtration rate, and CKD upstage 6 months after surgery were compared between the AKI and non‐AKI groups.

Results

A total of 26 patients (23.6%) experienced AKI after surgery. RENAL (radius, exophytic/endophitic properties, nearness of the tumor to the collecting system or sinus, anterior/posterior, location relative to the polar lines) nephrometry scores were ≥7 for 22 (84.6%) in the AKI group and 39 (46.4%) in the non‐AKI group (P = .0006). A significantly smaller proportion of patients in the AKI group than in the non‐AKI group recovered 90% of baseline function (38.5% vs 81.0%, P < .0001). CKD upstaging occurred in a total of 27 patients 24.5%) and in a significantly larger proportion of patients in the AKI group than in the non‐AKI group (42.3% vs 19.0%, P = .0160). There was no significant difference in characteristics and perioperative outcomes between the patients with and without CKD, except for in those experiencing AKI.

Conclusion

After RAPN, AKI can be associated with CKD upstaging.
Model‐informed drug repurposing: Viral kinetic modelling to prioritize rational drug combinations for COVID‐19
Authors: Dodds Michael G. , Krishna Rajesh , Goncalves Antonio , Rayner Craig R.
Published: July 2020

Aim

We hypothesized that viral kinetic modelling could be helpful to prioritize rational drug combinations for COVID‐19. The aim of this research was to use a viral cell cycle model of SARS‐CoV‐2 to explore the potential impact drugs, or combinations of drugs, that act at different stages in the viral life cycle might have on various metrics of infection outcome relevant in the early stages of COVID‐19 disease.

Methods

Using a target‐cell limited model structure that has been used to characterize viral load dynamics from COVID‐19 patients, we performed simulations to inform on the combinations of therapeutics targeting specific rate constants. The endpoints and metrics included viral load area under the curve (AUC), duration of viral shedding and epithelial cells infected. Based on the known kinetics of the SARS‐CoV‐2 life cycle, we rank ordered potential targeted approaches involving repurposed, low‐potency agents.

Results

Our simulations suggest that targeting multiple points central to viral replication within infected host cells or release from those cells is a viable strategy for reducing both viral load and host cell infection. In addition, we observed that the time‐window opportunity for a therapeutic intervention to effect duration of viral shedding exceeds the effect on sparing epithelial cells from infection or impact on viral load AUC. Furthermore, the impact on reduction on duration of shedding may extend further in patients who exhibit a prolonged shedder phenotype.

Conclusions

Our work highlights the use of model‐informed drug repurposing approaches to better rationalize effective treatments for COVID‐19.
Use of proton pump inhibitors is associated with lower rates of first‐time ischemic stroke in community‐dwelling elderly
Authors: Schmilovitz‐Weiss Hemda , Gingold‐Belfer Rachel , Peleg Noam , Grossman Alon , Issa Nidal , Boltin Doron , Beloosesky Yichayaou , Koren‐Morag Nira , Meyerovitch Joseph , Shirin Haim , Weiss Avraham
Published: July 2020

Aim

Data on cardiovascular outcomes in elderly using proton pump inhibitors (PPI) are scant. We aimed to test the association between PPI use and the occurrence of first‐time ischemic stroke (FTIS) among elderly.

Methods

The electronic database of a centrally located district branch of a large health maintenance organization in Israel was retrospectively screened (2002–2016) for community‐dwelling individuals (≥65–95 years) for demographics and co‐morbidities. Follow‐up was until FTIS, death or end of study. Findings were analyzed by PPI use and occurrence of FTIS.

Results

29,639 subjects (without history of stroke and use of antiplatelet aggregation drugs) mean age of 82.2 ± 5.5 years (range: 65–95 years, 38% male) were analyzed: 8,600 (29%) used PPIs. Mean follow up was 10.58 years (SD ± 5.44). Similar total and annual occurrence rates of FTIS were depicted in PPI users and non‐users (20.9% vs. 21% and 2% vs. 2.1%, respectively). On a Cox regression analysis, upon adjustment for age, gender and cardiovascular disease related risk factors, PPI use was significantly associated with lower rates of FTIS (HR 0.73, 95% C.I. 0.69–0.77, p < 0.001). The risk for FTIS was significantly lower in subjects using PPI at any dose and for any time period compared to non‐users (HR 0.9, 95% C.I. 0.85–0.96 for 7–48 yearly prescriptions and HR 0.51, 95% C.I. 0.46–0.55 for ≥49 yearly prescriptions).

Conclusions

PPI use was associated with lower rates of FTIS in community‐dwelling elders. Prospective large‐scale studies are needed to fully elucidate the effect of PPI in this aging population.
A comprehensive review of economic evaluations of therapeutic drug monitoring interventions for cancer treatments
Authors: Vithanachchi Dinusha T. , Maujean Annick , Downes Martin J. , Scuffham Paul
Published: July 2020

Therapeutic drug monitoring (TDM) of cancer drugs has been shown to improve treatment effectiveness and safety. The aim of this paper was to comprehensively review economic evaluations of TDM interventions for cancer drugs. Searches were conducted in 4 electronic databases, Medline, EMBASE, and Centre for Reviews and Dissemination databases (Database of Abstracts of Reviews of Effects and the NHS Economic Evaluation Database), from their inception to June 2019. Studies were included if they were economic evaluations of TDM interventions for an active cancer treatment. The quality of reporting of economic evaluations was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS checklist). Of the 11 publications identified, imatinib with TDM and 5‐fluorouracil with TDM were the most commonly assessed interventions (4 publications each). Overall study quality was good, with publications meeting 61 to 91% (median 80%) of CHEERS checklist criteria. A variety of studies were used to estimate the clinical effectiveness inputs for the cost effectiveness models. All publications considered TDM to be cost‐effective based on an incremental cost‐effectiveness ratio below the willingness to pay threshold (64%) or being cost‐saving (36%). TDM interventions were considered cost‐effective across the economic evaluations. Further clinical research assessing the impact of TDM on overall survival or other long‐term health outcomes may enhance the evidence base for TDM in oncology. Future economic evaluations of TDM should explicitly consider uncertainty in the underlying clinical evidence and incorporate changes in the use of newer targeted drugs that form the current standard of care.
Temporal analysis of multimodal data to predict collaborative learning outcomes
Authors: Olsen Jennifer K. , Sharma Kshitij , Rummel Nikol , Aleven Vincent
Published: July 2020

The analysis of multiple data streams is a long‐standing practice within educational research. Both multimodal data analysis and temporal analysis have been applied successfully, but in the area of collaborative learning, very few studies have investigated specific advantages of multiple modalities versus a single modality, especially combined with temporal analysis. In this paper, we investigate how both the use of multimodal data and moving from averages and counts to temporal aspects in a collaborative setting provides a better prediction of learning gains. To address these questions, we analyze multimodal data collected from 25 9–11‐year‐old dyads using a fractions intelligent tutoring system. Assessing the relation of dual gaze, tutor log, audio and dialog data to students' learning gains, we find that a combination of modalities, especially those at a smaller time scale, such as gaze and audio, provides a more accurate prediction of learning gains than models with a single modality. Our work contributes to the understanding of how analyzing multimodal data in temporal manner provides additional information around the collaborative learning process.
Participant or spectator? Comprehending the willingness of faculty to use intelligent tutoring systems in the artificial intelligence era
Authors: Wang Shanyong , Yu Haotian , Hu Xianfeng , Li Jun
Published: July 2020

The advancement of technology, especially the development and application of artificial intelligence, has deeply affected the education sector and brought opportunities for pedagogical adaptation. Intelligent tutoring systems, a major application of artificial intelligence in education, have drawn extensive concerns. However, in reality, the penetration rate of intelligent tutoring systems and the enthusiasm of faculty to use are still relatively low. This research examined the determinants of the willingness of faculty to use intelligent tutoring systems. Innovation diffusion theory was the theoretical basis of this research and it was adapted by incorporating perceived trust and experience. To gather data, a cross‐sectional questionnaire survey was performed and structural equation modeling was employed to analyze the data. The findings indicated that relative advantage, compatibility, perceived trust and experience are the contributing determinants of the willingness of faculty to use intelligent tutoring systems, while complexity has no significant effect. Meanwhile, complexity is significantly negatively affected by experience and compatibility. Relative advantage is significantly positively affected by perceived trust but not by complexity. Based on the research findings, relevant recommendations for encouraging faculty to use intelligent tutoring systems were proposed.
Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review
Authors: Chin Yip Han , Ng Cheng Han , Lee Ming Hui , Koh Jeffery Wei Heng , Kiew Jolene , Yang Samantha Peiling , Sundar Gangadhara , Khoo Chin Meng
Published: July 2020

Objective

Thyroid eye disease (TED) is a debilitating condition that frequently manifests in patients suffering from Graves’ disease (GD). This study aims to analyse the prevalence of TED among GD patients, with a focus on geographical region‐specific rates.

Methods

Medline and Embase were searched for articles examining TED prevalence on April 2020, and articles were retrieved and sieved. Statistical analysis was performed after Freeman‐Tukey double arcsine transformation. Thereafter, results were pooled with random effects by DerSimonian and Laird model.

Results

Fifty‐seven articles involving 26,804 patients were included in the review. The overall pooled prevalence of TED was 40% (CI: 0.32 to 0.48) and by continent was 38% (CI: 0.31 to 0.46) for Europe, 44% (CI: 0.32 to 0.56) for Asia, 27% (CI: 0.06 to 0.56) for North America and 58% (CI: 0.55 to 0.61) for Oceania. The prevalence of TED in Southeast Asia was 35% (CI: 0.24 to 0.47) and Middle East 48% (CI: 0.19 to 0.78). Subgroup analysis showed regions with predominantly Caucasians (37%; CI: 0.28 to 0.46) had a lower prevalence of TED compared to Asians (45%; CI: 0.33 to 0.58). The pooled prevalence of lid retraction was 57% (CI: 0.39 to 0.74), proptosis 57% (CI: 0.48 to 0.65), diplopia 36% (CI: 0.24 to 0.48) and ocular hypertension 13% (CI: 0.06 to 0.19).

Conclusion

A substantial proportion of patients with GD have TED and often manifest as lid retraction, proptosis and diplopia. Early detection through active screening might help to mitigate the progression of TED and its associated complications.
Gotong Royong and the Transformation of Kampung Ledok Code, Yogyakarta
Authors: Winardi Uji Nugroho
Published: July 2020

This article focuses on Kampung Ledok Code, a small riverside community in Yogyakarta that was less exposed to outside influence and in the beginning had tenuous bonds among the population. It aims to understand how this marginalized society articulated and made use of gotong royong to engineer the kampung’s transformation. Challenging the traditional perception of gotong royong as a collective spirit that has long been an important element of Indonesian national culture, some critics argue that gotong royong is a political construction for manpower mobilization. Yet people also attempt to make use of gotong royong for their own purposes. This article argues that gotong royong is historically constructed, but that the Ledok Code community employed the concept toward a variety of ends. It began with a communal spirit that bonded the population. It became a popular strategy to gain recognition, then a kampung ritual to generate neighborhood improvement. Eventually, gotong royong was institutionalized as a social norm to regulate the community.
Early outcomes of peroral endoscopic myotomy with fundoplication for achalasia cardia – Is it here to stay?
Authors: Patil Gaurav , Dalal Ankit , Maydeo Amit
Published: July 2020

Background

Peroral endoscopic myotomy with fundoplication (POEM‐F) has garnered widespread attention since it tries to achieve an appropriate antireflux procedure during the same setting. The outcomes of POEM‐F are currently unexplored.

Methods

Patients who underwent POEM‐F at our center were retrospectively studied to assess its safety and early outcomes.

Results

Twenty patients [70% male; median age 32 years (range 25–41)], with a median symptom duration of 2.1 years (range 1.5–3.7) with achalasia were included. POEM‐F procedure was completed in a median of 118 min (range 90–160), with 17/20 (85%) technical success. The median hospitalization was 4 days (range 2–7). Capnothorax (n = 3), resolved spontaneously (n = 2) in 4–6 h, while in one patient (n = 1) the endoscope inadvertently entered into the thoracic cavity for which prophylactic intercostal drain was required. Capnoperitoneum was seen in 17/17 (100%) patients who underwent fundoplication, subcutaneous emphysema in 8/17 (47%) patients. At 1‐month follow‐up endoscopy, 5/17 (29.4%) patients had loosening of the fundal wrap, 3/17 (17.6%) patients had ulceration in fundus and in gastroesophageal junction due to underlying hemoclips. At 3 months, loosening of the fundal wrap was seen in 7/17 (41.2%) patients. A 24‐h pH‐metry revealed abnormal esophageal acid exposure in 7/17 (41.2%) patients, while it was normal in those patients in whom the fundal wrap was maintained. 10/17 (58.8%) patients were off proton pump inhibitors.

Conclusion

POEM‐F is technically feasible with reasonable short term success. However, the durability, early success and safety of POEM‐F need reassessment in long‐term studies before being applied in clinical practice.
Cause of death in autopsy‐confirmed dementia disorders
Authors: Degerskär A. N. W. , Englund E. M.
Published: July 2020

Background and purpose

Dementia disorders predispose for lethal complications and decrease life expectancy. A more profound knowledge regarding end‐stage conditions in dementia could therefore ameliorate treatment and care of these patients.

Methods

Autopsy reports on 207 deceased individuals with clinically diagnosed neurocognitive disorder/dementia and on 200 neurocognitively healthy individuals of the same age range were studied. Autopsy results, especially cause of death, were compared between the dementia and the control groups.

Results

The two most frequent causes of death in the dementia population were pneumonia (34.3%) and acute myocardial infarction (30.4%). This result differed from that of the control group, in which acute myocardial infarction (42.5%) accounted for most events of deaths, followed by circulatory failure (12.5%). The leading cause of death varied amongst dementia subtypes. Further, in Alzheimer’s disease pneumonia was more frequent in severe/advanced cases whilst acute myocardial infarction was more common in milder cases.

Conclusions

Cause of death differed between the demented and the general population of the same age and between subtypes of dementia. Alzheimer’s disease severity was reflected in different final conditions. The findings have relevance for the final stage care and treatment in dementia disorders.
Genomic analysis reveals neutral and adaptive patterns that challenge the current management regime for East Atlantic cod Gadus morhua L
Authors: Johansen Torild , Besnier François , Quintela María , Jorde Per Erik , Glover Kevin A. , Westgaard Jon‐Ivar , Dahle Geir , Lien Sigbjørn , Kent Matthew P.
Published: July 2020

Challenging long‐held perceptions of fish management units can help to protect vulnerable stocks. When a fishery consisting of multiple genetic stocks is managed as a single unit, overexploitation and depletion of minor genetic units can occur. Atlantic cod (Gadus morhua) is an economically and ecologically important marine species across the North Atlantic. The application of new genomic resources, including SNP arrays, allows us to detect and explore novel structure within specific cod management units. In Norwegian waters, coastal cod (i.e. those not undertaking extensive migrations) are divided into two arbitrary management units defined by ICES: one between 62° and 70°N (Norwegian coastal cod; NCC) and one between 58° and 62°N (Norwegian coastal south; NCS). Together, these capture a fishery area of >25,000 km2 containing many spawning grounds. To assess whether these geographic units correctly represent genetic stocks, we analysed spawning cod of NCC and NCS for more than 8,000 SNPs along with samples of Russian White Sea cod, north‐east Arctic cod (NEAC: the largest Atlantic stock), and outgroup samples representing the Irish and Faroe Sea's. Our analyses revealed large differences in spatial patterns of genetic differentiation across the genome and revealed a complex biological structure within NCC and NCS. Haplotype maps from four chromosome sets show regional specific SNP indicating a complex genetic structure. The current management plan dividing the coastal cod into only two management units does not accurately reflect the genetic units and needs to be revised. Coastal cod in Norway, while highly heterogenous, is also genetically distinct from neighbouring stocks in the north (NEAC), west (Faroe Island) and the south. The White Sea cod are highly divergent from other cod, possibly yielding support to the earlier notion of subspecies rank.
Frontiers in modelling social–ecological dynamics of recreational fisheries: A review and synthesis
Authors: Solomon Christopher T. , Dassow Colin J. , Iwicki Carolyn M. , Jensen Olaf P. , Jones Stuart E. , Sass Greg G. , Trudeau Ashley , van Poorten Brett T. , Whittaker Dane
Published: July 2020

Recreational fisheries are culturally and economically important around the world. Recent research emphasizes that understanding and managing these systems requires a social–ecological perspective. We systematically reviewed quantitative social–ecological models of marine and freshwater recreational fisheries to summarize their conceptualization of social, ecological, and social–ecological dynamics and identify research frontiers. From a candidate set of 626 studies published between 1975 and 2018, 49 met criteria for inclusion in our review. These studies, though diverse in terms of focal species and processes considered, were geographically limited to a few locations and ignored large regions of the globe where recreational fishing is important. There were also important gaps in the social and ecological processes that were included in published models. Reflecting on these patterns in the context of previous conceptual frameworks, we define five key frontiers for future work: 1) exploring the implications of social and behavioural processes like heuristics, social norms, and information sharing for angler decisions and fishery dynamics; 2) modelling governance with more realistic complexity; 3) incorporating ideas from resilience thinking and complex adaptive systems, including slow variables, destabilizing feedbacks, surprises and diversity; 4) considering key ideas in fisheries systems, including spatial and temporal effort dynamics, catch hyperstability, and stocking; and 5) thinking synthetically about the models that we use to describe social–ecological dynamics in recreational fisheries, via explicit comparisons and formal integration with data. Exploration of these frontiers, while remembering the distinction between model complexity and model usefulness, will improve our ability to understand and sustain recreational fisheries.
Lessons from the Transition to Relational Teletherapy During COVID‐19
Authors: Burgoyne Nancy , Cohn Aaron Samuel
Published: July 2020

When the World Health Organization declared the coronavirus outbreak a pandemic, clinicians were challenged to maintain continuity of care. Teletherapy became the primary means of service delivery for many who had never or only sparingly used it. The Family Institute at Northwestern University, in response to encouraging findings with respect to the effectiveness of teletherapy and recognizing advantages with respect to access to care, launched our teletherapy services in 2018. As a relationship‐based organization, we were keen to exploit the opportunity that teletherapy provides to integrate additional members of the client system into the treatment. Over these two plus years, we have learned a great deal. Our learning was greatly accelerated by our transition to a 100% teletherapy practice in the wake of the pandemic. Teletherapy is a different context. Intentionally managing the context’s constraints and exploiting its strengths is key to providing high‐quality couple and family therapy. This step is often overlooked or resisted when teletherapy is an occasional add‐on to a face‐to‐face practice.
Caribbean reefs of the Anthropocene: Variance in ecosystem metrics indicates bright spots on coral depauperate reefs
Authors: Lester Sarah E. , Rassweiler Andrew , McCoy Sophie J. , Dubel Alexandra K. , Donovan Mary K. , Miller Margaret W. , Miller Scott D. , Ruttenberg Benjamin I. , Samhouri Jameal F. , Hay Mark E.
Published: July 2020

Dramatic coral loss has significantly altered many Caribbean reefs, with potentially important consequences for the ecological functions and ecosystem services provided by reef systems. Many studies examine coral loss and its causes—and often presume a universal decline of ecosystem services with coral loss—rather than evaluating the range of possible outcomes for a diversity of ecosystem functions and services at reefs varying in coral cover. We evaluate 10 key ecosystem metrics, relating to a variety of different reef ecosystem functions and services, on 328 Caribbean reefs varying in coral cover. We focus on the range and variability of these metrics rather than on mean responses. In contrast to a prevailing paradigm, we document high variability for a variety of metrics, and for many the range of outcomes is not related to coral cover. We find numerous “bright spots,” where herbivorous fish biomass, density of large fishes, fishery value, and/or fish species richness are high, despite low coral cover. Although it remains critical to protect and restore corals, understanding variability in ecosystem metrics among low‐coral reefs can facilitate the maintenance of reefs with sustained functions and services as we work to restore degraded systems. This framework can be applied to other ecosystems in the Anthropocene to better understand variance in ecosystem service outcomes and identify where and why bright spots exist.
Using ethnography and assemblage theory in political geography
Authors: Ghoddousi Pooya , Page Sam
Published: July 2020

While the focus on the ‘everyday’ in qualitative human geography has greatly increased the need for, and relevance of, ethnographic methods, Megoran argued that this is particularly true for political geography as it has the potential to challenge its focus on elite discourse, allowing researchers to bring forward multiple voices to investigate the becoming of political events. More recently, assemblage theory has gained traction in political geography, not only because of its capability to include the role of the material and the affective, but also revealing the links between micro‐ and macro‐politics by showing how agency emerges out of complex relations. In the first part of this paper, we present an overview of the recent uses of ethnography in political geography that have not embraced assemblage. Second, we explore the theoretical conceptualisations of, and opportunities provided by, an assemblage approach. Third, we go through the use of assemblage ethnographies in political geography, with a particular focus on Pooya's experience of research with Iranians in London. In this, he embraced a variety of ethnographic approaches, including ‘auto‐ethnography’, ‘netnographies’, ‘participant sensation’, in combination with observations, participatory workshops and activism. Showing the role of ethnography as a qualitative tool for political geographers to interrogate discursive social constructions, we argue that it holds even more promise for analysing and intervening in the emergent politics of socio‐material‐affective assemblages.
Financial literacy: A systematic review and bibliometric analysis
Authors: Goyal Kirti , Kumar Satish
Published: July 2020

Given the paucity of comprehensive summaries in the extant literature, this systematic review, coupled with bibliometric analysis, endeavours to take a meticulous approach intended at presenting quantitative and qualitative knowledge on the ever‐emerging subject of financial literacy. The study comprises a review of 502 articles ‐ published in peer‐reviewed journals from 2000 to 2019. Citation network, page‐rank analysis, co‐citation analysis, content analysis and publication trends have been employed to identify influential work, delineate the intellectual structure of the field and identify gaps. The most prominent journals, authors, countries, articles and themes have been identified using bibliometric analysis, followed by a comprehensive analysis of the content of 107 papers in the identified clusters. The three major themes enumerated are—levels of financial literacy amongst distinct cohorts, the influence that financial literacy exerts on financial planning and behaviour, and the impact of financial education. Additionally, content analysis of 175 papers has been conducted for the last four years’ articles that were not covered in the co‐citation analysis. Emerging themes identified include financial capability, financial inclusion, gender gap, tax & insurance literacy, and digital financial education. A conceptual framework has been modelled portraying the complete picture, following which potential areas of research have been suggested. This study will help policy‐makers, regulators and academic researchers know the nuts and bolts of financial literacy, and identify the relevant areas that need investigation.
Collaboration and Internationalization of SMEs: Insights and Recommendations from a Systematic Review
Authors: Zahoor Nadia , Al‐Tabbaa Omar , Khan Zaheer , Wood Geoffrey
Published: July 2020

This paper performs a systematic literature review of the undeniably diverse – and somewhat fragmented – current state of research on the collaborations and internationalization of small and medium‐sized enterprises (SMEs). We analyze key works and synthesize them into a framework that conceptually maps key antecedents, mediators, and moderators that influence the internationalization of SMEs. In addition, we highlight limitations of the literature, most notably in terms of theoretical fragmentation; extant theories are deployed and illustrated but rarely extended in a manner that significantly informs subsequent work. At an applied (but related) level, we argue the need for supplementary work that explores the distinct stages of internationalization – and the scope and scale of this process – rather than assuming closure around particular events. With this, we highlight the need for more rigorous and empirically informed explorations of contextual effects that take account of the consequences of developments in the global economic ecosystem.
Deciphering human γδ T cell response in cancer: Lessons from tumor‐infiltrating γδ T cells
Authors: Lo Presti Elena , Dieli Francesco , Fourniè Jean Jacques , Meraviglia Serena
Published: July 2020

The finding that γδ T cells are present among tumor‐infiltrating lymphocytes in humans suggests they participate in tumor immune surveillance, but their relevance is unclear because the relative abundance of tumor‐infiltrating γδ T cells correlates with positive or negative, or even do not correlate with prognosis. This likely depends on the fact that tumor‐infiltrating γδ T cells may play substantially different effector or regulatory functions, and correlation with patient's prognosis relies on distinct γδ T cell subsets in the context of the tumor. There is interest to exploit γδ T cells in tumor immunotherapy, but to make this approach successful there is urgent need to fully understand the biological functions of γδ T cells and of how they can be manipulated in vivo and ex vivo to safely provide benefit to the host. This review focuses on our previous and ongoing studies of tumor‐infiltrating γδ T lymphocytes in different types of human cancer. Moreover, we discuss the interaction of tumor‐infiltrating γδ T cells with other cells and molecules present in the tumor microenvironment, and their clinical relevance on the ground, that deep knowledge in this field can be used further for better immunotherapeutic intervention in cancer.
Safewards: Changes in conflict, containment, and violence prevention climate during implementation
Authors: Dickens Geoffrey L. , Tabvuma Tracy , Frost Steven A. ,   SWSLHD Safewards Steering Group
Published: July 2020

Since its development, there has been growing utilization of the Safewards package of interventions to reduce conflict and containment in acute mental health wards. The current study used the opportunity of an implementation of Safewards across one large metropolitan local health district in New South Wales Australia to evaluate change. Specific aims of the study were to measure, for the first time in Australia, changes in shift‐level reports of conflict and containment associated with Safewards introduction, and to measure any association with change in the violence prevention climate using a tool validated for use in the current study setting. Eight of eleven wards opted‐in to participating in Safewards. Implementation was conducted over a period of 24 weeks (4‐week preparation, 16‐week implementation, and 4‐week outcome phases). Conflict and containment were measured using the Patient–Staff Conflict Checklist Shift Report and violence prevention climate using the VPC‐14. From 63.2% response rate, the mean (SD) reported conflict and containment incidents per shift fell from 3.96 (6.25) and 6.81 (5.78) to 2.94 (4.22) and 5.82 (4.62), respectively. Controlling for other variables, this represented reductions of 23.0 and 12.0%, respectively. Violence prevention climate ratings did not change. Safewards was associated with significant improvements in all incidents of conflict and containment, including the most severe and restrictive types, and this was largely unaffected by outcomes measure response rate, shift or weekday/weekend reporting, or number of ward beds. Safewards is increasingly justified as one of very few interventions of choice in adult, acute mental health services and should be widely utilized.
Clinical study of Maggot therapy for Fournier's gangrene
Authors: Fonseca‐Muñoz Alicia , Sarmiento‐Jiménez Hugo E. , Pérez‐Pacheco Rafael , Thyssen Patricia J. , Sherman Ronald A.
Published: July 2020

Fournier's Gangrene is a fulminating necrotizing fasciitis of the perineum and genitalia. Standard treatment involves immediate excision of all necrotic tissue, aggressive antibiotic coverage, and supportive medical care. Still, the infection is commonly fatal or disfiguring. Wound treatment with disinfected blowfly larvae (maggot debridement therapy or MDT) has been shown to be highly effective, with multiple studies demonstrating effective debridement, disinfection, and promotion of granulation tissue. MDT also has been associated with preservation of viable tissue and minimised blood loss. This report describes a prospective clinical study of MDT for Fournier's gangrene aimed to test the hypothesis that early use of maggots could decrease the number of surgical treatments required to treat Fournier's gangrene. Subjects were provided with one initial surgical excision, followed by debridement using only medical grade Lucilia sericata larvae. Only two subjects were enrolled, both diabetic men. Intensive care and culture‐directed antimicrobial coverage were administered as usual. Maggot debridement was associated with the disappearance of necrotic tissue, control of infection and granulation tissue growth. In both subjects, wounds healed without requiring further surgical resection or anatomical reconstruction. Maggot therapy decreased the number of surgical procedures that otherwise would have been necessary, and led to favourable outcomes.
Sickle cell disease perceptions of caregivers, adolescent, and adult patients: Barriers and facilitators to medical care adherence
Authors: Hoegy Delphine , Guilloux Ronald , Bleyzac Nathalie , Gauthier‐Vasserot Alexandra , Cannas Giovanna , Bertrand Yves , Hot Arnaud , Dussart Claude , Janoly‐Dumenil Audrey
Published: July 2020

Aims

To provide an understanding of medical care adherence factors as reported by caregivers, adolescent, and adult patients with sickle cell disease and to analyse those concerns to identify barriers and facilitators about medical care adherence. Three topics influenced medical care adherence: the disease itself, therapeutics, and the healthcare system. This study will focus on the first topic.

Design

Qualitative explorative study, using semi‐structured and life‐experience interviews and manual inductive content analysis.

Methods

From December 2016 – March 2017, one semi‐structured interview was conducted by a researcher with each of the 15 adolescent patients, 10 adult patients, and 19 caregivers in a French public hospital. Interviews were audio‐taped and transcribed before a content analysis. Perceptions were classified into barriers and facilitators of medical care adherence.

Results

This article presents disease perceptions of caregivers and patients (adolescents and adults): daily management and social representations. These perceptions differ among parents, adolescent patients, and adult patients. However, all report important disease‐related “limitations” in their lives. The objective for adults (parents and patients) is to “live with the disease” and to achieve this, they find coping resources. Two major resources expressed by adults emerged: social resources (support from friends, patients’ association, and social visibility) and disease knowledge (theoretical and derived from experience). This is not the case of adolescents for whom social normality was the main concern.

Conclusion

Care management adherence is partly based on coping with the disease. Given the lower number of facilitators expressed by adolescents, it is essential to propose interventions in this population. It will help them cope with the disease and, consequently, optimize care management adherence.

Impact

Showing differences among caregivers, adult, and adolescent patient perceptions, this study impact future care practices. It revealed needs of intervention for adolescents.
Refugee Discrimination – The Good, the Bad, and the Pragmatic
Authors: Oberman Kieran
Published: July 2020

This article addresses three questions. To what extent does the current refugee regime discriminate among refugees? When is such discrimination wrong? Could discrimination ever be justified pragmatically, for the sake of admitting more refugees given political constraints? In answer to the first question, it finds discrimination is rampant. There is the kind of discrimination that gets noticed: discrimination that states choose to enact within the refugee regime. But there is also a kind of discrimination that is missed: discrimination that is a product of the regime itself. The second question proves tricky. Matters are clear at the extremes. Discrimination based on need is permissible. Discrimination based on race or religion is not. In between, we have a set of hard cases that are more difficult to judge. The article searches for relevant criteria. Finally, on the last question, the article concludes that a political leader could be justified in enacting discrimination as a pragmatic response to political constraints but that, even on such occasions, discrimination remains wrongful.
Imprinting aberrations of SNRPN, ZAC1 and INPP5F genes involved in the pathogenesis of congenital heart disease with extracardiac malformations
Authors: Zhao Xiaolei , Chang Shaoyan , Liu Xinli , Wang Shuangxing , Zhang Yueran , Lu Xiaolin , Zhang Ting , Zhang Hui , Wang Li
Published: July 2020

Congenital heart disease (CHD) with extracardiac malformations (EM) is the most common multiple malformation, resulting from the interaction between genetic abnormalities and environmental factors. Most studies have attributed the causes of CHD with EM to chromosomal abnormalities. However, multi‐system dysplasia is usually caused by both genetic mutations and epigenetic dysregulation. The epigenetic mechanisms underlying the pathogenesis of CHD with EM remain unclear. In this study, we investigated the mechanisms of imprinting alterations, including those of the Small nuclear ribonucleoprotein polypeptide N (SNRPN), PLAG1 like zinc finger 1 (ZAC1) and inositol polyphosphate‐5‐phosphatase F (INPP5F) genes, in the pathogenesis of CHD with EM. The methylation levels of SNRPN, ZAC1, and INPP5F genes were analysed by the MassARRAY platform in 24 children with CHD with EM and 20 healthy controls. The expression levels of these genes were detected by real‐time polymerase chain reaction (PCR). The correlation between methylation regulation and gene expression was confirmed using 5‐azacytidine (5‐Aza) treated cells. The methylation levels of SNRPN and ZAC1 genes were significantly increased in CHD with EM, while that of INPP5F was decreased. The methylation alterations of these genes were negatively correlated with expression. Risk analysis showed that abnormal hypermethylation of SNRPN and ZAC1 resulted in 5.545 and 7.438 times higher risks of CHD with EM, respectively, and the abnormal hypomethylation of INPP5F was 8.38 times higher than that of the control group. We concluded that abnormally high methylation levels of SNRPN and ZAC1 and decreased levels of INPP5F imply an increased risk of CHD with EM by altering their gene functions. This study provides evidence of imprinted regulation in the pathogenesis of multiple malformations.
LINC00941 promotes oral squamous cell carcinoma progression via activating CAPRIN2 and canonical WNT/β‐catenin signaling pathway
Authors: Ai Yilong , Wu Siyuan , Zou Chen , Wei Haigang
Published: July 2020

Dysregulation of long non‐coding RNAs (lncRNAs) has been implicated in many cancer developments. Previous studies showed that lncRNA LINC00941 was aberrantly expressed in oral squamous cell carcinoma (OSCC). However, its role in OSCC development remains elusive. In this study, we demonstrated that in OSCC cells, EP300 activates LINC00941 transcription through up‐regulating its promoter H3K27ac modification. Up‐regulated LINC00941 in turn activates CAPRIN2 expression by looping to CAPRIN2 promoter. Functional assays suggest that both LINC00941 and CAPRIN2 play pivotal roles in promoting OSCC cell proliferation and colony formation. In vivo assay further confirmed the role of LINC00941 in promoting OSCC cell tumour formation. Lastly, we showed that the role of LINC00941 and CAPRIN2 in OSCC progression was mediated through activating the canonical WNT/β‐catenin signaling pathway. Thus, LINC00941/CAPRIN2/ WNT/β‐catenin signaling pathway provides new therapeutic targets for OSCC treatment.
Identification of a nursery area for the critically endangered hammerhead shark (Sphyrna lewini) amid intense fisheries in the southern Gulf of Mexico
Authors: Cuevas‐Gómez Gabriela Alejandra , Pérez‐Jiménez Juan Carlos , Méndez‐Loeza Iván , Carrera‐Fernández Maribel , Castillo‐Géniz José Leonardo
Published: July 2020

Since the 1980s, there has been growing concern in the Mexican Atlantic regarding high catches of neonate and juvenile sharks in small‐scale fisheries. Fishery‐dependent data from 1993 to 1994 and 2007 to 2017 and fishers' ecological knowledge from 2017 were used to identify nursery areas for scalloped hammerhead, Sphyrna lewini, in the southern Gulf of Mexico. Catch records and fishing areas of neonates, YOYs, juveniles and adults of S. lewini (N = 1885) were obtained from calcareous and terrigenous regions in the western Yucatan Peninsula. The results suggest that a nursery for scalloped hammerhead is found in the terrigenous region, characterized by relatively shallow and turbid waters due to rivers’ discharges. Neonates and YOYs (96% and 86% of their total records, respectively) were commonly found there over the years in May–August in multiple fishing areas identified by fishers, although mainly between isobaths 10–30 m. The enforcement of management measures is necessary because the nursery is located in a region with intense fishing effort.