bluuebunny/crossref_metadata_2025 huggingface dataset:
Insertions in SARS-CoV-2 genome caused by template switch and duplications give rise to new variants that merit monitoring
Authors: Garushyants Sofya K. , Rogozin Igor B. , Koonin Eugene V.
Published: April 2021

The appearance of multiple new SARS-CoV-2 variants during the winter of 2020-2021 is a matter of grave concern. Some of these new variants, such as B.1.617.2, B.1.1.7, and B.1.351, manifest higher infectivity and virulence than the earlier SARS-CoV-2 variants, with potential dramatic effects on the course of the COVID-19 pandemic. So far, analysis of new SARS-CoV-2 variants focused primarily on point nucleotide substitutions and short deletions that are readily identifiable by comparison to consensus genome sequences. In contrast, insertions have largely escaped the attention of researchers although the furin site insert in the spike protein is thought to be a determinant of SARS-CoV-2 virulence and other inserts might have contributed to coronavirus pathogenicity as well. Here, we investigate insertions in SARS-CoV-2 genomes and identify 347 unique inserts of different lengths. We present evidence that these inserts reflect actual virus variance rather than sequencing errors. Two principal mechanisms appear to account for the inserts in the SARS-CoV-2 genomes, polymerase slippage and template switch that might be associated with the synthesis of subgenomic RNAs. We show that inserts in the Spike glycoprotein can affect its antigenic properties and thus merit monitoring. At least, three inserts in the N-terminal domain of the Spike (ins245IME, ins246DSWG, and ins248SSLT) that were first detected in 2021 are predicted to lead to escape from neutralizing antibodies, whereas other inserts might result in escape from T-cell immunity.
Social experience alters different types of learning abilities controlled by distinct brain nuclei inKryptolebias marmoratus
Authors: Li Cheng-Yu , Kültz Dietmar , Ward Audrey K. , Earley Ryan L.
Published: April 2021

Fighting experiences strongly influence aggressive behavior and physiology (winner-loser effects). These effects are conserved from invertebrates to vertebrates, but the underlying mechanisms remain unclear. Recent studies indicate that the brain social decision-making network (SDN) plays a key role in guiding experience-induced behavioral change. Also, while most studies have focused on how winning and losing experiences alter aggression, growing evidence points to these experiences driving multiple behavioral effects, including changes in the ability to learn. In mangrove rivulus fish (Kryptolebias marmoratus), we discovered that single winning experiences significantly improved spatial learning but not risk-avoidance learning, whereas single losing experiences drove the exact opposite to occur. These results provide strong evidence that winning and losing modulate diverse behaviors served by key nodes within the SDN, specifically the dorsolateral pallium (Dl; fish homolog to mammalian hippocampus, which serves spatial learning) and dorsomedial pallium (Dm; fish homolog to mammalian basolateral amygdala, which responds to fear). We therefore quantified whole-proteome expression within the forebrain (where Dm and Dl are located) of adult rivulus with divergent social experiences. We discovered 23 proteins were significantly differentially expressed in the forebrains of winners and losers. Differentially expressed proteins in losers related to modulation of cellular processes, apoptosis and learning while those in winners related to neuronal plasticity, neuroendocrine homeostasis, energy utilization, and learning. These results imply that winner-loser effects might be governed by very different patterns of protein expression, which could explain why winners and losers show such pronounced differences in behavioral performance.

Significance Statement

Social interactions permeate the daily lives of most animals and often result in changes in behavior for all parties. This implies that social experiences reorganize the brain in ways that promote the expression of alternative behaviors, or that help individuals cope with the outcome of such interactions. But how do aggressive interactions sculpt the brain at the molecular level? We used an emerging model organism,Kryptolebias marmoratus, to examine whether experiences modulate learning ability and then probe the potential neural mechanisms underlying these behavioral changes. We discovered that single winning and losing experiences dramatically altered spatial learning and risk-avoidance learning, respectively, indicating that winning and losing experiences have markedly different effects on the brain and cognitive processes.

Classification

Biological Sciences, Ecology
Kinetochore-associated Mps1 regulates the strength of kinetochore-microtubule attachments via Ndc80 phosphorylation
Authors: Sarangapani Krishna K. , Koch Lori B. , Nelson Christian R. , Asbury Charles L. , Biggins Sue
Published: April 2021

Dividing cells detect and correct erroneous kinetochore-microtubule attachments during mitosis, thereby avoiding chromosome mis-segregation. Most studies of this process have focused on the Aurora B kinase, which phosphorylates microtubule-binding elements specifically at incorrectly attached kinetochores, promoting their release and providing another chance for proper attachments to form. However, growing evidence suggests additional mechanisms, potentially involving Mps1 kinase, that also underlie error correction. Because these mechanisms overlapin vivo, and because both Mps1 and Aurora B function in numerous other vital processes, their contributions to the correction of erroneous kinetochore attachments have been difficult to disentangle. Here we directly examine how Mps1 activity affects kinetochore-microtubule attachments using a reconstitution-based approach that allowed us to separate its effects from Aurora B activity. When endogenous Mps1 that co-purifies with isolated kinetochores is activatedin vitro, it weakens their attachments to microtubules via phosphorylation of Ndc80, a major microtubule-binding element of the outer kinetochore. Mps1 phosphorylation of Ndc80 appears to contribute to error correction because phospho-deficient Ndc80 mutants exhibit genetic interactions and segregation defects when combined with mutants in an intrinsic error correction pathway. In addition, Mps1 phosphorylation of Ndc80 is stimulated on kinetochores lacking tension. These data suggest that Mps1 provides an additional mechanism for correcting erroneous kinetochore-microtubule attachments, complementing the well-known activity of Aurora B.
Mechanical phenotyping of acute promyelocytic leukemia reveals unique biomechanical responses in retinoic acid-resistant populations
Authors: Li Brian , Maslan Annie , Streets Aaron M. , Sohn Lydia L.
Published: April 2021

While all-trans retinoic acid (ATRA) is an essential therapy in the treatment of acute promyelocytic leukemia (APL), an aggressive subtype of acute myeloid leukemia, nearly 20% of APL patients are resistant to ATRA. As no biomarkers for ATRA resistance yet exist, we investigated whether cell mechanics could be associated with this pathological phenotype. Using mechano-node-pore sensing, a single-cell mechanical phenotyping platform, and patient-derived APL cell lines, NB4 (ATRA-sensitive) and AP-1060 (ATRA-resistant), we discovered that ATRA-resistant APL cells are less mechanically pliable. By investigating how different subcellular components of APL cells contribute to whole-cell mechanical phenotype, we determined that nuclear mechanics strongly influence an APL cell’s mechanical response. By arresting APL cells in S-phase or M-phase in the cell cycle, we found cell pliability to be inversely related to DNA content. In addition to DNA content affecting cell pliability, we observed that chromatin condensation also affects nuclear mechanics: decondensing chromatin with trichostatin A is especially effective in softening ATRA-resistant APL cells. RNA-Seq allowed us to compare the transcriptomic differences between ATRA-resistant and ATRA-responsive APL cells and highlighted gene expression changes that could be associated with mechanical changes. Overall, we demonstrate the potential of “physical” biomarkers in identifying APL resistance.
First report of the forensically important fly, Stearibia nigriceps (Diptera: Piophilidae) in South Korea: Confirmation of specimens from human corpses based on cytochrome c oxidase subunit I barcodes
Authors: Kim Hajin , Martín‐Vega Daniel , Shin Sang Eon , Wang Ah Rha , Park Seong Hwan
Published: April 2021

Piophilidae are a relatively small family of Diptera that is frequently associated with cadavers at advanced stages of decomposition and are, therefore, considered potentially useful forensic indicators. However, their use in forensic investigations is typically hampered by a deficiency in reliable identification tools. This is particularly evident in countries such as South Korea, where forensic entomology is still in its infancy and the diversity of forensically relevant insect taxa remains largely undocumented. In the present study, we used cytochrome c oxidase subunit I (COI) barcodes to identify samples of piophilid larvae collected during medicolegal investigations performed in South Korea. A total of 174 COI sequences were obtained and have been made publicly available, thus augmenting the reference barcode library for forensically important Piophilidae species. Of the 174 sequenced samples, 172 were identified as Stearibia nigriceps (Meigen), whereas the two remaining samples may represent a previously unsequenced piophilid species. Stearibia nigriceps is recorded from South Korea for the first time, and our results suggest that it might be a particularly relevant forensic indicator in certain case types and scenarios in that country. The findings of this study highlight the utility of COI barcodes for achieving accurate identification of entomological samples, even by non‐specialist forensic practitioners. They also contribute to the further development and consolidation of forensic entomology in South Korea and eastern Asia.
Solar Radiation Modification ‐ A “Silver Bullet” Climate Policy for Populist and Authoritarian Regimes?
Authors: Michaelowa Axel
Published: April 2021

Populist and authoritarian leaders are increasingly coming to power in large countries. They often have a climate sceptic approach and do away with mitigation policies when coming to power. Increasing impacts of extreme meteorological events linked to climate change could lead to a situation where the supporters of the populist leader or elites crucial for the survival of an authoritarian regime are pushing to do something to address climate change. In order not to lose power, the leader may look for quick and cheap solutions. In such a context, solar radiation modification (SRM), for example, by stratospheric aerosol injection (SAI), will become very attractive as it is likely to have low costs and rapid effects. Populist or authoritarian governments are unlikely to care for negative impacts of SRM abroad as they often act nationalistically with an explicit disdain for multilateral solutions. We discuss the incentive structure and political economy that populist and authoritarian leaders may face regarding unilateral use of SRM and elaborate how the international community could try to prevent or at least ‘contain’ such unilateral uses of SRM. Unfortunately, such ‘containment’ is contingent on the most powerful states not being populist or authoritarian regimes.
Addressing power imbalances in biosequestration governance
Authors: Lovera‐Bilderbeek Simone , Lahiri Souparna
Published: April 2021

Climate change is a global challenge that requires strong governance on a global scale. The Intergovernmental Panel on Climate Change has suggested that large‐scale biosequestration in the form of forest restoration or tree plantation establishment is a potential form of carbon dioxide removal (CDR) that could contribute significantly to climate change mitigation. Yet it has also cautioned that this approach has social and environmental trade‐offs that need to be addressed through enhanced land governance. Land governance, per definition, has a strong local dimension as most lands are inhabited by local communities. Glocal and other multi‐scale governance approaches have been proposed to address potential conflicts between global policies and the rights, needs and priorities of local communities. Yet these approaches often overlook the power imbalances between the actors that design global climate policies and the local, often politically and economically marginalized, indigenous and other forest‐dependent communities that are directly impacted by these policies. The paper will explore to what extent theoretical concepts like rights‐based approaches have been able to address these conflicts and power imbalances, and whether more profound changes in governance systems are required to ensure equitable implementation of CDR.
Quantifying surface topography of biological systems from 3D scans
Authors: Martinez Alejandro , Nguyen Damon , Basson Mandeep S. , Medina Josh , Irschick Duncan J. , Baeckens Simon
Published: April 2021

Understanding the three‐dimensional (3D) surface complexity of biological systems can yield fundamental insights into how organisms interact with their environments. The wealth of current imaging technologies permits detailed 3D visualization of biological surfaces on the macro‐, micro‐ and nanoscale. Analysis of the reconstructed 3D images, however, remains a challenging proposition.

Here, we present QuSTo, a versatile, open‐source program developed in Python to quantify surface topography from profiles obtained from 3D scans. The program calculates metrics that quantify surface roughness and the size (i.e. height and length) and shape (i.e. convexity constant (CC), skewness (Sk) and kurtosis (Ku)) of surface structures.

We demonstrate the applicability of our program by quantifying the surface topography of snake skin based on newly collected data from white light 3D scans of the ventrum and dorsum of 32 species. To illustrate the utility of QuSTo for evolutionary and ecological research, we test whether snake species that occur in different habitats differ in skin surface structure using phylogenetic comparative analyses.

The QuSTo application is free, open‐source, user‐friendly and easily adapted for specific analysis requirements (available in GitHub, github.com/GMLatUCDavis/QuSTo) and is compatible with 3D data obtained with different scanning techniques, for example, white light and laser scanning, photogrammetry, gel‐based stereo‐profilometry. Scientists from various disciplines can use QuSTo to examine the surface properties of an array of animal and plant species for both fundamental and applied biological and bioinspired research.
Influence of ultrasonic activation on antimicrobial activity of a new final irrigant containing glycolic acid: An invitro study
Authors: Souza Matheus Albino , Palhano Huriel Scartazzini , Macci Dierro , Broch Gabriélli Moraes , Tissiani Luanda , Rauber Bárbara Facco , Cecchin Doglas , Bervian Juliane , de Almeida Gomes Brenda Paula Figueiredo , Gabrielli Ezequiel Santin
Published: April 2021

This study evaluated the influence of ultrasonic activation (US) on the antimicrobial activity of a new final irrigant containing glycolic acid (GA). Extracted teeth were used, being 70 to counting of colony‐forming units (CFUs) and 35 to confocal laser scanning microscopy. Samples were inoculated with Enterococcus faecalis and divided into 7 groups: distilled water + US; 17% EDTA; Qmix; 17% GA; 17% EDTA + US; QMix + US; and 17% GA + US and kept in contact with test solution for 1 min in the groups with or no US. In the CFUs, the highest bacterial reduction was observed in QMix + US group, followed by QMix and GA + US. In the confocal evaluation, the lowest number of viable cells was observed in EDTA + US, with no statistical difference from QMix, QMix + US and GA + US (P > 0.05). The use of US improves the antimicrobial activity of EDTA and GA, being statistically different from the isolated use of these final irrigants in both evaluation tests.
Comparison of intense pulsed light and near‐infrared light in the treatment of dry eye disease: a prospective randomized study
Authors: Ren Xiaotong , Chou Yilin , Wang Yuexin , Chen Yanyan , Liu Ziyuan , Li Xuemin
Published: April 2021

Purpose

To compare the efficacy of intense pulsed light (IPL) and near‐infrared light (NIL) treatments in alleviating symptoms and signs of dry eye disease (DED).

Methods

Patients diagnosed with DED at the Peking University Third Hospital Eye Center from January 2019 to October 2019 were randomized to undergo either NIL therapy combined with meibomian gland expression (MGX; NIL Group) or IPL combined with MGX (IPL Group). Treatments were performed three times at 1‐month intervals. DED signs and symptoms were evaluated before every treatment. We compared the clinical improvement within and between the groups. Additional comparisons were made according to the meibomian gland (MG) dropout grade.

Results

A total of 260 eyes of 130 patients (mean age, 49.68 ± 18.01 years) were included. The dryness and total symptom scores and the MG expressibility and secretion quality (upper and lower eyelids) significantly improved after the three treatments in both groups (p < 0.05). However, IPL had superior efficacy in improving blurred vision, photophobia, burning, increased secretions and the total symptom score at 2 months in patients with more severe MG dropout.

Conclusions

Both IPL and NIL treatments were effective in the treatment of DED, but IPL provided greater symptom improvement, particularly in patients with severe MG dropout. NIL can be a new therapeutic option for the treatment of DED.
Betalactam hypersensitivity: The importance of delabelling in primary care
Authors: Ben Fadhel Najah , Aroua Fares , Chadli Zohra , Ben Romdhane Haifa , Chaabane Amel , Sahtout Mounira , Boughattas Naceur A. , Ben Fredj Nadia , Aouam Karim
Published: April 2021

Patients and methods

An allergy work‐up was performed on adult patients with a history of a penicillin allergy seen by primary medical care in Monastir (Tunisia) between July 2016 and February 2018. Patients with negative skin tests were challenged with amoxicillin. Patients who were delabelled were contacted by phone after 6 months to determine outcomes after any therapeutic penicillin‐class antibiotic intake.

Results

A total of 39 patients were evaluated and 33 (84.6%) were delabelled. Five patients were penicillin skin‐test positive and one was oral challenge positive. We succeeded in contacting 33 delabelled patients at 6 months. Twenty‐two patients tolerated a subsequent therapeutic course of amoxicillin, eight patients did not retake penicillin due to a lack of therapeutic indication, and three patients refused an indicated penicillin use fearful of another reaction.

Conclusion

This study highlights the importance of allergy work‐up in the diagnosis of beta‐lactam hypersensitivity. Most patients were excessively labelled as beta‐lactam allergic and this mislabelling could increase healthcare costs and lead to the development of drug resistance by the use of wide‐spectrum antibiotics
Immersion experiences and behavioural patterns in game‐based learning
Authors: Hsu Mei‐En , Cheng Meng‐Tzu
Published: April 2021

Games have been regarded as a potential vehicle for enhancing student learning. Previous studies mainly focused on learning outcomes; however, the learning processes and dynamic in‐game behaviours of students who are immersed in a game context are relatively undiscovered. The purposes of this study were to develop an educational game, Bio Detective, to facilitate student science learning and to investigate how game immersion experiences are related to in‐game behavioural patterns. The study included 128 7th graders (12–13 years old). A mixed‐method approach collecting both quantitative and qualitative data was employed, and an integration of cluster and sequential analysis was used. The findings showed that the students were able to learn from playing Bio Detective because significant improvements in science learning outcomes were obtained. The students who were totally immersed in Bio Detective acted more like expert problem solvers than their counterparts with no immersion experiences. They had better problem‐solving efficiency, and their behavioural patterns revealed that they had more heuristic and analogical thinking strategies. Interpretations and limitations are further discussed.

Practitioner notes

What is already known about this topic

Games are a potential vehicle for enhancing science learning.

Previous studies about game‐based learning mainly focused on learning outcomes.

Studies aiming to reveal the learning processes and dynamic in‐game behaviours of students who are immersed in a game context are relatively undiscovered.

What this paper adds

Student science learning was significantly enhanced through playing Bio Detective.

The behavioural patterns of the students with no immersion experiences were more inconsistent and complicated.

Students with experiences of total immersion exhibited more effective thinking and had more heuristic and analogical problem‐solving strategies.

Implications for practice and/or policy

Bio Detective can be effective for students to learn scientific concepts.

The behavioural patterns of gameplay can tell us more about individuals’ learning processes behind the scenes.

The in‐situ data collected by the objective methods combined with other instruments would delineate a clearer picture of the gaming/learning processes.
Economic cost of managing patients with oral potentially malignant disorders in Sri Lanka
Authors: Amarasinghe Hemantha , Jayasinghe Ruwan D. , Dharmagunawardene Dilantha , Attygalla Manjula , Kumara Dinesh R. , Kularatna Sanjeewa , Johnson Newell W.
Published: April 2021

Objectives

Cancer of the oral cavity is the leading malignancy amongst males in Sri Lanka, and eighth amongst women. Almost all malignancies are developed from a clinically visible precursor stage called an oral potentially malignant disorder (OPMD). The objective of this study was to estimate costs of managing patients with OPMD in Sri Lanka for a 12‐month period from diagnosis.

Methods

A hospital‐based costing study was conducted in Sri Lanka in the years 2016‐2017. Three selected treatment centres participated. For societal perspectives, healthcare, household and indirect costs were used. Costs to the healthcare system included clinic visits, diagnostic biopsy, consumables and drug costs. Capital costs included apportioned value of land, buildings, equipment and furniture. Household costs consisted of out‐of‐pocket expenditure and indirect costs of lost income.

Results

Sixty‐two patients were recruited (39 male and 23 female). The majority had awareness of oral potentially malignant disorders (OPMDs). Total average cost of managing a single patient with an OPMD for 1 year was SLR 19 547 (US$ 140) which includes a health system cost of SLR 7320 (US$ 52) and household cost of SLR 12 227 (US$ 87). Travel loss and income loss were a substantial burden to patients and their families.

Conclusions

Managing patients with an OPMD, even with annual monitoring, is less costly than managing patients with oral cancer. Out‐of‐pocket costs are very high, and these could be reduced by revising the National Management Guidelines to allow care closer to home.
Role of MRI to confirm healing in complex high cryptoglandular anal fistulas: long‐term follow‐up of 151 cases
Authors: Garg Pankaj , Yagnik Vipul D. , Kaur Baljit , Menon Geetha R. , Dawka Sushil
Published: April 2021

Aim

Complex fistula‐in‐ano can recur even after complete clinical healing has occurred. ‘Radiological healing’ of fistula on MRI correlates well with long‐term healing rates but no study has yet objectively quantified this. The aim of this study was to assess the accuracy of anal fistula healing as documented on MRI and to correlate it with long‐term healing as evidenced on long‐term follow‐up.

Methods

Patients with clinically healed anal fistulas who also had radiological healing checked by postoperative MRI were included in the study.

Results

Three hundred and twenty‐five patients operated for high complex fistula‐in‐ano were followed up for 14–68 months (median 38 months). Postoperative MRI was done to assess radiological healing of the fistula in 151 patients, and they were included in the study. The mean age was 39.4 ± 10.5 years (116 men). Five patients were lost to follow‐up. The fistulas did not heal radiologically (on MRI) in 20 patients and recurred in all these patients. The fistulas healed radiologically (on MRI) in 126 patients. On long‐term follow‐up, 124/126 patients remained healed while 2/126 had a recurrence. In the first patient, the fistula recurred 40 months after complete radiological healing. In the second patient, the fistula recurred 10 months after complete radiological healing but pus from the fistula tested positive for tuberculosis (by real‐time polymerase chain reaction) and he was excluded from the analysis. Thus, there was only one (1/125) recurrence on long‐term follow‐up.

Conclusions

Radiological healing on MRI correlates well with long‐term healing in complex fistula‐in‐ano.
Quantitative relations between BOLD responses, cortical energetics and impulse firing across cortical depth
Authors: Bennett Maxwell R. , Farnell Leslie , Gibson William G.
Published: April 2021

The blood oxygen level‐dependent (BOLD) functional magnetic resonance imaging (fMRI) signal arises as a consequence of changes in cerebral blood flow (CBF) and cerebral metabolic rate of oxygen that in turn are modulated by changes in neural activity. Recent advances in imaging have achieved sub‐millimetre resolution and allowed investigation of the BOLD response as a function of cortical depth. Here, we adapt our previous theory relating the BOLD signal to neural activity to produce a quantitative model that incorporates venous blood draining between cortical layers. The adjustable inputs to the model are the neural activity and a parameter governing this blood draining. A three‐layer version for transient neural inputs and a multi‐layer version for constant or tonic neural inputs are able to account for a variety of experimental results, including negative BOLD signals.
Lack of caste discrimination by males during sexual context in a neotropical paper wasp
Authors: de Souza André Rodrigues , Silva Rafael Carvalho da , Batista Nathan Rodrigues , Antonialli Júnior William Fernando , Nascimento Fábio Santos do
Published: April 2021

Potential mates often exhibit strong variation in reproductive quality, so the choice for the best sexual partner is generally adaptive. However, its adaptive value diminishes in cases where potential mates are similarly fit or when mate choice is too costly, leading mate choice to be unusual or absent. “Primitively eusocial” insects have flexible castes. Workers usually behave as “helpers,” but sometimes they mate and lay fertilized eggs. Despite worker totipotence, direct reproduction is, overall, higher in queens. Males of the temperate paper waspPolistes dominulaare able to discriminate castes, preferring gynes (= future queens) over workers, thus assuring more profitable mates. To our knowledge, no study has tested this ability in neotropical paper wasps. Here, we test the prediction that in the congeneric neotropical paper waspPolistes versicolor, male sexual preference for gynes is unusual or absent. We perform laboratory paired mating trials in which a male was introduced to either a gyne or a worker. Caste assigned was confirmed by morphophysiological analysis. As predicted, male sexual interest was similar regardless of female caste. Conducting gas chromatography analysis, we demonstrated that queens and workers have distinct cuticular hydrocarbon profiles so caste‐related cues are available. We discuss the possibility that reduced differences in direct reproductive potential between castes and high costs of caste discrimination account for the absence of mate choice for gynes inP. versicolormales despite its occurrence inP. dominula. Thus, caste discrimination by males during sexual context is not so strict in species in which workers are able to mate and lay fertilized eggs.
Risk‐Based Decision‐Support Groundwater Modeling for the Lower San Antonio River Basin, Texas, USA
Authors: Foster Linzy K. , White Jeremy T. , Leaf Andrew T. , Houston Natalie A. , Teague Aarin
Published: April 2021

A numerical surface‐water/groundwater model was developed for the lower San Antonio River Basin to evaluate the responses of low base flows and groundwater levels within the basin under conditions of reduced recharge and increased groundwater withdrawals. Batch data assimilation through history matching used a simulation of historical conditions (2006‐2013); this process included history‐matching to groundwater levels and base‐flow estimates at several gages, and was completed in a high‐dimensional (highly parameterized) framework. The model was developed in an uncertainty framework such that parameters, observations, and scenarios of interest are envisioned stochastically as distributions of potential values. Results indicate that groundwater contributions to surface water during periods of low flow may be reduced from 6% to 25% with a corresponding 25% reduction in recharge and a 25% increase in groundwater pumping over an 8‐year planning period. Furthermore, results indicate groundwater‐level reductions in some hydrostratigraphic units are more likely than in other hydrostratigraphic units over an 8‐year period under drought conditions with the higher groundwater withdrawal scenario.
Factors associated with erectile dysfunction diagnosis in men with HIV infection: a case–control study
Authors: Jansen N , Daniels C , Sunil T , Xu X , Cota J , Ganesan A , Agan BK , Okulicz JF
Published: April 2021

Objectives

HIV infection is associated with increased risk of erectile dysfunction (ED); however, factors associated with ED remain unclear. We evaluated the prevalence of ED among men living with HIV and factors associated with ED diagnosis in the US Military HIV Natural History Study (NHS).

Methods

A retrospective cohort study evaluated participants in the NHS, a cohort of HIV‐positive active duty members and beneficiaries with HIV infection. Men with a diagnosis of ED after HIV diagnosis were included. Cohort controls without ED diagnosis were matched 2:1 by age at HIV diagnosis and duration of follow‐up. Multivariate logistic regression models were used to identify factors associated with ED.

Results

A total of 543 of 5682 male participants (9.6% prevalence) had a diagnosis of ED, of whom 488 were included in the analysis. The median (interquartile range, IQR) age at ED diagnosis was 43 (37.0–49.0) years and the time from HIV diagnosis to antiretroviral therapy (ART) start was longer for cases (5.0 years, IQR: 2.0–9.0) than for controls (3.0 years, 1.0–6.0; P < 0.01). Cases had higher proportions of multiple comorbid conditions, including depression (33.4% vs. 21.7%), tobacco use (19.7% vs. 9.0%) and sleep apnoea (14.8% vs. 4.2%) compared with controls (P < 0.01 for all). Logistic regression showed increased odds of ED for delayed ART initiation > 4 years [odds ratio (OR) = 2.05, 95% confidence interval (CI): 1.56–2.71], protease inhibitor use ≥ 1 year (OR = 1.81, 95% CI: 1.38–2.38) and sleep apnoea (OR = 2.60, 95% CI: 1.68–4.01).

Conclusions

Erectile dysfunction was common in men with HIV and associated factors included both HIV‐related and traditional factors.
Associations of frailty, loneliness and the quality of life of empty nesters: A cross‐sectional study in rural areas
Authors: Wang Shouqi , Zhao Minghui , Shi Ying , Zhang Meiling , Ying Jie , Li Huanhuan , Li Yuan , Xing Zhuangjie , Zhang Haiyan , Sun Jiao
Published: April 2021

Aims

To explore loneliness, in association with frailty, in explaining the quality of life (QOL) of empty‐nest older adults in rural China.

Design

A cross‐sectional questionnaire survey was conducted.

Methods

Data collection was performed from June to August 2017 in Changchun, the capital city of Jilin province, which consists of seven districts and three counties. In total, 304 older adults aged 60 years and above participated. The characteristics of older adults were evaluated in terms of frailty status, loneliness and the QOL. One‐way and two‐way analyses of covariance and the area under the receiver operating characteristic curves were used to explore the relationships of frailty, loneliness and the QOL.

Results

The one‐way ANCOVA showed a significant difference among robust, prefrail and frail participants for loneliness. Moreover, an interaction effect of frailty with loneliness in determining the QOL was found. The receiver operating characteristic curves showed that loneliness and QOL could distinguish frail older adults, and the best cutoffs were 34.5 and 67.4, respectively.

Conclusion

This study demonstrates a close relationship between frailty and loneliness, suggesting the need to simultaneously consider the two with regard to the QOL of empty‐nest older adults in rural China.
Interdisciplinary guided dentistry, digital quality control, and the “copy‐paste” concepts
Authors: Coachman Christian , Bohner Lauren , Jreige Camila Sales , Sesma Newton , Calamita Marcelo
Published: April 2021

Objective

The aim of this report is to present an interdisciplinary approach with novel concepts to virtually plan and achieve esthetics and function.

Clinical Considerations

Despite the advancements in the digital workflow applied to restorative dentistry, the final outcomes are commonly not similar to initial planning. To overcome this major limitation, three concepts are proposed: guided dentistry, digital quality control and “copy‐paste” dentistry. Guided dentistry consists of simulations in 3D software and also includes the manufacture of guides/appliances to assist dentists in all clinical steps. Digital quality control involves the use of intraoral scanners and 3D software to compare the real outcomes with the pre‐operative simulations after every procedure. “Copy‐paste” dentistry is a consequence of the previous two concepts. Using the capacity of the software to overlap files, the original project can be maintained and adapted to achieve results more comparable with the initial design. The proposed method associates facially driven treatment planning and periodontal and restorative procedures to perform the patient's dental rehabilitation.

Conclusion

Through a guided workflow and digital control of clinical steps, the final outcomes obtained were equivalent and closer to the initial design.

Clinical Significance

In interdisciplinary cases, the treatment plan needs to address individual requirements and to coordinate sequential clinical stages. It is challenging to meet these demands in a conventional process. The proposed concepts engage technological resources to orientate the procedures and to provide assessment in each step. This approach enables the development of a complete and accurate functional‐esthetic rehabilitation. Ultimately, the technique presented is reproducible and the results reflect the established plan.
Nursing in Albania: A Catalytic Force in Transforming Health Professionals and Health Care
Authors: Rocco Gennaro , Affonso Dyanne , Caruso Rosario , Duka Blerina , Giardina Bruno , Notarnicola Ippolito , Sabatino Laura , Shaffer Franklin , Stievano Alessandro
Published: April 2021

Purpose

Transitions in nursing education and professionalism that align with global nursing standards are elucidated as critical success factors in transforming health professionals and health care in Albania. Progressive educational and regulatory pathways throughout the 2000s (1999–2020) are emphasized for their impact on the Albanian health system, including the achievement of universal healthcare coverage.

Methods

Data collected by the Ministry of Health and Sport and the Regulatory Authority for nursing and other healthcare professions in Albania were analyzed and outcomes explicated with regard to Albania’s major health challenges.

Discussion and Conclusions

Three milestones affirmed nursing as a driving force in the Albanian healthcare system: (a) nurses constitute the largest health professional workforce via a nurse–patient ratio of 1:400 in contrast to a physician–patient ratio of 1:2,500; (b) nurses are frontline care providers via clinical leadership in the management of primary healthcare centers, which ensure universal healthcare coverage; and (c) nurses are first responders via their presence and compassionate caring in the primary healthcare centers, including making critical shifts in converting primary healthcare centers to urgent care centers as needed.

Clinical Relevance

Nursing advancements have implicated quality care and professionalism in Albania across the health professions via three critical pathways: (a) health professional education at a university degree level for entry into practice (since 1999), which was prompted by and driven by nursing’s quest to be a self‐regulated profession (achieved in 2007); (b) healthcare global standards sparked by nursing’s mandate toward professional autonomy, as achieved via regulatory procedures and policies; and (c) interprofessional healthcare initiatives that serve as collaborative platforms for innovative educational, clinical, and research projects.
Non‐surgical rhinoplasty using hyaluronic acid dermal fillers: A systematic review
Authors: Kumar Vaibhav , Jain Anuj , Atre Swarali , Shome Debraj , Kapoor Rinky , Doshi Komal , Vadera Sapna
Published: April 2021

Background

Non‐surgical rhinoplasty using hyaluronic acid dermal fillers is a cosmetic procedure that has been becoming increasingly popular among patients wanting to correct nasal deformities or nasal irregularities, in the recent years.

Aim

This systematic review aims to provide quality evidence about the success of non‐surgical rhinoplasty procedures in terms of patient satisfaction and complications.

Methods

A systematic electronic literature search using keywords and MESH search terms over the PubMed/Medline, Cochrane Central, Scopus, and EBSCO online databases was conducted from November 2005 to February 2021. Additionally, the reference lists of included systematic reviews were hand searched. Data collected included patient satisfaction and complications from prospective and experimental studies providing highest level of evidence. Articles were critically appraised, and MINORS scale was used to assess the risk of bias.

Results

Based on the search criteria, 2896 citations were found. After removing duplicates and screening for relevance, 23 citations were finalized for full‐text review, of which 12 articles were excluded and 11 articles were included in the study. The average satisfaction of patients amongst the studies was found to be >90%. In all the studies, transient edema and erythema, post‐injection pain, and bruising were some temporary complications. Rare complications that were reported were vascular impairments and hematoma.

Conclusions

Non‐surgical rhinoplasty is a good, minimally invasive alternative over conventional rhinoplasty. There is however a paucity of quality data in the form of experimental and prospective studies regarding the accuracy, effectiveness, and complications of non‐surgical rhinoplasty.
Nurses’ perceptions of their role with respect to promoting physical activity in adult patients: a systematic review
Authors: van Hell‐Cromwijk Marlies , Metzelthin Silke F. , Schoonhoven Lisette , Verstraten Carolien , Kroeze Willemieke , de Man van Ginkel Janneke M.
Published: April 2021

Aims and objectives

To identify the nurses’ perceptions of their role with respect to promoting physical activity in adult patients and factors related to this role perceptions.

Background

Ageing and chronic diseases are often accompanied by a decrease in physical activity. Nurses are in an excellent position to promote physical activity, because of their close and frequent interactions with patients. However, they often fail to actively stimulate patients to physical activity due to a lack of time, competing priorities and their focus on acute problems. Unclear was how nurses view their professional role in the promotion of physical activity.

Design

Systematic literature review.

Methods

PubMed, COCHRANE and CINAHL EBSCO were searched for papers published from 2006 to September 2019. Two reviewers independently assessed the methodological quality, using MMAT criteria. Thematic synthesis was used to analyse the data. The PRISMA statement was followed for reporting.

Results

Overall, 10 quantitative, eight qualitative and one mixed methods study were included in the review. Analyses of these studies resulted in six themes: (1) active and professional role; (2) the recognised importance; (3) fear of patient falling; (4) patient's present health and need; (5) interdisciplinary context and responsibility; and (6) nurses’ knowledge.

Conclusions

Nurses perceive they have an active role in the promotion of physical activity and consider it as important and part of their professional role. Clear guidance increased education and stronger awareness of guidelines might enable nurses to translate their perceived role into daily practice. This will enhance professional fulfilment as well as patients’ physical activity.

Relevance to clinical practice

The findings guide the development of interventions that aim to improve nursing care with respect to the promotion of physical activity and help managers and educators to provide appropriate resources and education.
Prevalence of umbilical artery Doppler waveform abnormality during the early second trimester and the subsequent variation of waveforms in monochorionic diamniotic twin pregnancies: A prospective cohort study
Authors: Nakanishi Kentaro , Muto Haruka , Yamamoto Ryo , Kawaguchi Haruna , Hayashi Shusaku , Ishii Keisuke
Published: April 2021

Aim

To investigate the prevalence of qualitative abnormal umbilical artery Doppler waveforms (Abnormal UA) during the early second trimester and the subsequent variation of waveforms in monochorionic diamniotic (MCDA) twin pregnancies.

Methods

This prospective cohort study included 153 MCDA twin pregnancies. Pulsed Doppler examinations for UA were performed at four points, including the free‐loop (FL) and near the placental cord insertion site (CI) of each UA, between 16 and 17 weeks' gestation. Cases were classified into positive diastolic waveforms (Type I), persistent Abnormal UA (Type II), and intermittent Abnormal UA (Type III). When the diastolic velocity in UA Doppler was positive twice after different sequential recordings, the cases were determined to have achieved normalization. Follow‐up Doppler examinations of the UA were performed at 24, 28, and 32 weeks' gestation.

Results

Of all 153 cases, 38 (25%; 19 Type II and 19 Type III cases) showed Abnormal UA at the first examination. Abnormal UA was detectable at FL in all selective intrauterine growth restriction (sIUGR) cases, whereas it was noted only at CI site in some non‐sIUGR cases. Abnormal UA normalized in 12 (63%) Type II and 15 (79%) Type III cases.

Conclusions

A quarter of MCDA twin pregnancies in the early second trimester demonstrated Abnormal UA. In MCDA twins with Abnormal UA between 16 and 17 weeks' gestation, it is preferable to follow them up to consider the possibility of normalization of Abnormal UA as well as features of UA waveforms specific to FL and CI.
Hepatitis B surface antigen kinetics after discontinuation of and retreatment with oral antivirals in non‐cirrhotic HBeAg‐positive chronic hepatitis B
Authors: Chen Hongjie , Ding Xia , Liao Guichan , Xia Muye , Ren Zuning , Fan Rong , Peng Jie
Published: April 2021

The outcome of nucleos(t)ide analogues (NAs) discontinuation and retreatment is still uncertain. We evaluated hepatitis B surface antigen (HBsAg) kinetics after NAs discontinuation and during retreatment due to off‐treatment clinical relapse among non‐cirrhotic HBeAg‐positive CHB patients. Four groups were studied: 129 HBeAg‐positive patients from a prospective cohort who stopped NAs therapy after achieving sustained response (Group A), 39 patients who received retreatment after off‐treatment clinical relapse in the discontinuation group (Group B), 214 patients who maintained treatment after achieving sustained response (Group C) and 291 patients who firstly initiated antiviral treatment (Group D). During a 5‐year follow‐up, the cumulative incidence of HBsAg loss was significantly higher in Group A than Group C (22.3% vs. 1.6%, p < .001). The quantitative HBsAg (qHBsAg) level at enrolment and NAs discontinuation were independently associated with HBsAg loss. Additionally, patients in Group B showed significantly greater HBsAg loss than those in the Groups C and D, with 5‐year cumulative incidences of 9.0%, 1.6% (p = .040) and 0.6% (p < .001), respectively. Moreover, patients in the Group B exhibited better virologic response (100% vs. 98.8%, p < .001) and HBeAg seroconversion (92.6% vs. 69.8%, p < .001) than those in Group D at year 5. Propensity score‐matched analysis also showed the similar trend of HBsAg decline. NAs discontinuation with or without subsequent retreatment resulted in a more profound reduction of HBsAg in non‐cirrhotic HBeAg‐positive patients, suggesting that discontinuation may be a potential cure strategy for those with sustained virological suppression.
Risk‐sensitive benchmarked asset management with expert forecasts
Authors: Davis Mark H.A. , Lleo Sébastien
Published: April 2021

We propose a continuous‐time model in which investors use expert forecasts to construct a benchmark‐outperforming portfolio in two steps. The estimation step takes the form of a Kalman filter. The control step derives the optimal investment policy in closed form and establishes that the value function is the unique classical solution to the Hamilton‐Jacobi‐Bellman partial differential equation. We show that the optimal investment policy generates a continuum of investment strategies, from passive benchmark replication to fully active bets in the Kelly portfolio. However, our model warns against over‐betting on financial markets. Moreover, we find that the Kelly portfolio performs both security selection and factor tilt. A simulation study with market data confirms that factor choice is critical at every stage of the investment process. Finally, debiasing is equally crucial. Portfolios with debiased expert forecasts outperform portfolios with biased forecasts.
Developments of a population‐based prospective cohort study for dementia (the Nakajima study) and an educational program for dementia experts (the NINPRO)
Authors: Yamada Masahito
Published: April 2021

Aging of population is rapidly growing in Japan and all over the world. To overcome problem associated with an increase of older people with dementia, we have conducted a population‐based cohort study for dementia in Nakajima, Ishikawa, Japan (the Nakajima study) since 2006, and an educational program for development of dementia experts (the NINPRO) since 2014. The Nakajima study aimed to develop methods for early detection, prevention, and treatment of dementia; we developed a computerized assessment battery for cognition (C‐ABC) that can detect mild cognitive impairment (MCI) as well as dementia around 5 min and reported usefulness of magnetoencephalography as a tool of detection of early Alzheimer's disease (AD); we explored potentials of dietary polyphenols as preventive and therapeutic agents for AD/dementia leading to clinical trials. The NINPRO has provided activities for learning the basics, clinical practice, and care of dementia using e‐learning lectures and web‐based conferences, and has involved about 2,300 people of medical doctors, nurses, caregivers, and other professionals related to dementia. The Nakajima study and the NINPRO would contribute to improvement of prevention, early detection, medical practice, care, social welfare, and all other aspects of dementia in a super‐aged society in the middle of the 21st century.