bluuebunny/crossref_metadata_2025 huggingface dataset:
The economic effects of rural hospital closures
Authors: Malone Tyler L. , Planey Arrianna Marie , Bozovich Laura B. , Thompson Kristie W. , Holmes George M.
Published: March 2022

Objective

To provide an updated analysis of the economic effects of rural hospital closures.

Study Setting

Our study sample was national in scope and consisted of nonmetro counties from 2001 to 2018.

Study Design

We used a difference‐in‐differences study design to estimate the effect of a hospital closure on county income, population, unemployment, and size of the labor force. Specifically, we compared economic changes over time in nonmetro counties experiencing a hospital closure to changes in a control group of nonmetro counties over the same time period. We also leveraged insight from recent research to control for estimation bias due to heterogeneity in the closure effect over time or across groups defined by when closure was experienced.

Data Extraction

Data on (adjusted gross) annual income (in real dollars), annual population size, and monthly unemployment rate and labor force size were sourced from the Internal Revenue Service, Census Bureau, and Bureau of Labor Statistics, respectively. We used data from the North Carolina Rural Health Research Program to identify counties that experienced a hospital closure.

Principal Findings

Of the 1759 nonmetro counties in our study sample, 109 experienced a hospital closure during the study period. Relative to the nonclosure counterfactual, closures significantly decreased labor force size, on average, by 1.4% (95% CI: [−2.1%, −0.8%]). Results also suggest that Prospective Payment System (PPS) hospital closures significantly decreased population size, on average, by 1.1% (95% CI: [−1.7%, −0.5%]), relative to the nonclosure counterfactual.

Conclusions

Our analysis suggests that rural hospital closures often have adverse effects on local economic outcomes. Importantly, the negative economic effects of closure appear to be strongest following Prospective Payment System hospital closures and attenuated when the closed hospital is converted to another type of health care facility, allowing for the continued provision of services other than inpatient care.
The fluorescent protein iLOV as a reporter for screening of high‐yield production of antimicrobial peptides in Pichia pastoris
Authors: Kjeldsen Annemette , Kay Jack E. , Baxter Scott , McColm Stephen , Serrano‐Amatriain Cristina , Parker Scott , Robb Ellis , Arnold S. Alison , Gilmour Craig , Raper Anna , Robertson Graeme , Fleming Robert , Smith Brian O. , Fotheringham Ian G. , Christie John M. , Magneschi Leonardo
Published: March 2022

The methylotrophic yeast Pichia pastoris is commonly used for the production of recombinant proteins at scale. The identification of an optimally overexpressing strain following transformation can be time and reagent consuming. Fluorescent reporters like GFP have been used to assist identification of superior producers, but their relatively big size, maturation requirements and narrow temperature range restrict their applications. Here, we introduce the use of iLOV, a flavin‐based fluorescent protein, as a fluorescent marker to identify P. pastoris high‐yielding strains easily and rapidly. The use of this fluorescent protein as a fusion partner is exemplified by the production of the antimicrobial peptide NI01, a difficult target to overexpress in its native form. iLOV fluorescence correlated well with protein expression level and copy number of the chromosomally integrated gene. An easy and simple medium‐throughput plate‐based screen directly following transformation is demonstrated for low complexity screening, while a high‐throughput method using fluorescence‐activated cell sorting (FACS) allowed for comprehensive library screening. Both codon optimization of the iLOV_NI01 fusion cassettes and different integration strategies into the P. pastoris genome were tested to produce and isolate a high‐yielding strain. Checking the genetic stability, process reproducibility and following the purification of the active native peptide are eased by visualization of and efficient cleavage from the iLOV reporter. We show that this system can be used for expression and screening of several different antimicrobial peptides recombinantly produced in P. pastoris.
What Determines the Heterogeneous Performance of Special Economic Zones? Evidence from Sub‐Sahara Africa
Authors: Zeng Douglas Zhihua
Published: March 2022

As a policy tool for development, special economic zones (SEZs) are rapidly proliferating globally, mainly due to the new industrialization wave and competition for FDIs. However, their performance is quite mixed. What drives their heterogeneous performance? This paper intends to define a ‘quality framework’ for SEZs based on the key drivers for their success, and validates its effectiveness in a quantitative way through a ‘quality‐performance’ matrix using thirteen SEZ cases in Sub‐Sahara Africa. The research identifies seven key drivers and derives a ‘quality score’ for each zone based on its level at each driver. The score is then used to map with the zone's performance (mainly the jobs and investments in this paper). The regression result shows that the ‘quality’ of a SEZ is highly correlated with its ‘performance’, which provides important empirical evidence for effective SEZ policies. Based on this research, the paper also offers some key policy lessons.
Tripod Missions: Five Principles for Solving Society’s Most Pressing Challenges
Authors: Bach David , Meyer Henning
Published: March 2022

The COVID crisis has forced policymakers to design new and comprehensive rescue programmes under huge time pressure. This task has required innovative policy thinking and the pursuit of new kinds of collaboration. The handling of the pandemic, however, also provides valuable lessons on how to address some of society's other pressing challenges—above all climate change. ‘Tripod Missions’ provide a framework for turning the pandemic's lessons learned into a guide for tackling other major societal problems.
Whole genome sequencing identifies rare genetic variants in familial pancreatic cancer patients
Authors: Tan Ming , Brusgaard Klaus , Gerdes Anne‐Marie , Larsen Martin Jakob , Mortensen Michael Bau , Detlefsen Sönke , de Muckadell Ove B. Schaffalitzky , Joergensen Maiken Thyregod
Published: March 2022

Pancreatic ductal adenocarcinoma (PDAC) represents one of the most lethal malignancies with very high mortality and short survival time. About 5–10% of the PDAC patients have a familial predisposition to the disease designated as familial pancreatic cancer (FPC), suggesting genetic modulation of FPC pathogenesis. It is estimated that currently identified sequence variants account for less than 20% of the genetic basis of FPC leaving the majority of the genetic architecture unclarified. We performed whole genome sequencing (WGS) analysis on benign formalin‐fixed paraffin‐embedded (FFPE) tissues from 35 FPC patients focusing on genes enriched by rare and functional sequence variants. We identified 40 genes hosting at least 2 protein truncating variants (PTVs). Significant overlaps of the 40 genes were found (p < 1 × 10–22) with cancer genes, cancer driver genes and genes found in previous studies on cancer, including ATM, POLE, BRCA2, TYR03, PABPC1 and SSC5D. The PTV genes are significantly overrepresented in biological pathways in cancer development and progression including extracellular matrix organization, signaling by RHO GTPases and RHO GTPase cycle. Association analysis using external controls detected 6 genes with p < 0.05. The WGS analysis revealed high heterogeneity in the detected rare variants among FPC patients and provides novel genes harboring potential mutational hotspots for future validation and replication.
A retrospective study of the behavioural and psychological symptoms of dementia in patients admitted to a Specialist Dementia Care Unit
Authors: Djekovic Kate , Clowes Kim , Spalding Natasha , Waite Louise
Published: March 2022

Objectives

To explore the nature and severity of behavioural and psychological symptoms of dementia (BPSD) and outcomes for patients admitted to a specialist dementia care unit (SDCU) at a tertiary Australian hospital.

Methods

This single‐centre retrospective study categorised patients into a recognised seven‐tiered model of severity of BPSD using a novel tool developed for this study. Descriptive characteristics, pharmacological management, and range and severity of BPSD were examined.

Results

There were 125 patients admitted over a two‐year period reviewed, with 62% being males and a mean age of 82.4 years. Those with high severity BPSD (n = 61, 49%) had a longer length of stay (p = 0.049), were on a greater number of psychotropic medications on admission (p < 0.001) and were more likely to be trialled on a new psychotropic medication (p = 0.001). At least five behaviours on admission were demonstrated in 84% of patients. Behaviours were ameliorated with reduction in tier severity at discharge (p < 0.005). The mean number of psychotropic medications on admission was not significantly different to discharge (p = 0.14). Sixty‐seven per cent of patients living independently at admission were discharged to residential care, and 44% in residential care were discharged to a new facility.

Conclusions

Multi‐disciplinary management led to optimisation of behaviours and overall reduction in BPSD severity. This was achieved without a significant increase in the use of psychotropic medications, highlighting the importance of an individualised approach by a team skilled in the behavioural management of BPSD. The study confirms the high risk of transition to residential care for patients with BPSD.
Review article: paradoxical psoriasis as a consequence of tumour necrosis factor antagonists in patients with inflammatory bowel disease
Authors: Townsend Cassandra Marie , Lovegrove Fiona , Khanna Reena , Wilson Aze Suzanne
Published: March 2022

Background

Tumour necrosis factor (TNF) antagonists are an efficacious therapy used in the management of several immune‐mediated inflammatory diseases, including inflammatory bowel disease (IBD) and psoriasis. However, since being prescribed more widely, reports of new‐onset psoriatic lesions have began to emerge in the literature and are known as paradoxical psoriasis.

Aim

To review the evidence available in both the dermatology and gastroenterology literature pertaining to the entity known as paradoxical psoriasis as it relates to IBD and to create a comprehensive guide to assist clinicians who treat this challenging patient population.

Methods

A literature search was conducted in PubMed to identify manuscripts that presented, discussed or summarised data pertaining to paradoxical psoriasis presenting in individuals with IBD.

Results

Paradoxical psoriasis is now thought to be a contradictory effect of TNF antagonist therapy leading to psoriatic lesions often within the first year of treatment. The underlying pathogenesis, although not completely understood, is likely related to an imbalance of inflammatory cytokines. The histological appearance, while similar to classical psoriasis, does have unique features. The clinical presentation can vary among patients but often presents during maintenance therapy for inflammatory bowel disease. Treatment options should be determined based upon the severity of the skin lesion, activity of the underlying inflammatory bowel disease and the patient’s unique clinical history.

Conclusions

The approach to paradoxical psoriasis in IBD should be discussed with a multidisciplinary team to optimise and preserve intestinal disease remission and to ensure the resolution of debilitating skin lesions.
Laparoendoscopic single‐site surgery for urachal remnant with extraperitoneal approach through a suprapubic port
Authors: Hoshi Akio , Chihara Ichiro , Shiga Masanobu , Nitta Satoshi , Nagumo Yoshiyuki , Sakka Shotaro , Kojo Kosuke , Ikeda Atsushi , Yoshino Takayuki , Kimura Tomokazu , Kawahara Takashi , Kandori Shuya , Negoro Hiromitsu , Nishiyama Hiroyuki
Published: March 2022

Introduction

No standard procedure has been established for laparoendoscopic single‐site surgery for urachal remnants (LESS‐U). This study aimed to report the novel surgical techniques and initial outcomes of laparoendoscopic single‐site surgery with an extraperitoneal approach through a suprapubic port for urachal remnants (spLESS).

Methods

Fifty‐five patients (median age, 27 years; range, 15–69 years) who underwent LESS‐U were analyzed. To overcome the limitations inherent in the conventional procedure (LESS‐U through an umbilical port: uLESS), we modified the port placement and approached via the extraperitoneal space. spLESS is a novel procedure which reduces intestinal damage caused by the extraperitoneal approach and overcomes incomplete resection of the urachal remnant, especially in the bladder dome. Three trocars are inserted into the extraperitoneal space through a suprapubic port in spLESS, and complete resection of the urachal remnant from the umbilicus to the bladder is performed with an appropriate incision line. Patient characteristics and perioperative results were retrospectively collected. Cosmetic outcomes were prospectively evaluated using self‐administered questionnaires (body image and photo‐series questionnaire).

Results

spLESS and uLESS were performed in 43 and 12 patients, respectively. No differences were observed between the perioperative results. The cosmetic outcomes were compared between the groups using body image and photo‐series questionnaires. No patient developed major complications; there was no recurrence in either group.

Conclusions

spLESS is a novel procedure which can completely resect the urachal remnant and reduce the risk of intestinal damage. spLESS is a safe, effective, and feasible procedure with high postoperative cosmesis.
Ground‐penetrating radar (GPR) investigations of a large‐scale buried ice‐marginal landsystem, Skeiðarársandur, SE Iceland
Authors: Harrison Devin , Ross Neil , Russell Andrew J. , Jones Stuart J.
Published: March 2022

The sedimentary record of Icelandic ice‐contact environments provides critical insights into past glacier margin dynamics and position, relative sea level, and the geomorphic processes that drive the evolution of proglacial environments. This important archive has been little exploited, however, with most glacier and sea‐level reconstructions based on limited sedimentary exposures, coring and surface geomorphic evidence. We report an extensive (42 km of data within a 24‐km2 study area) and deep (reflections recorded at depths up to 100 m) low‐frequency (40 and 100 MHz) ground‐penetrating radar (GPR) survey of the Sandgígur moraines, SE Iceland. GPR profiles reveal a much larger (67 m high) and extensive (1.25 km wide) buried moraine ridge than that suggested by surface topography (typically 125 m wide and 7 m high). These data reveal that the Sandgígur moraines was deposited during a major Holocene re‐advance of Skeiðarárjökull. The moraine ridge is buried by sediments dominated by glacifluvial deposits with an estimated sediment volume of 1.04 km3. We combine GPR‐derived subsurface architecture and the surface morphology to develop a conceptual model detailing the geomorphic evolution of the moraine and surrounding region. These results provide new insights into the Holocene evolution of Skeiðarársandur, identifying the presence of a former major ice‐margin position, as well as a past relative sea‐level limit. Furthermore, we establish that sediment supply and available terrestrial accommodation space are dominant drivers in the formation and evolution of vast sandar environments.
Hurricane‐associated population decrease in a critically endangered long‐lived reptile
Authors: van den Burg Matthijs P. , Madden Hannah , van Wagensveld Timothy P. , Boman Erik
Published: March 2022

Catastrophic events, like hurricanes, bring lethal conditions that can have population‐altering effects. The threatened Caribbean dry forest occurs in a region known for its high‐intensity hurricane seasons and high species endemism, highlighting the need to better understand hurricane impacts in combination with habitat fragmentation and loss. However, such studies remain rare and for reptiles are mostly restricted to Anolis. Here, we used single‐season occupancy modeling to infer the impact of the intense 2017 Atlantic hurricane season on the critically endangered Lesser Antillean Iguana, Iguana delicatissima. We surveyed 30 transects across eight habitats on St. Eustatius during 2017–2019, which resulted in 344 individual surveys and 98 iguana observations. Analyses of abundance and site occupancy indicated both measures for 2018 and 2019 were strongly reduced compared to the pre‐hurricane 2017 state. Iguanas at higher elevations were affected more profoundly, likely due to higher wind speeds, tree damage, and extensive defoliation. Overall, our results indicate a decrease in population estimates (23.3%–26.5%) and abundance (22%–23.8%) for 2018 and 2019, and a 75% reduction in opportunistic sightings of tagged iguanas between 2017 and 2018. As only small and isolated I. delicatissima populations remain, our study further demonstrates their vulnerability to stochastic events. Considering the frequency and intensity of hurricanes are projected to increase, our results stress the urgent need for population‐increasing conservation actions in order to secure the long‐term survival of I. delicatissima throughout its range. Given the projected increase and poleward shift of hurricanes, our study provides important insights from a non‐model species.
In silico design of a novel nucleotide antiviral agent by free energy perturbation
Authors: Patel Dharmeshkumar , Cox Bryan D. , Kasthuri Mahesh , Mengshetti Seema , Bassit Leda , Verma Kiran , Ollinger‐Russell Olivia , Amblard Franck , Schinazi Raymond F.
Published: March 2022

Nucleoside analogs are the backbone of antiviral therapies. Drugs from this class undergo processing by host or viral kinases to form the active nucleoside triphosphate species that selectively inhibits the viral polymerase. It is the central hypothesis that the nucleoside triphosphate analog must be a favorable substrate for the viral polymerase and the nucleoside precursor must be a satisfactory substrate for the host kinases to inhibit viral replication. Herein, free energy perturbation (FEP) was used to predict substrate affinity for both host and viral enzymes. Several uridine 5’‐monophosphate prodrug analogs known to inhibit hepatitis C virus (HCV) were utilized in this study to validate the use of FEP. Binding free energies to the host monophosphate kinase and viral RNA‐dependent RNA polymerase (RdRp) were calculated for methyl‐substituted uridine analogs. The 2’‐C‐methyl‐uridine and 4’‐C‐methyl‐uridine scaffolds delivered favorable substrate binding to the host kinase and HCV RdRp that were consistent with results from cellular antiviral activity in support of our new approach. In a prospective evaluation, FEP results suggest that 2’‐C‐dimethyl‐uridine scaffold delivered favorable monophosphate and triphosphate substrates for both host kinase and HCV RdRp, respectively. Novel 2’‐C‐dimethyl‐uridine monophosphate prodrug was synthesized and exhibited sub‐micromolar inhibition of HCV replication. Using this novel approach, we demonstrated for the first time that nucleoside analogs can be rationally designed that meet the multi‐target requirements for antiviral activity.
Parent's self‐reported tooth brushing and use of fluoridated toothpaste: Associations with their one‐year‐old child's preventive oral health behaviour
Authors: Suokko Hanna , Tolvanen Mimmi , Virtanen Jorma , Suominen Auli , Karlsson Linnea , Karlsson Hasse , Lahti Satu
Published: March 2022

Objective

The aim of the study was to examine if the tooth brushing frequency and use of fluoridated toothpaste of the mother and father were associated with the tooth brushing frequency and use of fluoridated toothpaste for their 1‐year‐old child.

Methods

This cross‐sectional study is part of the FinnBrain Birth Cohort Study. Questionnaire data were obtained from 1672 mothers and 867 fathers on tooth brushing and use of fluoridated toothpaste, age, education, number of siblings and parity (when the child was 1‐year‐old). For 763 families (mother and father), data from both parents were available. Tooth brushing was dichotomized to at least twice daily (2× day) and less than 2× day, and use of fluoridated toothpaste for child to at least once daily and less than once daily. The association between brushing of child's teeth (both parents less than 2× day) and use of fluoridated toothpaste for the child (both parents less than once daily) with parent's own tooth brushing was modelled with logistic regression analyses adjusted for family‐related variables (parents' age and education, number of older siblings) using odds ratios (OR) and 95% confidence intervals (CI).

Results

Families in which both parents brushed their own teeth less than 2× day were more likely to brush their child's teeth less than 2× day than families in which both parents brushed their own teeth 2× day (OR = 9.23; 95%CI = 5.42–15.69). The likelihood of not brushing the child's teeth 2× day was less strong when at least one of the parents brushed his/her own teeth 2× day (mother 2× day: OR = 1.97; 95%CI = 1.25–3.10; father 2× day: OR = 2.85; 95%CI = 1.51–5.40).

Conclusions

Less frequent tooth brushing of both mothers and fathers was strongly associated with less frequent tooth brushing of their child. When educating parents on child oral home care, parents' own home care and inclusion of fathers also need more attention.
I have to hold it together: Trauma in law enforcement couples
Authors: Campbell Avery R. , Landers Ashley L. , Jackson Jeffrey B.
Published: March 2022

Objective

Grounded in secondary traumatic stress theory, this study explored the impact of work‐related traumatic stress on law enforcement couples.

Background

Studies exploring the impact of traumatic stress on law enforcement couples are limited. Such studies suggest that when traumatic stress impacts law enforcement professionals, their spouses often experience secondary traumatic stress and serve in a supportive role after trauma exposure.

Method

Semistructured dyadic interviews were conducted with law enforcement couples (N = seven couples, 14 participants) using transcendental phenomenology.

Results

Three themes emerged within the data that captured the essence of law enforcement couples' experiences of traumatic stress: (a) the stressful nature of the law enforcement profession, (b) the impact of work‐related traumatic stress on the couple relationship, and (c) protective factors and resilient coping characteristics.

Conclusion

The impact of work‐related traumatic stress manifested in couple's communication, role responsibilities and parenting, and commitment to the relationship and the profession. The impact of work‐related traumatic events differed for the law enforcement professional and their spouse based on the type of traumatic event. Overall, work‐related traumatic stress led couples to engage in a meaning‐making process and activation of resilient couple coping characteristics.

Implications

Given the significant impact that work‐related traumatic stress has on the law enforcement couple dyad, couple and family therapy services are needed for law enforcement professionals and their spouses. Couple and family therapists, family researchers, and other professionals working to promote healthy couple and family relationships should inquire about how couples adapt to traumatic stress and reinforce use of resilient coping characteristics.
Numerical Modeling of Head Losses in Different Types of Well Screens
Authors: Bayer‐Raich Martí , Jordana Salvador , Jaime Oscar M. , Lynch Timothy D. , McGillicuddy Kevin B. , Guimerà Jordi , Jaime M. Javier
Published: March 2022

Quantifying total well loss through well screens has been traditionally undertaken through experimentally based empirical equations or equations derived for water flow through (circular) orifices. Advances in computer capacity enables incorporation of CFD formulations at millimeter scale, coupling Darcy flow and Reynolds Averaged Navier Stokes (RANS) to better understand and quantify processes related to well loss for different screen types. This study provides a methodology of quantifying well screen head loss using numerical models, coupling Darcy flow (aquifer and filter/gravel pack) with turbulent flow (in‐well and through screen) at a sub‐millimeter scale. Results are used to compare performance of four different types of well screens (Louver, slotted, bridge and wire wrap) and their overall impact and contribution to total well head loss for different slot apertures, pumping rates and hydraulic conductivity of the filter/gravel pack providing a new empirical formulation to quantify screen head loss.
Eosinophilic angiocentric fibrosis and immunoglobulin 4‐related disease revisited
Authors: Chew Edwin Jun Chen , Lee Ming‐Han Hugo , Chung Hsi‐Wei , Tang Po Yin
Published: March 2022

Eosinophilic angiocentric fibrosis (EAF) has been postulated to lie on the spectrum of IgG4‐related disease (IgG4‐RD) in a study reported in 2011. However, the aetiology of EAF remains controversial, despite increasing literature reporting IgG4‐RD targeted investigations in those studies. This review aims to formally evaluate the relationship between EAF and IgG4‐RD using the latest 2019 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification scheme for IgG4‐RD. A literature search was performed on the PubMed database for all studies describing patients diagnosed with EAF. Additionally, two EAF cases were retrospectively identified from our institution and presented. The demographics, clinical presentation, histological and serological data of each patient were analysed. A total of 20 cases were evaluated, including 18 patients from 14 articles in the English literature and two cases from our institution. Six of 20 (30%) patients with EAF met the criteria for IgG4‐RD with the 2019 ACR/EULAR classification scheme. This represents the first attempt at formally evaluating the relationship between EAF and IgG4‐RD using a validated set of classification criteria. Using the currently available data, a small proportion of patients with EAF met the criteria for IgG4‐RD. However, various limitations of this study suggest that further efforts at disease characterization of EAF may be required.
Antiretroviral drug switches to zidovudine‐based regimens and loss to follow‐up during the first COVID‐19 lockdown in Bali, Indonesia
Authors: Gedela Keerti , Rajus Ngurah , Luis Hendry , Fridayantara Wayan Dede , Irwanto Irwanto , Sukmaningrum Evi , Wignall Frank Stephen
Published: March 2022

Objectives

International lockdowns during the COVID‐19 pandemic impacted antiretroviral drug supplies in Indonesia. We assessed the impact of antiretroviral treatment (ART) provision and being lost to follow‐up (LTFU) on people living with HIV, attending a key population‐focused HIV clinic in Denpasar, Bali.

Methods

This was a retrospective note review of anonymized data from adult Indonesian patients living with HIV. We collected demographic data and information on being LTFU, and assessed the numbers of patients impacted by ART switches from fixed‐dose combination (FDC) tenofovir/lamivudine/efavirenz to multi‐pill zidovudine‐based regimens, during the first international lockdown from March 2020.

Results

Records of 260 Indonesian adult patients registered for HIV care and prescribed ART were reviewed; 240 (92.3%) were men, and 90% were men who have sex with men. Between 13 March and 28 May 2020, 214 (87%) out of 247 patients (previously diagnosed with HIV) had to switch to individual, multi‐pill zidovudine‐based regimens from their FDC. The switch lasted a mean of 35 days (range 10–85). Twenty‐five patients (10%) were LTFU; patients who switched were more likely to remain in care. Data on viral load status and toxicity are lacking as laboratory testing requires self‐payment.

Conclusions

The majority of patients living with HIV had no choice but to switch to multi‐pill, zidovudine‐based regimens.

Despite significant efforts to minimize the impact of lockdown on care, 10% of patients were LTFU. Patients switching ART required greater clinic attention and support, improving retention.

Complete national data are needed to understand the impact of ART stockouts on virological suppression and drug resistance throughout Indonesia.
Soybean extruded by‐products as substrate for obtaining food ingredients containing probiotics
Authors: Castellanos‐Fuentes Adriana P. , Cortés Nazareno , Genevois Carolina E. , Flores Silvia K. , de Escalada Pla Marina F.
Published: March 2022

Extruded expeller meal (EEM) was widely used for feed production, but few exploited it as a food ingredient. Solid‐state fermentation (SSF) was applied for obtaining food ingredients (FI) based on EEM containing Lacticaseibacillus casei. The FI were characterised physicochemically and functionally. The effect of the SSF on these characteristics as well as the effect of the expeller matrix on the survival capacity of L. casei in in vitro gastrointestinal digestion and on epithelial adhesion were analysed. In general, the SSF process did not produce significant changes on the nutritional and functional properties studied. Probiotic cells supported in the FI were stable for 42 days showing >106 log (CFU g−1) viable probiotic microorganisms. More than 60% of them survived to gastrointestinal simulated conditions. Expeller matrix interfered the adhesion of L. casei with the epithelium. The FI could be incorporated to a porridge for improving the nutritional profile and providing functionality.
Rapidly progressive crescentic diabetic nephropathy: two case reports
Authors: Schroers Jade E. , Gilbert Alexander M. , McKenzie Paul R. , Kirwan Paul D. , Chadban Steven J. , Ying Tracey
Published: March 2022

Crescents are not a well recognised feature of diabetic nephropathy. We present two cases of patients presenting with a rapid decline in renal function and subacute onset of nephrotic syndrome. Glomerulonephritis screening was negative, and renal biopsy revealed non‐necrotising cellular crescents and typical features of late‐stage diabetic nephropathy. We review the literature for diabetic nephropathy with crescents and explore possible underlying mechanisms.
Real‐world experience with limited screening for occult malignancy in patients presenting with spontaneous venous thromboembolism: a single‐centre, retrospective cohort study
Authors: Grainger Brian T. , McCrea Te Apatuoterangi , Eaddy Nicola , Ockelford Paul , Young Laura
Published: March 2022

Spontaneous venous thromboembolism (VTE) may represent the first manifestation of previously undiagnosed malignancy; however, contemporary international guidelines call for a limited approach to screening for malignancy in such patients. This retrospective cohort study of 328 patients presenting to the Auckland City Hospital Thrombosis Unit identified 17 patients who were subsequently diagnosed with some form of malignancy within 12 months of their presentation. Review of their history, physical examination and limited age and gender‐appropriate cancer screening investigations as described by the National Institute for Clinical Excellence and International Society of Thrombosis and Haemostasis guidelines revealed that all 17 would have been safely diagnosed by the ‘limited’ screening approach endorsed by these guidelines, thus presenting a ‘real‐world’ basis for clinicians to pursue ‘limited’ screening for malignancy in their everyday practice in patients with spontaneous VTE.
Mixed gender accommodation: prevalence, trend over time and vulnerability of older adults
Authors: Towns Cindy R. , Rowley Natalie , Woods Lisa
Published: March 2022

Admitting male and female patients to the same room compromises the safety of female patients and violates the rights of all patients. We demonstrate that mixed bedding is common (47.22% of admissions), increasing and disproportionately affects vulnerable older patients in a large New Zealand hospital from 2011 to 2019 (n = 160 048). Eliminating mixed bedding should be a priority for our hospital system.
Self‐efficacy, burnout and academic success in nursing students: A counterfactual mediation analysis
Authors: Bulfone Giampiera , Iovino Paolo , Mazzotta Rocco , Sebastian Michael , Macale Loreana , Sili Alessandro , Vellone Ercole , Alvaro Rosaria
Published: March 2022

Aim

To test the mediating role of burnout in the relationship between self‐efficacy and academic success in nursing students.

Design

This was a cross‐sectional secondary analysis of longitudinal research aimed at exploring the academic success of nursing students.

Methods

We enrolled a convenience sample of nursing students attending 21 Italian baccalaureate nursing degree programmes. Data were collected from 2014 to the 2018–2019 academic year. We analysed the wave of data collected during the third year of the programme. The measurements were the Academic Nurse Self‐Efficacy scale (ANSEs) and the Scale of Work Burnout (SWEBO). A mediation analysis with a counterfactual approach was performed.

Results

The participants (n = 556) had a median age of 20 years (IQR 19–22) and the majority was female [70.5% (392/556)]. Academic success was reached by 51.97% (289/556) of the students. The findings reveal a significant direct effect of self‐efficacy on academic success and also a significant indirect effect of this relationship via burnout.

Conclusion

The mechanism by which self‐efficacy influences academic performance in nursing students is more complex than a simple direct relationship. Universities should consider screening students for variables affecting academic success to decrease academic costs and increase ranking systems classification.

Impact

Nurses' professors should be engaged in strategies to promote self‐efficacy. The area of intervention should be structured both during classes and internships, in tandem with the mentor and the clinical nurse.
Diversification and divergence of rainforest woody plants in South India and Madagascar relate to geomorphological history
Authors: Barthelemy Elizabeth , Ranaivosoa Rija Mamitiana Olivier , Zoelinirina Nofy Khristiane , Munoz François
Published: March 2022

Aim

Indian and Malagasy tropical rainforests share a common history that dates back to the fragmentation of Gondwana. We partitioned phylogenetic diversity across historical periods to uncover how such continental displacement led to the divergence of lineages, through vicariance and/or independent migration from other regions, influencing extant phylogenetic composition.

Location

Madagascar and South India (Western Ghats).

Taxon

Woody vascular plants (tracheophytes).

Methods

Using a time‐calibrated megaphylogeny, we partitioned the phylogenetic diversity of Indian and Malagasy tropical rainforest assemblages, across evolutionary periods defined based on milestone events in these regions of geological history. We decomposed the relative proportion of lineages with extant representatives in each area as well as in both areas, to quantify the common and separate biogeographical legacies in the two regions. We identified an excess or deficit of shared and unique lineages for each period and region.

Results

The proportion of shared lineages between Madagascar and India progressively decreased following the successive breakoff and isolation of Madagascar from the Indian‐Malagasy plate. Lineages unique to India are more numerous than expected at random in more recent time periods, whereas, lineages unique to Madagascar were significantly more present in older time periods.

Main conclusions

The flora of Madagascar harbours a greater number of ancient lineages than does the Western Ghats, consistent with the higher number of endemic families and genera of trees in Madagascar. More recent diversification in India could be related to the collision of India with Eurasia, which enabled subsequent biological interchanges.
Innovation and labor in the port industry: A comparison between Genoa and Antwerp
Authors: Bottalico Andrea , Vanelslander Thierry , Verhoeven Patrick
Published: March 2022

With the advancement of innovation initiatives in the port industry, port labor has fundamentally changed in terms of new tasks, skills required, professional profiles, training, employment relations, work organization, and number of jobs. Current literature often focuses more on the assessment of investments in this particular sector rather than on the evaluation of innovative processes and the interaction with employment issues. In this article, the authors assess the relationship between innovation and employment in the port industry by comparing two distinct case studies—the ports of Antwerp and Genoa—which are characterized by partially common features and different socio‐institutional contexts. Based on qualitative research conducted between 2016 and 2019, the comparative study finds that incremental innovative solutions produce a polarized port labor market in both cases, as previous studies assess. Nevertheless, the findings show that, in the case of Antwerp, a mediated and structured bargaining system interacts positively with employment issues and incremental innovative solutions, while in the case of Genoa, a disarticulated and less structured context reflects a weaker ability to influence virtuously the intertwine between innovation and employment.
Editorial: The times they are a‐changin’: paradigm shifts in child and adolescent psychology and psychiatry
Authors: Jaffee Sara R.
Published: March 2022

The world is a different place than it was more than 2 years ago, at the start of the COVID‐19 pandemic. The times are always changing, but events of the recent past have radically shifted how we work, when and how we interact with each other, and how we understand our history. The papers in the current issue echo this spirit of change, challenging us to fundamentally re‐think how we conceptualize psychopathology, where we define boundaries between ‘normal’ and ‘abnormal’ (and, who gets to define those boundaries), and whether our current conceptual models are generalizable to ever more diverse groups. These challenges represent healthy and timely critiques of dominant paradigms. Collectively, the authors who contributed to the current Annual Research Review make the case that these new frameworks will have big pay‐offs in terms of improving clinical practice and policy.
Shelf life estimation of glassy confections using moisture sorption isotherms
Authors: Macuglia Spanemberg Flavio E. , Sellitto Miguel Afonso , Mailan Porto Luana , Cruz dos Santos Amanda , Canez Lemos Souza Álex
Published: March 2022

This study aimed to develop a mathematical model of moisture diffusion applied to estimate the shelf life of glassy confection. The model was applied and validated on hard candies produced on an industrial scale at temperatures of 20 and 25°C. The results of the predicted and experimental shelf life at 20°C and 75.5% RH were 41 and 39 days respectively. At 25°C and 75.3% RH, it was 24 and 23 days, respectively. The model proved to be reliable for estimating shelf life, with a low percent relative error. At both temperatures, the model proved to be reliable for predicting moisture content as a function of time with R2 values close to the unit and mean percentage absolute error less than 10%. The method is practical and low cost and can be easily reproduced in future studies of stability in the confectionery industry.

Practical Applications

The problem of the stickiness of glassy confectionery on the packaging impacts consumer complaints, returns, and environmental impacts. The model applied in this study can be used as a basis for the development of practical and low‐cost methods for estimating expiration dates and shelf life in future studies of stability in the confectionery industry.
The miR166 mediated regulatory module controls plant height by regulating gibberellic acid biosynthesis and catabolism in soybean
Authors: Zhao Chen , Ma Jingjing , Zhang Yaohua , Yang Suxin , Feng Xianzhong , Yan Jun
Published: March 2022

MicroRNAs (miRNAs) are endogenous small non‐coding RNAs that play critical roles in regulating plant growth and development. Here, we used Short Tandem Target Mimic (STTM) technology to generate soybean (Glycine max (L.) Merr.) miRNA knockdown lines and identify miRNAs that regulate plant height, a key agronomic trait that affects yield. STTM166 successfully silenced miR166 in soybean and upregulated the expression of miR166 target genes, such as ATHB14‐LIKE. The miR166 knockdown lines (GmSTTM166) displayed a reduced plant height phenotype. Moreover, GmSTTM166 plants contained lower levels of bioactive gibberellic acid (GA3) than wild‐type plants, and application of exogenous GA partially rescued the dwarf phenotype of GmSTTM166. Knockdown of miR166 altered the expression of genes involved in GA biosynthesis and catabolism. Further analysis revealed that ATHB14‐LIKE directly represses transcription of the GA biosynthesis genes GmGA1 and GmGA2, while activating transcription of the GA catabolic gene GIBBERLLIN 2 OXIDASE 2 (GmGA2ox2). Collectively, these results reveal a pivotal role for miR166 in the genetic control of plant height in soybean, thereby providing invaluable insights for molecular breeding to improve soybean yield.
Implant‐Abutment Discrepancy Before and After Acrylic Resin Veneering of Complete‐Arch Titanium Frameworks Manufactured Using Milling and Electron Beam Melting Technologies
Authors: Revilla‐León Marta , Pérez‐López Javier , Barmak Abdul B. , Raigrodski Ariel J. , Rubenstein Jeffrey , Galluci German O.
Published: March 2022

Purpose

To assess the implant‐abutment discrepancy of complete‐arch frameworks manufactured using milling and additive electron beam melting (EBM) technologies, before and after acrylic resin veneering application.

Materials and Methods

A definitive implant cast with six implant replicas was digitized using a laboratory scanner. A software program was used to design an implant‐supported framework which was manufactured using milling (M group) and EBM (EBM group) technologies (n = 10). In the M group, titanium milled specimens were fabricated. In the EBM group, titanium EBM specimens were obtained. A coordinate measurement machine (CMM) was used to assess the implant‐abutment discrepancy at x‐, y‐, and z‐axed between the specimens and the implant‐abutment replicas of the definitive cast. The implant replicas positioned on the lateral incisor positions were not able to be assessed. The 3D gap discrepancy was calculated: . Acrylic resin veneering procedures were finished and the same CMM measurements were completed. Three‐way analysis of variance (ANOVA) test was used to analyze the data (α = 0.05).

Results

The manufacturing method (df = 1, F = 7.00, p = 0.009) and implant position (df = 3, F = 129.82, p < 0.001) were significant predictors of the x‐axis discrepancy. The veneering procedures (df = 1, F = 21.55, p < 0.001) and implant position (df = 3, F = 95.42, p < 0.001) were significant predictors of the y‐axis discrepancy. The manufacturing method (df = 1, F = 11.79, p = 0.001) was a significant predictor of the z‐axis discrepancy. Lastly, the manufacturing method (df = 1, F = 5.11, p = 0.026), implant position (df = 3, F = 11.36, p < 0.001), and veneering procedures (df = 1, F = 41.56, p < 0.001) were significant predictors of the 3D gap discrepancy in which the manufacturing method explains the 2.37% of variation in the 3D gap discrepancy, the implant position explains the 15.82% of variation in the 3D gap discrepancy, and veneering procedures explain the 19.29% of variation in the 3D gap discrepancy results.

Conclusions

The manufacturing methods, veneering procedures, and implant position influenced the linear implant‐abutment discrepancy. The milled technique tested obtained lower linear implant‐abutment discrepancy compared with the EBM method evaluated. The acrylic resin veneering procedures increased the implant‐abutment discrepancy.
Accuracy of Dental and Industrial 3D Printers
Authors: Anadioti Eva , Kane Brittany , Zhang Yu , Bergler Michael , Mante Francis , Blatz Markus B.
Published: March 2022

Purpose

This in vitro study evaluated the dimensional accuracy of three 3D printers and one milling machine with their respective polymeric materials using a simplified geometrical model.

Materials and methods

A simplified computer‐aided design (CAD) model was created. The test samples were fabricated with three 3D printers: a dental desktop stereolithography (SLA) printer, an industrial SLA printer, and an industrial fused deposition modeling (FDM) printer, as well as a 5‐axis milling machine. One polymer material was used per industrial printer and milling machine while two materials were used with the dental printer for a total of five study groups. Test specimens were then digitized using a laboratory scanner. The virtual outer caliper method was used to measure the linear dimensions of the digitized 3D printed and milled specimens in x‐, y‐, and z‐axes, and compare them to the known values of the CAD model. Data were analyzed with Kruskal‐Wallis one‐way ANOVA on Ranks followed by the Tukey's test.

Results

Milled specimens were not significantly different from the CAD model in any dimension (p > 0.05). All 3D printed specimens were significantly different from the CAD model in all dimensions (p = 0.01), except the dental SLA 3D printer with one of the polymers tested (Bis‐GMA) which was not significantly different in two (x and z) dimensions (p = 0.4 and p = 0.12).

Conclusions

The milling technology tested provided greater dimensional accuracy than the selected 3D printing. Printer, printing technology, and material selection affected the accuracy of the printed model.
Additively Manufactured Surgical Implant Guides: A Review
Authors: Elliott Tom , Hamilton Adam , Griseto Neil , Gallucci German O
Published: March 2022

Static computer assisted implant surgery (s‐CAIS) is an integral part of the digital workflow in implant dentistry and provides the link between the virtual planning environment and surgical field. The accuracy of s‐CAIS is influenced by many cumulative factors including the fit of the template which is related to the manufacturing process. This critical review provides an overview of the current research on additively manufactured surgical implant guides.
School Disengagement, School‐Age Births and High School Graduation: Evidence From Linked Administrative Records
Authors: Heiland Frank , Yunzal‐Butler Cristina , Korenman Sanders
Published: March 2022

BACKGROUND

Failure to complete secondary education often results from a process of educational disengagement. Studies of teen childbearing and high school completion have not adequately accounted for the role of school disengagement prior to conception and may overestimate causal impacts of teen childbearing.

METHODS

We link New York City birth and school records to study a cohort of 22,484 Black and Latina public school students. We measure disengagement with monthly absences from age 12 until the month before conception and identify five preconception attendance trajectories using group‐based trajectory modeling.

RESULTS

Preconception absenteeism can account for as much as half the deficit in high school completion associated with a teen birth. This finding is robust to statistical approaches, such as school fixed effects and inverse‐probability‐weighted regression adjustment.

CONCLUSIONS

Our results suggest that programs intending to increase educational attainment among young women should emphasize attendance and engagement, rather than primarily teenage pregnancy prevention.