bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of a quantitative PCR‐based method for studying temporal DNA degradation in waterlogged bone
Authors: Thornton Isis , Cartozzo Claire , Mays D’Arcy , Singh Baneshwar , Simmons Tal
Published: December 2020

While several studies have examined temporal DNA degradation in bones collected from terrestrial environments, studies on temporal DNA degradation in bones collected from aquatic environments are limited and mostly based on case studies. The objective of this study was to assess the impact of long‐term submersion, aquatic environment, bone type and DNA extraction method on DNA quality and quantity. Bone samples (scapulae and ribs), collected every ~1000 ADD from a freshwater lake and river, underwent DNA extraction via ChargeSwitch® gDNA Plant Kit and organic phenol–chloroform methods, and DNA quantitation using both TaqMan and SYBR Green‐based quantitative PCR (qPCR) methods. Results suggest that in both bone types, quality of recovered DNA (i.e., degradation index) declined significantly with increase in submersion time. Among two bone types, quality of recovered DNA from scapulae declined faster than rib samples. There was no significant difference in recovered DNA quantity between bone types, DNA extraction methods, or locations but various interactions between these variables showed significant difference. Overall, it can be concluded that DNA can be extracted from waterlogged bone in sufficient quantity to generate an STR profile up to 4000 ADD.
A quasi‐experimental pilot study to the effects of Responsive Aggression Regulation Therapy (Re‐ART) Outpatient for young adults
Authors: Hoogsteder Larissa M. , Schippers Eveline E. , Sweers Nienke , Stams Geert Jan J.M.
Published: December 2020

It is important to provide treatment for juvenile and young adult violent offenders, since no or (too) late treatment increases the risk of recidivism and persistent aggressive behavior in adulthood. In this study, we investigated the efficacy of the intervention Responsive Aggression Regulation Therapy (Re‐ART) Outpatient, which has been developed for adolescents and young adults between 16 and 24 years old with severe aggression problems. This quasi‐experimental (pilot) study compared the effects of Re‐ART Outpatient (n = 47) with a control group (n = 29) receiving treatment as usual on measures regarding risk of violent recidivism, impulsivity, emotional/personal functioning, family functioning, motivation, handling anger, self‐reported problem behavior, coping skills, and cognitive distortions. Re‐ART showed significantly better results than the control group on risk of violent recidivism, impulsivity, emotional/personal functioning, motivation, handling anger, certain coping skills, and certain cognitive distortions. Family functioning and self‐reported rule‐breaking behavior did not differ significantly between the groups. The results implicate that Re‐ART is a promising outpatient intervention for young adults with severe aggressive behavior. The results can be explained by the fact that Re‐ART treats both systemically and individually and pays specific attention to stress reduction and the improvement of executive functions.
Lineage diversification and niche evolution in the Reeves’ Butterfly Lizard Leiolepis reevesii (Agamidae)
Authors: ZHU Xiaming , HUA Lei , FANG Mengchao , DU Yu , LIN Chixian , LIN Longhui , JI Xiang
Published: December 2020

We used mitochondrial cytochrome b and ND4 genes and 9 microsatellite loci to determine genetic diversity, population structure, evolutionary history, and migration patterns within the Reeves’ butterfly lizard Leiolepis reevesii (Agamidae). Considering molecular‐based phylogeographical lineages, we then performed niche equivalency and similarity tests between divergent lineages. Phylogenetic analyses based on mitochondrial DNA (mtDNA) data revealed 2 lineages (A and B) diverging ≈0.84 million years ago and, respectively, restricted to the northern and southern portions of the Wuzhishan and Yinggeling mountain ranges. Lineage B contains individuals from southern Hainan; Lineage A includes individuals from all other localities and can be further divided into 3 clusters according to microsatellite data. The null hypothesis that the 2 lineages shared identical niches was rejected in all niche equivalency tests, indicating niche shifts during genetic divergence. Similarity tests provided evidence of niche conservatism, suggesting that the 2 lineages share more characteristics of their niche spaces than randomly expected. The niche similarity and equivalency tests indicated a complex niche pattern in which both lineages share a main portion of their ecological spaces. The climatic niche of Lineage B represented a marginal and specialized fraction of the entire ecological space of the climatic niche of Lineage A, with warmer conditions. Isolation caused by orogenesis and subsequent niche divergence, together with local adaptation, may have led to genetic differentiation and further lineage sorting in L. reevesii.
Gross anatomical, computed tomographic and magnetic resonance imaging study of the metacarpo/metatarsophalangeal joint in Egyptian buffalo(Bubalus bubalis)
Authors: Abdel Maksoud Mohamed K. M.
Published: December 2020

The current study aimed to describe the normal gross anatomy, computed tomography (CT) and magnetic resonance imaging (MRI) of the metacarpo/metatarsophalangeal (MCP/MTP) joint in Egyptian buffalo, and to determine the site of intra‐articular injection of this joint. This study was conducted on eighteen fresh cadaveric distal limbs of healthy Egyptian buffaloes. Six cadaveric MCP/MTP joints were freshly dissected for studying their normal morphological features and determination of the suitable site for intra‐articular injection. Another twelve MCP/MTP joints were imaged using a 16‐slice CT scanner and a 1.5 Tesla MRI scanner, injected with coloured latex and then sectioned into dorsal, sagittal and transverse slices. The articular surface, joint cavity, ligaments and surrounding tendons of the MCP/MTP joint were identified and briefly described. CT and MRI provided identification of the bony and soft tissue structures of the MCP/MTP joint with variable signal intensities. The present study provided a brief description of the normal gross anatomy of MCP/MTP joint in buffalo to serve as a reference for the evaluation of CT and MRI images, which in turn could enable the veterinary clinicians in interpretation of the clinical diseases in this joint.
Macroanatomic, light and scanning electron microscopic structure of the pecten oculi in northern bald ibis (Geronticus eremita)
Authors: Yilmaz Bestami , Demircioglu Ismail , Korkmaz Deniz , Alan Aydın , Yilmaz Rahsan , Ciris Abdulkadir
Published: December 2020

Eyes are the most primarily required sensory organs during the migration of migratory birds and Northern Bald Ibises (Geronticus eremita) are known to make long migrations. This study examined for the first time the structure of pecten oculi in northern bald ibises by using macroscopic anatomy as well as light and electron microscopic methods. In the study 20 eye globes from 10 adult bald ibises were used. The pecten was of pleated type. As in most bird species, it was located on the optic nerve head and projects into the vitreous from the optic nerve head. The wider basal part was observed to attached to retina and its free apical part was found in camera vitrea bulbi embedded in corpus vitreum. The pecten had 13–14 accordion like pleats lying between the basal and apical parts. In addition to arterial and venous vessels, numerous capillary vessels as well as melanocytes were observed within each pleat. The bridge binding the pleats at the apical part showed a stronger pigmentation compared to other parts of the pecten. The results of the study indicated that the general morphology of pecten oculi in northern bald ibises which is a migratory bird species were similar to that in other diurnal bird species.
Community awareness of speech pathology: A regional perspective
Authors: Janes Tina Leann , Zupan Barbra , Signal Tania
Published: December 2020

Objective

Speech pathology has a history of low public awareness and in the absence of current research it is unclear if community awareness has changed in recent years. This study sought to explore a regional community’s awareness of speech pathology as the impetus for considering future directions pertaining to awareness and understanding of the scope of practice of this profession.

Design

An anonymous online survey was created using questions from previously validated surveys on this topic, and then distributed via snowball sampling using social media.

Setting

Data are from residents of the Central Queensland community in Australia.

Participants

Two hundred and seven adults who live in Central Queensland completed the survey.

Main outcome measures

Comparisons were drawn between the responses from this survey to those from earlier studies.

Results

The majority of respondents had heard of speech pathology mostly due to personal contact, but they indicated that they did not know ‘a lot’ about speech pathology. Knowledgeable individuals had higher levels of education and were better able to identify speech pathologists’ scope of practice. Personal contact with a speech pathologist also significantly contributed to self‐rated knowledge and accurate identification of scope of practice of speech pathologists.

Conclusion

While regional Central Queensland community members have heard of speech pathology, their self‐reported knowledge of the profession continues to be low. In order to optimise service access and consumer outcomes it is recommended that the profession aims to improve community awareness of speech pathology.
SECRET® ‐ SExual Chronicle REcording Table: Validation and reliability
Authors: Zaccaro Claudia , Lotti Francesco , Morselli Simone , Sebastianelli Arcangelo , Frizza Francesca , Bigazzi Barbara , Liaci Andrea , Cai Tommaso , Vignozzi Linda , Vignolini Graziano , Serni Sergio , Gravas Stavros , Moncada Ignacio , Salonia Andrea , Gacci Mauro
Published: December 2020

Background

Recording the entire sexual history of a patient from the very first sexual experiences to the current sexual habits is a challenging issue that physicians usually address with partial and non‐standardized interviews.

Objectives

To validate the SExual Chronicle REcording Table (SECRET®), a structured written interview, developed and copyrighted both in English and Italian languages.

Materials and methods

A multicenter national validation study was performed asking 300 male patients affected by uro‐andrological diseases to complete SECRET®. The structured interview is based on four sexual dimensions (masturbation, oral, vaginal and anal sex), declined in seven items (1.Have you ever performed/Do you perform; 2.At what age did you first experience; 3.How many times a month; 4.With how many partners; 5.How much did/do you enjoy; 6.How many times did/do you use a condom; 7.How many times did/do you use the pull‐out method). Data were stratified according to four stages of life (<30; 30‐45; 45‐60; >60 years old). Validity and reliability were assessed by using standard statistical methods for SECRET® validation.

Results

Overall, 295 patients (98.4%) filled all the questions. SECRET® showed a high level of internal coherence (Cronbach's alpha coefficient ranged from 0.85 to 0.97) and reproducibility (paired sample t‐test at Test–Retest: p > .10).

Conclusions

SECRET® represents a novel, simple instrument to record a patient's sexual history in daily clinical practice and clinical research. SECRET® has shown a good validity, internal consistence and reliability in different clusters of patients with uro‐andrological diseases.
Do Temporary Workers Always Lower Workgroup Effectiveness? The Moderating Effect of Job Similarity in Blended Workgroups
Authors: Clinton Michael E. , Pratista Nathia , Sturges Jane
Published: December 2020

Workgroups containing both permanent and temporary workers are often referred to as being ‘blended’. There exists a general view in the literature that workgroups blended in this way function less well with greater rather than fewer temporary workers. However, this notion has received little direct testing. Drawing on social identity theory and the input‐process‐output model of group effectiveness, this study examines the performance of 131 workgroups containing varying proportions of temporary agency workers, along with the proposed group processes: distributive justice climates reported by permanent and temporary workers and altruistic behaviors from permanent to temporary workers and vice versa. We find that blended workgroups with a greater proportion of temporary workers do not exhibit poorer justice climates, altruism, or performance; the hypothesized negative effects only emerge when jobs performed by temporary and permanent workers within the workgroup are highly similar. Counter to expectations, a positive indirect effect between proportion of temporary workers to workgroup performance via altruism from permanent to temporary workers was found when job similarity is low. Theoretical and practical implications are considered, focusing on the importance of managing social identity threat in blended workgroups.
Conservation of endangered and rare plants requires strategies additional to deer‐proof fencing for conservation of sub‐alpine plant diversity
Authors: Koyama Asuka , Uchida Kei , Ozeki Masaaki , Iwasaki Takaya , Nakahama Naoyuki , Suka Takeshi
Published: December 2020

Questions

Deer‐proof fencing is an essential conservation tool to protect and recover plant species diversity in deer‐overbrowsed ecosystems, including species‐rich sub‐alpine grasslands. However, community‐level conservation tools (such as fencing) may be insufficient for single‐species conservation, particularly for non‐target endangered or rare species that are sparsely distributed. We examined whether fencing that can protect and recover total plant species richness also benefits non‐target endangered or rare species.

Location

A sub‐alpine semi‐natural Kirigamine grassland in Nagano Prefecture, Japan.

Methods

We conducted two complementary plant surveys (typical vegetation survey using 1‐m2 sampling units and flowering survey using 150‐m2 sampling units) to account for scarce species. We examined the community‐level responses (species richness, flowering species richness, and flowering abundance) of all species and endangered or rare species and the species‐level responses (occurrence and flowering abundance) of each species to deer fences.

Results

Fencing benefited not only the community‐level response of all species, but also that of endangered or rare species. As species‐level responses, about half of 43 endangered or rare species had greater flowering abundance inside the fences than outside, but only three of them showed a positive effect on their occurrence. These results suggest that once an endangered or rare species has disappeared, it may be difficult to recover.

Conclusions

Continued placement of deer fences is necessary to protect community‐level plant species richness of sub‐alpine endangered and rare species in deer‐overbrowsed ecosystems. We also highlight the necessity of additional strategies focusing on non‐target individual species across broad areas outside fences.
Disproportionality analysis in VigiBase as a drug repositioning method for the discovery of potentially useful drugs in Alzheimer's disease
Authors: Chrétien Basile , Jourdan Jean‐Pierre , Davis Audrey , Fedrizzi Sophie , Bureau Ronan , Sassier Marion , Rochais Christophe , Alexandre Joachim , Lelong‐Boulouard Véronique , Dolladille Charles , Dallemagne Patrick
Published: December 2020

Aims

Drug repositioning aims to propose new indications for marketed drugs. Although several methods exist, the utility of pharmacovigilance databases for this purpose is unclear. We conducted a disproportionality analysis in the World Health Organization pharmacovigilance database VigiBase to identify potential anticholinesterase drug candidates for repositioning in Alzheimer's disease (AD).

Methods

Disproportionality analysis is a validated method for detecting significant associations between drugs and adverse events (AEs) in pharmacovigilance databases. We applied this approach in VigiBase to establish the safety profile displayed by the anticholinesterase drugs used in AD and searched the database for drugs with similar safety profiles. The detected drugs with potential activity against acetylcholinesterase and butyrylcholinesterases (BuChEs) were then evaluated to confirm their anticholinesterase potential.

Results

We identified 22 drugs with safety profiles similar to AD medicines. Among these drugs, 4 (clozapine, aripiprazole, sertraline and S‐duloxetine) showed a human BuChE inhibition rate of over 70% at 10−5 M. Their human BuChE half maximal inhibitory concentration values were compatible with clinical anticholinesterase action in humans at their normal doses. The most active human BuChE inhibitor in our study was S‐duloxetine, with a half maximal inhibitory concentration of 1.2 μM. Combined with its ability to inhibit serotonin (5‐HT) reuptake, the use of this drug could represent a novel multitarget directed ligand therapeutic strategy for AD.

Conclusion

We identified 4 drugs with repositioning potential in AD using drug safety profiles derived from a pharmacovigilance database. This method could be useful for future drug repositioning efforts.
Patient factors predict complications after partial nephrectomy: validation and calibration of the Preoperative Risk Evaluation for Partial Nephrectomy (PREP) score
Authors: Huynh Melissa J. , Wang Ye , Joshi Mugdha , Krasnow Ross , Yu Alice X. , Mossanen Matthew , Chung Benjamin I. , Chang Steven L.
Published: December 2020

Objectives

To develop and validate the Preoperative Risk Evaluation for Partial Nephrectomy (PREP) score to predict the probability of major postoperative complications after partial nephrectomy (PN) based on patient comorbidities.

Patients and Methods

The Premier Healthcare Database was used to identify patients who had undergone elective PN. Through review of International Classification of Diseases ninth revision codes, we identified patient comorbidities and major surgical complications (Clavien–Dindo Grade III–V). Multivariable logistic regression was used to identify predictors of major complications. We used half of the set as the training cohort to develop our risk score and the other half as a validation cohort.

Results

From 2003 to 2015, 25 451 PNs were performed. The overall rate of major complications was 4.9%. The final risk score consisted of 10 predictors: age, sex, congestive heart failure, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, diabetes, hypertension, obesity, and smoking. In the training cohort, the area under the receiver operating characteristic curve (AUC) was 0.75 (95% confidence interval [CI] 0.73–0.78), while the AUC for the validation cohort was 0.73 (95% CI 0.70–0.75). The predicted probabilities of major complication in the low‐ (≤10 points), intermediate‐ (11–20 points), high‐ (21–30 points), and very high‐risk (>30 points) categories were 3% (95% CI 2.6–3.2), 8% (95% CI 7.2–9.2), 24% (95% CI 20.5–27.8), and 41% (95% CI 34.5–47.8), respectively.

Conclusions

We developed and validated the PREP score to predict the risk of complications after PN based on patient characteristics. Calculation of the PREP score can help providers select treatment options for patients with a cT1a renal mass and enhance the informed consent process for patients planning to undergo PN.
Morbidity and mortality after robot‐assisted radical cystectomy with intracorporeal urinary diversion in octogenarians: results from the European Association of Urology Robotic Urology Section Scientific Working Group
Authors: Mortezavi Ashkan , Crippa Alessio , Edeling Sebastian , Pokupic Sasa , Dell’Oglio Paolo , Montorsi Francesco , D'Hondt Frederiek , Mottrie Alexandre , Decaestecker Karel , Wijburg Carl J. , Collins Justin , Kelly John D. , Tan Wei Shen , Sridhar Ashwin , John Hubert , Canda Abdullah Erdem , Schwentner Christian , Rönmark Erik Peder , Wiklund Peter , Hosseini Abolfazl
Published: December 2020

Objectives

To evaluate the postoperative complication and mortality rate following laparoscopic radical cystectomy (RARC) with intracorporeal urinary diversion (ICUD) in octogenarians.

Patients and Methods

We conducted a retrospective analysis comparing postoperative complication and mortality rates depending on age in a consecutive series of 1890 patients who underwent RARC with ICUD for bladder cancer between 2004 and 2018 in 10 European centres. Outcomes of patients aged <80 years and those aged ≥80 years were compared with regard to postoperative complications (Clavien–Dindo grading) and mortality rate. Cancer‐specific mortality (CSM) and other‐cause mortality (OCM) after surgery were calculated using the non‐parametric Aalen‐Johansen estimator.

Results

A total of 1726 patients aged <80 years and 164 aged ≥80 years were included in the analysis. The 30‐ and 90‐day rate for high‐grade (Clavien–Dindo grades III–V) complications were 15% and 21% for patients aged <80 years compared to 11% and 13% for patients aged ≥80 years (P = 0.2 and P = 0.03), respectively. In a multivariable logistic regression analysis adjusting for pre‐ and postoperative variables, age ≥80 years was not an independent predictor of high‐grade complications (odds ratio 0.6, 95% confidence interval 0.3–1.1; P = 0.12). The non‐cancer‐related 90‐day mortality was 2.3% for patients aged ≥80 years and 1.8% for those aged <80 years, respectively (P = 0.7). The estimated 12‐month CSM and OCM rates for those aged <80 years were 8% and 3%, and for those aged ≥80 years, 15% and 8%, respectively (P = 0.009 and P < 0.001).

Conclusions

The minimally invasive approach to RARC with ICUD for bladder cancer in well‐selected elderly patients (aged ≥80 years) achieved a tolerable high‐grade complication rate; the 90‐day postoperative mortality rate was driven by cancer progression and the non‐cancer‐related rate was equivalent to that of patients aged <80 years. However, an increased OCM rate in this elderly group after the first year should be taken into account. These results will support clinicians and patients when balancing cancer‐related vs treatment‐related risks and benefits.
Negative first follow‐up prostate biopsy on active surveillance is associated with decreased risk of upgrading, suspicion of progression and converting to active treatment
Authors: Singh Sohail , Sandhu Preeti , Beckmann Kerri , Santaolalla Aida , Dewan Kamal , Clovis Sharon , Rusere Jonah , Zisengwe Grace , Challacombe Benjamin , Brown Christian , Cathcart Paul , Popert Rick , Dasgupta Prokar , Van Hemelrijck Mieke , Elhage Oussama
Published: December 2020

Objective

To determine the risk of disease progression and conversion to active treatment following a negative biopsy while on active surveillance (AS) for prostate cancer (PCa).

Patients and Methods

Men on an AS programme at a single tertiary hospital (London, UK) between 2003 and 2018 with confirmed low–intermediate‐risk PCa, Gleason Grade Group <3, clinical stage <T3 and a diagnostic prostate‐specific antigen (PSA) level of <20 ng/mL. This cohort included men diagnosed by transrectal ultrasonography guided (12–14 cores) or transperineal (median 32 cores) biopsy. Multivariate Cox hazards regression analysis was undertaken to determine (i) risk of upgrading, (ii) clinical or radiological suspicion of disease progression, and (iii) transitioning to active treatment. Suspicion of disease progression was defined as any biopsy upgrading, >30% positive cores, magnetic resonance imaging (MRI) Likert score >3/T3 or PSA level of >20 ng/mL. Conversion to treatment included radical or hormonal treatment.

Results

Among the 460 eligible patients, 23% had negative follow‐up biopsy findings. The median follow‐up was 62 months, with one to two repeat biopsies and two MRIs per patient during that period. Negative biopsy findings at first repeat biopsy were associated with decreased risk of converting to active treatment (hazard ration [HR] 0.18, 95% confidence interval [CI] 0.09–0.37; P < 0.001), suspicion of disease progression (HR 0.56, 95% CI: 0.34–0.94; P = 0.029), and upgrading (HR 0.48, 95% CI 0.23–0.99; P = 0.047). Data are limited by fewer men with multiple follow‐up biopsies.

Conclusion

A negative biopsy finding at the first scheduled follow‐up biopsy among men on AS for PCa was strongly associated with decreased risk of subsequent upgrading, clinical or radiological suspicion of disease progression, and conversion to active treatment. A less intense surveillance protocol should be considered for this cohort of patients.
Association of erectile dysfunction and cardiovascular disease: an umbrella review of systematic reviews and meta‐analyses
Authors: Mostafaei Hadi , Mori Keiichiro , Hajebrahimi Sakineh , Abufaraj Mohammad , Karakiewicz Pierre I. , Shariat Shahrokh F.
Published: December 2020

Objectives

To present an overall picture of the evidence regarding the association of erectile dysfunction (ED) with cardiovascular disease (CVD).

Methods

Systematic reviews and meta‐analyses that studied the association of ED with any CVD were included in this umbrella review. We did not restrict the population to a particular group or age. PubMed, Embase, the Joanna Briggs Institute (JBI) Database of Systematic Reviews and Implementation Reports, the Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and the PROSPERO register were searched to find relevant systematic reviews, with or without meta‐analyses, from inception to April 2020. The JBI Checklist for Systematic Reviews and Research Syntheses was used for the critical appraisal. Only studies with acceptable quality were included. Two independent reviewers extracted the data using the JBI data extraction tool for qualitative and quantitative data extraction.

Results

The summary estimate showed a higher risk of CVD (relative risk [RR] 1.45, 95% confidence interval [CI] 1.36–1.54; P < 0.001), coronary heart disease (RR 1.50, 95% CI 1.37–1.64; P < 0.001), cardiovascular‐related mortality (RR 1.50, 95% CI 1.37–1.64; P < 0.001), all‐cause mortality (RR 1.25, 95% CI 1.18–1.32; P < 0.001), myocardial infarction (RR 1.55, 95% CI 1.33–1.80; P < 0.001) and stroke (RR 1.36, 95% CI 1.26–1.46; P < 0.001) in patients with ED than in other patients.

Conclusions

Our results confirm that ED is an independent predictor of CVD and their outcomes. ED and CVD are two presentations of the same physiological phenomenon. ED normally precedes symptomatic CVD, providing a window of opportunity for healthcare practitioners to screen and detect high‐risk patients early to prevent avoidable morbidity and mortality.
From cartoons to quantitative models in Golgi transport
Authors: Quiros D. Nicolas , Nieto Franco , Mayorga Luis S.
Published: December 2020

Background

Cell biology is evolving to become a more formal and quantitative science. In particular, several mathematical models have been proposed to address Golgi self‐organisation and protein and lipid transport. However, most scientific articles about the Golgi apparatus are still using static cartoons that miss the dynamism of this organelle.

Results

In this report, we show that schematic drawings of Golgi trafficking can be easily translated into an agent‐based model using the Repast platform. The simulations generate an active interplay among cisternae and vesicles rendering quantitative predictions about Golgi stability and transport of soluble and membrane‐associated cargoes. The models can incorporate complex networks of molecular interactions and chemical reactions by association with COPASI, a software that handles ordinary differential equations.

Conclusions

The strategy described provides a simple, flexible and multiscale support to analyse Golgi transport. The simulations can be used to address issues directly linked to the mechanism of transport or as a way to incorporate the complexity of trafficking to other cellular processes that occur in dynamic organelles.

Significance

We show that the rules implicitly present in most schematic representations of intracellular trafficking can be used to build dynamic models with quantitative outputs that can be compared with experimental results.
Use of language in the medical decision‐making process for biologic therapy: Youth and parent perspectives
Authors: David Jennie G. , Daly Brian P. , Chute Douglas , Katz‐Buonincontro Jennifer , Clemente Ignasi , Lipstein Ellen A.
Published: December 2020

Background

Youth with chronic illnesses and their parents make complex medical decisions and also need to develop medical decision‐making skills for transition of care to adult care. The use of inclusive (e.g. ‘we decided …’) and exclusive (e.g. ‘they decided …’) language in youth and parents' medical decision‐making experiences provides insights into perceptions of engagement. This study assessed youth and parents' perceptions of engagement in medical decision‐making about biologic therapy.

Methods

This exploratory mixed‐methods secondary analysis of semistructured interview data included youth with juvenile idiopathic arthritis (JIA) and Crohn's disease (CD) and parents. Iterative qualitative coding of interviews generated themes. Exploratory analyses of variance (ANOVAs) and analyses of covariance (ANCOVAs) investigated differences in language use between youth and parents.

Results

Parents used more inclusive language in perceptions of medical decision‐making experiences than youth, which exploratory analyses found significant (p < 0.05). Youth used more exclusive language than parents in perceptions of medical decision‐making.

Conclusion

This research suggests that youth with chronic illnesses perceived limited engagement in medical decision‐making, with parents perceiving higher engagement. This presents challenges for youth as they prepare for the transition to adult care. Future research should assess how inclusive and exclusive language use impacts psychosocial and health outcomes.
Prevalence of and factors associated with unmet dental need among the US adult population in 2016
Authors: Taylor Heather , Holmes Ann M. , Blackburn Justin
Published: December 2020

Objectives

Understanding and addressing contributing factors to unmet dental need is an important public health challenge. This study investigated the prevalence of, and factors associated with, self‐reported unmet dental need using a nationally representative sample of US adults.

Methods

This was a cross‐sectional study using the Medical Expenditures Panel Survey (MEPS) from 2016. The weighted prevalence of unmet dental need was estimated among individuals aged 18 years or older. Chi‐squared and multivariate logit regression with marginal effects (ie absolute risk differences) were used to measure the association of unmet dental need with respondent characteristics.

Results

The prevalence of adults reporting unmet dental need was 6% (95% CI: 5.5 to 6.5). Adults with dental insurance were 1.7 percentage points (95% CI: −2.8 to −0.6) less likely to report unmet dental needs than adults without dental insurance. Those with middle income were 2.3 percentage points (95% CI: 1.2 to 3.4), those with low income were 3.3 percentage points (95% CI: 1.7 to 5.0), and those with poor/negative/near‐poor income were 4.2 percentage points (95% CI: 2.7 to 5.7) more likely to report an unmet dental need than adults with high income. Both Hispanics (−1.7 percentage points [95% CI: −2.8 to −0.6]) and non‐Hispanic Blacks (−1.1 percentage points [95% CI: −2.1 to −0.1]) were less likely to report an unmet dental need than whites. Smoking, education, general health status, chronic disease and marital status were also significantly associated with reporting an unmet dental need.

Conclusions

Future policies should continue to address cost and coverage barriers to adult dental care, as these remain significant barriers to access, particularly for low‐income adults. Future research should evaluate the reasons adults report unmet dental need and explore how adults' judgment of dental need compares to providers' clinical judgment. Additionally, research that explores how race and ethnicity affect perceptions of unmet dental need is warranted.
An international pragmatic randomized controlled trial to compare a single‐use negative‐pressure dressing versus the surgeon’s preference of dressing to reduce the incidence of surgical site infection following emergency laparotomy: the SUNRRISE trial protocol
Authors:   The SUNRRISE Study Group on behalf of the Northwest Research Collaborative and the West Midlands Research Collaborative
Published: December 2020

Aim

Surgical site infection (SSI) is a common complication following emergency laparotomy, occurring in around 25% of patients in UK practice. The adoption of single‐use negative‐pressure dressings (SUNPDs) has been proposed as a prophylactic method of reducing the rate of SSI. The primary aim of the randomized controlled trial (RCT) described herein is to determine if a SUNPD reduces SSI at 30 days after an emergency laparotomy.

Method

The Single Use Negative pRessure dressing for Reduction In Surgical site infection following Emergency laparotomy (SUNRRISE) study is an international, multicentre, pragmatic, phase III RCT with internal feasibility phase. As stated, the primary aim is to determine if a SUNPD reduces SSI at 30 days postoperatively. Patients will be randomized in a 1:1 ratio to receive either a SUNPD or a dressing of the surgeon's preference. Outcome assessors will be blinded to treatment allocation. The primary outcome measure is SSI within 30 days of surgery as defined by the US Centers for Disease Control criteria. A total of 840 patients will be required to detect a relative reduction of 40% in SSI rates (from 25% to 15%) with 90% power accounting for a 20% attrition rate.

Discussion

SUNRRISE is an international, multicentre RCT evaluating the prophylactic use of SUNPD in primary closed emergency laparotomy wounds for the reduction of SSI. Our hypothesis is that a SUNPD is superior to the surgeon's preference of dressing in reducing SSIs at 30 days. The findings may influence dressing choice following emergency abdominal surgery in the future.
Mothers’ Milk: How Gender and Immigration Obscure Agricultural Expertise and Care Work in Dairyland
Authors: Ortiz Cristina
Published: December 2020

Gender is a key lens through which to understand industrial agricultural production in rural twenty‐first century communities. Here, I examine the gendered imaginaries of dairy production that perpetuate the meaning of “farmer” as masculine and white. The expertise of Mexican immigrant workers, and particularly that of women on spousal visas, challenges such assumptions and highlights the role of unremunerated labor in sustaining the industrial food chain. Everyday experiences of gender and race are shaped not only by local‐level assumptions but also by federal‐level immigration policies and employer recruitment practices that result in a mostly male immigrant agricultural workforce. In this article, I draw on interviews with rural Minnesota community members, as well as local and regional news coverage, to examine how gender and race intersect to marginalize the work and expertise of Mexican immigrants in the rural Midwest. In this case, Mexican immigrant mothers frame their labor as part of a complex calculus of immigration benefits and sacrifices.
Real‐time artificial intelligence for endoscopic diagnosis of early esophageal squamous cell cancer (with video)
Authors: Yang Xiao‐Xiao , Li Zhen , Shao Xue‐Jun , Ji Rui , Qu Jun‐Yan , Zheng Meng‐Qi , Sun Yi‐Ning , Zhou Ru‐Chen , You Hang , Li Li‐Xiang , Feng Jian , Yang Xiao‐Yun , Li Yan‐Qing , Zuo Xiu‐Li
Published: December 2020

Background and aims

Endoscopic diagnosis of early esophageal squamous cell cancer (ESCC) is complicated and dependent on operators' experience. This study aimed to develop an artificial intelligence (AI) model for automatic diagnosis of early ESCC.

Methods

Non‐magnifying and magnifying endoscopic images of normal/noncancerous lesions, early ESCC, and advanced esophageal cancer (AEC) were retrospectively obtained from Qilu Hospital of Shandong University. A total of 10,988 images from 5075 cases were chosen for training and validation. Another 2309 images from 1055 cases were collected for testing. One hundred and four real‐time videos were also collected to evaluate the diagnostic performance of the AI model. The diagnostic performance of the AI model was compared with endoscopists by magnifying images and the assistant efficiency of the AI model for novices was evaluated.

Results

The AI diagnosis for non‐magnifying images showed a per‐patient accuracy, sensitivity, and specificity of 99.5%, 100%, 99.5% for white light imaging, and 97.0%, 97.2%, 96.4% for optical enhancement/iodine straining images. Regarding diagnosis for magnifying images, the per‐patient accuracy, sensitivity, and specificity were 88.1%, 90.9%, and 85.0%. The diagnostic accuracy of the AI model was similar to experts (84.5%, P = 0.205) and superior to novices (68.5%, P = 0.005). The diagnostic performance of novices was significantly improved by AI assistance. When it comes to the diagnosis for real‐time videos, the AI model showed acceptable performance as well.

Conclusions

The AI model could accurately recognize early ESCC among noncancerous mucosa and AEC. It could be a potential assistant for endoscopists, especially for novices.
Teaching Lean Principles in Nonmanufacturing Settings Using a Computer Equipment Order Quotation Administrative Process
Authors: Terpend Regis , Shannon Patrick
Published: December 2020

As organizations continue to expand their implementation of Lean practices, business schools and corporate training organizations have developed numerous games and simulations aimed at teaching Lean concepts in manufacturing settings. However, simulations have lagged behind the most recent adaptations of Lean outside of the factory in services, and more specifically, in office settings. In this article, we present a Lean simulation game, referred to as “Computer Solutions, Inc.” that provides participants with hands‐on experience in applying Lean principles in a nonmanufacturing setting.

The simulation takes place in the order‐quote department at “Computer Solutions, Inc.,” a company that specializes in designing customized computer solutions for small businesses. The order‐quote process is purely office‐based and involves such activities as collecting information, processing information, filling out documents, and forwarding those documents to different parts of the organization. This simulation is implemented as a “pencil‐and‐paper” exercise that can be performed by students in the classroom.

Our simulation brings some unique benefits that are often missing from current Lean manufacturing‐based simulations. It involves multiple rounds of Lean improvements that can span several weeks, providing students a chance to identify wastes and to make a thoughtful application of Lean tools and techniques. Students also get to experience the challenges of group dynamics that are often present in team‐based improvement efforts.
The risk of thrombosis in essential thrombocythemia is associated with the type of CALR mutation: A multicentre collaborative study
Authors: Pérez Encinas Manuel M. , Sobas Marta , Gómez‐Casares María Teresa , Abuin Blanco Aitor , Noya Pereira María Soledad , Raya José María , Andrade‐Campos Marcio M. , Álvarez Larrán Alberto , Lewandowski Krzysztof , Łukasz Szukalski , Hernández Boluda Juan Carlos , Ferrer‐Marín Francisca , Fox María Laura , Gołos Aleksandra , Gasior Kabat Mercedes , Magro Mazo Elena , Czyż Anna , Martín Martín Alejandro , Bellosillo Paricio Beatriz , Quinteiro García Celsa , González Martín Jesús María , Stuckey Ruth
Published: December 2020

Objectives

In patients with essential thrombocythemia (ET), after the JAK2V617F driver mutation, mutations in CALR are common (classified as type 1, 52‐bp deletion or type 2, 5‐bp insertion). CALR mutations have generally been associated with a lower risk of thrombosis. This study aimed to confirm the impact of CALR mutation type on thrombotic risk.

Methods

We retrospectively investigated 983 ET patients diagnosed in Spanish and Polish hospitals.

Results

With 7.5 years of median follow‐up from diagnosis, 155 patients (15.8%) had one or more thrombotic event. The 5‐year thrombosis‐free survival (TFS) rate was 83.8%, 91.6% and 93.9% for the JAK2V617F, CALR‐type 1 and CALR‐type 2 groups, respectively (P = .002). Comparing CALR‐type 1 and CALR‐type 2 groups, TFS for venous thrombosis was lower in CALR‐type 1 (P = .046), with no difference in TFS for arterial thrombosis observed. The cumulative incidence of thrombosis was significantly different comparing JAK2V617F vs CALR‐type 2 groups but not JAK2V617F vs CALR‐type 1 groups. Moreover, CALR‐type 2 mutation was a statistically significant protective factor for thrombosis with respect to JAK2V617F in multivariate logistic regression (OR: 0.45, P = .04) adjusted by age.

Conclusions

Our results suggest that CALR mutation type has prognostic value for the stratification of thrombotic risk in ET patients.
Corporate stakeholders, corporate valuation and ESG
Authors: Cornell Bradford , Shapiro Alan C.
Published: December 2020

In addition to explicit contracts, corporations issue their stakeholders implicit claims, including fair treatment of employees and the promise of continuing service to customers. Corporate value is created by selling these implicit claims for more than it costs to honour them. Recently, a new class of non‐investor stakeholders, related to environmental, social and governance (ESG) issues, has arisen. Although many ESG advocates stress their role in creating shareholder value, they do not explain how this value creation occurs. This paper shows that implicit claims provide a critical link that ties non‐investor stakeholders and ESG to shareholder value, both its creation and its possible destruction.
Subseafloor Archaea reflect 139 kyrs of paleodepositional changes in the northern Red Sea
Authors: More Kuldeep D. , Wuchter Cornelia , Irigoien Xabier , Tierney Jessica E. , Giosan Liviu , Grice Kliti , Coolen Marco J. L.
Published: December 2020

The vertical distribution of subseafloor archaeal communities is thought to be primarily controlled by in situ conditions in sediments such as the availability of electron acceptors and donors, although sharp community shifts have also been observed at lithological boundaries suggesting that at least a subset of vertically stratified Archaea form a long‐term genetic record of coinciding environmental conditions that occurred at the time of sediment deposition. To substantiate this possibility, we performed a highly resolved 16S rRNA gene survey of vertically stratified archaeal communities paired with paleo‐oceanographic proxies in a sedimentary record from the northern Red Sea spanning the last glacial–interglacial cycle (i.e., marine isotope stages 1–6; MIS1‐6). Our results show a strong significant correlation between subseafloor archaeal communities and drastic paleodepositional changes associated with glacial low vs. interglacial high stands (ANOSIM; R = .73; p = .001) and only a moderately strong correlation with lithological changes. Bathyarchaeota, Lokiarchaeota, MBGA, and DHVEG‐1 were the most abundant identified archaeal groups. Whether they represented ancient cell lines from the time of deposition or migrated to the specific sedimentary horizons after deposition remains speculative. However, we show that the majority of sedimentary archaeal tetraether membrane lipids were of allochthonous origin and not produced in situ. Slow post‐burial growth under energy‐limited conditions would explain why the downcore distribution of these dominant archaeal groups still indirectly reflect changes in the paleodepositional environment that prevailed during the analyzed marine isotope stages. In addition, archaea seeded from the overlying water column such as Thaumarchaeota and group II and III Euryarchaeota, which were likely not have been able to subsist after burial, were identified from a lower abundance of preserved sedimentary DNA signatures, and represented direct markers of paleoenvironmental changes in the Red Sea spanning the last six marine isotope stages.
Barriers and facilitators to integrate oral health care for older adults in general (basic) care in East Netherlands. Part 1: Normative integration
Authors: Niesten Dominique , Gerritsen Anneloes E. , Leve Verena
Published: December 2020

Objective

to synthesise a framework of barriers and facilitators in the normative integration of oral health care (OHC) into general health care for frail older adults at macro (system), meso (organisation and interprofessional integration) and micro (clinical practice) levels.

Background

Identification of these barriers and facilitators is expected to promote better and more appropriate care.

Methods

For this qualitative study, comprising 41 participants, representatives of 10 different groups of (professional) care providers, and OHC receivers (home‐dwelling, and nursing home patients) in East Netherlands were interviewed. Transcripts of the in‐depth, topic‐guided interviews were thematically analysed. In a subsequent workshop with 52 stakeholders, results and interpretations were discussed and refined.

Results

Two main themes were identified: (1) a compartmentalised care culture in which OHC and general health care are seen as two separate realms, and (2) prioritisation, awareness and attitude regarding OHC integration. Subthemes such as low political attention (macro level); unclear responsibilities, hierarchical relations and the lack of vision of organisations (meso level); and poor awareness and low prioritisation by care providers and patients (micro level) were identified as potential barriers. Subthemes such as leadership (meso level), and the supportive personality of individual caregivers and ownership of patients (micro level) were identified as facilitators.

Conclusion

Barriers and facilitators in normative OHC integration in The Netherlands are interrelated and apparent at macro‐, meso‐ and micro levels. They are mainly related to (a) a compartmentalised care culture, and (b) related low prioritisation, and poor awareness of and attitude towards (integration of) oral health (care).
“All are welcome here?”: Navigating race, class, gender, sexual orientation, age, and disability in American feminist coffeehouses of the 1970s and 1980s
Authors: Ketchum Alex D.
Published: December 2020

In the 1970s and 1980s, feminists in the United States began businesses in order to financially support themselves while enacting women's movement politics. Owning and operating a feminist business in a permanent location required large capital investment in order to rent space, buy supplies, and pay workers. Women's, and especially lesbians', social positioning due to discriminatory gender, racial, and sexual orientation laws affected whether or not being able to own a restaurant or store was even possible. Coffeehouses provided an alternative means through which to build feminist communities, with lower initial capital required than restaurants. Feminist coffeehouses in this article will primarily refer to recurring temporary public spaces that served refreshments and provided entertainment. This model of feminist organization expanded participation in some ways; without high fixed costs, coffeehouses enabled women with less money, women from marginalized racial groups, and women with marginalized sexual orientations the ability to create spaces centered on food, drink, and socializing. However, these spaces were not utopic; racism, ageism, trans‐exclusionism, and classism created tension in their respective communities. As coffeehouse organizers tried to address various inequalities, their approach in treating each identity category as discrete often erased women who experienced multiple forms of oppressions simultaneously.