bluuebunny/crossref_metadata_2025 huggingface dataset:
Type 1 diabetes, cognitive ability and incidence of cardiovascular disease and death over 60 years of follow‐up time in men
Authors: Dybjer Elin , Dahl Aslan Anna K. , Engström Gunnar , Nilsson Erik D. , Nägga Katarina , Nilsson Peter M. , Hassing Linda B.
Published: February 2022

Aims

There are few cohorts of type 1 diabetes that follow individuals over more than half a century in terms of health outcomes. The aim of this study was to examine associations between type 1 diabetes, diagnosed before age 18, and long‐term morbidity and mortality, and to investigate whether cognitive ability plays a role in long‐term morbidity and mortality risk.

Methods

In a Swedish cohort, 120 men with type 1 diabetes and 469 without type 1 diabetes were followed between 18 and 77 years of age as regards morbidity and mortality outcomes, and impact of cognitive ability at military conscription for the outcomes. In Cox regression analyses and Kaplan‐Meier analyses with log‐rank tests, associations between diabetes and cognitive ability respectively, and outcomes (mortality, cardiovascular morbidity and diabetes complications) were investigated.

Results

Men with type 1 diabetes suffered from dramatically higher mortality (HR 4.62, 95% CI: 3.56–5.60), cardiovascular mortality (HR 5.60, 95% CI: 3.27–9.57), and cardiovascular events (HR 3.97, 95% CI: 2.79–5.64) compared to men without diabetes. Higher cognitive ability at military conscription was associated with lower mortality in men without diabetes, but was not associated with any outcome in men with diabetes.

Conclusions

In this historical cohort study with 60 years of follow‐up time and a less effective treatment of diabetes than today, mortality rates and cardiovascular outcomes were high for men with type 1 diabetes. Morbidity or mortality did not differ between those that had low to normal or high cognitive ability among men with type 1 diabetes.
Growth differentiation factor 15 (GDF15) and semaglutide inhibit food intake and body weight through largely distinct, additive mechanisms
Authors: Ghidewon M. , Wald H.S. , McKnight A. D. , De Jonghe B. C. , Breen D. M. , Alhadeff A. L. , Borner T. , Grill H. J.
Published: February 2022

Aims

To evaluate whether the potent hypophagic and weight‐suppressive effects of growth differentiation factor‐15 (GDF15) and semaglutide combined would be a more efficacious antiobesity treatment than either treatment alone by examining whether the neural and behavioural mechanisms contributing to their anorectic effects were common or disparate.

Materials/Methods

Three mechanisms were investigated to determine how GDF15 and semaglutide induce anorexia: the potentiation of the intake suppression by gastrointestinal satiation signals; the reduction in motivation to feed; and the induction of visceral malaise. We then compared the effects of short‐term, combined GDF15 and semaglutide treatment on weight loss to the individual treatments. Rat pharmaco‐behavioural experiments assessed whether GDF15 or semaglutide added to the satiating effects of orally gavaged food and exogenous cholecystokinin (CCK). A progressive ratio operant paradigm was used to examine whether GDF15 or semaglutide reduced feeding motivation. Pica behaviour (ie, kaolin intake) and conditioned affective food aversion testing were used to evaluate visceral malaise. Additionally, fibre photometry studies were conducted in agouti‐related protein (AgRP)‐Cre mice to examine whether GDF15 or semaglutide, alone or in combination with CCK, modulate calcium signalling in hypothalamic AgRP neurons.

Results

Semaglutide reduced food intake by amplifying the feeding‐inhibitory effect of CCK or ingested food, inhibited the activity of AgRP neurons when combined with CCK, reduced feeding motivation and induced malaise. GDF15 induced visceral malaise but, strikingly, did not affect feeding motivation, the satiating effect of ingested food or CCK signal processing. Combined GDF15 and semaglutide treatment produced greater food intake and body weight suppression than did either treatment alone, without enhancing malaise.

Conclusions

GDF15 and semaglutide reduce food intake and body weight through largely distinct processes that produce greater weight loss and feeding suppression when combined.
Comparison of clinical features and 1‐year outcomes between patients with psychotic disorder not otherwise specified and those with schizophrenia
Authors: Li Ling , Rami Fatima Zahra , Piao Yan Hong , Lee Bo Mi , Kim Woo‐Sung , Sui Jing , Kim Sung‐Wan , Lee Bong Ju , Kim Jung Jin , Yu Je‐Chun , Lee Kyu Young , Won Seung‐Hee , Lee Seung‐Hwan , Kim Seung‐Hyun , Kang Shi Hyun , Kim Euitae , Chung Young Chul
Published: February 2022

Aim

Research on psychotic disorder not otherwise specified (PNOS) that clearly mentions its subgroups is very rare. This study was conducted to identify the demographic and clinical features, cognitive function, and 1‐year outcomes of patients with early stage PNOS compared with those with early stage schizophrenia (SZ).

Methods

The study subjects were 54 and 321 patients with PNOS and SZ, respectively, who were registered at least more than 1 year ago. Due to drop out, only 37 and 210 patients with PNOS and SZ were evaluated at the 1‐year follow‐up. We compared clinical variables (duration of untreated psychosis, symptom severity, self‐rating scales, and so on), cognitive function, and short‐term outcomes (treatment response, remission, compliance, drop out, relapse) between the two groups.

Results

The patients with PNOS were associated with higher diagnostic stability (53.7%) compared with those in previous studies. They had lower symptom severity, better treatment response at 2 months and higher remission rates at 12 months, but poorer compliance at 6 months compared with patients with SZ. Level of cognitive impairment in PNOS was intermediate between those of SZ patients and healthy controls.

Conclusions

These findings indicate that PNOS has unique clinical features, suggesting that it should be treated as a distinct clinical syndrome. At the same time, however, prevention of its possible progression to other psychotic disorders in some patients with PNOS is also important.
Anticholinergic drugs and forebrain magnetic resonance imaging changes in cognitively normal people and those with mild cognitive impairment
Authors: Meng Dewen , Mohammadi‐Nejad Ali‐Reza , Sotiropoulos Stamatios N. , Auer Dorothee P. ,   for the Alzheimer's Disease Neuroimaging Initiative
Published: February 2022

Background and purpose

Anticholinergic (AC) medication use is associated with cognitive decline and dementia, which may be related to an AC‐induced central hypocholinergic state, but the exact mechanisms remain to be understood. We aimed to further elucidate the putative link between AC drug prescription, cognition, and structural and functional impairment of the forebrain cholinergic nucleus basalis of Meynert (NBM).

Methods

Cognitively normal (CN; n = 344) and mildly cognitively impaired (MCI; n = 224) Alzheimer’s Disease Neuroimaging Initiative Phase 3 participants with good quality 3‐T magnetic resonance imaging were included. Structural (regional gray matter [GM] density) and functional NBM integrity (functional connectivity [FC]) were compared between those on AC medication for > 1 year (AC+) and those without (AC−) in each condition. AC burden was classed as mild, moderate, or severe.

Results

MCI AC+ participants (0.55 ± 0.03) showed lower NBM GM density compared to MCI AC− participants (0.56 ± 0.03, p = 0.002), but there was no structural AC effect in CN. NBM FC was lower in CN AC+ versus CN AC− (3.6 ± 0.5 vs. 3.9 ± 0.6, p = 0.001), and in MCI AC+ versus MCI AC− (3.3 ± 0.2 vs. 3.7 ± 0.5, p < 0.001), with larger effect size in MCI. NBM FC partially mediated the association between AC medication burden and cognition.

Conclusions

Our findings provide novel support for a detrimental effect of mild AC medication on the forebrain cholinergic system characterized as functional central hypocholinergic that partially mediated AC‐related cognitive impairment. Moreover, structural tissue damage suggests neurodegeneration, and larger effect sizes in MCI point to enhanced susceptibility for AC medication in those at risk of dementia.
Changes of serum metabolomics and gut microbiota reveal specific characteristics of children with febrile seizures
Authors: Hu Baifei , Zhu Xuefen , Zheng Junping , Guo Yanlei , Hu Haiming , Zou Xiaojuan , Yao Xiaowei , Liu Zhanli , Liu Hongtao
Published: February 2022

Background and purpose

Febrile seizures (FS) pose a severe threat to the neurological development of children. Probing the abnormality of host metabolism is essential for the prevention, diagnosis, and treatment of FS.

Methods

Based on clinically collected serum and fecal samples, we used nontargeted metabolomics and 16S rDNA sequencing to explore the relationship of serum metabolite levels and gut microbiota community with the occurrence of FS.

Results

Metabolomic analysis revealed abnormalities in multiple metabolic pathways in serum of FS patients, such as tryptophan metabolism and steroid hormone biosynthesis. Intestinal flora analysis indicated that the α‐diversity of gut microbiota in FS patients was significantly reduced. In addition, the relative abundance of a variety of bacteria at the phylum level was remarkably changed in patients with FS, including decreased Firmicutes and Verrucomicrobia. Eleven serum metabolites were identified to be biomarker candidates for FS diagnosis. With the help of a panel biomarker strategy combining four biomarkers as a cluster, four bacteria (i.e., Rothia, Coprococcus, Lactobacillus, and Oscillospira) in a defined panel displayed perfect differentiation of subtypes of FS.

Conclusions

Combining metabolomic and intestinal flora analysis revealed specific characteristics of children with FS, and provided new clues for the diagnosis of FS and the classification of seizure types. In summary, these findings may provide new insights into revealing the significance of serum metabolites and gut microbiota in the pathogenesis of FS.
Fracture performance improvement and fracture process simulation of concrete for shotcrete use in hot and dry environments
Authors: Liu Pin , Guo Chen , Cui Shengai , Wu Qihong , Xia Wei
Published: February 2022

In order to investigate the fracture performance of concrete in hot and dry tunnel environments, the fracture parameters are tested through three‐point bending tests on notched beams. The effects of basalt and steel fibers on the fracture properties in hot and dry environments are explored, and the effects of beam height and notch length on fracture parameters of concrete are analyzed by using numerical calculations. The results show that the fracture toughness of concrete in hot and dry environments is obviously lower than that in the standard curing condition. The addition of basalt and steel fibers has little effect on the initial fracture toughness but can significantly improve the unstable fracture toughness and fracture energy. The peak load and maximum fracture process zone length decrease with the increase of the notch length and increase with the increase of the beam height, while the unstable fracture toughness is basically not affected by the size changes of concrete beams.
Biologic therapies associated with development of palmoplantar pustulosis and palmoplantar pustular psoriasis: a systematic review
Authors: Lu Justin D. , Lytvyn Yuliya , Mufti Asfandyar , Zaaroura Hiba , Sachdeva Muskaan , Kwan Sarah , Abduelmula Abrahim , Kim Patrick , Yeung Jensen
Published: February 2022

Background

Palmoplantar pustulosis (PPP) and palmoplantar pustular psoriasis (PPPP) are chronic inflammatory skin conditions characterized by eruptions of sterile pustules on the palms and/or soles. Biologic use has been associated with PPP and PPPP development in the literature.

Objectives

To identify PPP and PPPP associated with biologics and summarize reported treatments and outcomes.

Methods

We systematically searched in MEDLINE and Embase for articles that reported PPP or PPPP during biologic treatment. After a full‐text review, 53 studies were included for analysis.

Results

We identified 155 patients with PPP/PPPP onset during biologic treatment, with a mean age of 44.1 years and a female preponderance (71.6%). The most frequently reported biologics were adalimumab (43.9%) and infliximab (33.3%). IL‐17 inhibitors, secukinumab (7.6%) and brodalumab (1.5%), were reported only in association with PPPP. Overall, 58.8% of patients had complete remission (CR) in 3.6 months and 23.5% had partial remission (PR) in 3.7 months. The most common treatments that led to CR were topical corticosteroids (n = 16) and biologic switching (n = 8).

Conclusions

Clinicians should anticipate PPP or PPPP as potential drug reactions to biologics such as adalimumab and infliximab. Large‐scale studies are required to confirm our findings and further explore the pathogenesis for biologic‐associated PPP and PPPP.
Rules and ward climate in acute psychiatric setting: Comparison of staff and patient perceptions
Authors: Corbetta Marta , Corso Barbara , Camuccio Carlo Alberto
Published: February 2022

The ward climate or atmosphere refers to its material, emotional and social conditions. A good ward climate in psychiatric settings can influence the mood, behaviour and self‐concept of patients and staff members and improve patient outcomes. Many studies have examined the relationship between ward climate and aggression, but only a few have investigated the effect of a ward’s environment, rules and activities. This multicentric observational study aimed to assess the relationship between the rules/activities and the climate of four acute psychiatric units of Northern Italy. The Essen Climate Evaluation Scheme (EssenCES) questionnaire, which was administered to patients and staff, was used to evaluate the different dimensions of ward atmosphere. There was a good response rate (79%) in patients and staff members who completed the questionnaire (114 patients and 109 staff). Safety perception appeared to be quite different in patients and staff. The patients who were authorized to have more visiting hours and more time to use their mobile phone had higher scores on Experienced Safety subscale. A negative correlation between the Therapeutic Hold and Experienced Safety subscales was found in the staff members, and this was due to their negative perception. The ward climate seemed to be affected by the unit’s rules, especially with respect to visits and the smartphones use. Nurses need to be aware of the importance of ward climate and how their own perception may differ from and that of patients: this gap could lead to decisions detached from the patients’ needs.
Frailty index and gender‐specific mortality in Korean adults: Findings from the Korean Longitudinal Study of Aging (2006–2018)
Authors: Baek Wonhee , Min Ari
Published: February 2022

Aims

To examine the predictive ability of the frailty index in estimating gender‐specific mortality in a population of Korean adults.

Design

A descriptive and prospective longitudinal design.

Methods

Data were used from the Korean Longitudinal Study of Aging conducted from 2006 through 2018. A total of 10,254 adults aged 45–98 years at baseline were included. A 41‐item deficit accumulation frailty index was measured, based on multi‐domain assessment such as self‐rating of health, physical condition, mental status, cognitive function, activities of daily living, instrumental activities of daily living and chronic conditions. We categorized the frailty index into robust (≤0.10), prefrail (0.10–0.25) and frail (≥0.25). Cox's proportional hazards regression analysis was employed to determine the association between the frailty index and all‐cause mortality.

Results

A total of 4705 individuals (45.9%) were categorized as robust, 4178 (40.7%) as prefrail and 1371 (13.4%) as frail. The frailty index increased with age, and females were found to have a higher frailty index than males. The survival probabilities were significantly lower in older adults (aged ≥65) compared with adults and significantly lower in males compared with females. Compared with the robust group, the risk of mortality in the prefrail and frail groups was 1.37 and 2.57 times higher, respectively. The association between frailty status and all‐cause mortality was similar in adults and older adults, while the hazard ratios were higher in frail group of males than that of females.

Conclusion

The frailty index had a predictive ability for all‐cause mortality with respect to age and sex.

Impact

Using a frailty index among community‐dwelling adults could be beneficial to support healthcare providers in early detection of individuals with frailty and facilitate the development of more effective interventions for reducing mortality.
Registered nurses' awareness and implementation of reasonable adjustments for people with intellectual disability and/or autism
Authors: Wilson Nathan J. , Pracilio Amy , Kersten Michelle , Morphet Julia , Buckely Thomas , Trollor Julian N. , Griffin Ken , Bryce Julianne , Cashin Andrew
Published: February 2022

Aim

To describe Australian registered nurses' awareness, and implementation of reasonable adjustments within their practice when caring for people with intellectual disability and/or autism. Additionally, the association between key demographic, workforce, and respondent variables and familiarity of the term and regularity of use was explored.

Design

Cross‐sectional survey.

Methods

Survey data were collected between August and October 2020 using an online survey tool. Data were analysed using descriptive and inferential statistics.

Results

Familiarity of the concept of reasonable adjustments was relatively low, compared to respondents who report applying adjustments when caring for people with intellectual disability and/or autism. Higher levels of confidence, comfort, and knowledge when caring for this cohort were associated with greater awareness and application of reasonable adjustments.

Conclusion

A higher volume, and diversity in type of, nursing education related to care for people with intellectual disability and/or autism is indicated.
Comparison of visual shade matching and photographic shade analysis
Authors: Rondón Luis Felipe , Ramírez Robert , Pecho Oscar E.
Published: February 2022

Objective

To compare the performance of a standardized photographic shade analysis (PSA) and visual shade matching (VSM) using two color difference formulas.

Materials and Methods

Fifty observers (35 undergraduate and 15 graduate students) evaluated the color of two upper left central incisors (LT—light tooth, and DT—dark tooth). VSM was performed using the VITA 3D Master (3D) shade guide in a controlled clinical environment. For PSA, a cross‐polarized filter and a gray card (Whibal) were used to standardize the photographs taken (target teeth and shade tabs from 3D). From the pictures obtained, the CIELAB coordinates, and color differences ( and ΔE00) were obtained. The shade tabs selected by two experienced researchers were conducted as part of the pilot study, and finally used as a standard for the analysis. Data were analyzed using descriptive statistics and the chi‐square test (p ≤ 0.05).

Results

Shade tabs selections of VSM and PSA agreed only for LT. The best “Match” selected by the researchers agreed with data from PSA using ΔE00. PSA using ΔE00 showed higher total percentages of “Match” and higher percentage of agreement among observers. A relationship was found for LT performing the PSA (p < 0.05).

Conclusions

The performance of the PSA was better than the VSM, but only when the CIEDE2000 color difference formula was used. Therefore, the color difference formulas influenced on the performance of PSA. Finally, the PSA improved the precision of the VSM.

Clinical Significance

To use a standardized PSA to improve the VSM and shade communication in clinical esthetic dentistry.
Public opinion regarding U.S. Food and Drug Administration approval of aducanumab and potential policy responses: A nationally representative survey
Authors: DiStefano Michael J. , Alexander G. Caleb , Polsky Daniel , Anderson Gerard F.
Published: February 2022

Background

Despite controversy among experts regarding aducanumab's approval by the U.S. Food and Drug Administration, little is known about public opinion on this matter.

Methods

We conducted a representative survey of U.S. adults ages 35 and older to (1) determine opinions regarding aducanumab's approval, (2) identify any evidence of reputational injury to the Food and Drug Administration, and (3) explore opinions regarding policy responses available to policymakers, such as those relating to a national coverage determination by the Centers for Medicare and Medicaid Services. The survey was administered online and in English and Spanish using a probability‐based sample derived from the National Opinion Research Center's AmeriSpeak® panel. Selection probabilities in the panel and survey design account for differences in population distribution and expected response rates by demographic. The survey was analyzed using survey weights to adjust for selection probabilities and non‐response.

Results

A total of 1025 respondents completed the survey. While approximately three‐quarters of respondents were initially unfamiliar with aducanumab, respondents were less supportive of the drug's approval once given information about the drug's potential clinical and economic impact. Sixty‐three percent of respondents support restricting aducanumab access to patients most likely to benefit. Seventy‐one percent indicated a willingness to enroll a family member with mild Alzheimer's disease in a “waitlist”‐style trial to further study aducanumab; sixty percent indicated a willingness to enroll a family member in a randomized placebo‐controlled trial. Eighty‐one percent agree aducanumab should be withdrawn from the market if confirmatory trials fail. The median respondent was willing to pay $1–5 in higher Part B premiums to cover aducanumab.

Conclusion

These findings demonstrate support for a range of proposed policies in response to aducanumab's approval. The opinions of an informed public ought to be considered when developing policies in response to aducanumab's approval.
Understanding Bank and Nonbank Credit Cycles: A Structural Exploration
Authors: DURDU C. BORA , ZHONG MOLIN
Published: February 2022

We explore the structural drivers of bank and nonbank credit cycles using a medium‐scale dynamic stochastic general equilibrium (DSGE) model with two types of financial intermediation. We posit economywide and sectoral disturbances in both macro and financial sectors. We estimate that sectoral shocks to the balance sheets of entrepreneurs are important for fluctuations in bank and nonbank credit growth at the business cycle frequency. Economywide entrepreneurial risk shocks gain predominance for explaining the lower frequency comovement between the two series. Macro shocks play very little role in explaining financial cycles.
Randomized, evaluator‐blinded comparative study of a potassium titanyl phosphate (KTP) 532‐nm picosecond laser and an alexandrite 755‐nm picosecond laser for the treatment of solar lentigines in Asians
Authors: Vachiramon Vasanop , Namasondhi Amornrut , Anuntrangsee Tanaporn , Jurairattanaporn Natthachat
Published: February 2022

Background

Various pigment‐specific lasers can be used to treat solar lentigines. However, the most effective treatment options remain to be explored to reduce complications, such as postinflammatory hyperpigmentation, especially in dark‐skinned patients.

Objectives

This study aims to compare the efficacy and safety between the KTP 532‐nm picosecond laser and the alexandrite 755‐nm picosecond laser for the treatment of solar lentigines in Asians.

Materials and Methods

Thirty patients who had at least two solar lentigines on their arms were enrolled. A total of 30 paired lentiginous lesions were randomly selected for a single treatment with either a KTP 532‐nm picosecond laser or an alexandrite 755‐nm picosecond laser. Mean luminance score (L*) was evaluated at baseline and at 6 and 12 weeks to determine treatment efficacy. Improvement was assessed by a blinded physician using a 5‐point score. Satisfaction was rated by patients using a visual analog scale. All adverse events were documented.

Results

All 30 patients completed the study. Both lasers showed significant improvement in mean L* from baseline (p < 0.001). With the parameter settings employed, lesions treated with the alexandrite 755‐nm picosecond laser showed greater improvement in mean L* when compared with treatment with the KTP 532‐nm picosecond laser at 12 weeks follow‐up (p = 0.002). According to physician scoring, more than 50% improvement was observed in 25 and 19 lesions of the alexandrite 755‐nm picosecond laser group and the KTP 532‐nm picosecond laser group, respectively. Adverse events did not differ between groups. A significantly higher satisfaction score was observed with the alexandrite 755‐nm picosecond laser at the last visit (p = 0.038).

Conclusion

Both types of picosecond laser may be used to treat solar lentigines. Proper treatment settings and endpoint observation are the most important factor to achieve a successful outcome.
Accuracy of bilirubin on the Siemens RAPIDPoint 500 blood gas analyser: A data mining study
Authors: Mukerji Shohini , Popat Himanshu , Chung Jason ZY
Published: February 2022

Aim

Blood gas analysers which can measure bilirubin in whole blood are commonly available in neonatal intensive care units; however, the accuracy of these measurements is not well established. We sought to determine accuracy of whole blood bilirubin on the Siemens RAPIDPoint 500 blood gas analyser with reference to formal laboratory total serum bilirubin on the Ortho Vitros 5600.

Methods

A method comparison of the bilirubin results from the blood gas analysers compared with the chemistry analysers was performed by data mining of results obtained as part of routine patient care. Results were included if patients underwent bilirubin testing by blood gas analyser and formal TSB, with both samples being collected within 20 min. Retrospective laboratory data was collected over a 28‐month period, 1 January 2019 to 1 May 2021.

Results

449 eligible sample pairs were included. A Bland‐Altman plot was generated to identify systematic differences between the methods. A mean bias of −11 μmol/L was observed with 95% limits from −60 μmol/L to 38 μmol/L. Some blood gas bilirubin results were up to 70 μmol/L lower than formal TSB measurements around the clinically significant concentration range of 200 to 300 μmol/L.

Conclusion

Clinicians need to be aware of potential differences between the results from their blood gas analysers compared to formal TSB results. Sole reliance on blood gas bilirubin results which underestimate TSB may lead to under‐recognition of neonatal jaundice that meets treatment thresholds. Formal measurement of TSB should be sought to inform decisions regarding treatment of neonatal jaundice.
Benign acute childhood myositis associated with influenza A/B in the paediatric emergency department and the efficacy of early‐onset oseltamivir
Authors: Turan Caner , Yurtseven Ali , Cicek Candan , Keskin Gulsum , Saz Eylem Ulas
Published: February 2022

Aim

To investigate the association of benign acute childhood myositis (BACM) with respiratory viruses. Also, we aimed to assess the effect of antiviral treatment on the improvement and complications.

Methods

This study was conducted at an urban‐academic emergency department during four influenza‐seasons (2016–2019), retrospectively. Demographics, clinical findings, laboratories, metabolic disease analyses and serological features were extracted from the medical records. Treatments, complications and outcomes were also recorded.

Results

A total of 114 children were included. The median age was 7.0 (min 1.25–max 17) years and 78.9% were male. The most common symptoms were leg pain (91.2%), anorexia (54.4%), fever (45.6%), sore throat (42.1%) and walking difficulty (32.5%). On admission, the median creatine phosphokinase level was 3332 IU/L (range, 1634–50 185), median aspartate aminotransferase 107 U/L (range, 38–1798). In the multiplex polymerase chain reaction analysis, 40.4% influenza B, 36.8% influenza A, 7.8% adenovirus, 7.8% parainfluenza virus, 5.3% rhinovirus, 5.3% respiratory syncytial virus and 1.8% Mycoplasma pneumoniae were detected. Rhabdomyolysis was developed in 6.7% and acute renal failure was seen in two patients. Oseltamivir was given in 44 (38.6%) patients who had influenza A/B. Metabolic disease screening tests were performed in 33.3% of patients and metabolic diseases were detected in 4 (3.5%) patients. The median recovery time was lower in patients with oseltamivir treatment (4 (min 2–max 5) − 5 (min 3–max 10) days) (P < 0.001).

Conclusion

Rhabdomyolysis is more common in BACM due to the influenza A virus. The early use of oseltamivir treatment was significantly associated with a shorter recovery time.
Clinicopathologic features, comorbid diseases, and prevalence of pulmonary hypertension in dogs with bronchomalacia
Authors: Gamracy Jennifer , Wiggen Kelly , Vientós‐Plotts Aida , Reinero Carol
Published: February 2022

Background

Reports of clinicopathologic features of bronchomalacia (BM) differ because of inconsistent definitions and frequent prevalence of comorbid cardiopulmonary disease. Pulmonary hypertension (PH) secondary to BM is poorly described.

Objectives

Dogs with BM will be older but of any somatotype, and increased expiratory effort, ≥1 comorbid disease, and PH will be more common than in dogs without BM.

Animals

Client‐owned dogs (n = 210) evaluated for respiratory signs.

Methods

Medical records of dogs with paired inspiratory: expiratory‐breath‐hold computed tomography, tracheobronchoscopy, or both between January 2016 and December 2019 were retrospectively reviewed. Comparisons between dogs with and without BM using Mann‐Whitney rank sum or χ2 tests (P < .05 significant were made). Because of high numbers of variables, criteria with high prevalence (>25%) were identified (n = 10) for univariate analysis (P < .005 significant). Significant variables were submitted for multivariate analysis.

Results

Bronchomalacia was identified in 41% of dogs of all sizes/somatotypes; 38% were >10 kg. All dogs with BM had ≥1 comorbid cardiopulmonary disorder. Dogs with BM were significantly older (P < .001), smaller (P < .001), and were more likely diagnosed with tracheal or mainstem bronchial collapse (P < .001) or bronchiectasis (P < .001). Multivariate analysis confirmed associations with age, tracheal or mainstem bronchial collapse, and bronchiectasis. In dogs with BM, PH was more prevalent.

Conclusions and Clinical Importance

Although significantly more common in older, smaller dogs, BM occurs in dogs of all sizes and in all instances with comorbidities. Echocardiography should be considered in dogs with BM to identify PH.
The Effects of Spaced Practice on Second Language Learning: A Meta‐Analysis
Authors: Kim Su Kyung , Webb Stuart
Published: February 2022

This meta‐analysis investigates earlier studies of spaced practice in second language learning. We retrieved 98 effect sizes from 48 experiments (N= 3,411). We compared the effects of three aspects of spacing (spaced vs. massed, longer vs. shorter spacing, and equal vs. expanding spacing) on immediate and delayed posttests to calculate mean effect sizes. We also examined the extent to which nine empirically motivated variables moderated the effects of spaced practice. Results showed that (a) spacing had a medium‐to‐large effect on second language learning; (b) shorter spacing was as effective as longer spacing in immediate posttests but was less effective in delayed posttests than longer spacing; (c) equal and expanding spacing were statistically equivalent; and (d) variability in spacing effect size across studies was explained methodologically by the learning target, number of sessions, type of practice, activity type, feedback timing, and retention interval. The methodological and pedagogical significance of the findings are discussed.
“Folly of the Fiction” and the “Native Taste”: Cultural Interfaces in Two Bengali Adaptations ofCymbeline
Authors: Sarkar Abhishek
Published: February 2022

This article examines how two nineteenth‐century Bengali adaptations ofCymbelinetransfer Shakespeare's play to a Hindu field of signifiers and reinterpret the elements of tragicomedy according to the worldview of traditional Indian drama.Kusumkumari Natak(1868) by Chandrakali Ghosh, which was enacted before a ticket‐buying audience at the nascent phase of the Bengali public theatre in Kolkata (formerly Calcutta), condenses or rejects much of the action and dialogue ofCymbelinefor the sake of economy. For example, it excludes Cloten and the confusion over his beheading and discards Posthumus's dream together with the prophetic riddle. On the other hand,Sushila Birsingha(1868) by Satyendranath Tagore, which was probably never staged, follows the convoluted plot and characterisation ofCymbelinequite closely.Cymbelinewould appeal to the Bengali audience because it recalls traditional Hindu tales of reunion and reconciliation, including those of Sakuntala‐Dushyanta (referenced byKusumkumari Natak) and Damayanti‐Nala (referenced bySushila Birsingha). Moreover, Innogen's ordeals would be compatible with the trope of the abandoned faithful wife (as exemplified by Sita, Sakuntala, Damayanti) in Sanskrit epic and drama. This would also enable the valorisation of wifely fidelity and chastity, a favourite topic of Hindu patriarchal imagination in the nineteenth century. More importantly, the theme of loss and recuperation inherent inCymbelineaccords with the episteme and aesthetics of classical Sanskrit drama, which avoided exploring grave moral challenges and rejected the finality of sufferings (thanks to the doctrines of Vedanta or monistic theism,karmaand reincarnation). This article also suggests thatCymbelinefell out of favour with subsequent Bengali translators and playgoers as the taste for tragedy grew among them.
Differential fuel utilization in liver transplant recipients and its relationship with non‐alcoholic fatty liver disease
Authors: Siddiqui Mohammad S. , Patel Samarth , Forsgren Mikael , Bui Anh T. , Shen Steve , Syed Taseen , Boyett Sherry , Chen Shanshan , Sanyal Arun J. , Wolver Susan , Kirkman Danielle , Celi Francesco S. , Bhati Chandra S.
Published: February 2022

Metabolic flexibility is the ability to match biofuel availability to utilization. Reduced metabolic flexibility, or lower fatty acid (FA) oxidation in the fasted state, is associated with obesity. The present study evaluated metabolic flexibility after liver transplantation (LT).

Methods

Patients receiving LT for non‐alcoholic steatohepatitis (NASH) (n = 35) and non‐NASH (n = 10) were enrolled. NASH was chosen as these patients are at the highest risk of metabolic complications. Metabolic flexibility was measured using whole‐body calorimetry and expressed as respiratory quotient (RQ), which ranges from 0.7 (pure FA oxidation) to 1.0 is (carbohydrate oxidation).

Results

The two cohorts were similar except for a higher prevalence of obesity and diabetes in the NASH cohort. Post‐prandially, RQ increased in both cohorts (i.e. greater carbohydrate utilization) but peak RQ and time at peak RQ was higher in the NASH cohort. Fasting RQ in NASH was significantly higher (0.845 vs. 0.772, p < .001), indicative of impaired FA utilization. In subgroup analysis of the NASH cohort, body mass index but not liver fat content (MRI‐PDFF) was an independent predictor of fasting RQ. In NASH, fasting RQ inversely correlated with fat‐free muscle volume and directly with visceral adipose tissue.

Conclusion

Reduced metabolic flexibility in patients transplanted for NASH cirrhosis may precede the development of non‐alcoholic fatty liver disease after LT.
Update on the management of gastric varices
Authors: Luo Xuefeng , Hernández‐Gea Virginia
Published: February 2022

Gastro‐oesophageal varices are the major clinical manifestations of cirrhosis and portal hypertension. Although less frequent than oesophageal varices (EV), bleeding from gastric varices (GV) is generally more severe and associated with higher mortality and a greater risk to rebleed. According to Sarin's classification, GVs are categorized into four types based on their location within the stomach and relationship with EV. Currently, treatment options for the management of GV include beta‐blockers, endoscopic band ligation, endoscopic cyanoacrylate injection, EUS‐guided coil/cyanoacrylate injection, transjugular intrahepatic portosystemic shunts and balloon‐occluded retrograde transvenous obliteration. The best treatment strategy of GV remains controversial because of the heterogeneity of GV, lack of high‐quality data and suboptimal trial design of the studies available. The proper treatment algorithm may require adequate endoscopic and imaging evaluation by a multidisciplinary team with multiple treatment options available. This review describes the hemodynamic features of GV, pharmacological, endoscopic and interventional radiological treatment options for GV.
Complicated Gender Gaps in Mathematics Achievement: Elevated Stakes during Performance as One Explanation
Authors: Lyons Emily , Mesghina Almaz , Richland Lindsey E.
Published: February 2022

Gender gaps in mathematics achievement persist in many contexts and when visible, these gaps are paradoxical. Low‐stakes measures of mathematics achievement such as grades and study behaviors favor girls, while gaps tend to reverse on assessments/competitions. We explore whether different impacts of raising performance stakes could be one explanation. Study 1 experimentally manipulated the stakes by imposing a performance‐contingent, social‐evaluative pressure either: before instruction (n = 66), before testing (n = 61), or none (n = 54). Pressure, particularly when experienced during instruction, reduced learning among girls. In contrast, boys trended toward enhanced learning under pressure. In the absence of pressure, girls exhibited strikingly larger gains in learning. Study 2 drew from a larger dataset (n = 386) to interrogate whether girls' superior learning in the no‐pressure context might simply be an artifact of differences in prior knowledge, cognitive resources, or demographic variables, but the effect replicated and was not explained by these factors.
‘A whole lot of uncertainty’: A qualitative study exploring clinical medical students' experiences of uncertainty stimuli
Authors: Stephens Georgina C. , Sarkar Mahbub , Lazarus Michelle D.
Published: February 2022

Introduction

Uncertainty tolerance (UT) describes how individuals respond to stimuli of uncertainty, with low UT among medical doctors and students linked to negative outcomes such as burnout. UT research in medical education has focused on measuring the construct, with little research seeking to understand how medical students experience uncertainty. Hence, knowledge on how education may shape students' UT development is lacking. As a first step to understanding students' UT, we asked ‘How do medical students, in their clinical years, experience uncertainty stimuli?’

Methods

Utilising a social constructionist approach, we undertook a qualitative study with 41 clinical years medical students. Data were collected during the 2020 academic year employing in‐semester reflective diary entries (n = 230 entries), and semi‐structured interviews at the end of semesters (n = 40 interviews). Data were analysed by framework analysis.

Results

Students described three major themes of uncertainty stimuli: (i) educational uncertainty, (ii) professional uncertainty and (iii) clinical uncertainty. Educational uncertainty was the dominant stimulus described by students and represents unknowns related to what students needed to learn and how to learn within the context of clinical placements. Professional uncertainty encompassed questions about who students are as developing professionals and who they would be as doctors. Clinical uncertainty was the least represented stimulus and concerned aspects of patient care where the body of medical knowledge is unable to provide clear answers.

Conclusions

Our findings indicate that clinical learners experience wide reaching uncertainties and suggest that students' stimuli may differ from those of clinicians with more established knowledge and careers. This work now paves the way forward in developing educational interventions to foster UT, such as modifying uncertainties not integral to learning, and purposefully introducing clinical uncertainties relevant to students' learning stage.
Conclusion: General and Particular Challenges of Expert Witnessing
Authors: Torres M. Gabriela , Staszkow Tatianna
Published: February 2022

The concluding reflection of the special section “Expert Witnessing in Asylum Practice” puts the particular challenges for anthropologists in context. It highlights the ways that issues of essentialism are particular to our discipline and points to current and future general challenges for expert witnesses working in the U.S. asylum system.
Metataxonomic and metabolomic evidence of biofilm homeostasis disruption related to caries: An in vitro study
Authors: Sánchez María C. , Velapatiño Angela , Llama‐Palacios Arancha , Valdés Alberto , Cifuentes Alejandro , Ciudad María J. , Collado Luis
Published: February 2022

The ecological dysbiosis of a biofilm includes not only bacterial changes but also changes in their metabolism. Related to oral biofilms, changes in metabolic activity are crucial endpoint, linked directly to the pathogenicity of oral diseases. Despite the advances in caries research, detailed microbial and metabolomic etiology is yet to be fully clarified. To advance this knowledge, a meta‐taxonomic approach based on 16S rRNA gene sequencing and an untargeted metabolomic approach based on an ultra‐high performance liquid chromatography‐quadrupole time‐of‐flight mass spectrometry analysis (UHPLC/Q‐TOF‐MS) were conducted. To this end, an in vitro biofilm model derived from the saliva of healthy participants were developed, under commensal and cariogenic conditions by adding sucrose as the disease trigger. The cariogenic biofilms showed a significant increase of Firmicutes phyla (p = 0.019), due to the significant increase in the genus Streptococcus (p = 0.010), and Fusobacter (p < 0.001), by increase Fusobacterium (p < 0.001) and Sphingomonas (p = 0.024), while suffered a decrease in Actinobacteria (p < 0.001). As a consequence of the shift in microbiota composition, significant extracellular metabolomics changes were detected, showed 59 metabolites of the 120 identified significantly different in terms of relative abundance between the cariogenic/commensal biofilms (Rate of change > 2 and FDR < 0.05). Forty‐two metabolites were significantly higher in abundance in the cariogenic biofilms, whereas 17 metabolites were associated significantly with the commensal biofilms, principally related protein metabolism, with peptides and amino acids as protagonists, latter represented by histidine, arginine, l‐methionine, glutamic acid, and phenylalanine derivatives.
Transcriptome and hyperspectral profiling allows assessment of phosphorus nutrient status in rice under field conditions
Authors: Takehisa Hinako , Ando Fuminori , Takara Yohei , Ikehata Akifumi , Sato Yutaka
Published: February 2022

Phosphorus (P) is one of the macronutrients indispensable for crop production, and therefore it is important to understand the potential of plants to adapt to low P conditions. We compared growth and leaf genome‐wide transcriptome of four rice cultivars during growth between two fields with different amount of available phosphate and further analysed the acceptable range of P levels for normal growth from the view of both appearance traits and internal P nutrient status, which was measured by profiling the expression of the P indicator gene. This demonstrated that rice plants have a robustness to moderate P‐deficient conditions expressing a system for P acquisition and usage without any effects on yield potential and that P indicator gene expression could be a useful index for early diagnosis of P status in plants. To develop a simple method for assessment of P status, we tried to predict the expression level using reflectance spectroscopy and hyperspectral imaging, thereby providing models with good performance. Our findings suggest that rice plants have the potential to adapt to moderate low P conditions in the field and showed that the hyperspectral technique is one of the useful tools for simple measurement of molecular‐level dynamics reflecting internal nutrient conditions.
New insights into the pathogenesis of Hermansky–Pudlak syndrome
Authors: Li Wei , Hao Chan‐Juan , Hao Zhen‐Hua , Ma Jing , Wang Qiao‐Chu , Yuan Ye‐Feng , Gong Juan‐Juan , Chen Yuan‐Ying , Yu Jia‐Ying , Wei Ai‐Hua
Published: February 2022

Hermansky–Pudlak syndrome (HPS) is characterized by defects of multiple tissue‐specific lysosome‐related organelles (LROs), typically manifesting with oculocutaneous albinism or ocular albinism, bleeding tendency, and in some cases with pulmonary fibrosis, inflammatory bowel disease or immunodeficiency, neuropsychological disorders. Eleven HPS subtypes in humans and at least 15 subtypes in mice have been molecularly identified. Current understanding of the underlying mechanisms of HPS is focusing on the defective biogenesis of LROs. Compelling evidences have shown that HPS protein‐associated complexes (HPACs) function in cargo transport, cargo recycling, and cargo removal to maintain LRO homeostasis. Further investigation on the molecular and cellular mechanism of LRO biogenesis and secretion will be helpful for better understanding of its pathogenesis and for the precise intervention of HPS.
Evolution of incidence of chilblain‐like lesions in children during the first year of COVID‐19 pandemic
Authors: Bascuas‐Arribas Marta , Andina‐Martinez David , Añon‐Hidalgo Juan , Alonso‐Cadenas Jose Antonio , Hernandez‐Martin Angela , Lamagrande‐Casanova Nuria , Noguero‐Morel Lucero , Mateos‐Mayo Ana , Colmenero‐Blanco Isabel , Torrelo Antonio
Published: February 2022

Background

The COVID‐19 pandemic has brought innumerable reports of chilblains. The relation between pernio‐like acral eruptions and COVID‐19 has not been fully elucidated because most reported cases have occurred in patients with negative microbiological tests for SARS‐CoV‐2.

Methods

A retrospective study of 49 cases of chilblains seen during the first year of the pandemic in a children's hospital in Madrid, Spain. The incidence of these skin lesions was correlated with the number of COVID‐19 admissions and environmental temperatures. Patients were separated into two groups depending on the day of onset (strict lockdown period vs. outside the lockdown period).

Results

Most chilblains cases presented during the first and third waves of the pandemic, paralleling the number of COVID‐19 admissions. The first wave coincided with a strict lockdown, and the third wave coincided with the lowest ambient seasonal temperatures of the year. Systemic symptoms preceding chilblains were more frequent in the first wave (45.8% vs. 8.0%, p = .002), as was the co‐occurrence with erythema multiforme‐like lesions (16.7% vs. 0%, p = .033). Laboratory test and skin biopsies were performed more frequently in the first wave (75.0% vs. 12.0%, p < .001; and 25.0% vs. 0%, p = .007; respectively). Five patients developed recurrent cutaneous symptoms.

Conclusions

An increased incidence of chilblains coincided not only with the two major waves of the pandemic, but also with the strict lockdown period in the first wave and low seasonal temperatures during the third wave. Both increased sedentary behaviors and cold environmental temperatures may have played an additive role in the development of COVID‐19‐related chilblains.