bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of overfishing of frugivorous fishes for cryptic function loss in a Neotropical floodplain
Authors: Araujo Joisiane Mendes , Correa Sandra Bibiana , Penha Jerry , Anderson Jill , Traveset Anna
Published: April 2021

Many frugivorous animals act simultaneously as seed predators and dispersers, and shifts in the abundance and mean phenotype of the frugivore population can alter the prevalence of antagonistic versus mutualistic interactions with seeds.

Here, we evaluated how a reduction in the abundance and species richness of large‐bodied frugivorous fishes affects their interactions with plants in a Neotropical floodplain. Fisheries selectively harvest large frugivorous fishes, which are the most effective seed dispersers. Thus, functional extinctions of fish mutualists can cascade to secondary extinctions of plants and their biotic associates, and ecosystem‐level change.

We evaluated functional responses of wetland communities to changes in fish body size by modelling the robustness of plant–frugivore networks to different extinction scenarios, using fish body size as a functional trait influencing seed dispersal and seed predation. We built ecological networks for frugivory, seed dispersal and seed predation.

All networks lacked modularity and showed reduced nestedness compared with randomized networks. The three networks indicated that frugivorous fish have wide niches and low to intermediate degree of specialization. Network robustness to extinction of frugivorous fish decreased with selective loss of large individuals.

Synthesis and applications. We predict that reductions in the abundance of large‐bodied fish species will enhance the dominance of plant species with small seeds and decrease plant diversity. The functionally most important species in our networks are the most susceptible to overfishing. Therefore, sustainable management in these ecosystems needs to contribute to protecting interactions and, consequently, ecological and evolutionary processes related to maintaining biodiversity in vast wetland forests.
Emerging technologies for the management of type 2 diabetes mellitus
Authors: Shah Nirali A. , Levy Carol J.
Published: April 2021

Diabetes mellitus is a global health problem affecting 422 million people worldwide, of which 34.2 million live in the United States alone. Complications due to diabetes can lead to considerable morbidity and mortality related to both microvascular and macrovascular disease. While glycosylated hemoglobin testing is the standard test utilized to evaluate glycemic control, emerging targets like “time in range” and “glycemic variability” often provide more accurate assessments of glycemic fluctuations and have implications for diabetes complications and quality of life. Patients with diabetes face considerable burdens of self‐care including frequent glucose monitoring, multiple insulin injections, dietary management, and the need to track daily activities, all of which lead to reduced adherence and psychological burnout. From the provider perspective, limited patient data and access to self‐management tools lead to treatment inertia and a reduced ability to help patients achieve and maintain their glycemic goals. In the past few decades, there have been considerable advances in treatment‐based technology and technological applications designed to help reduce patient burden and provide tools for better self‐management. These advances make real‐time clinical data available for clinicians to make necessary changes in treatment regimens. In this review, we discuss the latest emerging technologies available for the management of people with type 2 diabetes mellitus.
Regulating Cannabis: A Comparative Exploration of Canadian Legalization
Authors: Bowal Peter , Kisska‐Schulze Kathryn , Haigh Richard , Ng Adrienne
Published: April 2021

This article explores cannabis regulation in Canada and the United States and examines how recent legalization efforts have manifested differently in each country. Although some of these differences are explained by uncompromising constitutional structures, this comparative exercise examines each system's political choices. While emphasis is placed on the Canadian experience, this article seeks to inform and enhance policy and regulation in both countries in addition to highlighting inherent ethical issues.
A new generation of transdermal alcohol biosensing technology: practical applications, machine ‐learning analytics and questions for future research
Authors: Fairbairn Catharine E. , Bosch Nigel
Published: April 2021

The use of transdermal alcohol monitors has burgeoned in recent years, now encompassing hundreds of thousands of individuals globally. A new generation of sensors promises to expand the range of applications for transdermal technology exponentially, and advances in machine‐learning modeling approaches offer new methods for translating the data produced by transdermal devices. This article provides (1) a review of transdermal sensor research conducted to date, including an analysis of methodological features of past studies potentially key in driving reported sensor performance; (2) updates on methodological developments likely to be transformative for the field of transdermal sensing, including the development of new‐generation sensors featuring smartphone integration and rapid sampling capabilities as well as developments in machine‐learning analytics suited to data produced by these novel sensors and; (3) an analysis of the expanded range of applications for this new generation of sensor, together with corresponding requirements for sensor accuracy and temporal specificity. We also note questions as yet unanswered and key directions for future research.
Australian general surgical trainee experience with inguinal hernia surgery: a review of international training programmes and the learning curve
Authors: Giddings Hugh L. , Fenton‐Lee Douglas
Published: April 2021

Background

There are no publications addressing the level of experience Australian surgical trainees achieve in inguinal hernia surgery. Internationally, some training boards have set minimum competency requirements, but this is not true in Australia. The longer learning curve for laparoscopic inguinal hernia repairs (LIHRs) compared to open inguinal hernia repairs (OIHRs) has placed greater demands on trainees.

Methods

Logbook data on OIHR and LIHR for Australian surgical trainees who graduated as fellows between 2013 and 2018 were obtained. A literature review was performed to analyse international published logbook numbers for surgical trainees from the past decade. International training board requirements, estimations of the learning curve and hernia society guidelines for each procedure were reviewed.

Results

In total, 7946 operations were recorded from 58 trainees. On average 49.2 OIHRs (range 13–101), 21.5 LIHRs (range 1–94) and 71.1 inguinal hernia repairs overall (range 25–129) were performed during training. The European Hernia Society recommends that at least 30–50 of each procedure be performed during training. The learning curves for LIHRs (50–100 procedures) have been shown to be longer than for OIHRs (40–64 procedures).

Conclusion

Australian general surgical trainees are achieving adequate primary operator logbook numbers for OIHRs but are not completing the required number of LIHRs. The tailored approach to inguinal hernia repair requires skill in both open and laparoscopic repairs. This may not be possible with the current training structure in Australia.
Comparison of metal stents versus plastic stents for preoperative biliary drainage: a meta‐analysis of five randomized controlled trials
Authors: Zhang Wei , Xu Lin , Che Xu
Published: April 2021

Background

Although routine preoperative biliary drainage (PBD) is generally not recommended for patients with malignant distal biliary obstruction (MDBO), it is still necessary in many cases. The objective of this study is to compare the effects of metal stents (MSs) and plastic stents (PSs) on PBD in patients with MDBO.

Methods

All the randomized controlled trials (RCTs) that compared MS with PS for PBD and published from the date of database establishment to September 2020 were identified by searching the PubMed, EMBASE and Cochrane databases.

Results

Five RCTs involving 445 patients were included. There were 201 cases in the MS group, with 244 in the PS group. Re‐interventions (relative risk (RR) = 0.40, 95% confidence interval (CI) 0.21–0.75, P = 0.004), stent occlusions (RR = 0.36, 95% CI 0.18–0.75, P = 0.006), postoperative complications (RR = 0.76, 95% CI 0.59–0.97, P = 0.03) and preoperative cholangitis (RR = 0.19, 95% CI 0.05–0.78, P = 0.02) were lower in the MS group than in the PS group. Preoperative pancreatitis (RR = 2.11, 95% CI 1.06–4.19, P = 0.03) was higher in the MS group than in the PS group. No significant difference was observed in the overall preoperative complications, postoperative pancreatic fistulas, delayed gastric emptying, wound infections and postoperative bleeding between these two groups.

Conclusions

MS and PS exerted a similar effect on PBD, but PS had a higher risk of preoperative stent obstruction and postoperative complications, requiring more frequent interventions preoperatively. However, larger sample and higher quality RCTs are necessary for further verification.
Investigation of air bubble properties: Relevance to prevention of coronary air embolism during cardiac surgery
Authors: Kihara Kazuki , Orihashi Kazumasa
Published: April 2021

Although de‐airing procedures are commonly performed during cardiac surgery, use of these procedures is not necessarily based on evidence. Uncertainly remains around the size of bubbles that can be detected by echocardiography, whether embolized air or carbon dioxide can be absorbed, and the reasons for embolic events occurring despite extensive de‐airing. Since air bubbles are invisible in the blood, we used simple experimental models employing water and 10% dextran solution to determine the correlation between actual bubble size and the depicted size on echocardiography, bubble size, and floatation velocity and the absorption of carbon dioxide under embolization and irrigation conditions. Bubbles depicted as larger than 1 mm were overestimated by echocardiography: the actual size was larger than 0.4 mm in diameter. While bubbles of 0.5 mm had a floatation velocity of 2 to 3 cm/s, the buoyancy of bubbles smaller than 0.3 mm was negligible. Thus, bubbles that are depicted as larger than 1 mm on echocardiography or that present with apparent buoyancy should be visible and need to be meticulously removed. However, echocardiography cannot distinguish bubbles of around 0.1 mm in diameter from those of capillary size (<10 μm). Thus, we advise continuous venting of dense bubbles until they become sparse. While carbon dioxide was rapidly absorbed when circulating, the absorption of embolized carbon dioxide was negligible. These results suggest that detected intracardiac air represents residual “air,” with carbon dioxide already absorbed. Therefore, the use of conventional de‐airing procedures needs reconsideration: air and buoyant bubbles should be removed from the heart before they are expelled into the aorta; this requires timely and precise assessment with transesophageal echocardiography and effective collaboration between surgeons, anesthesiologists, and perfusionists.
Effects of Bifidobacterium animalis ssp. lactis 420 on gastrointestinal inflammation induced by a nonsteroidal anti‐inflammatory drug: A randomized, placebo‐controlled, double‐blind clinical trial
Authors: Mäkelä Sanna M. , Forssten Sofia D. , Kailajärvi Marita , Langén Ville L. , Scheinin Mika , Tiihonen Kirsti , Ouwehand Arthur C.
Published: April 2021

Aims

Use of nonsteroidal anti‐inflammatory drugs (NSAIDs) can cause damage to the gastric and duodenal mucosa. Some probiotics have proven useful in ameliorating the harmful side‐effects of NSAIDs. Our aim was to evaluate whether oral administration of Bifidobacterium animalis ssp. lactis 420 (B420) can attenuate the increase of calprotectin excretion into faeces induced by intake of diclofenac sustained‐release tablets.

Methods

A double‐blind, parallel‐group, placebo‐controlled and randomized clinical study was performed in 50 healthy male and female volunteers aged 20–40 years, in Finland. Study participation consisted of 4 phases: run‐in, intervention with B420 or placebo, B420 or placebo + NSAID treatment, and follow‐up. The primary outcome was the concentration of calprotectin in faeces. Secondary outcomes were haemoglobin and microbial DNA in faeces and blood haemoglobin levels.

Results

Intake of diclofenac increased the faecal excretion of calprotectin in both groups. The observed increases were 48.19 ± 61.55 μg/g faeces (mean ± standard deviation) in the B420 group and 31.30 ± 39.56 μg/g in the placebo group (difference estimate 16.90; 95% confidence interval: −14.00, 47.77; P = .276). There were no significant differences between the treatment groups in changes of faecal or blood haemoglobin. Faecal B. lactis DNA was much more abundant in the B420 group compared to the placebo group (ANOVA estimate for treatment difference 0.85 × 109/g faeces; 95% confidence interval: 0.50 × 109, 1.21 × 109; P < .0001).

Conclusions

Short‐term administration of the probiotic B420 did not protect the healthy adult study participants from diclofenac‐induced gastrointestinal inflammation as determined by analysis of faecal calprotectin levels.
Broadening constructionism through visual modelling: My self as subject and object
Authors: Clayson James E.
Published: April 2021

In this personal essay, I explain how my use of visual modelling has the capacity to broaden constructionism in five important ways. (1) It introduces new techniques for students to describe and document, in a personal way, what they are actually doing in modelling. (2) It introduces the big ideas of mathematical modelling and computational thinking in a way that is far more inclusive than many other constructionist‐oriented courses that are labelled as math, science or computer science. (3) It favours the modelling of student‐selected objects in the physical world over the modelling of concepts and problems drawn more directly from traditional math and science. (4) It introduces the core ideas of design and colour theories in context. (5) It demonstrates the benefits of using narratives and personal journaling to explore the thought processes that help us make sense of the world.

Practitioner notes

What is already known about this topic

We know a great deal about the successes of STEM‐centred constructionism.

Constructionist‐inspired Scratch, FabLabs and Maker Fairs attract millions in and out of schools all over the world.

The worldwide teaching of coding, beginning in the earliest years, is now informed by constructionist ideas. UCL ScratchMaths is a good example of this.

What this paper adds

It expands constructionist teaching and research beyond math and computer science, into the fine arts, social sciences, literature and the humanities.

It describes a multidisciplinary teaching project, begun in 1981, that mixes mathematical modelling, computer programming, drawing, narrative psychology, art history, design theory, intellectual history, writing and theatre—within a constructivist/constructionist framework.

It recommends that the history of successful interdisciplinary courses, like the one described in this paper, should be better known and documented so that lessons can be shared.

Implications for practice and/or policy

For constructionism to become a theory of learning, constructionists must first explore learning in many different disciplines and contexts. Interdisciplinarity can provide a useful opening for doing so.

For constructionists to play an important role in creating interdisciplinary courses, they must not just learn to work openly with colleagues from other disciplines, but they must also be eager to read and study approaches different from their own.

Finally, interdisciplinary activity occurs most felicitously when the actors involved commit to respectful exchanges, attentive listening and a willingness to create a common enterprise.
Serum hypoxia‐inducible factor‐2: A candidate prognostic biomarker for laryngeal cancer
Authors: Eskiizmir Görkem , Çalıbaşı Koçal Gizem , Uysal Tuğba , Ellidokuz Hülya , Başpınar Yasemin
Published: April 2021

Objectives

To determine the serum hypoxia‐inducible factor‐1, ‐2 and ‐3 (HIF‐1, ‐2 and ‐3) levels in patients with laryngeal neoplasm, and to investigate their role in differential diagnosis, prediction of tumour characteristic and extension, and prognosis and survival.

Study Design

Prospective, cohort study at a tertiary referral centre.

Settings

The study was conducted in a tertiary medical centre.

Participants

Patients with benign, premalignant and malignant laryngeal neoplasms were included. Sixty‐four patients with a laryngeal neoplasm were enrolled.

Main Outcome Measures

Serum HIF‐1, ‐2 and ‐3 levels were measured from blood samples that were drawn before treatment, using ELISA.

Results

A statistically significant difference between benign (HIF‐1, ‐2, ‐3:4046,1 pg/mL; 2581,5 pg/mL; 1321,0 pg/mL), premalignant (HIF‐1, ‐2, ‐3:3630,3 pg/mL; 3229,7 pg/mL; 2549,8 pg/mL) and malignant (HIF‐1, ‐2, ‐3:3576,7 pg/mL; 2595,8 pg/mL; 1106,3 pg/mL) laryngeal neoplasms was not detected when serum HIF‐1, ‐2 and ‐3 levels were compared. However, high serum HIF‐2 level adversely affected survival and locoregional control and had more than 7‐fold increase in hazard ratio. Moreover, serum HIF‐2 was an independent prognostic factor for 2‐year overall, disease‐free, distant metastasis‐free survival and locoregional control.

Conclusion

This is the first clinical study in which the diagnostic, predictive and prognostic roles of hypoxia‐related biomolecules were examined in laryngeal neoplasms. Hypoxia‐inducible factor‐2 is a prognostic factor in larynx cancer irrespective of treatment modality.
Renal haemodynamic response to sodium‐glucose cotransporter‐2 inhibition does not depend on protein intake: An analysis of three randomized controlled trials
Authors: van der Aart‐van der Beek Annemarie B. , Cherney David , Laverman Gozewijn D. , Stefansson Bergur , van Raalte Daniel H. , Hoogenberg Klaas , Reyner Daniel , Li Qiang , Di Tanna Gian Luca , Greasley Peter J. , Heerspink Hiddo J. L.
Published: April 2021

High protein intake may increase intraglomerular pressure through dilation of the afferent arteriole. Sodium‐glucose cotransporter‐2 (SGLT2) inhibitors may reduce intraglomerular pressure through activation of tubuloglomerular feedback. Given these opposing effects, we assessed whether the effect of dapagliflozin on glomerular filtration rate (GFR) and urinary albumin‐to‐creatinine ratio (UACR) was modified by estimated dietary protein intake using data from three separate randomized controlled trials (DELIGHT, IMPROVE and DIAMOND). The median protein intake was 58.4, 63.6 and 90.0 g/d, respectively. In the DELIGHT trial (n = 233), dapagliflozin compared to placebo caused an acute and reversible dip in GFR of 2.1 and 2.2 mL/min/1.73 m2, and reduced UACR by 20.5% and 28.4% in participants with high and low protein intake, respectively. Similarly, in IMPROVE (n = 30) and DIAMOND (n = 53), the effect of dapagliflozin on GFR and UACR was comparable in participants with high and low protein intake (all P for interaction > 0.40). This post hoc, exploratory analysis of three clinical trials suggests that dietary protein intake does not modify the individual response of clinical kidney variables to dapagliflozin.
Pharmacokinetics, safety, tolerability and efficacy of cotadutide, a glucagon‐like peptide‐1 and glucagon receptor dual agonist, in phase 1 and 2 trials in overweight or obese participants of Asian descent with or without type 2 diabetes
Authors: Asano Michiko , Sekikawa Akiko , Kim Hyosung , Gasser Robert A. , Robertson Darren , Petrone Marcella , Jermutus Lutz , Ambery Philip
Published: April 2021

Aim

To evaluate the safety and pharmacokinetics of cotadutide, a dual glucagon‐like peptide‐1 (GLP‐1) and glucagon receptor agonist, in overweight Asian participants with or without type 2 diabetes (T2D).

Materials and Methods

In the phase 1, randomized, blinded, single‐ascending dose study, 24 Japanese and eight Chinese healthy adults (body mass index [BMI] 23‐40 kg/m2) received one subcutaneous dose of cotadutide (50‐150 or 100 μg, respectively) or placebo. The primary endpoint was safety. In the phase 2a, randomized, double‐blinded, parallel dose‐ranging study with forced uptitration, 61 Japanese adults with T2D (BMI 24‐40 kg/m2; HbA1c 7.0%‐10.5%) received cotadutide (100, 200, 300 μg) or placebo for 48 days. Co‐primary endpoints were safety/tolerability, change in glucose AUC0‐4h and body weight.

Results

Significant reductions from baseline to day 48 were observed with cotadutide for glucose AUC0‐4h (33.6%‐42.1% reduction vs. +2.5% with placebo; 95% CIs: 100 μg −45.7%, −33.7%; 200 μg −35.6%, −23.7%; 300 μg −45.0%, −30.8%; placebo 3.4%, 8.3%) and body weight (1.3%‐2.5% decrease vs. +0.8% with placebo; 95% CIs: 100 μg −3.4%, −0.8%; 200 μg −4.7%, −2.0%; 300 μg −4.6%, −2.1%; placebo −2.1%, 0.4%). The most common adverse events with cotadutide were mild gastrointestinal symptoms with no serious adverse events. Increased pulse rate with cotadutide versus placebo is consistent with GLP‐1 monoagonists.

Conclusions

Once‐daily cotadutide was effective and well tolerated up to 300 μg in overweight Japanese patients with T2D. Further evaluation in Asian populations is warranted.
How can countries improve human development? Four distinct national planning strategies and the challenges for human development ahead
Authors: Telch Fabian , Appe Susan
Published: April 2021

Motivation

How can countries improve their human development? This article compares the national planning strategies of four countries with distinct approaches to human development.

Purpose

We explore what human development means and analyse, from a comparative perspective, how human development is present in the national planning strategies in Bhutan, Colombia, Ecuador, and Sweden.

Methods and approach

We collect the national planning strategy documents of these four countries. We use a deductive approach to code these data based on Sen’s human development theoretical framework, namely the five instrumental freedoms that are the primary ends and means of development: political freedoms, economic facilities, social opportunities, transparency guarantees, and protective security.

Findings

Our findings reveal that, despite varying socioeconomic and political conditions, and distinct strategies to achieve human development, these countries ultimately articulate similar challenges in their efforts to achieve human development, which include globalization and economic diversification, climate change, rising inequality, ineffective public administration, and demographic changes.

Policy implications

We further explore these challenges to better understand how national planning strategies can improve human development. Because the solutions for improving human development are interrelated and must be conducted in a comprehensive way, national planning strategies are important for their co‐ordination. We conclude that there are common challenges for countries looking ahead to achieve human development, no matter their political, economic, social, and cultural conditions. Our audience is present and future development scholars and decision‐makers.
Ocean seascapes predict distant‐water fishing vessel incursions into exclusive economic zones
Authors: Woodill A. John , Kavanaugh Maria , Harte Michael , Watson James R.
Published: April 2021

Many of the world's most important fisheries are experiencing illegal, unreported and unregulated (IUU) fishing, thereby undermining efforts to sustainably conserve and manage fish stocks. A major challenge to ending IUU fishing is improving our ability to identify whether a vessel is fishing illegally and where illegal fishing is likely to occur in the ocean. However, monitoring the oceans is costly, time‐consuming, and logistically challenging for maritime authorities to patrol. To address this problem, we use vessel tracking data and machine learning to predict whether a distant‐water fishing vessel is fishing within the Argentine exclusive economic zone (EEZ) on the Patagonian Shelf, one of the world's most productive regions for fisheries. We combine vessel location data with oceanographic seascapes—classes of oceanic areas based on oceanographic variables—and other remotely sensed oceanographic variables to train a series of machine learning models of varying levels of complexity. These models are able to predict whether a distant‐water fishing vessel is operating inside the EEZ with 69%–96% confidence, depending on the year and predictor variables used. These results offer a promising step towards pre‐empting illegal activities, rather than reacting to them forensically.
Latitudinal variation in the diversity–disturbance relationship demonstrates the context dependence of disturbance impacts
Authors: Bracewell Sally A. , Dafforn Katherine A. , Lavender James T. , Clark Graeme F. , Johnston Emma L.
Published: April 2021

Aim

The shape of the diversity–disturbance relationship is context dependent, but the mechanisms driving this context dependence are unclear due to limited standardized empirical assessments across different environmental and ecological settings. At seven sites and over 20° of latitude, spanning both temperate and tropical systems, we measured community response to a fine‐scale experimental disturbance gradient in communities of benthic invertebrates.

Location

East coast of Australia (16.48–36.43° S).

Time period

Sixty‐six weeks (August 2012–November 2013).

Major taxa studied

Benthic marine invertebrates.

Methods

Communities were grown on acrylic tiles and subjected to four experimental disturbance events over a 66‐week period. At the end of this period, the effect of increasing disturbance extent (from 0% to 100% community clearance) on measures of alpha and beta diversity were assessed.

Results

In the tropics, richness and diversity increased with disturbance because the creation of free space allowed for the colonization of new recruits. In temperate communities, increasing disturbance led to a monotonic loss in species richness and a more hump‐shaped relationship in evenness and diversity. In the tropics, compositional change with increasing disturbance was driven by changes in species identities and abundances as the cover of rare species increased. In temperate regions, however, differences in species abundances were primarily responsible for compositional changes, reflecting the shift to algal dominance in conditions of high disturbance.

Main conclusions

The shape of the diversity–disturbance relationship changed over latitude, indicating that the concept of “intermediate” disturbance differs amongst these communities. Faster rates of increases in bare space, loss of species richness and a shift to algal dominance suggest that, in these systems, higher‐latitude communities are more susceptible to negative outcomes of high levels of disturbance than lower‐latitude communities. We discuss how differences in community dynamics, including competition, regional diversity and availability of propagules, help to explain this pattern.
The Rise and Stall of EU Macro‐Prudential Policy. An Empirical Analysis of Policy Conflicts over Financial Stability, Market Integration, and National Discretion*
Authors: Stellinga Bart
Published: April 2021

The 2007–09 financial crisis appeared to demonstrate the need for a strong, supranational EU macro‐prudential policy framework to prevent similar future disasters. The implemented framework, however, is neither. It is highly complex, involving many constraints on the use of macro‐prudential instruments. It is also one of the principal areas of national discretion in EU banking regulation. To explain this, I build on the ‘financial trilemma’ thesis which holds that there are inherent tensions between pursuing financial stability, financial integration and national financial policies. Supranationalizing macro‐prudential policy proved difficult due to a lack of consensus on how to measure systemic risks and because of the distributional consequences involved. This increased the tension between stability and integration, as national macro‐prudential policies could constrain cross‐border finance and they could be misused for competitiveness considerations. Key policy actors disagreed on which goals to prioritize, with bargaining leading to a convoluted policy framework.
Prevalence of clinical‐level emotional/behavioral problems in schoolchildren during the coronavirus disease 2019 pandemic in Japan: A prospective cohort study
Authors: Takahashi Fumito , Honda Hideo
Published: April 2021

Background

Several empirical studies have investigated negative mental health outcomes related to the spread of infectious diseases, including coronavirus disease 2019 (COVID‐19). However, little is known about children's emotional/behavioral problems, especially externalizing problems, during such situations. This prospective cohort study aimed to investigate pandemic‐related emotional/behavioral problems and their risk factors among schoolchildren in Japan.

Methods

A total of 4800 parents with children in grades 1−12 participated in a two‐wave longitudinal survey. Wave 1 and Wave 2 were conducted on March 4−8 and May 15−18, 2020, respectively. Survey items included demographic information, parental depression, children's diagnoses of neurodevelopmental disorders, the total length of school closure, and emotional/behavioral problems. Children's emotional/behavioral problems were assessed using the Strengths and Difficulties Questionnaire (SDQ), which has cutoff points to differentiate clinical‐level problems, which were the primary focus of this study.

Results

The proportions of clinical‐level problems were higher at Wave 2 (emotional symptoms = 24.8%, conduct problems = 22.7%, hyperactivity/inattention = 36.8%, peer relationship problems = 36.2%, and lack of prosocial behavior = 23.5%) compared to Wave 1. Lower grade‐level and lower annual family income predicted the increased proportions of children's clinical‐level emotional symptoms, hyperactivity/inattention, and prosocial behavior at Wave 2. The total length of school closure was not a significant predictor of subsequent emotional/behavioral problems. The highest proportion of clinical‐level problems at Wave 2 for the four SDQ subscales was observed in children with neurodevelopmental disorders.

Conclusions

The number of schoolchildren with severe emotional/behavioral problems increased during the COVID‐19 pandemic. Appropriate prevention and early intervention programs should be provided, especially for children who are in lower grade levels, have low family incomes, or have neurodevelopmental disorders.
The impact of plasma 25‐hydroxyvitamin D on pulmonary function and exercise physiology in cystic fibrosis: A multicentre retrospective study
Authors: Revuelta Iniesta Raquel , Causer Adam J. , Arregui‐Fresneda Irantzu , Connett Gary , Allenby Mark I. , Daniels Thomas , Carroll Mary P. , Urquhart Don S. , Saynor Zoe L.
Published: April 2021

Background

A 25‐hydroxyvitamin D (25OHD) may exert immunomodulatory effects on respiratory health, which may translate to improvements in exercise physiology. Thus, we aimed to investigate whether plasma 25OHD is associated with lung function and aerobic fitness in people with cystic fibrosis (pwCF).

Methods

A multicentre retrospective review of pwCF (> 9 years old) attending the Royal Hospital for Sick Children (Edinburgh) or Wessex CF‐Unit (Southampton) was performed between July 2017 and October 2019. Demographic and clinical data were collected. Plasma 25OHD measured closest in time to clinical cardiopulmonary exercise testing and/or spirometry [forced expiratory volume (FEV1)% predicted] was recorded. Pancreatic insufficiency was diagnosed based on faecal elastase of < 100 µg g−1. We performed multiple‐regression analysis with aerobic fitness outcomes [peak oxygen uptake (VO2 peak)] and FEV1% predicted as primary outcomes.

Results

Ninety pwCF [mean ± SD age: 19.1 ± 8.6 years, 54 (60%) children, 48 (53%) males and 88 (98%) Caucasian] were included. 25OHD deficiency and insufficiency was 15 (17%) and 44 (49%), respectively. 25OHD deficiency and insufficiency was significantly associated with pancreatic insufficiency (χ2 = 4.8, p = 0.02). Plasma 25OHD was not significantly associated with FEV1% predicted (r2 = 0.06, p = 0.42, 95% CI = −0.09 to 0.19) or VO2 peak (r2 = 0.04, p = 0.07, 95% CI = −011 to 0.005) in all pwCF. However, 25OHD was significantly associated with both FEV1% (r2 = 0.15, p = 0.02, 95% CI = 1.99–2.64) and VO2 peak (r2 = 0.13, p = 0.05, 95% CI = −0.26 to −0.005) in the paediatric cohort.

Conclusions

We showed that 25OHD is associated with improved lung function and aerobic fitness in children and adolescents with CF. Mechanistic and high‐quality prospective studies including both lung function and aerobic fitness as primary outcomes are now warranted.
Do Physiological and Spiritual Factors Affect Economic Decisions?
Authors: DEMIROGLU CEM , OZBAS OGUZHAN , SILVA RUI C. , ULU MEHMET FATİH
Published: April 2021

We examine the effects of physiology and spiritual sentiment on economic decision‐making in the context of Ramadan, an entire lunar month of daily fasting and increased spiritual reflection in the Muslim faith. Using an administrative data set of bank loans originated in Turkey during 2003 to 2013, we find that small business loans originated during Ramadan are 15% more likely to default within two years of origination. Loans originated in hot Ramadans, when adverse physiological effects of fasting are greatest, and those approved by the busiest bank branches perform worse. Despite their worse performance, Ramadan loans have lower credit spreads.
Spreading language ideologies through social media: Enregistering the ‘fake ABC’ variety in Hong Kong
Authors: Chau Dennis
Published: April 2021

This paper explores how language ideologies are disseminated on social media through examining the enregisterment of a pseudo‐variety of language attributed to people in Hong Kong who are supposedly trying to act ‘Western’. Comments from Facebook discussions about ‘fake American‐born Chinese’ (fake ABC) are analyzed to identify the linguistic features people attribute to these speakers and how their attitudes towards these features reflect larger assumptions about language. The analysis shows how this pseudo‐variety is enregistered through collaborative stylization and metalinguistic commentary by online commenters and how this enregisterment reinforces a range of language ideologies dominant in contemporary Hong Kong, including ideologies of ‘standardness’, linguistic purity and authenticity. The analysis not only traces these beliefs to long‐standing conflicts within the society around such issues as race, gender, politics and national identity but also argues that language mocking practices on social media have become an important means through which ideologies are circulated and maintained.
Working together: Sociolinguistic research in urban Aboriginal Australia
Authors: Rodríguez Louro Celeste , Collard Glenys
Published: April 2021

Variationist sociolinguists have now collectively spent decades gathering vernacular language data, enriching linguistic theory through detailed empirical analysis. What the field is yet to offer are reflective accounts of how partnership with communities and participatory research models can begin to decolonise the field. In this paper we reflect on the Indigenous‐led fieldwork that allowed us to document Australian Aboriginal English in urban Nyungar country, Southwest Western Australia. We discuss how Indigenous leadership allowed us to choose appropriate data collection methods (the Indigenous cultural form of conversation and storytelling known as ‘yarning’). Our analysis of premonitory yarns about the death of youth in the community reveals a rich performative style which shows linguistically entrenched ties with traditional Aboriginal Australia, and which provides original material for sociolinguistic analysis. Our work has great potential for social transformation in the inclusion of Indigenous epistemologies, and through ‘hearing the voices’ of speakers rarely featured in sociolinguistic research.
Long‐term evolution of LI‐RADS observations in HCV‐related cirrhosis treated with direct‐acting antivirals
Authors: Cannella Roberto , Vernuccio Federica , Celsa Ciro , Cabibbo Giuseppe , Calvaruso Vincenza , Greco Silvia , Battaglia Salvatore , Choudhury Kingshuk Roy , Tang An , Midiri Massimo , Di Marco Vito , Cammà Calogero , Brancatelli Giuseppe
Published: April 2021

Background & Aims

The risk of progression of indeterminate observations to hepatocellular carcinoma (HCC) after direct‐acting antivirals (DAA) is still undetermined. To assess whether DAA therapy changes the risk of progression of observations with low (LR‐2), intermediate (LR‐3) and high (LR‐4) probability for HCC in cirrhotic patients and to identify predictors of progression.

Methods

This retrospective study included cirrhotic patients treated with DAA who achieved sustained virological response between 2015 and 2019. A total of 68 patients had pre‐DAA indeterminate observations and at least six months CT/MRI follow‐up before and after DAA. Two radiologists reviewed CT/MRI studies to categorize observations according to the LI‐RADSv2018 and assess the evolution on subsequent follow‐ups. Predictors of evolutions were evaluated by using the Cox proportional hazard model, Kaplan‐Meier method and log‐rank test.

Results

A total of 109 untreated observations were evaluated, including 31 (28.4%) LR‐2, 67 (61.5%) LR‐3 and 11 (10.1%) LR‐4. During a median follow‐up of 41 months, 17.4% and 13.3% of observations evolved to LR‐5 or LR‐M and LR‐5, before and after DAA respectively (P = .428). There was no difference in rate of progression of neither LR‐2 (P = 1.000), LR‐3 (P = .833) or LR‐4 (P = .505). At multivariate analysis, only initial LI‐RADS category was an independent predictor of progression to LR‐5 or LR‐M for all observations (hazard ratio 6.75, P < .001), and of progression to LR‐5 after DAA (hazard ratio 4.34, P = .047).

Conclusions

DAA therapy does not increase progression of indeterminate observations to malignant categories. The initial LI‐RADS category is an independent predictor of observations upgrade.
Carotid stiffness is associated with retinal microvascular dysfunction—The Maastricht study
Authors: van der Heide Frank C. T. , Zhou Tan Lai , Henry Ronald M. A. , Houben Alfons J. H. M. , Kroon Abraham A. , Dagnelie Pieter C. , van Dongen Martien C. J. M. , Eussen Simone J. P. M. , Berendschot Tos T. J. M. , Schouten Jan S. A. G. , Webers Carroll A. B. , Schram Miranda T. , van Greevenbroek Marleen M. J. , Wesselius Anke , Schalkwijk Casper G. , Koster Annemarie , Savelberg Hans H. C. M. , Schaper Nicolaas C. , Reesink Koen D. , Stehouwer Coen D. A.
Published: April 2021

Objective

This study investigated whether arterial stiffening is a determinant of subtle retinal microvascular changes that precede diabetic retinopathy.

Research design and methods

This study used cross‐sectional data from the Maastricht Study, a type 2 diabetes‐enriched population‐based cohort study. We used multivariable linear regression analysis to investigate, in individuals without and with type 2 diabetes, the associations of carotid distensibility coefficient and carotid‐femoral pulse wave velocity with retinal microvascular diameters and flicker light‐induced dilation and adjusted for cardiovascular and lifestyle risk factors.

Results

The retinal microvascular diameter study population consisted of N = 2434 participants (51.4% men, mean ± SD age 59.8 ± 8.1 years, and 28.1% type 2 diabetes). No measures of arterial stiffness were significantly associated with microvascular diameters. Greater carotid distensibility coefficient (i.e., lower carotid stiffness) was significantly associated with greater retinal arteriolar flicker light‐induced dilation (per standard deviation, standardized beta [95% CI] 0.06 [0.00; 0.12]) and non‐significantly, but directionally similarly, associated with greater retinal venular flicker light‐induced dilation (0.04 [−0.02; 0.10]). Carotid‐femoral pulse wave velocity (i.e., aortic stiffness) was not associated with retinal microvascular flicker light‐induced dilation. The associations between carotid distensibility coefficient and retinal arteriolar and venular flicker light‐induced dilation were two‐ to threefold stronger in individuals with type 2 diabetes than in those without.

Conclusion

In this population‐based study greater carotid, but not aortic, stiffness was associated with worse retinal flicker light‐induced dilation and this association was stronger in individuals with type 2 diabetes. Hence, carotid stiffness may be a determinant of retinal microvascular dysfunction.
Unique damage‐related, gap‐filling tooth replacement in pycnodont fishes
Authors: Collins Sally E. , Underwood Charlie J.
Published: April 2021

Most jawed vertebrates (gnathostomes) replace their teeth throughout life (polyphyodonty) and there is currently great interest in its molecular and cellular basis, particularly in fish. While much has still to be elucidated, it appears that whichever tooth replacement mechanism is used, only one tooth replaces one predecessor, at any one time. Here we present fossil crushing dentitions of two extinct pycnodont fishes, Pycnodus zeaformis and Pycnodus maliensis. Their surface features and x‐ray micro‐CT virtual sections show no evidence of one‐for‐one replacement. Instead, individual large teeth were replaced by multiple small teeth, for which, as far as we could ascertain, there is no known mechanism. This occurred where underlying dentigerous bone was damaged. Small teeth also developed where parts of large teeth had broken off, and in gaps between large teeth created by the geometry of their close alignment in rows. We compared the virtual sections to those of functionally analogous crushing dentitions of three modern fishes. Contrasting greatly to the pycnodonts, each showed an orderly, one‐for‐one replacement, typical of osteichthyans. We propose that the pycnodont specimens exhibit a gap‐filling tooth addition hitherto unseen in gnathostomes, and that the oral epithelium retained an initiatory competence throughout life, with a programming of ‘if a gap exists, fill it’. This would also have facilitated the addition of large teeth in rows, in space provided by ontogenetic growth. We hypothesize that gaps were registered as an absence of pressure at the crushing surface, initiating tooth development, as in the modern cichlid Astatoreochromis alluaudi.
Importing inputs for climate change mitigation: The case of agricultural productivity
Authors: Garcia‐Verdu Rodrigo , Meyer‐Cirkel Alexis , Sasahara Akira , Weisfeld Hans
Published: April 2021

This paper investigates the effects of temperature on agricultural TFP growth rates during the period 1992–2015. We argue that higher temperatures impede TFP growth, particularly in low‐income countries (LICs) using less imported inputs. Our estimates imply that a 1°C rise in annual average temperatures reduces TFP growth rates by 5.2 percentage points in the LICs in question. However, LICs using greater amounts of imported inputs are less affected by temperatures, suggesting a new source of gains from imported inputs mitigating the adverse effects of rising temperatures.
Impact of baseline serum ferritin and supplemental iron on altitude‐induced hemoglobin mass response in elite athletes
Authors: Koivisto‐Mørk Anu Elisa , Svendsen Ida Siobhan , Skattebo Øyvind , Hallén Jostein , Paulsen Gøran
Published: April 2021

The present study explored the impact of pre‐altitude serum (s)‐ferritin and iron supplementation on changes in hemoglobin mass (ΔHbmass) following altitude training. Measures of Hbmass and s‐ferritin from 107 altitude sojourns (9–28 days at 1800–2500 m) with world‐class endurance athletes (males n = 41, females n = 25) were analyzed together with iron supplementation and self‐reported illness. Altitude sojourns with a hypoxic dose [median (range)] of 1169 (912) km·h increased Hbmass (mean ± SD) 36 ± 38 g (3.7 ± 3.7%, p < 0.001) and decreased s‐ferritin −11 (190) µg·L−1 (p = 0.001). Iron supplements [27 (191) mg·day−1] were used at 45 sojourns (42%), while only 11 sojourns (10%) were commenced with s‐ferritin <35 µg/L. Hbmass increased by 4.6 ± 3.7%, 3.4 ± 3.3%, 4.2 ± 4.3%, and 2.9 ± 3.4% with pre‐altitude s‐ferritin ≤35 µg·L−1, 36–50 µg·L−1, 51–100 µg·L−1, and >100 µg·L−1, respectively, with no group difference (p = 0.400). Hbmass increased by 4.1 ± 3.9%, 3.0 ± 3.0% and 3.7 ± 4.7% without, ≤50 mg·day−1 or >50 mg·day−1 supplemental iron, respectively (p = 0.399). Linear mixed model analysis revealed no interaction between pre‐altitude s‐ferritin and iron supplementation on ΔHbmass (p = 0.906). However, each 100 km·h increase in hypoxic dose augmented ΔHbmass by an additional 0.4% (95% CI: 0.1–0.7%; p = 0.012), while each 1 g·kg−1 higher pre‐altitude Hbmass reduced ΔHbmass by −1% (−1.6 to −0.5; p < 0.001), and illness lowered ΔHbmass by −5.7% (−8.3 to −3.1%; p < 0.001). In conclusion, pre‐altitude s‐ferritin or iron supplementation were not related to the altitude‐induced increase in Hbmass (3.7%) in world‐class endurance athletes with clinically normal iron stores.
Peer Support Specialists and Bourdieu’s Theory of Practice: Lay Experts and Recovery in Mental Health Organizations1
Authors: Potter Deborah A.
Published: April 2021

Through in‐depth interviews, this study explored the objective and subjective experiences of 14 peer support specialists (PSSs) working in three community mental health centers. Abductive analyses identified Bourdieu’s theoretical framework as a useful tool to understand how peers constructed and enacted a distinct theory of practice which shaped their roles as lay experts. Recovery was the peers’ primary habitus (predisposition) and their recovery‐based theory of practice was supported by cultural frameworks and materialist resources. Despite resistance from some mental health professionals adhering to the medical model, three types of capital (economic, social, and cultural) enabled and legitimated the peers’ recovery‐based practices. Together, these sources of capital formed a palpable degree of symbolic capital that supported the peers’ recovery journey while also structuring and legitimizing their presence in the workplace. This study has implications primarily for mental health policy and research. It offers theoretically guided insights into how lay experts in mental health subjectively understood and objectively realized their recovery‐based role through material and symbolic sources of capital. Furthermore, these accounts extend our understanding of recovery beyond an endeavor that is practiced and realized by individuals. Recovery also is facilitated and reproduced at the organizational level by the community health agencies.