bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating left behind patterns in congested metro systems: a Bayesian model
Authors: Yu Chao , Li Haiying , Xu Xinyue , Sun Qi
Published: May 2021

Purpose

During rush hours, many passengers find it difficult to board the first train due to the insufficient capacity of metro vehicles, namely, left behind phenomenon. In this paper, a data-driven approach is presented to estimate left-behind patterns using automatic fare collection (AFC) data and train timetable data.

Design/methodology/approach

First, a data preprocessing method is introduced to obtain the waiting time of passengers at the target station. Second, a hierarchical Bayesian (HB) model is proposed to describe the left behind phenomenon, in which the waiting time is expressed as a Gaussian mixture model. Then a sampling algorithm based on Markov Chain Monte Carlo (MCMC) is developed to estimate the parameters in the model. Third, a case of Beijing metro system is taken as an application of the proposed method.

Findings

The comparison result shows that the proposed method performs better in estimating left behind patterns than the existing Maximum Likelihood Estimation. Finally, three main reasons for left behind phenomenon are summarized to make relevant strategies for metro managers.

Originality/value

First, an HB model is constructed to describe the left behind phenomenon in a target station and in the target direction on the basis of AFC data and train timetable data. Second, a MCMC-based sampling method Metropolis–Hasting algorithm is proposed to estimate the model parameters and obtain the quantitative results of left behind patterns. Third, a case of Beijing metro is presented as an application to test the applicability and accuracy of the proposed method.
A systematic literature review of sustainable entrepreneurship with thematic analysis
Authors: Ali Muhammad
Published: May 2021

Purpose

This paper reviews the literature available on sustainable entrepreneurship along with the terms used interchangeably (as the context demands) and explores the themes research have undertaken to explain the concept across multidisciplinary avenues. The purpose of this literature review is to determine the direction of research in the field of sustainable entrepreneurship. It also enables the author to find out the relevance with similar terminologies, i.e. green entrepreneurship, ecopreneurship, ecological entrepreneuship etc. Also, how various differentiating concepts under the guise of sustainable entrepreneurship contribute to the similar goals on organizational level.

Design/methodology/approach

Scopus and Web of Science databases are explored for research articles including term “sustainable entrepreneurship”. A list of 50 most cited articles is extracted from the results and analyzed for underlying themes and trends in current research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard is used to systematically search articles from two databases and filtering for the most relevant manuscripts.

Findings

The categorization of research articles is conducted to understand the direction of research in this field and the emphasis on specific aspects. Themes identified are further elaborated into subcategories to get to the underlying theme of the research article. The research trend implicates the shift toward practical application and evaluation along with conceptual exploration and analysis which is inherent in any field of research.

Originality/value

The literature review in primarily conducted on two most referred databases, i.e. Scopus and Web of Science, as the search for term “sustainable entrepreneurship” yeilded most results in these databases. Also the methodology adopted focused on the most cited articles in the past two decades to extract the themes and subthemes. This allows the researcher to determine the trends and gaps in the current research.
Cost‐effectiveness of mifepristone and misoprostol versus misoprostol alone for the management of missed miscarriage: an economic evaluation based on the MifeMiso trial
Authors: Okeke Ogwulu CB , Williams EV , Chu JJ , Devall AJ , Beeson LE , Hardy P , Cheed V , Yongzhong S , Jones LL , La Fontaine Papadopoulos JH , Bender‐Atik R , Brewin J , Hinshaw K , Choudhary M , Ahmed A , Naftalin J , Nunes N , Oliver A , Izzat F , Bhatia K , Hassan I , Jeve Y , Hamilton J , Debs S , Bottomley C , Ross J , Watkins L , Underwood M , Cheong Y , Kumar CS , Gupta P , Small R , Pringle S , Hodge FS , Shahid A , Horne AW , Quenby S , Gallos ID , Coomarasamy A , Roberts TE
Published: May 2021

Objective

To assess the cost‐effectiveness of mifepristone and misoprostol (MifeMiso) compared with misoprostol only for the medical management of a missed miscarriage.

Design

Within‐trial economic evaluation and model‐based analysis to set the findings in the context of the wider economic evidence for a range of comparators. Incremental costs and outcomes were calculated using nonparametric bootstrapping and reported using cost‐effectiveness acceptability curves. Analyses were performed from the perspective of the UK’s National Health Service (NHS).

Setting

Twenty‐eight UK NHS early pregnancy units.

Sample

A cohort of 711 women aged 16–39 years with ultrasound evidence of a missed miscarriage.

Methods

Treatment with mifepristone and misoprostol or with matched placebo and misoprostol tablets.

Main outcome measures

Cost per additional successfully managed miscarriage and quality‐adjusted life years (QALYs).

Results

For the within‐trial analysis, MifeMiso intervention resulted in an absolute effect difference of 6.6% (95% CI 0.7–12.5%) per successfully managed miscarriage and a QALYs difference of 0.04% (95% CI −0.01 to 0.1%). The average cost per successfully managed miscarriage was lower in the MifeMiso arm than in the placebo and misoprostol arm, with a cost saving of £182 (95% CI £26–£338). Hence, the MifeMiso intervention dominated the use of misoprostol alone. The model‐based analysis showed that the MifeMiso intervention is preferable, compared with expectant management, and this is the current medical management strategy. However, the model‐based evidence suggests that the intervention is a less effective but less costly strategy than surgical management.

Conclusions

The within‐trial analysis found that based on cost‐effectiveness grounds, the MifeMiso intervention is likely to be recommended by decision makers for the medical management of women presenting with a missed miscarriage.

Tweetable abstract

The combination of mifepristone and misoprostol is more effective and less costly than misoprostol alone for the management of missed miscarriages.
What is a face worth? Facial attractiveness biases experience‐based monetary decision‐making
Authors: Pandey Gayathri , Zayas Vivian
Published: May 2021

There is ample evidence that attractive individuals, across diverse domains, are judged more favourably. But most research has focused on single/one‐shot decisions, where decision‐makers receive no feedback following their decisions, and outcomes of their judgements are inconsequential to the self. Would attractive individuals still be judged favourably in experience‐based decision‐making where people make iterative decisions and receive consequential feedback (money gained/lost) following each decision? To investigate this question, participants viewed headshots of four financial partners presented side‐by‐side and repeatedly (over 50–100 trials) selected partners that would help maximize their profits. Following every partner‐selection, participants received feedback about the net monetary gains/losses the partner had conferred. Unbeknownst to participants, two partners (one attractive, one unattractive) were equally advantageous (conferred net‐gains overtime) and two partners (one attractive and one unattractive) were equally disadvantageous (conferred net‐losses overtime). Even though attractive and unattractive partners were equally profitable and despite receiving feedback, participants selected attractive partners more throughout the task were quicker to reselect them even when they conferred losses and judged them as more helpful. Indeed, attractive‐disadvantageous partners were preferred to the same extent (or more) as unattractive‐advantageous partners. Importantly, the effect of attractiveness on decision‐making was fully explained by the perceived trustworthiness of the financial partners.
Cytological diagnosis of candidal peritonitis masquerading as peritoneal carcinomatosis in a young woman
Authors: Aggarwal Divya , Gupta Parikshaa , Rajwanshi Arvind
Published: May 2021

Candidal peritonitis is a rare entity usually occurring in patients undergoing repeated peritoneal dialysis. The condition is associated with high morbidity and mortality despite aggressive anti‐fungal treatment; hence, establishing a prompt diagnosis is essential for better patient outcome. A case is described in a young female which was diagnosed promptly on cytological examination of the aspirate.
Genomic correlates of response and resistance to immune checkpoint inhibitors in carcinomas of unknown primary
Authors: Rassy Elie , Boussios Stergios , Pavlidis Nicholas
Published: May 2021

Background

Cancers of unknown primary (CUP) are highly aggressive tumours with limited molecular characterization. These tumours can be particularly sensitive to immune checkpoint inhibitors (ICI) by mounting a seemingly more effective anti‐tumour immune response. Unlike other tumour lineages, the biological basis and clinical efficacy of ICI in CUP remain largely unknown.

Materials and methods

The cBioPortal database was accessed to select eligible cases from the MSK‐IMPACTTMClinical Sequencing Cohort. The tumour cell genomic correlates of response and resistance to ICI in patients with CUP were compared to those with ICI‐eligible tumours: cervical cancer, gastric cancer, renal cell carcinoma, hepatocellular carcinoma, non‐small‐cell lung cancer, melanoma, Merkel cell carcinoma and urothelial bladder cancer.

Results

Among a total of 234 patients with CUP, the identified genomic alterations were mainly mutation correlates of resistance to ICI, notably mutations in oncogenic signalling pathways includingKRAS,STK11andEGFR(24.7%, 10.9% and 4.2%, respectively). Compared to other tumours considered eligible for ICI, CUP presents a higher prevalence of alterations in the oncogenic signalling pathwaysKRASandSTK11. CUP patients treated with ICI had similar median overall survival with and without genomic correlates of response and resistance to ICI. An exploratory analysis showed that patients with TMB >10 mutations had a trend for better outcomes.

Conclusions

A tumour mutation burden >10 mutations per megabase can provide a potential genomic correlate of response to ICI in patients with CUP. Further research is warranted to validate these findings.
Prognostic markers of post‐traumatic dental external root resorption in children—a pilot study
Authors: Gregorczyk‐Maga Iwona , Szustkiewicz‐Karoń Aleksandra , Kaszuba Marek , Januszek Rafał , Rahnama Mansur , Jurczak Anna , Maga Paweł
Published: May 2021

Background

External inflammatory root resorption (EIRR) is a frequent complication of traumatic dental injuries (TDI). The aim of this cohort study was to identify novel non‐invasive markers of post‐traumatic EIRR by assessing the changes in the pulp's blood flow and the composition of gingival sulcus fluid (GCF) in children after dental trauma.

Material and methods

Thirty‐two children were enrolled and assessed within 48 h of a TDI to their permanent incisors and during an additional three visits over a 6‐months follow up period. During each visit, a radiograph and laser Doppler flow (LDF) measurements of the pulp blood flow were performed on the injured tooth, and the GCF was sampled. The permanent first molar tooth of the same subject served as a control for the LDF measurements and the GCF sampling. Concentrations of IL‐1α in the GCF were measured using enzyme‐linked immunosorbent assays. Radiographs were used to confirm EIRR.

Results

EIRR occurred in fourteen (43.8%) teeth in 32 patients. The teeth with EIRR showed diminished LDF readings when compared with controls at all visits. The LDF readings of the injured teeth continued to decrease at follow up visits. In the EIRR group, levels of IL‐1α in the GCF of teeth with EIRR were increased and significantly higher than those of the control teeth at the visit when EIRR was diagnosed. The IL‐1α levels were significantly higher in the EIRR group when compared to the injured teeth of patients without EIRR at the last follow‐up visit.

Conclusions

The occurrence of EIRR after mechanical trauma of permanent teeth with complete root development is accompanied by a significant reduction in the blood flow of the tooth's pulp. It is accompanied by an increase in concentrations of IL‐1α in the GCF of EIRR affected teeth. The results of this pilot study identified the use of IL‐1α in GCF and LDF as non‐invasive markers of EIRR.
Microbial seasonality promotes soil respiratory carbon emission in natural ecosystems: A modeling study
Authors: He Liyuan , Lai Chun‐Ta , Mayes Melanie A. , Murayama Shohei , Xu Xiaofeng
Published: May 2021

Seasonality is a key feature of the biosphere and the seasonal dynamics of soil carbon (C) emissions represent a fundamental mechanism regulating the terrestrial–climate interaction. We applied a microbial explicit model—CLM‐Microbe—to evaluate the impacts of microbial seasonality on soil C cycling in terrestrial ecosystems. The CLM‐Microbe model was validated in simulating belowground respiratory fluxes, that is, microbial respiration, root respiration, and soil respiration at the site level. On average, the CLM‐Microbe model explained 72% (n = 19, p < 0.0001), 65% (n = 19, p < 0.0001), and 71% (n = 18, p < 0.0001) of the variation in microbial respiration, root respiration, and soil respiration, respectively. We then compared the model simulations of soil respiratory fluxes and soil organic C content in top 1 m between the CLM‐Microbe model with (CLM‐Microbe) and without (CLM‐Microbe_wos) seasonal dynamics of soil microbial biomass in natural biomes. Removing soil microbial seasonality reduced model performance in simulating microbial respiration and soil respiration, but led to slight differences in simulating root respiration. Compared with the CLM‐Microbe, the CLM‐Microbe_wos underestimated the annual flux of microbial respiration by 0.6%–32% and annual flux of soil respiration by 0.4%–29% in natural biomes. Correspondingly, the CLM‐Microbe_wos estimated higher soil organic C content in top 1 m (0.2%–7%) except for the sites in Arctic and boreal regions. Our findings suggest that soil microbial seasonality enhances soil respiratory C emissions, leading to a decline in SOC storage. An explicit representation of soil microbial seasonality represents a critical improvement for projecting soil C decomposition and reducing the uncertainties in global C cycle projection under the changing climate.
Storm and fire disturbances in Europe: Distribution and trends
Authors: Senf Cornelius , Seidl Rupert
Published: May 2021

Abiotic forest disturbances are an important driver of ecosystem dynamics. In Europe, storms and fires have been identified as the most important abiotic disturbances in the recent past. Yet, how strongly these agents drive local disturbance regimes compared to other agents (e.g., biotic, human) remains unresolved. Furthermore, whether storms and fires are responsible for the observed increase in forest disturbances in Europe is debated. Here, we provide quantitative evidence for the prevalence of storm and fire disturbances in Europe 1986–2016. For 27 million disturbance patches mapped from satellite data, we determined whether they were caused by storm or fire, using a random forest classifier and a large reference dataset of true disturbance occurrences. We subsequently analyzed patterns of disturbance prevalence (i.e., the share of an agent on the overall area disturbed) in space and time. Storm‐ and fire‐related disturbances each accounted for approximately 7% of all disturbances recorded in Europe in the period 1986–2016. Storm‐related disturbances were most prevalent in western and central Europe, where they locally accounted for >50% of all disturbances, but we also identified storm‐related disturbances in south‐eastern and eastern Europe. Fire‐related disturbances were a major disturbance agent in southern and south‐eastern Europe, but fires also occurred in eastern and northern Europe. The prevalence and absolute area of storm‐related disturbances increased over time, whereas no trend was detected for fire‐related disturbances. Overall, we estimate an average of 127,716 (97,680–162,725) ha of storm‐related disturbances per year and an average of 141,436 (107,353–181,022) ha of fire‐related disturbances per year. We conclude that abiotic disturbances caused by storm and fire are important drivers of forest dynamics in Europe, but that their influence varies substantially by region. Our analysis further suggests that increasing storm‐related disturbances are an important driver of Europe's changing forest disturbance regimes.
Effectiveness of orthodontic toothbrush versus conventional toothbrush on plaque and gingival index reduction: A systematic review and meta‐analysis
Authors: Marçal Felipe Franco , Mota de Paulo João Paulo , Barreto Liliana Girão , de Carvalho Guerra Lis Monteiro , Silva Paulo Goberlânio de Barros
Published: May 2021

Objective

In orthodontic patients submitted to oral hygiene instruction, what is the efficacy of orthodontic toothbrush (O‐TB) versus conventional toothbrush (C‐TB) on plaque and gingival index reduction in randomized and non‐randomized controlled clinical trials?

Methods

Electronic database search was performed on PubMed, ClinicalTrials.gov, Cochrane Library and Google Scholar. Database research, study selection, data extraction and ROBINS‐I and Risk of Bias Tool 2.0 analysis were conducted by two independently examiners in duplicate. Two different meta‐analyses were performed for plaque index and gingival index, followed by the analysis of overall quality of the evidence using GRADE.

Results

A total of 158 studies were identified for screening; six articles were included in qualitative synthesis, and of those, three were subjected to a quantitative synthesis (meta‐analysis). Three non‐randomized studies presented an overall ‘low’, ‘moderate’ and ‘high’ risk of bias for each one of the articles, and the three randomized clinical trials presented ‘low risk’ for two articles and ‘some concerns’ quality for the other one. The overall strength of evidence was ranked ‘very low’ quality for plaque index and gingival index subgroups.

Conclusions

Gingival bleeding is not modified by orthodontic design toothbrush, but there is circumstantial scientific evidence for recommending the use of an O‐TB instead a C‐TB based on the analysis of plaque index control. Although major plaque removal of the O‐TB was validated by meta‐analysis, this improvement is not completely clarified which calls for further clinical studies to assess the effects of using an O‐TB compared with a C‐TB.
A qualitative study of fourteen African countries’ nursing workforce and labour market
Authors: Bryant A. , Reynolds N.R. , Hart L. , Johnson P.G. , Kalula A. , Gokul B. , Davidson P.M.
Published: May 2021

Aim

The aim of this study was to describe factors affecting nursing education and labour markets in countries in East, Central, and Southern Africa, and critical areas for investment.

Background

An understanding about the relationship between the supply of nurses (determined by types of educational programmes, and the quantity and quality of nurse graduates), and workforce demand is critical to health policy development.

Methods

Six focus groups and 14 key informant interviews with nursing leaders and experts were conducted. Participants included government chief nursing officers, registrars of regulatory bodies, association leaders and heads of nursing education. The data were transcribed, coded and analysed using inductive techniques.

Findings

Participants discussed challenges and strengths of nursing education, school and regulatory infrastructure, financing mechanisms for the nursing workforce, the state of nursing jobs and scope of nursing practice.

Conclusion

Strengthened regulations and leadership are needed to improve investment in nursing, the quality of nursing education, and working conditions and to promote the achievement of better health outcomes.

Implications for Nursing Policy

Clarifying scope of practice for nurses in the health sector and creating competency‐based requirements is important. Governments should establish positions that align with updated competencies and provide fair and safe working conditions. The current and ongoing investment case for nursing requires improved data systems and a commitment to use labour market data for decision‐making.
Interventions to improve physical activity in colorectal cancer survivors: protocol for a systematic review and meta‐analysis of randomized controlled trials
Authors: Mbous Yves Paul Vincent , Mohamed Rowida , Kelley George A. , Kelly Kimberly Michelle
Published: May 2021

Aim

To examine the effectiveness of physical activity (PA) interventions on changes in PA among colorectal cancer survivors, including an examination of theoretical versus atheoretical‐driven approaches, with a special focus on their effectiveness across ethnic and racial minorities.

Design

Systematic review with aggregated data meta‐analyses.

Data sources

Using six databases (Cochrane Central Register of Controlled Trials, PubMed, PsycINFO, CINAHL with full text, Scopus and Web of Science), we will screen for randomized controlled trials written in English from May 1, 1993 up to December 31, 2020.

Review methods

Dual study‐selection and data abstraction will be performed. The Behavior Change Technique Taxonomy (v1) will be used to examine behavior change techniques among selected studies, while the Theory Coding Scheme will be used to assess the extent of theory use. Risk of bias will be assessed using the revised Cochrane risk‐of‐bias tool for randomized trials, while the strength of the evidence will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation instrument. In addition, intervention delivery will be appraised using the Template for Intervention Description and Replication. Changes in PA from each study will be calculated using the standardized mean difference effect size (Hedge's g). Results will be pooled using the inverse‐variance heterogeneity model. Heterogeneity (Cochran's Q) and inconsistency (I2) will be examined, while small‐study effects (publication bias) will be evaluated using the Doi plot and LFK Index. Meta‐regression will also be conducted to examine for potential associations between changes in physical activity and selected covariates (theoretical versus atheoretical‐driven approaches, race/ethnicity).

Discussion

This systematic review will identify specific racial/ethnic minorities for whom interventions are most effective and summarize the evidence of the effectiveness of theoretical vs. theoretical based intervention.

Impact

This systematic review can direct policymakers and practitioners towards actions that are likely to bring about positive physical activity behaviour change.
Behavioural variation between piscivore and insectivore rainbow trout Oncorhynchus mykiss
Authors: Monnet Gauthier , Rosenfeld Jordan S. , Richards Jeffrey G.
Published: May 2021

A proactive‐reactive continuum integrating multiple (i.e., 3+) dimensions of animal behaviour has been reported as a major axis of behavioural differentiation, but its stability along a biological hierarchy from individuals to populations remains speculative. Piscivore and insectivore rainbow trout (Oncorhynchus mykiss) represent closely related ecotypes with strong ecological divergence driven by selection for a large‐bodied piscivorous lifestyle with fast juvenile growth vs. selection for smaller adult body size and lower growth associated with an insectivorous diet. To evaluate whether differences in behaviour between ecotypes are consistent with a proactive‐reactive axis and consistent along a biological hierarchy, the authors examined variation in emergence time from a shelter, exploration, activity and predator inspection among individuals, populations and ecotypes of juvenile piscivore and insectivore rainbow trout O. mykiss. As expected, the faster‐growing piscivore ecotype was more proactive (i.e., shorter emergence time, exploration and predator inspection) than the more reactive insectivore ecotype. This behavioural contrast was partly maintained across populations, although activity differences were most pronounced among populations, rather than emergence time. Insectivore fry showed substantial variation in behavioural expression among individuals within populations; by contrast, piscivores showed highly similar proactive behaviours with significantly lower inter‐individual variation in behavioural expression, suggesting intense selection on behaviour supporting their faster growth. This work suggests that piscivore and insectivore O. mykiss broadly differ in behaviour along a proactive vs. reactive continuum, and highlights the greater multidimensionality of behavioural expression within the insectivore ecotype. Contrasting behaviours between ecotypes may result from differential selection for slow vs. fast juvenile growth and associated metabolism, and may contribute to adult trophic specialization.
Live birth by cesarean section after rupture of uterine cornua in simultaneous corneal and intrauterine pregnancies
Authors: Banzai Chiaki , Hiraishi Hikaru , Higeta Daisuke , Tsukagoshi Noriko , Murata Tomomi , Soda Masayuki
Published: May 2021

A patient became pregnant by in vitro fertilization and embryo transfer (IVF‐ET). She had a history of laparoscopic bilateral salpingectomy and enucleation of a left ovarian tumor due to bilateral hydrosalpinx and left endometriotic cyst in primary infertility. She noticed abdominal pain and visited the nearby general hospital by ambulance (gestational age 6 weeks and 1 day). She was admitted to our department because of ascites. An abdominal hemorrhage due to a rupture of the residual corneal segment of the fallopian tube was suspected and emergency laparoscopic surgery was performed. Simultaneous internal and external pregnancy resulted in rupture of the right tubal corneal at the ectopic site of pregnancy. The baby in the uterus grew smoothly and was delivered by cesarean section. This is a report of a case in which live birth after rupture of uterine cornua in simultaneous corneal and intrauterine pregnancies. We searched the literature for similar cases and examined management methods.
Treatment of proteinuria in dogs with telmisartan: A retrospective study
Authors: Lecavalier Julie , Fifle Lyanne , Javard Romain
Published: May 2021

Background

Use of telmisartan for the treatment of proteinuria in dogs has not been thoroughly investigated.

Hypothesis/Objectives

Telmisartan can be effective for the treatment of proteinuria in dogs.

Animals

Forty‐four client‐owned dogs with proteinuria.

Methods

Retrospective study. Dogs diagnosed with clinically relevant proteinuria (nonazotemic dogs with a urine protein‐to‐creatinine ratio [UPC] ≥2 and azotemic dogs with UPC ≥0.5) were separated into 3 groups: telmisartan alone, with benazepril, or with mycophenolate. The UPC was recorded before treatment and at subsequent follow‐ups (1, 3, 6, and 12 months, as available). Response to treatment was categorized as complete (UPC ˂0.5), partial (UPC decreased by ≥50% but still ≥0.5), or no response (UPC decreased by <50%). Serum creatinine and potassium concentrations and arterial pressure also were recorded.

Results

In the telmisartan group, treatment response (UPC ˂0.5 or decreased by ≥50%) was observed in 70%, 68%, 80%, and 60% of dogs at 1, 3, 6, and 12 months follow‐up, respectively. No significant changes were noted in serum creatinine or potassium concentrations, or in arterial blood pressure at all follow‐up times. Adverse effects consisted of mild self‐limiting gastrointestinal signs in 5 dogs. Two dogs developed clinically relevant azotemia that required discontinuation of the treatment before the first follow‐up.

Conclusions and Clinical Importance

Telmisartan can be considered for treatment of proteinuria in dogs, alone or in combination with other treatments for proteinuria.
Fresh frozen plasma transfusion in acute variceal haemorrhage: Results from a multicentre cohort study
Authors: Mohanty Arpan , Kapuria Devika , Canakis Andrew , Lin Honghuang , Amat Maelys J. , Rangel Paniz Graziella , Placone Nicholas T. , Thomasson Reggie , Roy Hemant , Chak Eric , Baffy Gyorgy , Curry Michael P. , Laine Loren , Rustagi Tarun
Published: May 2021

Background

Fresh frozen plasma (FFP) transfusion is often used in the management of acute variceal haemorrhage (AVH) despite best practice advice suggesting otherwise.

Objective

We investigated if FFP transfusion affects clinical outcomes in AVH.

Design, setting and patients

We performed a retrospective cohort study of 244 consecutive, eligible patients admitted to five tertiary health care centres between 2013 and 2018 with AVH.

Main outcome measurements

Multivariable regression analyses were used to study the association of FFP transfusion with mortality at 42 days (primary outcome) and failure to control bleeding at 5 days and length of stay (secondary outcomes).

Results

Patients who received FFP transfusion (n = 100) had higher mean Model for End Stage Liver Disease (MELD) score and more severe variceal bleeding than those who did not received FFP transfusion (n = 144). Multivariable analysis showed that FFP transfusion was associated with increased odds of mortality at 42 days (odds ratio [OR] 9.41, 95% confidence interval [CI] 3.71‐23.90). FFP transfusion was also associated with failure to control bleeding at 5 days (OR 3.87, 95% CI 1.28‐11.70) and length of stay >7 days (adjusted OR 1.88, 95% CI 1.03‐3.42). The independent association of FFP transfusion with mortality at 42 days persisted when the cohort was restricted to high‐risk patients and in patients without active bleeding.

Limitations and conclusions

Fresh frozen plasma transfusion in AVH is independently associated with poor clinical outcomes. As this an observational study, there may be residual bias due to confounding; however, we demonstrate no benefit and potential harm with FFP transfusions in AVH.
Role of TRPV4 channel in vasodilation and neovascularization
Authors: Chen Miao , Li Xiucun
Published: May 2021

The transient receptor potential vanilloid type 4 (TRPV4) channel, a Ca2+‐permeable nonselective cation channel, is widely distributed in the circulatory system, particularly in vascular endothelial cells (ECs) and smooth muscle cells (SMCs). The TRPV4 channel is activated by various endogenous and exogenous stimuli, including shear stress, low intravascular pressure, and arachidonic acid. TRPV4 has a role in mediating vascular tone and arterial blood pressure. The activation of the TRPV4 channel induces Ca2+ influx, thereby resulting in endothelium‐dependent hyperpolarization and SMC relaxation through SKCa and IKCa activation on ECs or through BKCa activation on SMCs. Ca2+ binds to calmodulin, which leads to the production of nitric oxide, causing vasodilation. Furthermore, the TRPV4 channel plays an important role in angiogenesis and arteriogenesis and is critical for tumor angiogenesis and growth, since it promotes or inhibits the development of various types of cancer. The TRPV4 channel is involved in the active growth of collateral arteries induced by flow shear stress, which makes it a promising therapeutic target in the occlusion or stenosis of the main arteries. In this review, we explore the role and the potential mechanism of action of the TRPV4 channel in the regulation of vascular tone and in the induction of neovascularization to provide a reference for future research.
Current progress on pathogenicity‐related transcription factors in Fusarium oxysporum
Authors: Zuriegat Qussai , Zheng Yuru , Liu Hong , Wang Zonghua , Yun Yingzi
Published: May 2021

Fusarium oxysporum is a well‐known soilborne plant pathogen that causes severe vascular wilt in economically important crops worldwide. During the infection process, F. oxysporum not only secretes various virulence factors, such as cell wall‐degrading enzymes (CWDEs), effectors, and mycotoxins, that potentially play important roles in fungal pathogenicity but it must also respond to extrinsic abiotic stresses from the environment and the host. Over 700 transcription factors (TFs) have been predicted in the genome of F. oxysporum, but only 26 TFs have been functionally characterized in various formae speciales of F. oxysporum. Among these TFs, a total of 23 belonging to 10 families are required for pathogenesis through various mechanisms and pathways, and the zinc finger TF family is the largest family among these 10 families, which consists of 15 TFs that have been functionally characterized in F. oxysporum. In this review, we report current research progress on the 26 functionally analysed TFs in F. oxysporum and sort them into four groups based on their roles in F. oxysporum pathogenicity. Furthermore, we summarize and compare the biofunctions, involved pathways, putative targets, and homologs of these TFs and analyse the relationships among them. This review provides a systematic analysis of the regulation of virulence‐related genes and facilitates further mechanistic analysis of TFs important in F. oxysporum virulence.
Antifungal activity of boric acid, triclosan and zinc oxide against different clinically relevant Candida species
Authors: Gavilanes‐Martínez Marly Alejandra , Coral‐Garzón Alejandra , Cáceres Diego H. , García Ana María
Published: May 2021

Background

The genus Candida includes about 200 different species, but only a few are able to produce disease in humans. The species responsible for the highest proportion of human infections is Candida albicans. However, in the last two decades there has been an increase in the proportion of infections caused by other Candida species, including C. glabrata (Nakaseomyces glabrata), C. parapsilosis, C. tropicalis, C. krusei (Pichia kudriavzevi) and more recently C. auris. Decolonisation of patients has been used as an infection control strategy for bacterial infections, but information about decolonisation products used in clinical practice for Candida and other fungal pathogens is limited. Compounds with antimicrobial activity, such as triclosan (TR), boric acid (BA) and zinc oxide (ZO), are mainly used in personal care products. These products can be used for long periods of time without an abrasive skin effect and are a possible alternative for patient decolonisation in healthcare settings.

Objective

The aim of this study was to evaluate the antifungal activity of boric acid (BA), triclosan (TR) and zinc oxide (ZO), individually and combined, against clinically relevant Candida species.

Materials and methods

Compounds to be screened for antifungal activity were evaluated at different concentrations, alone, and combined, using a well diffusion assay. The statistical evaluation was performed using analysis of variance (ANOVA) and a post hoc analysis using the multiple comparisons method.

Results

Individually, BA and TR showed antifungal activity against all Candida species evaluated but ZO did not show any antifungal activity. Mixtures of BA [5%]—TR [0.2%]; BA [5%]—TR [0.3%]; BA [5%]—TR [0.2%]—ZO [8.6%]; and BA [5%]—TR [0.2%]—ZO [25%] yielded the highest antifungal activity. An increased antifungal effect was observed in some mixtures when compared with individual compounds.

Conclusions

We demonstrated antifungal activity of BA and TR against multiple Candida species, including against a clade of the emerging healthcare‐associated pathogen C. auris. Additionally, this study shows enhancement of the antifungal effect and no antagonism among the mixtures of these compounds. Further research is needed to determine whether these compounds can reduce the burden of Candida on skin.
Distinct brain‐derived TDP‐43 strains from FTLD‐TDP subtypes induce diverse morphological TDP‐43 aggregates and spreading patterns in vitro and in vivo
Authors: Porta Sílvia , Xu Yan , Lehr Tagan , Zhang Bin , Meymand Emily , Olufemi Modupe , Stieber Anna , Lee Edward B. , Trojanowski John Q. , Lee Virginia M.‐Y.
Published: May 2021

Aim

The heterogeneity in the distribution and morphological features of TAR DNA‐binding protein‐43 (TDP‐43) pathology in the brains of frontotemporal lobar degeneration (FTLD‐TDP) patients and their different clinical manifestations suggest that distinct pathological TDP‐43 strains could play a role in this heterogeneity between different FTLD‐TDP subtypes (A‐E). Our aim was to evaluate the existence of distinct TDP‐43 strains in the brains of different FTLD‐TDP subtypes and characterise their specific seeding properties in vitro and in vivo.

Methods and Results

We used an inducible stable cell line expressing a mutant cytoplasmic TDP‐43 (iGFP‐NLSm) to evaluate the seeding properties of distinct pathological TDP‐43 strains. Brain‐derived TDP‐43 protein extracts from FTLD‐TDP types A (n = 6) and B (n = 3) cases induced the formation of round/spherical phosphorylated TDP‐43 aggregates that morphologically differed from the linear and wavy wisps and bigger heterogeneous filamentous (skein‐like) aggregates induced by type E (n = 3) cases. These morphological differences correlated with distinct biochemical banding patterns of sarkosyl‐insoluble TDP‐43 protein recovered from the transduced cells. Moreover, brain‐derived TDP‐43 extracts from type E cases showed higher susceptibility to PK digestion of full‐length TDP‐43 and the most abundant C‐terminal fragments that characterise type E extracts.

Finally, we showed that intracerebral injections of different TDP‐43 strains induced a distinctive morphological and subcellular distribution of TDP‐43 pathology and different spreading patterns in the brains of CamKIIa‐hTDP‐43NLSm Tg mice.

Conclusions

We show the existence of distinct TDP‐43 strains in the brain of different FTLD‐TDP subtypes with distinctive seeding and spreading properties in the brains of experimental animal models.
New opportunities for institutional analysis in public administration research
Authors: Siddiki Saba , Frantz Christopher K.
Published: May 2021

This Symposium features research that engages an institutional analysis approach, called the Institutional Grammar. Institutional analysis is the study of rules, norms, and strategies (e.g., public policies, organizational bylaws, social conventions) that govern social systems and organizations. The Institutional Grammar is an approach for comprehensively capturing the design of institutions; in particular, for describing the language of directives that comprise them. We posit that the engagement of the Institutional Grammar in public administration research can advance understanding of institutional dynamics of administrative settings and behaviors by lending conceptual and methodological clarity on the definition and measurement of institutions. In support of this position, we (i) provide a brief commentary on institutional analysis in public administration research; (ii) offer a brief overview of the Institutional Grammar; and (iii) highlight how methodological innovations presented in the Symposium articles advance the Institutional Grammar, and present opportunities for advancing institutional analysis in administrative settings.
Symptom scores in the diagnosis of pediatric cow’s milk protein allergy: A systematic review
Authors: Thompson Georgina , Zhelev Zhivko , Peters Jaime , Khalid Sara , Briscoe Simon , Shaw Liz , Nunns Michael , Ludman Sian , Hyde Christopher
Published: May 2021

Background

Cow's milk protein allergy (CMPA) is an immune‐mediated allergic response to proteins in milk that is common in infants. Broad CMPA symptoms make diagnosis a challenge, particularly in primary care. Symptom scores may improve a clinician's awareness of symptoms, indicating a need for further testing. This systematic review examined the development and evaluation of such symptom scores for use in infants.

Methods

CENTRAL, MEDLINE, EMBASE and CINAHL databases were searched from inception to 3 December 2019 (Updated 14 November 2020) for diagnostic accuracy studies, randomised controlled trials, observational studies, economic evaluations, qualitative studies and studies reporting development of the tools. Data were not suitable for meta‐analysis due to clinical and methodological heterogeneity, so were narratively synthesised.

Results

We found two symptom scores evaluated in one and fourteen studies, respectively. Estimated sensitivity and specificity ranged from 37% to 98% and 38% to 93%. The evaluations of each tool were at high risk of bias or failed to address issues such as clinical and cost‐effectiveness.

Conclusions

Estimates of accuracy of symptom scores for CMPA offered so far should be interpreted cautiously. Rigorous, conflict‐free research based on well‐defined roles for the tools is urgently required.
The COVID‐19 pandemic first wave in Sweden: A national registry study of the effects on pediatric anesthesia and surgery
Authors: Melander Sixten , Almström Jimmy , Enlund Gunnar , Frykholm Peter
Published: May 2021

Background

The COVID‐19 pandemic is pushing healthcare systems to their limits. Dramatic reductions in the adult elective surgery are ubiquitous, but corresponding changes in pediatric services are not well described. The Swedish Perioperative Registry contains data on all anesthetic procedures in Sweden, and therefore, provides a unique opportunity to analyze the effect of the pandemic on the pediatric anesthesia capacity on a national level. We hypothesized that there would be a significant reduction in pediatric elective procedures. The aim was to determine the effects on pediatric surgical and anesthetic services during the first wave of the COVID‐19 pandemic in Sweden.

Methods

For this retrospective registry cohort study, we extracted all procedures performed on patients <18 years of age in 2020 and 2019. Weeks 12 to 26 of 2020 were defined as the first wave, and data were analyzed according to level of care, type of surgery, procedure code, and emergency or elective surgery.

Results

We found 7015 fewer procedures during the first wave epoch. Elective cases were reduced by 53.7% while emergency surgery was not significantly affected. During the peak of the first wave in April, there was a 72.8% reduction in elective cases; ENT/maxillofacial surgery showed the greatest reduction (86.7%). The surgical and anesthesia capacity recovered to near‐normal levels by the end of June 2020.

Conclusion

We conclude that the impact of COVID‐19 on pediatric surgical procedures in Sweden during the first wave of the pandemic was dramatic, but elective services were restored a few months after the peak.
Reproductive justice and black lives: A concept analysis for public health nursing
Authors: Burger Kathryn , Evans‐Agnew Robin , Johnson Susan
Published: May 2021

Background

Inequities in maternal mortality in the United States are a form of structural violence against Black women. The concept of reproductive justice has been employed in the social sciences for almost 30 years, yet nursing has been slow to adopt this concept in promoting maternal‐child health.

Objective

To analyze the concept of reproductive justice as used in peer‐reviewed publications with the aim of reframing black maternal health in public health nursing scholarship, research, practice, and advocacy.

Design

We conducted a systematic review of the social science literature. We analyzed selected articles though a principle‐based concept analysis focusing on epistemological, pragmatic, linguistic, and logical principles.

Sample

Eight articles were selected from a pool of 377.

Results

Race was identified as a source of power for understanding reproductive justice through individual knowledge, collective knowledge, and praxis. Pragmatically, reproductive justice is a social justice‐oriented platform that bridges the pro‐choice/pro‐life divide; aids coalition building; and promotes inclusion. Linguistically, the concept is distinct from both reproductive health and reproductive rights. Reproductive justice is logically situated within intersectionality theory and the cumulative embodiment of oppressions Black women experience based on race, class, and gender.

Conclusion

Reproductive justice reframes public health nursing actions for Black women by focusing on uncovering systems of oppression, recognizing past historical injustices, and advancing cultural safety in health promotion. Multilevel interventions are needed to simultaneously address these injustices particularly in the areas of preconception health, maternal health, infant and child health, and Black family well‐being across the reproductive lifespan.
From universal to local: German identity in Nicholas of Cusa’s Catholic Concordance
Authors: Tanaka Julie K.
Published: May 2021

Nicholas of Cusa’s Catholic Concordance stands as a landmark of fifteenth‐century political thought. Modern scholarship has devoted much attention to Nicholas’s argument about consent in Book Two, but he also develops one of the earliest expressions of German identity. This has not received attention in historical and literary scholarship. Nicholas grounds his conceptualization of a German people and land in the political and ecclesiological debates of his day while tying it to the importance that history plays in defining a people. He establishes a new type of history for them told in terms not of Roman imperial history but of the Germans. His work foreshadows the efforts of German writers in the late fifteenth and sixteenth centuries who composed for the first time histories of Germany devoted to the Germans from their mythical origins to contemporary times and written in their own common language, German.
Joint Equivalence Design and Analysis of a Tensegrity Joint
Authors: Chen Bingxing , Jiang Hongzhou , Liu Jingxuan , Lu Shuaibo
Published: May 2021

We propose a method to design a tensegrity joint, making its elastic deformation an accurate joint-like motion, such as a rotation around the designed rotational center. The tensegrity joint can be a revolute, universal, and ball joint through this method. Axis drift is presented as a design criterion to describe the rotational center’s deviation degree with respect to the compliance center since the rotational center is not fixed to one point for different positions of the tensegrity joint. The axis drift is designed to be in a prescribed range so that the tensegrity joint is approximately equivalent to a rigid joint. In other words, the tensegrity joint’s elastic response under external torque and force becomes precise rigid joint-like kinematics and can replace rigid joints to transfer motion, force, and energy. A large-size tensegrity rotational joint is developed to verify the joint equivalence experimentally. The experimental results show that the tensegrity joint achieved maximum dimensionless axis drift of less than 2%, which indicates an excellent joint equivalence. The tensegrity joints’ ability to replace rigid joints as modular joints to construct a hyper redundant serial structure is demonstrated using a tensegrity robotic arm. The proposed compliant tensegrity joint has notable benefits of tensegrity structure, such as high mechanical efficiency, modularity, and scalability. It can be extended to many robotic applications, such as large-size serial robotic arms and snake-like robots.