bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-Based Clinical Practice Guideline: Reconstruction after Skin Cancer Resection
Authors: Chen Andrew , Albertini John G. , Bordeaux Jeremy S. , Chen Michael W. , Cook Jonathan L. , Davidson Caryn , Donnelly Katelyn C. , Galaria Irfan I. , Hannan Catherine M. , Kantor Jonathan , Kapp Daniel L. , Lawrence Naomi , Lober Clifford W. , Loeding Lauren D. , Miller Alexander , Ness Daniel T. , Neves Rogerio I. , Revenaugh Peter C. , Setabutr Peter , Tholpady Sunil S. , Tollefson Travis T. , Van Beek Marta J. , Weiss Paul R. , Alam Murad
Published: April 2021

A multi-disciplinary work group involving stakeholders from various backgrounds and societies was convened to develop guidelines for the management of reconstruction after skin cancer resection. The goal was to identify areas of common ground and provide evidence-based recommendations to improve patient care. Given the heterogeneity of reconstructive techniques and clinical scenarios, investigation centered around common elements in the process. In some cases, a distinction was made between treatment options in the office-based setting as opposed to those in the facility setting. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology). Final recommendations are related to concepts concerning the timing of reconstruction, management of anticoagulation, use of antibiotics, methods of pain control, and follow-up assessment. At times, there was insufficient evidence to make high-level recommendations. The literature analysis highlights the need for additional methodologically robust studies in this area, to help guide clinical practice.
Functional and Radiographic Disease Progression in Nonoperatively Managed Kienböck Disease
Authors: DeGeorge Brent R. , Chawla Sagar S. , Lewallen Laura , Kakar Sanjeev
Published: April 2021

Background:

The purpose of this study was to describe the natural history of Kienböck disease among patients who elected to proceed with nonoperative treatment.

Methods:

The authors performed a retrospective study of all patients treated nonoperatively for Kienböck disease within their institution from January 1, 1999, to December 31, 2014. Inclusion criteria included follow-up greater than 1 year, serial posteroanterior and lateral wrist radiographs, and clinical examination. Posteroanterior/lateral radiographs were independently reviewed at initial presentation and at final follow-up, including Lichtman stage, carpal index, Stahl index, ulnar variance, and intercarpal angles.

Results:

Twenty-five patients with 25 wrists were included (mean age, 50.2 years), with an average length of clinical follow-up of 3.9 years and a mean length of radiographic follow-up of 5.2 years. There was no significant difference in range of motion; however, patient-reported pain was significantly decreased, and modified Mayo wrist scores and grip strength were increased. Lichtman stage, scapholunate angle, and radioscaphoid angle were increased; and carpal index, posteroanterior lunate ratio, and Stahl index were decreased across the study period. The mean progression in Lichtman stage was 0.5 stage/year with a range of 0 to 1.6 stages/year throughout the study period. There was no significant difference in Lichtman stage progression based on stage at presentation. A history of smoking was associated with increased radiographic disease progression.

Conclusion:

The present study demonstrates that among patients with Kienböck disease managed nonoperatively, the majority of patients significantly improve over time with respect to pain, grip strength, and Mayo wrist score, despite radiographic progression of disease.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, IV.
Reaching Those Most at Risk for HIV Acquisition: Evaluating Racial/Ethnic Disparities in the Preexposure Prophylaxis Care Continuum in Baltimore City, Maryland
Authors: Schumacher Christina M. , Tao Xueting , Chandran Aruna , Fields Errol , Price Ashley , Greenbaum Adena , Jennings Jacky M. ,   the IMPACT Partner Collaborative
Published: April 2021

Background:

Reducing HIV incidence requires addressing persistent racial/ethnic disparities in HIV burden. Our goal was to evaluate preexposure prophylaxis (PrEP) delivery, overall and relative to community need, among 7 clinical sites participating in a health department–led demonstration project to increase PrEP in Baltimore city, MD.

Methods:

PrEP care continuum stages (screened, indicated, referred, linked, evaluated, prescribed) were examined among HIV-negative individuals receiving services at participating sites between September 30, 2015 and September 29, 2019. Community need was defined using information on new HIV diagnoses (2016–2018). Differences in care continuum progression by demographics/priority population and comparison of demographic compositions between care continuum stages and new HIV diagnoses were examined using modified Poisson regression and χ2 tests, respectively.

Results:

Among 25,886 PrEP-screened individuals, the majority were non-Hispanic (NH) black (81.1%, n = 20,998), cisgender male (61.1%, n = 15,825), and heterosexual (86.7%, n = 22,452). Overall, 31.1% (n = 8063) were PrEP-indicated; among whom, 56.8% (n = 4578), 15.6% (n = 1250), 10.8% (n = 868), and 9.0% (n = 722) were PrEP-referred, linked, evaluated, and prescribed, respectively. Among 2870 men who have sex with men (MSM), 18.7% (n = 538) were PrEP-prescribed. Across all groups, the highest attrition was between PrEP-referred and PrEP-linked. NH-black race (vs. NH-white) was independently associated with lower likelihood of PrEP prescription (aPR, 0.89; 95% confidence interval, 0.81 to 0.98 controlling for age/gender). Relative to the demographic composition of new HIV diagnoses, fewer NH-blacks (80.2% vs. 54.3%) and more NH-whites (10.7% vs. 30.3%) and MSM were PrEP prescribed (55.2% vs. 74.5%).

Conclusions:

This project showed promise delivering PrEP referrals and prescriptions overall and to MSM. Substantial improvement is needed to improve linkage overall and to decrease disparities in PrEP prescriptions among NH-blacks. Future work should focus on addressing service gaps that hinder PrEP utilization.
Extremely High Cell-free DNA Levels Observed in Renal Allograft Patient With SARS-CoV-2 Infection
Authors: Bunnapradist Suphamai , Datta Nakul , Schaenman Joanna , Ioannou Nick , Bloom Michelle S. , Malhotra Meenakshi , Tabriziani Hossein , Gauthier Philippe , Ahmed Ebad , Billings Paul R. , Lum Erik L.
Published: April 2021

Beyond its widely recognized morbidity and mortality, coronavirus disease 2019 poses an additional health risk to renal allograft recipients. Detection and measurement of donor-derived cell-free DNA (dd-cfDNA), expressed as a fraction of the total cell-free DNA (cfDNA), has emerged as a noninvasive biomarker for allograft rejection. Here, we present a case report of a patient who was infected with severe acute respiratory syndrome coronavirus 2, 11 mo post–kidney transplant. The patient was serially monitored using an analytically and clinically validated massively multiplex PCR-based dd-cfDNA assay to assess allograft injury and risk for rejection. Over the course of infection, low dd-cfDNA fractions were observed (below the 1% cutoff) and were accompanied by unusually highly elevated levels of total cfDNA, which gradually declined as the infection resolved. The case study highlights the variability in total cfDNA levels during and after viral infection, and the need to consider both total and dd-cfDNA levels when clinically interpreting the results for allograft rejection. Furthermore, the study highlights the importance of serial testing, wherein an interplay between total cfDNA and dd-cfDNA can inform the optimization of a patient’s immunosuppressive treatment regimen in response to infection.
Adsorption of semiflexible polymers in crowded environments
Authors: Chauhan Gaurav , Simpson Michael L. , Abel Steven M.
Published: April 2021

Macromolecular crowding is a feature of cellular and cell-free systems that, through depletion effects, can impact the interactions of semiflexible biopolymers with surfaces. In this work, we use computer simulations to study crowding-induced adsorption of semiflexible polymers on otherwise repulsive surfaces. Crowding particles are modeled explicitly, and we investigate the interplay between the bending stiffness of the polymer and the volume fraction and size of crowding particles. Adsorption is promoted by stiffer polymers, smaller crowding particles, and larger volume fractions of crowders. We characterize transitions from non-adsorbed to partially and strongly adsorbed states as a function of the bending stiffness. The crowding-induced transitions occur at smaller values of the bending stiffness as the volume fraction of crowders increases. Concomitant effects on the size and shape of the polymer are reflected by crowding- and stiffness-dependent changes to the radius of gyration. We also demonstrate that curvature of the confining surface can induce desorption when the bending stiffness is sufficiently large. The results of our simulations shed light on the interplay of crowding and bending stiffness on the spatial organization of biopolymers in encapsulated cellular and cell-free systems.
Neurexin-3 defines synapse- and sex-dependent diversity of GABAergic inhibition in ventral subiculum
Authors: Boxer Emma E , Seng Charlotte , Lukacsovich David , Kim JungMin , Schwartz Samantha , Kennedy Matthew J , Földy Csaba , Aoto Jason
Published: April 2021

Ventral subiculum (vSUB) is integral to the regulation of stress and reward, however the intrinsic connectivity and synaptic properties of the inhibitory local circuit are poorly understood. Neurexin-3 (Nrxn3) is highly expressed in hippocampal inhibitory neurons, but its function at inhibitory synapses has remained elusive. Using slice electrophysiology, imaging, and single-cell RNA sequencing, we identify multiple roles for Nrxn3 at GABAergic parvalbumin (PV) interneuron synapses made onto vSUB regular spiking (RS) and burst spiking (BS) principal neurons. Surprisingly, we found that intrinsic connectivity and synaptic function of Nrxn3 in vSUB are sexually dimorphic. We reveal that vSUB PVs make preferential contact with RS neurons in males, but BS neurons in females. Furthermore, we determined that despite comparable Nrxn3 isoform expression in male and female PV neurons, Nrxn3 maintains synapse density at PV-RS synapses in males, but suppresses presynaptic release at the same synapses in females.

Highlights

Overall inhibitory strength in ventral subiculum is cell-type specific

PV circuits in ventral subiculum are organized sex-specifically

Nrxn3 function in PV interneurons depends on postsynaptic cell identity

Nrxn3 has distinct functions at PV-RS synapses in females compared to males

Abstract Figure

Graphical Abstract
Interleukin-15 Receptor α Chain Knockout NOD-SCID mice have reduced numbers of NK cells, develop thymic lymphomas and fail to engraft human hematopoietic cells
Authors: Vecchione Andrea , Nauman Grace , Marharlooei Mohsen Khosravi , Danzl Nichole , Li Hao-Wei , Chavez Estefania , Low Benjamin E. , Wiles Michael V. , Serreze David , Ding Lei , Sykes Megan
Published: April 2021

NOD-SCID IL2rγcnull(NSG) mice are widely used to model human immune cell development because they are more permissive for human hematopoietic cell engraftment and reconstitution than NOD-SCID mice. While increased human reconstitution in the blood of NSG mice has been attributed to the absence of mouse NK cells, deletion of the common gamma chain (γc) limits development of lymphoid tissue inducer cells and precludes development of normal secondary lymphoid structures. The disorganized lymphoid tissue leads to compromised human T cell-B cell interactions and results in variable human immune cell function in human immune system (HIS) NSG compared to NOD-SCID mice. We attempted to remove mouse NK cells from NOD-SCID mice while retaining other γc-dependent cytokine responses by targeted disruption of the mouse genomicIL15RAlocus with CRISPR/Cas9. IL15Rα is required for the development, function and survival of NK cells. NOD-SCID IL15Rα-/-mice showed reductions in NK cells and NK cell function. However, NOD-SCID IL15Rα-/-mice demonstrated accelerated thymic lymphomagenesis and showed earlier mortality compared to NOD-SCID mice. This result suggests that mouse NK cells are important to delay lymphoma development in NOD-SCID mice. We transplanted thymectomized NOD-SCID ILl5Rα-/-mice with human fetal liver CD34+cells and thymus to determine if these mice supported engraftment and development of a transplanted HIS. Surprisingly, we found that peripheral human engraftment was inferior (mean 0.05% of lymphocytes) to that in both NOD-SCID (mean, 10.5% of lymphocytes) and NSG (mean, 54% of lymphocytes) mice. These results indicate that NOD-SCID IL15Rα-/-mice are not permissive for human CD34+cell engraftment.
Amino acids 484 and 494 of SARS-CoV-2 spike are hotspots of immune evasion affecting antibody but not ACE2 binding
Authors: Alenquer Marta , Ferreira Filipe , Lousa Diana , Valério Mariana , Medina-Lopes Mónica , Bergman Marie-Louise , Gonçalves Juliana , Demengeot Jocelyne , Leite Ricardo B. , Lilue Jingtao , Ning Zemin , Penha-Gonçalves Carlos , Soares Helena , Soares Cláudio M. , Amorim Maria João
Published: April 2021

Understanding SARS-CoV-2 evolution and host immunity is critical to control COVID-19 pandemics. At the core is an arms-race between SARS-CoV-2 antibody and angiotensin-converting enzyme 2 (ACE2) recognition, a function of the viral protein spike. Mutations in spike impacting antibody and/or ACE2 binding are appearing worldwide, with the effect of mutation synergy still incompletely understood. We engineered 25 spike-pseudotyped lentiviruses containing individual and combined mutations, and confirmed that E484K evades antibody neutralization elicited by infection or vaccination, a capacity augmented when complemented by K417N and N501Y mutations.In silicoanalysis provided an explanation for E484K immune evasion. E484 frequently engages in interactions with antibodies but not with ACE2. Importantly, we identified a novel amino acid of concern, S494, which shares a similar pattern. Using the already circulating mutation S494P, we found that it reduces antibody neutralization of convalescent and post-immunization sera, particularly when combined with E484K and N501Y. Our analysis of synergic mutations provides a landscape for hotspots for immune evasion and for targets for therapies, vaccines and diagnostics.

One-Sentence Summary

Amino acids in SARS-CoV-2 spike protein implicated in immune evasion are biased for binding to neutralizing antibodies but dispensable for binding the host receptor angiotensin-converting enzyme
A novel magnetic bead-based extraction method for the isolation of antimicrobial resistance genes with a case study in river water in Malawi
Authors: Byrne Rachel L. , Cocker Derek , Alyayyoussi Ghaith , Mphasa M. , Charles Mary , Mandula Tamandani , Williams Christopher T. , Rigby Jonathan , Hearn Jack , Feasey Nicholas , Adams Emily R. , Edwards Thomas
Published: April 2021

Background

The environmental is increasingly recognised as an important reservoir of antimicrobial resistance (AMR) genes. Polymerase chain reaction (PCR) and whole genome sequencing (WGS) have great potential in the surveillance of AMR genes. However, molecular methods are dependent upon the isolation of high-quality DNA yields. Currently, there is no consensus for the optimum DNA extraction strategies from complex environmental matrices for downstream molecular applications.

Methods

We present a novel magnetic bead-based method for the isolation of antimicrobial resistance genes (ARGs) from river water in Malawi, named MagnaExtract. We present this with analytic limit of detection (LOD) as well as a case study in Southern Malawi. Here we compare the DNA yield and subsequent PCR output from MagnaExtract with commercially available QIAGEN kits and the crude boil and spin method, utilising a high-resolution melt analysis (HRM) PCR panel designed for the detection of third generation cephalosporin and carbapenem resistant genes.

Results

Of the 98 water samples evaluated we found the MagnaExtract method to be comparable, and in some instance’s superior to commercially available kits for the isolation of ARGs from river water samples. In addition, we found overnight incubation to promote the recovery of extended spectrum beta-lactamase (ESBL) genes and simultaneous reduction in the detection of carbapenemase genes.

Conclusion

The MagnaExtract approach offers a simple, affordable, high yielding extraction method that could be used for the detection of ARGs isolated from river water samples in environmental surveillance campaigns in East Africa.
FUS Oncofusion Protein Condensates Recruit mSWI/SNF Chromatin Remodelers via Heterotypic Interactions Between Prion-like Domains
Authors: Davis Richoo B. , Kaur Taranpreet , Moosa Mahdi Muhammad , Banerjee Priya R.
Published: April 2021

Fusion transcription factors generated by genomic translocations are common drivers of several types of cancers including sarcomas and leukemias. Oncofusions of the FET (FUS, EWSR1, and TAF15) family of proteins result from fusion of the prion-like domain (PLD) of FET proteins to the DNA-binding domain (DBD) of certain transcription regulators and are implicated in aberrant transcriptional programs through interactions with chromatin remodelers. Here, we show that FUS-DDIT3, a FET oncofusion protein, undergoes PLD-mediated phase separation into liquid-like condensates. Nuclear FUS-DDIT3 condensates can recruit essential components of the global transcriptional machinery such as the chromatin remodeler SWI/SNF. The recruitment of mammalian SWI/SNF is driven by heterotypic PLD-PLD interactions between FUS-DDIT3 and core subunits of SWI/SNF, such as the catalytic component BRG1. Further experiments with single-molecule correlative force-fluorescence microscopy support a model wherein the fusion protein forms condensates on DNA surface and enrich BRG1 to activate transcription by ectopic chromatin remodeling. Similar PLD-driven co-condensation of mSWI/SNF with transcription factors can be employed by other oncogenic fusion proteins with a genericPLD-DBD domainarchitecture for global transcriptional reprogramming.
Hydrosphere occupancy modeling (ψ) and Akaike (AIC) habitat model selection of urban amphibian in West Java landscape
Authors: Basukriadi Adi , Nurdin Erwin , Wibowo Andri
Published: April 2021

Amphibians are animal that requires combinations of hydrosphere (riparian vegetation, water body) and vegetation (trees) microhabitats. In urban settings, those microhabitats are scarce and disappearing. One of areas that still have sufficient microhabitats to support amphibian populations is located in an 88.9 Ha urban forests of Universitas Indonesia Campus in West Java. Here, this paper aims to assess and model the several amphibian species occupancy (Ψ) with vegetation covers, riparian vegetation, and water bodies based on Akaike habitat selection (AIC) indices. The studied amphibian species includeBufo melanosticus, Hylarana nicobariensis, Fejervarya limnocharis, andPolypedates leucomystax. For modeling, 7 microhabitat models were developed and tested for amphibian species occupancy with covariates including vegetation cover, riparian vegetation, and water body microhabitats. The Principle Component Analysis (PCA) shows that the occupancies of amphibian were influenced mostly by the presences of water bodies followed by riparian vegetation, and vegetation covers. According to the values of Ψ and AIC,Polypedates leucomystaxandFejervarya limnochariswere species that have high occupancy in riparian vegetation microhabitats with Ψ values of −14.18 and −12.59. Likewise,Hylarana nicobariensishas an equal occupancy in vegetation, riparian vegetation, and water body microhabitats. WhileBufo melanosticusshows high occupancy in vegetated microhabitats (Ψ = −14.18) rather than in riparian vegetation and water bodies (Ψ = −8.79). The combinations of riparian vegetation and water bodies show higher occupancy (Ψ = −8.00) rather than Ψ(vegetation cover+water body = −5.64) and Ψ(vegetation cover+ riparian vegetation = −4.36) combinations.
Plastid phylogenomics of the Gynoxoid group (Senecioneae, Asteraceae) highlights the importance of motif-based sequence alignment amid low genetic distances
Authors: Escobari Belen , Borsch Thomas , Quedensley Taylor S. , Gruenstaeudl Michael
Published: April 2021

PREMISE

The genusGynoxysand relatives form a species-rich lineage of Andean shrubs and trees with low genetic distances within the sunflower subtribe Tussilaginineae. Previous molecular phylogenetic investigations of the Tussilaginineae have included few, if any, representatives of this Gynoxoid group or reconstructed ambiguous patterns of relationships for it.

METHODS

We sequenced complete plastid genomes of 21 species of the Gynoxoid group and related Tussilaginineae and conducted detailed comparisons of the phylogenetic relationships supported by the gene, intron, and intergenic spacer partitions of these genomes. We also evaluated the impact of manual, motif-based adjustments of automatic DNA sequence alignments on phylogenetic tree inference.

RESULTS

Our results indicate that the inclusion of all plastid genome partitions is needed to infer fully resolved phylogenetic trees of the Gynoxoid group. Whole plastome-based tree inference suggests that the generaGynoxysandNordenstamiaare polyphyletic and form the core clade of the Gynoxoid group. This clade is sister to a clade ofAequatoriumandParagynoxysand also includes some but not all representatives ofParacalia.

CONCLUSIONS

The concatenation and combined analysis of all plastid genome partitions and the construction of manually curated, motif-based DNA sequence alignments are found to be instrumental in the recovery of strongly supported relationships of the Gynoxoid group. We demonstrate that the correct assessment of homology in genome-level plastid sequence datasets is crucial for subsequent phylogeny reconstruction and that the manual post-processing of multiple sequence alignments improves the reliability of such reconstructions amid low genetic distances between taxa.
A new global regulator that facilitates the co‐metabolization of polyaromatic hydrocarbons and other nutrients in Novosphingobium
Authors: Rojo Fernando
Published: April 2021

In an article in this issue of Environmental Microbiology, Segura et al. report the identification of an unusual global regulator in Novosphingobium sp. HR1a, a metabolically versatile bacterial strain isolated from the rhizosphere able to assimilate a wide range of polyaromatic hydrocarbons (PAHs). Physiological and transcriptomic assays suggest that this regulator, named PahT, activates the expression of genes involved in the assimilation of PAHs, and of compounds such as sugars and acetate, facilitating their co‐metabolism. This effect is the opposite to the carbon catabolite repression strategy that allows metabolically versatile bacteria to favour the use of some compounds over others. PahT was found to stimulate sugar uptake and metabolization in the presence and absence of PAHs and to facilitate microaerobic respiration if PAHs were present. A survey of the genomes of several Sphingomonadaceae members showed that PahT is not present in all strains of this family, but that it is strongly associated with PAH degradation genes. Since not all PAH‐degrading strains contain pahT, it seems that PahT is not essential for PAH degradation but likely provides a selective advantage to PAH‐degrading strains in environments such as the rhizosphere where other potential carbon sources are available.
The Labour Party Under Keir Starmer: ‘Thanks, But no “isms” Please!’
Authors: Goes Eunice
Published: April 2021

The Labour leader, Keir Starmer, is under pressure to outline the ideological contours of his political agenda and make big policy announcements. But thus far, the Labour leader has resisted it. This article argues that Starmer's reluctance to reveal his agenda is deliberate and is part of a strategy of ‘ideological quietism’ whose main purpose is to win the support of socially conservative voters.
A review on mechanistic aspects of individual versus combined uses of enzymes as clean label‐friendly dough conditioners in breads
Authors: Dai Yaxi , Tyl Catrin
Published: April 2021

Numerous dough improvers are used alone or in combination to enhance the quality of baked goods such as breads. While modern consumers demand consistent quality, the expectations for ingredients have changed over the past few years, and reformulations have taken place to provide “clean label” options. However, the effects and mechanisms of blended dough conditioners suitable for such baked products have not been systematically summarized. In this review, dough and bread properties as affected by different improver combinations are examined, with a focus on additive or synergistic interactions between enzymes or between enzymes and ascorbic acid. The combination of enzymes that hydrolyze starch and cell wall polysaccharides has been shown to reduce textural hardness in fresh and stored bakes goods such as breads. Enzymes that hydrolyze arabinoxylans, the main nonstarch polysaccharide in wheat, have synergistic effects with enzymes that result in cross‐linking of wheat flour biopolymers. In some studies, the effects of bread improvers varied for wheat flours of different strength. Overall, bread products in which wheat is used in whole grain form or in a blend with other flours especially benefit from multiple improvers that target different flour constituents in doughs.
Considerations surrounding remote medicolegal assessments: a systematic search and narrative synthesis of the range of motion literature
Authors: Steadman Peter , Sheppard Dianne , Henderson Janette , Halliday Brett , Freckelton Ian
Published: April 2021

Remote telehealth practices were forced to advance 10 years in a few short weeks in March 2020 due to the onset of a global pandemic. In the sphere of non‐clinical medicine, a dramatic element of uncertainty entered the psyche of doctors and lawyers in relation to the validity of remote or virtual independent medical examination (vIME). This paper considers the key issues surrounding the virtual assessment of clients for medicolegal purposes. Our main hypothesis was that, within certain defined parameters, the vIME technique can deliver reliable and accurate assessments. To explore this, a systematic literature search focusing on advanced device‐based range of motion measurement was conducted, along with an historical snapshot of observation‐based range of motion measurement considering application to remotely performed IME. While some specialists are of the view that observational measurement may be applied reliably to some joints when conducted by experienced orthopaedic surgeons, evidence for this is scant. The results, instead, support the notion of using task substitution, that is specialists appropriately assisted in conducting vIMEs by musculoskeletal trained allied health practitioners, regardless of the measurement tool, for permanent impairment assessments. Moreover, self‐performed examinations by injured individuals using advanced technology are not reliable in this setting. Our final contention is that remote examinations with limited clinical assessment have utility for legal matters, such as the assessment of causation of injury, treatment advice or approvals and fitness for pre‐employment tasks or safe variations, with objective clinical adjunct support such as Picture Archiving and Communication System‐based modern radiology systems.
Diagnostic concordance of telemedicine for otolaryngology, head and neck surgery in regional Australia
Authors: Kwok Matthew , Hunn Samuel , Tan Hannah , Borschmann Michael
Published: April 2021

Background

The use of telehealth during the COVID‐19 pandemic has emerged as both a necessary and significant tool in the provision of safe and timely healthcare in the field of otolaryngology. Increased access to specialist care in a regional setting is an additional benefit. Variation in diagnostic accuracy of telehealth consultations may affect diagnosis and management. Therefore, our aim is to determine the diagnostic concordance of telemedicine for otolaryngology in an Australian regional setting with physical consultations.

Methods

Retrospective review was conducted for all patients who received an initial telemedicine appointment over a 7‐month period during the COVID‐19 pandemic in regional Victoria, Australia. Data were collected regarding initial diagnosis and management from telemedicine consultations, subsequent physical appointment findings and management and intraoperative findings. Statistical analysis was performed using Prism (version 8.0, GraphPad).

Results

Two hundred and fifty‐nine patients were included. The most common conditions referred were for consideration of tonsillectomy with or without adenoidectomy (44.0%). Overall diagnostic concordance of the initial referrer was 63.3% and for telephone appointments, it was 81.9%. Concordance of recommended treatment plans between telephone and physical appointments was 96.9%.

Conclusion

Although physical appointments are an essential aspect of practice in OHNS, there are significant benefits of phone only telemedicine within the context of a global pandemic which were compounded by a regional setting. Paediatric patients were found to have the highest concordance of diagnosis and treatment plans.
Rethinking the role of Research Ethics Committees in the light of Regulation (EU) No 536/2014 on clinical trials and the COVID‐19 pandemic
Authors: Tusino Silvia , Furfaro Maria
Published: April 2021

Research Ethics Committees (RECs)—or Institutional Review Boards (IRBs), as they are known in the US—were created about 50 years ago to independently assess the ethical acceptability of research projects involving human subjects, their fundamental role being the protection of the dignity and rights of research participants. In this paper we develop some critical reflections about the current situation of RECs. Our starting point is the definition of the role they should ideally play, a role that should necessarily include a collaborative approach and the focus on the ethics component of the review. This ideal is unfortunately quite far from reality: inadequacies in the functioning of RECs have been discussed for decades, along with reform proposals. Both in the US and in the European Union (EU), reforms that aim at the centralization of the review process were recently approved. Even though these reforms were needed, they nonetheless raise concerns. We focus on two such concerns, related in particular to Regulation (EU) No 536/2014: the risk of narrowing the scope of the ethics review and that of disregarding the local context. We argue that the COVID‐19 pandemic paved the way for the transition towards the centralized model and that an analysis of its impact on the research review process could provide some interesting insights into possible shortcomings of this new model. We conclude by identifying three objectives that define the role of a REC, objectives that any reform should preserve.
Ethical discourse of medical students and physicians on conscientious objection: A qualitative study in Turkey
Authors: Keleş Şükrü , Aksu Murat , Gülpınar Gizem , Yalım Neyyire Yasemin
Published: April 2021

This study is an investigation of the views of medical students (N=15) and physicians (N=14), in Turkey, on conscientious objection through elaboration on their experiences in medical practice within the framework of conscientious objection, and evaluation of the data from an ethical perspective. The data received from in‐depth interviews were evaluated by using the thematic content analysis method. They were then divided into contexts and themes as follows: “Refusal to provide healthcare services,” “scope of conscientious objection,” and “impact of conscientious objection (in case of legal entitlement).” The opinions of our research participants suggest that conscientious objection has become widespread in medical practices. It is argued that the tendency of healthcare providers and patients to find temporary resolutions to ethical dilemmas only complicates such resolutions. It is imperative, therefore, to set a rational limit on conscientious objection so as to prevent the adoption of an attitude shaped completely by the personal beliefs of the physician or the patient.
Orthodox Influences on Methodism
Authors: Carter David
Published: April 2021

This article describes the influence of the Orthodox tradition on Methodism in the course of the development of the ecumenical movement. It relates the proposals made in the 1990s for an international dialogue between the traditions, proposals which have yet to be acted on. The article also describes a series of resonances between the two traditions that exist from earlier parallel developments, as well as emphases that have occurred independently but that can now be recognized as establishing commonalities that could be fruitful in later dialogue. Mention is made of commonality in the theological use of hymnody (Charles Wesley and St Symeon in particular) and of common emphases on trinitarian theology holiness/theosis, the divine image in human nature and on holistic mission.
Gender differences in the relationship between personality, cognitive function and regular dental visits in Japanese community‐dwelling older adults
Authors: Kubota Chieko , Moriya Shingo , Hama Yohei , Onda Rie , Watanabe Yutaka , Uchida Yoko
Published: April 2021

Objectives

Studies have examined the association between personality and health behaviour, but research focusing exclusively on regular dental visits has yet to be conducted. This study examined the association between personality traits and regular dental visits among Japanese community‐dwelling older adults.

Methods

The participants in this cross‐sectional study included 1,057 community‐dwelling older adults aged 65–74 years from Ranzan and Yoshimi towns; data were collected from October to November 2015 and October to November 2016, respectively. Interviews were conducted to obtain sociodemographic, income, occupation and medical data. The Tokyo Metropolitan Institute of Gerontology Index of Competence was used to assess higher‐level competence; general intelligence was also evaluated. The ‘Big Five’ personality traits—openness to experience, consciousness, neuroticism, extraversion and agreeableness—were also examined. A multivariable logistic regression analysis was performed to examine the relationship between regular dental visits and personality traits.

Results

Among men, the number of natural teeth, current employment status and conscientiousness were associated with dental care utilization. Among women, the number of natural teeth, current annual income, the intellectual activity domain of the Tokyo Metropolitan Institute of Gerontology Index of Competence and openness were significant.

Conclusions

The factors associated with regular dental visits differed by gender. Overall, work was associated with men's visits, whereas intellectual activity and economic factors were relevant to women. Factors such as personality traits should be considered when addressing barriers to oral health. Understanding personality traits will help practitioners more effectively encourage older adults to make dental visits.
‘Code‐95’ rapid response calls for patients under airborne precautions in the COVID‐19‐era: a cross‐sectional survey of healthcare worker perceptions
Authors: Subramaniam Ashwin , Zuberav Alexandr , Wengritzky Robert , Bowden Christopher , Tiruvoipati Ravindranath , Wang Wei Chun , Wadhwa Vikas
Published: April 2021

Background

To allow better allocation of staff and resources, rapid response teams attending to acutely deteriorating or aggressive patients with suspected or confirmed COVID‐19 infection were pre‐warned with the announcement of 'Code‐95' with calls.

Aim

To assess healthcare worker (HCW) perspectives on pre‐warning rapid response calls (RRC) with ‘Code‐95’ in announcements when attending to deteriorating or aggressive patients with suspected/confirmed COVID‐19 infection.

Methods

Design: prospective cross‐sectional single‐centre survey of HCW over a 3‐week period. Setting: tertiary public hospital. Participants: HCW caring for deteriorating or aggressive patients. Main outcome measures: the primary outcome was to assess HCW perspectives in attending Code‐95 calls. Secondary outcomes were to identify any differences related to craft group, age, experience or presence of comorbidities.

Results

A total of 297 responses was analysed; 86.7% of HCW (n = 257) attending Code‐95 calls reported anxiety. Medical staff reported greater anxiety in comparison to nursing staff (93.8% vs 78.5%; P = 0.002). Efferent team reported higher anxiety in contrast to afferent team (92.6% vs 58.8%; P = 0.021). There was no significant difference in perceived anxiety based on age (≤40 vs >40 years of age), years of experience (≤5 vs >5 years), comorbidities or mental illness; 54% reported concerns about adequacy of infection‐control policies and personal protective equipment; 45% were worried about inadequate training for responding to Code‐95 calls.

Conclusions

Most surveyed HCW supported Code‐95 announcements pre‐warning them of potential COVID‐19 exposure when attending a RRC. However, the majority of HCW reported anxiety when attending these calls. Medical and efferent team HCW perceived greater anxiety compared to nursing and afferent team HCW. The Code‐95 system to pre‐warn rapid response teams may be a useful addition to protecting HCW from infectious diseases, although broader implementation will require greater resourcing, training and support.
Can the CHA2DS2‐VA schema be used to decide on anticoagulant therapy in Aboriginal and other Australians with non‐valvular atrial fibrillation?
Authors: Hung Joseph , Kelty Erin , Nedkoff Lee , Thompson Sandra C. , Katzenellenbogen Judith M.
Published: April 2021

The Australasian guidelines recommend use of the CHA2DS2‐VA schema to stratify ischaemic stroke risk in patients with non‐valvular atrial fibrillation (N‐VAF) and determine risk thresholds for recommending oral anticoagulant (OAC) therapy. However, the CHA2DS2‐VA score has not been validated in a representative Australian population cohort with N‐VAF, including in Aboriginal people who are known to have a higher age‐adjusted stroke risk than other Australians. In a retrospective data‐linkage study of 49 114 patients aged 24–84 years with N‐VAF, 40.0% women and 2.5% Aboriginal, we found that patients with a CHA2DS2‐VA score >2 had high annual stroke rates (>2%) that would justify OAC therapy. This occurred regardless of Aboriginal status. Non‐Aboriginal patients with a CHA2DS2‐VA score of 0 had a mean annual stroke rate of 0.4%, and hence were not likely to benefit from antithrombotic therapy. However, Aboriginal patients with a zero CHA2DS2‐VA score had a significantly higher annual stroke rate of 0.9%, and could potentially obtain net clinical benefit from anticoagulation, primarily with the safer non‐vitamin K antagonist OAC. We conclude that clinicians can confidently use the CHA2DS2‐VA score to make decisions regarding anticoagulation in accordance with stroke risk in patients with N‐VAF, except in Aboriginal people in whom the risk score was unable to identify those at truly low risk of stroke.
A technological review on processing of sugarcane juice: Spoilage, preservation, storage, and packaging aspects
Authors: Panigrahi Chirasmita , Shaikh Anas Ejaz Yasmeen , Bag Bijaya Bharati , Mishra Hari Niwas , De Sirshendu
Published: April 2021

Sugarcane juice is a proven health‐promoting drink having a substantial amount of polyphenols, antioxidants, and functional nutrients known to prevent several ailments. Owing to its perishable nature, sugarcane juice is mostly consumed fresh postextraction. Prior to juice extraction, the pretreatment of canes is felt vital and is generally adopted to minimize subsequent postcrushing destructive changes in juice quality. The application of processing techniques to sugarcane juice is crucial, primarily to enhance its shelf‐life and for value‐addition to meet consumers' demand. This review focuses on critical aspects encountered during sugarcane juice processing, which are of prime importance to food scientists. This addresses pretreatment of sugarcanes; physicochemical, nutritional, and functional characteristics of sugarcane juice; its microbiological and biochemical spoilage; processing techniques for enhancing its shelf‐life and/or quality characteristics, and finally its packaging and storage. The understanding of juice characteristics and spoilage has resulted in the introduction of novel processing, packaging, and storage technologies leading to juice products with higher retention of nutritional and quality characteristics. Implementation of such technologies for industrial‐scale processing of sugarcane juice is not only advantageous over the conventional ones but also useful in the development of additive‐free, high‐quality processed juice with natural, and fresh sensory appeal in packaged form. Such an attempt would promote entrepreneurship in sugarcane juice processing and would be useful for the commercialization of shelf‐stable sugarcane juice in packed form.

Practical applications

With the increasing consumer demands for natural and healthy foods, significant efforts are being made for manufacture and supply of food products which retain valuable nutrients and quality attributes after the processing and packaging operations. Realizing that sugarcane juice is one such food product, which is highly nutritive and is known to prevent several ailments, it is highly required to comprehensively describe several aspects about its shelf life extension and storage stability. To study the effects of processing on sensitive sensory qualities of juice is of utmost importance. The highlights of novel processing technologies reviewed are expected to be useful for food process engineers and industrialists to manufacture shelf‐stable packaged sugarcane juice.
Should we or shouldn’t we?
Authors: Lawrence Andrew J.
Published: April 2021

Reward‐seeking is critical for survival. Learning about the relationship between actions and outcomes helps us to make decisions and select behaviours that result in a specific outcome. This special issue entitled “The Neurochemistry of Reward‐Seeking” addresses this crucial facet of behaviour and brings together a number of key thought‐leaders to provide a timely update on the circuitry, chemistry and mechanisms underlying different aspects of reward‐seeking. The reviews in this issue canvass unanswered questions in the field and provide a degree of forethought about how we may advance our understanding of reward‐seeking by embracing novel technology alongside existing scholarship. This issue also highlights the neurochemical complexity of reward‐seeking, and the reader will uncover both distinct and shared circuits and transmitters driving various forms of reward‐seeking. Accordingly, we hope that this special issue will provide a valuable resource for the field and trigger future research on this topic.

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Bromus orientalis (Poaceae: B. sect. Bromopsis), a new species from Turkey
Authors: Behçet Lütfi , Yapar Yakup
Published: April 2021

A new perennial brome, Bromus orientalis, is described from Bingöl province in Eastern Anatolia, Turkey. The species is known only from the type locality where ca 50 individuals were found in 2018. It is similar to Bromus ramosus and Bromus benekenii but differs from them by having leaf sheaths without auricules and 3‐veined lower glumes that are 11–12 mm long. Detailed descriptions, distribution, ecology, conservation status and photographs of the new species are provided along with the comparison to B. ramosus and B. benekenii.
Inter‐specific aggression generates ant mosaics in canopies of primary tropical rainforest
Authors: Mottl Ondřej , Yombai Jacob , Novotný Vojtěch , Leponce Maurice , Weiblen George D. , Klimeš Petr
Published: April 2021

The ant mosaic is a concept of the non‐random spatial distribution of individual ant species in trees built upon the assumption of interspecific behavioural associations. However, colony identity and environmental variance may also play a role in species distribution. Here we assess the presence of ant mosaics in a primary forest ecosystem and whether they are structured by species' aggressive behaviours or by habitat filtering.

We sampled arboreal ants from vertically stratified baits exposed in 225 canopy trees in a 9‐ha plot of primary lowland forest in Papua New Guinea, the largest forest area surveyed to detect ant mosaics. We performed behavioural tests on conspecific ants from adjacent trees to determine the territories of individual colonies. We explored the environmental effects on the ant communities using information on the plot vegetation structure and topography. Furthermore, we created a novel statistical method to test for the community non‐random spatial structure across the plot via spatial randomisation of individual colony territories. Finally, we linked spatial segregation among the four most common species to experimentally assessed rates of interspecies aggression.

The ant communities comprised 57 species of highly variable abundance and vertical stratification. Ant community composition was spatially dependent, but it was not affected by tree species composition or canopy connectivity. Only local elevation had a significant but rather small effect. Individual colony territories ranged from one tree to 0.7 ha. Species were significantly over‐dispersed, with their territory overlap significantly reduced. The level of aggression between pairs of the four most common species was positively correlated with their spatial segregation. Our study demonstrates the presence of ant mosaics in tropical pristine forest, which are maintained by interspecific aggression rather than habitat filtering, with vegetation structure having a rather small and indirect effect, probably linked to microclimate variability.
Knowledge, attitude, and practices of grassroot health workers about early childhood caries
Authors: Godhi Brinda Suhas , Kaul Shefali , Shanbhog Raghavendra
Published: April 2021

Objective

This study examines the knowledge levels pertaining to early childhood caries (ECC) among grassroot workers of rural India.

Design

A questionnaire study assessing the awareness levels of various ECC aspects was carried out among 88 auxiliary nurse midwives (ANMs), 140 Anganwadi workers (AWWs), and 210 Accredited Social Health Activist (ASHA) workers in a district of Southern India. A 24‐item pretested, structured, and close‐ended, self‐administered questionnaire was used to collect information on the knowledge of early childhood oral health‐related factors. Descriptive statistics and multivariate ANOVA were used to summarize the results.

Results

Overall, only 59% of ANMs, 49% of AWWs, and 47% of ASHA workers were found to have adequate knowledge about ECC.

Conclusion

The current study clearly highlighted the discrepancy in the awareness levels among grassroot health care workers. A deficit was found to exist in the knowledge of the tested health care workers regarding infant oral care and ECC transmissibility.
Characterization of the novel HLA‐C*06:314 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Blouin Laura , Visentin Jonathan
Published: April 2021

HLA‐C*06:314 differs from HLA‐C*06:02:01:01 by one nucleotide substitution in codon 327 in exon 7.