bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic mesenteric ischaemia: the importance of the individual mesenteric artery
Authors: Høyer Christian , Christensen Mette Høgh , Sandermann Jes , Leusink Robert , Abrahamsen Jan
Published: October 2021

Background

Chronic mesenteric ischaemia (CMI) is a vastly underdiagnosed condition that typically leads to postprandial abdominal pain and weight loss. The aim of the study was to explore the involvement of various mesenteric vessels in total splanchnic blood flow (SBF) and hepatic vein oxygenation.

Methods

Single‐blinded comparative trial of 476 patients clinically suspected of CMI. Routine investigation included measurement of hepatic vein oxygen saturation, indirect measurement of the total splanchnic blood flow (SBF), using Fick's principle and the tracer [99mTc]Mebrofenin, before and after a meal, and digital subtraction angiography.

Results

A total of 176 of the 476 patients (36%) had at least one angiographically significant stenosis (lumen reduction ≥70%). In patients with a significant one‐vessel disease, the percentage having CMI according to SBF was 10% for a celiac trunk stenosis (n = 60), 50% for a superior mesenteric stenosis (n = 24) and 6% for an inferior mesenteric artery stenosis (n = 34). In patients with a significant two‐vessel disease, the percentage with CMI according to SBF response was 92%, 18% and 79%, for no significant stenosis of the celiac trunk (n = 13), superior mesenteric artery (n = 17) and inferior mesenteric artery (n = 19), respectively.

Conclusion

Patients with significant one‐ or two‐vessel stenosis involving the superior mesenteric artery have a higher likelihood of CMI according to flow criteria and a greater postprandial decrease in hepatic vein saturation on average than patients with no involvement of the superior mesenteric artery.
Sessile serrated lesions in patients with adenoma on index colonoscopy do not increase metachronous advanced adenoma risk
Authors: Hong Seung Wook , Kim Jeongseok , Lee Ji Young , Lee Jong‐Soo , Chang Hye‐Sook , Park Hye Won , Kim Gwang‐Un , Yoon Jiyoung , Ye Byong Duk , Byeon Jeong‐Sik , Myung Seung‐Jae , Yang Suk‐Kyun , Choe Jaewon , Yang Dong‐Hoon
Published: October 2021

Objectives

Post‐polypectomy surveillance intervals should be determined based on index colonoscopy findings. However, the risk of metachronous lesions, resulting from the coexistence of adenoma and sessile serrated lesions (SSLs), has rarely been addressed. We evaluated the impact of synchronous SSL on the risk of metachronous lesions within similar adenoma risk groups.

Methods

We retrieved individuals with one or more adenomas on index colonoscopy in a single‐center retrospective cohort and stratified them into four groups depending on the presence of SSL and low‐risk/high‐risk adenoma (LRA/HRA). Participants who underwent surveillance colonoscopies at least 12 months apart were included. We compared the risks of metachronous lesions including HRA, advanced adenoma (AA), or SSL within similar adenoma risk groups according to the presence of SSL.

Results

Overall 4493 individuals were included in the analysis. The risk of metachronous HRA/AA was not significantly higher in the adenoma with SSL group compared with the adenoma without SSL group, irrespective of LRA (HRA, 6/86 vs. 231/3297, P = 1.00; AA, 0/86 vs. 52/3297, P = 0.64) or HRA (HRA, 11/64 vs. 240/1046, P = 0.36; AA, 3/64 vs. 51/1046, P = 1.00). However, the risk of metachronous SSL in individuals with synchronous SSL was higher than that in those without SSL for both LRA (15/86 vs. 161/3297, P < 0.001) and HRA groups (11/64 vs. 61/1046, P = 0.002).

Conclusion

The presence of synchronous SSL did not increase the risk of metachronous HRA/AA, compared with isolated adenoma, but increased the risk of metachronous SSL.
Home equity lending, credit constraints and small business in the US
Authors: Lastrapes William D. , Schmutte Ian , Watson Thor
Published: October 2021

We use Texas's constitutional amendment in 1997 that expanded the scope of home equity loans as a source of exogenous variation to estimate the effects of relaxing credit constraints on small businesses. We find, using standard panel data methods and restricted‐use microdata from the US Census Bureau, that the Texas amendment increased the use of home equity finance by small businesses, increased new business and job creation and reduced firm exit and job loss. The effects are larger and significant for businesses with fewer than 10 employees.
Functional cognitive and language outcomes after cerebral hemispherectomy for hemimegalencephaly
Authors: Puka Klajdi , Jones Monika , Mathern Gary W.
Published: October 2021

Objective

Hemispheric surgeries are an effective treatment option to control seizures for children with hemimegalencephaly (HME); however, not enough is known about their cognitive outcomes. This study aimed to delineate the cognitive and language outcomes after hemispherectomy for HME and identify the clinical characteristics associated with cognition and language.

Methods

Data came from the Global Pediatric Epilepsy Surgery Registry, a patient‐driven web‐based registry for epilepsy surgery. We focused on children's functional status, assessed through parent‐reports of cognitive and language skills. Parents also reported on their satisfaction with surgery, their child's quality of life, and various demographic, clinical, and surgery characteristics.

Results

Parents of 45 children (40% female) participated. Children were aged 2.6 (SD 6.5) months at seizure onset, 10.8 (SD 12.7) months at hemispherectomy, and 8.7 (SD 4.8) years at follow‐up, at which point 68% were seizure‐free. We found that at follow‐up, 43% had average or mildly impaired cognition, 26% could speak age appropriately, and 21% had satisfactory reading skills. A total of 55%, 43%, and 17% of children first babbled, spoke their first words, and started speaking in sentences at an age‐appropriate period, respectively. Children who had undergone a right hemisphere resection and those who were older at epilepsy onset were more likely to have better cognitive and language outcomes.

Significance

Children with HME have delayed language milestones and continue to require significant language and literacy support long‐term after cerebral hemispherectomy.
Creep fracture parameter C* solutions for semi‐elliptical surface cracks in plates under tensile and bending loads
Authors: Wang Kai , Wang Guozhen , Tu Shantung , Xuan Fuzhen
Published: October 2021

In order to predict and assess creep life for plate structures with semi‐elliptic surface cracks under high temperature condition, the accurate calculation of the creep fracture mechanics parameter C* is a critical step. In this paper, the effects of crack sizes, plate geometries, and material creep properties on the parameter C* have been investigated under tensile and bending loads by extensive finite element analyses. Based on the results, the creep influence functions Hc for calculating C* values were obtained and fitted into equations for surface cracks in plates under both loads. The equations have been verified by finite element calculations. The C* solutions were obtained through these equations which are suitable for wide ranges of crack sizes, plate geometries, and materials.
Population‐level effects of parasitism on a freshwater ecosystem engineer, the unionid mussel Anodonta anatina
Authors: Brian Joshua I. , Dunne Sebastian E. , Ellis Christine L. , Aldridge David C.
Published: October 2021

Parasites can negatively affect hosts at individual, population, and species‐level scales. However, the link between individual‐ and population‐level impacts is often poorly understood. In particular, the population‐level response to parasitism may alter wider ecosystem dynamics if animals with ecosystem engineering capabilities are infected.

Here, we examine the effects of parasitism on a freshwater ecosystem engineer, the unionid mussel Anodonta anatina, at two different sites. We study three common parasites: the digenean trematode Rhipidocotyle campanula; the unionicolid mite Unionicola intermedia; and the ectoparasitic invasive zebra mussel Dreissena polymorpha. As well as demonstrating the individual‐level effects of parasitism on the native host mussel, we construct a simple model to estimate the reduction in population‐level reproductive output caused by parasites.

We show that both infection prevalence and intensity were population‐specific, with one site having more than three times as many native mussels infected by trematodes and mites than the other, but more than four times fewer mussels afflicted by invasive zebra mussels. Negative reproductive consequences for individual host mussels were documented as a result of parasitism, with trematodes causing castration at both sites. Mites were also correlated with a reduction in the viability of larval offspring (glochidia) by more than 25%, but only at one site, suggesting some potential impacts of parasitism may be population specific. The population‐level model shows that parasitism alone reduces larval output of the two populations by 10% and 13%, respectively.

Our study takes the important step of scaling individual‐level effects of parasitism to population‐level processes, and highlights the influence that parasites may have in the population dynamics of unionid mussels. Given the ecosystem engineering capabilities of A. anatina, such effects may have important impacts on the wider biota.

Even at relatively low prevalences, the observed effects of parasites on native mussel populations suggests that parasitism must be considered in the conservation of freshwater mussels, one of the world's most globally imperilled faunal groups. Further, understanding how the effects of parasitism on individual hosts scales to the ecosystem level is a crucial and unaddressed question in freshwater biology.
Challenging sheep grazing in orchards: Changes in nutrition, performance, and the health of animals and the effects on the vegetation and soil
Authors: Yoshihara Yu , Miyagawa Yuki , Sakai Masaru
Published: October 2021

We proposed a mixture of animal husbandry and fruit tree industry: livestock grazing under an orchard layer to increase agricultural productivity per area and reduce the costs of feed, fertilizer, and weed control. Lambs were reared in‐house for 1 month and then moved to a pear orchard for 1 month of grazing. We recorded the changes in body weight, blood properties (e.g., albumin, cholinesterase, and nonesterified fatty acids), and parasitic infection to compare the in‐housed lambs with the grazing lambs in the orchard. Additionally, we conducted field investigations for changes in vegetation and soil properties before and after grazing. Grazing caused significant increases in body weight, helminth eggs in dung, and soil water retention, and significant decreases in plant biomass, grass digestibility, and soil hardness. In contrast, the nutritional values of the feed, blood properties, and soil chemical properties (e.g., pH, P, N, and C) were not significantly changed after grazing. These results highlighted that the fruit tree industry combined with livestock production would be an acceptable management approach for Japanese agriculture, although further case studies are required.
Grazing impacts on ground beetle (Coleoptera: Carabidae) abundance and diversity on semi‐natural grassland
Authors: Pozsgai Gabor , Quinzo‐Ortega Luis , Littlewood Nick A.
Published: October 2021

Semi‐natural grasslands are commonly managed as a grazing resource for domestic livestock but, due to their unique biodiversity, they are also of conservation interest. Numerous drivers have impacted on the status of these grasslands in recent decades, most importantly changing grazing management strategies. These changes have the potential to affect the biodiversity associated with these habitats, including on some rich invertebrate assemblages. Responses, however, are often dissimilar between different invertebrate taxa.

We investigated the responses of ground beetles to different grazing regimes within a replicated, controlled, long‐term grazing experiment on upland semi‐natural grassland in Scotland.

Although there was substantial overlap of species composition of ground beetle assemblages in different grazing treatments, species richness, abundance and Shannon diversity of ground beetles were significantly lower in ungrazed plots than in plots subject to high‐ or low‐intensity sheep grazing. Ground beetle abundance (but not species richness or diversity) was lower in ungrazed plots compared to those with low‐intensity mixed grazing by sheep and cattle. However, no differences were identified in abundance, species richness or diversity between the three grazed treatments.

Our results suggest that ground beetles may show different responses to grazing compared to responses of some other invertebrate groups and demonstrate the difficulty of attempting to manage grazing to optimise conditions for a wide range of invertebrates.
Central obesity in school‐aged children increases the likelihood of developing paediatric autoimmune diseases
Authors: Räisänen Laura , Lommi Sohvi , Engberg Elina , Kolho Kaija‐Leena , Viljakainen Heli
Published: October 2021

Background

The incidences of both paediatric obesity and autoimmune diseases have been increasing, but their relationship with one another is unclear.

Objective

To determine whether obesity or particular dietary patterns in school‐aged children are potential risk factors for autoimmune diseases during adolescence.

Methods

This matched case–control study included 525 children, followed up from a median age of 11.3 to 16.7 years. Of them, 105 children received primary autoimmune diagnoses (diabetes, thyroiditis, arthritis, or inflammatory bowel diseases) after baseline and generated the case group. Four children with matching age, sex, and residential area generated the control group of 420 children. At baseline, age‐ and sex‐specific body mass index categories were acquired and waist‐to‐height ratio (WHTR) was calculated. Central obesity was present when WHTR ≥0.5. Dietary patterns were analysed using a food frequency questionnaire (FFQ).

Results

School‐aged children with central obesity were 2.11 (OR, 95% CI 1.11–3.98) times more likely to develop autoimmune diseases before age of 19 years than those without central obesity. Being overweight was not related to the onset of these diseases (OR 1.60, 95% CI 0.89–2.87, nor were dietary patterns.

Conclusion

Central obesity in school‐aged children was related to the development of autoimmune diseases, while being overweight and dietary patterns were not.
United States nurses' experiences during the COVID‐19 pandemic: A grounded theory
Authors: Kelley Marjorie M. , Zadvinskis Inga M. , Miller Pamela S. , Monturo Cheryl , Norful Allison A. , O’Mathúna Dónal , Roberts Haley , Smith Julia , Tucker Sharon , Zellefrow Cindy , Chipps Esther
Published: October 2021

Objective

The objective of this study was to explore nurses' experiences and perceptions at selected United States (U.S.) healthcare sites during the COVID‐19 pandemic.

Background

The COVID‐19 pandemic brought rapid changes to the healthcare community. While a few studies have examined the early pandemic experiences of nurses in China and Europe, nurses' experiences across the United States have remained relatively underexplored.

Design

A qualitative study design was used.

Methods

Using a constructivist grounded theory methodology and methods, we conducted eight focus groups across four hospital sites in the eastern, midwestern and western United States. Registered nurses with a minimum of six months' experience working in all clinical specialties were eligible. Forty‐three nurses participated. Data were analysed iteratively using the constant comparative method. The COREQ guidelines supported the work and reporting of this study.

Results

The nurses experiencing a pandemic (NEXPIC) grounded theory emerged positing associations between four interrelated themes: Challenges, Feelings, Coping and Ethics. Nurses reported Challenges associated with changes in the work environment, community and themselves. They expressed more negative than positive feelings. Nurses coped using self‐care techniques, and teamwork within the healthcare organisation. Moral dilemmas, moral uncertainty, moral distress, moral injury and moral outrage were ethical issues associated with nurses' Challenges during the pandemic. Moral courage was associated with positive Coping.

Conclusions

Awareness of frontline nurses' complex and interrelated needs may help healthcare organisations protect their human resources. This new theory provides preliminary theoretical support for future research and interventions to address the needs of frontline nurses.

Relevance to clinical practice

Nurses face added distress as frontline at‐risk caregivers. Interventions to promote nurses' ability to cope with personal and professional challenges from the pandemic and address ethical issues are needed to protect the nursing workforce. This study offers a new substantive theory that may be used to underpin future interventions.
Evaluation of Marginal and Internal Fit of a CAD/CAM Monolithic Zirconia‐Reinforced Lithium Silicate Porcelain Laminate Veneer System
Authors: Baig Mirza Rustum , Akbar Aqdar A. , Sabti Mohammad Y. , Behbehani Zahra
Published: October 2021

Purpose

To evaluate the marginal and internal fit of monolithic computer‐aided design/computer‐aided manufacturing (CAD/CAM) ZLS (Vita Suprinity) glass ceramic porcelain laminate veneers (PLVs), in terms of marginal and internal gap widths, in comparison to monolithic lithium disilicate (LDS) [IPS e.max CAD] CAD/CAM veneers, and, also, to analyze the effect of incisal preparation designs (butt joint and chamfer), on the marginal and internal fit accuracy.

Materials and Methods

Forty dental stone dies poured from impressions made of two master metal dies with different incisal preparation designs were scanned to produce digital models. Forty ceramic veneers were designed and milled using the virtual models‐10 ZLS butt joint, 10 ZLS chamfer, 10 LDS butt joint, and 10 LDS chamfer. The monolithic ceramic veneers produced were then subjected to marginal and internal gap width evaluation using X‐ray nano‐computed tomography and computerized digital analysis (n = 10). Descriptive analyses of data were performed and the influence of “material” and “preparation design” on the marginal and internal fit of veneers was assessed using 2‐way ANOVA (α = 0.05). Bonferroni post‐hoc multiple comparison tests were used to further analyze the interactions between the material and preparation design after adjusting the α value by Holm‐Bonferroni method (α = 0.01).

Results

Mean marginal and internal gaps for ZLS PLVs were 65 ±11 μm and 112 ±14 μm for butt joint, and 100 ±24 μm and 100 ±21 μm for chamfer, respectively. Corresponding values for LDS PLVs were 78 ±25 μm and 114 ±17 μm for butt joint, and 104 ±18 μm and 106 ±7 μm for chamfer. Marginal gap and internal gap differences between ZLS and LDS PLVs were not significant (marginal gap: F = 1.786, p = 0.190; internal gap: F = 0.807, p = 0.375). However, the preparation designs (butt joint and chamfer) differed significantly in terms of marginal gaps (F = 23.797, p = 0.000), but not internal gaps (F = 3.703; p = 0.059).

Conclusions

Butt joint margins produced better marginal accuracy in terms of marginal gap, compared to chamfers, for ZLS CAD/CAM laminate veneers.
The novel repressor Rce2 competes with Ace3 to regulate cellulase gene expression in the filamentous fungus Trichoderma reesei
Authors: Chen Yumeng , Wang Wei , Liu Pei , Lin Aibo , Fan Xingjia , Wu Chuan , Li Ni , Wei Liujing , Wei Dongzhi
Published: October 2021

The filamentous fungus Trichoderma reesei is widely used for industrial cellulase production. In T. reesei, cellulase gene expression is tightly controlled by a regulatory network involving multiple transcription factors. Here, we isolated a novel protein, Rce2, using a pull‐down assay and mass spectrometry analysis, from a partial carbon catabolite de‐repression mutant, T. reesei Rut‐C30, cultured under glucose‐repressing conditions. Deletion and overexpression of Rce2 in T. reesei wild‐type QM6a and mutant Rut‐C30 revealed that Rce2 acts as a repressor of cellulase gene expression. DNase I footprinting assays, electrophoretic mobility shift assays, and chromatin immunoprecipitation assays revealed that Rce2 was located in the nucleus and bound to the consensus sequences 5′‐(T/A)NNNNCCG‐3′ and 5′‐CGGNNNN(T/A)‐3′ in the promoters of cellulase‐related genes to repress their transcription. Additionally, Rce2 antagonized Ace3 binding to the cbh1 promoter to repress its transcription. However, Rce2 was not involved in Cre1‐mediated carbon catabolite repression. These results demonstrate the mechanism through which Rce2 represses the expression of cellulase genes and provide novel insights into the regulatory system of cellulases and methods that can be used for the regulation of gene expression in T. reesei.
Phase‐variable expression of pdcB, a phosphodiesterase, influences sporulation in Clostridioides difficile
Authors: Dhungel Babita Adhikari , Govind Revathi
Published: October 2021

Clostridioides difficile is the causative agent of antibiotic‐associated diarrhea and is the leading cause of nosocomial infection in developed countries. An increasing number of C. difficile infections are attributed to epidemic strains that produce more toxins and spores. C. difficile spores are the major factor for the transmission and persistence of the organism. Previous studies have identified global regulators that influence sporulation in C. difficile. This study discovers that PdcB, a phosphodiesterase, enhances sporulation in C. difficile strain UK1. Through genetic and biochemical assays, we show that phase‐variable expression of pdcB results in hypo‐ and hyper‐sporulation phenotypes. In the “ON” orientation, the identified promotor is in the right orientation to drive the expression of pdcB. Production of the PdcB phosphodiesterase reduces the intracellular cyclic‐di‐GMP (c‐di‐GMP) concentration, resulting in a hyper‐sporulation phenotype. Loss of PdcB due to the pdcB promoter being in the OFF orientation or mutation of pdcB results in increased c‐di‐GMP levels and a hypo‐sporulation phenotype. Additionally, we demonstrate that CodY binds to the upstream region of pdcB. DNA inversion reorients the CodY binding site so that in the OFF orientation, CodY binds a site that is upstream of the pdcB promoter and can further repress gene expression.
Multifocal contact lens design, not addition power, affects accommodation responses in young adult myopes
Authors: Gifford Kate L , Schmid Katrina L , Collins Josh M , Maher Clare B , Makan Riya , Nguyen Evonne , Parmenter Gemma B , Rolls Bronte M , Zhang Xinyue S , Atchison David A
Published: October 2021

Purpose

Prolonged nearwork has been implicated in myopia progression. Accommodation responses of young‐adult myopes wearing different multifocal contact lenses were compared.

Methods

Twenty adults, 18–25 years, with myopia (spherical equivalent refraction −0.50 to −5.50 D, mean −2.1 ± 1.6 D) wore five lens types in random order: Proclear single vision distance (SV), MiSight concentric dual‐focus +2.00 D Add (MS), Biofinity aspheric centre distance +1.50 D Add (CD1) and +2.50 D Add (CD2) (all Coopervision), and NaturalVue aspheric (Visioneering Technologies) (NVue). Using a Grand‐Seiko WAN‐5500 autorefractor with binocular correction and viewing right eye accommodative responses were measured after a 10 min adaptation period at 4.0, 1.0, 0.5, 0.33 and 0.25 m distances. Dynamic measurements were taken for 4 s at 6 Hz. Accommodative stimuli and responses were referenced to 4 m (i.e., refraction differences between 4 m and nearer distances). Accommodation lags and refraction instabilities (standard deviations of dynamic responses) were determined. For comparison, results were obtained for an absolute presbyopic eye, where trial lenses counteracted the accommodation stimulus.

Results

For SV and MS, accommodation responses were similar to the stimulus values. For aspheric lenses CD1, CD2 and NVue, accommodation responses were approximately 1.0 D lower across the stimulus range than with SV and MS, and rates of change were approximately 0.84 D per 1 D stimulus change. MS produced greater refraction instabilities than other lenses. For the presbyope, changes in refraction matched the trial lenses, indicating that corrections due to measurement through the different lenses were not needed.

Conclusion

Reductions in accommodation response occurred in young myopes wearing aspheric multifocal contact lenses independent of the labelled ‘add’ power. The concentric dual‐focus MS lens produced minimal lags but had greater instability than the other lenses. The results indicate that the mechanism of multifocal contact lenses slowing myopia progression is unlikely to be through relaxing accommodation, at least in young adults.
Properties of Orthopaedic Cements Biomechanically Little Affected by Exceptional Use of Liquid Antibiotics
Authors: Sophie Hetzmannseder , Yuhan Chang , Clemens Kittinger , Klaus‐Dieter Kühn
Published: October 2021

Objectives

To specify the concentration of the liquid antibiotics to be added to polymethylmethacrylate (PMMA) and its impact on the quality of the spacer is the purpose of this study with liquid clindamycin added to different cements.

Methods

In the present study, eight different cement mixtures were prepared and investigated. In the following, number 1 indicates the references, 2 all cements after liquid clindamycin was added to the liquid cement compound, 3 all cements after liquid clindamycin was added to the cement powder, and 4 all cements after liquid clindamycin was added to the cement dough. After curing, cements were filled into metal moulds and a pressure of 3 bar was maintained for 30 min. Mechanical investigations were carried out according to ISO 5833 (2002) and DIN 53435 (2007). For microbiological tests, standardized cylindrical mouldings (diameter: 25 mm, height: 10 mm) were produced and incubated in 10 ml buffer solution at room temperature for 24 h. All eluates were generated by spreading previously established suspensions of Staphylococcus aureus, Staphylococcus epidermidis, Cutibacterium acnes and methicillin‐resistant Staphylococcus aureus (MRSA) with a 0.5 McFarland turbidity standard.

Results

Apparently, we found that in all investigated cases, the admixture of liquid antibiotic negatively affected the mechanical characteristics of the cement mould. Among the various test groups, the influence on the ISO compression strength and ISO flexural modulus of the investigated test groups was only minimal when liquid clindamycin was added to cement liquid. Compared to admixing of liquid clindamycin into cement powder or dough ISO compression strength and ISO flexural modulus and flexural strength showed the maximum reduction. The efficacy against chosen germs was reduced as well when liquid antibiotic was admixed instead of powder. This admixture of liquid anti‐infective agents resulted in a 234% enhanced elution after 10 days 29 a negative effect on the inhibition zones were detected during the previous period.

Conclusion

The admixture of powdery antibiotic is preferable to liquid antibiotics. If no powdery antibiotic is available, we can recommend the admixture of liquid antibiotic to liquid cement prior to dough production in case powdery antibiotics cannot be used. However, we discourage the admixture of liquid antibiotic to cement powder or cement dough during early low viscose phase.
Comparison of Minimally Invasive Fixation of Mid‐Shaft Clavicular Fractures with Threaded Elastic Intramedullary Nail (TEIN) and Elastic Locking Intramedullary Nail (ELIN)
Authors: Ren Liang , Yang Zhiqiang , Wang Yongqing , Basanta Sapkota , Du Bosong , Gao Zhuo , Hao Baoxi , Chen Renhui
Published: October 2021

Objective

To compare the effectiveness of threaded elastic intramedullary nail and elastic locking intradullary nail (ELIN) for mid‐shaft clavicular fractures.

Methods

The clinical data of 47 patients with middle clavicle fracture treated by TEIN and ELIN from August 2017 to March 2019 were analyzed retrospectively. Twenty‐three patients received intramedullary fixation treatment with ELIN, nine males and 14 females, AO/OTA fracture classification type 2A (n = 17) and 2B (n = 6). Twenty‐four patients received intramedullary fixation treatment with TEIN, including nine males and 15 females, AO/OTA classification: type 2A (n = 18) and 2B (n = 6). All patients were anesthetized with ipsilateral cervical plexus block. After internal fixation was removed, the clinical outcomes were assessed and evaluated. The Constant‐Murley score and disabilities of the arm, shoulder and hand questionnaire (DASH) score were compared between the two groups to evaluate the functional status of all patients. The study was done accordingly to the guidelines provided by the ethics committee.

Results

All patients in the two groups completed the operation successfully and were followed up. In the ELIN group, the operation time was 20.78 ± 7.71 min, intra‐operative blood loss was 13.26 ± 9.72 mL, incision length was 1.60 ± 0.92 cm, internal fixation removal time was 12.86 ± 2.24 weeks, Constant‐Murley score was 99.30 ± 1.36 points and DASH score was 1.43 ± 3.00 points. In the TEIN group, the operation time, intra‐operative blood loss, incision length, internal fixation removal time, Constant‐Murley and DASH scores were 22.83 ± 8.17 min, 22.08 ± 11.22 mL, 2.48 ± 0.84 cm, 15.66 ± 5.58 weeks, 95.79 ± 7.38 point and 6.69 ± 11.55 point respectively. In the ELIN group, four cases developed skin irritation, and the symptoms were relieved after removal of internal fixation. In the TEIN group, one patient's internal fixation broke and had an obvious scar at the incision, but there was no fracture after replacement of internal fixation; withdrawal of TEIN occurred in four patients, the nail did not shift again until the last follow‐up; skin irritation and temporary bursitis occurred in six patients, and the symptoms were relieved after internal fixation was removed. No other conditions were found in the patients, and bony healing was achieved in all patients.

Conclusion

ELIN prevents shortening and malunion of the clavicle, reduces secondary damage to related tissues, and leads to restoration of clavicle length and faster osseous healing.
Relieved Low Back Pain after Total Hip Arthroplasty in Patients with Both Hip Osteoarthritis and Lumbar Degenerative Disease
Authors: Ran Tian‐fei , Ke Song , Li Jie , Lyu Ming‐rui , Zhou Yuan‐yuan , Zhang Rui , Song Xin , Wang Min
Published: October 2021

Objective

To investigate the relief of low back pain after hip arthroplasty in patients with hip joint and spinal degenerative diseases, and to discuss the effects of unilateral and bilateral hip surgery on the relief of low back pain.

Methods

In this retrospective study, we followed 153 patients (69 males and 84 females, age: 43–88 years) who had undergone total hip arthroplasty (THA) via a posterolateral approach and also suffered from lumbar degenerative diseases in the period of 2009 to 2019. The inclusion criteria were: (i) patients who had been diagnosed with severe hip degenerative disease and also been diagnosed with lumbar degenerative disease; (ii) patients who had undergone THA surgery; and (iii) patients who were retrospectively recruited. The exclusion criteria were: (i) patients who had undergone lumbar fusion or internal fixation surgery; or (ii) patients who had vascular claudication, history of major trauma, diabetic polyneuropathy, lumbar and pelvic infections, tumor diseases; (iii) or patients who had undergone THA because of femoral neck fracture or ankylosing spondylitis. The improvement of hip joint function and the relief of low back pain (LBP) were studied, and the effect of unilateral and bilateral THA on the relief of LBP were discussed. Hip pain and function were evaluated by the Harris Hip Score (HHS), LBP was evaluated by Visual Analog Scale (VAS), and lumbar function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system.

Results

The average follow‐up time was 44.3 months (24–108 months). All patients recovered smoothly without complications. The LBP VAS of 153 patients decreased from 4.13 ± 1.37 preoperatively to 1.90 ± 1.44 postoperatively. The average HHS increased from 45.33 ± 13.23 preoperatively to 86.44 ± 7.59 postoperatively at the latest follow‐up. According to Japanese Orthopaedic Association scoring system, the proportion of patients with good response to treatment in these 153 patients reached 93.46%. LBP VAS decreased from 4.18 ± 1.38 preoperatively to 1.95 ± 1.49 postoperatively in unilateral group and from 3.94 ± 1.32 preoperatively to 1.73 ± 1.23 postoperatively in bilateral group, respectively. There were only nine patients with persistent or aggravated LBP after operation. Among them, six patients underwent subsequent lumbar surgery (five patients had pain relieved after reoperation and one patient had not) and the other three patients chose conservative treatment for pain.

Conclusion

THA can relieve LBP while relieving hip pain and restoring hip function in patients with both hip and lumbar degenerative disease, thus possibly avoiding further spinal surgery.
One‐year changes in the pediatric emergency department caused by prolonged coronavirus disease 2019 pandemic
Authors: Bae Woori , Choi Arum , Kim Kyunghoon , Kang Hyun Mi , Kim Sae Yun , Lee Heayon , Yoo Il Han , Yang Eun Ae , Chun Yoon Hong , Bin Joong Hyun , Yoon Jong‐seo , Lee Sang Haak , Kim Hyun Hee , Kim Sukil , Jeong Dae Chul
Published: October 2021

Background

With the coronavirus disease 2019 (COVID‐19) pandemic lasting for more than a year, it is imperative to identify the associated changes in the use of emergency medical care for efficient operation of the pediatric emergency department (PED). This study was conducted to determine the long‐term impact of the COVID‐19 pandemic on patterns of PED visits.

Methods

This is a retrospective observational study of visits to the PED of six hospitals, between January 1, 2017, and December 31, 2020. We compared changes in the characteristics of patients before and during the COVID‐19 pandemic.

Results

A total of 245 022 visits were included in this analysis. After the first case of COVID‐19 was reported in Korea, we observed a significant decrease (54.2%) in PED visits compared with the annual average number of visits in the previous 3 years. Since then, the weekly number of PED visits decreased by 11.9 person/week (95% CI: −15.3–−8.4, P < 0.001), which included an increase of 0.21% (95% CI: 0.15%–0.26%, P < 0.001) per week in high acuity patients. From 2017 to 2020, the proportion of infectious respiratory diseases by year was 25.9%, 27.0%, 28.6%, and 16.3%, respectively, demonstrating a significant decrease in 2020 (P < 0.001).

Conclusions

During the COVID‐19 pandemic, the number of patient visits to PEDs continues to decline, especially among those with infectious diseases. However, the disease severity of patients has gradually increased. There has been a change in the characteristics of visits to PEDs after COVID‐19 which will require an appropriate response from a long‐term perspective.
The analysis of genotype‐phenotype correlation in familial Mediterranean fever
Authors: Ozturk Kubra , Cakan Mustafa
Published: October 2021

Background

Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease manifesting with phenotypic heterogeneity. It is a clinically diagnosed disease supported by Mediterranean fever gene mutation analysis. This medical record review study aimed to make a new interpretation of clinical features in FMF patients by grouping genetic results based on the classification proposed by the Eurofever/ Paediatric Rheumatology International Trials Organisation.

Methods

The medical charts of pediatric FMF patients who were diagnosed and followed up regularly at the two pediatric rheumatology units were reviewed. Genetic analysis results were classified as confirmatory and nonconfirmatory as defined in the new Eurofever/ Paediatric Rheumatology International Trials Organisation classification criteria, and they were compared with clinical findings.

Results

A total of 216 FMF patients were involved in the study. Group 1 was composed of 133 (61.6%) patients with a confirmatory mutation and group 2 included 83 (38.4%) patients with a nonconfirmatory mutation. All clinical findings were compared, and in terms of fever (P = 0.027), abdominal pain (P = 0.016), arthritis (P = 0.008) and erysipelas‐like erythema (ELE; P = 0.003) incidence, there was a significant difference between the two groups. The most common Mediterranean fever gene mutation patterns were homozygous (33.8%) and heterozygous (17.1%) mutations of M694V. The frequency of arthritis and ELE in patients with M694V homozygous mutations was significantly higher than in the other patients (P = 0.002 and P <0.001, respectively).

Conclusions

The most frequently observed clinical features of FMF (i.e., fever and abdominal pain) are both observed in patients with confirmatory and nonconfirmatory mutations, ELE and arthritis are more commonly observed in patients with confirmatory mutations.
Exploring instigator and defender policy scenarios in the siting of energy infrastructure
Authors: You Jongeun , Weible Christopher M. , Heikkila Tanya
Published: October 2021

Energy infrastructure is the foundation of any modern society, yet decisions on where and how to site this infrastructure can be contentious. This article argues that energy infrastructure siting is illustrative of policy scenarios involving instigators of a proposed policy and defenders of the status quo. Through analyzing natural gas pipelines, electricity transmission lines, solar power plants, and wind power plants, and leveraging a unique dataset of over 1000 newspaper articles on 16 selected cases, we extract discourse over the project life cycle across infrastructure types and conflict intensities. This article delineates policy scenarios involving two primary sets of actors—the proposal instigator (e.g., an energy corporation) and the defender of the status quo (e.g., a community). When higher levels of conflict exist, defenders represent more actors than instigators, as defenders have the advantage of mobilizing and recruiting around the status quo. The frames used by defenders are also more diverse than those used by instigators. Additionally, the balance of discourse is associated with the characteristics of the proposal and conflict intensity, as well as who wins or loses.

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Ash, John. 2010. “New Nuclear Energy, Risk, and Justice: Regulatory Strategies for an Era of Limited Trust.” Politics & Policy 38(2): 255–84. https://doi.org/10.1111/j.1747‐1346.2010.00237.x

Khodr, Hiba, and Isabella Ruble. 2013. “Energy Policies and Domestic Politics in the MENA Region in the Aftermath of the Arab Upheavals: The Cases of Lebanon, Libya, and KSA.” Politics & Policy 41(5): 656–89. https://doi.org/10.1111/polp.12033

Kilinç‐Pala, Pinar Buket. 2021. “Approaches in Energy Exclusive Security: Theories of Energy Security and the Dominance of Realism.” Politics & Policy 49(3): 771–94. https://doi.org/10.1111/polp.12411
Virulence assessment of Australian Pyrenophora tritici‐repentis isolates
Authors: See Pao Theen , Chen Kefei , Marathamuthu Kalai A. , Wood Blake , Schultz Nikki , Shankar Manisha , Moffat Caroline S.
Published: October 2021

The virulence of 57 Australian isolates of Pyrenophora tritici‐repentis (Ptr), a necrotrophic fungal pathogen responsible for the major wheat disease tan spot, was assessed through plant infection assays. Isolates collected from the northern, southern, and western wheat‐cropping regions of Australia were evaluated against 16 Australian bread wheat cultivars under controlled growth conditions. Following infection, the wheat panel displayed varying disease symptoms ranging from tiny necrotic specks to spreading chlorotic and necrotic lesions. Analysis of variance indicated that the wheat cultivar exhibited a greater effect on the disease response, explaining 62.7% of the variation, in comparison to the isolate (10.4%). The interaction between the cultivar and the isolate was statistically significant and was attributed to 9.8% of the total variation. All Ptr isolates examined were able to cause disease, but did not display a clear distinction in virulence on the wheat panel investigated, instead showing subtle differences in aggressiveness. Based on the disease responses, there was no obvious pattern between isolate aggressiveness and cropping region. Some cultivars, such as Hydra, exhibited an effective level of resistance in relation to the panel of isolates tested. All 57 Ptr isolates were found to possess the ToxA effector gene and lack the ToxB effector gene. The gene expression level of ToxA was up‐regulated at 3 days postinfection in both ToxA‐sensitive and ‐insensitive cultivars, independent of ToxA–Tsn1 recognition.
Climate change‐adaptive participatory field gene banking for a California endemic oak
Authors: McLaughlin Blair , Fogg Alissa , Ennis Katherine K. , Halstrom Grant , Herrera Alicia , Quadri Paulo
Published: October 2021

Anthropogenic climate change is causing demographic shifts at species' range edges. Trailing edge populations, which may be genetically distinct and adapted to relative climate extremes, already are showing declines in some species. The associated loss of trailing edge genetic diversity may limit possibilities for future climate‐adaptive restoration. For plants with recalcitrant seed, such as oaks, that cannot tolerate conventional seed banking, we propose a novel approach to the conservation of climate‐threatened genetic diversity: dispersed, participatory field gene banking. In this collaborative model, trailing edge transplants are stewarded at dispersed sites across a species' projected regional refugia. In 2018, we initiated a pilot participatory field gene bank for the foundational, endemic California blue oak (Quercus douglasii), a species experiencing increasing climate‐related declines at its trailing edge. To evaluate seedling performance, the gene bank was designed as a set of 23 small, dispersed common gardens with paired local and trailing edge seeds. Trailing edge seedlings showed lower survival and growth relative to locals, yet they also showed lower levels of leaf disease and herbivory, traits that could confer an adaptive advantage in a more xeric future. The substantial early survival of translocated seeds suggests that participatory field gene banking may offer an effective means of preserving trailing edge genetic diversity for oaks, thereby maintaining genetic resources that could be critical for future climate change‐adaptive restoration. However, further observations are needed to confirm the strategy's longer‐term viability and evaluate evidence of local adaptation.
Joint effects of exporting and outward FDI on firm‐level capital investment in India
Authors: Girma Sourafel , Maemir Hibret
Published: October 2021

This paper examines the simultaneous impacts of exporting and outward foreign direct investment (OFDI) on the domestic investment of Indian manufacturing firms. Combining difference‐in‐differences with generalized propensity score matching estimators, we find that greater engagement in exporting and OFDI is associated with a higher domestic capital investment, although the magnitude of these effects differs across firms depending on the intensity of their participation and the interaction between these two decisions. Whereas exporting is associated with a monotonic increase in firms’ domestic capital investment, we find a hump‐shaped relationship between the intensity of firms’ OFDI engagement and their subsequent domestic capital investment. We also document evidence that firms that simultaneously export and invest abroad tend to exhibit a higher level of domestic investment, suggesting that these two decisions are complementary in relation to their effect on domestic capital investment.
Immunomodulatory potential of flavonoids for the treatment of autoimmune diseases and tumour
Authors: Han Limin , Fu Qiang , Deng Chuan , Luo Li , Xiang Tengxiao , Zhao Hailong
Published: October 2021

The immune system plays an indispensable role in maintaining human health against the invasion of foreign materials, microorgainisms and pathogens. The autoimmune diseases and chronic inflammatory disorders are characterized by dysregulated immune responses resulting in excessive and uncontrolled tissue inflammation, as well as tumour, and others. In recent years, flavonoids are widely recognized as potentially natural polyphenol compounds for the treatment of multiple diseases, given their immunomodulatory activity, antioxidant and antineoplastic activities. However, the exact mechanisms of flavonoids on the immune system and inhibiting tumour remains unclear. This review article provides an overview of the impact and mechanism of flavonoids on innate and adaptive immune system through the analysis of various immune cells. Meanwhile, we also explain the probable therapeutic mechanism of flavonoids on tumour and other chronic diseases. Overall, this review may provide a certain theoretical direction and theoretical basis for the application of flavonoids in the treatment of immune‐related disorders and tumour.
SARS‐CoV‐2 prevalence and transmission in swimming activities: Results from a retrospective cohort study
Authors: Termansen Martin Brink , Christiansen Ask Vest , Frische Sebastian
Published: October 2021

There is an urgent need for research on the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causing coronavirus disease 2019 (COVID‐19), as the transmissibility differs between settings and populations. Here we report on a questionnaire‐based retrospective cohort study of the prevalence and transmission of SARS‐CoV‐2 among participants in swimming activities in Denmark in the last 5 months of 2020 during the COVID‐19 pandemic.

Eight of 162 swimming activities with a SARS‐CoV‐2 positive participant led to transmission to 23 other participants. Overall, the percentage of episodes leading to transmission was 4.9% (competitive swimming 8.9%; recreational swimming 1.3%). Overall, the incidence rate of transmission was 19.5 participants per 100 000 pool activity hours (corresponding values: 43.5 and 4.7 for competitive and recreational swimming, respectively).

Compliance with precautionary restrictions was highest regarding hand hygiene (98.1%) and lowest in distancing personal sports bags (69.9%). As a result of low statistical power, the study showed no significant effect of restrictions.

Insight into the risk of transmission of SARS‐CoV‐2 during indoor swimming is needed to estimate the efficiency of restrictive measures on this and other sports and leisure activities. Only when we know how the virus spreads through various settings, optimal strategies to handle the COVID‐19 pandemic can be developed.