bluuebunny/crossref_metadata_2025 huggingface dataset:
Alcohol‐related liver disease mortality and missed opportunities in secondary care: A United Kingdom retrospective observational study
Authors: Subhani Mohsan , Elleray Rebecca , Bethea Jane , Morling Joanne R. , Ryder Stephen D.
Published: May 2022

Introduction

Alcohol‐related liver disease (ARLD) is a preventable cause of mortality. Historical epidemiological studies on ARLD often lack a detailed linked assessment of health‐related contacts prior to death which limits understanding of opportunities for intervention. We aimed to analyse retrospective population‐based data of all adult residents of Nottinghamshire dying from ARLD to determine the factors associated with delayed diagnosis of ARLD and the potential missed opportunities for interventions.

Methods

We linked the Office for National Statistics and Hospital Episode Statistics databases to identify adult (≥18 years) residents of Nottinghamshire, who died of ARLD over the 5‐year period (1 January 2012 to 31 December 2017). Death was used as the primary outcome, and logistic regression analysis was conducted to test the association between key variables and mortality due to ARLD.

Results

Over 5 years, 799 ARLD deaths were identified. More than half had no diagnosis or a diagnosis of ARLD less than 6 months before death. Emergency presentation at first ARLD diagnosis and White ethnicity were significantly associated with a delay in diagnosis. Overall, the cohort had a median of five hospital admissions, four accident and emergency attendances and 16 outpatient appointments in the 5 years before death. Treatment was provided by a range of specialities, with general medicine the most common. Alcohol was associated with most admissions.

Discussion and Conclusions

This study identified deficiencies in ARLD secondary care and provides us with a powerful methodology that can be used to evaluate and improve how alcohol issues are managed and where action can be best targeted.
Experiential legacies of early‐life dietary polyunsaturated fatty acid content on juvenile Walleye: Potential impacts from climate change
Authors: Almeida L. Zoe , Grayson John , Ludsin Stuart A. , Dabrowski Konrad , Marschall Elizabeth A.
Published: May 2022

Climate‐induced shifts in plankton blooms may alter fish recruitment by affecting the fatty acid composition of early‐life diets and corresponding performance. Early‐life nutrition may immediately affect survival but may also have a lingering influence on size and growth via experiential legacies. We explored the short‐ and longer‐term performance consequences of different concentrations of polyunsaturated fatty acids (PUFA) for juvenile Walleye (Sander vitreus, Mitchill 1818). For the first 10 days of feeding, juveniles were provided Artemia enriched with: oleic acid (low PUFA), high docosahexaenoic acid and high eicosapentaenoic acid (high PUFA), or high PUFA and a form of vitamin E (high PUFA + E). After 10 days, all fish were fed a high‐quality diet and reared for an additional 27 days. Juveniles fed either high PUFA diet were 1.15‐fold larger (PUFA mean ± SD = 20.0 ± 3.3 mg; PUFA + E = 19.8 ± 3.3 mg) than those fed the low PUFA (17.3 ± 2.8 mg) diet after 10 days of feeding. After 27 days, juveniles initially fed the high PUFA diet were still 1.10‐ to 1.20‐fold larger (PUFA = 407.0 ± 61.6 mg; PUFA + E = 422.7 ± 58.7 mg) than those initially fed the low PUFA diet (356.5.0 ± 39.5 mg). Our findings demonstrate that fatty acid composition of juvenile Walleye diets has immediate and lingering size effects. As changes in climate continue to alter lower trophic levels, fish management and conservation may need to consider short‐ and long‐term effects of temporal or spatial differences in early‐life diet quality.
Concept map‐based learning in an oral radiographic interpretation course: Dental students' perceptions of its role as a learning tool
Authors: Gil Yoon Min , Lee Byung‐Do
Published: May 2022

Objectives

Concept mapping is used to promote critical thinking and meaningful learning in health professions education. This study aimed to evaluate dental undergraduates' perceptions of concept mapping as a learning tool for oral radiographic interpretation competency.

Methods

A total of 39 third‐year undergraduates at a dental college participated in the oral radiological interpretation session. The students received 1 hour of instruction before creating their concept map (CM). Participants were provided an assignment of four relevant clinical cases to draw an individualised CM. The students' draft and final CM were submitted. The instructor evaluated the CMs to identify whether students could analyse, connect and organise the information in a meaningful way. Among them, 37 completed the questionnaire about their experiences and responses to concept mapping.

Results

Students perceived concept mapping positively. The instructor's feedback helped them recognise their misconceptions and fostered greater motivation to learn. Students attempted to integrate basic biomedical knowledge and clinical features through cross‐linking. However, they also expressed negative attitudes toward concept mapping regarding time consumption and heavy burden.

Conclusions

Concept mapping motivated students' directed learning and gave them the opportunity to recognise their misconceptions. This study suggests the potential use of CMs as an adjunctive learning strategy in the oral radiographic interpretation class.
Cerebral laterality of writing in right‐ and left‐handers: A functional transcranial Doppler ultrasound study
Authors: Papadatou‐Pastou Marietta , Sampanis Panagiotis , Koumzis Ioannis , Stefanopoulou Sofia , Sousani Dionysia , Tsigkou Athina , Badcock Nicholas A.
Published: May 2022

The cerebral lateralization of written language has received very limited research attention in comparison to the wealth of studies on the cerebral lateralization of oral language. The purpose of the present study was to further our understanding of written language lateralization, by elucidating the relative contribution of language and motor functions. We compared written word generation with a task that has equivalent visuomotor demands but does not include language: the repeated drawing of symbols. We assessed cerebral laterality using functional transcranial Doppler ultrasound (fTCD), a non‐invasive, perfusion‐sensitive neuroimaging technique in 23 left‐ and 31 right‐handed participants. Findings suggest that the linguistic aspect of written word generation recruited more left‐hemispheric areas during writing, in right‐handers compared to left‐handers. This difference could be explained by greater variability in cerebral laterality patterns within left‐handers or the possibility that the areas subserving language in left‐handers are broader than in right‐handers. Another explanation is that the attentional demands of the more novel symbol copying task (compared to writing) contributed more right‐hemispheric activation in right‐handers, but this could not be captured in left‐handers due to ceiling effects. Future work could investigate such attentional demands using both simple and complex stimuli in the copying condition.
Immunosuppressant and neuromyelitis optica spectrum disorder: optimal treatment duration and risk of discontinuation
Authors: Li Rui , Li Cong , Huang Qiao , Liu Zifeng , Chen Jingjing , Zhang Bingjun , Liu Chunxin , Shu Yaqing , Wang Yuge , Kermode Allan G. , Qiu Wei
Published: May 2022

Background and purpose

Preventing relapse by immunosuppressants (ISs) is critical for the prognosis of neuromyelitis optica spectrum disorder (NMOSD); however, the optimal duration of IS treatment is still under discussion. The objective was to explore the optimal duration of IS treatment and the risk of IS discontinuation for NMOSD.

Method

This cohort study was conducted at a major neurological center that housed the largest NMOSD database in South China. Eligible participants were patients with NMOSD undergoing IS treatment. The main outcome measures were changes in relapse risk based on IS treatment duration, clinical outcomes and predictors of relapse following IS discontinuation.

Results

In total, 343 patients were included in this study. The duration of IS treatment was strongly associated with a decrease in relapse risk (hazard ratio [HR] 0.53, p < 0.001). Continuous IS treatment resulted in decreased relapse HRs within 5 years of receiving IS medication, with a mild rebound starting at 5 years. Rituximab reduced the risk of NMOSD relapse to approximately zero within 3 years. The rate of relapse after IS withdrawal was high (77.5%). As opposed to other ISs, a delayed relapse following rituximab withdrawal was observed in this study. Longitudinal extensive transverse myelitis (HR = 2.023, p = 0.006) was associated with a higher risk of relapse after IS discontinuation.

Conclusions

Long‐term IS medication for NMOSD is generally suitable. Patients with longitudinal extensive transverse myelitis had a higher risk of relapse after IS discontinuation. Future studies should explore individualized strategies of rituximab maintenance treatment.
IL‐17A is a pertinent therapeutic target for moderate‐to‐severe hidradenitis suppurativa: Combined results from a pre‐clinical and phase II proof‐of‐concept study
Authors: Kimball Alexa B. , Loesche Christian , Prens Errol P. , Bechara Falk G. , Weisman Jamie , Rozenberg Izabela , Jarvis Philip , Peters Thomas , Roth Lukas , Wieczorek Grazyna , Kolbinger Frank , Jemec Gregor B. E.
Published: May 2022

Hidradenitis Suppurativa (HS) is a chronic, recurrent, inflammatory, follicular skin disease whose pathology is complex and not fully understood. The objective of this study was to elucidate the role of IL‐17A in moderate‐to‐severe HS. Transcriptomic and histological analyses were conducted on ex vivo HS (n = 19; lesional and non‐lesional) and healthy control (n = 8) skin biopsies. Further, a Phase II exploratory, randomized, double‐blind, placebo‐controlled study was carried out in moderate‐to‐severe HS patients. Patients were treated with either CJM112 300 mg (n = 33), a fully human anti‐IL‐17A IgG1/κ monoclonal antibody, or placebo (n = 33). The main outcome of the translational analyses was to identify IL‐17A‐producing cells and indications of IL‐17A activity in HS lesional skin. The primary objective of the clinical study was to determine the efficacy of CJM112 in moderate‐to‐severe HS patients by HS‐Physician Global Assessment (HS‐PGA) responder rate at Week 16. Transcriptomic and histopathologic analyses revealed the presence of heterogeneous cell types in HS lesional skin; IL‐17A gene signatures were increased in HS lesional vs non‐lesional or healthy skin. High expression of IL‐17A was localized to T cells, neutrophils, and mast cells, confirming the transcriptional data. Clinically, the proportion of Week 16 HS‐PGA responders was significantly higher (p = 0.03) in the CJM112 group vs placebo (32.3% vs 12.5%). This study elucidated the role of the IL‐17A pathway in HS pathogenesis and clinically validated the IL‐17A pathway in moderate‐to‐severe HS patients in a proof‐of‐concept study using the anti‐IL‐17A‐specific antibody CJM112.
Spectroscopic investigations of Dy3+‐doped tungstate–tellurite glasses for solid‐state lighting applications
Authors: Vikas  , Jayasimhadri Mula , Haranath Divi
Published: May 2022

A series of Dy3+‐activated lithium–tungstate–tellurite (LTT) glasses have been synthesized employing a conventional melt quenching procedure. The structural and luminescent features of LTT glasses were examined in detail to reveal their feasibility in solid‐state lighting (SSL) applications. Various physical parameters such as density, molar volume, and other parameters were evaluated. A broad hump showed in the X‐ray diffraction profile affirms the non‐crystalline or amorphous behavior of the as‐prepared LTT glasses. The absorption spectrum exhibits several bands between the 400 and 1800 nm range, which confirms that the transitions initiate from the lowest energy state (6H15/2) to numerous excited states. Photoluminescence (PL) spectra reveal three significant peaks centered at 481 (blue), 575 (yellow), and 664 nm (red) related to Dy3+ ions under 388 nm excitation. The chromaticity coordinates of LTT glasses were situated in the white light region and nearest to the standard white light (0.33, 0.33). The decay profile shows the biexponential behavior of the prepared LTT (x = 0.1, 1.0, and 2.0 mol%) glasses. Temperature‐dependent PL spectra show appreciable thermal constancy of the prepared LTT glasses having a high value of activation energy. The previous results indicate that Dy3+‐doped tungstate–tellurite glasses are potential luminescent materials to utilize in SSL applications, especially for white light‐emitting diodes.
Assessment of the need of a waiting period after pulmonary vein isolation with the ablation index software
Authors: Sousa Pedro A. , Barra Sérgio , Adão Luís , Primo João , Khoueiry Ziad , Puga Luís , Lebreiro Ana , Fonseca Paulo , Lagrange Philippe , Gonçalves Lino ,   Study Group Members
Published: May 2022

Purpose

Since the widespread availability of contact‐force sensing catheters, the need for a waiting period after pulmonary vein isolation (PVI) has not been reassessed. We aim to evaluate whether a waiting period is still necessary after PVI guided by the ablation Index (AI).

Methods

Prospective, multicenter, randomized study of consecutive patients referred for paroxysmal atrial fibrillation (AF) ablation from May 2019 to February 2020. Patients were randomized in a 1:1 ratio to PVI with versus without a waiting period of 20 min. Acute pulmonary vein (PV) reconnection after adenosine challenge was the primary endpoint. A per‐protocol analysis was designed to determine whether a strategy of dismissing the waiting period after PVI was noninferior to waiting for 20 min for identifying acute PV reconnection. PVI was guided by tailored AI values and an interlesion distance ≤6 mm.

Results

During the enrollment period, 167 patients (56% males, mean age of 57 ± 14 years) fulfilled the study inclusion criteria – 84 patients (308 PV) in the waiting period group (Group A) and 83 patients (314 PV) in the group without a waiting period (Group B). Acute PV reconnection was identified in 3.8% (95% confidence interval [CI], 1.7%–5.9%) of PVs in the study group B compared to 2.9% (95% CI, 1.0%–4.8%) of PVs in the Group A (p = .002 for non‐inferiority). At 1‐year follow‐up, there was no significant difference in arrhythmia recurrence between groups (9.5% in Group A vs. 9.6% in Group B, hazard ratio: 1.03 [95% CI, 0.39–2.73], p = .98).

Conclusion

In paroxysmal AF patients submitted to ablation, a tailored PVI guided by the AI rendered a 20‐min waiting period unnecessary.
Distribution of atrial low voltage induced by vein of Marshall ethanol infusion
Authors: Kamakura Tsukasa , André Clémentine , Duchateau Josselin , Nakashima Takashi , Nakatani Yosuke , Takagi Takamitsu , Krisai Philipp , Ascione Ciro , Balbo Conrado , Tixier Romain , Chauvel Rémi , Cheniti Ghassen , Kusano Kengo , Cochet Hubert , Denis Arnaud , Sacher Frédéric , Hocini Mélèze , Jaïs Pierre , Haïssaguerre Michel , Derval Nicolas , Pambrun Thomas
Published: May 2022

Introduction

Systematic and quantitative descriptions of vein of Marshall (VOM)‐induced tissue ablation are lacking. We sought to characterize the distribution of low voltage observed in the left atrium (LA) after VOM ethanol infusion.

Methods and Results

The distribution of ethanol‐induced low voltage was evaluated by comparing high‐density maps performed before and after VOM ethanol infusion in 114 patients referred for atrial fibrillation ablation. The two most frequently impacted segments were the inferior portion of the ridge (82.5%) and the first half of the mitral isthmus (pulmonary vein side) (92.1%). Low‐voltage absence in these typical areas resulted from inadvertent ethanol infusion in the left atrial appendage vein (n = 3), initial VOM dissection (n = 3), or a “no branches” VOM morphology (n = 1). Visible anastomosis of the VOM with roof or posterior veins more frequently resulted in low‐voltage extension beyond typical areas, toward the entire left antrum (19.0% vs. 1.9%, p = .0045) or the posterior LA (39.7% vs. 3.8%, p < .001) but with a limited positive predictive value ranging from 29.4% to 43.5%. Ethanol‐induced low voltage covered a median LA surface of 3.6% (1.9%–5.0%) and did not exceed 8% of the LA surface in 90% of patients.

Conclusion

VOM ethanol infusion typically locates at the inferior ridge and the adjacent half of the mitral isthmus. Low‐voltage extensions can be anticipated but not guaranteed by the presence of visible anastomosis of the VOM with roof or posterior veins.
Ontogenetic shift in diet and trophic role of Raja clavata inferred by stable isotopes and stomach content analysis in the Sea of Marmara
Authors: Gül Güzin , Demirel Nazli
Published: May 2022

Trophic ecology studies on predator–prey interactions reveal insights into ecological communities and help understand a species’ role in the food web by contributing to improved fisheries management and conservation capabilities. Understanding the ecological role of overexploited and endangered predators is essential to deciphering how their feeding behaviour influences food web dynamics. In this study, the authors investigated the feeding behaviour of the common and IUCN‐listed Near Threatened (NT) thornback ray Raja clavata, using carbon and nitrogen stable isotope and stomach content analysis (SCA). It has recently suffered an 87% decline in reported catches from the Sea of Marmara within the last decade. These results show that thornback ray mainly feeds on teleost species, except in summer, with both methods showing this species changes its diet ontogenetically by SCA. This ontogenetic diet shift was at lengths 40–50 cm by changing group preferences from Crustacea to Teleostei. MixSIAR results showed that both adult and juvenile individuals of R. clavata feed mainly on the crustaceans, but the contribution of teleosts represented by Trachurus sp. was very low (<15%). The trophic position increased total length and was higher than other batoid species in the Sea of Marmara.
Urinary calculi in larvae of striped trumpeter, Latris lineata
Authors: Dias Valera L. , Battaglene Stephen C. , Cobcroft Jennifer M. , Goemann Karsten , Nowak Barbara F.
Published: May 2022

Urinary calculi are observed in some cultured marine fish larvae and may negatively impact larval health and survival. This study assessed urinary calculi in striped trumpeter Latris lineata larvae from hatching to 28 days post‐hatching (dph). The prevalence of urinary calculi was variable over time and ranged from 15% to 50%, whereas the average size of calculi increased with larval age. Urinary calculi were semi‐translucent, light cream to white colour with irregular morphology and a uniform internal structure. The calculi resulted in pressure atrophy causing a distended epithelium of the urinary bladder of fish with calculi. The calculi were predominantly formed of calcium hydrogen phosphate (CaHPO4). Routine assessment of the prevalence of urinary calculi in marine fish larvae is recommended, along with other parameters, to monitor larval quality and inform hatchery management actions.
Patients living with dementia have worse outcomes when undergoing high‐risk procedures
Authors: Shah Samir K. , Adler Rachel R. , Xiang Lingwei , Clark Clancy J. , Cooper Zara , Finlayson Emily , Kim Dae Hyun , Lin Kueiyu Joshua , Lipsitz Stuart R. , Weissman Joel S.
Published: May 2022

Background

Patients with Alzheimer's Disease and Related Dementias (ADRD) undergoing inpatient procedures represent a population at elevated risk for adverse outcomes including postoperative complications, mortality, and discharge to a higher level of care. Outcomes may be particularly poor in patients with ADRD undergoing high‐risk procedures. We sought to determine traditional (e.g., 30‐day mortality) and patient‐centered (e.g., discharge disposition) outcomes in patients with ADRD undergoing high‐risk inpatient procedures.

Methods

This retrospective cohort study analyzed electronic health records linked to fee‐for‐service Medicare claims data at a tertiary care academic health system. All patients from a large multi‐hospital health system undergoing high‐risk inpatient procedures from October 1, 2015 to September 30, 2017 with continuous Medicare Parts A and B enrollment in the 12 months prior to and 90 days following the procedure were included.

Results

This study included 6779 patients. 536 (7.9%) had ADRD. A multivariable analysis of outcomes demonstrated higher risks for postoperative complications (OR 1.49, 95% CI 1.23–1.81) and 90‐day mortality (OR 1.44 [95% CI 1.09–1.91]) in patients with ADRD compared to those without. Patients with ADRD were more likely to be discharged to a higher level of care (OR 1.70, 95% CI 1.32–2.18) and only 37.3% of patients admitted from home were discharged to home.

Conclusions

Compared to those without ADRD, patients living with ADRD undergoing high‐risk procedures have poor traditional and patient‐centered outcomes including increased risks for 90‐day mortality, postoperative complications, longer hospital lengths of stay, and discharge to a higher level of care. These data may be used by patients, their surrogates, and their physicians to help align surgical decision‐making with health care goals.
ToTEM: A software for fast TEM image simulation
Authors: Yuan P. J. , Wu K. P. , Chen S. W. , Zhang D. L. , Jin C. H. , Yao Y. , Lin F.
Published: May 2022

ToTEM, a multislice‐based image simulation software is developed for transmission electron microscope (TEM). This software implements the following major features: (i) capability of assigning three‐dimensional potentials of atom into multiple slices and precise introduction of phase shift caused by the sub‐pixel atomic position, (ii) employing CUDA coding and graphical processing units (GPU) with multithreading parallel algorithm based on the powerful batch (inverse) fast Fourier transform (FFT), which is especially beneficial for image simulation of scanning transmission electron microscopy (STEM) or (integrated) differential phase contrast (I)DPC, (iii) design for efficiently generating large batch of data set of high‐resolution transmission electron microscopy (HRTEM) images. Image simulation acceleration for STEM has been verified by simulating a large‐scale SrTiO3. Additionally, iDPC image of MFI‐type zeolites with xylene molecules encapsulated in straight channels demonstrates the advantage of iDPC in detecting light molecules.
Randomised comparative study on the efficacy of 3% versus 30% NaCl solution in the treatment of umbilical granuloma
Authors: Janyoungsak Pornpimon , Emrat Kanuengnit , Chatmapanrangsee Jidapa , Nuntnarumit Pracha
Published: May 2022

Aim

This study aimed to compare the efficacy of 3% versus 30% NaCl solution in treating umbilical granuloma (UG) and to evaluate parental satisfaction.

Methods

A randomised, double‐blinded, comparative study in neonates with UG was conducted. Stratified, block‐of‐four randomisation was used to allocate neonates into two groups, treated with 3% or 30% pharmaceutical‐grade NaCl solution, three times daily. The time to resolution was determined by daily photographs of UG and weekly hospital visits. If there was no response after 2 weeks, silver nitrate was used. Parental satisfaction was measured on a rating scale of 1–5.

Results

One hundred neonates were enrolled, 48 in the 3% NaCl group and 52 in the 30% NaCl group. Baseline demographic data were not different between the groups. There was no significant difference in the resolution rate (93.8% vs 98.1%) or the median (interquartile range) time to resolution (7 (5–13) vs 7 (4–11) days) between the 3% and 30% NaCl groups, respectively. No skin burn or cellulitis was detected. About 95% of parents scored >4 for satisfaction.

Conclusions

Hypertonic NaCl solution is highly effective in treating UG without side effects. Hypertonic NaCl solution should be considered as an alternative treatment for UG.
Prevalence of Vibrio coralliilyticus in stony coral Porites sp. in the Gulf of Aqaba, Jordan
Authors: Al-Karablieh N. , Al-Horani F.A. , Alnaimat S. , Abu Zarga M.H.
Published: May 2022

The purpose of this study was to assess the health of stony coral Porites sp. based on the presence of bacterial pathogens, specifically Vibrio coralliilyticus, in the Gulf of Aqaba, and to assess the impact of anthropogenic activities on Porites sp. Porites sp. specimens were collected from the Marine Science Station (MSS) and a public beach (Yamanyeh) in Jordan. Mucus, water and sediment samples were collected throughout the year. The Vibrio-like population was higher in diseased samples than in healthy samples and was slightly higher in Yamanyeh than in MSS in all the samples. In samples from both sites, there was a seasonal variation in the Vibrio-like population, with a decline in population as the temperature reduced. All samples contained virulent isolates clustered with V. coralliilyticus strains. Inoculation of healthy Porites sp. fragments with virulent isolates and V. coralliilyticus strain caused bleaching of the coral after 48 h. Therefore, V. coralliilyticus represents a pathogenic agent which may contribute to bleaching in Porites sp. in the Gulf of Aqaba and may not be affected considerably by anthropogenic activities. This is the first report of a bacterial pathogen of corals in Jordan; future studies should identify other coral pathogens in this region.
Information‐theoretic model of induced technical change: Theory and empirics
Authors: Yang Jangho
Published: May 2022

The paper develops an information‐theoretic model of induced technical change where payoff‐maximizing agents are exposed to a positive degree of uncertainty when adopting new technology due to unobserved cost factors. The derived equilibrium of the model comes in the form of a non‐degenerate probability distribution that defines the distance of productivity growth from the potential maximum growth on the innovation possibilities frontier, often called the technical inefficiency function (TIF) in the frontier estimation literature. Many forms of the TIF are shown to be derived by specifying a particular functional form of the payoff function in our model. The paper estimates the innovation possibilities frontier and the TIF using the KLEMS data for 1995–2015 and documents the time evolution and sectoral heterogeneity of the innovation possibilities frontier.
A qualitative study of medical students' perceptions of resident feedback
Authors: Wong Shannon N. , Luo Cong (John) , MacDonald Graham , Hatala Rose
Published: May 2022

Context

Residents play a pivotal role in medical students' clinical education. From a feedback lens, the near‐peer relationship between student and resident holds the potential to foster an educational alliance that could influence learning. We undertook the current qualitative study to explore medical students' perceptions of feedback experiences with residents, addressing when, how and why (and conversely when not and why not) resident feedback plays a role in their clinical education.

Methods

Our methodology was qualitative interpretive description, informed by phenomenology. We conducted 24 semi‐structured interviews with third and fourth year medical students at one institution. The interviews aimed to foster rich discussion about students' feedback experiences with residents during clinical rotations. Data collection and analysis proceeded iteratively. Initial interviews were independently open‐coded by three investigators and then collaboratively refined. Codes were applied to subsequent interviews, and new codes were developed. During the final stages of analysis, we organised our themes by drawing on a sociocultural perspective to examine students' perceptions of relationship‐building with residents and when and how this influenced feedback and learning.

Results

From the students' perspectives, when residents contributed to building interpersonal relationships with students, this in turn influenced students' receptivity to both encouraging and constructive feedback conversations. In the context of resident–student relationships that were perceived as supportive, resident feedback influenced how students approached learning and working in the clinical environment, as well as students' visions of their future selves. In unsupportive relationships, students were less inclined to engage in feedback with residents and students noted resident behaviours that they wanted to avoid in themselves.

Conclusion

Residents are uniquely positioned to create a strong educational alliance with students in which feedback conversations can flourish. Focusing educational efforts on resident feedback conversations has the potential to significantly impact the feedback culture of our clinical environments.
Countering elevated CO2 induced Fe and Zn reduction in Arabidopsis seeds
Authors: Sun Peng , Isner Jean‐Charles , Coupel‐Ledru Aude , Zhang Qi , Pridgeon Ashley J. , He Yaqian , Menguer Paloma K. , Miller Anthony J. , Sanders Dale , Mcgrath Steve P. , Noothong Fonthip , Liang Yun‐Kuan , Hetherington Alistair M.
Published: May 2022

Growth at increased concentrations of CO2 induces a reduction in seed zinc (Zn) and iron (Fe). Using Arabidopsis thaliana, we investigated whether this could be mitigated by reducing the elevated CO2‐induced decrease in transpiration.

We used an infrared imaging‐based screen to isolate mutants in At1g08080 that encodes ALPHA CARBONIC ANHYDRASE 7 (ACA7). aca7 mutant alleles display wild‐type (WT) responses to abscisic acid (ABA) and light but are compromised in their response to elevated CO2.

ACA7 is expressed in guard cells. When aca7 mutants are grown at 1000 ppm CO2 they exhibit higher transpiration and higher seed Fe and Zn content than WT grown under the same conditions.

Our data show that by increasing transpiration it is possible to partially mitigate the reduction in seed Fe and Zn content when Arabidopsis is grown at elevated CO2.
Lipschutz ulcers in a 4‐month‐old girl
Authors: Sindhuja Tekumalla , Khaitan Binod K. , Agarwal Shipra , Agarwala Sandeep , Bhari Neetu
Published: May 2022

Lipschutz ulcers, or non‐sexually acquired genital ulcers, typically occur in older children and young adults. A diagnosis of Lipschutz ulcers can only be made after excluding common infectious and non‐infectious causes of mucosal ulcers. Herein, we present the case of a 4‐month‐old girl with painful ulceration of the labia consistent with Lipschutz ulcers.
Dual treatment of cutaneous leishmaniasis with topical amphotericin B and photodynamic therapy in a pediatric patient
Authors: Knapp Calvin , Vaz Louise , Onoday Heather , Small Alison
Published: May 2022

Cutaneous leishmaniasis is a parasitic infection that can result in scarring, contributing to significant morbidity when a cosmetically sensitive area is involved. We report a case of a 13‐year‐old boy with cutaneous leishmaniasis involving the face and arm. He was treated with a combination of photodynamic therapy as well as topical amphotericin with a cosmetically satisfying outcome. This combination of noninvasive treatment regimens has not been reported to our knowledge and merits further study in the pediatric population.
Peace by peaceful means: Responding to aggression creatively and nonviolently
Authors: Clements Kevin P.
Published: May 2022

This article elaborates a range of non violent pacifist responses to the invasion of Ukraine and resistance to the development of a new cold war between the East and the West. It focuses attention on the relief of suffering; diverse forms of non violent resistance and the creation of ripe conditions for a ceasefire and a negotiated settlement. It argues for a more vigorous multilateralism and an end to competition between the United States and Russia over which country is to dominate the global order in the 21st century.
From right or wrong to true or false: Moral and epistemic framing in debates over cannabis policy reformulation
Authors: Lévesque Gabriel
Published: May 2022

Cannabis legalization is often referred to as a moral issue. However, given the limits of morality policy as a distinct policy subcategory and the contemporary dominance of technocratic politics, one could wonder if it is really framed as such within political institutions. In this article, I ask how moral frames compete and interact with other frames in debates over morality policy. Working with a moral/epistemic dichotomy, I conduct framing analysis on parliamentary debates in Quebec, Ontario, and Maine, which have recently reformulated their cannabis policy. Although trends in framing vary across cases, moral frames are consistently less salient than epistemic frames. Furthermore, a pattern of complementary framing is found, whereby actors combine moral and epistemic frames. Overall, this study shows that cannabis policy is often framed as nonmoral, and that its moral component is nonexclusive. I conclude by discussing some implications of these findings in the post‐legalization landscape.

Related Articles

Branton, Regina, and Ronald J. McGauvran. 2018. “Mary Jane Rocks the Vote: The Impact of Climate Context on Support for Cannabis Initiatives.” Politics & Policy 46(2): 209–32. https://doi.org/10.1111/polp.12248.

Brekken, Katheryn C., and Vanessa M. Fenley. 2021. “Part of the Narrative: Generic News Frames in the U.S. Recreational Marijuana Policy Subsystem.” Politics & Policy 49(1): 6–32. https://doi.org/10.1111/polp.12388.

Fisk, Jonathan M., Joseph A. Vonasek, and Elvis Davis. 2018. “‘Pot’Reneurial Politics: The Budgetary Highs and Lows of Recreational Marijuana Policy Innovation.” Politics & Policy 46(2): 189–208. https://doi.org/10.1111/polp.12246.
Admission hypocalcemia in pediatric major trauma patients—An uncommon phenomenon associated with an increased need for urgent blood transfusion
Authors: Epstein Danny , Ben Lulu Hen , Raz Aeyal , Bahouth Hany
Published: May 2022

Background

Hemorrhage is a leading cause of death among children. Recent data from adult trauma suggests that early, transfusion‐unrelated, hypocalcemia is common and that it is associated with an increased need for blood transfusion, mortality, and coagulopathy. The objectives of this study are to evaluate the prevalence of admission hypocalcemia in severely injured children and its correlation with urgent blood transfusion.

Study Design and Methods

This is a retrospective cohort study of all severely injured (Injury Severity Score [ISS] > 15) pediatric (<18 years) trauma patients admitted to Rambam Health Care Campus, Israel between 2012 and 2020. We excluded patients transferred from other facilities and those who received blood before determining calcium levels. Severe hypocalcemia was defined as ionized calcium (Ca++) < 1.0 mmol/L and mild hypocalcemia as 1.0 mmol/L ≤ Ca++ < 1.1 mmol/L. The primary outcome was urgent blood transfusion (transfusion in the emergency department [ED]).

Results

Six hundred seventy‐three severely injured children were admitted from the field. Ca++ levels were determined before blood transfusion in 457 patients. Severe hypocalcemia was found in three patients (0.7%) and mild hypocalcemia in additional 21 patients (4.6%). Hypocalcemic patients required more urgent blood transfusion (29.2% vs. 6.5%, p < .001) and had higher ISS (29 [interquartile range, IQR: 22–35] vs. 25 [IQR: 19–34], p = .05). Multivariable logistic regression analysis identified Ca++ < 1.1 mmol/L as an independent predictor of the need for blood transfusion, odds ratio 5.44 (95% confidence interval 1.44–20.58), p = .01.

Discussion

Contrary to adults, admission hypocalcemia is uncommon in severely injured children. However, it may be associated with an increased risk of blood transfusion in the ED.
Patterns and determinants of blood transfusion in intensive care in Sweden between 2010 and 2018: A nationwide, retrospective cohort study
Authors: Holmqvist Jacob , Brynolf Anne , Zhao Jingcheng , Halmin Märit , Hollenberg Jacob , Mårtensson Johan , Bell Max , Block Linda , Edgren Gustaf
Published: May 2022

Background

Intensive care unit (ICU) patients are transfused with blood products for a number of reasons, from massive ongoing hemorrhage, to mild anemia following blood sampling, combined with bone marrow depression due to critical illness. There's a paucity of data on transfusions in ICUs and most studies are based on audits or surveys. The aim of this study was to provide a complete picture of ICU‐related transfusions in Sweden.

Methods

We conducted a register based retrospective cohort study with data on all adult patient admissions from 82 of 84 Swedish ICUs between 2010 and 2018, as recorded in the Swedish Intensive Care Register. Transfusions were obtained from the SCANDAT‐3 database. Descriptive statistics were computed, characterizing transfused and nontransfused patients. The distribution of blood use comparing different ICUs was investigated by computing the observed proportion of ICU stays with a transfusion, as well as the expected proportion.

Results

In 330,938 ICU episodes analyzed, at least one transfusion was administered for 106,062 (32%). For both red‐cell units and plasma, the fraction of patients who were transfused decreased during the study period from 31.3% in 2010 to 24.6% in 2018 for red‐cells, and from 16.6% in 2010 to 9.4% in 2018 for plasma. After adjusting for a range of factors, substantial variation in transfusion frequency remained, especially for plasma units.

Conclusion

Despite continuous decreases in utilization, transfusions remain common among Swedish ICU patients. There is considerable unexplained variation in transfusion rates. More research is needed to establish stronger critiera for when to transfuse ICU patients.
COVID‐19, services trade and greenfield investment in ASEAN+6
Authors: Shingal Anirudh
Published: May 2022

Given the importance of services for economic activity in general and the salience of reducing service link costs for overcoming the economic and health challenges emanating from COVID‐19, we examine the effect of the pandemic on services trade in the original group of ASEAN+6 countries that began negotiating the RCEP agreement. Stylised facts show that ASEAN+6 commercial services’ exports and imports declined by 19.7% and 22.1%, respectively, on a YoY basis during 2020, with considerable heterogeneity across countries and sectors. ASEAN+6 announced greenfield investment in services also fell by a third during 2020, with the intra‐ASEAN+6 decline being more severe at 41.8%. Meanwhile, structural gravity estimates suggest that the stringency of containment measures imposed in the wake of the pandemic may have reduced ASEAN+6 services exports by 61.6%.
Profiling Destruxin Synthesis by Specialist and Generalist Metarhizium Insect Pathogens during Coculture with Plants
Authors: Barelli Larissa , Behie Scott W. , Hu Shasha , Bidochka Michael J.
Published: May 2022

The development of an intimate and beneficial association between fungi and plants requires an exchange of a complex mixture of chemical cues. These compounds are a means of communication, promoting or limiting the interaction, but can have numerous other biological and ecological functions.
Mouse Mx1 Inhibits Herpes Simplex Virus Type 1 Genomic Replication and Late Gene ExpressionIn Vitroand Prevents Lesion Formation in the Mouse Zosteriform Model
Authors: Tessema Melkamu B. , Farrukee Rubaiyea , Andoniou Christopher E. , Degli-Esposti Mariapia A. , Oates Clare V. , Barnes James B. , Wakim Linda M. , Brooks Andrew G. , Londrigan Sarah L. , Reading Patrick C.
Published: May 2022

While a number of studies have demonstrated that human Mx proteins can inhibit particular herpesvirusesin vitro, we are the first to report the antiviral activity of mouse Mx1 (mMx1) against alphaherpesviruses bothin vitroandin vivo. We demonstrate that both overexpressed mMx1 and endogenous mMx1 potently restrict HSV-1 growthin vitro. mMx1-mediated inhibition of HSV-1 was not associated with inhibition of virus entry and/or import of the viral genome into the nucleus, but rather with inhibition of HSV-1 genomic replication as well as subsequent late gene expression.
A Dual Enrichment Strategy Provides Soil- and Digestate-Competent Nitrous Oxide-Respiring Bacteria for Mitigating Climate Forcing in Agriculture
Authors: Jonassen Kjell Rune , Ormåsen Ida , Duffner Clara , Hvidsten Torgeir R. , Bakken Lars R. , Vick Silas H. W.
Published: May 2022

N
2
O emissions from farmed soils are a major source of climate forcing. Here, denitrifying bacteria act as both source and sink for N
2
O, determined by regulatory traits or the absence of genes coding for the enzymes producing or reducing N
2
O.
Peptidoglycan Recycling Promotes Outer Membrane Integrity and Carbapenem Tolerance in Acinetobacter baumannii
Authors: Islam Nowrosh , Kazi Misha I. , Kang Katie N. , Biboy Jacob , Gray Joe , Ahmed Feroz , Schargel Richard D. , Boutte Cara C. , Dörr Tobias , Vollmer Waldemar , Boll Joseph M.
Published: May 2022

Carbapenem treatment failure associated with “superbug” infections has rapidly increased in prevalence, highlighting the urgent need to develop new therapeutic strategies. Antibiotic tolerance can directly lead to treatment failure but has also been shown to promote the acquisition of true resistance within a population.
Complete Genome Sequence of Vibrio harveyi Strain ATCC 33866
Authors: Yao Yue , Zhou Qianjin , Feng Yu , Leptihn Sebastian , Yu Yunsong , Hua Xiaoting
Published: May 2022

Here, we report the complete genome sequence of
Vibrio harveyi
strain ATCC 33866, generated from Illumina and Oxford Nanopore sequencing. The assembled genome sequence comprises two circular chromosomes with lengths of 3,504,760 bp and 2,218,060 bp, respectively.
Draft Genome Sequence of Plesiomonas shigelloides Strain zfcc0051 (Phylum
Proteobacteria
)
Authors: VanderHoek Zoe K. , Browning Addison M. , Washburn Quinn , Kent Micheal L. , Sharpton Thomas J. , Gaulke Christopher A.
Published: May 2022

Here, we report a draft genome sequence of
Plesiomonas shigelloides
strain zfcc0051, an isolate derived from zebrafish (
Danio rerio
) feces. The genome consists of 115 contigs (>500 bp) and has a total assembly length of 4,041,537 bases.
Complete Genome Sequences of
Thermus
Strains Isolated from Senami Hot Spring in Japan
Authors: Miyazaki Kentaro
Published: May 2022

Extremely thermophilic strains belonging to the genus
Thermus
were isolated from Senami Hot Spring in Japan. Here, I report the complete genome sequences of five
Thermus thermophilus
strains and one
Thermus brockianus
strain, which were obtained by combining Oxford Nanopore long-read and DNBSEQ or Illumina short-read sequencing data.
Secondary Metabolism Gene Clusters Exhibit Increasingly Dynamic and Differential Expression during Asexual Growth, Conidiation, and Sexual Development in Neurospora crassa
Authors: Wang Zheng , Lopez-Giraldez Francesc , Slot Jason , Yarden Oded , Trail Frances , Townsend Jeffrey P.
Published: May 2022

Secondary metabolites (SMs) are low-molecular-weight compounds that often mediate interactions between fungi and their environments. Fungi enriched with SMs are of significant research interest to agriculture and medicine, especially from the aspects of pathogen ecology and environmental epidemiology.
A Look inside the Replication Dynamics of SARS-CoV-2 in Blyth’s Horseshoe Bat (
Rhinolophus lepidus
) Kidney Cells
Authors: Auerswald Heidi , Low Dolyce H. W. , Siegers Jurre Y. , Ou Teyputita , Kol Sonita , In Saraden , Linster Martin , Su Yvonne C. F. , Mendenhall Ian H. , Duong Veasna , Smith Gavin J. D. , Karlsson Erik A.
Published: May 2022

The current COVID-19 pandemic demonstrates the significance of bats as reservoirs for severe viral diseases. However, as bats are difficult to establish as animal models, bat cell lines can be an important proxy for the investigation of bat-virus interactions and the isolation of bat-borne viruses.
Effects of Spike Mutations in SARS-CoV-2 Variants of Concern on Human or Animal ACE2-Mediated Virus Entry and Neutralization
Authors: Kim Yunjeong , Gaudreault Natasha N. , Meekins David A. , Perera Krishani D. , Bold Dashzeveg , Trujillo Jessie D. , Morozov Igor , McDowell Chester D. , Chang Kyeong-Ok , Richt Juergen A.
Published: May 2022

The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to have devastating impacts on global health and socioeconomics. The recent emergence of SARS-CoV-2 variants of concern, which contain mutations that can affect the virulence, transmission, and effectiveness of licensed vaccines and therapeutic antibodies, are currently becoming the common strains circulating in humans worldwide.
Tobacco industry pricing strategies for single cigarettes and multistick packs after excise tax increases in Colombia
Authors: Sheikh Zaineb Danish , Branston J Robert , Llorente Blanca Amalia , Maldonado Norman , Gilmore Anna B
Published: May 2022

Introduction

Taxes on tobacco products are an efficient way of reducing consumption. However, they are only effective if passed on to consumers with higher prices. This study aims to examine tobacco industry (TI) pricing strategies in response to tax increases, and whether they differ by price segments or presentation (packs or individual sticks) in Colombia. This is the first such academic study in Latin America and the first anywhere to include the market for single sticks.

Methods

Using data on cigarette pricing/taxation from a survey of smokers (2016–2017) and official government data on pricing (2007–2019), the TI’s pricing strategies were examined, split by brand, price segments, different sized packs and single cigarettes.

Results

The TI employed targeted pricing strategies in Colombia: differentially shifting taxes; and launching new brands/brand variants. The industry overshifted taxes when increases were smaller and predictable, but used undershifting more when there was a larger increase in 2017, after which it mostly overshifted on budget and premium (but undershifted mid-priced) brands. The prices for single sticks increased more than the tax increase in 2017 when their consumption also increased.

Conclusion

The pricing strategies identified suggest excise taxes can be increased further, particularly the specific component, to reduce the price gap between brand segments. Brands should be restricted to a single variant along with prohibitions on launching new brands/brand variants. Lastly, since the pricing of single sticks does not match the pattern of packs, more monitoring of their sales and distribution is required, especially since they promote consumption and hinder effective implementation of tobacco tax policies.
Responses of the rhizosphere microbiome to long-term nitrogen addition in a boreal forest
Authors: Fu Yulei , Yan Guoyong , Liu Guancheng , Huang Binbin , Sun Xingyu , Wang Xiaochun , Xing Yajuan , Wang Qinggui
Published: May 2022

As the interface between plants and soil, the response of the rhizosphere to nitrogen deposition is particularly important. The rhizosphere responses to nitrogen deposition are not consistent. Here, four levels of nitrogen addition treatments were applied in boreal forests of China for 8 years: control, low nitrogen, medium nitrogen, and high nitrogen. We analyzed the soil properties and microbial communities of rhizosphere and bulk soils under different nitrogen application levels and assessed the relationship between the main species and environmental factors. The results showed that long-term nitrogen addition significantly reduced the content of total carbon in the soil and increased the soil microbial biomass nitrogen in the rhizosphere. The total carbon content in the rhizosphere under high nitrogen was 40.79 g·kg−1, which was significantly lower than that in the control (51.82 g·kg−1). The diversity of the rhizosphere and bulk soil fungal communities had different significant responses to nitrogen addition. Some specific microbial taxa could be used as rhizosphere bacterial biomarkers under different nitrogen treatments. The soil microbial biomass nitrogen was the significant environmental variable affecting bacterial species variation in the rhizosphere. Nitrogen addition will change the diversity of the rhizosphere microbial community by changing soil microenvironmental factors.