bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of various ripeness groups winter bread wheat varieties according to productivity and grain quality
Authors: Nekrasov E I , Marchenko D M , Ivanisov M M , Kravchenko N S
Published: November 2021

The purpose of the current study was a comparative estimation of productivity and grain quality of the early ripening, middle early and middle ripening winter bread wheat varieties in the conditions of the southern part of the Rostov region. The study was conducted in the Agricultural Research Center “Donskoy” in 2017-2019. The objects of the study were 15 winter bread wheat verities. The study established that the middle early ripening varieties Krasa Dona, Lidiya, Lilit and Premiera showed a significant increase to the standard variety Don 107 from 0.46 to 0.85 t/ha according to productivity. The comparative estimation of the ripeness different groups varieties showed that such middle early ripening varieties with its maximum percentage as Don 107 (12.29%), Lidiya (12.46%), Volnitsa (12.72%) and the early ripening sample Podarok Krymu (with 12.68% of mass fraction of protein), that correspond to the 3rd quality class, were identified according to the mass fraction of protein in grain. The early ripening varieties Zhavoronok (24.98%) and Podarok Krymu (26.77%) with the highest values and the middle early ripening varieties Don 107 (24.81%), Volnitsa (25.22%) and Asket (26.30%), corresponding to the 3rd quality class, were identified according to the trait gluten content in grain.
The effect of growth regulators with retardant properties on the growth and development of winter wheat
Authors: Voronov S I , Vlasova O I , Shtyrkhunov V D , Govorkova S B , Savinov E V
Published: November 2021

The article presents the results of experiments to study the reaction of winter soft wheat of the Nemchinovskaya 17 variety to growth regulators with retardant properties. It was found that the use of growth regulators at the end of the tillering-exit phase into the tube reduced the height of plants by an average of 0.115 m compared to the control without treatment, where the height of plants was on average 0.813 m. According to the results of observations, a differentiated reaction of the tested winter wheat to lodging was established when using the studied growth regulators. In plants treated with Reggi and Messidor growth regulators, lodging was not observed and ranged from 4.4 to 5 points of lodging on the control without treatment – 3 points. The tested plant growth regulators have a significant impact on the yield of winter wheat of the studied variety and the formation of its structural elements. The increase in yield according to the variants of the experiment was about 4.1-6.1 t/ha depending on the type of drug. The highest yield increases were obtained with the use of Reggi at a dose of 1.5 l/ha.
Spring wheat yield (Triticum aestivum L.) when applying selenium fertilizers in extreme growing conditions
Authors: Seregina I I , Makarskaya I G , Tsygutkin A S , Kirichkova I V
Published: November 2021

To study the effect of sodium Selenite application different methods on the yield of spring wheat varieties, depending on the conditions of water supply, a series of vegetation experiments in accordance with the methodology were carried out. The object of the study is spring wheat of the Zlata variety (Triticum aestivum L.). It was found that the effect of selenium on the yield of wheat of the Zlata variety depended on the method of its application and the conditions of water supply. With optimal water supply, the positive effect of selenium on the yield of spring wheat plants was revealed with both methods of applying sodium selenite. It was found that in conditions of drought, the positive effect of selenium was obtained with both methods of using sodium selenite. The greatest efficiency of selenium is obtained in foliar processing of plants. The increase in grain weight in this variant was 1.4 times. The increase in the share of the agronomic significant part of the wheat crop yield to 36% is shown, which indicates the decrease in the negative effect of drought on the formation of spring wheat yield when using foliar processing of plants.
Polymer-loaded three dimensional microwave cavities for hybrid quantum systems
Authors: Ruether Myles , Potts Clinton A , Davis John P , LeBlanc Lindsay J
Published: November 2021

Microwave cavity resonators are crucial components of many quantum technologies and are a promising platform for hybrid quantum systems, as their open architecture enables the integration of multiple subsystems inside the cavity volume. To suspend these subsystems within the centre of a cavity where field strengths are strong and uniform, auxiliary support structures are often required, but the effects of these structures on the microwave cavity mode are difficult to predict due to a lack of a priori knowledge of the materials’ response in the microwave regime. Understanding these effects becomes even more important when frequency matching is critical and tuning is limited, for example, when matching microwave modes to atomic resonances for atomic vapour cells inside enclosed microwave cavities. Here, we study the microwave cavity mode in the presence of three commonly-used machinable polymers, paying particular attention to the change in resonance and the dissipation of energy. We demonstrate how to use the derived dielectric coefficient for cavity design in a test case, wherein we match a polymer-filled 3D microwave cavity to a hyperfine transition in rubidium.
Mary the goddess?
Authors: Leith Mary Joan Winn
Published: November 2021

‘Mary the goddess?’ considers the question of whether the Virgin Mary is a goddess. According to official Christian theology throughout the centuries, Mary is not and cannot be a goddess. Nevertheless, Christian piety has at times followed a separate track from official theology by treating Mary as a goddess. It is worth considering here the oft-noted parallels between the Virgin Mary and Graeco-Roman goddesses, the history of the Black Madonna, and contemporary forms of goddess-centred spirituality.
Eastern Mary—Byzantium and Islam
Authors: Leith Mary Joan Winn
Published: November 2021

‘Eastern Mary—Byzantium and Islam’ examines Marian ideals in Byzantine Christianity as well as the Islamic view of Maryam, which reflects and rejects the Byzantine worldview from which Islam partly emerged. It was in the east that Christians celebrated the first Marian festivals and dedicated the earliest Marian churches. A Byzantine icon serves to illustrate key ideas about Mary as they developed in the east, where the first Marian relics were also discovered and venerated. Muslims revere Al-ʿAdhraʾ (the Virgin) as a model of piety, following the lead of the Prophet Muhammad, who stated that Maryam was one of the four spiritually perfect women in Paradise. There are a number of famous texts in the Qur’an devoted to Mary, a significant factor in Islam’s high regard for Mary and Jesus.
Modern Mary—Reformation to the present
Authors: Leith Mary Joan Winn
Published: November 2021

‘Modern Mary—Reformation to the present’ looks at the Virgin Mary from the Protestant Reformation of the 16th century to the present. During this period Mary was often at the centre of conflicts over religious ideals that contributed to the Enlightenment. The Catholic Council of Trent reaffirmed Mary’s perpetual virginity, intercession, pilgrimage, and relics. Catholic Marian beliefs were shaped by some of the misgivings that Protestants had voiced about Catholic views of Mary. The rosary and apparitions of Mary illustrate Catholic views of Mary after the Council of Trent. The so-called ‘Marian Century’ began in 1854 with Pope Pius IX’s declaration of Mary’s Immaculate Conception effectively ended in 1965 with the church reforms of Vatican II. Marian spirituality in the 21st century have taken often surprising directions.
2. The physical environment
Authors: Dodds Klaus , Woodward Jamie
Published: November 2021

‘The physical environment’ describes the Arctic as the polar opposite of the Antarctic continent as it is an ocean semi-enclosed by land. The rocks of the Arctic record key periods in Earth history. The Arctic environment has had an interesting path of evolution. Why is the Arctic cold today? The polar latitudes actually receive less solar energy than the rest of the Earth's surface. What is the key role of sea ice in the Arctic climate system? How does sea ice decline impact upon the Arctic Ocean? The Greenland ice sheet, high latitude glaciers, and the importance of permafrost in the far north are also important topics related to the physical environment.
7. The Arctic carbon vault
Authors: Dodds Klaus , Woodward Jamie
Published: November 2021

‘The Arctic carbon vault’ describes the large share of Earth's organic carbon sequestered in the frozen ground and within the shelf sea sediments of the Arctic Ocean. The organic carbon stock of the permafrost is roughly equivalent to half of total global soil carbon. A cold Arctic with extensive permafrost is an effective long-term carbon sink as carbon is safely locked away as long as permafrost is maintained. Giant craters appeared on the Yamal peninsula. The thawing permafrost leads to the formation of thermokarst lakes, which are frozen bodies of water held in subsidence depressions created by the thawing of ground ice. Well-preserved carcasses of extinct ice age beasts, including woolly mammoths and cave bears, have been recovered from the thawing permafrost.
3. Towards the idea of Pakistan
Authors: Virdee Pippa
Published: November 2021

‘Towards the idea of Pakistan’ highlights the forts, tombs, and mosques that summed up the presence of the Mughuls in West Pakistan. These markers of conquest and conviction have created a physical landscape that is aesthetically awe-inspiring and spiritually soothing. Looking at the partitioned history of the Indian subcontinent from the 11th to the 18th century, shows where Buddhism migrated, Sikhism manifested, Hinduism strengthened, and Islam became established. The period produced a protracted, hybridized composite Indo-Islamic identity, which became involved in the politics of the mid-20th century. The inability to resolve the political tension between the various religious and political groups inevitably resulted in the Partition and creation of Pakistan in 1947.
5. Building the land of the pure
Authors: Virdee Pippa
Published: November 2021

‘Building the land of the pure’ talks about Zulfikar Ali Bhutto, the first fully elected prime minister of the belatedly formed government of Pakistan. It mentions Bhutto's affiliation to the religious clergy for support and constitution of the newly christened ‘Islamic Republic’. The prime minister’s move marked the slow but sure shift towards political orthodoxy in Pakistan in line with the influence of the Sunni state of Saudi Arabia. The exclusion and reaffirmation of the religious identity of Pakistan as the core for building the country was the land of the pure. There were persistent voices of dissent to this one way of imagining a nation.
Definitions and justifications
Authors: Whatmore Richard
Published: November 2021

‘Definitions and justifications’ describes the history of political thought as a recent field of research. Historically, however, every society has formulated histories of political thought from the anodyne to the systematic. The past, where politics has been closely entwined with the worship of deities on whom the survival of a society depends, is also very relevant here. If national myths in culture justify combat or describe thwarted destinies in history, these beliefs will be reflected in the history of political thought. There is the perceived history of decline that can lead to the transformation of politics, which is manifested among nations that fell behind European states during the nineteenth century.
Individual participant data meta-analysis with mixed-effects transformation models
Authors: Tamási Bálint , Crowther Michael , Puhan Milo Alan , Steyerberg Ewout W , Hothorn Torsten
Published: November 2021

One-stage meta-analysis of individual participant data (IPD) poses several statistical and computational challenges. For time-to-event outcomes, the approach requires the estimation of complicated nonlinear mixed-effects models that are flexible enough to realistically capture the most important characteristics of the IPD. We present a model class that incorporates general normally distributed random effects into linear transformation models. We discuss extensions to model between-study heterogeneity in baseline risks and covariate effects and also relax the assumption of proportional hazards. Within the proposed framework, data with arbitrary random censoring patterns can be handled. The accompanying $\textsf{R}$ package tramME utilizes the Laplace approximation and automatic differentiation to perform efficient maximum likelihood estimation and inference in mixed-effects transformation models. We compare several variants of our model to predict the survival of patients with chronic obstructive pulmonary disease using a large data set of prognostic studies. Finally, a simulation study is presented that verifies the correctness of the implementation and highlights its efficiency compared to an alternative approach.
Statins for primary prevention among elderly men and women
Authors: Bergami Maria , Cenko Edina , Yoon Jinsung , Mendieta Guiomar , Kedev Sasko , Zdravkovic Marija , Vasiljevic Zorana , Miličić Davor , Manfrini Olivia , van der Schaar Mihaela , Gale Chris P , Badimon Lina , Bugiardini Raffaele
Published: November 2021

Aims

We undertook a propensity match-weighted cohort study to investigate whether statin treatment recommendations for statins translate into improved cardiovascular (CV) outcomes in the current routine clinical care of the elderly.

Methods and results

We included in our analysis (ISACS Archives -NCT04008173) a total of 5619 Caucasian patients with no known prior history of CV disease who presented to hospital with a first manifestation of CV disease with age of 65 years or older. The risk of ST-segment elevation myocardial infarction (STEMI) was much lower in statin users than in non-users in both patients aged 65–75 years [14.7% absolute risk reduction; relative risk (RR): 0.55, 95% CI 0.45–0.66] and those aged 76 years and older (13.3% absolute risk reduction; RR: 0.58, 95% CI 0.46–0.72). Estimates were similar in patients with and without history of hypercholesterolaemia (interaction test; P-values = 0.24 and 0.35). Proportional reductions in STEMI diminished with female sex in the old (P for interaction = 0.002), but not in the very old age (P for interaction = 0.26). We also observed a remarkable reduction in the risk of 30 day mortality from STEMI with statin therapy in both age groups (10.2% absolute risk reduction; RR: 0.39; 95% CI 0.23–0.68 for patients aged 76 or over and 3.8% absolute risk reduction; RR 0.37; 95% CI 0.17–0.82 for patients aged 65–75 years old; interaction test, P-value = 0.46).

Conclusions

Preventive statin therapy in the elderly reduces the risk of STEMI with benefits in mortality from STEMI, irrespective of the presence of a history of hypercholesterolaemia. This effect persists after the age of 76 years. Benefits are less pronounced in women. Randomized clinical trials may contribute to more definitively determine the role of statin therapy in the elderly.
Joint inversion of seismic slopes, traveltimes and gravity anomaly data based on structural similarity
Authors: Liu Jie , Zhang Jianzhong
Published: November 2021

Attention is paid to joint inversion of multiple geophysical data because of its advantages on weakening the non-uniqueness of inversion and further enhancing comprehensive interpretation. Due to the good correlation between rock velocity and density, seismic and gravity data have been widely used in joint inversion. However, the joint inversion of pre-stack seismic reflection and gravity data remains underdeveloped at the exploration scale. Without a quantitive relation between velocity and density, we develop a structure-based joint inversion using seismic reflection traveltimes, slopes and Bouguer gravity anomaly data simultaneously for building both velocity and density models. In our method, cubic B-spline interpolation is used to parametrize the common knots of velocity and density models. Incorporating seismic slopes into the joint inversion framework, we build a composite objective function which minimizes the weighted-sum of seismic/gravity data misfits, regularization and structural constraint terms. By subdividing the knot spacing, a multiscale strategy is alternative to increase the stability of inversion. First, we describe the methodology, followed by three synthetic examples to illustrate the feasibility and benefits of the method. Examination of the convergence curves via inversion suggests that the desired solution is more likely to be obtained with gentle convergence of each term, thus it can be used as an indicator for weight adjustment. Additionally, locations of scattering points and acoustic impedance can be obtained as by-products. Compared with the inversion of the respective data, the joint inversion exhibits the complementary characteristics of seismic and gravity data, improves the distribution and structural features of the resulting physical properties, especially in deep and complex tectonic situations.
Stochastic mathematical models for the spread of COVID-19: a novel epidemiological approach
Authors: Mourad Ayman , Mroue Fatima , Taha Zahraa
Published: November 2021

In this paper, three stochastic mathematical models are developed for the spread of the coronavirus disease (COVID-19). These models take into account the known special characteristics of this disease such as the existence of infectious undetected cases and the different social and infectiousness conditions of infected people. In particular, they include a novel approach that considers the social structure, the fraction of detected cases over the real total infected cases, the influx of undetected infected people from outside the borders, as well as contact-tracing and quarantine period for travellers. Two of these models are discrete time–discrete state space models (one is simplified and the other is complete) while the third one is a continuous time–continuous state space stochastic integro-differential model obtained by a formal passing to the limit from the proposed simplified discrete model. From a numerical point of view, the particular case of Lebanon has been studied and its reported data have been used to estimate the complete discrete model parameters, which can be of interest in estimating the spread of COVID-19 in other countries. The obtained simulation results have shown a good agreement with the reported data. Moreover, a parameters’ analysis is presented in order to better understand the role of some of the parameters. This may help policy makers in deciding on different social distancing measures.
Paid and unpaid work productivity loss associated with treated hypertension in Southern Ethiopia: a patient-level analysis
Authors: Sorato Mende Mensa , Davari Majid , Kebriaeezadeh Abbas , Sarrafzadegan Nizal , Shibru Tamiru
Published: November 2021

Objective

Hypertension-related illness increases healthcare expenditure and reduces productivity. There is inadequate information about work productivity loss associated with hypertension in Ethiopia. This study was conducted to determine the extent of paid and unpaid worker productivity loss among adult hypertensive patients in Southern Ethiopia. Facility-based descriptive cross-sectional study was conducted by using the valuation of lost productivity (VOLP) tool adapted to the Ethiopian context. The data entry and analysis were done by using Microsoft Excel 2013 and SPSS version 21.0.

Key findings

A total of 301 adult hypertensive patients on regular follow-up at selected public hospitals were included in this study. One hundred ninety-five patients were females with a mean age of 50.7 ± 7.3 years. Less than one in five 39 (13.0%) of patients achieved their BP control target. Fifty-three (17.7%) of patients reported that hypertension reduced their work performance by 50%. One hundred twenty-five (60.1%) patients reported that they would complete the same work in less time, if they have no health problem. After adjusting for team impact and work substitutability, 3247.4 USD and 1844.81 USD were lost per month from paid and unpaid work. Overall annual work productivity loss was 38 968.4 USD, and the percentage of lost productivity per month was 18.7%.

Hypertension reduced the work productivity of adults by one-fifth. Therefore, it is important to devise strategies by involving all relevant stakeholders for preventing hypertension to save this productivity loss. In addition to this, improving the blood pressure control rate could help to reduce associated productivity loss.
Leiomyosarcoma of the chest wall mimicking schwannoma resected by a video-assisted thoracoscopic approach: a case report
Authors: Yamamoto Saki , Hirose Masahide , Oyaizu Takeshi , Muramatsu Aya , Suzuki Makoto , Ohta Shinichiro
Published: November 2021

Chest wall sarcomas account for <20% of all soft tissue sarcomas of which leiomyosarcomas represent only 1–4%. We report a case of thoracic leiomyosarcoma that resembled schwannoma in preoperative image studies. A 79-year-old man presented to our hospital with a chest wall tumor that increased in size over 3 months. Computed tomography of the chest revealed a 3-cm mass arising from the chest wall. Thoracic magnetic resonance imaging showed a solid tumor that was hypo-intense on T1-weighted imaging and iso-intense on T2-weighted imaging. Chest wall resection was performed using a video-assisted thoracoscopic approach after a frozen section examination revealed sarcoma. The histological diagnosis was leiomyosarcoma. Liver and multiple lung metastases were detected 5 years after surgery. Malignant tumors should be considered in any patient with chest wall tumors. The thoracoscopic approach could be an optimal treatment for chest wall tumor.
Automated algorithms to build active galactic nucleus classifiers
Authors: Falocco S , Carrera F J , Larsson J
Published: November 2021

We present a machine learning model to classify active galactic nuclei (AGNs) and galaxies (AGN-galaxy classifier) and a model to identify type 1 (optically unabsorbed) and type 2 (optically absorbed) AGN (type 1/2 classifier). We test tree-based algorithms, using training samples built from the X-ray Multi-Mirror Mission–Newton (XMM–Newton) catalogue and the Sloan Digital Sky Survey (SDSS), with labels derived from the SDSS survey. The performance was tested making use of simulations and of cross-validation techniques. With a set of features including spectroscopic redshifts and X-ray parameters connected to source properties (e.g. fluxes and extension), as well as features related to X-ray instrumental conditions, the precision and recall for AGN identification are 94 and 93 per cent, while the type 1/2 classifier has a precision of 74 per cent and a recall of 80 per cent for type 2 AGNs. The performance obtained with photometric redshifts is very similar to that achieved with spectroscopic redshifts in both test cases, while there is a decrease in performance when excluding redshifts. Our machine learning model trained on X-ray features can accurately identify AGN in extragalactic surveys. The type 1/2 classifier has a valuable performance for type 2 AGNs, but its ability to generalize without redshifts is hampered by the limited census of absorbed AGN at high redshift.
The histone H3K27 demethylase REF6/JMJ12 promotes thermomorphogenesis in Arabidopsis
Authors: He Kaixuan , Mei Hailiang , Zhu Jiaping , Qiu Qi , Cao Xiaofeng , Deng Xian
Published: November 2021

Dynamic trimethylation of histone H3 at Lys27 (H3K27me3) affects gene expression and controls plant development and environmental responses. In Arabidopsis thaliana, RELATIVE OF EARLY FLOWERING 6 (REF6)/JUMONJI DOMAIN-CONTAINING PROTEIN 12 demethylates H3K27me3 by recognizing a specific DNA motif. However, little is known about how REF6 activates target gene expression after recognition, especially in environmental responses. In response to warm ambient temperature, plants undergo thermomorphogenesis, which involves accelerated growth, early flowering and changes in morphology. Here we show that REF6 regulates thermomorphogenesis and cooperates with the transcription factor PHYTOCHROME INTERACTING FACTOR 4 to synergistically activate thermoresponsive genes under warm ambient temperature. The ref6 loss-of-function mutants exhibited attenuated hypocotyl elongation at warm temperature, partially due to downregulation of GIBBERELLIN 20-OXIDASE 2 and BASIC HELIX-LOOP-HELIX 87. REF6 enzymatic activity is necessary for warm ambient temperature responses. Together, our results provide direct evidence of an epigenetic modifier and a transcription factor working together to respond to the environment.
Vitamin D deficiency and anemia in pregnant women: a systematic review and meta-analysis
Authors: Lima Michele S , Pereira Marcos , Castro Caroline T , Santos Djanilson B
Published: November 2021

Context

Epidemiological studies suggest an association between vitamin D deficiency and anemia. Evidence of this relationship in pregnant women, however, is scarce.

Objective

The aim of this systematic review was to investigate the association between vitamin D deficiency and gestational anemia through observational studies.

Data Sources

The PubMed, Scopus, Web of Science, ScienceDirect, Embase, and Virtual Health Library databases were searched from inception to April 2021.

Study Selection

Original articles reporting observational studies that investigated the association between vitamin D deficiency and gestational anemia were included. Articles that did not have an abstract, as well as reviews articles, experimental studies, and editorials, were excluded. Two reviewers independently performed study selection, data extraction, and assessment of study quality. Disagreements between the reviewers were resolved by a third reviewer.

Data Extraction

Study quality was assessed by 2 scales. Data were extracted from eligible studies and arranged in a 2 × 2 table. Odds ratios with 95% confidence intervals for the risk of the outcome were estimated using a fixed-effect model.

Results

In total, 985 studies were retrieved, of which 17 were included in the systematic review: 11 cohort studies, 3 case-control studies, and 3 cross-sectional studies. For the meta-analysis, 8 studies with a total of 6530 women were included. There was a 61% increase in the odds of anemia in pregnant women with vitamin D deficiency (OR = 1.61; 95%CI, 1.41–1.83; I2 = 48%).

Conclusions

Vitamin D deficiency may be a risk factor for anemia in pregnant women.

Systematic Review Registration

PROSPERO registration no. CRD42020182697.
Thalia longicauda(Quoy and Gaimard) from the south-western Atlantic Ocean (31°S–38°S): distribution and population structure
Authors: Daponte María C , Thompson Gustavo A
Published: November 2021

Although the salp Thalia longicauda is common in the southern hemisphere, there is little information on its biology and ecology. Our study aimed to describe the morphology of the development of solitaries and aggregates and to determine the developmental stages, length distribution and population structure of this species. Plankton samples were collected by the R/V ARA “Puerto Deseado” from 31°55′S to 38°08′S (October 2013). Thalia longicauda was present at 50% of the stations, ranging between 1.21 and 2970 ind. 1000 m−3. Solitaries and aggregates represented 53.76 and 46.24%, respectively. We described the growth of the blastogenic stolon and the formation of blocks of aggregates buds. Each solitary may produce at least three blocks with a total of 36–86 aggregate buds. The relationship between total number of aggregate buds (y) and total length of the solitary (x) was y = 3.321x − 13.489. We characterized six developmental stages for solitaries and four for aggregates. The juvenile/mature ratio of solitaries and aggregates suggested that the population was actively reproducing both sexually and asexually. Based on seawater temperature and salinity data, T. longicauda may be considered as a temperate species inhabiting the southern range of subtropical waters and the northern range of sub-Antarctic waters.
Nitrogen fertilization modulates beneficial rhizosphere interactions through signaling effect of nitric oxide
Authors: Kang An , Zhang Nan , Xun Weibing , Dong Xiaoyan , Xiao Ming , Liu Zihao , Xu Zhihui , Feng Haichao , Zou Jianwen , Shen Qirong , Zhang Ruifu
Published: November 2021

Chemical nitrogen (N) fertilization is customary for increasing N inputs in agroecosystems. The nutritional effects of N fertilization on plants and soil microbes have been well studied. However, the signaling effects of N fertilization on rhizosphere plant–microbe interactions and the following feedback to plant performance remain unknown. Here, we investigated the effect of different N fertilizations on the behavior of the plant growth-promoting rhizobacteria (PGPR) Bacillus velezensis SQR9 in the cucumber (Cucumis sativus L.) rhizosphere. Moderate N fertilization promoted higher rhizosphere colonization of strain SQR9 than insufficient or excessive N input. Nitric oxide (NO) produced through the denitrification process under N fertilization was identified as the signaling molecule that dominates the root colonization of PGPR, and this effect could be neutralized by the NO-specific scavenger 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxy-3-oxide. Gene expression analysis demonstrated that NO regulated the biofilm formation of strain SQR9 by affecting the synthesis of extracellular matrix γ-polyglutamic acid, consequently impacting its root colonization. Finally, we demonstrated that moderate N fertilization-modulated enhanced PGPR root colonization can significantly promote plant growth and nitrogen use efficiency. This study provides insights into our understanding of the beneficial rhizosphere plant–microbe interactions under N fertilization and suggests that rational fertilization is critical to promote beneficial rhizosphere interactions for sustainable agricultural production.
Research Recommendations Following the Discovery of Pain Sensitizing IgG Autoantibodies in Fibromyalgia Syndrome
Authors: Goebel Andreas , Andersson David , Barker Chris , Basu Neil , Bullock Craig , Bevan Stuart , Bashford-Rogers Rachael J M , Choy Ernest , Clauw David , Dulake Debra , Dulake Richard , Flor Herta , Glanvill Marcia , Helyes Zsuzsanna , Irani Sarosh , Kosek Eva , Laird Jennifer , MacFarlane Gary , McCullough Hayley , Marshall Andrew , Moots Robert , Perrot Serge , Shenker Nick , Sher Emanuele , Sommer Claudia , Svensson Camilla I , Williams Amanda , Wood Geoff , Dorris Emma R
Published: November 2021

Background

Fibromyalgia syndrome (FMS) is the most common chronic widespread pain condition in rheumatology. Until recently, no clear pathophysiological mechanism for fibromyalgia had been established, resulting in management challenges. Recent research has indicated that serum immunoglobulin Gs (IgGs) may play a role in FMS. We undertook a research prioritisation exercise to identify the most pertinent research approaches that may lead to clinically implementable outputs.

Methods

Research priority setting was conducted in five phases: situation analysis; design; expert group consultation; interim recommendations; consultation and revision. A dialogue model was used, and an international multi-stakeholder expert group was invited. Clinical, patient, industry, funder, and scientific expertise was represented throughout. Recommendation-consensus was determined via a voluntary closed eSurvey. Reporting guideline for priority setting of health research were employed to support implementation and maximise impact.

Results

Arising from the expert group consultation (n = 29 participants), 39 interim recommendations were defined. A response rate of 81.5% was achieved in the consensus survey. Six recommendations were identified as high priority- and 15 as medium level priority. The recommendations range from aspects of fibromyalgia features that should be considered in future autoantibody research, to specific immunological investigations, suggestions for trial design in FMS, and therapeutic interventions that should be assessed in trials.

Conclusions

By applying the principles of strategic priority setting we directed research towards that which is implementable, thereby expediating the benefit to the FMS patient population. These recommendations are intended for patients, international professionals and grant-giving bodies concerned with research into causes and management of patients with fibromyalgia syndrome.
Efficient Screening for Fear of Movement in Outpatient Settings: Short Form and Computer Adaptive Tests for Fear Avoidance and Negative Pain Coping
Authors: Lentz Trevor A , Kallen Michael A , Deutscher Daniel , George Steven Z
Published: November 2021

Objective

The purpose of this study was to develop screening measures using item response theory (IRT) for 2 factors highly relevant to fear of movement (FoM): fear avoidance and negative pain coping.

Methods

A total of 431 patients with neck (n = 93), shoulder (n = 108), low back (n = 119), or knee (n = 111) conditions seeking physical therapy completed 8 validated psychological questionnaires measuring fear avoidance and negative pain coping, resulting in 97 candidate items for IRT analysis. Unidimensionality and local independence were assessed using exploratory factor analyses followed by confirmatory factor analyses. Items were assessed for model fit to the graded response model for ordinal items. Using the final item bank, a computer adaptive test (CAT) administration mode was constructed, and reduced item sets were selected to create short forms (SFs), including items with highest information (reliability) at the different levels of the trait being measured while also considering clinical content.

Results

The results supported a 28-item bank for fear avoidance and 16-item bank for negative pain coping. A 10-item and 8-item SF were developed for fear avoidance and negative pain coping, respectively. Additionally, 4-item form versions were created to provide options with lower administrative burden. CAT administration used a mean (median) of 7.7 (8) and 7.0 (7) items for fear avoidance and negative pain coping, respectively. All factors demonstrated construct validity by discriminating patient groups in expected clinical patterns.

Conclusion

These newly derived SFs and CAT administration modes provide reliable, valid, and efficient options to screen for fear avoidance and negative pain coping in populations with musculoskeletal pain.

Impact

These tools, collectively referred to as the Screening for Pain Vulnerability and Resilience tools, address a critical need for standard FoM screening processes that aid in clinical decision-making to identify who might benefit from psychologically informed approaches.
Easy-BILAG: a new tool for simplified recording of SLE disease activity using BILAG-2004 index
Authors: Carter Lucy M , Gordon Caroline , Yee Chee-Seng , Bruce Ian , Isenberg David , Skeoch Sarah , Vital Edward M
Published: November 2021

Objective

BILAG-2004 index is a comprehensive disease activity instrument for SLE but administrative burden and potential frequency of errors limits its use in routine practice. We aimed to develop a tool for more accurate, time-efficient scoring of BILAG-2004 index with full fidelity to the existing instrument.

Methods

Frequency of BILAG-2004 items was collated from a BILAG-biologics registry (BILAG-BR) dataset. Easy-BILAG prototypes were developed to address known issues affecting speed and accuracy. After expert verification, accuracy and usability of the finalized Easy-BILAG was validated against standard format BILAG-2004 in a workbook exercise of 10 case vignettes. Thirty-three professionals ranging in expertise from 14 UK centres completed the validation exercise.

Results

Easy-BILAG incorporates all items present in ≥5% BILAG-BR records, plus full constitutional and renal domains into a rapid single page assessment. An embedded glossary and colour-coding assists domain scoring. A second page captures rarer manifestations when needed. In the validation exercise, Easy-BILAG yielded higher median scoring accuracy (96.7%) than standard BILAG-2004 documentation (87.8%, P = 0.001), with better inter-rater agreement. Easy-BILAG was completed faster (59.5 min) than the standard format (80.0 min, P = 0.04) for 10 cases. An advantage in accuracy was observed with Easy-BILAG use among general hospital rheumatologists (91.3 vs 75.0, P = 0.02), leading to equivalent accuracy as tertiary centre rheumatologists. Clinicians rated Easy-BILAG as intuitive, convenient, and well adapted for routine practice.

Conclusion

Easy-BILAG facilitates more rapid and accurate scoring of BILAG-2004 across all clinical settings, which could improve patient care and biologics prescribing. Easy-BILAG should be adopted wherever BILAG-2004 assessment is required.
New Pathways for Successfully Reducing Health Inequities Experienced by the Deaf and Hard of Hearing Community
Authors: Reiher Josh
Published: November 2021

In this Invited Commentary, the author briefly reviews 3 articles from this issue of Academic Medicine that serve as a welcome addition to the literature in the quest to reduce the significant health inequities experienced by the Deaf and hard of hearing (DHoH) community. The author connects these articles to his own story as a DHoH medical student navigating the medical education system and also to his perspective as a practicing family medicine physician in a rural community health center. The path to bridging these health inequities is multifactorial. This includes identifying and eliminating barriers to increasing DHoH physician representation in the workforce, enhancing DHoH cultural competency in medical education, and using advances in technology through the creation of communication access plans and language access teams in hospitals and medical clinics for DHoH patients.
Overcoming COVID-19 Challenges: Using Remote and Hybrid Simulation Designs in DNP Programs
Authors: O’Brien Janet E. , Thrall Charlotte A. , Sebbens Danielle
Published: November 2021

Simulation is a critical component of nursing and medical education used to teach skills and assess student performance. In March 2020, faculty members—including the authors—at the Grace Center for Innovation in Nursing Education at the Edson College of Nursing and Health Innovation (Edson College) simulation programs at Arizona State University quickly responded to the crisis presented by COVID-19. Within a few days, all nursing simulations were transitioned from a predominately in-person design to fully online. Maintaining simulation activities throughout the first several months of the pandemic allowed students at Edson College to meet clinical assessment objectives. This transition, implemented in 2 phases, included a detailed plan of action for all Doctor of Nursing Practice (DNP) nurse practitioner objective structured clinical exams (OSCEs). The challenges required innovative planning and flexibility while maintaining the integrity of the OSCE and simulation experience. The methods implemented out of necessity are now an important part of the authors’ curricular toolbox, providing options for continued and future educational practice. This paper details the simulations designed and implemented in 2 DNP programs: the family nurse practitioner and acute care pediatric nurse practitioner programs.
An Innovative Academic Practice Model for Clinical Nursing Education During the COVID-19 Pandemic
Authors: Hahn-Schroeder Heidi , Honig Judy , Smith Candice , Chin Susan , Frazier Lorraine
Published: November 2021

In March of 2020, Columbia University School of Nursing (CUSON) Masters Direct Entry (MDE) program and New York Presbyterian Hospital (NYPH) created an innovative academic partnership to address the clinical needs of students and to help alleviate the burden of surging COVID-19 cases on nurses and the health care system. Through this partnership, students were hired as nurse technicians to assist with patient care during the first wave of the COVID-19 pandemic. As a result of this enhanced relationship, a pipeline of well-qualified graduate nurses with unique skills to adapt to a rapidly changing practice environment was created. Student participants in this opportunity developed an understanding of the organizational and leadership structures of the health care institution. The understanding of organizational and leadership structures will help transform the delivery of care.
Asia Now Surpasses Europe in Spine Research Productivity
Authors: Häckel Sonja , Phurtag Rinchen D. , Benneker Lorin M. , Liu Kara B. , Albers Christoph E. , Hoppe Sven , Bigdon Sebastian F. , Deml Moritz C.
Published: November 2021

Study Design.

Bibliometric review.

Objective.

This study aims to understand the worldwide research productivity trends in spine-related research over the past five decades.

Summary of Background Data.

Research productivity in the field of spine surgery has increased tremendously over the past decades. However, knowledge regarding the detailed regional disparity is limited.

Methods.

We evaluated original research articles published in four prestigious journals on spine research (European Spine Journal, Journal of Neurosurgery: Spine, Spine, and The Spine Journal) from 1976 to 2020. For 1 year of each decade, the origin of the first and the senior author was assigned to their region of origin. For the year 2020, a detailed analysis of countries and states of origin was performed, and the number of articles was normalized by registered MDs per country (per 10,000 population).

Results.

We included a total of 4436 articles and 8776 authors for analysis. From 1976 to 2020, the percentage of publications originating from North America decreased (77%–38%). In contrast, Asian contributions drastically increased (3%–36%), whereas articles originating from Europe only slightly raised (20%–22%). In 2020, the United States was the most productive country worldwide (34% with most articles from New York (19%), followed by China (16%) and Japan (10%). After normalization to registered MDs (per 10,000 population), the United States proved to have the highest number of articles. Besides this, India now ranked fourth and Egypt eighth in terms of the most productive countries per MDs.

Conclusion.

North America contributed the largest share of all articles published in the last five decades. Asia, which ranks second in 2020, has overtaken Europe. Normalization to registered MDs can be a helpful tool to reflect a country's research productivity more accurately.

Level of Evidence: 3
Effect of Mismatch Repair Status on Outcome of Early-Stage Grade 1 to 2 Endometrial Cancer Treated With Vaginal Brachytherapy
Authors: Russo Andrea L. , Lee Larissa J. , Wo Jennifer Y. , Niemierko Andrzej , Park Diane , Alban Gabriela , King Martin , Philp Lauren , Growdon Whitfield B. , Oliva Esther , Spriggs David R. , Yeku Oladapo O.
Published: November 2021

Objectives:

The objective of this study was to determine if deficiency of mismatch repair (dMMR) proteins in patients with early-stage favorable endometrial cancer treated with vaginal brachytherapy (VB) is associated with increased recurrence.

Materials and Methods:

A multi-institutional retrospective cohort study of 141 patients with stage I to II grade 1 and 2 endometrioid adenocarcinoma treated with surgery and adjuvant VB was performed to compare recurrence risk in dMMR (n=41) versus MMR-preserved (pMMR) (n=100). Additional clinical and pathologic risk factors were also collected. Univariate analysis and multivariable analysis Cox regression analysis was performed to identify factors associated with any recurrence. Kaplan-Meier method and log rank test were used to compare recurrence free survival and overall survival (OS).

Results:

Median follow up was 42 months. Forty-one patients (29%) were dMMR. There were 7 recurrences (17%) in dMMR versus 4 recurrences (4%) in pMMR (P=0.009). On univariate analysis of any recurrence, both dMMR (hazard ratio: 5.3, P=0.008) and stage (hazard ratio: 3.8, P=0.05) were statistically significantly associated with time to first recurrence. The 5-year recurrence free survival was 90% (95% CI: 73%-96%) in pMMR versus 61.0% (95% CI: 19%-86%) in dMMR (P=0.003). Five-year OS was 96% (95% CI: 76%-99%) in pMMR versus 86% (95% CI: 62%-95%) in dMMR (P=0.03).

Conclusions:

MMR deficiency in stage I to II grade 1 to 2 endometrial cancer patients treated with adjuvant VB alone was associated with statistically significant increased risk for any recurrence and worse OS. MMR status may be an important prognosticator in this cohort of patients warranting adjuvant treatment intensification in the clinical trial setting.
Fédération Nationale Des Centres de Lutte Contre Le Cancer (FNCLCC) Grading, Margin Status and Tumor Location Associate With Survival Outcomes in Malignant Peripheral Nerve Sheath Tumors
Authors: Wakeman Kristina M. , Zhang Qian S. , Bandhlish Anshu , Cranmer Lee D. , Ricciotti Robert W. , Mantilla Jose G.
Published: November 2021

Background:

Histologic grading using the Fédération Nationale des Centres de Lutte Contre Le Cancer (FNCLCC) system is not universally accepted as applicable to malignant peripheral nerve sheath tumor (MPNST), as its prognostic value is not well established.

Methods:

We retrospectively evaluated 99 cases of MPNST to investigate any association between the outcomes overall survival (OS) and progression-free survival (PFS), and predictor variables FNCLCC grade, clinical setting, tumor location, and tumor size at diagnosis using multivariable Cox proportional hazard analysis.

Results:

Univariable and multivariable analysis demonstrate a statistically significant association between FNCLCC grade and both OS and PFS when comparing tumors by histologic grade. Of note, no deaths were observed in patients with grade 1 MPNST. Other variables associated with unfavorable outcomes include fragmented resection and primary site, with tumors in the extremities having favorable OS, but not PFS, when compared with those in truncal locations. Tumors in the head and neck had favorable PFS, but not OS, compared with those in the trunk. No statistically significant differences in OS or PFS were observed when comparing patient age and sex, tumor size at diagnosis, clinical setting (primary vs. type-1 neurofibromatosis vs. radiation associated) or history of neoadjuvant therapy. Interobserver agreement for FNCLCC grading of these tumors was considered good (S*=0.77, 95% confidence interval: 0.71-0.84).

Conclusions:

Association between FNCLCC grading and survival outcomes in MPNST suggests potential value to routinely grading these neoplasms. However, the subjectivity of the grading system, particularly when assigning a tumor differentiation score, may pose a challenge, especially in low and intermediate grade lesions.
Dowling–Degos Disease Presenting With Associated Epidermal Inclusion Cysts: A Case Report and Review of the Literature
Authors: Marinelli Kathleen C. , Marinelli Lisa M. , Roberts Amanda M. , Lincoln Mark S.
Published: November 2021

Dowling–Degos Disease (DDD) is a rare and disfiguring autosomal dominant genodermatosis characterized by reticulate hyperpigmented macules or follicular comedone-like papules in the intertriginous areas that typically presents in the third or fourth decade of life. It is a progressive disease that is often treatment-resistant. Although its association with hidradenitis suppurativa has been well described, DDD has also been less commonly reported in conjunction with other dermatologic diseases with unknown etiologic associations. Herein, we present a case of DDD with associated epidermal inclusion cysts and conduct a literature review of dermatologic conditions reported in association with DDD.