bluuebunny/crossref_metadata_2025 huggingface dataset:
Medicinal cannabis in children and adolescents with autism spectrum disorder: A scoping review
Authors: Fletcher Sarah , Pawliuk Colleen , Ip Angie , Huh Linda , Rassekh S. Rod , Oberlander Tim F. , Siden Harold
Published: August 2021

Background

Autism spectrum disorder (ASD) is a neurodevelopmental condition estimated to affect 1 in 66 children in Canada and 1 in 270 individuals worldwide. As effective therapies for the management of ASD core and associated symptoms are limited, parents are increasingly turning to clinicians for advice regarding the use of medicinal cannabis to manage behavioural disturbances.

Objective

The objective of this scoping review was to identify and map symptoms, outcomes and adverse events related to medicinal cannabis treatment for ASD‐related behaviours.

Methods

Ovid MEDLINE, Embase, CINAHL, PsycInfo, Web of Science Core Collection, Google Scholar and grey literature sources were searched up to 5 January 2020 for studies. Included studies met the following criteria: (1) investigate the use of medicinal cannabis, (2) at least 50% participants had ASD, (3) at least 50% of the study population was 0–18 years old and (4) any study design (published or unpublished).

Results

We identified eight completed and five ongoing studies meeting the inclusion criteria. All studies reported substantial behaviour and symptom improvement on medicinal cannabis, with 61% to 93% of subjects showing benefit. In the three studies reporting on concomitant psychotropic medication usage and with cannabis use, up to 80% of participants observed a reduction in concurrent medication use. Adverse events related to cannabis use were reported in up to 27% of participants related, and two participants had psychotic events.

Conclusions

Early reports regarding medicinal cannabis in paediatric ASD symptom management are presented as positive; the evidence, however, is limited to very few retrospective cohort and observational studies. Evidence of safety and efficacy from prospective clinical trials is needed.
Kaposiform hemangioendothelioma further broadens the phenotype of PIK3CA‐related overgrowth spectrum
Authors: Carli Diana , Kalantari Silvia , Manicone Rosaria , Coppo Paola , Francia di Celle Paola , La Selva Roberta , Santoro Federica , Ranieri Carlotta , Cardaropoli Simona , Fagioli Franca , Ferrero Giovanni Battista , Resta Nicoletta , Mussa Alessandro
Published: August 2021

Kaposiform hemangioendothelioma (KHE) is a rare locally aggressive mixed vascular tumor, with typical onset in early childhood and characterized by progressive angio‐ and lymphangiogenesis. Its etiopathogenesis and molecular bases are still unclear. Here, we report the first case of congenital KHE harboring a PIK3CA mosaic pathogenic variant (c.323G > A, p.Arg108His) in a boy with very subtle PIK3CA‐related overgrowth spectrum (PROS) features. This finding provides insights into the pathophysiology of KHE, offering targeted therapeutic options by inhibition of the PI3K/Akt/mTOR pathway. We propose the inclusion of this mixed lymphatic and vascular anomaly within the PROS.
Fetal surgery for spina bifida: a great success story in surgical innovation
Authors: Joyeux Luc , Belfort Michael A
Published: August 2021

This commentary is on the original articles by Worley et al. on pages 1294–1301 and Hepp et al. on pages 1302–1307 of this issue.
AlasdairMacIntyre, universities, and the common good
Authors: Smith Nicholas H. , Dunstall Andrew
Published: August 2021

Best known as a political philosopher, Alasdair MacIntyre is also a critic of the modern university. The paper examines the grounds of MacIntyre's criticism of modern universities; it offers an assessment of the philosophical debate occasioned by MacIntyre's writings on the topic; and it proposes a way of taking this debate forward. The debate is shown to be centered around three objections to MacIntyre's normative idea of the university: that it is overly intellectualist, parochial, and moralizing. The merits of these objections are considered and a different interpretation of the normative core of MacIntyre's conception of the university is presented: realization and promotion of the common good. An analysis is offered of the kinds of common good universities may serve to realize, including practices internal to the institution, education of a public, and flourishing relationships in various social roles. The implications of this neo‐Aristotelian analysis of the normative core of universities are also shown to be at odds with some of MacIntyre's explicitly stated views on the role of universities in forming an educated pubic and educating students for work.
Lesion features on magnetic resonance imaging discriminate multiple sclerosis patients
Authors: Hurtado Rúa Sandra M. , Kaunzner Ulrike W. , Pandya Sneha , Sweeney Elizabeth , Tozlu Ceren , Kuceyeski Amy , Nguyen Thanh D. , Gauthier Susan A.
Published: August 2021

Background

Magnetic resonance imaging (MRI) provides insight into various pathological processes in multiple sclerosis (MS) and may provide insight into patterns of damage among patients.

Objective

We sought to determine if MRI features have clinical discriminative power among a cohort of MS patients.

Methods

Ninety‐six relapsing remitting and seven progressive MS patients underwent myelin water fraction (MWF) imaging and conventional MRI for cortical thickness and thalamic volume. Patients were clustered based on lesion level MRI features using an agglomerative hierarchical clustering algorithm based on principal component analysis (PCA).

Results

One hundred and three patients with 1689 MS lesions were analyzed. PCA on MRI features demonstrated that lesion MWF and volume distributions (characterized by 25th, 50th, and 75th percentiles) accounted for 87% of the total variability based on four principal components. The best hierarchical cluster confirmed two distinct patient clusters. The clustering features in order of importance were lesion median MWF, MWF 25th, MWF 75th, volume 75th percentiles, median individual lesion volume, total lesion volume, cortical thickness, and thalamic volume (all p values <0.01368). The clusters were associated with patient Expanded Disability Status Scale (EDSS) (n = 103, p = 0.0338) at baseline and at 5 years (n = 72, p = 0.0337).

Conclusions

These results demonstrate that individual MRI features can identify two patient clusters driven by lesion‐based values, and our unique approach is an analysis blinded to clinical variables. The two distinct clusters exhibit MWF differences, most likely representing individual remyelination capabilities among different patient groups. These findings support the concept of patient‐specific pathophysiological processes and may guide future therapeutic approaches.
Enhancing the population of the encounter complex affects protein complex formation efficiency
Authors: Di Savino Antonella , Foerster Johannes M. , Ullmann G. Matthias , Ubbink Marcellus
Published: August 2021

Optimal charge distribution is considered to be important for efficient formation of protein complexes. Electrostatic interactions guide encounter complex formation that precedes the formation of an active protein complex. However, disturbing the optimized distribution by introduction of extra charged patches on cytochrome c peroxidase does not lead to a reduction in productive encounters with its partner cytochrome c. To test whether a complex with a high population of encounter complex is more easily affected by suboptimal charge distribution, the interactions of cytochrome c mutant R13A with wild‐type cytochrome c peroxidase and a variant with an additional negative patch were studied. The complex of the peroxidase and cytochrome c R13A was reported to have an encounter state population of 80%, compared to 30% for the wild‐type cytochrome c. NMR analysis confirms the dynamic nature of the interaction and demonstrates that the mutant cytochrome c samples the introduced negative patch. Kinetic experiments show that productive complex formation is fivefold to sevenfold slower at moderate and high ionic strength values for cytochrome c R13A but the association rate is not affected by the additional negative patch on cytochrome c peroxidase, showing that the total charge on the protein surface can compensate for less optimal charge distribution. At low ionic strength (44 mm), the association with the mutant cytochrome c reaches the same high rates as found for wild‐type cytochrome c, approaching the diffusion limit.
Various parameters of the multiaxial variable amplitude loading and their effect on fatigue life and fatigue life computation
Authors: Papuga Jan , Margetin Matúš , Chmelko Vladimír
Published: August 2021

The paper discusses various partial solutions used for estimating fatigue life under variable amplitude multiaxial loading in the high‐cycle fatigue domain. The concurring effects are treated, and their proposed solutions are commented upon. The major focus is on the categories of the phase shift effect and of cycle counting and on the scope and quality of data, which support discussed theories. Results of own new experimental data set on specimens from S355 steel are provided. Fatigue life estimates for McDiarmid and Findley multiaxial methods and for two different methods of load path decomposition to cycles are shown to highlight some of the points open for discussion. It is concluded that the available experimental data are not sufficient to substantiate a clear decision to follow a definite algorithm.
In praise of Geography as a field of study for the climate emergency
Authors: Taylor Peter J. , O’Keefe Phil
Published: August 2021

We argue that Geography should be centre stage for understanding today's climate emergency. It warrants this position because as a field of study it uniquely straddles physical/environmental and human/social scholarships. In the wider academic world, bringing together scholars across this “cultural” divide has traditionally been difficult, and continues to be so in current responses to human‐induced climate change. Specifically, physical scholarship and science dominate at the expense of social scholarship and science. But it is now widely recognised we are living in a time of climate emergency and this simply will not do. Geography as a field of study that bridges these two forms of knowledge has the potential to become strategically relevant in this situation. The concept of risk that links environment and people from the Natural Hazards paradigm is identified as a way in which a holistic Geography can take an important lead in worldwide scholarly inputs into anthropogenic climate change understanding and consequent policy development.
Immune tolerance induction in severe haemophilia A: A UKHCDO inhibitor and paediatric working party consensus update
Authors: Hart Daniel P. , Alamelu Jayanthi , Bhatnagar Neha , Biss Tina , Collins Peter W. , Hall Georgina , Hay Charles , Liesner Ri , Makris Michael , Mathias Mary , Motwani Jayashree , Palmer Ben , Payne Jeanette , Percy Charles , Richards Michael , Riddell Anne , Talks Kate , Tunstall Oliver , Chalmers Elizabeth
Published: August 2021

Introduction

In good risk patients (historic inhibitor peak < 200BU), the International Immune Tolerance Study demonstrated equal efficacy to induce tolerance between high (200iu/kg/day) and low dose (50iu/kg ×3 times/week) immune tolerance induction (ITI) regimens. However, the trial stopped early on account of the excessive bleed rate in the low dose ITI arm.

Methods

United Kingdom Haemophilia Centre Doctors’ Organization (UKHCDO) Paediatric and Inhibitor working parties considered available ITI data alongside the bi‐phenotypic antibody emicizumab (Hemlibra®) efficacy and safety data to develop a consensus guideline for the future UK ITI guideline.

Results

This revision of UKHCDO ITI guidance incorporates the recommendation to use emicizumab as a prophylaxis haemostatic agent to reduce bleeding rates and to facilitate low dose and reduced frequency of FVIII CFC for ITI in the majority of children.

Conclusion

This consensus protocol will facilitate future evaluation of ITI outcomes in the evolving landscape of haemophilia therapeutics and ITI strategies.
Experiences of self‐care during the COVID‐19 pandemic among individuals with rheumatoid arthritis: A qualitative study
Authors: Leese Jenny , Backman Catherine L. , Ma Jasmin K. , Koehn Cheryl , Hoens Alison M. , English Kelly , Davidson Eileen , McQuitty Shanon , Gavin James , Adams Jo , Therrien Stephanie , Li Linda C.
Published: August 2021

Objectives

This study aimed to explore the impact of the coronavirus disease 2019 (COVID‐19) pandemic on self‐care of individuals living with rheumatoid arthritis (RA).

Methods

Guided by a constructivist, qualitative design, we conducted one‐to‐one in‐depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized‐controlled trials. An inductive, reflexive thematic analysis approach was used.

Results

Twenty‐six participants (aged 27–73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self‐care describes how participants took measures to continue self‐care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self‐care. (2) Managing emotions describes resilience‐building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic.

Conclusion

The insights gained may inform clinicians and researchers on ways to support the self‐care strategies of individuals with RA and other chronic illnesses during and after the COVID‐19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care.

Patient or Public Contribution

This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.
Rapid synthesis of YAG phosphor by facile mechanical method
Authors: Kondo Akira , Kozawa Takahiro , Ishikawa Toshihiro , Naito Makio
Published: August 2021

In this study, synthesis of yttrium aluminum garnet (YAG):Ce3+ phosphor powders for white light emitting diodes was investigated by mechanical method using the attrition‐type mill with no external heating and no flux in dry phase. High mechanical energy input to the starting powder mixture of Y2O3, Al2O3 and CeO2 achieved the synthesis of YAG:Ce3+ without any flux materials. X‐ray diffraction patterns of the processed powders after 5 min processing revealed the peaks of YAG were clearly identified. The maximum temperature of the mill chamber during the processing was 240℃. The YAG phosphor obtained by the mechanical method revealed the internal quantum yield of 65% in the case of the sample mechanically processed under a reducing atmosphere. The synthesized powder showed granule structure consisting of submicron size of YAG particles, which is better handling for the fabrication of light emitting diode devices.
The role of ethnicity in whistleblowing: The case of Kenyan auditors
Authors: Hellmann Andreas , Endrawes Medhat , Mbuki Jane
Published: August 2021

We examine whether ethnicity influences the ethical evaluation of an auditor's willingness (or unwillingness) to engage in whistleblowing. Utilising the concepts of ethnic identity and construal of self, we asked Kenyan auditors to assess an ethical dilemma in which auditors and wrongdoers belong to the same or a different ethnic group. We found that ethnic identity has no significant effect on an auditor's ethical evaluation of remaining silent if both the wrongdoer and potential whistleblower are from the same ethnic group. However, there is a significant effect on the ethical evaluation of whistleblowing if the wrongdoer is from a different ethnic group. We found that auditors with an interdependent construal of self are more likely to perceive as ethical the decision to remain silent if the wrongdoer is a member of their own ethnic group, but this finding did not hold when the wrongdoer is from a different ethnic group.
Parenting stress, self‐efficacy and COVID‐19 health risks as predictors of general stress among nurses
Authors: Garcia Aileen S. , Carotta Christin L. , Brown Robin , Da Rosa Patricia , Pravecek Brandi , Carson Paula
Published: August 2021

Aim

The purpose of the study was to examine the influence of parenting stress, self‐efficacy and COVID‐19 health risks on general stress among nurses in the Midwest, United States, during the pandemic.

Background

As frontline workers amidst the coronavirus disease 2019 (COVID‐19) pandemic, nurses have been subject to stressors at home and at work.

Method

This quantitative, cross‐sectional study included 896 nurses with at least one child below 18 years of age. Using purposive sampling, participants answered an online survey composed of demographic questions, perception of COVID‐19 health risks, measures of self‐efficacy, general stress and parenting stress. Bivariate correlation and multiple regression were conducted. Data were collected from July 13 to August 13, 2020.

Results

The four predictors, along with eight demographic covariates, accounted for 40% of the variance in general stress. Parenting stress and COVID‐19 health risks were positively related to general stress, while self‐efficacy was negatively associated with general stress.

Conclusions

Results highlight the negative influence of parenting stress on nurses' general stress and the importance of self‐efficacy in reducing stress. Findings suggest that support services for nurses should focus not only on work‐related stressors but also consider parenting stressors, work‐home imbalances and self‐efficacy.
DC resistance degradation of SrTiO3: The role of virtual‐cathode needles and oxygen bubbles
Authors: Alvarez Ana , Chen I‐Wei
Published: August 2021

This study of highly accelerated lifetime tests of SrTiO3, a model semiconducting oxide, is motivated by the interest in reliable multilayer ceramic capacitors and resistance‐switching thin‐film devices. Our analytical solution to oxygen‐vacancy migration under a DC voltage—the cause of resistance degradation in SrTiO3—agrees with previous numerical solutions. Yet all solutions fail to explain why degradation kinetics feature a very strong voltage dependence, which we attribute to the nucleation and growth of cathode‐initiated fast‐conducting needles. While they have no color contrast in SrTiO3 single crystals, hence nominally “invisible,” needle’s presence in DC‐degraded samples—in silicone oil and in air—was unambiguously revealed by in‐situ hot‐stage photography. Observations in silicone oil and thermodynamic and kinetic considerations further revealed that copious oxygen bubbling and general reduction mark the onset of final accelerating degradation toward failure. Conversely, if oxygen vacancies cannot be sufficiently depleted from the near‐anode region to render it sufficiently conductive, then final failure is postponed, which is often the case at lower temperatures and voltages when the lifetime tests are incomplete. Remarkably, both undoped and Fe‐doped SrTiO3 can emit electroluminescence at higher current densities, thus providing a vivid indicator of resistance degradation and a metal‐to‐insulator resistance transition during cooling. The implications of these findings to thin ceramic and thin‐film SrTiO3 devices are discussed, along with connections to similarly DC‐degraded fast‐ion yttria‐stabilized zirconia.
The effect of left atrial appendage closure on heart failure biomarkers: A PRAGUE‐17 trial subanalysis
Authors: Herman Dalibor , Osmancik Pavel , Neuzil Petr , Hala Pavel , Lekesova Veronika , Benesova Klara , Hozman Marek , Jarkovsky Jiri , Novackova Martina , Widimsky Petr , Reddy Vivek Y. ,   PRAGUE‐17 Trial Investigators
Published: August 2021

Introduction

The randomized PRAGUE‐17 trial demonstrated noninferiority of left atrial appendage closure (LAAC) to non‐vitamin K anticoagulants (NOACs) for the prevention of major cardiovascular or cerebrovascular events. However, the left atrial appendage is an important source of natriuretic peptides and plays a role in left atrial reservoir function. Changes of heart failure (HF) biomarkers after LAAC compared to NOAC has not been studied. The aim of the study was to compare the changes in concentrations of HF biomarkers between LAAC and NOAC patients.

Methods

Of 402 patients randomized in the PRAGUE‐17 trial, biomarkers were analyzed in 144 patients (73 in the NOAC and 71 in the LAAC group). Both groups had similar baseline characteristics. Serum concentration of NT‐proBNP, NT‐proANP, Galectin‐3, and GDF‐15 were measured at baseline (before the procedure in the LAAC group), at the 6‐month (and at 24‐month for NT‐proBNP) follow‐up timepoint.

Results

There were no significant differences in baseline, 6 month, and delta (δ = baseline − 6 month) concentrations of NT‐proANP between the groups (NOAC: baseline 2.6 [0.5; 4.9], 6‐month 3.1 [1.8; 4.8], p = .068; LAAC: baseline 3.3 [1.1; 4.6], 6‐month 2.6 [0.9; 5.3], p = .51; p value for δ in concentrations between groups = 0.42). Similarly, there were no significant differences in baseline, 6, 24 months, and delta concentrations of NT‐proBNP between the groups (NOAC: baseline 461.0 [113.5; 1342.0], 6 month 440.0 [120.5; 1291.5], 24 month 798 [274; 2236], p = .39; LAAC: baseline 421.0 [100.0; 1320.0], 6 month 601.0 [145.0; 1230.0], 24 month 855 [410; 1367], p = .28; p value for δ in concentrations between groups = 0.73 at 6 months, and 0.58 at 24 months). Finally, no significant differences were present in baseline, 6 month, and δ concentrations of Galectin‐3 and GDF‐15 between the two groups.

Conclusion

LAAC did not significantly influence the levels of HF biomarkers 6 months after the procedure.
Incidence and risk factors of severe non‐proliferative/proliferative diabetic retinopathy: More than a decade follow up in the Tehran Lipids and Glucose Study
Authors: Sardarinia Mahsa , Asgari Samaneh , Hizomi Arani Reyhane , Eskandari Fatemeh , Azizi Fereidoun , Khalili Davood , Hadaegh Farzad
Published: August 2021

Aims/Introduction

To examine the incidence rate of severe non‐proliferative and proliferative diabetic retinopathy (severe‐NPDR/PDR) and determine its potential risk factors.

Materials and Methods

The study consisted of 1,169 participants (675 women) with type 2 diabetes mellitus, aged ≥20 years. A trained interviewer collected information about the history of pan‐retinal photocoagulation as a result of diabetic retinopathy. Multivariable Cox proportional hazards regression models were applied.

Results

We found 187 cases (126 women) of severe‐NPDR/PDR during a median follow‐up period of 12.7 years; the corresponding incidence rate was 13.6 per 1,000 person‐years. Being overweight (hazard ratio [HR], 95% confidence interval [CI] 0.60, 0.39–0.92) and obese (HR 0.48, 95% CI 0.27–0.83) were associated with lower risk, whereas being smoker (HR 1.75, 95% CI 1.12–2.74), having fasting plasma glucose levels 7.22–10.0 mmol/L (HR 2.81, 95% CI 1.70–4.62), fasting plasma glucose ≥10 mmol/L (HR 5.87, 95% CI 3.67–9.41), taking glucose‐lowering medications (HR 2.58, 95% CI 1.87–3.56), prehypertension status (HR 1.65, 95% CI 1.05–2.58) and newly diagnosed hypertension (HR 1.96, 95% CI 1.06–3.65) increased the risk of severe‐NPDR/PDR. Among newly diagnosed diabetes patients, being male was associated with a 59% lower risk of severe‐NPDR/PDR (HR 0.41, 95% CI 0.21–0.79). Furthermore, patients who had an intermediate level of education (6–12 years) had a higher risk of developing PDR (HR 1.86, 95% CI 1.05–3.30) compared with those who had <6 years of education.

Conclusions

Among Iranians with type 2 diabetes mellitus, 1.36% developed severe‐NPDR/PDR annually. Normal bodyweight, being a smoker, out of target fasting plasma glucose level, prehypertension and newly diagnosed hypertension status were independent risk factors of severe‐NPDR/PDR. Regarding the sight‐threatening entity of advanced diabetic retinopathy, the multicomponent strategy to control diabetes, abstinence of smoking and tight control of blood pressure should be considered.
Secular trend of treatment uptake in patients with chronic hepatitis B: A territory‐wide study of 135 395 patients from 2000 to 2017
Authors: Lai Jimmy C‐T , Wong Vincent W‐S , Yip Terry C‐F , Hui Vicki W‐K , Tse Yee‐Kit , Lee Hye‐Won , Liang Lilian Y , Lui Grace C‐Y , Chan Henry L‐Y , Wong Grace L‐H
Published: August 2021

Background and Aims

The uptake of antiviral treatment for patients with chronic hepatitis B (CHB) has been suboptimal. We aimed to determine the secular trend of treatment uptake in the territory‐wide CHB cohort in Hong Kong from 2000 to 2017 and the factors for no treatment despite fulfilling treatment criteria.

Methods

Chronic hepatitis B patients under public clinics and hospitals were identified through electronic medical records. The treatment indications were defined according to the Asian‐Pacific guidelines published at the time of patients' first appearance in four periods: 2000–2004, 2005–2009, 2010–2013, and 2014–2017.

Results

There were 135 395 CHB patients were included; 1493/12472 (12.0%), 7416/43426 (17.1%), 10 129/46559 (21.8%), 8051/32 938 (24.4%) patients fulfilled treatment criteria in the four periods, respectively. The treatment uptake rate increased with time: 35.1%, 43.4%, 60.2%, and 68.6% respectively.

High fibrosis indices (APRI, FIB‐4, and Forns indices) appeared to be the main factors for treatment indication in non‐cirrhotic patients, with over 90% fulfilling treatment criteria due to high fibrosis indices alone. Of those fulfilling treatment criteria by high fibrosis indices, less than 60% of patients (25.2%, 36.1%, 46.0%, and 58.9%, respectively) had antiviral treatment initiated. Normal platelet count (odds ratio 0.42, P < 0.001) was the independent factor associated with not initiating antiviral treatment in patients fulfilling treatment criteria.

Conclusions

Treatment uptake rates have been increasing over time. Normal platelet count, which reflects less advanced liver disease, precludes patients from receiving antiviral treatment even if treatment indication is fulfilled. Hence, the importance to identify non‐cirrhotic patients with significant liver fibrosis should be emphasized.
Genetic diversity in a long‐lived mammal is explained by the past’s demographic shadow and current connectivity
Authors: Lehnen Lisa , Jan Pierre‐Loup , Besnard Anne‐Laure , Fourcy Damien , Kerth Gerald , Biedermann Martin , Nyssen Pierrette , Schorcht Wigbert , Petit Eric J. , Puechmaille Sebastien J.
Published: August 2021

Within‐species genetic diversity is crucial for the persistence and integrity of populations and ecosystems. Conservation actions require an understanding of factors influencing genetic diversity, especially in the context of global change. Both population size and connectivity are factors greatly influencing genetic diversity; the relative importance of these factors can, however, change through time. Hence, quantifying the degree to which population size or genetic connectivity are shaping genetic diversity, and at which ecological time scale (past or present), is challenging, yet essential for the development of efficient conservation strategies. In this study, we estimated the genetic diversity of 42 colonies of Rhinolophus hipposideros, a long‐lived mammal vulnerable to global change, sampling locations spanning its continental northern range. Here, we present an integrative approach that disentangles and quantifies the contribution of different connectivity measures in addition to contemporary colony size and historic bottlenecks in shaping genetic diversity. In our study, the best model explained 64% of the variation in genetic diversity. It included historic bottlenecks, contemporary colony size, connectivity and a negative interaction between the latter two. Contemporary connectivity explained most genetic diversity when considering a 65 km radius around the focal colonies, emphasizing the large geographic scale at which the positive impact of connectivity on genetic diversity is most profound and hence, the minimum scale at which conservation should be planned. Our results highlight that the relative importance of the two main factors shaping genetic diversity varies through time, emphasizing the relevance of disentangling them to ensure appropriate conservation strategies.
The effects of dispersal on spatial synchrony in metapopulations differ by timescale
Authors: Luo Mingyu , Reuman Daniel C. , Hallett Lauren M. , Shoemaker Lauren , Zhao Lei , Castorani Max C. N. , Dudney Joan C. , Gherardi Laureano A. , Rypel Andrew L. , Sheppard Lawrence W. , Walter Jonathan A. , Wang Shaopeng
Published: August 2021

Understanding the processes that stabilize species populations is a fundamental question in ecology and central to conservation biology. In metapopulations, dispersal can act as a ‘double edged' sword for species stability by simultaneously decreasing local population variability (thereby decreasing local extinction risk) while increasing spatial synchrony (thereby increasing landscape‐level extinction risk). These dynamics may operate at different timescales, complicating efforts to assess their relative importance for long‐term stability. Here, we use a simple metapopulation model to understand how dispersal affects population variability and spatial synchrony across timescales. Our model shows that dispersal has contrasting effects at short versus long timescales on the variability and synchrony of populations. For populations that exhibit slow recovery when perturbed (i.e. under‐compensatory growth), dispersal decreases local population variability while increasing spatial synchrony at long timescales. In contrast, at short timescales dispersal increases local population variability while decreasing spatial synchrony. For populations that recover via damped oscillation when perturbed (i.e. over‐compensatory growth), the effects of dispersal are all opposite to those for populations with under‐compensatory growth, at both short and long timescales. The timescale‐dependent effect of dispersal has important implications for empirical studies. Specifically, studies conducted over short periods may only observe population variability increasing and spatial synchrony decreasing with dispersal, whereas the opposite patterns may predominate over longer periods. Our results provide novel insights on the dynamics underlying the role of dispersal and highlight the importance of time series length in empirical studies of metapopulations.
Ecological consequences of urbanization on a legume–rhizobia mutualism
Authors: Murray‐Stoker David , Johnson Marc T. J.
Published: August 2021

Mutualisms are key determinants of community assembly and composition, but urbanization can alter the dynamics of these interactions and associated effects on ecosystem functions. Legume–rhizobia mutualisms are a model interaction to evaluate the ecological and ecosystem‐level effects of urbanization, particularly urban‐driven eutrophication and nitrogen (N) deposition. Here, we evaluated how urbanization affected the ecology of the mutualism between white cloverTrifolium repensand its rhizobial symbiontRhizobium leguminosarumsymbiovartrifoliialong an urbanization gradient. We found that the abundance of rhizobium nodules on white clover decreased with urbanization. White clover acquired N from mixed sources of N fixation and uptake from the soil for the majority of the urbanization gradient, but white clover primarily acquired N from the soil rather than N fixation by rhizobia at the urban and rural limits of the gradient. Importantly, we identified soil N as a critical nexus for urban‐driven changes in the white clover–rhizobium mutualism. Taken together, our results demonstrate that urbanization alters the ecological consequences of a legume–rhizobium mutualism, with direct and indirect effects of the urban landscape on an ecologically‐important mutualistic interaction.
Phenotypic plasticity may mediate habitat filtering in a forest edge community
Authors: Gianoli Ernesto , Escobedo Víctor M.
Published: August 2021

A key process determining community assembly is habitat filtering, which reduces the range of trait values and thus leads to trait convergence. Habitat filtering is often assumed to involve a reduction in species richness, but such trait convergence could also result from phenotypic plasticity. By allowing more species in the community to show the ‘right' phenotype and pass the filter, phenotypic plasticity could maintain species richness despite trait convergence. If phenotypic plasticity plays this role, environmental changes should modify trait distribution but not species composition or richness. We tested this hypothesis in a forest edge community recently invaded by the alien shrub Rubus praecox. We measured functional traits beneath Rubus canopy (Rubus‐invaded community) and in adjacent microsites naturally free from Rubus (original community), comparing trait dispersion and community structure parameters. We also characterized the microenvironments to seek functional explanations for the observed phenotypic changes. The functional dispersion parameter FDis showed habitat filtering in the Rubus‐invaded community (trait convergence), while in the original community it did not differ from a null model. Species richness and composition did not differ between the two communities. Soil characteristics were similar in both communities but light availability was greatly reduced in the Rubus‐invaded community. A principal component analysis of community‐weighted means of functional traits showed that phenotypic changes between communities were mostly consistent with functional responses to shading, including an increase in specific leaf area and a reduction in flavonoid concentration in the Rubus‐invaded community. We verified the conditions necessary to infer that phenotypic plasticity mediates the outcome of habitat filtering driven by Rubus in the study system, i.e. plasticity would explain species persistence despite trait convergence. Phenotypic plasticity, often subsumed within intraspecific variation in community assembly studies, should be considered individually to improve our understanding of the causes and consequences of habitat filtering.
Paradoxical psoriasis in pediatric patients: A systematic review
Authors: Cyrenne Benoit M. , Parpia Alyssa S. , Sibbald Cathryn
Published: August 2021

Background

Paradoxical psoriasis occurs in pediatric patients following treatment with biologic agents. These presentations are not well described, and optimal treatment strategies have not been established.

Objective

To describe the reported rates, demographic characteristics, clinical presentation, and treatment options for TNF‐α inhibitor–induced psoriasis.

Methods

Systematic review of published cases and cohort studies of paradoxical psoriasis induced by biologic agents, with specific reference to TNF‐α inhibitors.

Results

We identified 4564 pediatric patients treated with TNF‐α inhibitors, of whom 210 (4.6%) developed paradoxical psoriasis. Infliximab was the drug most likely to induce psoriasis (8.3%), followed by adalimumab (3.3%). Individual‐level data were acquired from 129 individuals with a mean age of 13.6 years (SD: 4.0); 45.0% were male. The scalp was the most commonly affected area (47.5%), followed by the ears (30.8%). Most (63.3%) patients were continued on TNF‐α inhibitor therapy. Among those who switched TNF‐α inhibitors, only 32.0% had complete clearance of their skin lesions. Among patients who were switched to a non‐TNF‐α inhibitor, 81% had complete clearance of their paradoxical psoriasis.

Limitations

Data were acquired from retrospective studies including case reports and case series.

Conclusion

TNF‐α inhibitor–induced psoriasis is a common adverse effect; however, most patients can continue their original therapy and be managed with skin‐directed topical or systemic medications. If a patient requires medication discontinuation, switching to a new TNF‐α inhibitor is unlikely to lead to resolution of their skin lesions.
Apical‐root apoplastic acidification affects cell wall extensibility in wheat under salinity stress
Authors: Shao Yang , Feng Xiaohui , Nakahara Hiroki , Irshad Muhammad , Eneji A. Egrinya , Zheng Yuanrun , Fujimaki Haruyuki , An Ping
Published: August 2021

Plant salt tolerance is associated with a high rate of root growth. Although root growth is governed by cell wall and apoplastic pH, the relationship between these factors in the root elongation zone under salinity stress remains unclear. Herein, we assess apoplastic pH, pH‐ and expansin‐dependent cell wall extensibility, and expansin expression in the root elongation zone of salt‐sensitive (Yongliang‐15) and ‐tolerant (JS‐7) cultivars under salinity stress. A six‐day 80 mM NaCl treatment significantly reduced apical root apoplastic pH in both cultivars. Using a pH‐dependent cell wall extensibility experiment, we found that, under 0 mM NaCl treatment, the optimal pH for cell wall loosening was 6.0 in the salinity‐tolerant cultivar and 4.6 in the salinity‐sensitive cultivar. Under 80 mM treatment, a pH of 5.0 mitigated the cell wall stiffness caused by salinity stress in the salinity‐tolerant cultivar but promoted cell wall stiffening in the salinity‐sensitive cultivar. Salinity stress altered expansin expression and differentially affecting cell wall extensibility under pH 5.0 and 6.0. TaEXPA8 might be relative to cell wall loosening at pH 5.0, whereas TaEXPA5 relative to cell wall loosening at pH 6.0. These results elucidate the relationship between expansins and cell wall extensibility in the root elongation zone, with important implications for enhancing plant growth under salinity stress.
Extracellular vesicles of bovine small follicular fluid promote ovarian cortical stromal cell proliferation and steroidogenesis
Authors: Ying Wang , Hengqin Wang , Xiaomei Wang , Yunqi Zhao , Yong Zhang , Fusheng Quan
Published: August 2021

The aim of this study was to investigate the effects of extracellular vesicles (EVs) on the proliferation and steroid hormone synthesis of bovine ovarian cortical stromal cells in vitro. The release and uptake of EVs are the new mechanisms of cell‐to‐cell communication. Using reverse transcriptase polymerase chain reaction, enzyme‐linked immunosorbent assay, TUNEL and other experiments, we found that EVs in bovine follicular fluid can promote the proliferation and synthesis of androstenedione and progesterone in ovarian cortical stromal cells. Moreover, 100 μg/ml EVs caused the most significant effect. We conclude that EVs at 100 μg/ml can significantly promote the proliferation and synthesis of androstenedione and progesterone in ovarian cortical stromal cells. This research is of great significance for further elucidating the regulatory role of follicular fluid EVs in follicular development and atresia and for research on the interaction of ovarian stromal cells, granulosa cells and oocytes.
Using GIS to Understand the Influence of Hurricane Harvey on Spatial Access to Primary Care
Authors: Kar Armita , Wan Neng , Cova Thomas J. , Wang Hongmei , Lizotte Steven L.
Published: August 2021

Hurricanes can have a significant impact on the functioning and capacity of healthcare systems. However, little work has been done to understand the extent to which hurricanes influence local residents’ spatial access to healthcare. Our study evaluates the change in spatial access to primary care physicians (PCPs) between 2016 and 2018 (i.e., before and after Hurricane Harvey) in Harris County, Texas. We used an enhanced 2‐step floating catchment area (E2SFCA) method to measure spatial access to PCPs at the census tract level. The results show that, despite an increased supply of PCPs across the county, most census tracts, especially those in the northern and eastern fringe areas, experienced decreased access during this period as measured by the spatial access ratio (SPAR). We explain this decline in SPAR by the shift in the spatial distribution of PCPs to the central areas of Harris County from the fringe areas after Harvey. We also examined the socio‐demographic impact in the SPAR change and found little variation in change among different socio‐demographic groups. Therefore, public health professionals and disaster managers may use our spatial access measure to highlight the geographic disparities in healthcare systems. In addition, we recommend considering other social and institutional dimensions of access, such as users’ needs, preferences, resource capacity, mobility options, and quality of healthcare services, in building a resilient and inclusive post‐hurricane healthcare system.
‘We experienced lack of understanding in the healthcare system’. Experiences of childhood sexual abuse survivors of the childbearing process, health and motherhood
Authors: Jonsdottir Inga Vala , Sigurdardottir Sigrun , Halldorsdottir Sigridur , Jonsdottir Sigridur Sia
Published: August 2021

Background

Childhood sexual abuse (CSA) has widespread and long‐lasting impact on women's lives and health. Increased knowledge and deeper understanding are needed of survivors’ experiences of the childbearing process, health and motherhood.

Methods

In this phenomenological study, 16 in‐depth interviews were conducted with nine female CSA survivors. The interviews were recorded, transcribed verbatim and thematically analysed.

Results

The overarching theme of the study is: ‘more understanding is needed’, which refers to the participants’ experience that greater understanding is needed from health professionals of the long‐term effects of CSA on childbearing women. Most of the women had suffered from poor health, especially chronic pain associated with fibromyalgia and gynaecological diseases. All of them had suffered mental health consequences particularly anxiety, depression and PTSD. The majority had experienced flashbacks to the violence and disassociation. Many had experienced miscarriages, had deviations from normal pregnancies and births, such as prolonged labour, caesarean sections, induction of labour, vacuum extraction, bleeding and exaggerated pregnancy problems, such as great nausea and pelvic pain. All but one had a negative experience in one of their births. All of them had experienced a lack of understanding in the healthcare system, perceived abuse of power and felt vulnerable in those situations. All of them had a strong need for a sense of control and participation in decision‐making in the childbearing process. Most of them had experienced problems in bonding with their children and some have had difficulties touching them. All of them were in dire need of protecting their children from potential violence and many expressed a tendency to overprotect them.

Conclusions

Healthcare professionals need to have more knowledge and greater understanding of how healthcare services can be improved so that CSA survivors can have a better experience of the childbearing process.
Elevated carbon dioxide and temperature effects on soil properties from sole crops and intercrops
Authors: Oelbermann Maren , Morgan Svenja , Echarte Laura
Published: August 2021

Climate change is associated with more intense phases of heat, drought or precipitation that can have a negative impact on soil properties. Our goal was to understand if elevated CO2 (eCO2) and temperature (eT), and a multicomponent (eCO2eT) climate effect will influence soil properties from cereal‐legume intercrops differently compared to sole crops. We hypothesized that cereal‐legume intercrops can regulate climate effects, causing soil properties and greenhouse gas fluxes to be similar to ambient climate conditions. eT and eCO2eT decreased soil organic carbon (C) (p = .001) and nitrogen (N) (p = .003) but increased (p = .011) soil nitrate in all crop systems, compared to ambient conditions. For crop systems, soil ammonium was lower (p = .001) with all climate effects, but nitrate was greater (p = .011) with eCO2 and eCO2eT compared to ambient conditions. The microbial community had a preferential (p = .024) consumption of C3 sources in the sole crops. Climate effects also influenced how C and N were accessed by microbes in all crop systems, shifting (p = .001) species richness and microbial community structure. CO2 fluxes were greater (p = .001) with eT and eCO2, whereas N2O fluxes were greater (p = .005) with eCO2 and eCO2eT. However, greenhouse gas fluxes from the intercrop were similar between eT or eCO2eT and ambient conditions. For soil properties, we rejected our hypothesis since cereal‐legume intercrops did not have an advantage over sole crops to cope with single‐ and multicomponent climate effects, but we partially accepted our hypothesis since greenhouse gas fluxes were similar between AMB and eT or eCO2eT.
The novel HLA‐DRB1*15:01:42 allele was identified by next‐generation sequencing
Authors: He Yanmin , You Xuan , Tao Sudan , He Ji , Zhu Faming
Published: August 2021

HLA‐DRB1*15:01:42 differs from HLA‐DRB1*15:01:01:01 by one single nucleotide substitution at position 732 C>T.
User experiences of using a spatial analysis tool in collaborative GIS for maritime spatial planning
Authors: Koski Christian , Rönneberg Mikko , Kettunen Pyry , Armoškaitė Aurelija , Strake Solvita , Oksanen Juha
Published: August 2021

Maritime spatial planning (MSP) is a decision‐making process for managing human activities at sea. Stakeholder participation is critical to MSP processes. Spatial decision support systems (SDSSs) can be effective tools for analyzing problems in MSP, for example, the impact of human activities on marine ecosystems. However, despite the fact that multiple SDSSs have been developed for MSP, they are rarely used in real‐world MSP processes. We aim to provide insight into stakeholders' understanding and perception of the appropriateness and completeness of SDSSs in an MSP stakeholder meeting. We studied whether SDSSs can benefit from being integrated into CGIS to support alternative methods for problem exploration and solving in groups. The results show that most, but not all, stakeholders understood well or fairly well what the tool does and how to use it, and agreed that the tool was appropriate and had the necessary requirements for problem solving. The results also show that problem exploration and solving with an SDSS in groups can benefit from the tool being integrated into a CGIS. Further research is needed to find effective solutions to overcome stakeholders' challenges in using GIS, and to develop flexible solutions that enable alternative problem‐solving methods.