bluuebunny/crossref_metadata_2025 huggingface dataset:
China's trilemma: monetary policy autonomy in an economy with a managed floating exchange rate
Authors: Li Huiqing , Xu Yixuan , Zhuang Ying
Published: March 2021

Mundell's trilemma theory says that capital flow, exchange rate stability, and monetary policy autonomy cannot be achieved simultaneously. Using monthly data from the People's Bank of China from 1999 to 2019, we find that the trilemma theory is not nearly as tight in China's practice as in theory, and the central bank can internally offset the effect of exchange rate volatility by ways other than the monetary base (such as central bank securities). Our results also indicate that, before 2012, monetary policy autonomy in China was weak due to the problem of ‘funds outstanding for foreign exchange’. With the reform of the Renminbi (RMB) exchange rate system in 2005, the effectiveness of central bank securities in compensating for the flow of foreign exchange reserves has gradually been strengthened in China.
Forging volumetric methods
Authors: Jackman Anna , Squire Rachael
Published: March 2021

The last two decades have seen a “volumetric turn” within Anglophone social sciences and humanities scholarship. This turn is premised on the idea that space may be better understood in three‐dimensional terms – with complex heights and depths – rather than as a series of two‐dimensional areas or surfaces. While there is an increasingly diverse and rich set of scholarship accounting for voluminous complexities in the air, oceans, ice, mountains, and undergrounds, all too often this work foregrounds state and military‐led approaches to volume. This has resulted in a limited methodological toolkit through which to explore voluminous complexities as they emerge and extend beyond military and state contexts. Often reliant on elite interviews, archives, and cartographies, there has been little critical discussion of both methodological practice and the “flatness” of research outputs articulating three‐dimensional worlds. In this paper we address this by foregrounding the role of immersive and multisensory methodologies (sounding volumes, seeing‐sensing drone volumes, and object volumes). To conclude, we offer avenues for further inquiry, including attending to shifting everyday voluminous experiences in the Anthropocene, and the need to diversify the communication of “volume” research.
Explaining the concept of oral health literacy: Findings from an exploratory study
Authors: Safari‐Moradabadi Ali , Rakhshanderou Sakineh , Ramezankhani Ali , Ghaffari Mohtasham
Published: March 2021

Objectives

Identifying those with inadequate oral health literacy is difficult because little is known about its various multiple dimensions. Accordingly, the present research investigated dimensions of the concept using a qualitative approach.

Method

Participants (n = 15) who met inclusion criteria (Including having expertise in the fields of general dental, social dental, and health education and health promotion and having at least 5 years of relevant working experience) were recruited by purposive sampling via the public health and dentistry faculty in Tehran between December 2018 and October 2019. Thematic analysis was used to assess the data.

Results

A total of 15 specialists (ranging in age from 28 to 61, mean 44) were included in the study. Their working experience averaged 15.5 years (SD = 7.7, Min = 6, Max = 30). Independent analysis of qualitative data by three researchers led to identification of seven themes and 18 sub‐categories, including need perception (feeling the need and paying attention to meeting the need), emotional literacy (valuation of oral health, formation of personality and taking care of oral health), planning literacy (planning and goal‐orientation), communicative literacy (choice in decision‐making, interpersonal communication skill and claiming), behavioural literacy (self‐care), cognitive literacy (knowledge, information comprehension, information use, and information analysis) and media literacy (the ability to use up‐to‐date technologies, the ability to search for and acquire the information, and judgment).

Conclusions

Our findings provide insights into the dimensions of oral health literacy. It is hoped that these findings can be used to guide the development of interventions on OHL and that aspects of the concept can help to enhance levels of OHL and help to promote health at societal level.
Association between nasal and nasopharyngeal bacterial colonization in early life and eczema phenotypes
Authors: Hu Chen , Duijts Liesbeth , van Meel Evelien R. , Looman Kirsten I. M. , Kiefte‐de Jong Jessica C. , Pardo Luba M. , Hijnen DirkJan , Pasmans Suzanne G. M. A. , de Jongste Johan C. , Moll Henriette A. , Nijsten Tamar
Published: March 2021

Background

An association has been reported between early life Staphylococcus aureus nasal carriage and higher risk of childhood eczema, but it is unclear whether this relationship is causal and associations with other bacterial species are unclear.

Objective

To examine the associations of early life nasal and nasopharyngeal bacterial carriage with eczema phenotypes, and the direction of any associations identified.

Methods

Among 996 subjects of a population‐based prospective cohort study, nasal swabs for Staphylococcus  aureus, and nasopharyngeal swabs for Streptococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenzae were collected and cultured from age 6 weeks to 6 years. Never, early, mid‐, late transient and persistent eczema phenotypes were identified from parental‐reported physician‐diagnosed eczema from age 6 months until 10 years. Multinomial regression models and cross‐lagged models were applied.

Results

Staphylococcus aureus nasal carriage at 6 months was associated with an increased risk of early transient and persistent eczema (OR (95% CI): 2.69 (1.34, 5.39) and 4.17 (1.12, 15.51)). The associations between Staphylococcus aureus nasal carriage and eczema were mostly cross‐sectional, and not longitudinal. No associations of Staphylococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal bacterial carriage with eczema and eczema phenotypes were observed (OR range (95% CI): 0.71 (0.35, 1.44) to 1.77 (0.84, 3.73)).

Conclusions

Early life Staphylococcus aureus nasal carriage, but not Staphylococcus pneumoniae, Moraxella catarrhalis and Haemophilus influenza nasopharyngeal carriage, was associated with early transient and persistent eczema. Staphylococcus aureus nasal carriage and eczema were mostly cross‐sectionally associated, and not longitudinally, making a causal relationship in either direction unlikely.
Altered distributions in circulating follicular helper and follicular regulatory T cells accountable for imbalanced cytokine production in multiple sclerosis
Authors: Haque R , Kim Y , Park K , Jang H , Kim S Y , Lee H , Kim H J
Published: March 2021

Follicular T helper (Tfh) and regulatory (Tfr) cells are distinct subsets of CD4+ T lymphocytes, regulating humoral immune responses in the germinal center. It is widely accepted that dysregulated Tfh and Tfr cells are associated with autoimmunity. In this study, we evaluated the frequencies of circulating chemokine receptor (CXCR)5+ programmed cell death 1 (PD-1+) Tfh (cTfh) and CXCR5+PD-1+forkhead box protein 3 (FoxP3+) CD25+ Tfr (cTfr) cells, and their corresponding cytokines from the peripheral blood mononuclear cells of 28 patients with relapsing–remitting multiple sclerosis (MS) and 16 age- and sex-matched healthy controls (HC). Subsets of cTfh cells by Th1- and Th17-related surface markers (CXCR3 and CCR6) were also evaluated. We found that the frequency of cTfh cells was significantly higher in MS patients compared to that of HC. Conversely, the frequency of cTfr cells was lower in MS patients than that of HC. Interleukin (IL)-21-producing cTfh cells were significantly increased in MS patients, while IL-10-secreting cTfr cells were lower in MS patients compared to levels in HC. Among cTfh cells, cTfh17.1 cells were the major subtypes that were significantly increased in MS patients compared to HC, with the frequency of IL-21-secreting cells being the highest. These results suggest that an imbalanced distribution of cTfh and cTfr exist in MS patients, which contributes to the reciprocally altered IL-21 and IL-10 production.
Food security and Canada's agricultural system challenged by COVID‐19: One year later
Authors: Deaton B. James , Deaton Brady J.
Published: March 2021

This paper assesses the earlier projections made by the authors in March 2020 about the impact of COVID‐19 on Canada's food security. First, as measured in the early part of the second quarter of 2020, COVID‐19 is associated with an increased prevalence of household food insecurity as measured by Statistics Canada. Also, as we predicted, we did not observe a rapid general increase in food prices that would have suggested a breakdown in parts of the food system. In this regard, we now develop a general insight that we believe is worthy of ongoing consideration. Put simply, concerns expressed about food insecurity should not be seen as tantamount to a failure of our food supply system. Household income, for example, is an important part of the story. The converse is also true: the success of our food supply system as measured by its capacity to adapt to challenges like COVID‐19 or provide a variety of food at relatively low prices—while necessary, and (in our opinion) critical considerations—will not alone eliminate food insecurity in Canada. The oversimplified conflation of food insecurity concerns with the robustness of our food supply system does a disservice to ongoing efforts to address food insecurity as well as our capacity to assess and improve the Canadian food supply system.
Acute kidney injury post‐heart transplant: An analysis of peri‐operative risk factors
Authors: Jocher Brandon M. , Schilling Joel D. , Fischer Irene , Nakajima Tomohiro , Wan Fei , Tanaka Yuki , Ewald Gregory A. , Kutkar Kunal , Masood Muhammad , Itoh Akinobu
Published: March 2021

Acute kidney injury is a common complication following heart transplantation, and the factors contributing to acute kidney injury are not well understood. We conducted a retrospective cohort study evaluating patients who underwent heart transplantation between 2009 and 2016 at a single institution. The primary endpoint was incidence of acute kidney injury as defined by Kidney Disease Improving Global Outcomes criteria. Secondary endpoints included 30‐day hospital readmission, 30‐day mortality, and 1‐year mortality. A total of 228 heart transplant patients were included in the study for analysis. In total, 145 (64%) developed acute kidney injury, where 43 (30%) were classified as stage I, 28 (19%) as stage II, and 74 (51%) as stage III. Risk factors found to be associated with the presence of acute kidney injury included increased use of vasopressors and inotropes post‐transplant. Protective factors included cardiopulmonary bypass time <170 min. Acute kidney injury was found to be associated with increased 30‐day and 1‐year mortality.
White matter microstructure of the neural emotion regulation circuitry in mild traumatic brain injury
Authors: van der Horn Harm Jan , Mangina Namrata R. , Rakers Sandra E. , Kok Jelmer G. , Timmerman Marieke E. , Leemans Alexander , Spikman Jacoba M. , van der Naalt Joukje
Published: March 2021

Emotion regulation is related to recovery after mild traumatic brain injury (mTBI). This longitudinal tractography study examined white matter tracts subserving emotion regulation across the spectrum of mTBI, with a focus on persistent symptoms. Four groups were examined: (a) symptomatic (n = 33) and (b) asymptomatic (n = 20) patients with uncomplicated mTBI (i.e., no lesions on computed tomography [CT]), (c) patients with CT‐lesions in the frontal areas (n = 14), and (d) healthy controls (HC) (n = 20). Diffusion and conventional MRI were performed approximately 1‐ and 3‐months post‐injury. Whole‐brain deterministic tractography followed by region of interest analyses was used to identify forceps minor (FM), uncinate fasciculus (UF), and cingulum bundle as tracts of interest. An adjusted version of the ExploreDTI Atlas Based Tractography method was used to obtain reliable tracts for every subject. Mean fractional anisotropy (FA), mean, radial and axial diffusivity (MD, RD, AD), and number of streamlines were studied per tract. Linear mixed models showed lower FA, and higher MD, and RD of the right UF in asymptomatic patients with uncomplicated mTBI relative to symptomatic patients and HC. Diffusion alterations were most pronounced in the group with frontal lesions on CT, particularly in the FM and UF; these effects increased over time. Within the group of patients with uncomplicated mTBI, there were no associations of diffusion measures with the number of symptoms nor with lesions on conventional MRI. In conclusion, mTBI can cause microstructural changes in emotion regulation tracts, however, no explanation was found for the presence of symptoms.
Sexual dimorphic effects of restraint stress on prefrontal cortical function are mediated by glucocorticoid receptor activation
Authors: Velli Angeliki , Iordanidou Chrysoula , Asimi Theodora , Vynichaki Maria‐Ioanna , Cholevas Anastasios , Mantouka Adamantia‐Iliana , Nassens Liesje , Chalkiadaki Kleanthi , Sidiropoulou Kyriaki
Published: March 2021

Stress, a major regulator and precipitating factor of cognitive and emotional disorders, differentially manifests between males and females. Our aim was to investigate the mechanisms underlying the sexual dimorphic effects of acute restraint stress (RS) on males and females on the function of the prefrontal cortex (PFC). Adult male and female mice were subjected to RS or left in their home‐cage (NR), and then tested in the light‐dark test followed by the temporal order object recognition (TOR) task. Female mice exhibited increased anxiety‐like levels, whereas male mice only showed deficits in the TOR task. When the behavioural tests were conducted 24 hr following restraint stress (RS24), only the reduced performance in the TOR task in male mice persisted. In a different cohort, evoked field excitatory postsynaptic potentials (fEPSPs) were recorded in layer II of acute PFC slices, immediately or 24 hr after RS. Long‐term potentiation (LTP) was significantly reduced in RS and RS24 male, but not female, compared with their respective NR group. LTP in PFC slices incubated with corticosterone showed significantly reduced LTP only in males. To determine whether glucocorticoid signalling is implicated in the RS‐induced behavioural effects, a different cohort of mice was administered mifepristone, a corticosterone receptor antagonist. Mifepristone administration 1 hr before RS prevented the effects of RS on the TOR task in males, but not anxiety. In conclusion, RS has differential effects on recency memory and anxiety, in males and females, which are partly mediated by the effects of corticosterone signalling on synaptic plasticity.
Social network analysis of small social groups: Application of a hurdle GLMM approach in the Alpine marmot (Marmota marmota)
Authors: Panaccio Matteo , Ferrari Caterina , Bassano Bruno , Stanley Christina R. , von Hardenberg Achaz
Published: March 2021

Social network analysis (SNA) has recently emerged as a fundamental tool to study animal behavior. While many studies have analyzed the relationship between environmental factors and behavior across large, complex animal populations, few have focused on species living in small groups due to limitations of the statistical methods currently employed. Some of the difficulties are often in comparing social structure across different sized groups and accounting for zero‐inflation generated by analyzing small social units. Here, we use a case study to highlight how Generalized Linear Mixed Models (GLMMs) and hurdle models can overcome the issues inherent to study of social network metrics of groups that are small and variable in size. We applied this approach to study aggressive behavior in the Alpine marmot (Marmota marmota) using an eight‐year long dataset of behavioral interactions across 17 small family groups (7.4 ± 3.3 individuals). We analyzed the effect of individual and group‐level factors on aggression, including predictors frequently inferred in species with larger groups, as the closely related yellow‐bellied marmot (Marmota flaviventris). Our approach included the use of hurdle GLMMs to analyze the zero‐inflated metrics that are typical of aggressive networks of small social groups. Additionally, our results confirmed previously reported effects of dominance and social status on aggression levels, thus supporting the efficacy of our approach. We found differences between males and females in terms of levels of aggression and on the roles occupied by each in agonistic networks that were not predicted in a socially monogamous species. Finally, we provide some perspectives on social network analysis as applied to small social groups to inform subsequent studies.
Protein crystallography: alive and well
Authors: Wlodawer Alexander
Published: March 2021

The motto of this Virtual Issue of The FEBS Journal is a paraphrase of the statement made in 1897 by Mark Twain, which is usually quoted as ‘Reports of my death have been greatly exaggerated’. With the incredible progress in the utilization of cryo‐EM for the determination of high‐resolution macromolecular structures that led to the award of the Nobel Prize in Chemistry to Jacques Dubochet, Joachim Frank, and Richard Henderson in 2017, it became a common assumption that crystallography was dead. However, as this Virtual Issue should show very clearly, that is emphatically not the case. To put the current relative importance of different technologies of determination of macromolecular structures into perspective, 78% of structures deposited in the Protein Data Bank since January 2020 were still determined by X‐ray crystallography. The reasons why that is the case will be clear after reading the papers gathered here.
Fatigue behavior of Ti6Al4V alloy components manufactured by selective laser melting subjected to hot isostatic pressing and residual stress relief
Authors: Jesus J. S. , Borrego L. P. , Ferreira J. A. M. , Costa J. D. , Capela C.
Published: March 2021

Fatigue behavior (Rε = −1) of HIPed and stress relieved Ti6Al4V alloy specimens produced by selective laser melting (SLM) was analyzed and compared resulting that the hot isostatic pressing (HIP) process caused a microstructural transformation decreasing the hardness and monotonic properties leading to cyclic softening that not allowed fatigue strength to increase. A bilinear behavior in the elastic strain–fatigue life curve was observed due to the decrease of the Young's modulus during the cyclic elastoplastic tests, consequence of subgrains formation. The Smith–Watson–Topper and total strain energy density models adjusted by the bilinear behavior showed a good concordance between predicted and experimental fatigue lives in notched samples.
Has the Crisis Introduced a New Paradigm in Banks' Credit Allocation? The Non‐financial Corporations' Perspective
Authors: Lopes Andresa , Oliveira Vítor , Ramos Ângelo , Silva Fátima
Published: March 2021

In the years prior to the onset of the global financial crisis, the sharp credit growth, in a context of optimistic income expectations, boosted by an increase in competition in the banking system, less restrictive lending criteria and favorable financing conditions in international wholesale debt market, led to a marked rise in the debt levels of non‐financial corporations. In this paper, we use a panel data regression, with fixed effect estimators, to study how the relationship between bank credit granted to each firm and a set of firm‐specific indicators, that measure overall balance sheet performance and riskiness, changed over the 2006–2017 period. The results suggest that, during and after the Portuguese sovereign debt crisis, the sensitivity of the bank credit granted to firms to overall balance sheet strength and riskiness of firms increased, except in the case of leverage, where the sensitivity decreased slightly. Nonetheless, banks on average lent more to lower leveraged firms than to higher leveraged firms throughout the period considered. The results also show that statistical significance slightly reduces with the size of the firm and, when compared with the pre‐crisis sub‐period, banks did not increase lending to higher leveraged large firms in the crisis and post‐crisis sub‐periods. Finally, we find that the most capitalized banks were the ones more willing and/or able to support firms, during the crisis, even firms that experienced a deterioration in their indicators.
Determining mental health literacy of undergraduate nursing students to inform learning and teaching strategies
Authors: Saito Amornrat S. , Creedy Debra K.
Published: March 2021

There is limited research on mental health literacy among undergraduate nursing students in Australia. Overseas studies indicate significant gaps in students’ knowledge and practice. The aims of this study were to (1) assess mental health literacy knowledge in undergraduate nursing students and compare these across year levels, and to (2) identify students’ learning needs about mental health literacy in practice. A convenience sample of 114 Bachelor of Nursing students studying at one Australian University completed the online survey. Results showed that third‐year students reported higher levels of mental health literacy compared to first‐ and second‐year students. Almost 40% of students felt they did not have sufficient understanding of mental health literacy for practice. Most respondents (66.7%) wanted more information on different types of mental illnesses, treatments, how to reduce mental health stigma, and how to care for and communicate with people with mental illness. Students identified that mental health first aid training should be compulsory for all nursing students. Mental health literacy is a crucial area to be addressed in undergraduate nursing education. Explicit content and skill development are required to improve students’ awareness of health literacy and inform their practice.
The experiences of mothers of children and young people with intellectual disabilities during the first COVID‐19 lockdown period
Authors: Rogers Gemma , Perez‐Olivas Gisela , Stenfert Kroese Biza , Patel Varsha , Murphy Glynis , Rose John , Cooper Vivien , Langdon Peter E. , Hiles Steve , Clifford Clair , Willner Paul
Published: March 2021

Background

Recent COVID‐19 lockdown restrictions resulted in reduced access to educational, professional and social support systems for children with intellectual disabilities and their carers.

Aim

The aim of this study was to gain insight into the ways mothers of children with intellectual disabilities coped during the first 2020 lockdown period.

Methods

Eight mothers of children with intellectual disabilities were interviewed. The recordings of these interviews were subjected to a thematic analysis.

Results

Three main themes were identified: carrying the burden; a time of stress; and embracing change and looking to the future.

Conclusions

All mothers experienced increased burden and stress. However, some also described some positive impact of lockdown conditions on them as well as on their child's well‐being and behaviour. These findings are discussed in the light of the (Journal of Applied Research in Intellectual Disabilities, 33, 2020, 1523) survey results on parental coping and suggestions for future service provision during pandemic conditions are proposed.
Real regulatory capital management and bank payouts: Evidence from available‐for‐sale securities
Authors: Fabrizi Michele , Ipino Elisabetta , Magnan Michel , Parbonetti Antonio
Published: March 2021

This study examines whether payout policies create incentives for banks to engage in cherry‐picking activities using available‐for‐sale (AfS) securities, otherwise known as gains trading. Such activities are more likely to arise in situations in which capital ratios would otherwise constrain banks’ ability to distribute resources to shareholders. Using a large sample comprising 766 unique US banks, we find a significant and positive association between total payout and realized gains on AfS securities for banks with low regulatory capital. This is consistent with the conjecture that capital‐constrained banks engage in gains trading to free up resources for dividend payments or share repurchases. When partitioning our sample, we find that capital‐constrained banks realize gains and losses on AfS securities only when it is costly to decrease the payout and when the monitoring level is weaker. Further analyses reveal that banks engaging in gains trading to distribute cash to shareholders exhibit significantly higher levels of future default risk and more negative extreme bank‐specific daily returns, patterns that are consistent with risk‐shifting. Finally, with the advent of Basel III, the practice seems to continue among banks that chose to retain prudential filters.
Experience and procedural efficacy of pulmonary vein isolation using the fourth and second generation cryoballoon: The shorter, the better?
Authors: Heeger Christian‐Hendrik , Bohnen Jan‐Eric , Popescu Sorin , Meyer‐Saraei Roza , Fink Thomas , Sciacca Vanessa , Kirstein Bettina , Hatahet Sascha , Traub Anna , Lopez Lisbeth D. , Schlüter Michael , Kuck Karl‐Heinz , Eitel Charlotte , Vogler Julia , Richard Tilz Roland
Published: March 2021

Background

The second‐generation cryoballoon (CB2) provides effective and durable pulmonary vein isolation (PVI) associated with encouraging clinical outcome. The novel fourth‐generation cryoballoon (CB4) incorporates a 40% shorter distal tip. This design change may translate into an increased rate of PVI real‐time signal recording, facilitating an individualized ablation strategy using the time to effect (TTE).

Methods and Results

Three hundred consecutive patients with paroxysmal or persistent atrial fibrillation were prospectively enrolled. The first 150 consecutive patients underwent CB2 based PVI (CB2 group) and the last 150 consecutive patients were treated with the CB4 (CB4 group). A total of 594/594 (100%, CB4) and 589/594 (99.2%, CB2) pulmonary veins (PVs) were successfully isolated utilizing the CB4 and CB2, respectively (p = .283). The real‐time PVI visualization rate was 47% (CB4) and 39% (CB2; p = .005) and the mean freeze cycle duration 200 ± 90 s (CB4) and 228 ± 110 s (CB2; p < .001), respectively. The total procedure time did not differ between the groups (CB4: 64 ± 32 min) and (CB2: 62 ± 29 min, p = .370). No differences in periprocedural complications were detected.

Conclusions

A higher rate of real‐time electrical PV recordings are seen using the CB4 as compared to CB2, which may facilitate an individualized ablation strategy using the TTE.
Risk stratification by long non‐coding RNAs profiling in COVID‐19 patients
Authors: Cheng Jie , Zhou Xiang , Feng Weijun , Jia Min , Zhang Xinlu , An Taixue , Luan Minyuan , Pan Yi , Zhang Shu , Zhou Zhaoming , Wen Lei , Sun Yun , Zhou Cheng
Published: March 2021

Coronavirus disease 2019 (COVID‐19), caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has become a global pandemic worldwide. Long non‐coding RNAs (lncRNAs) are a subclass of endogenous, non‐protein‐coding RNA, which lacks an open reading frame and is more than 200 nucleotides in length. However, the functions for lncRNAs in COVID‐19 have not been unravelled. The present study aimed at identifying the related lncRNAs based on RNA sequencing of peripheral blood mononuclear cells from patients with SARS‐CoV‐2 infection as well as health individuals. Overall, 17 severe, 12 non‐severe patients and 10 healthy controls were enrolled in this study. Firstly, we reported some altered lncRNAs between severe, non‐severe COVID‐19 patients and healthy controls. Next, we developed a 7‐lncRNA panel with a good differential ability between severe and non‐severe COVID‐19 patients using least absolute shrinkage and selection operator regression. Finally, we observed that COVID‐19 is a heterogeneous disease among which severe COVID‐19 patients have two subtypes with similar risk score and immune score based on lncRNA panel using iCluster algorithm. As the roles of lncRNAs in COVID‐19 have not yet been fully identified and understood, our analysis should provide valuable resource and information for the future studies.
Single‐cell analysis reveals metastatic cell heterogeneity in clear cell renal cell carcinoma
Authors: Liu Kun , Gao Rui , Wu Hao , Wang Zhe , Han Guang
Published: March 2021

Renal cell carcinoma (RCC) is one of the leading causes of cancer‐related death worldwide. Tumour metastasis and heterogeneity lead to poor survival outcomes and drug resistance in patients with metastatic RCC (mRCC). In this study, we aimed to assess intratumoural heterogeneity (ITH) in mRCC cells by performing a combined analysis of bulk data and single‐cell RNA‐sequencing data, and develop novel biomarkers for prognosis prediction on the basis of the potential molecular mechanisms underlying tumorigenesis. Eligible single‐cell cohorts related to mRCC were acquired using the Gene Expression Omnibus (GEO) dataset to identify potential mRCC subpopulations. We then performed gene set variation analysis to understand the differential function in primary RCC and mRCC samples. Subsequently, we applied weighted correlation network analysis to identify coexpressing gene modules that were related to the external trait of metastasis. Protein‐protein interactions were used to screen hub subpopulation‐difference (sub‐dif) markers (ACTG1, IL6, CASP3, ACTB and RAP1B) that might be involved in the regulation of RCC metastasis and progression. Cox regression analysis revealed that ACTG1 was a protective factor (HR < 1), whereas the other four genes (IL6, CASP3, ACTB and RAP1B) were risk factors (HR > 1). Kaplan‐Meier survival analysis suggested the potential prognostic value of these sub‐dif markers. The expression of sub‐dif markers in mRCC was further evaluated in clinical samples by immunohistochemistry (IHC). Additionally, the genetic features of sub‐dif marker expression patterns, such as genetic variation profiles, correlations with tumour‐infiltrating lymphocytes (TILs), and targeted signalling pathway activities, were assessed in bulk RNA‐seq datasets. In conclusion, we established novel subpopulation markers as key prognostic factors affecting EMT‐related signalling pathway activation in mRCC, which could facilitate the implementation of a treatment for mRCC patients.
Characterizing the degeneration of nuclear membrane and mitochondria of adipose‐derived mesenchymal stem cells from patients with type II diabetes
Authors: Horiguchi Michiko , Hata Shinichi , Tsurudome Yuya , Ushijima Kentaro
Published: March 2021

Regenerative therapeutic approaches involving the transplantation of stem cells differentiated into insulin‐producing cells are being studied in patients with rapidly progressing severe diabetes. Adipose‐derived mesenchymal stem cells have been reported to have varied cellular characteristics depending on the biological environment of the location from which they were harvested. However, the characteristics of mesenchymal stem cells in type II diabetes have not been clarified. In this study, we observed the organelles of mesenchymal stem cells from patients with type II diabetes under a transmission electron microscope to determine the structure of stem cells in type II diabetes. Transmission electron microscopic observation of mesenchymal stem cells from healthy volunteers (N‐ADSC) and those from patients with type II diabetes (T2DM‐ADSC) revealed enlarged nuclei and degenerated mitochondrial cristae in T2DM‐ADSCs. Moreover, T2DM‐ADSCs were shown to exhibit a lower expression of Emerin, a constituent protein of the nuclear membrane, and a decreased level of mitochondrial enzyme activity. In this study, we successfully demonstrated the altered structure of nuclear membrane and the decreased mitochondrial enzyme activity in adipose‐derived mesenchymal cells from patients with type II diabetes. These findings have contributed to the understanding of type II diabetes‐associated changes in mesenchymal stem cells used for regenerative therapy.
Human SHC‐transforming protein 1 and its isoforms p66shc: A novel marker for prediabetes
Authors: Jelinek Herbert F , Helf Charlotte , Khalaf Kinda
Published: March 2021

Aims

Prediabetes is a multifactorial condition. Current guidelines for diabetes screening recommend either the use of glycated hemoglobin (HbA1c), or blood glucose level (BGL). This research aimed to identify if p66shc a component of the Human SHC‐Transforming Protein 1 (Shc1), a mitochondrial associated oxidative stress biomarker, is significantly altered in patients with elevated BGL. Furthermore, we evaluated if inflammatory and oxidative stress markers, such as p66shc, are a useful addition to the regularly used biomarkers to increase sensitivity for identification of prediabetes.

Methods

All participants attended the Diabetic Health Screening at Charles Sturt University (CSU), Australia. The cross‐sectional clinical study collected demographic and clinical variables from 346 participants and classified into control or prediabetes based on fasting BGL. Blood and urine samples were analyzed for oxidative stress and inflammation markers. Logistic regression was used to compare multidimensional diagnostic models for prediabetes, including p66shc/Shc1, to the current HbA1c‐only model in terms of sensitivity, specificity and predictive accuracy. Significance was set at P ≤ 0.05.

Results

A significant decrease of p66shc/Shc1 was determined in prediabetes compared to controls (P ≤ 0.05). HbA1c testing resulted in an accuracy of 62%, while adding p66shc and triglycerides increased predictive accuracy to 88.05%. When HbA1c was omitted and Shc1 was combined with 8‐hydroxy‐2′‐deoxyguanosine (8‐OHdG) and monocyte chemo‐attractant protein‐1 (MCP‐1), a predictive accuracy of 89.5% was achieved.

Conclusion

Our findings showed a major improvement of sensitivity to identify prediabetes by including oxidative stress and inflammatory biomarkers underlining beneficial diagnostic information, which most likely improves prevention and early treatment options in prediabetes.
Conceptual framework for telehealth strategies to increase family involvement in treatment and recovery for youth opioid use disorder
Authors: Hogue Aaron , Bobek Molly , Levy Sharon , Henderson Craig E. , Fishman Marc , Becker Sara J. , Dauber Sarah , Porter Nicole , Wenzel Kevin
Published: March 2021

With opioid use at crisis levels, it is imperative to support youth ages with opioid use disorders (OUD) in taking medication and accessing behavioral services over long periods. This article presents a conceptual framework for telehealth strategies that can be adopted to increase family involvement across a four‐stage continuum of youth OUD treatment and recovery: Treatment Preparation, Treatment Initiation, Treatment Stabilization, OUD Recovery. It first identifies provider‐delivered tele‐interventions that can enhance OUD services in each of the four stages, including family outreach, family engagement, family‐focused intervention, and family‐focused recovery maintenance. It then introduces several types of direct‐to‐family tele‐supports that can be used to supplement provider‐delivered interventions. These include both synchronous tele‐supports (remote interactions that occur in real time) such as helplines, peer‐to‐peer coaching, and online support groups; and asynchronous tele‐supports (communications that occur without participants being simultaneously present) such as automated text messaging, self‐directed internet‐based courses, and digital web support.
Comparing dysmenorrhea beliefs and self‐management techniques across symptom‐based phenotypes
Authors: Rogers Sarah Katherine , Rand Kevin L. , Chen Chen Xiao
Published: March 2021

Objectives

To compare beliefs about dysmenorrhea and self‐management techniques across three dysmenorrhea symptom‐based phenotypes.

Background

Many reproductive‐age women experience dysmenorrhea, with varying symptoms and intensity. Dysmenorrhea symptom‐based phenotypes have been identified in previous research, defining distinctive phenotypes of mild localised pain, severe localised pain, and multiple severe symptoms. It is unknown if women from different phenotypes hold different beliefs about dysmenorrhea or if they engage in different self‐management techniques.

Design

Quantitative secondary analysis of cross‐sectional survey data.

Methods

This online study surveyed 762 women with dysmenorrhea in the United States. Participants reported their dysmenorrhea symptom intensity, beliefs about dysmenorrhea (i.e. beliefs about consequences, timeline, controllability, symptom severity, normalcy, emotional response to symptoms and treatments) and self‐management techniques to prevent or treat symptoms. Beliefs regarding dysmenorrhea and types of self‐management techniques used were compared across three phenotypes utilising ANOVA tests and Tukey's HSD for pairwise comparisons. Reporting followed the STROBE guidelines.

Results

Women with multiple severe symptoms had significantly more negative beliefs regarding dysmenorrhea and utilised significantly more self‐management techniques than women with severe localised pain and women with mild localised pain. Women with severe localised pain had significantly more negative beliefs regarding dysmenorrhea and utilised significantly more self‐management techniques than women with mild localised pain. Negative beliefs regarding dysmenorrhea included: consequences of dysmenorrhea, timeline of symptoms, personal and treatment control, symptom severity, normalcy of symptoms, emotional response to symptoms and willingness to utilise complementary medicine.

Conclusion

Results further support the distinction between dysmenorrhea symptom‐based phenotypes. Not only do women in different phenotypes experience different severity and number of dysmenorrhea symptoms, they also perceive and manage their dysmenorrhea differently.

Relevance to Clinical Practice

These findings have implications for tailoring interventions to different dysmenorrhea symptom‐based phenotypes.
Evaluating and communicating hepatitis C cascades of care data in Tayside, Scotland: A journey towards elimination
Authors: Baiano Cassandra X. , Caven Madeleine , Robinson Emma M. , Dillon John F.
Published: March 2021

Chronic hepatitis C virus (HCV) is one of the leading causes of liver cirrhosis and hepatocellular carcinoma. The WHO 2030 Elimination Goals require each country to evaluate their response to their epidemics. This can be achieved by visualization of cascades of care, depicting how infected cases move through disease control stages. However, methods of displaying data are debated and lack practical application. This project proposes a new way of codifying and displaying HCV data using Tayside as a case study. 1464 cases of active HCV infections in Tayside from 2015 to 2019 were analysed from NHS Tayside’s HCV Database. Variables were evaluated to create a systematic coding framework that was then used to code each patient’s diagnosis, treatment and cure status each year from 2015 to 2019. Graphical representation of the data in the form of a stacked clustered bar chart demonstrates general trends and conversion rates. For example, Tayside has seen an increase in diagnosis‐to‐cure rates from 18% to 49% (2015‐2019). This method also demonstrates the portion of newly and previously diagnosed people accessing treatment, those with unsuccessful or incomplete treatments, completed treatments with unconfirmed cure, and the number of deaths and relocations. In conclusion, this project proposes a novel way of displaying cascades of care data that relays yearly snapshots of an epidemic, cumulative progression over time, nuanced information of each stage and progression towards elimination targets. This method can be meaningfully used to improve local service planning, knowledge exchange across health systems and reporting to bodies like the WHO.
Macronutrient intake, carbohydrate metabolism and cholesterol in Polish male amateur athletes on a vegan diet
Authors: Śliż Daniel , Parol D. , Wełnicki M. , Chomiuk T. , Grabowska I. , Dąbrowska D. , Król W. , Price S. , Braksator W. , Mamcarz A.
Published: March 2021

Vegan diets are gaining in popularity with physically active individuals. Many long‐distance runners follow a vegan diet at least periodically. This cross‐sectional study of Polish, male, vegan (VEG) (n = 44) and omnivore (OMN) (n = 54) athletes, aged 20–39 years and matched for body mass index (BMI) and training duration, compared their energy and macronutrient intakes, carbohydrate metabolism and cholesterol concentrations. The participants self‐recorded their diets for 4 days. Serum concentrations of cholesterol, glucose, C‐peptide and insulin were measured. The VEG group consumed less protein (12.0% of daily dietary energy ± 1.9% vs. 18.1% ± 3.3%; p < 0.01), less fat (25.6% ± 9.8% vs. 31.7% ± 6.6%; p < 0.01) and more carbohydrate (61.7% ± 11.1% vs. 49.0% ± 7.9%; p < 0.01) than the OMN group. Protein intakes relative to body mass were also lower in the VEG group than the OMN group (1.11 g/kg ± 0.30 vs. 1.44 g/kg ± 0.41; p < 0.01) and below the range recommended for endurance athletes (1.2–2.0 g/kg). The VEG group consumed more unsaturated fatty acids and less saturated fatty acids and had a higher n‐6/n‐3 fatty acid ratio (6.5% ± 2.3% vs. 5.0% ± 2.1%; p < 0.01). The VEG group consumed 0 mg EPA+DHA versus 156 mg in the OMN group (p < 0.01), the current guideline being 250 mg. The VEG group had significantly better insulin sensitivity (HOMA‐IR) and lower C‐peptide and total blood cholesterol levels. In conclusion, the vegan diet provided a healthy balance of macronutrients, and vegan athletes had better insulin sensitivity and lower cholesterol than omnivore athletes, but protein, EPA and DHA may be inadequate and increased intake or supplementation of these nutrients could be considered by vegan athletes.
Complications of distraction osteogenesis: Narrative review
Authors: Kende Prajwalit P. , Sarda Ashish Sunilkumar , Desai Harsh , Landge Jayant , Nimma Vijayalaxmi , Varte Varthangpuii
Published: March 2021

Aim

The aim of this narrative review is to discuss the complications of distraction osteogenesis (DO) of facial skeleton and their management.

Materials and Method

A detailed literature search was done on PubMed, Google Scholar and Embase from the year 1990 onwards. Any systematic review, randomized controlled trial, controlled clinical trial, retrospective/prospective study discussing about complications of maxillofacial DO and their management were included.

Results

Complications related to DO were divided based on phases as (a) planning (patient counselling, improper vector, errors in device selection, etc.), (b) surgery (tooth injury, neurosensory disturbance, incomplete osteotomy, etc.), (c) distraction (device failure, pain at regenerate site, premature consolidation, etc.) and (d) consolidation (infection, hypertrophic scar, relapse, etc.).

Conclusion

Widespread applications are possible with DO though it is a device‐dependent and technique‐sensitive procedure. With proper planning and execution, DO can become the gold standard for managing various maxillofacial disorders.
Determinants of blood eosinophilia in moderate and severe asthmatic patients during childhood: Evidence from the severe asthma molecular phenotype (SAMP) cohort
Authors: Just Jocelyne , Saf Sarah , Guiddir Tamazoust , Cottel Nathalie , Amat Flore , Lambert Nathalie , Saint‐Pierre Philippe , Bourgoin‐Heck Mélisande
Published: March 2021

Background

Asthma is a heterogeneous disease in which the interaction between genetic and environmental factors plays a major role. The significance of blood eosinophil is unclear. The aim of the study was to determine the significance of blood eosinophil count in moderate‐to‐severe asthmatic children of preschool age and school age.

Methods

This was a prospective cross‐sectional study performed from 2011 to 2015 including children from the severe asthma molecular phenotype (SAMP) cohort at Trousseau Hospital (Paris, France). We included children with severe and moderate asthma, or severe and moderate recurrent wheeze, aged from 1 to 15 years at the time of exploration.

Results

We analyzed data from 402 children: 248 of preschool age and 154 of school age. Blood eosinophil count third quartile thresholds were 322 and 600 cells/μL for the preschool‐ and school‐age groups, respectively. In multivariate analysis, a blood eosinophil count over this threshold was associated with elevated total IgE (OR = 5.33, P < .01), multiple hospitalizations for asthma attacks (OR = 4.96, P = .03), and a maternal history of asthma (OR = 4.91, P = .01) in preschool children; and with staphylococcal toxin–specific IgE (OR = 2.75, P = .03) in children of school age. Random forest analysis reinforced these results.

Conclusion

High blood eosinophil count is linked to both atopic features and control of asthma with different parameters associated with these features depending on age.
Life history trait response to ambient temperature and food availability variations in the bean weevil Zabrotes subfasciatus
Authors: Corrêa Cindi P. , Parreiras Sheila S. , Beijo Luiz A. , de Ávila Paulo M. , Teixeira Isabel R. V. , Barchuk Angel Roberto
Published: March 2021

Temperature is among the most influential factors in animal biology, and especially thermal fluctuations are key determinants of life history traits for ectothermic organisms. Diet characteristics add complexity to the effect of temperature on animals' life history traits. This is even more intricate in phytophagous insects that develop inside hosts. Here, using the seed beetle Zabrotes subfasciatus Boheman we tested life history trait response to five different ambient temperatures (15, 25, 30, 35, and 45 °C). We also tested the effect of the interaction between temperature and diet on the weevils' life history traits and estimated fitness for individuals at different temperature and food supplementation conditions. We first showed that the relationship between temperature and egg size and number, and adult emergence is altered by sugar ingestion, mainly at 30 °C. Additionally, we showed that temperature and sugar ingestion have opposite effects on longevity, with this trait being heightened by sugar ingestion at 25 °C. Interestingly, except at 35 °C, egg size shows a response that opposes the temperature‐size rule, which states increasing environmental temperature reduces insect's size. Finally, excluding the extreme temperatures, fitness patterns increased with temperature and the clearer effect of parental feeding on fitness was registered at 30 °C. Since 30 °C is the temperature at which our weevil populations are maintained in the laboratory, these results point to a possible long‐term “acclimation effect” on the weevils' fitness. Thus, testing the effect of the temperature experienced by the original population on the experimental weevils' fitness might shed light on the biological explanation of the observed temperature vs diet interaction.