bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical course and outcome after treatment with ventricular assist devices in paediatric patients: A single‐centre experience
Authors: Romlin Birgitta , Dahlin Anna , Hallhagen Stefan , Björk Kerstin , Wåhlander Håkan , Söderlund Fredrik
Published: February 2021

Background

Heart failure is a rare condition in the paediatric population, associated with high morbidity and mortality. When medical therapy is no longer sufficient, mechanical circulatory support such as a ventricular assist device can be used to bridge these children to transplant or recovery. Coagulation‐related complications such as thrombi, embolism and bleeding events represent the greatest challenge in paediatric patients on mechanical support. We aimed to describe the outcomes and coagulation‐related complications in this patient population at our institution.

Methods

A total of 20 patients with either Berlin Heart EXCOR® or HeartWare® implantation were reviewed in this retrospective study. Study endpoints were survival to heart transplant, weaning due to recovery or death. Thrombotic events were defined as thrombus formation in the device or in the patient, or cardioembolic strokes. Bleeding events were defined as events requiring interventional surgery or transfusion of red blood cells.

Results

The aetiology of heart failure included cardiomyopathy (n = 12), end‐stage congenital heart disease (n = 6) and myocarditis (n = 2). Of the 20 patients, 12 were bridged to transplant, 7 recovered and could be weaned and 1 died. The median duration of mechanical support was 84 days (range: 20‐524 days). At least one major or minor bleeding event occurred in 45% of the patients. Thrombotic events occurred 21 times in 10 patients. Four of the patients (20%) had no bleeding or thromboembolic event.

Conclusion

In all, 95% of the patients were successfully bridged to transplant or recovery. Bleeding events and thrombotic events were common.
Role of candidate gene variants in modulating the risk and severity of alcoholic hepatitis
Authors: Beaudoin James J. , Liang Tiebing , Tang Qing , Banini Bubu A. , Shah Vijay H. , Sanyal Arun J. , Chalasani Naga P. , Gawrieh Samer
Published: February 2021

Background

Alcoholic hepatitis (AH) is a severe and life‐threatening alcohol‐associated liver disease. Only a minority of heavy drinkers acquires AH and severity varies among affected individuals, suggesting a genetic basis for the susceptibility to and severity of AH.

Methods

A cohort consisting of 211 patients with AH and 176 heavy drinking controls was genotyped for five variants in five candidate genes that have been associated with chronic liver diseases: rs738409 in patatin‐like phospholipase domain‐containing protein 3 (PNPLA3), rs72613567 in hydroxysteroid 17‐beta dehydrogenase 13 (HSD17B13), rs58542926 in transmembrane 6 superfamily member 2 (TM6SF2), rs641738 in membrane bound O‐acyltransferase domain containing 7 (MBOAT7), and a copy number variant in the haptoglobin (HP) gene. We tested the effects of individual variants and the combined/interacting effects of variants on AH risk and severity.

Results

We found significant associations between AH risk and the risk alleles of rs738409 (p = 0.0081) and HP (p = 0.0371), but not rs72613567 (p = 0.3132), rs58542926 (p = 0.2180), or rs641738 (p = 0.7630), after adjusting for patient's age and sex. A multiple regression model indicated that PNPLA3 rs738409:G [OR = 1.59 (95% CI: 1.15–2.22), p = 0.0055] and HP*2 [OR = 1.38 (95% CI: 1.04–1.82), p = 0.0245], when combined and adjusted for age and sex also had a large influence on AH risk among heavy drinkers. In the entire cohort, variants in PNPLA3 and HP were associated with increased total bilirubin and Model for End‐stage Liver Disease (MELD) score, both measures of AH severity. The HSD17B13 rs72613567:AA allele was not found to reduce risk of AH in patients carrying the G allele of PNPLA3 rs738409 (p = 0.0921).

Conclusion

PNPLA3 and HP genetic variants increase AH risk and are associated with total bilirubin and MELD score, surrogates of AH severity.
Impact of COVID‐19 and Nationwide Lockdowns on Vegetable Prices: Evidence from Wholesale Markets in China
Authors: Ruan Jianqing , Cai Qingwen , Jin Songqing
Published: February 2021

In this paper, we employ a combination of time regression discontinuity design method (T‐RD) and the difference‐in‐difference method (DID) to identify and quantify the causal effects of the strict lockdown policy on vegetable prices using multiple‐year daily price data from 151 wholesale markets of Chinese cabbage. We find that the lockdown policy caused a large and immediate surge in price and price dispersion of Chinese cabbage, though they fluctuated smoothly for the same period in normal years. The DID results further show that the price surge peaked in the fourth week of lockdown but gradually came down to the level of a normal year by week 11. However, the price rose again (though to a much smaller extent) in response to the resurgence of COVID‐19 in a few provinces in early‐mid April but quickly returned to the normal level in week 15 when the lockdown measures were largely removed. We also find that the supply chain disruption is the driving factor for the price hike. Policy implications are drawn.
Presidential Approval and the Inherited Economy
Authors: Sances Michael W.
Published: February 2021

Are leaders held accountable for inherited conditions, and does accountability increase with time in office? I combine hundreds of opinion polls to test how new presidents are rewarded or punished for current economic perceptions, and how these judgments evolve over time. I find the economy influences voter evaluations in a president's first year, that it influences evaluations more so in the second year, and that it does not influence evaluations any more in later years. Surveys of governor approval and state economic conditions yield similar results, as does an original survey experiment exploiting the varying tenure of state governors in the wake of the 2018 elections. While raising questions about voter competence, these findings also suggest leaders have incentives to spread effort more broadly over their terms.
Geographical access to recreational marijuana
Authors: Ambrose Christopher A. , Cowan Benjamin W. , Rosenman Robert E.
Published: February 2021

We investigate whether adult marijuana use in Washington responds to increased local access as measured by drive time to the nearest legal marijuana retailer as well as measures of retail density. Using survey data from the Behavioral Risk Factor Surveillance System, we find that as retailers open closer to where they live, more individuals use marijuana and more frequently. These effects are concentrated among young adults (ages 18–26), women, and rural residents. Controlling for distance to the nearest retailer, we find that whether retail density affects marijuana use depends on how it is measured.
Mergers and labor market outcomes in the US airline industry
Authors: Kim Myongjin , Ge Qi , Kim Donggeun
Published: February 2021

This article examines US airline mergers between 1993 and 2018 and studies their impact on the labor market. Our difference‐in‐differences estimates indicate a significant reduction in the merging airlines' long‐term wage and fringe benefits following the mergers. The effect is particularly salient among large‐scale mergers involving major airlines and low cost carriers. The results also suggest a negative short‐term employment impact of mergers that varies by occupation types. Our findings are consistent with the impact of merger‐induced monopsony power discussed in recent literature and offer important policy implications regarding how to account for employer monopsony power during mergers and acquisitions.
Is Lying Bound to Commitment? Empirically Investigating Deceptive Presuppositions, Implicatures, and Actions
Authors: Reins Louisa M. , Wiegmann Alex
Published: February 2021

Lying is an important moral phenomenon that most people are affected by on a daily basis—be it in personal relationships, in political debates, or in the form of fake news. Nevertheless, surprisingly little is known about what actually constitutes a lie. According to the traditional definition of lying, a person lies if they explicitly express something they believe to be false. Consequently, it is often assumed that people cannot lie by more indirectly communicating believed‐false claims, for instance by merely conversationally implicating them. In this paper, we subject this claim to an empirical test. In a preregistered study of 300 participants, we investigate how people judge cases of implicit deceptions that would usually be excluded by the traditional definition of lying (i.e., conversational implicatures, presuppositions, and nonverbal actions). Our results show that people do in fact consider it possible to lie by indirect means, suggesting that people have a broader concept of lying than is usually assumed. Moreover, our findings indicate that lie judgments are closely tied to the extent to which agents are perceived as having committed themselves to the believed‐false claims they have communicated. We discuss the implications of our results for the traditional definition of lying and propose a new commitment‐based definition of lying that can account for the findings of our experiment.
PAK4 suppresses motor neuron degeneration in hSOD1G93A‐linked amyotrophic lateral sclerosis cell and rat models
Authors: Cong Chaohua , Liang Weiwei , Zhang Chunting , Wang Ying , Yang Yueqing , Wang Xudong , Wang Shuyu , Huo Di , Wang Hongyong , Wang Di , Feng Honglin
Published: February 2021

Objectives

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by the progressive loss of motor neurons (MN). CREB pathway‐mediated inhibition of apoptosis contributes to neuron protection, and PAK4 activates CREB signalling in diverse cell types. This study aimed to investigate PAK4’s effect and mechanism of action in ALS.

Methods

We analysed RNA levels by qRT‐PCR, protein levels by immunofluorescence and Western blotting, and apoptosis by flow cytometry and TUNEL staining. Cell transfection was performed for in vitro experiment. Mice were injected intraspinally to evaluate PAK4 function in vivo experiment. Rotarod test was performed to measure motor function.

Results

The expression and activation of PAK4 significantly decreased in the cell and mouse models of ALS as the disease progressed, which was caused by the negative regulation of miR‐9‐5p. Silencing of PAK4 increased the apoptosis of MN by inhibiting CREB‐mediated neuroprotection, whereas overexpression of PAK4 protected MN from hSOD1G93A‐induced degeneration by activating CREB signalling. The neuroprotective effect of PAK4 was markedly inhibited by CREB inhibitor. In ALS models, the PAK4/CREB pathway was inhibited, and cell apoptosis increased. In vivo experiments revealed that PAK4 overexpression in the spinal neurons of hSOD1G93A mice suppressed MN degeneration, prolonged survival and promoted the CREB pathway.

Conclusions

PAK4 protects MN from degeneration by activating the anti‐apoptotic effects of CREB signalling, suggesting it may be a therapeutic target in ALS.
PERK signaling pathway in bone metabolism: Friend or foe?
Authors: Guo Jiachao , Ren Ranyue , Sun Kai , He Jinpeng , Shao Jingfan
Published: February 2021

Osteoblasts and osteoclasts participate in the process of bone remodelling to meet the needs of normal growth and development or repair pathological damage. Endoplasmic reticulum stress (ER stress) can break the intracellular homeostasis of osteoclasts and osteoblasts, which is closely related to abnormal bone remodelling. The double‐stranded RNA‐dependent protein kinase (PKR)‐like ER kinase (PERK) is a key transmembrane protein that regulates ER stress, and growing evidence suggests that the PERK pathway plays a crucial role in regulating bone metabolism under both physiological and pathological conditions. Based on the current findings, we summarized the main mechanisms involved in bone metabolism downstream of the PERK pathway, among which elF2α, FOXO1, CaN, Nrf2 and DAG play a role in regulating the differentiation of osteoblasts and osteoclasts. Importantly, strategies by the regulation of PERK pathway exert beneficial effects in preclinical trials of several bone‐related diseases. Given the importance and novelty of PERK pathway, we provide an overview and discuss the roles of PERK pathway in regulating bone metabolism and its impact on bone‐related diseases. We hope that the development of research in this field will bring a bright future for the treatment of bone‐related diseases.
Orthotopic liver transplant in the pregnant recipient: A systematic review of preoperative management and maternal and fetal outcomes
Authors: Romano Diana N. , Mokuolu Debbie C. , Katz Daniel J. , DeMaria Jr Samuel
Published: February 2021

Severe liver dysfunction requiring transplantation is a major event at any stage of life, but for those requiring liver transplantation while pregnant, two lives hang in the balance. Available evidence on this relatively rare event consists solely of case reports and have yet to be reviewed or synthesized. We performed a systematic literature review and analyzed reports of 22 patients who underwent liver transplantation during pregnancy. This review describes the reported etiologies of hepatic failure in pregnant patients requiring transplantation, perioperative anesthetic management techniques, and the maternal and fetal clinical outcomes.
Land‐use intensification increases richness of native and exotic herbaceous plants, but not endemics, in Malagasy vanilla landscapes
Authors: Raveloaritiana Estelle , Wurz Annemarie , Grass Ingo , Osen Kristina , Soazafy Marie Rolande , Martin Dominic A. , Faliniaina Lucien , Rakotomalala Nantenaina H. , Vorontsova Maria S. , Tscharntke Teja , Rakouth Bakolimalala
Published: February 2021

Aim

North‐eastern Madagascar is a hotspot of plant diversity, but vanilla and rice farming are driving land‐use change, including slash‐and‐burn management. It still remains unknown how land‐use change and land‐use history affect richness and composition of endemic, native and exotic herbaceous plant species.

Location

North‐eastern Madagascar.

Methods

We assessed herbaceous plants along a land‐use intensification gradient ranging from unburned land‐use types (i.e. old‐growth forest, forest fragment and forest‐derived vanilla agroforest) to burned land‐use types (i.e. fallow‐derived vanilla agroforest, woody fallow and herbaceous fallow) and rice paddy. We compared land‐use types and analysed the effects of land‐use history, canopy closure and landscape forest cover on species richness. Additionally, we analysed species compositional changes across land‐use types.

Results

Across 80 plots, we found 355 plant species (180 native non‐endemics, 57 exotics, 60 endemics and 58 species of unknown origin). Native and exotic species richness increased with increasing land‐use intensity, whereas endemics decreased. Unburned land‐use types had higher endemic species richness (4.28 ± 0.37 [mean ± SE]) than burned ones (2.4 ± 0.21). Exotic and native species richness, but not endemics, decreased with increasing canopy closure. Increasing landscape forest cover reduced exotic, but not native or endemic richness. Species composition of old‐growth forests was unique compared to all other land uses and forest‐derived, not fallow‐derived vanilla agroforests, had a similar endemic species composition to forest fragments.

Main conclusions

Our results indicate that old‐growth forests and forest fragments are indispensable for maintaining endemic herbaceous plants. We further show that the land‐use history of agroforests should be considered in conservation policy. In forest‐derived vanilla agroforests, management incentives are needed to halt loss of canopy closure, thereby maintaining or even enhancing endemics. In conclusion, considering species origin (endemic, native and exotic) and composition is essential for the identification of suitable management practices to avoid irreversible species loss.
Impact of diabetes on COVID‐19 and other infection: Report from the 22nd Hong Kong Diabetes and Cardiovascular Risk Factors—East Meets West Symposium
Authors: Luk Andrea O. Y. , Ng Susanna S. S. , Holt Richard I. G.
Published: February 2021

The coronavirus disease 2019 (COVID‐19) pandemic has posed enormous challenges to healthcare systems worldwide. The negative impact of COVID‐19 is widespread and includes not only people who contracted the disease but also those with chronic morbidities such as diabetes whose care is compromised due to diversion of medical resources. People with diabetes are generally more susceptible to infection as a result of altered immunity. People with diabetes have a worse prognosis from COVID‐19 and there is evidence to suggest that severe acute respiratory syndrome coronavirus 2 may directly affect pancreatic function precipitating hyperglycaemic crises. In the United Kingdom, one of the most heavily affected countries, guidelines are in place to unify the management of people with diabetes hospitalized for COVID‐19. Diabetes services are re‐organized to ensure that medical care of people with diabetes is maintained despite resource and other practical constraints. Public health measures including social distancing, hand hygiene and the use of face masks are crucial in containing community transmission of the virus. Hong Kong, one of the most densely populated city in the world, is particularly vulnerable and has in place a stringent containment policy and aggressive contact tracing to ensure public safety during this pandemic.
How long do population level field experiments need to be? Utilising data from the 40‐year‐old LTER network
Authors: Cusser Sarah , Helms Jackson , Bahlai Christie A. , Haddad Nick M.
Published: February 2021

We utilise the wealth of data accessible through the 40‐year‐old Long‐Term Ecological Research (LTER) network to ask if aspects of the study environment or taxa alter the duration of research necessary to detect consistent results. To do this, we use a moving‐window algorithm. We limit our analysis to long‐term (> 10 year) press experiments recording organismal abundance. We find that studies conducted in dynamic abiotic environments need longer periods of study to reach consistent results, as compared to those conducted in more moderated environments. Studies of plants were more often characterised by spurious results than those on animals. Nearly half of the studies we investigated required 10 years or longer to become consistent, where all significant trends agreed in direction, and four studies (of 100) required longer than 20 years. Here, we champion the importance of long‐term data and bolster the value of multi‐decadal experiments in understanding, explaining and predicting long‐term trends.
Population genomics of invasive rodents on islands: Genetic consequences of colonization and prospects for localized synthetic gene drive
Authors: Oh Kevin P. , Shiels Aaron B. , Shiels Laura , Blondel Dimitri V. , Campbell Karl J. , Saah J. Royden , Lloyd Alun L. , Thomas Paul Q. , Gould Fred , Abdo Zaid , Godwin John R. , Piaggio Antoinette J.
Published: February 2021

Introduced rodent populations pose significant threats worldwide, with particularly severe impacts on islands. Advancements in genome editing have motivated interest in synthetic gene drives that could potentially provide efficient and localized suppression of invasive rodent populations. Application of such technologies will require rigorous population genomic surveys to evaluate population connectivity, taxonomic identification, and to inform design of gene drive localization mechanisms. One proposed approach leverages the predicted shifts in genetic variation that accompany island colonization, wherein founder effects, genetic drift, and island‐specific selection are expected to result in locally fixed alleles (LFA) that are variable in neighboring nontarget populations. Engineering of guide RNAs that target LFA may thus yield gene drives that spread within invasive island populations, but would have limited impacts on nontarget populations in the event of an escape. Here we used pooled whole‐genome sequencing of invasive mouse (Mus musculus) populations on four islands along with paired putative source populations to test genetic predictions of island colonization and characterize locally fixed Cas9 genomic targets. Patterns of variation across the genome reflected marked reductions in allelic diversity in island populations and moderate to high degrees of differentiation from nearby source populations despite relatively recent colonization. Locally fixed Cas9 sites in female fertility genes were observed in all island populations, including a small number with multiplexing potential. In practice, rigorous sampling of presumptive LFA will be essential to fully assess risk of resistance alleles. These results should serve to guide development of improved, spatially limited gene drive design in future applications.
Multiaxial fatigue life prediction method of notched specimens considering stress gradient effect
Authors: Liu Jianhui , Ran Yong , Xie Linjun , Xue Wenzhuo
Published: February 2021

This paper investigates the effect of stress gradient on the fatigue life of U‐notched specimens under multiaxial proportional loading by studying the shear stress gradient and normal stress gradient on the crack initiation plane separately. First, based on the energy method and critical plane method, an energy‐critical plane method for determining the direction of crack initiation is proposed. Second, with the help of the concept of stress field intensity, the shear stress gradient and normal stress gradient on the critical plane are studied. Finally, a multiaxial fatigue life prediction model is established by combining the equivalent stress field intensity, composed of the shear stress field intensity and normal stress field intensity, with the Manson–Coffin equation. Theoretical analysis is verified by the experiments of Q345 steel notched specimens, and the results show that the predicted accuracy of the proposed method is not conservative and is superior to the local stress–strain method.
Proposal of Stroop test cut‐off values as screening for neuropsychological impairments in cirrhosis: A Japanese multicenter study
Authors: Kondo Yasuteru , Iwasa Motoh , Kawaratani Hideto , Miyaaki Hisamitsu , Hanai Tatsunori , Kon Kazuyoshi , Hirano Hirotaka , Shimizu Masahito , Yoshiji Hitoshi , Okita Kiwamu , Koike Kazuhiko
Published: February 2021

Aim

Despite its relevant clinical impact and high prevalence, covert hepatic encephalopathy (HE) still remains underdiagnosed. As patients with liver cirrhosis tend to be older in Japan, more suitable tests for the elderly and cut‐off values based on this attribute are needed. Recently, a Stroop test has been developed and validated for the screening and diagnosis of covert HE in the United States. The present study aims to establish the cut‐off values of the Stroop test to screen covert HE.

Methods

This study was a prospective multicenter cross‐sectional endeavor. We undertook a survey of 311 cirrhotic patients, administering the number connection test (NCT)‐A and ‐B and the Stroop‐off and ‐on test.

Results

We determined the cut‐off values of Stroop test results for cirrhotic patients in a variety of age ranges. The cut‐off value of the Stroop test was strongly correlated with age. There was a significant correlation between the results of NCT‐B and age, and Stroop‐on test results showed a correlation with serum albumin (Alb) levels. Serum Alb ≤3.2 g/dl could have the potential to be an objective biomarker of covert HE. In addition, stepwise logistic regression analysis revealed a relationship between the results of the Stroop‐on test and plasma ammonia levels.

Conclusions

We established the cut‐off values of Stroop test results and confirmed the efficacy of the Stroop test as a simple tool for assessing cognitive alterations. The Stroop test could be suitable as a necessary minimum for the diagnosis of covert HE.
Influence of sweet potato flour on the microstructure and nutritional quality of gluten‐free fresh noodles
Authors: Salama Mahmoud , Mu Taihua , Sun Hongnan
Published: February 2021

This study investigated the influence of sweet potato flour (SPF) on the microstructure, nutritional and sensory qualities of gluten‐free fresh noodles (GFFN). Five kinds of GFFN were produced using SPF (0%–50%) and were compared with cornflour (CF) and wheat flour (WF) noodles. Adding SPF increased springiness and chewiness of the noodles. The β‐sheet (amide I, C=O and N–H) and total β‐sheet (1704–1683 and 1633–1614 cm−1) protein structures in SPF noodles significantly increased relative to WF. Besides, electron microscopy showed matrix of the filamentous structure in SPF noodles that can mimic a matrix network identical to that of the network in WF. Furthermore, total phenols and antioxidant activity (DPPH and FRAP) were the highest for 40% SPF noodles. This research confirmed that SPF had the potential for improving the microstructure and nutritional value of the noodles, especially for consumers with coeliac disease.
The production of volatile compounds in model casein systems with varying fat levels as affected by low‐frequency ultrasound
Authors: Bui Anh Thi Hong , Cozzolino Daniel , Zisu Bogdan , Chandrapala Jayani
Published: February 2021

The effects of low‐frequency ultrasound on the production of volatile compounds in model casein protein systems containing various fat concentrations of 2%, 4% and 6% (w/w) were investigated. Ultrasound application was performed at 20 kHz for up to 10 min which corresponded to energy densities ranging from 9.54 to 190.8 J mL−1. Similar volatile compounds were detected both in pure fat and mixtures of casein and fat (CF) systems. These volatiles belonged to the groups of aldehydes, ketones, esters, alcohols and hydrocarbons, which were the products of oxidation of lipids or protein degradation due to acoustic cavitation. The amount of fat in the casein systems had minor effects on the production of volatiles, whereas the production of volatile compounds was significantly affected by the ultrasound treatment. Short sonication times <5 min generated similar volatile profiles to the untreated samples. In contrast, prolonged sonication for 5 and 10 min considerably increased the production of volatile compounds and the amounts of fatty acids. Thus, the application of low–frequency ultrasound for short periods should be considered to minimise the production of volatile compounds which can ultimately affect the taste.
Reduced expansion of CD94/NKG2C+ NK cells in chronic lymphocytic leukemia and CLL‐like monoclonal B‐cell lymphocytosis is not related to increased human cytomegalovirus seronegativity or NKG2C deletions
Authors: Puiggros Anna , Blanco Gonzalo , Muntasell Aura , Rodríguez‐Rivera María , Nonell Lara , Altadill Mireia , Puigdecanet Eulàlia , Arnal Magdalena , Calvo Xavier , Gimeno Eva , Abella Eugènia , Abrisqueta Pau , Bosch Francesc , Yélamos José , Ferrer Ana , López‐Botet Miguel , Espinet Blanca
Published: February 2021

Introduction

Dysregulated NK cell‐mediated immune responses contribute to tumor evasion in chronic lymphocytic leukemia (CLL), although the NK cell compartment in CLL‐like monoclonal B‐cell lymphocytosis (MBL) is poorly understood. In healthy individuals, human cytomegalovirus (HCMV) induces the expansion of NK cells expressing high levels of CD94/NKG2C NK cell receptor (NKR) specific for HLA‐E.

Methods

We analyzed the expression of NKG2A, NKG2C, ILT2, KIR, CD161, and CD57 in 24 MBL and 37 CLL. NKG2C was genotyped in these patients and in 81 additional MBL/CLL, while NKG2C gene expression was assessed in 26 cases. In 8 CLL patients with increased lymphocytosis (≥20 × 109/L), tumor HLA‐E and HLA‐G expression was evaluated.

Results

NKR distribution did not significantly differ between MBL and CLL patients, although they exhibited reduced NKG2C+ NK cells compared with a non‐CLL group (4.6% vs 12.2%, P = .012). HCMV+ patients showed increased percentages of NKG2C+ NK cells compared with HCMV− (7.3% vs 2.9%, P = .176). Frequencies of NKG2C deletions in MBL/CLL were similar to those of the general population. Low/undetectable NKG2C expression was found among NKG2C+/− (45%) and NKG2C+/+ (12%) patients. CLL cases with increased lymphocytosis displayed especially reduced NKG2C expression (1.8% vs 8.1%, P = .029) and tumor cells with high HLA‐E (>98%) and variable HLA‐G expression (12.4%, range: 0.5‐56.4). CLL patients with low NKG2C expression (<7%) showed shorter time to first treatment (P = .037).

Conclusion

Reduced percentages of CD94/NKG2C+ NK cells were observed in CLL and MBL patients independently of HCMV serostatus and NKG2C zygosity, particularly in CLL patients with increased lymphocytosis, which could potentially be related to the exposure to tumor cells.
Association of electronic health literacy with health‐promoting behaviours in adolescents
Authors: Korkmaz Aslan Gülbahar , Kartal Asiye , Turan Türkan , Taşdemir Yiğitoğlu Gülay , Kocakabak Cansel
Published: February 2021

Aim

This study aimed to determine the electronic health (e‐health) literacy level of high school students and its relationship with their health‐promoting behaviours.

Methods

This was a cross‐sectional study conducted between April and May 2018. The study sample consisted of 409 students, who were aged between 14 and 19 years old, in three high schools located in the city centre of Denizli. Multiple regression analyses were performed to examine the predictive variables for six dimensions of health‐promoting behaviours.

Results

In this study, the mean (SD) e‐health literacy score of 27.89 (6.19) was slightly above moderate level. e‐Health literacy was found to significantly predict all six dimensions of health‐promoting behaviours positively, that is, e‐health literacy was determined to predict the dimensions of nutritional behaviours (β = 0.64, P < 0.001), life appreciation (β = 0.55, P < 0.001), social support (β = 0.72, P < 0.001), exercise (β = 0.36, P < 0.001), stress management (β = −0.22, P < 0.001) and health responsibility (β = 0.68, P < 0.001).

Conclusion

With e‐health literacy significantly predictive of health‐promoting behaviours, nurses are recommended to consider the e‐health literacy levels of adolescents in the health‐promoting programs they design.
Mechanism of hypertensive crisis during energy device ablation of the adrenal gland: An experimental animal study
Authors: Fujisaki Akira , Takayama Tatsuya , Suzuki Motofumi , Kubo Taro , Teratani Takumi , Kurokawa Shinsuke , Kameda Tomohiro , Komatsubara Maiko , Morita Tatsuo , Fujimura Tetsuya
Published: February 2021

Objective

To elucidate the mechanism of hypertensive crisis during energy device ablation of the adrenal gland.

Methods

Electrocoagulation on the adrenal glands of six pigs was carried out with the same energy device (VIO300D) using four methods: (i) monopolar coagulation; (ii) monopolar soft coagulation using IO‐advanced ball‐type electrodes; (iii) bipolar soft coagulation by pinching; and (iv) bipolar soft coagulation by non‐pinching (surface contact) using Bipolar forceps Premium. After electrocoagulation for 5 s, blood pressure and pulse changes were monitored, and adrenal hormones were measured from a central vein. The adrenal glands were removed, and the degree of tissue damage was scored histologically.

Results

Hypertensive crisis occurred with electrocoagulation of the adrenal gland by the monopolar coagulation, monopolar soft coagulation and bipolar soft coagulation pinching methods. Blood pressure did not change with the bipolar soft coagulation non‐pinching method. Pathologically, tissue damage to the adrenal medulla was associated with elevated blood pressure and adrenaline and noradrenaline release.

Conclusions

Hypertensive crisis caused by energy device ablation to the adrenal gland is caused by the release of catecholamines due to heat damage to the adrenal medulla rather than the type of energy device. Proper use of an energy device that does not cause thermal degeneration of the medulla is required to prevent hypertensive crisis.
Professor Serara Kupe‐Mogwe’s contribution to development of the nursing profession in Botswana
Authors: McFarland D. M.
Published: February 2021

Background

The aim of this communication is to pay tribute to a nursing pioneer of our time, Professor Serara Kupe‐Mogwe, for her outstanding contribution to development of the nursing profession in Botswana. I pay this tribute in response to the World Health Organization’s declaration of 2020 as the Year of the Nurse and the Midwife.

Methods

Data supporting this manuscript were obtained through Internet searches, local newspapers, and interviews with those who knew her.

Results

Kupe‐Mogwe’s contributions to nursing in Botswana are presented.

Conclusion

The legacy she has left is celebrated and should be remembered.

Implications for Nursing and/or Health policy

The findings have implications for nursing education, nursing leadership, and acknowledgment of women and their contribution.
Perceived human and material costs of disasters as drivers of donations
Authors: Zagefka Hanna
Published: February 2021

Are disaster relief appeals more successful if they emphasize the material cost of disaster events in terms of economic damages and need for shelter, food, and health care, or if they emphasize the human cost in terms of psychological suffering and trauma caused? Although giving patterns seem to suggest that large‐scale events that cause widespread material damage (e.g., the Asian Tsunami of 2004) are more successful at eliciting donations than smaller scaled events, it is argued that this pattern is explained by the fact that large perceived material damage leads to more perceived human suffering. In other words, it is the perceived human suffering which is the proximal driver of donations, rather than the material damage itself. Therefore, relief appeals that emphasize the human cost of events are more successful at eliciting donations than appeals that emphasize the material cost of events. This was demonstrated in a study focusing on donations by British participants (N = 200) to the Syrian refugee crisis in 2020, a study focusing on donations by British participants to victims of severe weather events in Eastern and Southern Africa in 2020 (N = 210), and a study among British participants focusing on a fictitious event (N = 150).
Mindful BALANCE (breathe act learn about ‘now’ care everyday): A pilot project for depressed female adolescents
Authors: Rich Beverly Waldman , Stager Sharon L.
Published: February 2021

Problem

Major depressive episodes in adolescent females have increased during the past decade, placing them at risk to engage in unhealthy lifestyle behaviors, unsafe thoughts, suicidal ideation, and lethal actions. Mindfulness, a tool for stress management, is underutilized.

Methods

Mindful BALANCE (Breathe Act Learn About ‘Now’ Care Everyday), a group therapy pilot program introduced a variety of mindfulness activities. The extended mindfulness followed the Creating Opportunities for Personal Empowerment (COPE), a Cognitive Behavioral Therapy Skills Building (CBSB) Healthy Lifestyle program. The pilot program was offered in an outpatient mental health department for 7 weeks.

Findings

Mindful BALANCE is a feasible program as an adjunct to individualized psychotherapy. Six subjects engaged without absence with a completion rate of 83%. Six subjects had pre‐ and post‐scores for depression and anxiety decrease. Mindfulness practice was reported to decrease the perception of stress.

Conclusion

Mindful BALANCE decreased perceived depression and anxiety symptoms while positively impacting healthy activities in adolescent females. Further research is necessary to readdress feasibility and extended mindfulness components in improving global well‐being and diminishing suicide risk.
Diffusing the Abolitionist Norm in Japan: EU ‘Death Penalty Diplomacy’ and the Gap between Rhetoric and Reality in EU–Japan Relations
Authors: Bacon Paul , Nakamura Hidetoshi
Published: February 2021

This article uses Börzel and Risse's norm diffusion framework to conceptualize and evaluate the EU's ‘death penalty diplomacy’ in Japan. Despite the ‘exceptional’ nature of Japanese politics with regard to the death penalty the EU has enjoyed numerous successes in its attempts to diffuse the abolitionist norm within Japan. These successes have occurred through both direct and indirect methods of norm diffusion, and through socialization, persuasion and functional emulation. Despite the dramatic increase in executions in Japan in 2018, in practice the EU and Japan have established an understanding that executions will in future stabilize at a low and symbolic level. The EU has also co‐funded research that successfully challenged the Japanese government's public opinion polling‐based justification for retaining the death penalty. This research also played an important role in socializing and persuading the Japanese Federation of Bar Associations to change its official position and to support the abolition of the death penalty.
Evidence‐based traditional Chinese medicine research: Two decades of development, its impact, and breakthrough
Authors: Tian Guihua , Zhao Chen , Zhang Xiaoyu , Mu Wei , Jiang Yin , Wei Xuxu , Zhao Mengzhu , Shi Zhaofeng , Jin Yinghui , Si Jinhua , Wang Jiaying , Hu Jiayuan , Guan Manke , Qiu Ruijin , Zhong Changming , Li Min , Sun Yang , Chen Zhao , You Liangzhen , Li Jinyu , Shang Hongcai
Published: February 2021

It has been over 20 years since the introduction of evidence‐based medicine (EBM) into the research of traditional Chinese medicine (TCM). The development of evidence‐based TCM research has profoundly influenced the process of clinical research and decision‐making, impelling researchers to pay attention to raise evidence quality, accumulate data, and explore appropriate evaluation methods adaptive to TCM original theories and knowledge. In this paper, the authors aim to summarize and review the existing work and seek promising research interests in this field, expecting to inspire more thoughts leading to breakthroughs in the near future.
Development and usability evaluation of VOICES: A digital health tool to identify elder mistreatment
Authors: Abujarad Fuad , Ulrich Davis , Edwards Chelsea , Choo Esther , Pantalon Michael V. , Jubanyik Karen , Dziura James , D'Onofrio Gail , Gill Thomas M.
Published: February 2021

Background/Objectives

A major barrier for society in overcoming elder mistreatment is an inability to accurately identify victims. There are several barriers to self‐reporting elder mistreatment, including fear of nursing home placement or losing autonomy or a caregiver. Existing strategies to identify elder mistreatment neglect to empower those who experience it with tools for self‐reporting. In this project, we developed and evaluated the usability of VOICES, a self‐administrated digital health tool that screens, educates, and motivates older adults to self‐report elder mistreatment.

Design

Cross‐sectional study with User‐Centered Design (UCD) approach.

Setting

Yale School of Medicine and the Agency on Aging of South‐Central Connecticut.

Participants

Thirty eight community‐dwelling and cognitively intact older adults aged 60 years and older, caregivers, clinicians, and social workers.

Intervention

A tablet‐based self‐administrated digital health tool that screens, educates, and motivates older adults to self‐report elder mistreatment.

Measurements

Qualitative and quantitative data were obtained from: (1) focus groups participants including: feedback from open‐ended discussion, demographics, and a post‐session survey; (2) usability evaluation including: demographics, usability measures, comfortability with technology, emotional state, and open‐ended feedback.

Results

Focus group participants (n = 24) generally favored using a tablet‐based tool to screen for elder mistreatment and expressed comfort answering questions on elder mistreatment using tablets. Usability evaluation participants (n = 14) overall scored VOICES a mean System Usability Scale (SUS) score of 86.6 (median = 88.8), higher than the benchmark SUS score of 68, indicating excellent ease of use. In addition, 93% stated that they would recommend the VOICES tool to others and 100% indicated understanding of VOICES' information and content.

Conclusion

Our findings show that older adults are capable, willing, and comfortable with using the innovative and self‐administrated digital tool for elder mistreatment screening. Our future plan is to conduct a feasibility study to evaluate the use of VOICES in identifying suspicion of mistreatment.
Central signalling cross‐talk between insulin and leptin in glucose and energy homeostasis
Authors: Boucsein Alisa , Kamstra Kaj , Tups Alexander
Published: February 2021

Energy homeostasis is controlled by an intricate regulatory system centred in the brain. The peripheral adiposity signals insulin and leptin play a crucial role in this system by informing the brain of the energy status of the body and mediating their catabolic effects through signal transduction in hypothalamic areas that control food intake, energy expenditure and glucose metabolism. Disruptions of insulin and leptin signalling can result in diabetes and obesity. The central signalling cross‐talk between insulin and leptin is essential for maintenance of normal healthy energy homeostasis. An important role of leptin in glucoregulation has been revealed. Typically regarded as being controlled by insulin, the control of glucose homeostasis critically depends on functional leptin action. Leptin, on the other hand, is able to lower glucose levels in the absence of insulin, although insulin is necessary for long‐term stabilisation of euglycaemia. Evidence from rodent models and human patients suggests that leptin improves insulin sensitivity in type 1 diabetes. The signalling cross‐talk between insulin and leptin is likely conveyed by the WNT/β‐catenin pathway. Leptin activates WNT/β‐catenin signalling, leading to inhibition of glycogen synthase kinase‐3β, a key inhibitor of insulin action, thereby facilitating improved insulin signal transduction and sensitisation of insulin action. Interestingly, insights into the roles of insulin and leptin in insects and fish indicate that leptin may have initially evolved as a glucoregulatory hormone and that its anorexigenic and body weight regulatory function was acquired throughout evolution. Furthermore, the regulation of both central and peripheral control of energy homeostasis is tightly controlled by the circadian clock, allowing adaptation of homeostatic processes to environmental cues.
Rethinking rural‐urban linkages: Villages and agribusiness in the Ecuadorian Highlands
Authors: Martínez Valle Luciano
Published: February 2021

This article addresses current linkages between rural villages and agribusiness in two rural territories in the Ecuadorian highlands. It seeks to analyse rural space endogenously or “from the inside” in order to highlight the socio‐economic changes that have been generated in rural villages embedded in territories dominated by agribusiness. These changes correspond not only to the capitalist dynamics generated by these agribusinesses but also to the responses of local actors. Far from disappearing from the rural scene, these villages have adapted to different degrees to the new conditions and opportunities within the territory. In no way, they can be considered as passive recipients of the capitalist dynamics implemented over the last three decades. On the contrary, to the extent that they have managed to reactivate their productive functions in a diversified manner, they have laid the social and material bases for their continued territorial relevance and permanence.
The clinical spectrum of periorbital vascular complications after facial injection
Authors: Lee Ko‐Eun , Kim Gye‐Jung , Sa Ho‐Seok
Published: February 2021

Background

Serious complications due to periorbital vascular occlusion can occur after facial injections, including skin necrosis, ophthalmoplegia, blepharoptosis, and visual loss. Visual loss after facial filler injection is particularly rare, but it is known to have a poor prognosis despite treatment.

Aims

This study aimed to describe the prognosis and various clinical features of periorbital vascular complications after facial injection of cosmetic filler or local anesthetic.

Patients/Methods

This single‐center retrospective study included 10 consecutive patients who presented with occluded periorbital vessels after facial injection.

Results

Nine patients were injected with cosmetic facial fillers: seven with hyaluronic acid, one with collagen, and one with poly‐Llactic acid. The other patient was injected with lidocaine mixed with epinephrine. Injection sites included the glabella (n = 5), nasal dorsum (n = 4), and temporal fossa (n = 1). Presumed arteries affected included the central (n = 2) or branch (n = 3) retinal artery, ophthalmic artery (n = 4), and angular artery (n = 1). Nine patients (90%) had purpura and blisters, and eight patients (80%) had ophthalmoplegia at presentation, but all of them recovered within 3 months. Six patients (60%) were blind at the last follow‐up, and five of them had occlusion of the central retinal artery or ophthalmic artery. There was a patient with sequelae of phthisis bulbi, which was cosmetically managed with retrobulbar filler injections.

Conclusion

Facial injections can cause periorbital arterial occlusion, and the clinical features are diverse according to the site and extent of vascular occlusion and injection materials. Visual prognosis was associated with the site of vascular occlusion and initial visual acuity. Other common complications, such as skin lesions, blepharoptosis, and limited extraocular movement, can fully resolve only with supportive treatments in most cases.
Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review
Authors: Soikkeli‐Jalonen Anu , Mishina Kaisa , Virtanen Heli , Charalambous Andreas , Haavisto Elina
Published: February 2021

Aims and objectives

To systematically review existing literature exploring supportive interventions for family members of very seriously ill patients in inpatient care.

Background

Being around a patient with a very serious illness in inpatient care setting is stressful and burdensome for family members. There is little information available on interventions that support family members of very seriously ill patients in inpatient care.

Design

A systematic review.

Methods

The literature review was conducted in May 2020 using four databases: PubMed (Medline), CINAHL, PsycINFO and Cochrane. A quality assessment was performed using the Quality Assessment Tool for Before‐After (Pre‐Post) Studies With No Control Group by the National Heart, Lung, and Blood Institute. The PRISMA checklist was used to support specific reporting and the TIDieR checklist to form detailed descriptions of the interventions.

Results

Of the 7165 identified studies, 11 studies were included in the review based on predetermined criteria. Interventions were based on meetings with family members, education or therapy. Mindfulness‐ and therapy‐based interventions and multiple‐session tailored interventions showed beneficial outcomes for psychological symptoms and educational interventions on preparedness and self‐efficacy. Several different measuring instruments to evaluate similar outcomes, such as psychological symptoms and coping, were used.

Conclusions

Only a few supportive interventions for family members of very seriously ill patients in inpatient care were found, which made comparing the differences in the varying study methods and outcomes difficult. More studies on supportive interventions and their feasibility and effectiveness are essential. Further evaluation of instruments is necessary to identify the most valid and reliable ways of measuring symptoms and coping.

Relevance to Clinical Practice

The results of this study can be used in clinical practice when selecting effective interventions or assessing family members' need for support. Additionally, the results can be used for guidance when developing new, effective interventions.