bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic circulating biomarkers to detect vision‐threatening diabetic retinopathy: Potential screening tool of the future?
Authors: Frudd Karen , Sivaprasad Sobha , Raman Rajiv , Krishnakumar Subramanian , Revathy Yeddula Rebecca , Turowski Patric
Published: July 2021

With the increasing prevalence of diabetes in developing and developed countries, the socio‐economic burden of diabetic retinopathy (DR), the leading complication of diabetes, is growing. Diabetic retinopathy (DR) is currently one of the leading causes of blindness in working‐age adults worldwide. Robust methodologies exist to detect and monitor DR; however, these rely on specialist imaging techniques and qualified practitioners. This makes detecting and monitoring DR expensive and time‐consuming, which is particularly problematic in developing countries where many patients will be remote and have little contact with specialist medical centres. Diabetic retinopathy (DR) is largely asymptomatic until late in the pathology. Therefore, early identification and stratification of vision‐threatening DR (VTDR) is highly desirable and will ameliorate the global impact of this disease. A simple, reliable and more cost‐effective test would greatly assist in decreasing the burden of DR around the world. Here, we evaluate and review data on circulating protein biomarkers, which have been verified in the context of DR. We also discuss the challenges and developments necessary to translate these promising data into clinically useful assays, to detect VTDR, and their potential integration into simple point‐of‐care testing devices.
Mindfulness meditation experiences of novice practitioners in an online intervention: Trajectories, predictors, and challenges
Authors: Osin Evgeny N. , Turilina Irina I.
Published: July 2021

Background

The benefits of mindfulness interventions are well‐known, but their challenges and individual differences in reactions to these challenges are much less clear.

Methods

The study used a mixed‐methods design to investigate the individual trajectories of daily experiences during meditation in a sample of novice volunteers participating in a 3‐week, distance‐based, guided meditation intervention (N = 175).

Results

Multilevel modelling revealed individual differences in the change trajectories of the experiences of effort, meaning, and boredom during meditation, indicating that meditation gradually became less effortful, less boring, more interesting, and more important over the 3 weeks. The individual differences in the levels of these experiences and their change trends were associated with baseline differences in well‐being, reflective processes, self‐management, and self‐control skills, as well as autonomous motivation to engage in the course.

Conclusions

Individuals who are initially more autonomous and mindful find it easier to engage with online mindfulness interventions and draw more benefits from the process, whereas those with lower self‐regulation skills or higher proneness to rumination are more likely to experience mindfulness as effortful and boring, and, eventually, to give it up.
Adopting the COM‐B model and TDF framework in oral and dental research: A narrative review
Authors: Buchanan Heather , Newton Jonathon Timothy , Baker Sarah R , Asimakopoulou Koula
Published: July 2021

Background

Recent advances in the psychological understanding of health‐related behaviour have focused on producing a comprehensive framework to model such behaviour. The Capability‐Opportunity‐Motivation‐Behaviour (COM‐B) and its associated Theoretical Domains Framework (TDF) allow researchers to classify psychological and behavioural constructs in a consistent and transferable manner across studies.

Aim

To identify oral and dental health‐related studies that have used the TDF and/or COM‐B as frameworks to guide research and examine the ways in which these concepts have been practically used in such research.

Method

Narrative review of published literature. To be included, the paper had to (1) state that the TDF or COM‐B had been used and to have targeted at least one construct identified in either framework, (2) include primary empirical data, (3) focus on a behaviour directly related to oral or dental‐related health (eg brushing, applying fluoride varnish, flossing) and/or attitudes, intentions and beliefs related to the behaviour. Studies could include any research design, and participants of any age or gender and include patients, parents or dental health professionals.

Findings

Nine studies were identified that had drawn on the COM‐B and/or TDF as the framework for their research. Seven of the studies were based on the TDF only, with one employing both the COM‐B and Health Belief Model, and one using the TDF with COM‐B. The nine studies covered a broad range of oral health‐related behaviours including child tooth brushing, fluoride varnish application and non‐ or micro‐invasive management of proximal caries lesions. The populations in the studies included dentists, dental teams and parents of children. All studies adopted only a subset of the constructs within the TDF, often without justification.

Conclusions

It is encouraging that oral health researchers are adopting standardized psychological frameworks to develop their research and oral health interventions. Future work should build on the small number of studies identified in this review and consider using standardized tools to do so.
Impacts of the COVID‐19 epidemic on the department of stomatology in a tertiary hospital: A case study in the General Hospital of the Central Theater Command, Wuhan, China
Authors: Dong Qingshan , Kuria Angelica , Weng Yanming , Liu Yu , Cao Yang
Published: July 2021

Objective

The impact of the worldwide COVID‐19 pandemic on the dental community is evident. Dental education programmes and academic activities have suffered from the ramifications of the pandemic. This study aimed to depict the impacts of the COVID‐19 epidemic on the clinical services and academic activities in the department of stomatology of a tertiary hospital in Wuhan, China.

Methods

We obtained historical data of the Department of Stomatology from the Health Information System of the General Hospital of Central Theater Command, Wuhan, China between January 2018 and June 2020. Mean, standard deviation and median with interquartile range were used to summarize the variables. Line plots were used to illustrate the temporal trend. The Kruskal‐Wallis equality‐of‐populations rank test was used to compare the difference between groups.

Results

A significant decrease was noted in the monthly average number of patients seeking outpatient services for the year 2020, which were decreased by two‐thirds from 2018 to 2020. The number of emergency cases also decreased significantly by 57.6% in 2020. The monthly number of teaching hours decreased from 3.8 ± 1.5 in 2018 and 4.7 ± 1.4 in 2019 to 1.7 ± 1.9 in 2020. The number of interns also decreased by more than 77.0% in 2020.

Conclusions

The impacts of COVID‐19 in the stomatology clinic were significant with notable decreases in clinical services and education offered to the stomatology students. There is a need to find solutions to keep as many dental professionals as needed remaining on the frontline of oral health care.
Evaluation of laryngeal vascular changes with image1 s enhancement system in reference to the European laryngological society guideline
Authors: Yıldırım Sibel , Küçük Tarık Babür , Büyükatalay Zahide Çiler , Gökmen Muhammet Fatih , Gökcan Mustafa Kürşat , Dursun Gürsel
Published: July 2021

Objectives

To assess the feasibility of using Image1 S™ endoscopic enhancement system for discrimination of the vascular patterns in laryngeal lesions.

Design

Forty patients presenting with benign, dysplastic and malignant laryngeal lesions were examined with Image1 S system. The vascular patterns were classified by a group of authors according to the European Laryngological Society (ELS) guideline, as perpendicular or longitudinal, in all lesions. The relationship between the vascular patterns and the pathological results was statistically analysed. Endoscopic images of the lesions were evaluated through an online survey by a group of otolaryngologists with different levels of clinical expertise and asked them to choose a diagnosis and a vascular pattern. The vascular pattern evaluations of the participants were compared to the authors’ evaluations to determine the interobserver reliability. The final diagnostic judgements of the participants were compared with the definitive histopathological diagnoses.

Setting

Tertiary university hospital.

Participants

Forty patients with laryngeal lesions and thirty otolaryngologists with different clinical experience levels.

Main outcome measures

The study evaluates the usefulness of the Image1 S system for the detecting the vascular patterns associated with benign, dysplastic, and malignant lesions and measures the level of accuracy and inter observer agreement in detecting the final histopathology.

Results

Histopathological examination diagnosed 12 patients as benign, 12 dysplastic and 16 malignant. Using Image1 S, the vascular patterns were longitudinal in 11 lesions, perpendicular in 28 lesions and undetectable in 1 lesion. With white light, longitudinal pattern was observed in 14 lesions, perpendicular in 21 lesions and undetectable in 5 lesions. The correlation between the vascularisation pattern and the pathological diagnosis was found to be significant (p < .001). The qualitative evaluation of the vascular patterns by the two groups of observers showed significant reliability (κ = 0.63, p < .001). The agreement with the final diagnoses was also significant (κ = 0.56, p < .001).

Conclusions

Image1 S endoscopic enhancement system with spectral modes provides an improved visibility of the vascular patterns defined by the ELS in laryngeal lesions. ELS classification can reliably distinguish benign lesions from suspected ones and can be applied even by less‐experienced clinicians but the final diagnosis needs experience and should be confirmed with histopathology.
A distance‐based living donor kidney education program for Black wait‐list candidates: A feasibility randomized trial
Authors: Sieverdes John C. , Mueller Martina , Nemeth Lynne S. , Patel Sachin , Baliga Prabhakar K. , Treiber Frank A.
Published: July 2021

Addressing racial disparities in living donor kidney transplants (LDKT) among Black patients warrants innovative programs to improve living donation rates. The Living Organ Video Educated Donors (LOVED) program is a 2‐arm, culturally‐tailored, distance‐based, randomized controlled feasibility trial. The group‐based, 8‐week program used peer‐navigator led video chat sessions and web‐app video education for Black kidney waitlisted patients from United States southeastern state. Primary feasibility results for LOVED (n = 24) and usual care (n = 24) arms included LOVED program tolerability (i.e., 95.8% retention), program fidelity (i.e., 78.9% video education adherence and 72.1% video chat adherence). LDKT attitudinal and knowledge results favored the LOVED group where a statistically significant effect was reported over 6‐months for willingness to approach strangers (estimate ± SE: ‐1.0 ± .55, F(1, 45.3) = 7.5, P = .009) and self‐efficacy to advocate for a LDKT ‐.81 ± .31, F(1, 45.9) = 15.2, P < .001. Estimates were improved but not statistically significant for willingness to approach family and friends, LDKT knowledge and concerns for living donors (all P’s > .088). Secondary measures at 6 months showed an increase in calls for LOVED compared to usual care (P = .008) though no differences were found for transplant center evaluations or LDKTs. Findings imply that LOVED increased screening calls and attitudes to approach potential donors but feasibility outcomes found program materials require modification to increase adherence.
Factors associated with a change in disposition for mental health patients boarding in an urban Paediatric emergency department
Authors: O'Donnell Erin P. , Breden Larisa E. , Munjapara Vasu , Ryan Leticia M. , Yanek Lisa , Reynolds Elizabeth K. , Ngo Thuy
Published: July 2021

Aim

Paediatric emergency departments (ED) nationwide experience a shared burden of boarding mental health patients. Whilst boarding, some patients have a change in disposition from hospitalization to discharge home. This phenomenon raises concern because EDs often have scarce resources for mental health patients. We sought to understand which patient and clinical factors are associated with a change in disposition outcome.

Methods

A nested age‐sex‐race frequency‐matched case–control study was conducted including paediatric patients who presented to an urban PED for mental healthcare over a 36‐month period. Control patients included patients admitted to an inpatient psychiatric facility, whilst case patients were those discharged home. Descriptive statistics and multivariable logistic regression analyses were performed to compare groups.

Results

Case patients were more likely to receive intramuscular Haloperidol (OR 2.2 [CI 1.1–4.4]) for agitation and a psychiatric consult (OR 2.3 [1.4–3.9]) whilst boarding. Case patients were also more likely to present with behavioural concerns (OR 1.8 [CI 1.1–3.1]) and have additional complexities such as medical comorbidities (OR 1.8 [CI 1.1–2.9]) or suicidal ideation/attempt (OR 2.6 [CI 1.1–6.1]). Amongst the most common themes for disposition change was improved patient status (58.8%).

Conclusion

These findings suggest that boarding mental health patients have different disposition outcomes and thus may benefit from patient‐specific treatment interventions. Given that patients' statuses may change during the boarding period prompting discharge to home, more focus should be directed to developing brief evidence‐based practises that may be implemented in the ED and effectively bridge the gap to outpatient mental health services.
Seizure detection using wearable sensors and machine learning: Setting a benchmark
Authors: Tang Jianbin , El Atrache Rima , Yu Shuang , Asif Umar , Jackson Michele , Roy Subhrajit , Mirmomeni Mahtab , Cantley Sarah , Sheehan Theodore , Schubach Sarah , Ufongene Claire , Vieluf Solveig , Meisel Christian , Harrer Stefan , Loddenkemper Tobias
Published: July 2021

Objective

Tracking seizures is crucial for epilepsy monitoring and treatment evaluation. Current epilepsy care relies on caretaker seizure diaries, but clinical seizure monitoring may miss seizures. Wearable devices may be better tolerated and more suitable for long‐term ambulatory monitoring. This study evaluates the seizure detection performance of custom‐developed machine learning (ML) algorithms across a broad spectrum of epileptic seizures utilizing wrist‐ and ankle‐worn multisignal biosensors.

Methods

We enrolled patients admitted to the epilepsy monitoring unit and asked them to wear a wearable sensor on either their wrists or ankles. The sensor recorded body temperature, electrodermal activity, accelerometry (ACC), and photoplethysmography, which provides blood volume pulse (BVP). We used electroencephalographic seizure onset and offset as determined by a board‐certified epileptologist as a standard comparison. We trained and validated ML for two different algorithms: Algorithm 1, ML methods for developing seizure type‐specific detection models for nine individual seizure types; and Algorithm 2, ML methods for building general seizure type‐agnostic detection, lumping together all seizure types.

Results

We included 94 patients (57.4% female, median age = 9.9 years) and 548 epileptic seizures (11 066 h of sensor data) for a total of 930 seizures and nine seizure types. Algorithm 1 detected eight of nine seizure types better than chance (area under the receiver operating characteristic curve [AUC‐ROC] = .648–.976). Algorithm 2 detected all nine seizure types better than chance (AUC‐ROC = .642–.995); a fusion of ACC and BVP modalities achieved the best AUC‐ROC (.752) when combining all seizure types together.

Significance

Automatic seizure detection using ML from multimodal wearable sensor data is feasible across a broad spectrum of epileptic seizures. Preliminary results show better than chance seizure detection. The next steps include validation of our results in larger datasets, evaluation of the detection utility tool for additional clinical seizure types, and integration of additional clinical information.
Agencies in the news? Public agencies' media evaluations in a low‐trust context
Authors: Peci Alketa
Published: July 2021

Bureaucratic reputations are largely shaped by the media's evaluations of such agencies. However, the research overlooks how the media evaluates public agencies, particularly in low‐trust contexts. Using inductive machine‐learning techniques, we uncover the media's evaluations of Brazilian regulatory agencies based on more than 38,000 stories published within the last 20 years with the aim of exploring what drives their media evaluations and which reputational dimensions are privileged in the negative media coverage of regulatory agencies. We find different patterns of media evaluations that reflect a unique interplay of media logic, agency strategizing, and the quality of the policy context in which the agencies operate. However, even in a low‐trust context, some agencies are able to build a favorable media reputation. In contrast, agencies with unfavorable media reputations are systematically questioned along many reputational dimensions and are subject to stronger negativity bias.
Prospective study for an independent predictor of prognosis in liver cirrhosis based on the new sarcopenia criteria produced by the Japan Society of Hepatology
Authors: Kikuchi Nahoko , Uojima Haruki , Hidaka Hisashi , Iwasaki Shuichiro , Wada Naohisa , Kubota Kousuke , Nakazawa Takahide , Shibuya Akitaka , Fujikawa Tomoaki , Kako Makoto , Sato Teruko , Koizumi Wasaburo
Published: July 2021

Aim

There are limited data from prospective studies showing the clinical usefulness of the new criteria for sarcopenia in liver disease produced by the Japan Society of Hepatology. Therefore, we aimed to evaluate the clinical usefulness of this new criteria for prognosis in cirrhotic patients.

Methods

This prospective study was performed at six centers. The 300 enrolled patients, aged more than 20 years with liver cirrhosis, were evaluated over a 3‐year period for skeletal muscle mass index and grip strength. Sarcopenia was defined according to the Japan Society of Hepatology criteria by grip strength and computed tomography‐based skeletal muscle mass index values. We investigated the correlation between sarcopenia and the survival rate of cirrhotic patients.

Results

Among the 300 assessed patients there were 99 (33%) patients with sarcopenia. The number of deaths in the sarcopenia and non‐sarcopenia groups was 34 (34.3%) and 38 (18.9%), respectively (p = 0.002). Multivariate analysis confirmed that sarcopenia, decompensated phase, albumin‐bilirubin grade, and hepatocellular carcinoma (HCC) stage 3/4 were independent factors correlated with death in patients with liver cirrhosis during the observation period. The interaction between sarcopenia and the presence of HCC was statistically significant (p < 0.001), and the presence of HCC had the highest hazard ratio of 6.665 for deaths in cirrhotic patients when non‐sarcopenia and the absence of HCC were used as references.

Conclusions

The new Japan Society of Hepatology criteria for sarcopenia are accurate predictors of poor prognosis in patients with liver cirrhosis.
Reduction of oil uptake of fried food by coatings: A review
Authors: Xie Dongfei , Guo Debin , Guo Zhen , Hu Xiuting , Luo Shunjing , Liu Chengmei
Published: July 2021

Fried food is popular because of its attractive aroma, colour and taste. However, its high oil content may cause cardiovascular diseases, such as high cholesterol and high blood pressure. Therefore, it is of great significance to reduce the oil uptake of fried food. It is found that water‐oil replacement, surfactant theory and the cooling‐phase effect are the main mechanisms of oil uptake in fried food. According to these mechanisms, improving the frying technology, changing the frying medium and coating treatment can reduce the amount of oil in fried foods. Among these methods, coating treatment is the most common method to reduce the oil content. Protein coatings usually have better performance than polysaccharide coatings. The performance of protein coatings depends on the type of food and protein. In addition, oil resistance of protein coatings can be improved by adding the plasticiser, combination with other components and cross‐linking treatment.
Enhancing active patient participation in nursing handover: A mixed methods study
Authors: Street Maryann , Dempster Jenny , Berry Debra , Gray Erika , Mapes Joanne , Liskaser Raj , Papageorgiou Sia , Considine Julie
Published: July 2021

Aims and objectives

To explore: i) the frequency and nature of patient participation in nursing handover and ii) patients’ and nurses’ perceived strategies to enhance patient involvement in nursing handover.

Background

Patient participation in nursing handover is important for patient‐centred care, shared decision‐making, patient safety and a positive healthcare experience

Design

A multi‐site prospective study using a mixed methods design.

Methods

Between September and December 2019, nursing handovers were observed on ten randomly selected wards, followed by semi‐structured interviews with patients (n = 33), and nurses (n = 20) from the observed handovers. Data were analysed using descriptive statistics for structured observations and thematic analysis of interviews, and triangulated to develop a greater understanding of patient participation in nursing handover. This study is reported using the Good Reporting of Mixed Methods Study guidelines.

Results

The median patient age was 77 years and 47% (n = 55) patients were female. Of the 117 handovers, 76.9% (n = 90) were conducted in the patient's presence. Patients were active participants in 33.3% (n = 30) and passive participants in 46.7% (n = 42) of handovers; in 20% of handovers (n = 18), the patient had no input at all. Active participation was more likely in women (vs. men), surgical patients (vs. medical patients) and when nurses displayed engagement behaviours (eye contact, opportunity to ask questions, explanations). Three major themes were identified from the interviews: ‘Being Involved’, ‘Layers of Influence’ and ‘Information Exchange’.

Conclusions

The main finding was that patient participation in handover was low and strongly influenced by a complex interplay of factors including patient and nurse preferences and perceptions.

Relevance to Clinical Practice

Handover is an essential tool in the provision of safe patient care. Patients were able to actively participate in nursing handover when they understood the purpose and timing of handover and had rapport with nurses.
Efficacy of auricular acupressure in maintenance haemodialysis patients: A systematic review and meta‐analysis
Authors: Yang Ting , Wang Shurui , Zhang Xiaohong , Liu Lirong , Liu Yanhui , Zhang Chunmei
Published: July 2021

Objectives

To systematically evaluate the efficacy of auricular acupressure on sleep disorders, depression, pruritus, xerostomia and daily net weight gain (%) in maintenance haemodialysis patients.

Background

Auricular acupressure has been used for various complications in maintenance haemodialysis patients, such as sleep disorders, depression, pruritus and xerostomia, but the efficacy has not yet been unified.

Design

Systematic review and meta‐analysis.

Methods

Randomised controlled trials comparing auricular acupressure intervention with non‐AA intervention in maintenance haemodialysis patients were included. We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to 27 November 2020. The risk of bias was assessed by the Cochrane risk of bias tool. The RevMan 5.3 software was used to perform the meta‐analysis. A descriptive analysis was conducted if the data were high of heterogeneity or could not be meta‐analysed. The PRISMA statement was used to report systematic review and meta‐analysis.

Results

A total of 12 RCTs with 805 MHD patients were included. Meta‐analysis showed that auricular acupressure had a significant difference for improving sleep disorders (MD = −1.97 points, 95% CI: −2.62 to −1.32, p < .0001), pruritus (MD = −1.55 points, 95% CI: −2.01 to −1.08, p < .0001), and daily net weight gain (%) (MD = −0.29, 95% CI: −0.37 to −0.21, p < .0001). The efficacy of depression and xerostomia were analysed descriptively due to insufficient data.

Conclusions

The meta‐analysis results indicated that auricular acupressure had a positive efficacy in maintenance haemodialysis patients to improve sleep disorders, pruritus and daily net weight gain (%). But the results should be treated conservatively on account of the low quality of included studies. Future researchers need to conduct more high‐quality, large sample, multi‐centre randomised controlled studies to provide a solid basis to demonstrate of the efficacy of auricular acupressure in maintenance haemodialysis patients.

Relevance to clinical practice

Auricular acupressure has the advantages of low cost, non‐invasive and easy to be accepted by patients. This review suggested that auricular acupressure could be considered a non‐pharmacological intervention for maintenance haemodialysis patients. Medical staff could teach maintenance haemodialysis patients auricular acupressure to help them self‐manage some complications at home.
Optic nerve sheath diameter assessment by neurosonology: A review of methodologic discrepancies
Authors: Stevens Raoul R. F. , Gommer Erik D. , Aries Marcel J.H. , Ertl Michael , Mess Werner H. , Huberts Wouter , Delhaas Tammo
Published: July 2021

Background and Purpose

Reported cutoff values of the optic nerve sheath diameter (ONSD) for the diagnosis of elevated intracranial pressure (ICP) are inconsistent. This hampers ONSD as a possible noninvasive bedside monitoring tool for ICP. Because the influence of methodological differences on variations in cutoff values is unknown, we performed a narrative review to identify discrepancies in ONSD assessment methodologies and to investigate their effect on reported ONSD values.

Methods

We used a structured and quantitative approach in which each ONSD methodology found in the reviewed articles was categorized based on the characteristic appearance of the ultrasound images and ultrasound marker placement. Subsequently, we investigated the influence of the different methodologies on ONSD values by organizing the ONSDs with respect to these categories.

Results

In a total of 63 eligible articles, we could determine the applied ONSD assessment methodology. Reported ultrasound images either showed the optic nerve and its sheath as a dark region with hyperechoic striped band at its edges or as a single dark region surrounded by lighter retrobulbar fat. Four different ultrasound marker positions were used to delineate the optic nerve sheath, which resulted in different ONSD values and more importantly, different sensitivities to changes in ICP.

Conclusions

Based on our observations, we recommend to place ultrasound markers at the outer edges of the hyperechoic striped bands or at the transitions from the single dark region to the hyperechoic retrobulbar fat because these locations yielded the highest sensitivity of ONSD measurements for increased ICP.
Cranial cruciate ligament rupture in small dogs (<15 kg): a narrative literature review
Authors: Brioschi V. , Arthurs G. I.
Published: July 2021

Small breed dogs (<15 kg) affected by cranial cruciate ligament rupture secondary to cranial cruciate ligament disease are usually middle‐aged (mean age at presentation: 5.4 to 9.8 years); terrier breeds, miniature and toy poodles are over‐represented. Small breed dogs have a different morphology of the proximal tibia compared to medium and large breed dogs with a steep tibial plateau angle (mean tibial plateau angle 28.8° to 36.3°), absent base of the flare of the tibial tuberosity and a caudally bowed fibula. There is a lack of evidence regarding the optimal management of cranial cruciate ligament rupture in small dogs. The treatment options consist of conservative management, extracapsular stabilisation, cranial closing wedge ostectomy, tibial plateau levelling osteotomy and tibial tuberosity advancement. The limited evidence available shows that conservative management is likely to result in prolonged recovery time (average time to recovery approximately 4 months). There is paucity of reports focussing on extracapsular stabilisation in small breed dogs, and questions have been raised regarding the early failure of the extracapsular suture subject to higher loads due to the steep tibial plateau angle of small breed dogs. Cranial closing wedge ostectomy and tibial plateau levelling osteotomy have been reported to have low major complication rates and good subjective outcomes. It is controversial whether tibial tuberosity advancement is a suitable technique in dogs with steep tibial plateau angle, which includes most small breed dogs.
A biogeographical analysis of Muhlenbergia (Poaceae: Chloridoideae: Cynodonteae: Muhlenbergiinae)
Authors: Peterson Paul M. , Roquet Cristina , Romaschenko Konstantin , Herrera Arrieta Yolanda , Susanna Alfonso
Published: July 2021

A phylogeny based on the analysis of six DNA sequence markers (ITS, ndhA intron, rpl32‐trnL, rps3, rps16 intron, and rps16‐trnK) is used to infer ancestral areas and divergence times, and reconstruct the biogeographical history and evolution of 150 of the 183 (82%) species of Muhlenbergia. Our results suggest that the genus originated 9.3 mya in the Sierra Madre (Occidental and Oriental) in Mexico, splitting into six lineages: M. ramulosa diverging 8.2 mya, M. subg. Muhlenbergia at 5.9 mya, M. subg. Pseudosporobolus at 5.9 mya, M. subg. Clomena at 5.4 mya, M. subg. Bealia at 4.3 mya, and M. subg. Trichochloa at 1 mya, each of these with a high probability of Sierra Madrean origin. Our results further suggest that founder‐event speciation from Sierra Madre to South America occurred independently multiple times in all five subgenera during the Pleistocene and late Pliocene. One long‐distance dispersal event most likely originating from Central or Eastern North America to East and Central Asia occurred 1.6–1 mya in M. subg. Muhlenbergia. In our cladogram, members of M. subg. Trichochloa show little genetic resolution, suggesting very low levels of divergence among the species, and this may be a consequence of rapid radiation.
Dispersal in a house sparrow metapopulation: An integrative case study of genetic assignment calibrated with ecological data and pedigree information
Authors: Saatoglu Dilan , Niskanen Alina K. , Kuismin Markku , Ranke Peter S. , Hagen Ingerid J. , Araya‐Ajoy Yimen G. , Kvalnes Thomas , Pärn Henrik , Rønning Bernt , Ringsby Thor Harald , Sæther Bernt‐Erik , Husby Arild , Sillanpää Mikko J. , Jensen Henrik
Published: July 2021

Dispersal has a crucial role determining ecoevolutionary dynamics through both gene flow and population size regulation. However, to study dispersal and its consequences, one must distinguish immigrants from residents. Dispersers can be identified using telemetry, capture‐mark‐recapture (CMR) methods, or genetic assignment methods. All of these methods have disadvantages, such as high costs and substantial field efforts needed for telemetry and CMR surveys, and adequate genetic distance required in genetic assignment. In this study, we used genome‐wide 200K Single Nucleotide Polymorphism data and two different genetic assignment approaches (GSI_SIM, Bayesian framework; BONE, network‐based estimation) to identify the dispersers in a house sparrow (Passer domesticus) metapopulation sampled over 16 years. Our results showed higher assignment accuracy with BONE. Hence, we proceeded to diagnose potential sources of errors in the assignment results from the BONE method due to variation in levels of interpopulation genetic differentiation, intrapopulation genetic variation and sample size. We show that assignment accuracy is high even at low levels of genetic differentiation and that it increases with the proportion of a population that has been sampled. Finally, we highlight that dispersal studies integrating both ecological and genetic data provide robust assessments of the dispersal patterns in natural populations.
The impact of body size on Aedes [Stegomyia] aegypti wingbeat frequency: implications for mosquito identification
Authors: de Nadai B. L. , Maletzke A. G. , Corbi J. J. , Batista G. E. A. P. A. , Reiskind M. H.
Published: July 2021

Billions of people are at risk due to mosquito‐borne diseases. Ideally, the control of mosquito‐borne diseases should integrate mosquito control and surveillance to maximize transmission prevention while minimizing environmental impacts. Mosquito surveillance is often limited in scope by logistical constraints, especially the labour and expertise in identifying captured mosquitoes. Mosquito sounds, primarily the wingbeat frequencies (WBF), have been extensively studied in the literature, often targeting a straightforward assessment of this technology with species identification in laboratory conditions. Optical sensors for measuring the WBF of free‐flying mosquitoes are the most recent proposal to automate species identification. However, many of the factors that may influence WBF within and between species have not been fully examined, resulting in failures in the species identification. Here we show that body size and temperature modify the wingbeat frequency of female Aedes [Stegomyia] aegypti Linnaeus (Diptera:Culicidae) and such an optical sensor can capture these alterations. We demonstrate that this study's optical sensor can distinguish wingbeat frequency from large and small mosquitoes at different temperatures. The relationship between WBF and size should be taken into account to improve the accuracy of devices that automatically identify species using WBF.
Large differences in leaf cuticle conductance and its temperature response among 24 tropical tree species from across a rainfall gradient
Authors: Slot Martijn , Nardwattanawong Tantawat , Hernández Georgia G. , Bueno Amauri , Riederer Markus , Winter Klaus
Published: July 2021

More frequent droughts and rising temperatures pose serious threats to tropical forests. When stomata are closed under dry and hot conditions, plants lose water through leaf cuticles, but little is known about cuticle conductance (gmin) of tropical trees, how it varies among species and environments, and how it is affected by temperature.

We determined gmin in relation to temperature for 24 tropical tree species across a steep rainfall gradient in Panama, by recording leaf drying curves at different temperatures in the laboratory.

In contrast with our hypotheses, gmin did not differ systematically across the rainfall gradient; species differences did not reflect phylogenetic patterns; and in most species gmin did not significantly increase between 25 and 50°C. gmin was higher in deciduous than in evergreen species, in species with leaf trichomes than in species without, in sun leaves than in shade leaves, and tended to decrease with increasing leaf mass per area across species. There was no relationship between stomatal and cuticle conductance.

Large species differences in gmin and its temperature response suggest that more frequent hot droughts may lead to differential survival among tropical tree species, regardless of species’ position on the rainfall gradient.
Genetic syndromes with diabetes: A systematic review
Authors: Shi Daniel , Motamed Mehras , Mejía‐Benítez Aurora , Li Leon , Lin Ethan , Budhram Dalton , Kaur Yuvreet , Meyre David
Published: July 2021

Previous reviews and clinical guidelines have identified 10–20 genetic syndromes associated with diabetes, but no systematic review has been conducted to date. We provide the first comprehensive catalog for syndromes with diabetes mellitus. We conducted a systematic review of MEDLINE, Embase, CENTRAL, PubMed, OMIM, and Orphanet databases for case reports, case series, and observational studies published between 1946 and January 15, 2020, that described diabetes mellitus in adults and children with monogenic or chromosomal syndromes. Our literature search identified 7,122 studies, of which 160 fulfilled inclusion criteria. Our analysis of these studies found 69 distinct diabetes syndromes. Thirty (43.5%) syndromes included diabetes mellitus as a cardinal clinical feature, and 56 (81.2%) were fully genetically elucidated. Sixty‐three syndromes (91.3%) were described more than once in independent case reports, of which 59 (93.7%) demonstrated clinical heterogeneity. Syndromes associated with diabetes mellitus are more numerous and diverse than previously anticipated. While knowledge of the syndromes is limited by their low prevalence, future reviews will be needed as more cases are identified. The genetic etiologies of these syndromes are well elucidated and provide potential avenues for future gene identification efforts, aid in diagnosis and management, gene therapy research, and developing personalized medicine treatments.
Neuraxial anesthesia and pain control for pediatric burn patients receiving excision and split‐thickness skin grafts—A retrospective case series
Authors: Liu John , Chen Joy , Nguyen Phat‐Tan
Published: July 2021

Background

Postoperative pain management in pediatric burn patients requiring excision and split‐thickness skin grafts remains largely under‐studied. ICU care is often necessary due to the level of sedation and amount of opioids required to achieve adequate pain control.

Aims

Our case series aimed to describe a pain management strategy using neuraxial anesthesia intraoperatively. Primary outcomes include pain scores, postoperative opioid consumption, and adverse events.

Methods

A retrospective chart review was performed on a total of 61 patients who received intraoperative neuraxial anesthesia for split‐thickness skin grafting between January 1st, 2017 and June 1st, 2018. Patient demographics, operating room data, and subsequent hospital course was extracted from their electronic medical record and plotted using R Studio statistical software.

Results

The overwhelming majority of patients received single‐shot spinals with both local anesthetic and either morphine or hydromorphone. Average pain scores were 1 out of 10 with standard deviation of 1.6 in the immediate postoperative period and decreased over the next 72 h. Oral morphine equivalents consumed did not exceed 0.61 ME/kg/day. The most common adverse reaction was pruritus.

Conclusions

Spinal anesthesia was most commonly used for split‐thickness skin grafting in the pediatric burn population and provides excellent analgesia for patients’ immediate postoperative course, including their initial dressing changes, with minimal risk for complications. Pain was well‐controlled in all subgroups indicating that this strategy can be used flexibly in a variety of pediatric burn patients.
Expanding the range of editable targets in the wheat genome using the variants of the Cas12a and Cas9 nucleases
Authors: Wang Wei , Tian Bin , Pan Qianli , Chen Yueying , He Fei , Bai Guihua , Akhunova Alina , Trick Harold N. , Akhunov Eduard
Published: July 2021

The development of CRISPR‐based editors recognizing distinct protospacer‐adjacent motifs (PAMs), or having different spacer length/structure requirements broadens the range of possible genomic applications. We evaluated the natural and engineered variants of Cas12a (FnCas12a and LbCas12a) and Cas9 for their ability to induce mutations in endogenous genes controlling important agronomic traits in wheat. Unlike FnCas12a, LbCas12a‐induced mutations in the wheat genome, even though with a lower rate than that reported for SpCas9. The eight‐fold improvement in the gene editing efficiency was achieved for LbCas12a by using the guides flanked by ribozymes and driven by the RNA polymerase II promoter from switchgrass. The efficiency of multiplexed genome editing (MGE) using LbCas12a was mostly similar to that obtained using the simplex RNA guides and showed substantial increase after subjecting transgenic plants to high‐temperature treatment. We successfully applied LbCas12a‐MGE for generating heritable mutations in a gene controlling grain size and weight in wheat. We showed that the range of editable loci in the wheat genome could be further expanded by using the engineered variants of Cas12a (LbCas12a‐RVR) and Cas9 (Cas9‐NG and xCas9) that recognize the TATV and NG PAMs, respectively, with the Cas9‐NG showing higher editing efficiency on the targets with atypical PAMs compared to xCas9. In conclusion, our study reports a set of validated natural and engineered variants of Cas12a and Cas9 editors for targeting loci in the wheat genome not amenable to modification using the original SpCas9 nuclease.
Smallholder farmers’ perception of climate change and drivers of adaptation in agriculture: A case study in Guinea
Authors: Ceci Paolo , Monforte Lavinia , Perelli Chiara , Cicatiello Clara , Branca Giacomo , Franco Silvio , Diallo Fatoumata Binta Sombily , Blasi Emanuele , Scarascia Mugnozza Giuseppe
Published: July 2021

In developing countries, the adoption of effective climate change adaptation strategies can safeguard rural communities’ livelihoods. Using survey data collected in Guinea in 2012, the paper investigates the factors affecting households’ strategies to face adverse climate change impacts. A three‐step methodology is applied: (1) assessment of the magnitude of real climatic trends in the study area together with farmers’ perception of climate change; (2) identification of physical and socioeconomic variables influencing farmers’ adaptation propensity; and (3) analysis of factors affecting adaptation choices, including climate change perception. The climatic data analysis confirms increase in minimum and maximum temperature trends, increase in annual average millimeters of rain, and decrease in average number of storms per year. Farmers’ perception of climate change turned out to be aligned with historical climatic trends and represents an important determinant for the adoption of adaptation strategies. The regression model results suggest that the propensity to adapt is positively influenced by the level of education and a limited access to water resources and agricultural inputs, forcing households to adopt new cropping calendars. Effective policy action should consider different areas, including climate change awareness, education, access to natural and physical assets, and availability of economic resources to local communities.
Towards the Internet of Water: Using graph databases for hydrological analysis on the Flemish river system
Authors: Bollen Erik , Hendrix Rik , Kuijpers Bart , Vaisman Alejandro
Published: July 2021

The “Internet of Water” project will deploy 2,500 sensors along the Flemish river system, in Belgium. These sensors will be part of a monitoring system. This will produce an enormous amount of data, on which prediction and analysis tasks can be performed. To represent, store, and query river data, relational databases are normally used. However, this choice introduces an “impedance mismatch” between the conceptual representation (typically a graph) and the storage model (relational tables). To solve this problem, this article proposes to use graph databases. The Flemish river system is presented as a use case and the Neo4j graph database and its high‐level query language, Cypher, are used for storing and querying the data, respectively. A relational alternative is implemented over the PostgreSQL database. A collection of representative queries of interest for hydrologists is defined over both database implementations.
Joint Trauma System, Defense Committee on Trauma, and Armed Services Blood Program consensus statement on whole blood
Authors: Shackelford Stacy A. , Gurney Jennifer M. , Taylor Audra L. , Keenan Sean , Corley Jason B. , Cunningham Cord W. , Drew Brendon G. , Jensen Shane D. , Kotwal Russ S. , Montgomery Harold R. , Nance Erika T. , Remley Michael A. , Cap Andrew P. ,   the Joint Trauma System Defense Committee on Trauma,   the Armed Services Blood Program
Published: July 2021

Hemorrhage is the most common mechanism of death in battlefield casualties with potentially survivable injuries. There is evidence that early blood product transfusion saves lives among combat casualties. When compared to component therapy, fresh whole blood transfusion improves outcomes in military settings. Cold‐stored whole blood also improves outcomes in trauma patients. Whole blood has the advantage of providing red cells, plasma, and platelets together in a single unit, which simplifies and speeds the process of resuscitation, particularly in austere environments. The Joint Trauma System, the Defense Committee on Trauma, and the Armed Services Blood Program endorse the following: (1) whole blood should be used to treat hemorrhagic shock; (2) low‐titer group O whole blood is the resuscitation product of choice for the treatment of hemorrhagic shock for all casualties at all roles of care; (3) whole blood should be available within 30 min of casualty wounding, on all medical evacuation platforms, and at all resuscitation and surgical team locations; (4) when whole blood is not available, component therapy should be available within 30 min of casualty wounding; (5) all prehospital medical providers should be trained and logistically supported to screen donors, collect fresh whole blood from designated donors, transfuse blood products, recognize and treat transfusion reactions, and complete the minimum documentation requirements; (6) all deploying military personnel should undergo walking blood bank prescreen laboratory testing for transfusion transmitted disease immediately prior to deployment. Those who are blood group O should undergo anti‐A/anti‐B antibody titer testing.
Perception of risk in massive transfusion as it relates to fetal outcomes: A survey of surgeons and nurses at one American trauma center
Authors: Uhlich Rindi , Hu Parker , Yazer Mark , Jansen Jan O. , Patrician Patricia , Reynolds Lindy , Marques Marisa B. , Stephens Shannon W. , Gelbard Rondi B. , Kerby Jeffrey , Holcomb John B.
Published: July 2021

Background

The use of blood products early in the resuscitation of bleeding trauma patients is widely accepted, but made difficult by limited supplies of D− red blood cell (RBC)‐containing products. Use of D+ RBC‐containing products would alleviate this issue, but could lead to alloimmunization. Risk associated with transfusing D+ RBC in emergency bleeding situations is being reconsidered. The level of concern surrounding emergency transfusion as it relates to future fetal harm was surveyed among surgeons and nurses.

Methods

Faculty and staff in the Departments of Surgery and Nursing were surveyed on the risks of receiving an emergency RBC transfusion and the subsequent potential for fetal harm. Answers were grouped as likely to accept (likely/very likely) or refuse transfusion (unlikely/very unlikely). Participants were compared by sex, and women by child‐bearing age, ([15–50 years] vs. [>50 years]).

Results

Ninety surveys were initiated with 76 fully completed. Male (n = 39) and female (n = 37) respondents were comparable. Most female respondents (30/37, 81%) were of childbearing age. Overall, both males (38/39, 95%) and females (33/37, 89%; p = .19) were likely to accept a transfusion in an emergency. There was no difference in transfusion acceptance if the risk of fetal harm was presented as 1% (p = .73) or 0.1% (p = .51). Most females (34/37, 92%) were not opposed to transfusion even if there was an unspecified risk of future fetal harm.

Conclusion

Most of the surgeons and nurses who responded would accept a transfusion in an emergency situation even if it might lead to harming a future fetus.