bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti‐TNF and immunosuppressive combination therapy is preferential to inducing clinical remission in patients with active inflammatory bowel disease: A systemic review and meta‐analysis
Authors: Chen Liang , Xu Chun Jin , Wu Wei , Ding Bai Jing , Liu Zhan Ju
Published: May 2021

Objective

To compare the efficacy and safety of a combination therapy of biologics and immunosuppressants with biological monotherapy in inflammatory bowel disease (IBD) in a systematic review and meta‐analysis.

Methods

Eligible randomized controlled trials (RCTs) on the comparison of the efficacy and safety of biologics and immunomodulators with biological monotherapy were identified from the EMBASE, PubMed and the Cochrane Library databases published up to 1 May 2020. Raw data were extracted, pooled relative risk (RR) and 95% confidence interval (CI) was calculated, the fixed‐effect and inverse variance models were used. Funnel plots were performed to analyze publication bias.

Results

Twelve RCTs were eligible for analysis. Overall, there was statistically a benefit for combination treatment over biologic monotherapy (IFX/ADA) in inducing clinical remission and preventing relapse in patients with IBD (RR 0.89, 95% CI 0.80‐0.98). Moreover, the combination therapy was superior to biological monotherapy for active CD (RR 0.83, 95% CI 0.73‐0.94). Also, there were significant benefits for combination therapy in the subgroup treated with infliximab (IFX) (RR 0.83, 95% CI 0.70‐0.97).

Conclusions

Combination therapy has slight benefits in inducing clinical remission in active CD compared with biological monotherapy. Patients with IBD who receive therapy with IFX and immunomodulator also have a mild advantage in comparison with those treated with IFX monotherapy.
Ineffective health management in people with type 2 diabetes
Authors: Cavalcante Tahissa Frota , de Oliveira Lidia Rocha , Moreira Rafaella Pessoa , Costa Edmara Chaves , de Souza Maciel Ferreira José Erivelton
Published: May 2021

Purpose

To analyze the Nursing Diagnosis Ineffective Health Management in people with type 2 diabetes.

Methods

Cross‐sectional correlational study conducted with 112 patients from August 2018 to April 2019 in a primary healthcare facility, Ceará, Brazil. Used a structured interview and a form created by the authors specifically for the study. Descriptive and inferential statistics were used in the data analysis.

Findings

The Nursing Diagnosis Ineffective Health Management was present in 63.4% of the patients. The defining characteristics with the highest prevalence were difficulty with prescribed regimen (61.6%) and failure to include a treatment regimen in daily living (60.7%). The following significant associations were found: gender and failure to take action to reduce risk factors (P = 0.003), medication and difficulty with prescribed regimen (P = 0.003), and high blood pressure and ineffective choices in daily living for meeting health goals (P = 0.005). The following defining characteristics were associated with the presence of Ineffective Health Management: difficulty with prescribed regimen (P = 0.001), failure to take action to reduce risk factors (P = 0.008), ineffective choices in daily living for meeting health goals (P = 0.001), and failure to include the treatment regimen in daily living (P = 0.001).

Conclusions

The Nursing Diagnosis Ineffective Health Management had a high prevalence in the sample. Its defining characteristics are associated with the nursing diagnosis itself and with sociodemographic and clinical variables.

Implications for nursing practice

Ineffective Health Management should be considered a priority for developing and implementing nursing care for people with type 2 diabetes, especially in primary health care settings.
Topical epigallocatechin‐3‐gallate in the treatment of vitiligo
Authors: Hu Wenting , Zhang Lingling , Lin Fuquan , Lei Jiehao , Zhou Miaoni , Xu AiE
Published: May 2021

Objective

To preliminarily assess the efficacy and safety of the topical application of Epigallocatechin‐3‐gallate (EGCG) in treating vitiligo, a 6‐month clinical trial was carried out.

Method

Patients were randomly given topical application of EGCG on the assigned lesions, with pimecrolimus being used as the control for twice a day over a 6‐month treatment period. Responses to treatment were assessed based on the changes in VASI score for percentage reduction in body surface area and the PGA scores.

Results

According to our results, both drugs were discovered to be markedly effective on repigmentation. The VASI of lesion had diminished from 1.19 ± 0.42 to 0.63 ± 0.38, in the EGCG‐treated lesions, while from 1.18 ± 0.43 to 0.61 ± 0.36 in the pimecrolimus‐treated lesions, and there was no statistically significant difference in VASI score between the EGCG‐treated lesions and pimecrolimus‐treated lesions (P = 0.755). Meanwhile, the mean PGA score on the EGCG applied side was 4.39 ± 2.23, while that was 4.43 ± 2.02 on the pimecrolimus applied side (P = 0.886). Furthermore, difference in the improvement degree between pimecrolimus side and EGCG side was not statistically significant (P = 0.845). Notably, no serious side effects were observed throughout the study.

Conclusion

Findings of the study indicate that topical EGCG can be effective on treating vitiligo.
Cities of Sanctuary in Environments of Hostility: Competing and Contrasting Migration Infrastructures
Authors: Mosselson Aidan
Published: May 2021

This paper analyses the tensions, contradictions and overlaps between supportive migration infrastructures and the generalised anti‐migrant atmosphere created by the UK government. It utilises infrastructural perspectives to show how the hostile environment has become an everyday reality that forced migrants have to constantly endure and navigate. As an everyday reality, the hostile environment inheres and comes to life in various settings, spaces, infrastructures and affects. Specifically, this paper documents how government buildings, urban landscapes and houses provided to forced migrants are all conduits through which anti‐migrant hostility is encountered and reproduced. It also demonstrates how the hostile environment permeates infrastructures designed to provide support to forced migrants, creating divisions between those providing care and those being cared for, thus recreating affective and interpersonal borders. At the same time, the paper shows how anti‐migrant infrastructures are contested and repurposed by activists, demonstrating the processual and always in‐the‐making nature of infrastructures.
Current prophylactic plasma infusion protocols do not adequately prevent long‐term cumulative organ damage in the Japanese congenital thrombotic thrombocytopenic purpura cohort
Authors: Sakai Kazuya , Fujimura Yoshihiro , Miyata Toshiyuki , Isonishi Ayami , Kokame Koichi , Matsumoto Masanori
Published: May 2021

Congenital thrombotic thrombocytopenic purpura (cTTP), known as Upshaw–Schulman syndrome, is an ultrarare thrombotic disorder caused by ADAMTS13 gene mutations; however, its long‐term outcomes have not been widely studied. A questionnaire survey was administered to physicians of patients in the Japanese cTTP registry to characterise these outcomes. We analysed 55 patients in remission, with 41 cases receiving prophylactic fresh frozen plasma (FFP; median dosage: 13·2 ml/kg per month) and 14 receiving on‐demand FFP. Patients receiving prophylactic FFP were considered as having a more severe form of the disease and had lower platelet counts and higher serum creatinine levels than those receiving on‐demand FFP (median 138 × 109/l vs. 243 × 109/l, P = 0·003 and 0·71 mg/dl vs 0·58 mg/dl, P = 0·009, respectively). Patients who received prophylactic FFP more commonly developed organ damage, including renal impairment, cerebral infarctions, and cardiac hypofunction, than those who did not. Adverse FFP‐related events were seen in 78% of the prophylactic FFP group, with allergic reactions being most common. Since current protocols for FFP administration to the prophylactic FFP group in Japan may be insufficient for preventing cumulative organ damage, a higher dosage of ADAMTS13 supply using recombinant ADAMTS13 agent is needed in these patients.
Being child‐centred: Factors that facilitate professional judgement and decision‐making in child protection
Authors: Bastian Carmela , Dunk‐West Priscilla , Wendt Sarah
Published: May 2021

This paper presents findings from a qualitative study that focused on factors that facilitate professional judgement and decision‐making that is child‐centred. Appreciative inquiry informed the methodology that enabled four focus groups (n = 50) with child protection practitioners who worked with children and young people living out‐of‐home care. The study found that, firstly, child protection practitioners had clear conceptualizations of what child‐centred practice means and, secondly, articulated how functioning teams, effective organizational structures and relationships were crucial to child‐centred practice. The findings point to the importance of relationality in effective child‐centred professional judgement and decision‐making in child protection contexts.
Healthcare professional preferences in the health and fitness assessment and optimization of older patients facing colorectal cancer surgery
Authors: Daniels Sarah L. , Burton Maria , Lee Matthew J. , Moug Susan J. , Kerr Karen , Wilson Tim R. , Brown Steven R. , Wyld Lynda
Published: May 2021

Aim

There are few age‐ and fitness‐specific, evidence‐based guidelines for colorectal cancer surgery. The uptake of different assessment and optimization strategies is variable. The aim of this study was to explore healthcare professional opinion about these issues using a mixed methods design.

Methods

Semi‐structured qualitative interviews were undertaken with healthcare professionals from a single UK region involved in the treatment, assessment and optimization of colorectal surgery patients. Interviews were analysed using the framework approach. An online questionnaire survey was subsequently designed and disseminated to UK surgeons to quantitatively assess the importance of interview themes. Descriptive statistics were used to analyse questionnaire data.

Results

Thirty‐seven healthcare professionals out of 42 approached (response rate 88%) were interviewed across five hospitals in the south Yorkshire region. Three broad themes were developed: attitudes towards treatment of the older patient, methods of assessment of suitability and optimization strategies. The questionnaire was completed by 103 out of an estimated 256 surgeons (estimated response rate 40.2%). There was a difference in opinion regarding the role of major surgery in older patients, particularly when there is coexisting dementia. Assessment was not standardized. Access to optimization strategies was limited, particularly in the emergency setting.

Conclusion

There is wide variation in the process of assessment and provision of optimization strategies in UK practice. Lack of evidence‐based guidelines, cost and time constraints restrict the development of services and pathways. Differences in opinion between surgeons towards patients with frailty or dementia may account for some of the variation in colorectal cancer outcomes.
Impact of the initial decline in estimated glomerular filtration rate on the risk of new‐onset atrial fibrillation and adverse cardiovascular and renal events in patients with type 2 diabetes treated with sodium‐glucose co‐transporter‐2 inhibitors
Authors: Chan Yi‐Hsin , Chen Shao‐Wei , Chao Tze‐Fan , Kao Yi‐Wei , Huang Chien‐Ying , Chu Pao‐Hsien
Published: May 2021

Aim

To investigate the impact of initial decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes (T2D) following sodium‐glucose co‐transporter‐2 inhibitor (SGLT2i) treatment.

Materials and Methods

We used medical data from a multicentre healthcare provider in Taiwan and recruited 11 769 patients with T2D with baseline/follow‐up eGFR data available after 1 to 3 months of SGLT2i treatment from 1 June 2016 to 31 December 2018. Patients were followed up from the drug index date until the occurrence of adverse clinical events, SGLT2i discontinuation or the end of the study period, whichever took place first.

Results

Overall, SGLT2i treatment was associated with an initial eGFR decline of 3.5% ± 14.0% after a median treatment period of 10 weeks. A total of 37.1% (n = 4371) of patients experienced no eGFR decline, and 30.5% (n = 3593), 20.2% (n = 2376), 8.5% (n = 999) and 3.7% (n = 430) of patients experienced an eGFR decline of 0%‐10%, 10%‐20%, 20%‐30% and more than 30%, respectively. The mean eGFR over time became stable after 6 months in all eGFR decline categories, even in the group with a pronounced eGFR decline of more than 30%. Compared with no eGFR decline, an initial eGFR decline of 0%‐10%, 10%‐20% or 20%‐30% was not associated with a higher risk of atrial fibrillation (AF), major adverse cardiovascular events (MACE, including ischaemic stroke, systemic embolism and acute myocardial infarction)/heart failure (HF) and composite renal outcome (doubling of the serum creatinine level/end‐stage kidney disease), whereas an eGFR decline of more than 30% was associated with a higher risk of new‐onset AF (adjusted hazard ratio [aHR] = 2.20, 95% confidence interval [CI] = 1.40‐3.47), MACE/HF (aHR = 2.09, 95% CI = 1.04‐4.17) and composite renal outcome (aHR = 1.82, 95% CI = 1.18‐2.83). The multivariate analysis indicated that the use of a diuretic or insulin, presence of stroke, older age, female sex, a higher HbA1c level, and a lower body mass index of less than 25 kg/m2 were independent factors associated with an eGFR decline of more than 30% following SGLT2i initiation.

Conclusions

A pronounced eGFR decline of more than 30% following SGLT2i treatment was associated with adverse cardiovascular or renal events among patients with T2D.
High‐dose sodium‐glucose co‐transporter‐2 inhibitors are superior in type 2 diabetes: A meta‐analysis of randomized clinical trials
Authors: Shi Fang‐Hong , Li Hao , Shen Long , Fu Jing‐Jing , Ma Jing , Gu Zhi‐Chun , Lin Hou‐Wen
Published: May 2021

Aim

To determine the overall efficacy of high‐ versus low‐dose sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors in patients with type 2 diabetes (T2D).

Material and Methods

A literature search using MEDLINE, EMBASE and the Cochrane Library was performed from 1 January 2006 to 23 September 2020. Random effects models were used to calculate mean differences (MDs) and pooled relative risk (RR). Prespecified subgroup analyses for each SGLT2 inhibitor, follow‐up and controls were performed. Leave‐one‐out sensitivity and meta‐regression analyses were conducted.

Results

A total of 51 randomized controlled trials involving 23 989 participants (weighted mean age, 58.9 years; men, 58.8%) were eligible for our meta‐analysis. For glycaemic regulation ability, a significant reduction in HbA1c (MD −0.080%, 95% confidence interval [CI] −0.100 to −0.060), fasting plasma glucose (MD −0.227 mmol/L, 95% CI −0.282 to −0.173) and postprandial plasma glucose (MD −0.834 mmol/L, 95% CI −1.268 to −0.400) levels was observed in the high‐dose SGLT2 inhibitor group. Treatment with high‐dose SGLT2 inhibitors enabled easier achievement of the target (HbA1c <7%) than low‐dose SGLT2 inhibitors (RR 1.148, 95% CI 1.104 to 1.193). High‐dose SGLT2 inhibitor‐based treatment resulted in more efficient regulation of body weight and blood pressure (body weight: MD −0.346 kg, 95% CI −0.437 to −0.254; systolic blood pressure: MD −0.583 mmHg, 95% CI −0.903 to −0.263; diastolic blood pressure: MD −0.352 mmHg, 95% CI −0.563 to −0.142). The results were similar in sensitivity analyses.

Conclusions

The overall efficacy of SGLT2 inhibitors, mainly canagliflozin, dapagliflozin and empagliflozin, was found to be dose dependent.
Communicating your point of view
Authors: Faulkner Paul
Published: May 2021

What is it like to give birth? Or have your first child? Or see red for the first time? Arguably, knowing how to answer these questions requires having certain experiences. Arguably you cannot get to know what it is like to give birth, for instance, by simply reading someone's birth story. If this is so, then there are certain limits on testimony as a source of knowledge. This claim is familiar: it has been argued that we cannot, or should not, rely on testimony when it comes to moral matters. And argued that we cannot, or should not, rely on testimony when it comes to aesthetic judgement. This paper aims to build an explanation of our pessimism about testimony as to what experiences are like that also covers moral and aesthetic testimony, about which we can be similarly pessimistic. And the explanation given is such that it can make good sense of the optimism we can demonstrate with respect to each of these domains.
Rule of law, national judges and the Court of Justice of the European Union: Let's keep it juridical
Authors: Marques Filipe
Published: May 2021

The debate on the rule of law in the EU is mainly taking place from an EU law point of view, stemming from the analysis of CJEU judgments and its interpretation of general principles and primary EU law. This article argues that only by comprehending the global context of rise of populism and delegitimation of the judiciary may we realise the risks that national judges and the CJEU started to take when they entered the stage of this discussion. An overview is made of the global trend of delegitimation of the judiciary, referring to the example of Poland. The author then analyses how the CJEU and national courts, while defending the rule of law, are also mutually contributing to their own protection against external threats, and why that dialogue is essential to keep the debate juridical, as a way of avoiding what the author identifies as the “populist trap to the judiciary”.
Evaluating the suitability of marginal land for a perennial energy crop on the Loess Plateau of China
Authors: Liu Yanmei , Chen Shaolin , von Cossel Moritz , Xu Bingcheng , Gao Huanlin , Jiang Rui , Faaij Andre
Published: May 2021

With a large marginal land area, the Loess Plateau in China holds great potential for biomass production and environmental improvement. Identifying suitable locations for biomass production on marginal land is important for decision‐makers from the viewpoint of land‐use planning. However, there is limited information on the suitability of marginal land within the Loess Plateau for biomass production. Therefore, this study aims to evaluate the suitability of the promising perennial energy crop switchgrass (Panicum virgatum L.) on marginal land across the Loess Plateau. A fuzzy logical model was developed and validated based on field trials on the Loess Plateau and applied to the marginal land of this region, owing to its ability of dealing with the continuous nature of soil, landscape variations, and uncertainties of the input data. This study identified that approximately 12.8–20.8 Mha of the Loess Plateau as available marginal land, of which 2.8–4.7 Mha is theoretically suitable for switchgrass cultivation. These parts of the total marginal land are mainly distributed in northeast and southwest of the Loess Plateau. The potential yield of switchgrass ranges between 44 and 77 Tg. This study showed that switchgrass can grow on a large proportion of the marginal land of the Loess Plateau and therefore offers great potential for biomass provision. The spatial suitability maps produced in this study provide information to farmers and policymakers to enable a more sustainable development of biomass production on the Loess Plateau. In addition, the fuzzy‐theory‐based model developed in this study provided a good framework for evaluating the suitability of marginal land.
Sustainability aspects of milk production in Sweden
Authors: Krizsan Sophie J. , Chagas Juana C. , Pang Degong , Cabezas‐Garcia Edward H.
Published: May 2021

Resource use efficiency and economic initiatives point towards using less human‐edible input in ruminant food production. This could also promote the nutrient‐rich dairy products to consumers in comparison with alternative plant‐based drinks. The global population is growing and food production will need to increase to feed more people in the future. The Swedish government has launched a national food strategy, which aims to move Swedish food production towards self‐sufficiency and sustainability, and greater exports. Simultaneously, strong economic development has stimulated consumers to request more high‐value foods, such as meat and refined dairy products. At the same time, public opinion states that today's food production from ruminants is negative for the environment and contributes to climate change. This review assesses some aspects of dietary ingredient composition and feeding choices that can contribute to making Swedish dairy production more sustainable. Efficient dietary methane mitigating strategies can decrease emissions of greenhouse gases in line with European Union targets and avoid major changes in dietary consumption patterns of meat and milk from ruminants. Although feeding management seems to be the most important approach to decrease nitrogen losses, rational use of fertilizers and improved manure management practices on dairy farms should also be considered to decrease the impact of nitrogen losses to the environment.
Patient partners’ perspectives of meaningful engagement in synthesis reviews: A patient‐oriented rapid review
Authors: Boden Catherine , Edmonds Anne Marie , Porter Tom , Bath Brenna , Dunn Kate , Gerrard Angie , Goodridge Donna , Stobart Christine
Published: May 2021

Background

A growing literature describes promising practices for patient‐oriented research (POR) generally; however, those for systematic reviews are largely derived through the lens of a researcher. This rapid review sought to understand meaningful engagement in synthesis reviews from the patient partner (PP) perspective.

Design

The review team comprised PPs, librarians, SCPOR staff and academic faculty. We searched OVID MEDLINE and EMBASE, ProQuest Nursing and Allied Health, and core POR websites. Documents describing PP reflections on their involvement in synthesis reviews were included. Screening and data extraction were conducted by two independent reviewers. Thematic analysis was employed to identify themes in the data regarding PP perceptions of engagement in synthesis reviews.

Results

The literature search yielded 1386 citations. Eight journal articles and one blog post were included. Seven studies focused on conducting systematic reviews on a particular health or patient‐related topic to which PP involvement was an important part and two studies focused specifically on the experience of including PP in synthesis reviews. PPs engaged in the review process through a variety of mechanisms, levels and stages of the review process. Three major themes emerged from the data: (1) foster partnerships through team development, (2) provide opportunities for outcomes valued by PP and (3) strengthen the research endeavour.

Conclusion

Fostering partnerships through team development is foundational for meaningful engagement in synthesis reviews. It requires sensitively balancing of various needs (eg overburdening with contributions). Meaningful involvement in reviews has both personal and research benefits.

Patient Involvement

Patient partners were equal collaborators in all aspects of the review.
Implementation of training to improve communication with disabled children on the ward: A feasibility study
Authors: Wilkinson Kath , Gumm Rebecca , Hambly Helen , Logan Stuart , Morris Christopher
Published: May 2021

Background

Parents of disabled children report poorer inpatient experiences when they stay in hospital, and some staff report finding communicating with disabled children challenging. This study tested the feasibility of implementing a training package for staff on paediatric wards to improve communication with disabled children, especially those with communication difficulties, and their families. The package was developed with parent carers and clinicians, and comprises a manual, a video of parent carers talking about real experiences, discussion points and local resources. The 50‐minutes training is intended for in‐house delivery by local facilitators.

Methods

Thirteen training sessions were delivered in paediatric wards across four hospitals in England, totalling 123 staff who took part. Participants completed questionnaires before (n = 109) and after (n = 36) training, and a sample of champions (senior clinicians) and facilitators were interviewed at the end of the study.

Results

Facilitators found the training easy to deliver, and participants felt they took away important messages to improve their practice. After the training, further changes were reported at an organizational level, including offering further training and reviewing practices.

Conclusions

This study provides supporting evidence for the implementation of a low‐cost, minimal‐resource training package to support staff communication with children and their families in hospitals. It provides promising indication of impact on behavioural change at the individual and organizational level.

Patient and public contribution

Parent carers identified the need and helped to develop the training, including featuring in the training video. They were also consulted throughout the study on research design, delivery and reporting.
The role of skill versus luck in new venture survival
Authors: Soto‐Simeone Aracely , Sirén Charlotta , Antretter Torben
Published: May 2021

In our paper ‘New venture survival: A review and extension’ in the International Journal of Management Reviews, we synthesized more than five decades of entrepreneurship, management and sociology research on the reasons why some new ventures survive and others fail. Based on our review and analysis, we provided an up‐to‐date systematization of the literature and a framework that includes important extensions to Stinchcombe's seminal work. Coad and Storey criticized our framework for basing venture outcome on skill—something that can be influenced by entrepreneurs and other stakeholders. In this paper, we argue that: (i) the distinction between survival and performance matters when thinking about the antecedents of these constructs; (ii) gambling is an incompatible analogy for entrepreneurship; and (iii) psychological processes cannot be ignored when studying new ventures’ survival. We also correct some points made by Coad and Storey about our findings. We encourage future studies on new venture survival to be cautious of adopting a view of venturing as a ‘game of chance’—which is, in our perspective, a potentially discouraging view for people pursuing entrepreneurship.
Radical prostatectomy improves survival in selected metastatic prostate cancer patients: A North American population‐based study
Authors: Stolzenbach Lara Franziska , Deuker Marina , Collà‐Ruvolo Claudia , Nocera Luigi , Tian Zhe , Maurer Tobias , Steuber Thomas , Tilki Derya , Briganti Alberto , Saad Fred , Chun Felix KH , Graefen Markus , Karakiewicz Pierre I
Published: May 2021

Objective

To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.

Methods

Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were abstracted from the Surveillance, Epidemiology and End Results database (2004–2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used.

Results

Of 4280 patients, 954 (22.3%) were treated with radical prostatectomy. After propensity score matching, 5‐year cancer‐specific mortality was 47.0 versus 53.0% in radical prostatectomy versus external beam radiation therapy patients (P = 0.003). In propensity score matched competing risks regression models, radical prostatectomy was associated with lower cancer‐specific mortality versus external beam radiation therapy (hazard ratio 0.79, 95% confidence interval 0.79–0.90; P = 0.001). Finally, landmark analyses rejected the bias favoring radical prostatectomy. Finally, in subgroup analyses, we relied on selection criteria that most closely resembled the STAMPEDE criteria and a similar hazard ratio of 0.8 (P < 0.001) was recorded.

Conclusion

In metastatic prostate cancer, radical prostatectomy results in lower cancer‐specific mortality relative to external beam radiation therapy. Even after adjustment for age at diagnosis, prostate‐specific antigen and biopsy Gleason grade grouping, lower cancer‐specific mortality rates are recorded in radical prostatectomy patients than in external beam radiation therapy patients. As a result, radical prostatectomy should be considered as a treatment option in selected metastatic prostate cancer patients. However, further validation will be provided by ongoing clinical trials.
COVID‐19 vaccination in haematology patients: an Australian and New Zealand consensus position statement
Authors: McCaughan Georgia , Di Ciaccio Pietro , Ananda‐Rajah Michelle , Gilroy Nicole , MacIntyre Raina , Teh Benjamin , Weinkove Robert , Curnow Jennifer , Szer Jeff , Enjeti Anoop K , Ross David M , Mulligan Stephen , Trotman Judith , Dickinson Michael , Quach Hang , Choi Phillip , Polizzotto Mark N. , Tam Constantine S. , Ho P. Joy , Ku Matthew , Gregory Gareth , Gangatharan Shane , Hapgood Greg , Cochrane Tara , Cheah Chan , Gibbs Simon , Wei Andrew , Johnston Anna , Greenwood Matthew , Prince H. Miles , Latimer Maya , Berkahn Leanne , Wight Joel , Armytage Tasman , Hamad Nada
Published: May 2021

Australia and New Zealand have achieved excellent community control of COVID‐19 infection. In light of the imminent COVID‐19 vaccination roll out in both countries, representatives from the Haematology Society of Australia and New Zealand and infectious diseases specialists have collaborated on this consensus position statement regarding COVID‐19 vaccination in patients with haematological disorders. It is our recommendation that patients with haematological malignancies, and some benign haematological disorders, should have expedited access to high‐efficacy COVID‐19 vaccines, given that these patients are at high risk of morbidity and mortality from COVID‐19 infection. Vaccination should not replace other public health measures in these patients, given that the effectiveness of COVID‐19 vaccination, specifically in patients with haematological malignancies, is not known. Given the limited available data, prospective collection of safety and efficacy data of COVID‐19 vaccination in this patient group is a priority.
Prevalence of chronic obstructive pulmonary disease with breathlessness in Australia: weighted using the 2016 Australian census
Authors: Toelle Brett G. , Ampon Rosario D. , Abramson Michael J. , James Alan L. , Maguire Graeme P. , Wood‐Baker Richard , Johns David P. , Marks Guy B.
Published: May 2021

Access to up‐to‐date Australian disease prevalence estimates assists health services and consumer organisations to plan and allocate resources. The Burden of Obstructive Lung Disease study was conducted between 2006 and 2012 and provided chronic obstructive pulmonary disease (COPD) (post‐bronchodilator airflow limitation) prevalence estimates weighted to the 2006 Australian census. Using the 2016 Australian census, an updated prevalence estimate of all COPD is 8.30% (95% confidence interval = 6.59%–10.01%) for adults aged 40 or more years in Australia and includes 2.52% with mild breathlessness, 0.99% with moderate breathlessness and 0.91% with severe breathlessness.
Differentiation and activation of fibroblastic reticular cells
Authors: Lütge Mechthild , Pikor Natalia B. , Ludewig Burkhard
Published: May 2021

Secondary lymphoid organs (SLO) are underpinned by fibroblastic reticular cells (FRC) that form dedicated microenvironmental niches to secure induction and regulation of innate and adaptive immunity. Distinct FRC subsets are strategically positioned in SLOs to provide niche factors and govern efficient immune cell interaction. In recent years, the use of specialized mouse models in combination with single‐cell transcriptomics has facilitated the elaboration of the molecular FRC landscape at an unprecedented resolution. While single‐cell RNA‐sequencing has advanced the resolution of FRC subset characterization and function, the high dimensionality of the generated data necessitates careful analysis and validation. Here, we reviewed novel findings from high‐resolution transcriptomic analyses that refine our understanding of FRC differentiation and activation processes in the context of infection and inflammation. We further discuss concepts, strategies, and limitations for the analysis of single‐cell transcriptome data from FRCs and the wide‐ranging implications for our understanding of stromal cell biology.
The dark side of technology: cyberloafing, a Turkish study of nursing behaviour
Authors: Sarıoğlu Kemer A. , Dedeşin Özcan S.
Published: May 2021

Aim

This study aimed to explore the frequency of both serious and minor cyberloafing behaviours of nurses and the factors which affect these behaviours.

Background

Cyberloafing is using the internet or an internet connected device at work for personal use. Cyberloafing is a behaviour that negatively affects the personal performance of healthcare staff.

Methods

A total of 375 nurses in three large hospitals in Eastern Turkey participated in this descriptive research. A personal information form and the Cyberloafing Scale were used to collect the data.

Results

The data analyses showed moderate levels of minor cyberloafing scores and low levels of serious cyberloafing scores. The more serious level of cyberloafing behaviour was found among nurses who had social networking accounts and spent more than four hours on the internet each day. Minor cyberloafing behaviours occurred more frequently than the serious level.

Conclusions

The frequency of cyberloafing behaviours is influenced by time spent on the internet, having social networking accounts, age, marital status, education and professional experience.

Implications for nursing and health policy

The findings support the development of policies that are designed to have nurses focus on patient care during work hours; use their working hours more effectively; and prevent cyberloafing.
The long‐time orphan protist Meringosphaeramediterranea Lohmann, 1902 [1903] is a centrohelid heliozoan
Authors: Zlatogursky Vasily V. , Shɨshkin Yegor , Drachko Daria , Burki Fabien
Published: May 2021

Meringosphaera is an enigmatic marine protist without clear phylogenetic affiliation, but it has long been suggested to be a chrysophyte‐related autotroph. Microscopy‐based reports indicate that it has a worldwide distribution, but no sequence data exist so far. We obtained the first 18S rDNA sequence for M. mediterranea (identified using light and electron microscopy) from the west coast of Sweden. Observations of living cells revealed granulated axopodia and up to 6 globular photosynthesizing bodies about 2 μm in diameter, the nature of which requires further investigation. The ultrastructure of barbed undulating spine scales and patternless plate scales with a central thickening is in agreement with previous reports. Molecular phylogenetic analysis placed M. mediterranea inside the NC5 environmental clade of Centroplasthelida (Haptista) along with additional environmental sequences, together closely related to Choanocystidae. This placement is supported by similar scales in Meringosphaera and Choanocystidae. We searched the Tara Oceans 18S V9 metabarcoding dataset, which revealed four OTUs with 94.8%–98.2% similarity, with oceanic distribution similar to that based on morphological observations. The current taxonomic position and species composition of the genus are discussed. The planktonic lifestyle of M. mediterranea contradicts the view of some authors that centrohelids enter the plankton only temporarily.
MicroRNA expression profiling of sea perch brain cells reveals the roles of microRNAs in autophagy induced by RGNNV infection
Authors: Jia Peng , Pan Hongbo , Cui Kuopeng , Jia Kuntong , Yi Meisheng
Published: May 2021

Nervous necrosis virus (NNV) is one of the most destructive fish viruses and affects more than 120 marine and freshwater teleost species. However, the pathogenesis of NNV has not been made clear. MicroRNAs (miRNAs) play important roles in the regulation of viral infection. To understand the roles and regulation patterns of miRNAs in NNV infection, high‐throughput sequencing was carried out in Lateolabrax japonicus brain (LJB) cells with or without red‐spotted grouper NNV (RGNNV) infection at 12 and 24 hr. Here, we identified 59 known and 61 novel differentially expressed miRNAs (DE miRNAs) between mock and RGNNV‐infected LJB cells. KEGG pathway analysis showed that the target genes of DE miRNAs were significantly enriched in immune‐related signalling pathways, such as autophagy, mitophagy and TGF‐beta signalling pathways. The expression patterns of four DE miRNAs (lja‐miR‐145, lja‐miR‐182, lja‐miR‐183 and lja‐miR‐187) were verified by qRT‐PCR both in vivo and in vitro. We found that lja‐miR‐145 promoted RGNNV proliferation, while lja‐miR‐183 suppressed RGNNV proliferation. Furthermore, lja‐miR‐145 facilitated RGNNV‐induced autophagy activation, whereas lja‐miR‐183 repressed autophagy in LJB cells as measured by LC3B‐II/I and p62 protein levels. All these results indicate the involvement of lja‐miR‐145 and lja‐miR‐183 in RGNNV‐induced autophagy. In conclusion, this study provides evidence for the important roles of miRNAs in NNV infection and a basis for uncovering the molecular regulation mechanism of NNV‐induced autophagy.
Culture, cognisance, capacity and capability: The interrelationship of individual and organisational factors in developing a research hospital
Authors: Oulton Kate , Wray Jo , Kelly Paula , Khair Kate , Sell Debbie , Gibson Faith
Published: May 2021

Aim

To share our experience of implementing a programme of interventions aimed at building research capacity and capability of nurses and allied health professionals in a specialist children's hospital.

Background

Clinicians at the forefront of care are well positioned to lead on research to improve outcomes and experiences of patients but some professional groups continue to be underrepresented. Inequities persist alongside robust national infrastructures to support Clinical Academic Careers for non‐medical health professionals, further highlighting the need to address local infrastructure and leadership to successfully build research capacity.

Design

An evolving programme of inquiry and analysis was established in one organisation, this included targeted interventions to mitigate barriers and enable research capacity and capability.

Methods

An all‐staff survey was conducted in 2015 to understand the existing research culture. Interventions were put in place, evaluated through a second survey (2018), and focus group interviews with staff who had accessed interventions.

Results

Respondents demonstrated high levels of interest and commitment to research at the individual level which were not always harnessed at the organisational level. Inequities between professional groups existed in terms of training, time to undertake research and opportunities and outputs. Follow‐up revealed continuing structural barriers at an organisational level, however at an individual level, interventions were reflected in >30 fellowship awards; major concerns were reported about sustaining these research ambitions.

Conclusions

Success in building a research‐active clinical workforce is multifactorial and all professional groups report increasing challenges to undertake research alongside clinical responsibilities. Individuals report concerns about the depth and pace of cultural change to sustain Clinical Academic Careers and build a truly organisation‐wide research hospital ethos to benefit patients.

Relevance to clinical practice

The achievements of individual nurses and allied health professionals indicate that with supportive infrastructure, capacity, cognisance and capability are not insurmountable barriers for determined clinicians. We use the standards for reporting organisational case studies to report our findings (Rodgers et al., 2016 Health Services and Delivery Research, 4 and 1).
Can the Market Multiply and Divide? Non‐Proportional Thinking in Financial Markets
Authors: SHUE KELLY , TOWNSEND RICHARD R.
Published: May 2021

We hypothesize that investors partially think about stock price changes in dollar rather than percentage units, leading to more extreme return responses to news for lower‐priced stocks. Consistent with such non‐proportional thinking, we find a doubling in price is associated with a 20% to 30% decline in volatility and beta (controlling for size/liquidity). To identify a causal price effect, we show that volatility jumps following stock splits and drops following reverse splits. Lower‐priced stocks also respond more strongly to firm‐specific news. Non‐proportional thinking helps explain asset pricing patterns such as the size‐volatility/beta relation, the leverage effect puzzle, and return drift and reversals.
What drives transmission of severe acute respiratory syndrome coronavirus 2?
Authors: Andersson J.
Published: May 2021

Linked to: V. Stadnytskyi et al. J Intern Med 2021; https://doi.org/10.1111/joim.13326
Perceiving teachers as procedurally just limits the negative effects of delinquent peer associations: An analysis of Australian adolescent boys’ and girls’ perceptions of school authority
Authors: Cardwell Stephanie M. , Mazerolle Lorraine , Piquero Alex R. , Luengen Kelsy
Published: May 2021

This research addressed whether perceptions of antisocial peers play a role in shaping individual perceptions of the legitimacy of school authority figures in young people. Using data from a sample of 102 young people from Brisbane, Australia, who participated in the Ability School Engagement Program, we examined whether associating with peers who engage in antisocial behavior was related to perceptions of the legitimacy of school authority over time. Mixed‐effects linear regression analyses indicated that associations with antisocial peers were related to poorer perceptions of school authority over a 2‐year period. We also found that antisocial peer associations had a bigger impact on perceptions of school legitimacy for girls compared to boys. These relationships, however, were not statistically significant when perceptions of school procedural justice were controlled for, suggesting the important role of school procedural justice in shaping perceptions of school legitimacy, even among young people who associate with more antisocial peers.
Pharmacokinetics and pharmacodynamics of intravenous and oral apixaban in horses
Authors: Wallace Gabrielle E. , McKaba Victoria F. , Reinhart Jennifer M. , Li Zhong , Austin Scott , Fries Ryan C.
Published: May 2021

Large vessel and microvascular thrombi are common complications in systemically ill horses contributing to patient morbidity and mortality. Apixaban, an oral factor Xa inhibitor, shows excellent efficacy against stroke and deep vein thrombosis in humans. The purpose of this study was to determine serum apixaban concentrations and anti‐factor Xa activity in horses after orally administered apixaban. Five horses received a single dose of intravenous (0.09 mg/kg) and oral (1 mg/kg) apixaban in a cross‐over design. Serum apixaban concentrations and anti‐Xa activity were measured serially via liquid chromatography‐tandem mass spectrometry and a commercial assay, respectively, for 12 hr following oral administration. Apixaban was detected in all horses after both oral and intravenous administration. Oral administration yielded a mean maximum concentration of 60.3 ng/ml (59.4–111 ng/ml), mean time to maximum concentration of 0.5 hr (0.5–2), mean half‐life of 6.2 hr (4.6–8.3), and mean oral bioavailability of 10% (3.8–17.4). After oral administration, anti‐Xa activity had a strong positive relationship with serum apixaban and was best represented by a dose‐response model with the following parameters: E0 = 5.00 ng/ml, EMAX = 311 ng/mL, EC50 = 267 ng/ml, and n = 1.58. Anti‐Xa activity was significantly higher 2 hr post‐administration compared with baseline (p = .032). Despite low oral bioavailability, administration of 1 mg/kg oral apixaban, in healthy horses, achieves serum concentrations similar to those reported in humans. Apixaban has potential clinical utility in horses and warrants further investigation.
Cold adaptation drives population genomic divergence in the ecological specialist,Drosophila montana
Authors: Wiberg R. A. W. , Tyukmaeva V. , Hoikkala A. , Ritchie M. G. , Kankare M.
Published: May 2021

Detecting signatures of ecological adaptation in comparative genomics is challenging, but analysing population samples with characterised geographic distributions, such as clinal variation, can help identify genes showing covariation with important ecological variation. Here, we analysed patterns of geographic variation in the cold‐adapted speciesDrosophilamontanaacross phenotypes, genotypes and environmental conditions and tested for signatures of cold adaptation in population genomic divergence. We first derived the climatic variables associated with the geographic distribution of 24 populations across two continents to trace the scale of environmental variation experienced by the species, and measured variation in the cold tolerance of the flies of six populations from different geographic contexts. We then performed pooled whole genome sequencing of these six populations, and used Bayesian methods to identify SNPs where genetic differentiation is associated with both climatic variables and the population phenotypic measurements, while controlling for effects of demography and population structure. The top candidate SNPs were enriched on the X and fourth chromosomes, and they also lay near genes implicated in other studies of cold tolerance and population divergence in this species and its close relatives. We conclude that ecological adaptation has contributed to the divergence ofD.montanapopulations throughout the genome and in particular on the X and fourth chromosomes, which also showed highest interpopulationFST. This study demonstrates that ecological selection can drive genomic divergence at different scales, from candidate genes to chromosome‐wide effects.
A Form of Hope in Richard Strauss'sMetamorphosen
Authors: TAN EMILY X. X.
Published: May 2021

Richard Strauss'sMetamorphosenwas composed in the final months of the Second World War and is often described as the composer's personal elegy for the decline of Western culture. This article presents a new reading of the work which challenges the pessimistic interpretations currently surrounding it. I argue that sonata form and its associated hermeneutic narratives fail to account fully for its structure and suggest instead that Strauss's negotiation and eventual surpassing of this paradigmatic tonal form offers a deeper insight into its meaning. Drawing an analogy between the autonomous musical work and sonata structure on the one hand, and the modern human subject and social ideology on the other, I posit that, asMetamorphosenaims towards the production of a new sense of totality, so the subject finds meaning beyond the ideological limitations of its circumstance.