bluuebunny/crossref_metadata_2025 huggingface dataset:
A Closed‐Form Solution for Free‐ and Seepage‐Flow Field in Axisymmetric Infilled Conduit
Authors: Zhang Shuai , Zhang Bin , Ye Fei , Fu Wenxi
Published: August 2021

Numerous continuous conduits exist in rock masses. These conduits affect the specific discharge distribution of the bulk rock mass. In this study, a modified theoretical model is presented to explore the specific discharge distribution in bedrock with an axisymmetric infilled conduit. The movement of fluid in the free region abides by the Navier‐Stokes equation, and the seepage flow in the filling and rock regions complies with the Brinkman‐extended Darcy equation. The analytical solution for the specific discharge distribution is derived by requiring flow continuity at the domain interface. This solution can be reduced to Darcy's law and Poiseuille's law. Sensitivity analysis shows that both the relative aperture of the free region and the permeability of the filling or rock regions positively influence the specific discharge. The specific discharge distribution curves seem to have an intersection for different porosity values. Moreover, the width of the transition layer where the porous media flow differs from traditional Darcy's flow is positively correlated with the permeability. However, the width is not directly correlated with the relative aperture and the porosity.
Mutational landscape of Juvenile Myelomonocytic Leukemia (JMML)—A real‐world context
Authors: Nathany Shrinidhi , Chatterjee Gaurav , Ghai Shruti , Moulik Nirmalya Roy , Shetty Dhanalaxmi , Subramanian PG , Tembhare Prashant , Gujral Sumeet , Dhamne Chetan , Banavali Sripad , Narula Gaurav , Patkar Nikhil
Published: August 2021

Introduction

Juvenile myelomonocytic leukemia (JMML) is a rare childhood neoplasm (<5% cases), which has been categorized under myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in the recent classification by the World Health Organization.

Methods

We developed a 51‐gene (151.5kB) low‐cost targeted myeloid panel based on single‐molecule molecular inversion probes to comprehensively evaluate the genomic profile of Juvenile myelomonocytic leukemia (JMML).

Results

A total of 50 children with clinical and pathological features of JMML were sequenced at high coverage. Among the 50 patients, 44(88%) harbored mutations in one of the RAS/MAPK‐pathway genes, most frequently in NRAS (32%), followed by PTPN11 (28%) and NF1 (22%). One‐fifth of children had more than one mutation, with 5 cases harboring two RAS pathway mutations. Monosomy 7 was detected in 32% (16) patients, and five of these did not harbor any RAS pathway mutations. Children with monosomy 7 showed shorter overall survival compared with their wild‐type counterparts (P = .02).

Conclusion

Our study highlights that comprehensive genomic profiling identifies at least one mutation in almost 90% of JMML patients. Performing genomic analysis at baseline might help in triaging children with JMML for allogenic stem cell transplant in resource‐constrained settings.
Family structure and function in relation to adolescent reproductive health in developing countries: A scoping review
Authors: Susanto Tantut , Gunawan Joko
Published: August 2021

Aim

The study purpose was to explore the relationships between family structure and function and adolescent reproductive health in the context of family systems in developing countries.

Background

The structures and functions of family are important elements for adolescent reproductive health. However, few studies discuss their relationships with the reproductive health of adolescents.

Design

This study employed a scoping review design.

Data sources

The search was conducted for literature published from 2010 until 2020 using the electronic databases PubMed, CINAHL, Scopus, and Science Direct sourcing full‐text papers in English. Original research papers that focused on family structures, family functions, and adolescent reproductive health were included.

Review methods

Data extraction and analysis were completed on all retrieved studies. Content analysis was used for data analysis.

Results

Fifteen articles were included. The nature of the relationship between the family structures and functions on adolescent reproductive health were explained in the categories of (i) family process and life cycle, (ii) family norms and values, (iii) family communication patterns and processes, (iv) family roles and connectedness, and (v) family coaching and guidance.

Conclusion

Findings of this study suggest that the relationships between family functions and structures and adolescent reproductive health were explained in multiple constructs. Further studies are needed to examine those constructs on reproductive health in adolescent in developing countries.
Improving the physical health of young people with early psychosis with lifestyle interventions: Scoping review
Authors: Hui Ting Ting , Garvey Loretta , Olasoji Michael
Published: August 2021

People with mental illness experience a shorter life expectancy compared to the general population. Poor physical health trajectory emerges following the onset of psychosis and is further compounded by the initiation of antipsychotic treatment. Young people are particularly at risk as the onset of mental illness mostly occurs between the age of 12 and 25 years. This represents a crucial period for early intervention to prevent a physical ill health trajectory. Furthermore, those who are at ultra‐high risk for psychosis should also be targeted for early intervention. Lifestyle interventions have been identified as the first‐line physical health promotion practice for improving the physical health of people with severe mental illness. The aim of this study was to conduct a scoping review following the JBI methodological guidance on scoping reviews to explore the current literature on lifestyle intervention trialled for early psychosis, including first‐episode psychosis and those who are at ultra‐high risk for psychosis. This review also explores the extent of literature examining physical health literacy in this specific population. The literature search was conducted on Medline, Embase, PsycINFO and Scopus. Twenty‐two studies were included for the purpose of this scoping review, 21 of which examined the effects of lifestyle interventions and one of which reported on physical health literacy. This scoping review indicates the need for co‐designed lifestyle interventions with the involvement of service users, families and carers and a focus on promoting physical health literacy, social support, and an incorporation of a health behaviour change model focus on promoting autonomous motivation. The findings of this study can inform future development of a novel co‐designed lifestyle intervention for the targeted population.
Knowledge coordination via digital artefacts in highly dispersed teams
Authors: Fang Yulin , Neufeld Derrick , Zhang Xiaojie
Published: August 2021

Virtual teams face the unique challenge of coordinating their knowledge work across time, space, and people. Information technologies, and digital artefacts in particular, are essential to supporting coordination in highly dispersed teams, yet the extant literature is limited in explaining how such teams produce and reproduce digital artefacts for coordination. This paper describes a qualitative case study that examined the day‐to‐day practices of two highly dispersed virtual teams, with the initial conceptual lens informed by Carlile's (2004) knowledge management framework. Our observations suggest that knowledge coordination in these highly dispersed virtual teams involves the continuous production and reproduction of digital artefacts (which we refer to as technology practices) through three paired modes: ‘presenting‐accessing’ (related to knowledge transfer); ‘representing‐adding’ (related to knowledge translation); and ‘moulding‐challenging’ (related to knowledge transformation). We also observed an unexpected fourth pair of technology practices, ‘withholding‐ignoring,’ that had the effect of delaying certain knowledge coordination processes. Our findings contribute to both the knowledge coordination literature and the practical use of digital artefacts in virtual teams. Future research directions are discussed.
Digital self‐control interventions for distracting media multitasking ‐ A systematic review
Authors: Biedermann Daniel , Schneider Jan , Drachsler Hendrik
Published: August 2021

Digital distractions can interfere with goal attainment and lead to undesirable habits that are hard to get red rid of. Various digital self‐control interventions promise support to alleviate the negative impact of digital distractions. These interventions use different approaches, such as the blocking of apps and websites, goal setting, or visualizations of device usage statistics. While many apps and browser extensions make use of these features, little is known about their effectiveness. This systematic review synthesizes the current research to provide insights into the effectiveness of the different kinds of interventions. From a search of the ‘ACM’, ‘Springer Link’, ‘Web of Science’, ’IEEE Xplore’ and ‘Pubmed’ databases, we identified 28 digital self‐control interventions. We categorized these interventions according to their features and their outcomes. The interventions showed varying degrees of effectiveness, and especially interventions that relied purely on increasing the participants' awareness were barely effective. For those interventions that sanctioned the use of distractions, the current literature indicates that the sanctions have to be sufficiently difficult to overcome, as they will otherwise be quickly dismissed. The overall confidence in the results is low, with small sample sizes, short study duration, and unclear study contexts. From these insights, we highlight research gaps and close with suggestions for future research.
Overexpression of bone morphogenetic protein 7 reduces oligodendrocytes loss and promotes functional recovery after spinal cord injury
Authors: Liu Shuxin , Zhang Wei , Yang Lin , Zhou Fan , Liu Peng , Wang Yaping
Published: August 2021

Spinal cord injury (SCI), as a severe disease with no effective therapeutic measures, has always been a hot topic for scientists. Bone morphogenetic protein 7 (BMP7), as a multifunctional cytokine, has been reported to exert protective effects on the nervous system. The present study aimed to investigate the neuroprotective effect and the potential mechanisms of BMP7 on rats that suffered SCI. Rat models of SCI were established by the modified Allen's method. Adeno‐associated virus (AAV) was injected at T9 immediately before SCI to overexpress BMP7. Results showed that the expression of BMP7 decreased in the injured spinal cords that were at the same time demyelinated. AAV‐BMP7 partly reversed oligodendrocyte (OL) loss, and it was beneficial to maintain the normal structure of myelin. The intervention group showed an increase in the number of axons and Basso‐Beattie‐Bresnahan scores. Moreover, double‐labelled immunofluorescence images indicated p‐Smad1/5/9 and p‐STAT3 in OLs induced by BMP7 might be involved in the protective effects of BMP7. These findings suggest that BMP7 may be a feasible therapy for SCI to reduce demyelination and promote functional recovery.
Apparent diffusion coefficient echoplanar imaging maps of the optic nerves in childhood idiopathic intracranial hypertension
Authors: Seber Turgut , Bayram Nurettin , Bayram Ayşe Kaçar , Seber Tuğba Uylar
Published: August 2021

Background and Purpose

Dueto motion artifacts, optic nerve (ON) findings of idiopathic intracranial hypertension (IIH) can easily be overlooked on T2‐weighted (T2w) turbo spin‐echo sequence. This study aimed to investigate the contribution of the apparent diffusion coefficient (ADC) map derived from the interleaved multi‐shot (IMS) echoplanar imaging (EPI) to the ON findings of IIH in children.

Methods

MRIs of 42 pediatric patients aged 3‐17 years diagnosed with definite IIH according to modified Dandy criteria were retrospectively re‐evaluated, between April 2018 and January 2021. Forty‐two age‐ and sex‐matched subjects with no IIH symptoms and reported as normal were included as a control group.

Results

ON sheath distance (ONSD) on the ADC map (p = .005) and vertical tortuosity (p = .030) were significant single MRI parameters for predicting IIH. Other single parameters were not statistically significant. Flattening of the posterior sclera (FPS) and ON protrusion (ONP) were observed on ADC maps more frequently than T2w (42.8% vs. 19% and 19% vs. 4.7%, respectively). From combined MRI parameters, the presence of at least one of ONP, FPS, or ONSD on ADC maps (p = .001) showed greater significance than the presence of T2w (p = .048). The predictive values of other MRI findings evaluated together were not statistically significant (p > .05).

Conclusions

This study's results show that due to the short readout time and less sensitivity to motion, the ADC map obtained from IMS‐EPI can contribute to orbital findings of IIH, in addition to T2w.
Psychological distress and resilience in first responders and health care workers during the COVID‐19 pandemic
Authors: Pink Jennifer , Gray Nicola S. , O’Connor Chris , Knowles James R. , Simkiss Nicola J. , Snowden Robert J.
Published: August 2021

During the COVID‐19 pandemic, first responders and health care workers faced elevated virus‐related risks through prolonged contacts with the public. Research suggests that these workers already experienced lower levels of psychological well‐being linked to occupational risks. Thus, the pandemic’s impact might have particularly affected mental health in these groups. This paper analysed data from a large‐scale Welsh population study (N = 12,989) from June to July 2020. Levels of psychological distress were compared across various occupations, including police, fire and rescue, and NHS health care workers. Resilience was also indexed, and its role considered as a protective factor for psychological distress. Surprisingly, health care workers reported lower distress levels than the general population. Further, fire and rescue and police groups had lower distress than most groups and significantly higher resilience. Within police officers, higher resilience levels were protective for distress. Fire and rescue workers were half as likely as others to report distress, even accounting for demographic factors and resilience. The findings offer an optimistic view of psychological resilience in these critical occupations. They illustrate potential benefits to one’s mental health of playing a crucial societal role during crises and reiterate the importance of enhancing resilience within groups who encounter high‐risk situations daily.

Practitioner points

Our findings provide evidence that health care workers and first responders showed lower levels of psychological distress than the general population during the first period of lockdown due to the COVID‐19 pandemic in the United Kingdom. This may indicate that playing a critical role in society during an episode of crisis, and acting to help others, may be protective of one’s own mental health.

The research also provides an optimistic view of the psychological resilience of critical first responders and health care workers during a period early on in the COVID‐19 pandemic (June–July 2020). This highlights the benefits of fostering resilience in those working within high‐risk first responder and health care occupations.
Stem cells from human exfoliated deciduous teeth relieve pain via downregulation of c‐Jun in a rat model of trigeminal neuralgia
Authors: Bai Xiaofeng , Xiao Ke , Yang Zhijie , Zhang Ziqi , Li Jing , Yan Ziyi , Cao Keda , Zhang Weiqian , Zhang Xia
Published: August 2021

Background

Stem cells from human exfoliated deciduous teeth (SHED) have excellent immunomodulatory and neuroprotective abilities. It is possible that systemic SHED transplantation could ameliorate trigeminal neuralgia. The phosphorylation of c‐Jun contributes to the development of hyperalgesia and allodynia.

Objective

The present study aimed to evaluate whether systemic SHED transplantation could lead to analgesic effects by regulating peripheral c‐Jun in the trigeminal ganglia (TG) in a rat model of trigeminal neuralgia.

Methods

Chronic constriction injury of the infraorbital nerve (CCI‐ION) was performed to establish a rat pain model. SHED were obtained from discarded exfoliated deciduous teeth from children and transplanted by a single infusion through the tail vein. SHED were labelled with the PKH26 red fluorescent cell linker mini kit for tract distribution. The mechanical threshold was determined using von Frey filaments. The mRNA levels of c‐Jun in the ipsilateral TG were quantified. The phosphorylation of c‐Jun in the ipsilateral TG was assessed by immunohistochemistry and Western blotting.

Results

PKH26‐labelled SHED were distributed to both sides of TG, lung, liver and spleen. Systemic SHED transplantation significantly elevated the mechanical thresholds in CCI‐ION rats and blocked the upregulation of c‐Jun mRNA levels in the TG caused by nerve ligation. The activation of c‐Jun in the TG was blocked by SHED transplantation.

Conclusions

These findings demonstrate that systemic SHED administration reverts trigeminal neuralgia via downregulation of c‐Jun in the TG.
Variable length Markov chain with exogenous covariates
Authors: Zanin Zambom Adriano , Kim Seonjin , Lopes Garcia Nancy
Published: August 2021

Markov chains with variable length are useful stochastic models for data compression that avoid the curse of dimensionality faced by full Markov chains. In this article we introduce a variable length Markov chain whose transition probabilities depend not only on the state history but also on exogenous covariates through a generalized linear model. The goal of the proposed procedure is to estimate not only the context of the process, that is, the history of the process that is relevant for predicting the next state, but also the coefficients corresponding to the significant exogenous variables. The proposed method is consistent in the sense that the probability that the estimated context and the coefficients are equal to the true data generating mechanism tends to 1 as the sample size increases. Simulations suggest that, when covariates do contribute to the transition probabilities, the proposed procedure can recover both the tree structure and the regression parameters. It outperforms variable length Markov chains when covariates are present while yielding comparable results when covariates are absent. For models with fixed length, the accuracy of the proposed algorithm in recovering the true data generating mechanism is close to the methods available in the literature. The proposed methodology is used to predict the gains and losses of the Hang Seng index based on its own history and three large stock market indices.
Survival and prognostic indicators in downer dairy cows presented to a referring hospital: A retrospective study (1318 cases)
Authors: Puerto‐Parada Maria , Bilodeau Marie‐Ève , Francoz David , Desrochers André , Nichols Sylvain , Babkine Marie , Arango‐Sabogal Juan Carlos , Fecteau Gilles
Published: August 2021

Background

Downer cow syndrome, a common problem in dairy cattle, represents a diagnostic and therapeutic challenge for the attending veterinarian. Identifying prognostic indicators and assessing the odds of survival may improve the accuracy of the clinician's prognosis at the time of diagnosis.

Objective

To describe a population of downer dairy cows referred to a hospital and investigate predictors of outcome.

Animals

Recumbent adult dairy cows (cows unable or unwilling to stand without help) treated at a referral hospital.

Methods

Data at the time of admission were collected from medical records of downer dairy cows treated at the Centre Hospitalier Universitaire Vétérinaire between 1994 and 2016. Simple and multivariable logistic regression analyses were performed to assess the association of predictors with the outcome.

Results

Among 1318 cows included, 727 (55%) cows were discharged, and 591 (45%) cows died or were euthanized. Cows with longer time of recumbency before referral (odds ratio [OR] = 3.6), tachycardia (100‐120 beats per minute [bpm], OR = 1.93; >120 bpm, OR = 2.92), tachypnea (OR = 1.76), hypothermia (OR = 2.08), anemia (OR = 3.30), neutropenia (OR = 1.7), high aspartate aminotransferase activity (500‐1000 U/L, OR = 2.16; >1000 U/L, OR = 6.69), and increased serum creatinine concentration (OR = 1.75) had higher odds of nonsurvival.

Conclusions and Clinical Importance

These findings may help the practitioner to consider treatment options and decide if referral is likely beneficial based on the odds of success. Early recognition of low chance of survival may facilitate an early decision for euthanasia.
Divergence and hybridization in sea turtles: Inferences from genome data show evidence of ancient gene flow between species
Authors: Vilaça Sibelle Torres , Piccinno Riccardo , Rota‐Stabelli Omar , Gabrielli Maëva , Benazzo Andrea , Matschiner Michael , Soares Luciano S. , Bolten Alan B. , Bjorndal Karen A. , Bertorelle Giorgio
Published: August 2021

Reconstructing past events of hybridization and population size changes are required to understand speciation mechanisms and current patterns of genetic diversity, and ultimately contribute to species' conservation. Sea turtles are ancient species currently facing anthropogenic threats including climate change, fisheries, and illegal hunting. Five of the seven extant sea turtle species are known to currently hybridize, especially along the Brazilian coast where some populations can have ~32%–42% of hybrids. Although frequently observed today, it is not clear what role hybridization plays in the evolutionary diversification of this group of reptiles. In this study, we generated whole genome resequencing data of the five globally distributed sea turtle species to estimate a calibrated phylogeny and the population size dynamics, and to understand the role of hybridization in shaping the genomes of these ancient species. Our results reveal discordant species divergence dates between mitochondrial and nuclear genomes, with a high frequency of conflicting trees throughout the nuclear genome suggesting that some sea turtle species frequently hybridized in the past. The reconstruction of the species' demography showed a general decline in effective population sizes with no signs of recovery, except for the leatherback sea turtle. Furthermore, we discuss the influence of reference bias in our estimates. We show long‐lasting ancestral gene flow events within Chelonioidea that continued for millions of years after initial divergence. Speciation with gene flow is a common pattern in marine species, and it raises questions whether current hybridization events should be considered as a part of these species' evolutionary history or a conservation issue.
Public policy, systemic resilience and viability theory
Authors: Karacaoglu Girol , Krawczyk Jacek B.
Published: August 2021

Policy problems are typically formulated as optimization problems. Governments are conceptualized as optimizing agents. Risky situations are modelled as outcomes with known probabilities. Under ‘radical’ uncertainty, this model collapses because possible outcomes and their probabilities are unknown. Public policy must then build resilience to ‘unknown unknowns’. Viability theory offers a superior tool for such situations than optimization. The width of the viability kernel represents a mathematical expression for the degree of resilience to unknown shocks. Policy then aims at suitable investments that expand the viability kernel. We demonstrate the design of policy using viability theory with a simple model.
Functional diversity of isoprenoid lipids in Methylobacterium extorquens PA1
Authors: Rizk Sandra , Henke Petra , Santana‐Molina Carlos , Martens Gesa , Gnädig Marén , Nguyen Ngoc Anh , Devos Damien P. , Neumann‐Schaal Meina , Saenz James P.
Published: August 2021

Hopanoids and carotenoids are two of the major isoprenoid‐derived lipid classes in prokaryotes that have been proposed to have similar membrane ordering properties as sterols. Methylobacterium extorquens contains hopanoids and carotenoids in their outer membrane, making them an ideal system to investigate the role of isoprenoid lipids in surface membrane function and cellular fitness. By genetically knocking out hpnE and crtB we disrupted the production of squalene and phytoene in M. extorquens PA1, which are the presumed precursors for hopanoids and carotenoids respectively. Deletion of hpnE revealed that carotenoid biosynthesis utilizes squalene as a precursor resulting in pigmentation with a C30 backbone, rather than the previously predicted canonical C40 phytoene‐derived pathway. Phylogenetic analysis suggested that M. extorquens may have acquired the C30 pathway through lateral gene transfer from Planctomycetes. Surprisingly, disruption of carotenoid synthesis did not generate any major growth or membrane biophysical phenotypes, but slightly increased sensitivity to oxidative stress. We further demonstrated that hopanoids but not carotenoids are essential for growth at higher temperatures, membrane permeability and tolerance of low divalent cation concentrations. These observations show that hopanoids and carotenoids serve diverse roles in the outer membrane of M. extorquens PA1.
Breakthrough invasive fungal infections in liver transplant recipients exposed to prophylaxis with echinocandins vs other antifungal agents: A systematic review and meta‐analysis
Authors: Gatti Milo , Rinaldi Matteo , Ferraro Giuseppe , Toschi Alice , Caroccia Natascia , Arbizzani Federica , Raschi Emanuel , Poluzzi Elisabetta , Pea Federico , Viale Pierluigi , Giannella Maddalena
Published: August 2021

Introduction

Although echinocandins are recommended as first‐line prophylaxis for high‐risk orthotopic liver transplant (OLT) recipients, occurrence of breakthrough‐invasive fungal infections (IFIs) remains a serious concern. We aim to assess the risk of breakthrough IFIs among OLT recipients exposed to prophylaxis with echinocandins compared to other antifungals.

Materials and methods

Two authors independently searched PubMed‐MEDLINE, Embase, study registries and reference lists from inception to March 2021, to retrieve randomised controlled trials (RCTs) or observational studies comparing efficacy and safety of echinocandins vs other antifungals for prophylaxis in OLT recipients. Data were independently extracted from two authors, and the quality of included studies was independently assessed according to ROB 2.0 tool for RCTs and ROBINS‐I tool for observational studies. The primary outcome was occurrence of breakthrough IFI at the end of prophylaxis (EOP).

Results

698 articles were screened, and ten studies (3 RCTs and 7 observational) were included. No difference between echinocandins and other antifungals in terms of breakthrough IFIs at the EOP emerged both from RCTs (odds ratio [OR] 0.85, 95% CI 0.24–2.99) and observational studies (OR 1.43, 95% CI 0.28–7.40). No difference emerged also for secondary outcomes. In the subgroup comparison between echinocandins and polyenes, a trend for higher risk of breakthrough IFI at the EOP (OR 4.82, 95% CI 0.97–24.03) was noted.

Conclusions

Echinocandins do not seem to be associated with increased risk of breakthrough IFIs in OLT recipients. However, the large diversity in the comparator group hinders a definitive interpretation. Further studies exploring the relationship between echinocandin use and breakthrough IFIs according to specific comparators are warranted.
Reliability and validity of the Actiwatch and Clouclip for measuring illumination in real‐world conditions
Authors: Howell Colleen M , McCullough Sara J , Doyle Lesley , Murphy Marie H , Saunders Kathryn J
Published: August 2021

Purpose

To compare real‐world measures of illumination obtained with the Actiwatch‐2 and Clouclip‐M2 with ‘gold standard’ photometry measures and to evaluate the ability of Actiwatch‐2 to correctly identify photometer‐defined conditions: scotopic (≤0.01 lux), mesopic (0.02–3 lux), indoor photopic (>3–1,000 lux) and outdoor photopic (>1,000 lux); and Clouclip to correctly identify photometer‐defined conditions within its operating range (>1 lux). Inter‐device reliability of Clouclip for illumination and viewing distance measures was also investigated.

Methods

A Hagner‐S2 photometer was used as reference. Measures of illumination were obtained from a range of real‐world conditions. To investigate inter‐device reliability, five Clouclips were simultaneously exposed to varied light conditions and object distances.

Results

Strong correlations existed between illumination measured with the photometer and both Actiwatch‐2 (ρ = 0.99, p < 0.0001) and Clouclip (ρ = 0.99, p < 0.0001). However, both devices underestimated illumination compared to the photometer; disparity increased with increasing illumination and was greater for Actiwatch‐2 than Clouclip measures. Actiwatch‐2 successfully categorised illumination level (scotopic, mesopic, indoor and outdoor photopic) in 71.2% of cases. Clouclip successfully categorised illumination levels as scotopic/mesopic (≤3 lux) and indoor and outdoor photopic in 100% of cases. Mean differences and limits of agreement (LOA) were 430.92 ± 1,828.74 and 79.35 ± 407.33 lux, between the photometer and Actiwatch‐2 and photometer and Clouclip, respectively. The Intra‐class Correlation Coefficients for illumination and viewing distance measured with five Clouclips were 0.85 and 0.96, respectively.

Conclusion

These data illustrate that different Clouclip devices produce comparable measures of viewing distance and illumination in real‐world settings. Both Actiwatch‐2 and Clouclip underestimate illumination in the field compared to gold standard photometer measures. The disparity increases at higher levels of illumination and the discrepancy was greater for Actiwatch‐2 measures. For researchers interested in categorising light exposure, Clouclip classifies illumination levels >2 lux more accurately than Actiwatch‐2 but cannot discriminate between scotopic and low mesopic light.
Lessons from COVID‐19: A reflection on the strengths and weakness of early consensus recommendations for pediatric difficult airway management during a respiratory viral pandemic using a modified Delphi method
Authors: Stein Mary Lyn , Park Raymond S. , Afshari Arash , Disma Nicola , Fiadjoe John E. , Matava Clyde T. , McNarry Alistair F. , von Ungern‐Sternberg Britta S. , Kovatsis Pete G. , Peyton James M.
Published: August 2021

Background

The authors recognized a gap in existing guidelines and convened a modified Delphi process to address novel issues in pediatric difficult airway management raised by the COVID‐19 pandemic.

Methods

The Pediatric Difficult Intubation Collaborative, a working group of the Society for Pediatric Anesthesia, assembled an international panel to reach consensus recommendations on pediatric difficult airway management during the COVID‐19 pandemic using a modified Delphi method. We reflect on the strengths and weaknesses of this process and ways care has changed as knowledge and experience have grown over the course of the pandemic.

Recommendations

In the setting of the COVID‐19 pandemic, the Delphi panel recommends against moving away from the operating room solely for the purpose of having a negative pressure environment. The Delphi panel recommends supplying supplemental oxygen and using videolaryngoscopy during anticipated difficult airway management. Direct laryngoscopy is not recommended. If the patient meets extubation criteria, extubate in the OR, awake, at the end of the procedure.

Reflection

These recommendations remain valuable guidance in caring for children with anticipated difficult airways and infectious respiratory pathology when reviewed in light of our growing knowledge and experience with COVID‐19. The panel initially recommended minimizing involvement of additional people and trainees and minimizing techniques associated with aerosolization of viral particles. The demonstrated effectiveness of PPE and vaccination at reducing the risk of exposure and infection to clinicians managing the airway makes these recommendations less relevant for COVID‐19. They would likely be important initial steps in the face of novel respiratory viral pathogens.

Conclusions

The consensus process cannot and should not replace evidence‐based guidelines; however, it is encouraging to see that the panel's recommendations have held up well as scientific knowledge and clinical experience have grown.
The treatment and management of atopic dermatitis in the pediatric emergency department: Highlighting physician practices and the desire for patient‐centered resources
Authors: Longowal Maninder , Woo Taylor E. , D’Mello Jennifer , Ramien Michele
Published: August 2021

Atopic dermatitis is a common, complex skin disorder with significant morbidity. The management of atopic dermatitis is multifactorial and often varies by physician experience and comfort level. We conducted a single‐institution survey of pediatric emergency medicine physicians regarding their perceived confidence in managing atopic dermatitis, knowledge of treatment options, and interest in patient‐centered clinical resources. The results of our survey suggest that many pediatric emergency physicians at our center are somewhat confident managing atopic dermatitis and that topical corticosteroids represent the mainstay of treatment of AD. Our survey identified common AD therapies used by emergency department physicians and highlights the desire for further patient‐centered resources in the emergency care setting.
Influence of anti‐coronavirus disease 2019 policies on 10 pediatric infectious diseases
Authors: Yamamoto‐Kataoka Sachiko , Kataoka Yuki , Tochitani Kentaro , Miyakoshi Chisato , Yamamoto Yosuke
Published: August 2021

Background

To combat the coronavirus disease 2019 pandemic, many countries, including Japan, implemented policies limiting social activities and encouraging preventive behaviors. This study examines the influence of such policies on the trends of 10 infectious pediatric diseases: pharyngoconjunctival fever; group A streptococcal pharyngitis; infectious gastroenteritis; chickenpox; erythema infectiosum; hand, foot, and mouth disease; herpangina; respiratory syncytial virus; exanthem subitum; and mumps.

Methods

The research adopted a retrospective cohort study design. We collected data from Japan's National Epidemiological Surveillance Program detailing the incidences of the 10 diseases per pediatric sentinel site for a period beginning at 9 weeks before government‐ordered school closures and ending at 9 weeks after the end of the state of emergency. We obtained corresponding data for the equivalent weeks in 2015–2019. We estimated the influence of the policies using a difference‐in‐differences regression model.

Results

For seven diseases (pharyngoconjunctival fever; group A streptococcal pharyngitis; infectious gastroenteritis; chickenpox; erythema infectiosum; hand, foot, and mouth disease; and herpangina), the incidence in 2020 decreased significantly during and after the school closures. Sensitivity analysis, in which the focus area was limited to the policy‐implementation period or existing trend patterns, replicated these significant decreases for one of the above mentioned seven diseases – infectious gastroenteritis.

Conclusions

Policies such as school closures and encouragement of preventive behaviors were associated with significant decreases in the incidences of most of the 10 diseases, which sensitivity analysis replicated in infectious gastroenteritis. To determine the long‐term effects of these policies, prospective cohort studies are needed.
Impact of tacrolimus variability on pediatric heart transplant outcomes
Authors: Sirota Megan , Heyrend Caroline , Ou Zhining , Masotti Susan , Griffiths Eric , Molina Kimberly
Published: August 2021

Background

Tacrolimus is a narrow therapeutic index drug, requiring consistent levels to maximize transplant success while reducing adverse effects. Elevated tacrolimus level variability (ETLV) is associated with poor outcomes in both pediatric and adult solid organ transplant recipients. We sought to describe the prevalence of ETLV and identify associations with patient‐specific factors and poor outcomes.

Methods

Tacrolimus levels were evaluated from 118 patients at our single center. As a marker of variability, standard deviations (SD) were calculated for each patient from their entire tacrolimus level data set (global SD), and 1–2 years and 1–5 years post‐HT (prediction window SDs). SD ≥3 denoted ETLV.

Results

There was large variability in tacrolimus levels (median global SD 3.1; IQR 2.3, 4; SD ≥3, n = 64, 54%). Patients with elevated SD (≥3) vs lower SD (<3) were more likely to have poor outcomes including rejection (73% vs 46%), cardiac allograft vasculopathy (CAV, 22% vs 9%), and death (20% vs 6%). The prediction window analysis noted ETLV was associated with a 40% greater risk of CAV, re‐HT, or death (p = .024) and increasing age at transplantation was associated with a 12% increase in the risk of rejection (p = <.001) and a 19% increase in the risk of a composite event (p = .021).

Conclusion

ETLV is prevalent in the pediatric HT population with increased frequency of poor outcomes in those with SD ≥3. ETLV is an easily accessible marker with which to risk‐stratify patients.
Effect of TEOA on the Process of Photopolymerization at 532 nm and Properties of Nanogels
Authors: Peng Yuanyuan , Wang Zhipeng , Peña Jhair , Guo Zhiming , Xing Jinfeng
Published: August 2021

Nanogel is an important kind of biomaterials applied for wound dressings, drug delivery, medical diagnostics and biosensors. The properties of nanogels closely depend on the density of the crosslinking network. In this study, the role of triethanolamine (TEOA) in the effect on the crosslinking degree of nanogels based on poly(ethylene glycol) diacrylate (PEGDA) was investigated and illustrated. The effect of TEOA on the process of photopolymerization at 532 nm and properties of the nanogels was systematically investigated by using UV‐vis spectroscopy, FT‐IR spectroscopy, 1H NMR, DLS, SEM, AFM and DSC. In brief, the double‐bond conversion of photopolymerization and the crosslinking degree of nanogels can be effectively regulated by TEOA.
A Highly Selective and Sensitive Colorimetric Chemosensor for the Detection of Hydrogen Sulfide: A Real‐time Application in Multiple platforms
Authors: Jothi Dhanapal , Munusamy Sathishkumar , Kulathu Iyer Sathiyanarayanan
Published: August 2021

Calorimetric chemosensors are found to be advantageous sensing systems due to their simplicity and favorable responsive properties. Although some colorimetric probes have been reported to detect hydrogen sulfide (H2S), the creation of rapid, highly selective and sensitive probes for the detection of H2S remains a challenging target. In this work, we established dinitrosulphonamide decorated phenanthridine and 2,4‐dinitro‐N‐(4‐(7,8,13,14‐tetrahydrodibenzo[a, i]phenanthridin‐5‐yl)phenyl)benzenesulfonamide (PHSH), for the calorimetric detection of H2S. H2S‐triggered thiolysis of PHSH resulted in a marked absorption enhancement alongside a visual color change from colorless to dark yellow. The result indicated that the chemosensor showed high sensitivity and selectivity with a fast response of less than 10 s with a detection limit as low as 6.5 nM. The chemosensor reaction mechanism with H2S was studied by UV‐vis, 1H NMR, mass and HPLC analysis. In addition, the chemosensor has been used for the determination of H2S in many real‐time samples.
The relationship between hepatic fibrosis and arterial stiffness in hemodialysis patients
Authors: Guzel Fatma Betul , Ozturk Ilyas , Gisi Kadir , Ispiroglu Murat , Akkus Gulsum , Erken Ertugrul , Altunoren Orcun , Gungor Ozkan
Published: August 2021

Introduction

The main cause of death in hemodialysis patients is cardiovascular diseases. Increased arterial stiffness is a predictor of cardiovascular events for hemodialysis patients. Among the nondialysis patient population, arterial stiffness increases in those with hepatic fibrosis and nonalcoholic fatty liver disease. This study aims to examine the relationship between hepatic fibrosis and arterial stiffness in hemodialysis patients for the first time in the literature.

Material and method

The study includes chronic hemodialysis patients over 18 years of age who had been treated for hemodialysis for at least 6 months. Patients with chronic liver disease, chronic viral hepatitis (HBV and HCV), alcohol use, or liver disease accompanied by polycystic kidney disease and active infection were excluded. Hepatic fibrosis scores were measured using the FibroScan device. Single‐cuff Mobil‐o‐Graph was used for measurement of arterial stiffness.

Results

Fifty‐nine patients were enrolled; 54.2% of the patients were male, and the mean age was 53.9 ± 12.9 years. Thirty‐nine percent of the patients had diabetes. Average pulse wave velocity (PWV) value of the patients was 8.3 ± 1.6 m/s, and it had positive correlation with age, CAP score, fibrosis score, and body mass index and showed negative correlation to albumin. It was seen that the patients with a PWV value ≥ 10 m/s have significantly higher CAP score compared with the patients with a PWV < 10 m/s. When the factors predicting PWV were examined in the regression analysis, age and systolic blood pressure were found to be determinants.

Conclusion

Increased hepatic fibrosis in hemodialysis patients is associated with increased arterial stiffness, but this relationship is not independent.
Single‐nucleus RNA sequencing of plant tissues using a nanowell‐based system
Authors: Sunaga‐Franze Daniele Y. , Muino Jose M. , Braeuning Caroline , Xu Xiaocai , Zong Minglei , Smaczniak Cezary , Yan Wenhao , Fischer Cornelius , Vidal Ramon , Kliem Magdalena , Kaufmann Kerstin , Sauer Sascha
Published: August 2021

Single‐cell genomics provides unprecedented potential for research on plant development and environmental responses. Here, we introduce a generic procedure for plant nucleus isolation combined with nanowell‐based library preparation. Our method enables the transcriptome analysis of thousands of individual plant nuclei. It serves as an alternative to the use of protoplast isolation, which is currently a standard methodology for plant single‐cell genomics, although it can be challenging for some plant tissues. We show the applicability of our nucleus isolation method by using different plant materials from different species. The potential of our single‐nucleus RNA sequencing method is shown through the characterization of transcriptomes of seedlings and developing flowers from Arabidopsis thaliana. We evaluated the transcriptome dynamics during the early stages of anther development, identified stage‐specific activities of transcription factors regulating this process, and predicted potential target genes of these transcription factors. Our nucleus isolation procedure can be applied in different plant species and tissues, thus expanding the toolkit for plant single‐cell genomics experiments.
Transfusion requirements and alloimmunization to red blood cell antigens in orthotopic liver transplantation
Authors: Uzuni Ajna , El‐Bashir Jaber , Galusca Dragos , Yeddula Sirisha , Nagai Shunji , Yoshida Atsushi , Abouljoud Marwan S. , Otrock Zaher K.
Published: August 2021

Background and Objectives

Orthotopic liver transplantation (OLT) has been associated with high blood transfusion requirements. We evaluated the transfusion needs and frequency of alloimmunization to RBC antigens among OLT recipients pre‐ and post‐transplantation.

Materials and Methods

We reviewed the medical records of patients who underwent a first OLT between January 2007 and June 2017. Transfusions given only during the perioperative period, defined by 1 week before OLT until 2 weeks following OLT, were included in this study. Records were reviewed in June 2019 for updated antibody testing results.

Results

A total of 970 patients underwent OLT during the study period. The median age of patients was 57 years; 608(62.7%) were male. During the perioperative period, transfused patients received an average of 10.7 (±10.7) RBC units, 15.6 (±16.2) thawed plasma units and 4.1 (±4.3) platelet units. At the time of OLT, a total of 101 clinically significant RBC alloantibodies were documented in 58(5.98%) patients. Fifty‐three of these antibodies were directed against Rh blood group antigens. Twenty‐two (37.9%) patients had more than one alloantibody. Patients with alloimmunization before OLT (N = 58) received perioperatively comparable number of RBCs to non‐alloimmunized patients (10.5 ± 10.6 vs. 9.6 ± 10.7; p = 0.52). There was no significant difference in perioperative or intraoperative RBC transfusion between patients with one alloantibody and those with multiple alloantibodies. Only 16 patients (16/737; 2.17%) developed new alloantibodies at a median of 61 days after OLT. The overall alloimmunization rate was 9.8% (72/737), and female patients were more likely to be alloimmunized.

Conclusion

Blood transfusion requirements in OLT remain high. However, the rate of RBC alloimmunization was not higher than the general patient population.
Intercultural Competence and Study Abroad Programs-A Mixed Method Study
Authors: Tang Liqin , Matt John , Kero Patty
Published: August 2021

The purpose of this mixed methods study was to investigate the intercultural competence (IC) level of college students, explore whether there is a statistically significant difference in the IC level between students with study abroad (SA) experience and those without SA experience, and examine their attitudes, ideas and experiences about SA programs and intercultural communication. Data collected from online questionnaires and Zoom interviews were examined through the lens of Hall’s the Iceberg Analogy of Culture and M. J. Bennett’s Developmental Model of Intercultural Sensitivity (DMIS), which were also used as the conceptual framework in this study. Both quantitative and qualitative results indicated the IC level of college students was high, reaching up to the acceptance stage or/and adaptation stage of Bennett’s DMIS. Quantitative study showed that the IC level of students who participated in SA programs was higher than those who didn’t.