bluuebunny/crossref_metadata_2025 huggingface dataset:
Executive cues of organizational virtue and market performance: Creating value during times of earnings uncertainty
Authors: Jancenelle Vivien E.
Published: June 2021

This study investigates whether cues of organizational virtue (conscientiousness, courage, empathy, integrity, warmth, and zeal) sent by top managers can create market value in the context of post‐earnings announcement conference calls and earnings uncertainty. We contend that executive cues of organizational virtue embedded within earnings conference calls can mitigate shareholders' reactions to earnings surprises and use textual analysis to test for the effect of organizational virtue cues on market performance in a longitudinal sample of 1920 firm‐quarter observations. The results suggest that cues of conscientiousness, courage, and zeal are capable of adding back firm value after the posting of earnings surprises, while empathy worsens the market's reaction to earnings surprises. Integrity and warmth were not found to have an effect.
Incidence and impact of community respiratory viral infections in post‐transplant cyclophosphamide‐based graft‐versus‐host disease prophylaxis and haploidentical stem cell transplantation
Authors: Mulroney Carolyn M. , Abid Muhammad Bilal , Bashey Asad , Chemaly Roy F. , Ciurea Stefan O. , Chen Min , Dandoy Christopher E. , Diaz Perez Miguel A. , Friend Brian D. , Fuchs Ephraim , Ganguly Siddhartha , Goldsmith Scott R. , Kanakry Christopher G. , Kim Soyoung , Komanduri Krishna V. , Krem Maxwell M. , Lazarus Hillard M. , Ljungman Per , Maziarz Richard , Nishihori Taiga , Patel Sagar S. , Perales Miguel‐Angel , Romee Rizwan , Singh Anurag K. , Reid Wingard John , Yared Jean , Riches Marcie , Taplitz Randy
Published: June 2021

Community respiratory viral infections (CRVIs) are associated with pulmonary function impairment, alloimmune lung syndromes and inferior survival in human leucocyte antigen (HLA)‐matched allogeneic haematopoietic stem cell transplant (HCT) recipients. Although the incidence of viral infections in HLA‐haploidentical HCT recipients who receive post‐transplant cyclophosphamide (PTCy)‐based graft‐versus‐host disease (GVHD) prophylaxis is reportedly increased, there are insufficient data describing the incidence of CRVIs and the impact of donor source and PTCy on transplant outcomes. Analysing patients receiving their first HCT between 2012 and 2017 for acute myeloid leukaemia, acute lymphoblastic leukaemia and myelodysplastic syndromes, we describe comparative outcomes between matched sibling transplants receiving either calcineurin‐based GVHD prophylaxis (SibCNI, N = 1605) or PTCy (SibCy, N = 403), and related haploidentical transplants receiving PTCy (HaploCy, N = 757). The incidence of CRVIs was higher for patients receiving PTCy, regardless of donor type. Patients in the HaploCy cohort who developed a CRVI by day +180 had both a higher risk of treatment‐related mortality [hazard ratio (HR) 2⋅14, 99% confidence interval (CI) 1⋅13–4⋅07; P = 0⋅002] and inferior 2‐year overall survival (HR 1⋅65, 99% CI 1⋅11–2⋅43; P = 0⋅001) compared to SibCNI with no CRVI. This finding justifies further research into long‐term antiviral immune recovery, as well as development of preventive and treatment strategies to improve long‐term outcomes in such patients.
Multiplex technologies for the assessment of minimal residual disease and low‐level mutation detection in leukaemia: mass spectrometry versus next‐generation sequencing
Authors: Shanmuganathan Naranie , Branford Susan
Published: June 2021

With the focus of leukaemia management shifting to the implications of low‐level disease burden, increasing attention is being paid on the development of highly sensitive methodologies required for detection. There are various techniques capable of identification of measurable residual disease (MRD) either evidencing as relevant mutation detection [e.g. nucleophosmin 1 (NPM1) mutation] or trace levels of leukaemic clonal populations. The vast majority of these methods only permit detection of a single clone or mutation. However, mass spectrometry and next‐generation sequencing enable the interrogation of multiple genes simultaneously, facilitating a more complete genomic profile. In the present review, we explore the methodologies of both techniques in conjunction with the important advantages and limitations associated with each assay. We also highlight the evidence and the various instances where either technique has been used and propose future strategies for MRD detection.
Ten‐year review of neuroimaging in acute paediatric strabismus
Authors: Chong Cheefoong , Allen Natalie , Jarvis Rebecca , Dai Shuan
Published: June 2021

Background

Acute childhood strabismus is often a clinical conundrum faced by ophthalmologists. Currently, there are no clear clinical guidelines on how to investigate a child presenting with acute strabismus. Furthermore, there is no consensus as to whether to initially perform neuroimaging of a child to rule out the small but serious risk of intracranial pathology, or to pursue a careful observational approach. This paper aims to outline a standardised approach to investigating acute strabismus in paediatric patients.

Methods

A retrospective chart review of all paediatric patients that presented over a 10‐year period to the ophthalmology departments at two tertiary level hospitals in New Zealand was conducted. Patients under 18 years of age with an acute presentation of strabismus, who underwent neuroimaging, were included.

Results

A total of 500 patient records were reviewed. Seventy patients met the study inclusion criteria. Of these patients, 17 (24.3%) had non‐isolated strabismus while 53 patients (75.7%) had isolated strabismus. Twelve patients (70.6%) who presented with a non‐isolated strabismus had abnormal neuroimaging. Of those who presented with an isolated strabismus, 4 (7.5%) had abnormal neuroimaging.

Conclusions

Acute onset non‐isolated strabismus is a significant predictor of underlying neurological abnormality in children and requires urgent neuroimaging. However, a cautious approach in which there is close observation, along with general paediatric and/or paediatric neurology input, may be appropriate for children presenting acutely with an isolated strabismus.
Toward pharmacogenetic SLCO1B1‐guided dosing of methotrexate in arthritis using a murine Slco1b2 knockout model
Authors: Taylor Zachary L. , Thompson Lauren E. , Bear Heather , Mizuno Tomoyuki , Vinks Alexander A. , Ramsey Laura B.
Published: June 2021

Low‐dose methotrexate (MTX) is a first‐line therapy for the treatment of arthritis. However, there is considerable interindividual variability in MTX exposure following standard dosing. Polymorphisms in SLCO1B1 significantly effect MTX clearance, altering therapeutic response. One decreased function variant, rs4149056 (c.521T>C, Val174Ala), slows MTX clearance and in vitro uptake of MTX. This phenotype was recapitulated in a mouse model using a knockout (KO) of the murine orthologue, Slco1b2. Our objective was to investigate the impact of this phenotype on the pharmacokinetics and therapeutic outcomes of low‐dose MTX in a murine model of collagen‐induced arthritis (CIA). We evaluated response to MTX in mice with CIA using wildtype (WT), heterozygous, and KO Slco1b2 mice on a DBA1/J background. Arthritis was macroscopically evaluated daily to quantify disease progression. Mice received 2 mg/kg or a pharmacogenetically guided MTX dose subcutaneously 3 times a week for 2 weeks. MTX concentrations were collected at the end of the study and exposure (day*µM) was estimated using a two‐compartment model. Mice displayed a seven‐fold range in MTX exposure and revealed a significant exposure‐response relationship (p = 0.0027). KO mice receiving the 2 mg/kg dosing regimen had 2.3‐fold greater exposure to MTX (p < 0.0001) and a 66% reduction in overall disease progression (p = 0.011) compared to WT mice. However, exposure and response were equivalent when pharmacogenetically guided dosing was used. These studies demonstrate that an exposure‐response relationship exists for MTX and that Slco1b2 genotype affects MTX exposure and therapeutic response. Such evidence supports the use of SLCO1B1‐pharmacogenetic dosing of low‐dose MTX for patients with arthritis.
Assessment of the impact of Japanese‐specific long‐term safety data on new drug approval
Authors: Uzu Shinobu , Sekine Shohko , Asano Junichi , Ikuma Mutsuhiro
Published: June 2021

Under the International Council for Harmonization (ICH)‐E1 guideline for drugs intended for chronic or repeated intermittent use in non‐life‐threatening diseases, data from 100 patients exposed for a minimum of 1 year are required to be included in the safety data base of a new drug application. In response to the recent globalization of drug development, the Ministry of Health, Labour, and Welfare of Japan requires that the data according to the ICH‐E1 guideline should be collected from 100 Japanese patients by the administrative notice of Basic Principles on Global Clinical Trials (reference cases) by considering ethnic differences in safety between Japanese and foreigners. In this study, we assessed Pharmaceuticals and Medical Devices Agency (PMDA) review reports of new drugs from 2016 to 2020 that include safety data for 100 Japanese patients exposed to these drugs for a minimum of 1 year to see if the study data led to the detection of Japanese‐specific safety issues. The result showed that the safety data from these patients provided only marginal value to identify Japanese‐specific safety issues, and no drugs were subjected to regulatory measures. Based on these studies and the fact that Japanese‐specific safety differences detected for a few drugs did not lead to adaptations of drug regulatory measures, we would like to propose not to make it a rule to collect safety data from 100 Japanese patients exposed at least 1 year, while keeping the ICH‐E1 guideline.
The makeshift curtain: A generous Christianity: Ecclesiologies beyond the religious‐secular binary1
Authors: Wyller Trygve
Published: June 2021

The article discusses how one might reflect further on ecclesiological impacts from Scandinavian creation theology (SCT). The idea is that the SCT from Gustaf Wingren and Knud Ejler Løgstrup opens for an ecclesiology beyond the secular‐religious binary. A generous Christianity appears when practices of non‐faith (secularity) take place within ecclesia. The article discusses a concrete case from the Swedish congregation Bergsjøen where a makeshift curtain for visiting Muslims is constructed in the church basement. The makeshift curtain could be interpreted as a representation of creation and in this way being an important part of the ministry as a whole. The article discusses with recent Nordic and international ecclesiological and political theology. The conclusion is that, different from Catherine Keller's proposal of a “weak” political theology, SCT opens for an embodied, generous, Christianity.
What is the value of simulated patient assessment in structured clinical examinations of undergraduate students, and how should it be used?
Authors: Ali K. , Hanks S. , Cockerill J.
Published: June 2021

Introduction

The aim of this study was to explore correlations between clinical assessor and simulated patient (SP) scores drawn from summative Integrated Structured Clinical Examination (ISCE) and inform the best use of SP scores in future assessments.

Materials and Methods

This retrospective study explores summative clinical assessor and formative SP numeric scores drawn from summative ISCE assessments spanning three academic years (2017–18 to 2019–20). Analyses were carried out using R 3.5.1 (R Core Team, 2018), with the stats package.

Results

The sample consisted of 169 final‐year BDS students across the three cohorts and included 95 females (56.2%) and 74 males (43.8%). Data from eight substations where SPs were included, were explored. Kendall's Tau, a non‐parametric correlation, was used to investigate the relationships between the assessor and SP scores. Clinical assessor scores were out of a total of 20 points across various assessed domains within each substation. The formative SP assessment was out of 10 points with the same five affective domains related to communication included in each substation. Overall, the assessor and patient substation scores were not correlated (τ = 0.04, p = .272) indicating that communication skills alone, as assessed by patients, do not correlate with more holistic performance across other domains. There was significant positive correlation for two of the eight substations with the other substations showing very little correlation.

Conclusion

This study shows that assessment of student performance by SPs does not show a correlation with examiner scores and may provide additional information relating to affective skills of students. Notwithstanding the limitations of this study, the findings underscore the need to investigate further the value of involvement of SPs in clinical assessments to explore if scores by SPs can be used to enhance the validity of assessments if used summatively.
Global distribution and evolutionary transitions of angiosperm sexual systems
Authors: Wang Yunyun , Luo Ao , Lyu Tong , Dimitrov Dimitar , Xu Xiaoting , Freckleton Robert P. , Li Yaoqi , Su Xiangyan , Li Yichao , Liu Yunpeng , Sandanov Denis , Li Qingjun , Hao Zhanqing , Liu Shuguang , Wang Zhiheng
Published: June 2021

Angiosperm sexual systems are fundamental to the evolution and distribution of plant diversity, yet spatiotemporal patterns in angiosperm sexual systems and their drivers remain poorly known. Using data on sexual systems and distributions of 68453 angiosperm species, we present the first global maps of sexual system frequencies and evaluate sexual system evolution during the Cenozoic. Frequencies of dioecy and monoecy increase with latitude, while hermaphrodites are more frequent in warm and arid regions. Transitions to dioecy from other states were higher than to hermaphroditism, but transitions away from dioecy increased since the Cenozoic, suggesting that dioecy is not an evolutionary end point. Transitions between hermaphroditism and dioecy increased, while transitions to monoecy decreased with paleo‐temperature when paleo‐temperature >0℃. Our study demonstrates the biogeography of angiosperm sexual systems from a macroecological perspective, and enhances our understanding of plant diversity patterns and their response to climate change.
Ptf1a function and transcriptional cis‐regulation, a cornerstone in vertebrate pancreas development
Authors: Duque Marta , Amorim João Pedro , Bessa José
Published: June 2021

Vertebrate pancreas organogenesis is a stepwise process regulated by a complex network of signaling and transcriptional events, progressively steering the early endoderm toward pancreatic fate. Many crucial players of this process have been identified, including signaling pathways, cis‐regulatory elements, and transcription factors (TFs). Pancreas‐associated transcription factor 1a (PTF1A) is one such TF, crucial for pancreas development. PTF1A mutations result in dramatic pancreatic phenotypes associated with severe complications, such as neonatal diabetes and impaired food digestion due to exocrine pancreatic insufficiency. Here, we present a brief overview of vertebrate pancreas development, centered on Ptf1a function and transcriptional regulation, covering similarities and divergences in three broadly studied organisms: human, mouse and zebrafish.
HUMBOLDT AND METABIOGRAPHY
Authors: Rupke Nicolaas
Published: June 2021

In the wake of contemporary anxieties about climate change and environmental degradation, biographers of Alexander von Humboldt have sought inspiration from his life as an explorer, a plant geographer and a scientific writer. A ‘green Humboldt’ has emerged, to many a key thinker on the environment, to some the founding father of modern environmentalism. During earlier times and in separate places, in the course of the nearly 200‐year tradition of Humboldt biography, different – even very different – biographical traits have been highlighted, different narratives have been produced, each related to contemporaneous predilections and preoccupations. Does this mean that in telling Humboldt's life – or in telling scientific lives more generally – ‘anything goes’? Are we ‘telling it as we like it’ or ‘telling it like it is’? Can we have ‘lives after death’, that is, a plurality of biographical Humboldts, suited to distinct times, places and concerns and yet, for each of them, lay claim to authenticity? The genre of metabiography systematically engages with questions such as these and recognises the possible historical validity of multiple appropriations and Humboldt reincarnations, aka avatars. This article traces the recent emergence of scientific metabiography, and discusses some of the points that are being made pro and con.
Measurement and analysis of neighborhood congestion: Evidence from sidewalk pedestrian traffic and walking speeds
Authors: Gabe Todd
Published: June 2021

Regional scientists and planners are interested in congestion, both vehicular and pedestrian. This paper examines pedestrian congestion on sidewalks in the tourism district of Bar Harbor, Maine, with a focus on the effects of cruise passengers. The analysis considers pedestrian counts and the effects of passengers on walking speeds. Cruise passengers increase sidewalk pedestrian traffic overall, but the effects on walking speeds are mixed. For both indicators of sidewalk congestion, cruise passenger impacts decrease at greater distances from the passenger point‐of‐entry into Bar Harbor. The methods presented in the paper can be applied to sidewalk congestion related to a wide range of facilities and events (e.g., transportation hubs, museums and concert halls, sporting events, large pilgrimage events).
Clinical features, disease progression, and use of healthcare resources in a large sample of 866 patients from 24 headache centers: A real‐life perspective from the Italian chROnic migraiNe (IRON) project
Authors: Barbanti Piero , Fofi Luisa , Grazzi Licia , Vernieri Fabrizio , Camarda Cecilia , Torelli Paola , Cevoli Sabina , Russo Antonio , Bono Francesco , Finocchi Cinzia , Rao Renata , Messina Stefano , De Simone Roberto , Vanacore Nicola , Bonassi Stefano ,   IRON Study Group
Published: June 2021

Objective

To develop a dedicated Italian chronic migraine (CM) database (IRON project) to overcome disease misconceptions, improve clinical administration, reduce patients’ burden, and rationalize economic resource allotment.

Background

Proper CM management requires a comprehensive appraisal of its full clinical, social, and economic complexity.

Methods

In this cross‐sectional study, CM patients were screened in 24 certified headache centers with face‐to‐face interviews. Information on sociodemographic factors, medical history, characteristics of CM, and of prior episodic migraine (EM), and healthcare resource use was gathered using a semistructured web‐based questionnaire.

Results

A total of 866 CM patients were enrolled. CM started ~20 years after EM onset (age at EM onset 17.4 ± 9.1 vs. age at CM onset 35.3 ± 12.5 [mean ± SD]). CM prophylaxis, used by 430/866 (49.6%) of the patients, was often ineffective, not tolerated, and prematurely discontinued. Medications and diagnostic workup, frequently inappropriate, were mostly subsidized by the Italian national health service. CM patients with ≥25 headache days/month revealed substantial clinical differences and heavier disability and economic burden compared with those with <25 headache days/month.

Conclusions

CM is a heterogeneous headache disorder deserving more in‐depth clinical characterization, sharper diagnostic criteria, and tailored treatments. CM registries are expected to improve clinical management, resulting in increased disease awareness, better healthcare resource allocation, and reduced economic burden.
Novel artificial intelligent/neural network system for staging of nonalcoholic steatohepatitis
Authors: Okanoue Takeshi , Shima Toshihide , Mitsumoto Yasuhide , Umemura Atsushi , Yamaguchi Kanji , Itoh Yoshito , Yoneda Masato , Nakajima Atsushi , Mizukoshi Eishiro , Kaneko Shuichi , Harada Kenichi
Published: June 2021

Aim

To develop a novel noninvasive test using an artificial intelligence (AI)/neural network (NN) system (named Fibro‐Scope) to determine the fibrosis stage in nonalcoholic steatohepatitis (NASH).

Methods

Three hundred twenty‐four and 110 patients with histologically diagnosed nonalcoholic fatty liver disease (NAFLD) were enrolled for training and validation studies, respectively. Two independent pathologists histologically diagnosed patients with NAFLD for the validation study. Fibro‐Scope was undertaken using 12 items: age, sex, height, weight, waist circumference, aspartate aminotransferase, alanine aminotransferase, γ‐glutamyl transferase, cholesterol, triglyceride, platelet count, and type 4 collagen 7s.

Results

Differentiation of F0 versus F1–4 using the Fibro‐Scope revealed 99.5% sensitivity, 90.9% specificity, 97.4% positive predictive value, and 98.0% negative predictive value in a training study with gray zone analysis, which was also effective in the analysis without gray zone. Discrimination was also excellent when comparing F0–1 versus F2–4 and F0–2 versus F3–4. In a validation study with gray zone analysis, differentiation of F0 from F1–4 using Fibro‐Scope was also excellent. The discrimination of F0–1 from F2–4 using Fibro‐Scope with gray zone analysis showed over 80% sensitivity and specificity in the histological diagnosis of both pathologists, but was lower without the gray zone analysis. The discrimination of F0–2 from F3–4 was effective in the analysis with gray zone; however, their sensitivity and specificity were slightly inferior in the analysis without gray zone.

Conclusions

Artificial intelligence/neural network algorithms termed Fibro‐Scope are easy to use and can accurately differentially diagnose minimal, moderate, and advanced fibrosis. Fibro‐Scope will promote rapid NASH diagnosis and facilitate diagnosing the fibrosis stage in NASH.
The effect of a basic skin care product on the structural strength of the dermo‐epidermal junction: An exploratory, randomised, controlled split‐body trial
Authors: El Genedy‐Kalyoncu Monira , Richter Claudia , Surber Christian , Blume‐Peytavi Ulrike , Kottner Jan
Published: June 2021

Skin ageing is associated with various structural alterations including a decreased strength of the dermo‐epidermal adhesion increasing the risk for shear type injuries (skin tears). Topical applications of basic skin care products seem to reduce skin tear incidence. The suction blister method leads to the artificial and controlled separation of dermis and epidermis. Therefore, time to blister formation may be used as outcome measuring the strength of dermo‐epidermal adhesion. We conducted an exploratory, randomised, controlled trial with a split‐body design on forearms in healthy female subjects (n = 12; mean age 70.3 [SD 2.1] years). Forearms assigned to the intervention were treated twice daily with petrolatum for 8 weeks. Suction blisters were induced on forearms after 4 and 8 weeks and time to blister formation was measured. Stratum corneum and epidermal hydration were measured and epidermal thickness was assessed via optical coherence tomography. Time to blistering was longer and stratum corneum as well as epidermal hydration was consistently higher in intervention skin areas. We conclude that topical application of basic skin care products may improve mechanical adhesion of the dermo‐epidermal junction and that the parameter “time to blistering” is a suitable outcome to measure dermo‐epidermal adhesion strength in clinical research.
Examining the impact of Diabetes Inpatient Specialist Nursing in acute trusts in London
Authors: Lawler Jessica , Cook Robert , Dosanj Ravinder , Trevatt Paul , Leary Alison
Published: June 2021

Aims

To examine if the introduction of Diabetes Inpatient Specialist Nurses impacted on length of stay and rates of readmission.

Design

Knowledge discovery through data mining as part of a larger realist evaluation of the role.

Methods

Data from January 2017 to January 2019 was extracted and examined. A subset of performance data from July 2017–November 2018 was analysed. This consisted of 7320 records for Hospital Episode Statistics and 272 incident reports (Datix). The data were analysed via Generalised Linear Model regression routines in R. Analysis of readmission rates utilized binary logistic regression, while for the Length of Stay a count regression method was employed.

Results

Four trusts were found to have complete and rich data sets. All Trusts that returned complete data were found to have varying decreased length of stay and reduced readmission rates. In two trusts there were significant decreases in patient readmissions and length of stay after the introduction of the Diabetes Inpatient Specialist Nurses. A marked decrease (approximately half) in patient length of stay was found in one London trust after the introduction of the post. Issues with data quality were noted.

Conclusion

Reduced patient length of stay and rate of readmission were found since introduction of Diabetes Specialist Nurses. Patient safety data was incomplete and varied significantly between trusts.

Impact

The project sought to understand the impact of employing Diabetes Inpatient Specialist Nurses in hospitals in London. Overall, the specialist nurses helped reduce length of stay and the rate of readmissions. The research will have an impact on the workforce in diabetes and also people with diabetes who need hospital care.
Play interactions of parents toward children with autism spectrum disorder: NeuroPLAY parent play behavior assessment scale
Authors: Gürkan Tazegül Elif N. , Kutlu Konuk Feyza , Aksu Şerife S. , Unay Öykü S. , Yıldız Bıçakçı Müdriye , Ekici Barış , Tatlı Burak
Published: June 2021

Problem

The aim of this study is to analyze the changes that NeuroPLAY, which is an intensive early intervention method for children with autism spectrum disorder (ASD) and ages of 12–42 months, has created in the play skills of the parents of children with ASD by using method strategies.

Methods

The study cohort includes 91 children ages ranging from 18 to 42 months old. The study is designed for repetitive measurements performed pre‐ and post‐intervention. Within the scope of the study, children's ASD symptoms were evaluated with the Childhood Autism Rating Scale (CARS) and changes in the play skills of parents were evaluated using NeuroPLAY Parental Play Behavior Assessment Scale (NPPBAS).

Results

The NPPBAS score at the beginning of the intervention was 12.55; repeated measurements (46.22 after 3 months, 45.95 after 6 months, and 48.53 after 12 months) were observed to increase core. The older age of the parents in the intervention program is associated with lower final NPPBAS scores. However, it was determined that the CARS score, which is an indicator of the autism spectrum, will decrease after intervention regardless of the parents' age.

Conclusion

The results showed that NeuroPLAY led to significant improvement in play behaviors of the parents.
Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID‐19 pandemic with a structural equation model
Authors: Kandemir Didem , Temiz Zeynep , Ozhanli Yasemin , Erdogan Hatice , Kanbay Yalcin
Published: June 2021

Background

Faced with this critical situation and directly involved in the treatment and care of COVID‐19 patients, front‐line healthcare workers are at high risk in terms of mental health symptoms.

Aims and Objectives

To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model.

Design

A multi‐site survey study.

Methods

The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress‐21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist.

Results

In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001).

Conclusions

It was found that the majority of the intensive care nurses fighting COVID‐19 on the front‐line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression.

Relevance to clinical practice

This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front‐line during the COVID‐19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.
The economics of diversity: Innovation, productivity and the labour market
Authors: Ozgen Ceren
Published: June 2021

The empirical evidence on the economic impacts of diversity is mixed. Many studies in the literature present context‐dependent and data‐driven results which are challenging to reconcile with each other. This paper offers a systematic synthesis of the empirical findings on the economic impacts of diversity on innovation, productivity and the labour market. It presents a structured framework which takes the spatial scale of the analysis in the papers as a reference to understand the inconsistency of some previous predictions and the varying magnitudes of the diversity impact. The empirical findings reconcile more meaningfully when diversity effects are documented discretely at the regional, firm and individual levels. The paper further sets out an agenda for future research and links the findings for policy relevance.
Manometric parameters, when measured with the 3‐dimensional high‐definition anorectal manometry probe, poorly predict prolonged balloon expulsion time
Authors: Woo Matthew , Pandey Armaan , Gill Harman , Li Dorothy , Buresi Michelle , Nasser Yasmin , Sawhney Summit , Andrews Christopher N.
Published: June 2021

Background

There are little data evaluating the performance of the 3‐dimensional high‐definition anorectal manometry (3D‐HDAM) system in the diagnosis of dyssynergic defecation. Physical properties of the thicker, rigid, 3D‐HDAM probe may have implications on the measurements of anorectal pressures.

Aim

Our aim was to compare 3D‐HDAM to balloon expulsion test and magnetic resonance (MR) defecography.

Methods

Consecutive constipated patients referred for anorectal function testing at the Calgary Gut Motility Centre (Calgary, Canada) between 2014 and 2019 were assessed. All patients underwent anorectal manometry with the 3D‐HDAM probe, and a subset underwent BET or MR defecography. Anorectal manometric variables were compared between patients who had normal and abnormal BET.

Results

Over the study period, 81 patients underwent both 3D‐HDAM and BET for symptoms of constipation. 52 patients expelled the balloon within 3 minutes. Patients with abnormal BET had significantly lower rectoanal pressure differential (RAPD) (−61 vs. −31 mmHg for normal BET,p = 0.03) and defecation index (0.29 vs. 0.56, p = 0.03). On logistic regression analysis, RAPD (OR: 0.99, 95% CI: 0.97–0.99, p = 0.03) remained a negative predictor of abnormal BET. On ROC analysis, RAPD had an AUC of 0.65. There was good agreement between dyssynergic patterns on 3D‐HDAM and defecographic evidence of dyssynergia (sensitivity 80%, specificity 90%, PLR 9, NLR 0.22, accuracy 85%).

Conclusions

Manometric parameters, when measured with the 3D‐HDAM probe, poorly predict prolonged balloon expulsion time. RAPD remains the best predictor of prolonged balloon expulsion time. The 3D‐HDAM probe may not be the ideal tool to diagnose functional defecatory disorders.
Exercise vs Conventional Treatment for Treatment of Primary Osteoporosis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials
Authors: Yan Yan , Tan Biao , Fu Fanyu , Chen Qianglong , Li Wenlong , Chen Weiheng , He Haijun
Published: June 2021

Objective

Physical exercise has obvious effects on bone loss, pain relief, and improvement of bone metabolism indexes in patients with osteoporosis, but currently lacks sufficient evidence. The aim of this systematic review and meta‐analysis was to synthesize and present the best available evidence on the effectiveness and safety of exercises in the treatment of primary osteoporosis.

Methods

Publications pertaining to the effectiveness of exercise on bone mineral density (BMD), visual analog scores (VAS), and biochemical markers of bone metabolism in primary osteoporosis (POP) from PubMed, Cochrane Library, Embase, VIP, CNKI, and Wanfang Database were retrieved from their inception to April 2020.

Results

A total of 20 studies with 1824 participants were included. The results of the meta‐analysis revealed that exercise therapy for lumbar spine and femoral neck BMD is statistically different from conventional therapy (lumbar spine BMD: SMD = 0.78, 95%CI: 0.46, 1.10, P < 0.00001, I2 = 85%; femoral neck BMD (SMD = 0.80, 95%CI: 0.34, 1.27, P = 0.0007, I2 = 88%), exercise therapy can significantly increase the lumbar spine BMD of patients with OP, especially in lumbar spine2‐4 BMD (SMD = 0.47; 95%CI: 0.20, 0.75; P = 0.0008; I2 = 69%). Compared with conventional treatment, kinesitherapy also has significant differences in alleviating the pain of POP patients (SMD = −1.39, 95%CI: −2.47,−0.31, P = 0.01, I2 = 97%). Compared with conventional therapy, kinesitherapy has no significant difference in improving biochemical markers of bone metabolism such as bone glaprotein (BGP) (SMD = 2.59, 95%CI:0.90, 4.28, P = 0.003, I2 = 98%), N‐terminal pro peptide of type I procollagen (PINP) (SMD = 0.77, 95%CI: −0.44 to 1.98, P = 0.21, I2 = 95%), serum phosphorus (SMD = 0.04, 95%CI: −0.13, 0.22, P = 0.61, I2 = 30%), alkaline phosphatase (ALP) (SMD = −0.08, 95%CI: −0.44, 0.27, P = 0.64, I2 = 76%), and serum calcium (SMD = 0.12, 95%CI: −0.18, 0.43, P = 0.42, I2 = 63%) in POP patients.

Conclusions

Kinesitherapy significantly improved lumbar spine and femoral neck BMD, and relieve the pain of patients in the current low‐quality evidence. Additional high‐quality evidence is required to confirm the effect of exercise therapy on the biochemical markers of bone metabolism in POP patients.
Chemical and cultural control of Ipomoea hederacea var. integriuscula in narrow‐row soybean in southwestern Japan
Authors: Asami Hidenori , Tachibana Masaaki , Homma Koki
Published: June 2021

In Japan, the spread of morning glory (Ipomoea spp.) in soybean fields has become a serious issue. To establish a control approach for Ipomoea species, this study considered the optimal system combining cultural and chemical control methods. Field experiments were conducted for 3 years to investigate the effects of no‐tillage compared with tillage seeding in narrow‐row soybean and of application timing of selective post‐emergence herbicides bentazone and fluthiacet‐methyl. The cumulative emergence of entireleaf morning glory (Ipomoea hederacea [L.] Jacq. var. integriuscula A. Gray) in no‐tillage was 25–79% of that in tillage, and the initial growth was suppressed. In no‐tillage, the dry matter weight of I. hederacea var. integriuscula was suppressed compared to tillage methods. However, in no‐tillage, initial soybean growth was inferior, and reduction of the relative photosynthetic photon flux density (RPPFD) in the soybean canopy was delayed. A combination of selective post‐emergence herbicide applications at the second and fourth trifoliate leaf stages (TLS) of soybean was most effective in I. hederacea var. integriuscula suppression. The initial growth of soybean greatly fluctuated yearly, and the period when the RPPFD became less than 50% varied at the fourth through seventh TLS. Therefore, if the initial soybean growth is good, the end of the required period for weed control can be defined as the fourth TLS. No‐tillage cultivation combined with management to promote soybean growth, such as adequate soil moisture control by subirrigation systems, may be effective in controlling I. hederacea var. Integriuscula.
An Adaptive Model Predictive Control Scheme for Energy-Efficient Control of Building HVAC Systems
Authors: Zeng Tingting , Barooah Prabir
Published: June 2021

An autonomous adaptive model predictive control (MPC) architecture is presented for control of heating, ventilation, and air condition (HVAC) systems to maintain indoor temperature while reducing energy use. Although equipment use and occupant changes with time, existing MPC methods are not capable of automatically relearning models and computing control decisions reliably for extended periods without intervention from a human expert. We seek to address this weakness. Two major features are embedded in the proposed architecture to enable autonomy: (i) a system identification algorithm from our prior work that periodically re-learns building dynamics and unmeasured internal heat loads from data without requiring re-tuning by experts. The estimated model is guaranteed to be stable and has desirable physical properties irrespective of the data; (ii) an MPC planner with a convex approximation of the original nonconvex problem. The planner uses a descent and convergent method, with the underlying optimization problem being feasible and convex. A yearlong simulation with a realistic plant shows that both of the features of the proposed architecture—periodic model and disturbance update and convexification of the planning problem—are essential to get performance improvement over a commonly used baseline controller. Without these features, long-term energy savings from MPC can be small while with them, the savings from MPC become substantial.
Regulation of laryngeal resistance and maximum power transfer with semi-occluded airway vocalization
Authors: Titze Ingo R.
Published: June 2021

Steady airflow resistances in semi-occluded airways as well as acoustic impedances in vocalization are quantified from the lungs to the lips. For clinical and voice training applications, the primary focus is on two airway conditions, an oral semi-occlusion and a semi-occlusion above the vocal folds. Laryngeal airflow resistance is divided into glottal airflow resistance and epilaryngeal airway resistance. Maximum aerodynamic power is transferred to the vocal tract if the glottal airflow resistance is reduced while the epilaryngeal airway resistance is increased. A semi-occlusion at the lips helps to set up this condition. For the acoustic power transfer, the epilaryngeal airway also serves to match the impedance of the source to the impedance of the vocal tract.
Mutations in a Membrane Permease or
hpt
Lead to 6-Thioguanine Resistance in Staphylococcus aureus
Authors: Chin Denny , Goncheva Mariya I. , Flannagan Ronald S. , Heinrichs David E.
Published: June 2021

We recently discovered that 6-thioguanine (6-TG) is an antivirulence compound that is produced by a number of coagulase-negative staphylococci. In
Staphylococcus aureus
, it inhibits
de novo
purine biosynthesis and ribosomal protein expression, thus inhibiting growth and abrogating toxin production.
In Vitro
Antibacterial Activity of Cefiderocol against Multidrug-Resistant Acinetobacter baumannii
Authors: Abdul-Mutakabbir Jacinda C. , Nguyen Logan , Maassen Philip T. , Stamper Kyle C. , Kebriaei Razieh , Kaye Keith S. , Castanheira Mariana , Rybak Michael J.
Published: June 2021

Cefiderocol (CFDC), a novel siderophore cephalosporin, demonstrates strong activity against multidrug-resistant (MDR)
Acinetobacter baumannii
. Limited studies have evaluated CFDC alone and in combination with other Gram-negative antibiotics against MDR
A. baumannii
isolates.
Anaerobic Microbiota Derived from the Upper Airways Impact Staphylococcus aureus Physiology
Authors: Lucas Sarah K. , Villarreal Alex R. , Ahmad Madison M. , Itabiyi Abayo , Feddema Erin , Boyer Holly C. , Hunter Ryan C.
Published: June 2021

Staphylococcus aureus
is associated with the development of persistent and severe inflammatory diseases of the upper airways. Yet,
S. aureus
is also carried asymptomatically in the sinonasal cavity of ∼50% of healthy adults. The causes of this duality and host and microbial factors that tip the balance between
S. aureus
pathogenesis and commensalism are poorly understood.
The ChvG-ChvI and NtrY-NtrX Two-Component Systems Coordinately Regulate Growth of Caulobacter crescentus
Authors: Stein Benjamin J. , Fiebig Aretha , Crosson Sean
Published: June 2021

TCSs enable bacteria to regulate gene expression in response to physiochemical changes in their environment. The ChvGI and NtrYX TCSs regulate diverse pathways associated with pathogenesis, growth, and cell envelope function in many α-proteobacteria.
Slab-derived sulfate generates oxidized basaltic magmas in the southern Cascade arc (California, USA)
Authors: Muth Michelle J. , Wallace Paul J.
Published: June 2021

Whether and how subduction increases the oxidation state of Earth's mantle are two of the most important unresolved questions in solid Earth geochemistry. Using data from the southern Cascade arc (California, USA), we show quantitatively for the first time that increases in arc magma oxidation state are fundamentally linked to mass transfer of isotopically heavy sulfate from the subducted plate into the mantle wedge. We investigate multiple hypotheses related to plate dehydration and melting and the rise and reaction of slab melts with mantle peridotite in the wedge, focusing on electron balance between redox-sensitive iron and sulfur during these processes. These results show that unless slab-derived silicic melts contain much higher dissolved sulfur than is indicated by currently available experimental data, arc magma generation by mantle wedge melting must involve multiple stages of mantle metasomatism by slab-derived oxidized and sulfur-bearing hydrous components.
Long-term Aptian marine osmium isotopic record of Ontong Java Nui activity
Authors: Matsumoto Hironao , Coccioni Rodolfo , Frontalini Fabrizio , Shirai Kotaro , Jovane Luigi , Trindade Ricardo , Savian Jairo F. , Tejada Maria Luisa G. , Gardin Silvia , Kuroda Junichiro
Published: June 2021

The early to mid-Aptian was punctuated by episodic phases of organic-carbon burial in various oceanographic settings, which are possibly related to massive volcanism associated with the emplacement of the Ontong Java, Manihiki, and Hikurangi oceanic plateaus in the southwestern Pacific Ocean, inferred to have formed a single plateau called Ontong Java Nui. Sedimentary osmium (Os) isotopic compositions are one of the best proxies for determining the timing of voluminous submarine volcanic episodes. However, available Os isotopic records during the age are limited to a narrow interval in the earliest Aptian, which is insufficient for the reconstruction of long-term hydrothermal activity. We document the early to mid-Aptian Os isotopic record using pelagic Tethyan sediments deposited in the Poggio le Guaine (Umbria-Marche Basin, Italy) to precisely constrain the timing of massive volcanic episodes and to assess their impact on the marine environment. Our new Os isotopic data reveal three shifts to unradiogenic values, two of which correspond to black shale horizons in the lower to mid-Aptian, namely the Wezel (herein named) and Fallot Levels. These Os isotopic excursions are ascribed to massive inputs of unradiogenic Os to the ocean through hydrothermal activity. Combining the new Os isotopic record with published data from the lowermost Aptian organic-rich interval in the Gorgo a Cerbara section of the Umbria-Marche Basin, it can be inferred that Ontong Java Nui volcanic eruptions persisted for ∼5 m.y. during the early to mid-Aptian.
Supplemental Material: A record of syn-tectonic sedimentation revealed by perched alluvial fan deposits in Valles Marineris, Mars
Authors: Davis Joel , al. et
Published: June 2021

Figures S1–S8, Table S1 (fan characteristics), and Table S2 (instrument and image ID numbers).
Supplemental Material: Deformation-induced Japan twinning in quartz during incipient mylonitization
Authors: Bestmann Michel , al. et
Published: June 2021

Methods, twinning in quartz, and Japan-Law twin symmetry test.
Supplemental Material: Ulungarat Basin: Record of a major Middle Devonian to Mississippian syn-rift to post-rift tectonic transition, eastern Brooks Range, Arctic Alaska
Authors: Anderson A.V. , Meisling K.E.
Published: June 2021

Describes the organization, sedimentology, and
depositional environments of the Ulungarat Basin succession including
description of type sections of the Ulungarat and Mangaqtaaq formations. Table
S1 documents published fossil and radiometric age constraints used to construct
the mid-Paleozoic tectonostratigraphic chart (Fig. 12), including basis for age
assignment and list of source references. A reference list of all sources cited
in Table S1 is included.
People with amputations in rural Sierra Leone: the impact of 3D-printed prostheses
Authors: van Gaalen Melissa D , van der Stelt Merel , Vas Nunes Jonathan H , Brouwers Lars
Published: June 2021

We report the case of a man with a transhumeral amputation in a rural area of Sierra Leone. The patient had fractured his humerus during a football match. Due to lack of transportation and medical centres nearby, the patient was seen by a traditional healer. Although the traditional healer expected the fractured bone to heal within 3 days, the open fracture became infected. This finally resulted in a transhumeral amputation. The patient began to have a lack of self-confidence and felt excluded from society. He could not afford a conventionally fabricated prosthesis. Fourteen years later, the patient received a lightweight three-dimensional-printed arm prosthesis developed at the Masanga Hospital. The patient was very satisfied because the prosthesis met his criteria of aesthetics and functionality. His story highlights the socioeconomic hardship of being a person with an amputation in Sierra Leone and the need for affordable technological solutions.
Leg ulceration due to cutaneous melioidosis in a returning traveller
Authors: Stavrou Christiana , Veraitch Ophelia , Morris-Jones Stephen , Walker Stephen L
Published: June 2021

A 26-year-old man, returned to the UK having travelled extensively in Asia. He was referred with a 3-month history of distal leg ulceration following an insect bite while in Thailand. Despite multiple courses of oral antibiotics, he developed two adjacent ulcers. A wound swab isolated an organism identified asBurkholderia thailandensis. The histology of the skin biopsy was non-specific. A diagnosis of cutaneous melioidosis was made, based on clinical and microbiological grounds. The ulcers re-epithelialised on completion of intravenous ceftazidime followed by 3 months of high dose co-trimoxazole and wound care. Many clinical microbiology laboratories have limited diagnostics for security-related organisms, with the result thatB. pseudomallei, the causative bacterium of melioidosis, may be misidentified. This case highlights the importance of maintaining high levels of clinical suspicion and close microbiological liaison in individuals returning from South-East Asia and northern Australia with such symptoms.