bluuebunny/crossref_metadata_2025 huggingface dataset:
First clinical experience with a novel optical-ultrasound imaging device on various skin pathologies
Authors: Csány Gergely , Gergely L. Hunor , Szalai Klára , Lőrincz Kende K. , Strobel Lilla , Csabai Domonkos , Hegedüs István , Marosán-Vilimszky Péter , Füzesi Krisztián , Sárdy Miklós , Gyöngy Miklós
Published: July 2021

Objectives

A compact handheld skin ultrasound imaging device has been developed that uses co-registered optical and ultrasound imaging to provide diagnostic information about the full skin depth and lesions encountered therein. The aim of the current work is to present the first clinical results of the device. Using additional photographic, dermoscopic and ultrasonic images as reference, the images from the device are assessed in terms of the detectability of the skin layer boundaries (between the epidermis, dermis, and subcutis), and in terms of image features produced by common skin lesions.

Methods

Combined optical-ultrasonic recordings of various types of common skin lesions (melanoma, basal cell carcinoma, keratosis, dermatofibroma, naevus, dermatitis, psoriasis) were taken with the device (N = 53) and compared with images from a reference portable skin ultrasound imager. The investigator and two additional independent experts evaluated and compared the images in terms of skin structure detectability and skin lesion features.

Results

Skin structure detectability was unanimously over 90 % for epidermis, dermis and lesion. Morphological and echogenicity information observed for melanoma, basal cell carcinoma, keratoses, dermatofibroma, naevi, atopic dermatitis, psoriasis were found consistent with those of the reference ultrasound device and relevant ultrasound images in the literature.

Conclusions

The presented device is able to obtain simultaneous in-vivo optical and ultrasound images of common skin lesions. This has the potential to provide relevant information in a number of settings to be investigated in the future, including preoperative planning of skin cancer treatment.
A Propensity-Matched Nested Case-Control Study of Acute Coronary Syndrome Patients Genotyped for CYP2C19
Authors: Kilpatrick Kate , James Nick , Smith Kevin , Mackay John , Shepherd Phillip , Boyle Luke , Thurier Quentin , Ayar Zina , Gladding Patrick
Published: July 2021

Introduction

Ticagrelor is widely considered superior to clopidogrel however a pharmacogenetic substudy of PLATO indicated that the majority of this difference is due to genetic nonresponders to clopidogrel. We evaluated patient outcomes following genotyping for CYP2C19 in a propensity matched acute coronary syndrome cohort treated with either clopidogrel, ticagrelor or aspirin monotherapy.

Methods

ICD10 coding identified 6,985 acute coronary syndrome patients at Waitematā District Health Board over a five year period (2012-2016). Ticagrelor was subsidised by The Pharmaceutical Management Agency of New Zealand in July 2013. Patients were genotyped for CYP2C19 *2, *3 and *17 alleles using the Nanosphere Verigene analyser and treatment was tailored accordingly. Logistic regression and nearest neighbour propensity matching was employed in a 1:3 fashion with each treatment group to balance patient characteristics.

Results

A total of 146 patients were genotyped and compared with 438 matched patients taking either clopidogrel, ticagrelor or aspirin monotherapy. Post July 2013 clopidogrel was prescribed more often in responders than in those without genotype information (68 vs 39%, χ2 9, 95% CI 4 to 34, p=0.003). Conversely, ticagrelor was used more frequently in clopidogrel nonresponders. Mortality with personalised treatment was equivalent to ticagrelor (HR 0.8, 95% CI 0.3 to 1.8) but higher in those treated with clopidogrel (HR 2.3, 95 % CI 1 to 5.3). Readmissions with ACS were higher in nonresponders treated with clopidogrel versus those treated with genotype appropriate dual antiplatelet therapy (HR 3.9, 95% CI 0.8 to 18, p =0.03).

Conclusion

Personalised antiplatelet management was equivalent to ticagrelor with respect to all-cause mortality and ACS readmissions. It also led to more appropriate use of both clopidogrel and ticagrelor and potential cost savings.
Eco-friendly practices and pro-environmental behaviours: the Australian folk and world music festival perspective
Authors: Alonso-Vazquez Marisol , Ballico Christina
Published: July 2021

Purpose

The coronavirus disease 2019 (COVID-19) pandemic has once again brought to our attention one of the three main pillars of sustainability–the environment. It has also brought into sharp relief the fragility of the live music festival sector, whose success hinges fundamentally on the capacity for both travel and mass gatherings to occur. Considering this intersection of environmental sustainability and the live music festival sector, this paper–which reports on events occurring long before the global pandemic took hold–examines the ways in which eight Australian folk and world music festivals successfully engage in eco-friendly and pro-environmental practices and educational activities at their events. Findings from this research will assist industry practitioners in being able to engage in similar practices at their events, as well as further academic understandings of the relationship between the environment and the live music sector, and the role of environmental communication practices within this.

Design/methodology/approach

This study engaged an exploratory research design using interviews to gain an insight into the perceptions of eight live music festival promoters regarding their patrons' on-site eco-friendly behaviours and engagement with the eco-friendly initiatives at their events.

Findings

Social support within the on-site festival community (applied here through the notion of a sense of communitas), coupled with the provision of eco-friendly initiatives and effective environmental communication approaches, were key pivot drivers to support patrons' pro-environmental behaviours. Engagement with environmental authorities and experts during the festivals was found to validate their eco-friendly approaches.

Originality/value

This paper provides details of, as well as insights into, the success of the eco-friendly and pro-environmental education practices engaged at select world and folk music festivals in Australia. It broadens and builds upon existing understandings of environmental communication practices.
Ontology alignment evaluation for online assessment of e-learners: a new e-learning management system
Authors: B.R. Rajakumar , Yenduri Gokul , Vyas Sumit , D. Binu
Published: July 2021

Purpose

This paper aims to propose a new assessment system module for handling the comprehensive answers written through the answer interface.

Design/methodology/approach

The working principle is under three major phases: Preliminary semantic processing: In the pre-processing work, the keywords are extracted for each answer given by the course instructor. In fact, this answer is actually considered as the key to evaluating the answers written by the e-learners. Keyword and semantic processing of e-learners for hierarchical clustering-based ontology construction: For each answer given by each student, the keywords and the semantic information are extracted and clustered (hierarchical clustering) using a new improved rider optimization algorithm known as Rider with Randomized Overtaker Update (RR-OU). Ontology matching evaluation: Once the ontology structures are completed, a new alignment procedure is used to find out the similarity between two different documents. Moreover, the objects defined in this work focuses on “how exactly the matching process is done for evaluating the document.” Finally, the e-learners are classified based on their grades.

Findings

On observing the outcomes, the proposed model shows less relative mean squared error measure when weights were (0.5, 0, 0.5), and it was 71.78% and 16.92% better than the error values attained for (0, 0.5, 0.5) and (0.5, 0.5, 0). On examining the outcomes, the values of error attained for (1, 0, 0) were found to be lower than the values when weights were (0, 0, 1) and (0, 1, 0). Here, the mean absolute error (MAE) measure for weight (1, 0, 0) was 33.99% and 51.52% better than the MAE value for weights (0, 0, 1) and (0, 1, 0). On analyzing the overall error analysis, the mean absolute percentage error of the implemented RR-OU model was 3.74% and 56.53% better than k-means and collaborative filtering + Onto + sequential pattern mining models, respectively.

Originality/value

This paper adopts the latest optimization algorithm called RR-OU for proposing a new assessment system module for handling the comprehensive answers written through the answer interface. To the best of the authors’ knowledge, this is the first work that uses RR-OU-based optimization for developing a new ontology alignment-based online assessment of e-learners.
The COVID-19 pandemic: the woes of small construction firms in Ghana
Authors: Amoah Christopher , Bamfo-Agyei Emmanuel , Simpeh Fredrick
Published: July 2021

Purpose

COVID-19 came as a surprise to the global economy and devastated many sectors worldwide, including the construction sector. Small construction firms are believed to be an engine of growth in many developing countries, including Ghana; thus, their survival cannot be trivialized. This study explored the impact of the COVID-19 on the businesses of the small confirms in Ghana.

Design/methodology/approach

A qualitative research approach was adopted for this study. Open-ended interview questions were distributed via email to 45 small construction firms (D3K3 and D4K4) purposefully selected. Thematic contents analysis was used to analyze 30 interview questions received.

Findings

This study has revealed that the COVID-19 has severely affected small construction firms in Ghana. Small construction firms are struggling in their finances; their cash flow/payments for work done are severely affected; they cannot secure contracts and management site efficiently. Their worker's productivity level has dwindled, which has subsequently escalated their project cost and completion time. These effects identified are significantly affecting the survival of these small construction firms.

Research limitations/implications

The study included small construction operating in the Central, Western and Greater Accra regions of Ghana during the second wave of the COVID-19 pandemic. However, the findings may be applicable to construction sites outside these regions.

Practical implications

The implication is the COVID-19 pandemic hugely impacts the small construction firm's business operations. Therefore, they must be mindful of the new norm (COVID-19) and institute strategies to help them overcome the challenges and sustain their businesses.

Originality/value

The study gives insight into the effects of the COVID-19 on the businesses of small construction firms in Ghana and proposes strategies that they must implement to overcome their challenges and sustain their businesses.
Clinical effectiveness of efinaconazole 10% solution for treatment of onychomycosis with longitudinal spikes
Authors: Watanabe Shinichi , Iozumi Ken , Abe Masatoshi , Ito Yoshiko , Uesugi Takashi , Onoduka Takashi , Kato Ichiro , Kato Fumihiro , Kodama Kazuo , Takahashi Hidetoshi , Takeda Osamu , Tomizawa Koki , Tateishi Yasuki , Fujii Mizue , Mayama Jun , Muramoto Fumio , Yasuda Hidemi , Yamanaka Kiyomitsu , Oh‐i Tsunao , Kasai Hiroko , Tsuboi Ryoji , Hattori Naoko , Maruyama Ryuji , Omi Tokuya , Shimoyama Harunari , Nakasu Ichiro , Watanabe‐Okada Emiko , Nishimoto Shuhei , Mochizuki Takashi , Fukuzawa Masao , Seishima Mariko , Sugiura Kazumitsu , Yamamoto Osamu , Shindo Masahisa , Kiryu Hiroe , Kusuhara Masahiro , Takenaka Motoi
Published: July 2021

Onychomycosis with longitudinal spikes in the nail plate has been reported to be refractory to oral drugs as with dermatophytoma. We evaluated the efficacy of 10% efinaconazole solution in the treatment of onychomycosis with longitudinal spikes. Of the 223 subjects who were enrolled in a previous study, a post‐hoc analysis of 82 subjects with longitudinal spikes was performed in this study. The opacity ratio of longitudinal spikes was decreased over time from 8.1 to 0.9 at the final assessment. In addition, the longitudinal spike disappearance rate increased early after the application to 81.7% at the final assessment. Therefore, 10% efinaconazole solution can be a first‐line drug for longitudinal spikes, which have been regarded as refractory to oral drugs.
Simultaneous joint migration inversion as a high‐resolution time‐lapse imaging method: Feasibility and robustness study
Authors: Qu Shan , Verschuur Dirk Jacob
Published: July 2021

The conventional time‐lapse processing workflow is usually sensitive to the non‐repeatable uncertainties between different vintages caused by noise, acquisition designs and independent processing. Therefore, in order to reduce these non‐repeatable uncertainties, all the datasets are usually acquired from well‐sampled and well‐repeated acquisition surveys, and the independent processing is always carefully tailored to maximally reduce the non‐repeatable uncertainties during processing. Moreover, the conventional time‐lapse analysis method, based on a time‐shift map, is not always a good indicator of the actual velocity differences due to its local one‐dimensional subsurface assumption. In order to relax these rigid requirements and have a better velocity change indicator, a robust high‐resolution simultaneous joint migration inversion was proposed as an effective time‐lapse tool for reservoir monitoring. The method combines a simultaneous data‐processing strategy with the joint migration inversion method. Joint migration inversion is a full wavefield inversion method with a parameterization in terms of reflectivity and propagation velocity. The simultaneous strategy allows the baseline and monitor parameters to communicate and compensate with each other dynamically during inversion, thus, suppressing the non‐repeatable uncertainties during the time‐lapse processing. To investigate the feasibility of using high‐resolution simultaneous joint migration inversion in practice, some numerical experiments are conducted to test the dependence of high‐resolution simultaneous joint migration inversion on the quality of the time‐lapse datasets including the following aspects: random noise; sparse surveys; ocean bottom node versus streamer (different types of monitoring surveys); non‐repeated sources, including source positioning errors and non‐repeated source wavelets; spatial weighting operators in the L2‐norm penalty terms; and sensitivity to weak time‐lapse effects. All the experiments are carried on the basis of a realistic synthetic time‐lapse model based on the Grane field offshore Norway. These experiments show that high‐resolution simultaneous joint migration inversion is robust to random noise, survey sparsity, survey non‐repeatability, source positioning errors and source wavelet discrepancies. Furthermore, high‐resolution simultaneous joint migration inversion remains effective when the spatial weighting operators in the L2‐norm penalty terms are largely relaxed, and high‐resolution simultaneous joint migration inversion is capable of detecting weak time‐lapse changes (e.g. velocity changes down to 35 m/s).
Litterfall silicon flux in relation to vegetation differences in old‐growth and logged lowland forests in Borneo
Authors: Nakamura Ryosuke , Imai Nobuo , Aoyagi Ryota , Kitayama Kanehiro , Kitajima Kaoru
Published: July 2021

Lowland tropical forests cycle large quantities of silicon (Si) via litterfall, but little is known how litterfall Si flux is modified in logged forests. In Sabah, Borneo, we compared an old‐growth forest stand and stands that had received reduced‐impact logging (RIL) or conventional logging (CL) about 20–30 years ago, in terms of Si concentration of recently abscised dead leaves, Si flux via litterfall, and water extractable Si from upper soil horizons. The Si concentration of dead leaves produced by dominant tree species in Dipterocarpaceae differed widely among genera and species (1.2–29.7 mg Si g‐dry‐mass−1). Some pioneer trees (e.g., Macaranga spp.) and bamboo species that dominate the RIL and CL stands exhibited high Si concentration in their dead leaves. Litterfall Si flux was higher in the RIL stand (392 kg ha−1 year−1) where bamboo was abundant, than in the CL and old‐growth stands (187 and 153 kg ha−1 year−1, respectively). Water extractable Si from the soil was also the highest in the RIL stand, followed by the CL and old‐growth stands. In conclusion, our study suggests that bamboos and pioneer trees with high dead‐leaf Si concentrations increase Si flux in post‐logging stands, in a manner to compensate for the loss of Si flux associated with decreased abundance of Si accumulating Dipterocarpaceae trees. The correlation between litterfall Si flux and water extractable soil Si among the three stands also suggests a feedback loop of Si via plants in this lowland tropical forest that received contrasting types of logging.
Taking Your Own Side in the Argument
Authors: Cooper Andrew
Published: July 2021

This contribution is written in response to Helen Morgan's paper ‘Whiteness: A problem for our times’. A distinctive feature of her writing and thinking in this essay, and her new book, is how she moves easily and freely between psychoanalytic, sociological, political and psychological frameworks of understanding. In doing so her work exemplifies something that the psychoanalytic community has mostly been poor at achieving – a recognition of both its distinctive and unique potential to illuminate social and political processes, and a parallel acknowledgement of its need to enter into equilateral dialogue with other intellectual paradigms. Social and political life is historical, specific, local and complex, and not amenable to reductionist or universalizing modes of analysis and engagement. Through some examples I aim to add to Helen's very thoughtful and well researched paper, to show how psychoanalysis needs to respect other languages and methodologies for engaging with the world, render its own more accessible to non‐specialists, and relinquish its tendency to assume the status of a ‘master discourse’.
Focal cortical dysplasia type 1
Authors: Coras Roland , Holthausen Hans , Sarnat Harvey B.
Published: July 2021

The ILAE classification of Focal Cortical Dysplasia (FCD) from 2011 has quickly gained acceptance in clinical practice and research and is now widely used around the world. This histopathology‐based classification scheme proposed three subtypes, that is, FCD Type 1 (with architectural abnormalities of the neocortex), FCD Type 2 (with cytoarchitectural abnormalities of the neocortex) and FCD Type 3 (architectural abnormalities of the neocortex associated with another principle lesion acquired during early life). Valuable knowledge was gathered during the last decade validating the clinical, pathological and genetic classification of FCD Type 2. This is in contrast to FCD subtype 1 and 3 with only few robust or new insights. Herein, we provide an overview about current knowledge about FCD Type 1 and its three subtypes. Available data strengthened, however, FCD Type 1A in particular, whereas a comprehensive clinico‐pathological specification for FCD Type 1B and 1C subtypes remain to be shown. The lack of a valid animal model for FCD Type 1 further supports our call and the ongoing need for systematic research studies based on a careful clinico‐pathological and genetic stratification of patients and human brain tissues.
Role of VAPB and vesicular profiles in α‐synuclein aggregates in multiple system atrophy
Authors: Mori Fumiaki , Miki Yasuo , Tanji Kunikazu , Kon Tomoya , Tomiyama Masahiko , Kakita Akiyoshi , Wakabayashi Koichi
Published: July 2021

The pathological hallmark of multiple system atrophy (MSA) is fibrillary aggregates of α‐synuclein (α‐Syn) in the cytoplasm and nucleus of both oligodendrocytes and neurons. In neurons, α‐Syn localizes to the cytosolic and membrane compartments, including the synaptic vesicles, mitochondria, and endoplasmic reticulum (ER). α‐Syn binds to vesicle‐associated membrane protein‐binding protein B (VAPB) in the ER membrane. Overexpression of wild‐type and familial Parkinson's disease mutant α‐Syn perturbs the association between the ER and mitochondria, leading to ER stress and ultimately neurodegeneration. We examined brains from MSA patients (n = 7) and control subjects (n = 5) using immunohistochemistry and immunoelectron microscopy with antibodies against VAPB and phosphorylated α‐Syn. In controls, the cytoplasm of neurons and glial cells was positive for VAPB, whereas in MSA lesions VAPB immunoreactivity was decreased. The proportion of VAPB‐negative neurons in the pontine nucleus was significantly higher in MSA (13.6%) than in controls (0.6%). The incidence of cytoplasmic inclusions in VAPB‐negative neurons was significantly higher (42.2%) than that in VAPB‐positive neurons (3.6%); 67.2% of inclusion‐bearing oligodendrocytes and 51.1% of inclusion‐containing neurons were negative for VAPB. Immunoelectron microscopy revealed that α‐Syn and VAPB were localized to granulofilamentous structures in the cytoplasm of oligodendrocytes and neurons. Many vesicular structures labeled with anti‐α‐Syn were also observed within the granulofilamentous structures in the cytoplasm and nucleus of both oligodendrocytes and neurons. These findings suggest that, in MSA, reduction of VAPB is involved in the disease process and that vesicular structures are associated with inclusion formation.
The first two non‐Finnish HYLS1 variants: Expanding the phenotypic spectrum of hydrolethalus syndrome
Authors: Ghesh Leïla , Musquer Marie Denis , Devisme Louise , Stichelbout Morgane , Boutaud Lucile , Elkhartoufi Nadia , Vaast Pascal , Boute Odile , Riteau Anne‐Sophie , Le Vaillant Claudine , Winer Norbert , Joubert Madeleine , Bezieau Stéphane , Thomas Sophie , Attie‐Bitach Tania , Beneteau Claire
Published: July 2021

Hydrolethalus syndrome (HLS) is a rare lethal fetal malformation disorder related to ciliogenesis disruption. This condition is more frequent in Finland where a founder missense variant in the HYLS1 gene was identified. No other HYLS1 variant has hitherto been implicated in HLS. We report two unrelated French fetuses presenting with a phenotype of HLS with brain abnormalities, limbs malformations with pre and postaxial hexadactyly and abnormal genitalia. These two fetuses have compound heterozygous variants in HYLS1. The first allele carries the same Finnish missense variant (NM_145014.2: c.632A > G, p.[Asp211Gly]) in both fetuses and the second allele carries a new missense variant (c.662G > C, p.[Arg221Pro]) in the first fetus, and a new nonsense variant (c.613C > T, p.[Arg205*]) in the second fetus. This is the first report of HYLS1 mutated cases outside Finland. Both cases presented here are consistent with HLS with additional malformations, allowing expansion of the phenotypic presentation previously described.
Global and Local Feature Distinctiveness Effects in Language Acquisition
Authors: Siew Cynthia S. Q.
Published: July 2021

Various aspects of semantic features drive early vocabulary development, but less is known about how the global and local structure of the overall semantic feature space influences language acquisition. A feature network of English words was constructed from a large database of adult feature production norms such that edges in the network represented feature distances between words (i.e., Manhattan distances of probability distributions of features elicited for each pair of words). A word's global feature distinctiveness is measured with respect to all other words in the network and a word's local feature distinctiveness is measured relative to words in sub‐networks derived from clustering analyses. This paper investigates how feature distinctiveness of individual words at local and global scales of the network influences language acquisition. Regression analyses indicate that global feature distinctiveness was associated with earlier age of acquisition ratings, and was a stronger predictor of age of acquisition than local feature distinctiveness. These results suggest that the global structure of the semantic feature network could play an important role in language acquisition, whereby globally distinctive concepts help to structure vocabulary development over the lifespan.
Research progress on biomarkers of pulmonary embolism
Authors: Yang Pengbo , Li Hexin , Zhang Junhua , Xu Xiaomao
Published: July 2021

Objectives

To present a review on the traditional and new biomarkers of pulmonary embolism (PE).

Data source

A systematic search has been carried out using keywords as PE, biomarker, diagnosis and risk stratification.

Results

The results of this work have been structured into three parts: first, conventional biomarkers for vascular, cardiac and inflammation, including static markers and dynamic markers for measuring the time course; next, a review of new biomarkers in recent years, such as RNAs and markers obtained through proteomics and mass spectrometry; finally, use of new detection methods to directly detect the activity of existing markers, such as the determination of coagulation factor II and plasmin activities based on the proteolytic activation of an engineered zymogen.

Conclusions

This work summarized the characteristics of current traditional biomarkers for clinical diagnosis and risk stratification of PE, as well as a series of newly discovered biomarkers obtained through various clinical experimental methods.
How Covid‐19 financially hit urban refugees: evidence from mixed‐method research with citizens and Syrian refugees in Turkey
Authors: Elçi Ezgi , Kirisçioglu Eda , Üstübici Aysen
Published: July 2021

Peering through a lens of disasters and inequalities, this article measures the financial impacts of Covid‐19 on citizens and refugee communities in Turkey during a relatively early phase of the global pandemic. Our data comes from an online survey (N = 1749) conducted simultaneously with Turkish citizens and Syrian refugees living in Turkey, followed by in‐depth online interviews with Syrian refugees. Our findings indicate that the initial Covid‐19 measures had a higher financial impact on Syrians than on citizens when controlled for employment, wealth, and education, among other variables. In line with the literature, our research confirms that disasters’ socio‐economic effects disproportionally burden minority communities. We additionally discuss how Covid‐19 measures have significantly accelerated effects on refugees compared to the local population, mainly due to the structural and policy context within which forcibly displaced Syrians have been received in Turkey.
What are the factors associated with long‐term glycaemic control in patients with type 2 diabetes and elevated glycated haemoglobin (≥7.0%) at initiation of second‐line therapy? Results from the DISCOVER study
Authors: Bonnet Fabrice , Chen Hungta , Cooper Andrew , Gomes Marίlia B. , Ji Linong , Leigh Paul , Ramirez Larisa , Shestakova Marina V. , Shimomura Iichiro , Siddiqui Afrah , Tang Fengming , Vora Jiten , Watada Hirotaka , Khunti Kamlesh
Published: July 2021

Aims

Glycaemic control is a cornerstone of type 2 diabetes (T2D) management. We assessed factors associated with good long‐term glycaemic control in patients with glycated haemoglobin (HbA1c) ≥7.0% at initiation of second‐line glucose‐lowering therapy, using data from DISCOVER, a global, prospective, 3‐year observational study of patients with T2D.

Materials and Methods

This analysis included patients with HbA1c ≥7.0% at baseline (initiation of second‐line therapy). Multivariable regression models assessed factors associated with having HbA1c <7.0% at 3 years in two distinct groups: patients with (a) HbA1c ≥7.0% and <9.0%, and (b) HbA1c ≥9.0% at baseline.

Results

In total, 7575 patients with baseline HbA1c ≥7.0% were included (2233 with baseline HbA1c ≥9.0%). At 6 months, 43.7% and 24.2% of patients had an HbA1c level <7.0% in groups a and b, respectively; the corresponding proportions at 3 years were 45.8% and 29.3%. Having HbA1c <7.0% at 6 months (vs. ≥7.0%) was the strongest predictor of having HbA1c <7.0% at 3 years in both group a and group b [odds ratio (95% confidence interval): 2.01 (1.77‐2.27) and 2.68 (2.10‐3.41), respectively]. Longer T2D duration was associated with a decreased likelihood of having HbA1c <7.0% at 3 years.

Conclusions

In patients with poor glycaemic control at initiation of second‐line therapy, early attainment of HbA1c <7.0% appears predictive of long‐term glycaemic control, suggesting that timely modification of treatment strategies in patients with elevated HbA1c after 6 months is important to minimize therapeutic inertia.
The program evaluation of 'Go‐To Educator Training' on educators' knowledge about and stigma toward mental illness in six Canadian provinces
Authors: Wei Yifeng , Kutcher Stan , Baxter Andrew , Heffernan Amy
Published: July 2021

Aim

Schools are well positioned to promote mental health literacy and assist in the early identification of students who may have a mental disorder. However, many educators are unprepared to effectively address these issues. Enhancing this capacity may improve mental health outcomes for students. This report describes the application of a gatekeeper‐type program, the 'Go‐To Educator Training' (GTET), targeting educators whom students naturally gravitate toward for support, designed to improve educators' mental health knowledge and early identification skills and decrease stigma.

Methods

GTET was conducted in six Canadian provinces (Ontario, Nova Scotia, New Brunswick, Newfoundland, Alberta and Manitoba) (2012‐2015), with 949 secondary school educators involved. Pre‐ and postintervention mental health knowledge and stigma surveys were completed. Paired t‐tests assessed change in knowledge and stigma. ANCOVA compared knowledge and stigma change across subgroups. Correlation measured the relationship between knowledge and stigma.

Results

Knowledge significantly improved (t[919] = 58.40, P < .001, d = 2.12) and stigma significantly decreased (t[872] = 4.52, P < .001, d = 0.14). Similar results were identified within each province/region. Knowledge and stigma were correlated before (N = 922, r = .18, P < .01) and after the training (N = 888, r = .22, P < .01).

Conclusions

These results suggest GTET may be an effective school‐based mental health related intervention. Further study is needed to measure its long‐term impact and its role in addressing youth mental health care referrals.
The impact, identification and management of dispersive soils in rainfed cropping systems
Authors: Page Kathryn L. , Dang Yash P. , Dalal Ram C. , Kopittke Peter M. , Menzies Neal W.
Published: July 2021

Dispersive soils limit crop growth and significantly impact world food production. Although numerous reviews have examined soil dispersion, many focus on irrigated systems and fail to differentiate the approaches required for rainfed agriculture. This review seeks to fill this gap by focusing on the impact, identification and management of dispersive soils in rainfed areas. Dispersive soils can have large impacts on crop production because of their adverse physical, chemical and biological effects, with this impact particularly large in rainfed systems where irrigation water is unavailable to supplement crop water supply and assist with amelioration. However, the identification of these soils is challenging and tests that can reliably relate soil characteristics to crop performance are lacking. Recent work has found that first identifying consistently lower yielding locations (using yield mapping or proximal/remote sensing) and then using traditional soil testing to identify the potential cause/s of the yield loss may be a promising approach, although this requires refinement. Knowledge of the type of dispersive soil (e.g., saline/non‐saline, acidic/alkaline/neutral) and where constraints occur in the profile (surface or subsoil) must also be determined during identification as this will affect management approaches, particularly where multiple constraints need to be treated together to achieve yield increase. Improved understanding of how to economically use ameliorants and combine them to achieve maximum benefit in the presence of multiple constraints is needed. Greater appreciation of how to use agronomic management to improve crop growth in the presence of dispersive behaviour is also likely to increase profitability in rainfed systems where amelioration is often impractical or uneconomical. Dispersive soils are a major challenge for rainfed cropping, and so the refinement of our management approach can help improve profitability and productivity.

Highlights

Dispersive soils limit crop growth and significantly impact world food production

We examine the impact, identification and management of dispersive soils in rainfed agriculture

Improvements in the identification of dispersive soils are required to improve management

Refinement of ameliorant use and agronomic management will improve profitability and productivity
Urban fox squirrels exhibit tolerance to humans but respond to stimuli from natural predators
Authors: Kittendorf Anna , Dantzer Ben
Published: July 2021

Animals in urban areas that experience frequent exposure to humans often behave differently than those in less urban areas, such as exhibiting less vigilance or anti‐predator behavior. These behavioral shifts may be an adaptive response to urbanization, but it may be costly if animals in urban areas also exhibit reduced anti‐predator behavior in the presence of natural predators. In trials with only a human observer as the stimulus, urban squirrels exhibited reduced vigilance and anti‐predator behavior compared to those in less urban areas. Next, we exposed squirrels in multiple urban and less urban sites to acoustic playbacks of a control stimulus (non‐predatory bird calls), a natural predator (hawk), and dogs and recorded their vigilance and three different anti‐predator behaviors when a human approached them while either broadcasting one of these three playbacks or no playbacks at all. Squirrels at urban sites also did not differ in their behavioral responses to the playbacks from possible predators (hawks or dogs) when they were compared to those at less urban sites exposed to these playbacks. Urban squirrels also exhibited increased vigilance and anti‐predator behavior when exposed to a human paired with hawk playbacks compared to the control playbacks. Together, our results indicate that urban squirrels did perceive and assess risk to the natural predator appropriately despite exhibiting increased tolerance to humans. These results provide little support for the hypothesis that increased tolerance to humans causes animals to lose their fear of natural predators.
Immune system and microbiome in the esophagus: implications for understanding inflammatory diseases
Authors: Kaymak Tanay , Hruz Petr , Niess Jan Hendrik
Published: July 2021

The gastrointestinal tract is the largest compartment of the body's immune system exposed to microorganisms, structural components and metabolites, antigens derived from the diet, and pathogens. Most studies have focused on immune responses in the stomach, the small intestine, and the colon, but the esophagus has remained an understudied anatomic immune segment. Here, we discuss the esophagus' anatomical and physiological distinctions that may account for inflammatory esophageal diseases.
Using biophysical modelling and population genetics for conservation and management of an exploited species, Pecten maximus L.
Authors: Hold Natalie , Robins Peter , Szostek Claire L. , Lambert Gwladys , Lincoln Harriet , Le Vay Lewis , Bell Ewen , Kaiser Michel J.
Published: July 2021

Connectivity between populations is important when considering conservation or the management of exploitation of vulnerable species. We investigated how populations of a broadcast‐spawning marine species (scallop, Pecten maximus) that occur in discrete geographic locations were connected to each other. Population genetic insights were related to the outputs from a three‐dimensional hydrodynamic model implemented with scallop larval behaviour to understand the extent to which these areas were linked by oceanographic processes and how this was altered by season and two contrasting years that had strongly different average temperature records (warm vs cold) to provide contrasting oceanographic conditions. Our results span from regional to shelf scale. Connectivity was high at a regional level (e.g. northern Irish Sea), but lower at scales >100 km between sites. Some localities were possibly isolated thus dependent on self‐recruitment to sustain local populations. Seasonal timing of spawning and inter‐annual fluctuations in seawater temperature influenced connectivity patterns, and hence will affect spatial recruitment. Summer rather than spring spawning increased connectivity among some populations, due to the seasonal strengthening of temperature‐driven currents. Furthermore, the warm year resulted in higher levels of modelled connectivity than the cold year. The combination of genetic and oceanographic approaches provided valuable insights into the structure and connectivity at a continental shelf scale. This insight provides a powerful basis for defining conservation management units and the appropriate scale for spatial management. Temporal fluctuations in temperature impact upon variability in connectivity, suggesting that future work should account for ocean warming when investigating population resilience.
Risk of severe clinical events after sustained virological response following direct‐acting antiviral therapy in HIV and hepatitis C virus coinfected participants
Authors: Chalouni Mathieu , Wittkop Linda , Bani‐Sadr Firouzé , Lacombe Karine , Esterle Laure , Gilbert Camille , Miailhes Patrick , Zucman David , Valantin Marc Antoine , Brégigeon‐Ronot Sylvie , Morlat Philippe , Billaud Eric , Piroth Lionel , Naqvi Alissa , Sogni Philippe , Salmon Dominique ,   for the ANRS CO13 HEPAVIH Cohort Study Group
Published: July 2021

Objectives

Sustained virological response (SVR) decreases the risk of hepatitis C virus (HCV)‐related events. Nevertheless, a substantial risk of events persists. We estimated incidences and identified factors associated with severe clinical events after SVR following treatment with a direct‐acting antiviral (DAA) in HIV/HCV‐coinfected patients.

Methods

Participants from the ANRS CO13 HEPAVIH were included if they reached SVR. Incidence rates of overall mortality, liver‐related events, AIDS‐defining events, ischaemic events and non‐liver non‐AIDS‐defining cancers (NLNA) were estimated. Factors associated with the risk of those events were identified using Poisson models adjusted on age at SVR and sex.

Results

In all, 775 participants were included. Incidence rates (95% confidence interval) of liver‐related events, overall mortality, AIDS‐defining events, ischaemic events and NLNA cancers per 1000 person‐years were 5.9 (3.3–10.3), 22.2 (16.8–29.5), 0.6 (0.1–4.5), 7.3 (4.4–12.2) and 13.7 (9.4–20.0), respectively. For all events, incidence rates were higher in cirrhotic than in non‐cirrhotic participants. Cirrhosis, liver stiffness and CD4 count were associated with liver‐related events. Factors associated with overall mortality were age, cirrhosis, liver stiffness and gamma‐glutamyl transferase (GGT). For ischaemic events and NLNA cancers, associated factors were total cholesterol and CD4 count, respectively.

Conclusions

After SVR following a DAA treatment, liver‐related and AIDS‐defining events were observed less frequently than NLNA cancers. Severity of liver disease was associated with the risk of liver‐related events and of overall mortality but not with ischaemic events and NLNA cancers. Factors reflecting HIV infection were associated with NLNA cancers and liver‐related events.
Stewart‐Treves syndrome and other cutaneous malignancies in the context of chronic lymphedema: a systematic review
Authors: Kim Patrick J. , Mufti Asfandyar , Sachdeva Muskaan , Lytvyn Yuliya , Zabihi‐Pour Dorsa , Zaaroura Hiba , Yeung Jensen
Published: July 2021

Introduction

Angiosarcoma developing in chronically lymphedematous tissue, or Stewart‐Treves syndrome (STS), is a rare and lethal complication of lymphedema. This systematic review summarizes characteristics and outcomes of STS and other cutaneous malignancies arising in chronic lymphedema.

Methods

MEDLINE and EMBASE databases were searched on February 19th, 2021, to identify 200 articles included in the analysis.

Results

Of 369 included patients, 89.7% (n = 331/369) had STS and 10.3% (n = 38/369) had other associated malignancies. Mean age of onset was 61.2 years, and 85.9% (n = 317/369) of cases were female. Common risk factors were previous cancer history (69.8%,n = 258/369) and radiation history (53.7%,n = 198/369). Lymphedema was most commonly attributed to surgical causes (68.3%,n = 252/369). STS begins on average 14.9 years after lymphedema with mortality of 53.9% (n = 178/331) and remission rate of 16.1% (n = 53/331). Other malignancies begin on average 23.7 years after lymphedema, with mortality of 10.5% (n = 4/38) and remission rate of 31.6% (n = 12/38). STS and other malignancies had 5‐year survivals of 22.4% and 65.2%, respectively (P = 0.00145). For all patients, patients initially treated with excision had the best survival (median: 48 months, 5‐year survival: 43.3%) and radiotherapy had the worst survival (median: 10 months, 5‐year survival: 6.5%) (P = 0.0141).

Conclusion

Malignancy can appear in lymphedematous tissue many years after lymphedema onset. STS has poorer prognosis compared to other malignancies. Further research should be conducted to better understand the causes, risk factors, and management of this phenomenon.
Assessment of the impact of drying processes on orange peel quality characteristics
Authors: Phuon Vichearavann , Ramos Inês N. , Brandão Teresa R. S. , Silva Cristina L. M.
Published: July 2021

Orange peel was dried applying three different processes: convective drying, microwave drying, and freeze‐drying. Some physicochemical properties (moisture content, water activity, and color parameters) and phytochemical characteristics (total phenolic compounds and total antioxidant activity) were assessed in fresh and dried samples. Four kinetic models were tested aiming for convenient modeling of the convective drying curves. The Page and Approximation of diffusion models were adequate in data fitting, which was assessed by the magnitude of the adjusted coefficient of determination () and reduced χ2. The moisture content and water activity of peel dried with the three processes were within acceptable levels for safe storage of products. All processes affected peel color. However, the browning index of freeze‐dried samples was equivalent to fresh ones, being higher when convective and microwave drying were applied. Higher chroma parameters were obtained in dried samples indicating a more intense color than fresh peel. Freeze‐drying enhanced total phenolic compounds and total antioxidant activity of orange peel when compared to convective and microwave drying. Therefore, from a quality point of view this process seems to be the most appropriate to produce dried orange peel.

Practical Applications

Dried orange peel transformed in flour, or slices, cubes, or different geometrical features, may be suitable for incorporation as an ingredient in many types of foods such as cakes, biscuits, or bread, enriching their content in phenolic compounds and total antioxidant activity, therefore creating a value‐added product. Within the drying conditions used in this study, it was found that the freeze‐drying process is preferable when a lighter and more yellow dried orange peel is desired, with improved phytochemical characteristics. On the other hand, when a darker product with color similar to the fresh peel needs to be attained, the microwave drying process should be chosen.
Serum levels of survivin in patients with psoriasis and their relation to disease characteristics
Authors: Akpinar Umit , Gur Aksoy Gunes , Hayran Yildiz , Firat Oguz Esra , Yalcın Basak
Published: July 2021

Background

Psoriasis is a chronic inflammatory disease in which T helper 1 (Th1) and Th17 cells play a major role in its pathogenesis. Studies have shown that keratinocytes in psoriatic tissue are resistant to apoptosis and have a high proliferation rate. Survivin is a multifunctional protein belonging to an apoptosis inhibitor family, which has significant effects on the immune system, such as activation of dendritic cells and T cells and immunomodulation.

Objectives

To investigate a possible relationship between serum survivin levels and psoriasis disease characteristics and severity.

Materials and Methods

The present study included 84 patients with psoriasis who did not receive any systemic treatment for psoriasis in the last three months and 84 volunteers without psoriasis. Demographic data, smoking status, and alcohol consumption of the participants were questioned, and body mass index (BMI) was calculated. In the patient group, disease duration, family history, accompanying arthritis, and nail involvement were questioned and psoriasis area severity index (PASI) scores were calculated. Serum survivin levels were measured in all subjects.

Results

Serum survivin level was significantly higher in the patients compared to the controls (p = 0.008). There was no relationship between serum survivin level and disease duration, family history, joint involvement, nail involvement, BMI, and PASI score (all p‐values > 0.05). Serum survivin levels were significantly higher in smokers than non‐smokers and in alcohol consumers than patients that did not drink alcohol in the psoriasis group (p = 0.034 and p = 0.006, respectively).

Conclusion

Serum survivin levels were higher in psoriasis patients than the control group. This finding suggests that this molecule, which is both immunomodulatory and an apoptosis inhibitor, may play a role in the pathogenesis of psoriasis. Significantly high serum survivin level in psoriasis patients who smoke suggests that smoking may act through survivin. More comprehensive studies are needed to evaluate the role of survivin in the pathogenesis of psoriasis and its relationship with smoking.
Investigation of the prevalence of hand eczema among healthcare professionals in Turkey: A cross‐sectional study
Authors: Falay Gür Tuğba , Savaş Erdogan Sevil , Doğan Bilal
Published: July 2021

Background

Hand eczema is one of the common occupational dermatoses, having high prevalence among healthcare professionals (HCP). We found no epidemiological data in the literature concerning the prevalence of hand eczema among HCP in Turkey.

Aims

The aim of the present study was to investigate the prevalence of hand eczema among HCP in Turkey and to determine the demographic characteristics and risk factors that cause eczema.

Methods

A clinical assessment‐ and questionnaire‐based cross‐sectional study was conducted with 734 HCP working in a tertiary hospital. Demographic characteristics and personal and occupational risk factors were evaluated in terms of the development of hand eczema.

Results

The survey response rate was 81.8%. The point prevalence of eczema was 27.6%, and the 12‐month prevalence was 45.9%. Age, occupation, duration of work, atopic diseases, handwashing frequency, dry skin, moisturizing frequency, and presence and duration of glove use were important factors in the development of hand eczema. Powdered glove reaction was significantly higher in those with hand eczema (p = 0.0001).

Conclusions

The prevalence of hand eczema is high among HCP in Turkey. Combining self‐reported questionnaires with clinical examination findings can provide a more accurate calculation of the prevalence of hand eczema. The availability of epidemiological data on hand eczema can provide guidelines for the prevention and treatment of this condition. Except for situations requiring absolute handwashing, disinfecting hands with alcohol‐based lotions and applying a powder‐free policy in all healthcare centers will reduce the prevalence of hand eczema among HCP.