bluuebunny/crossref_metadata_2025 huggingface dataset:
Calciphylaxis in uraemic and nonuraemic settings: clinical risk factors and histopathological findings
Authors: Ababneh E. I. , Hassanein M. , Saad A. M. , Cook E. E. , Ko J. S. , Fatica R. A. , Vachharajani T. J. , Fernandez A. P. , Billings S. D.
Published: November 2021

Background

Calciphylaxis is a life-threatening cutaneous ulcerative/necrotic disease characterized by vascular calcification/occlusion. It occurs most commonly in end-stage kidney disease (ESKD), known as uraemic calciphylaxis (UC) but can also occur in patients with chronic kidney disease (CKD) and normal kidney function (nonuraemic calciphylaxis; NUC). There are few large series of NUC in the literature.

Aim

To compare the clinicopathological features of UC and NUC.

Methods

We retrospectively compared the clinicopathological features of 35 patients with NUC during the period 2010–2020 with those of 53 patients with UC (control group). Cases were classified as NUC in the absence of all of the following: ESKD, significant CKD (defined as serum creatinine > 3 mg/dL or creatinine clearance < 15 mL/min) and acute kidney injury requiring kidney replacement therapy or kidney transplantation.

Results

NUC represented 40% of the total cases, and there was a higher number of women (P < 0.01) and a higher median body mass index (P = 0.06) compared with the control UC group. Elevated parathyroid hormone was present in 44% of patients with NUC. Most of the tested patients were positive for lupus anticoagulants (56%). NUC biopsies showed a higher rate of extravascular calcium deposits (73% vs. 47%, P = 0.03). Dermal reactive vascular proliferation was the most common dermal change (32%).

Conclusions

NUC is more common than previously reported and shows a higher predilection for obese postmenopausal women. Undiagnosed hyperparathyroidism shows a possible association with NUC. Lupus anticoagulants were positive in most patients. NUC biopsies are more likely than UC biopsies to display extravascular calcium deposition.
Risk of skin cancer after ultraviolet phototherapy in patients with vitiligo: a systematic review and meta-analysis
Authors: Wu Y.-H. , Chou C.-L. , Chang H.-C.
Published: November 2021

Background

Although ultraviolet (UV) phototherapy is an effective treatment for vitiligo, its effect on the risk of skin cancer remains controversial.

Aim

To investigate the association between UV phototherapy and skin cancer risk in patients with vitiligo.

Methods

A systematic review was performed for studies published before 5 May 2021 in the PubMed, Embase, Web of Science and Cochrane Library databases. The primary outcome was the association of UV phototherapy with the risk of skin cancer in patients with vitiligo. A meta-analysis with a random-effects model was conducted.

Results

Five retrospective cohort studies covering a total of 228 607 patients with vitiligo (110 038 who had been treated with UV phototherapy and 118 569 patients who had not) were included in the meta-analysis. The risk of nonmelanoma skin cancer [Mantel–Haenszel risk ratio (MHRR) = 0.95; 95% CI 0.44–2.05] and melanoma (MHRR = 1.11; 95% CI 0.33–3.82) did not significantly increase after phototherapy in patients with vitiligo. In the subgroup analysis, we also found no significant association between phototherapy with narrowband UVB phototherapy specifically and risk of skin cancer in patients with vitiligo. There was no significant difference in risk of skin cancer between patients from Europe and those from East Asia and the risk was not affected by the number of narrowband UVB phototherapy sessions.

Conclusions

The findings of this systematic review and meta-analysis suggest that UV phototherapy is a safe treatment for vitiligo with no significant risk of skin cancer.
Obesity‐related genetic polymorphisms are associated with the risk of early puberty in Han Chinese girls
Authors: Li Di , Zhang Boxian , Cheng Jinquan , Chen Dingyan , Wu Yu , Luo Qingshan , Zhou Li
Published: November 2021

Objective

To explore the association between obesity and precocious puberty from the perspective of genetic polymorphism.

Design

Two hundred and ninety‐eight pairs of girls in early puberty and age‐matched controls (±3 months) were recruited. The genotypes of four obesity‐related single‐nucleotide polymorphism (SNP) loci (rs10968576, rs12935153, rs4674340 and rs7635103) were determined and the effect of variation on early puberty in Chinese Han girls was evaluated. The unstimulated luteinizing hormone (LH), follicle‐stimulating hormone and estradiol levels were also measured to determine the relationship with SNP polymorphisms.

Results

The effect allele A of rs12935153 was associated with early puberty (odds ratio [OR] = 1.256, 95% confidence interval [CI]: 1.010–1.585), but the significance disappeared after multiple comparisons. After adjusting for body mass index, rs12935153 variation increased the risk of early puberty in additive (OR = 1.589, 95% CI: 1.222–2.066), dominant (OR = 1.788, 95% CI: 1.210–2.642) and recessive (OR = 1.915, 95% CI: 1.207–3.038) models of inheritance. Individuals harbouring AA genotype in rs12935153 had a risk of higher LH levels than that of wild type (OR = 1.668, 95% CI: 1.093–2.546).

Conclusions

The association between obesity and precocity can be explained from a genetic perspective. Our study suggests that variations in rs12935153 increase the risk of early puberty in Chinese girls. Further studies are needed to verify our findings.
Tip of delivery system of a lumen‐apposing metal stent getting stuck in a patient undergoing endoscopic ultrasound‐guided drainage of walled‐off pancreatic necrosis
Authors: Chu Yu‐Long , Kuo Yu‐Ting , Wang Hsiu‐Po
Published: November 2021

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Global trends in the trophic specialisation of flower‐visitor networks are explained by current and historical climate
Authors: Luna Pedro , Villalobos Fabricio , Escobar Federico , Neves Frederico S. , Dáttilo Wesley
Published: November 2021

Trophic specialisation is known to vary across space, but the environmental factors explaining such variation remain elusive. Here we used a global dataset of flower‐visitor networks to evaluate how trophic specialisation varies between latitudinal zones (tropical and temperate) and across elevation gradients, while considering the environmental variation inherent in these spatial gradients. Specifically, we assessed the role of current (i.e., net primary productivity, temperature, and precipitation) and historical (i.e., temperature and precipitation stability) environmental factors in structuring the trophic specialisation of floral visitors. Spatial variations in trophic specialisation were not explained by latitudinal zones or elevation. Moreover, regardless of network location on the spatial gradient, there was a tendency for higher trophic specialisation in sites with high productivity and precipitation, whereas historical temperature stability was related to lower trophic specialisation. We highlight that both energetic constraints in animal foraging imposed by climate and resource availability may drive the global variation in trophic specialisation.
Are There Distinctive Profiles in Examinee Essay‐Writing Processes?
Authors: Bennett Randy E. , Zhang Mo , Sinharay Sandip , Guo Hongwen , Deane Paul
Published: November 2021

Grouping individuals according to a set of measured characteristics, or profiling, is frequently used in describing, understanding, and acting on a phenomenon. The advent of computer‐based assessment offers new possibilities for profiling writing because aspects can be captured that were not heretofore observable. We explored whether writing processes could be profiled of over 30,000 adults taking a high‐school equivalency examination. Process features were extracted from keystroke logs, aggregated into composite indicators, and used with essay score to assign individuals to profiles. Analyses included computing the percentages of individuals that could be classified, using MANOVA to examine differences among profiles on external variables, and examining if profiles could be distinguished from one another based on patterns derived from cluster analysis. Results showed that about 30% of examinees could be classified into profiles that were largely distinct. These results contribute toward a foundation for using such profiles in describing how individuals compose and in how their writing might be improved.
Outcome of superficial keratectomy without conjunctival graft as a surgical technique for immune‐mediated keratitis in horses: Four cases
Authors: Dieterman E. , Hermans H. , Slenter I. J. M. , Kuijpers N. W. , Grinwis G. C. M. , Boevé M. H.
Published: November 2021

This case report describes four horses with unilateral superficial or mid‐stromal immune‐mediated keratitis (IMMK) treated with a superficial keratectomy (SK) without a conjunctival graft. In two horses, the surgery was performed under general anaesthesia, and in two horses standing with sedation and local blocks. Results of this report show that SK is a viable treatment option in horses with chronic superficial and/or mid‐stromal IMMK that can even be performed in the standing, sedated horse. When sufficient corneal tissue is removed, no recurrence is to be expected in the long‐term follow‐up (up to 31 months). In two horses, healing occurred without complications. Two horses developed a secondary bacterial infection post‐operatively (Enterococcus faecalis and Staphylococcus aureus). In one case, this resulted in a pre‐perforating melting corneal ulcer necessitating conjunctival pedicle graft surgery 13 days post keratectomy. In three horses, there was no recurrence of the IMMK with a long‐term follow‐up of 6–31 months. One case showed recurrence of IMMK in the cornea region surrounding the keratectomy 9 months after surgery.
Association between dry mouth and physical frailty among community‐dwelling older adults in Japan: The Otassha Study
Authors: Ohara Yuki , Kawai Hisashi , Shirobe Maki , Iwasaki Masanori , Motokawa Keiko , Edahiro Ayako , Kim Hunkyung , Fujiwara Yoshinori , Ihara Kazuhige , Watanabe Yutaka , Obuchi Shuichi , Hirano Hirohiko
Published: November 2021

Objective

To elucidate the relationship between physical frailty and dry mouth among community‐dwelling older adults in Japan.

Background

Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty.

Materials and Methods

This cross‐sectional study included 643 individuals (mean age, 73.9 years) from the Otassha Study in 2019. Xerostomia was assessed using the 5‐item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre‐frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation.

Results

Among the participants, 4.5% and 49.8% had physical frailty and pre‐frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one‐point increase in SXI, 1.12; 95% confidence interval, 1.06‐1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty.

Conclusion

Xerostomia is associated with physical frailty among community‐dwelling older adults in Japan.

Clinical Trial Registration: Not applicable.
Quantitative trait locus mapping of five significant quality traits such as crude protein content of tetraploid hybrid crested wheatgrass in multiple environments
Authors: Yang Dongsheng , Yu Xiaoxia , Yu Zhuo , Li Jiaqi , Li Jingwei , Lu Qianqian , Wu Guofang
Published: November 2021

Agropyron is an important germplasm material of the genetic improvement for Gramineae forage and Triticeae crops. In the present research, in order to determine the stable and major quantitative trait loci (QTLs) controlling five significant quality traits, a total of 115 individuals from F2 segregation population of tetraploid hybrid crested wheatgrass and their parents were used as materials. On the basis of the ultra‐high density molecular genetic linkage map of tetraploid crested wheatgrass constructed with single nucleotide polymorphism (SNP) markers, we first determined QTLs for the phenotypic data of five quality traits in three different environments (Hohhot‐2018, Hohhot‐2019 and Tongliao‐2019) in 2 years (2018 and 2019) by Map QTL 6.0 software. The results showed that a total of 28 QTLs controlling quality traits of wheatgrass were located on 11 linkages (LGs), including LG1, LG2, LG3, LG4, LG6, LG7, LG8, LG9, LG12, LG13 and LG14. Among them, there were two QTLs for crude protein content (CPC), four QTLs for water‐soluble carbohydrate content (WSCC), 12 QTLs for starch content (SC), five QTLs for phosphorus content (PC) and five QTLs for calcium content (CC), which accounted for 10.1% to 21.6% of the phenotypic variation and all were major QTLs of genetic contribution rate >10%. However, only six stable QTLs were detected at least in two environments and in the mean environment data, including one for CPC (qCpc4‐1), one for WSCC (qWscc4‐2), two for SC (qSc1‐2, qSc9‐12), one for PC (qPc4‐4) and one for CC (qCc4‐2). These QTLs determining five traits would provide a theoretical basis for further fine mapping and the molecular marker‐assisted selection of elite gene in tetraploid crested wheatgrass.
Excess weight gain in the paediatric bleeding disorders population: Impact of the COVID‐19 Pandemic
Authors: Malcolmson Caroline , Tetzlaff Deirdre , Maguire Bryan , Wakefield Cindy , Carcao Manuel , Bouskill Vanessa
Published: November 2021

Introduction

The COVID‐19 pandemic has resulted in lifestyle changes for children. The aim of this study was to evaluate the impact of the pandemic on weight/BMI in children with severe bleeding disorders.

Methods

We conducted a retrospective review of patients age 3–18 years with severe bleeding disorders on prophylactic therapy treated at SickKids Hospital (Toronto, Canada) between February 01, 2018 and March 31, 2021. We evaluated the following pre‐ and post‐COVID variables: weight (kg), weight percentile, BMI (kg/m2), BMI percentile, HJHS score, and prophylactic dosing (units/kg).

Results

One hundred and four patients were included in the final analysis. Diagnoses were as follows:  haemophilia A (n = 92; 70.8%), haemophilia B (n = 17; 13.1%), type 3 von Willebrand disease (n = 11; 8.5%), the remainder were diagnosed with rare factor deficiencies.  Median interval time from pre‐COVID measurements to latest follow‐up was 12.4 months (IQR 10.32–14.52 months) during which there was a statistically significant increase in median weight percentile +5.75 centiles (from 63rdcentile to 68.75thcentile). There was a statistically significant increase in mean BMI of +1.03 kg/m2(P = < .001) while median BMI percentile increased +8.82 centiles (from 53.9thcentile to 62.72ndcentile) and mean BMI percentile increased 3.42 centiles (from 57.5 centile to 60.9 centile). The group that gained the most weight centiles, BMI and BMI centiles were 5–14 years old.

Conclusion

There was a trend to weight gain over the study period. More long‐term data is required to evaluate the impact of this increase in weight and BMI on children with bleeding disorders.
Impact of Chitosan‐Prunus cerasoides gum exudates on the thermal properties, storage stability and antioxidant activity of anthocyanins from Berberis lycium Royle
Authors: Sendri Nitisha , Bhatt Vinod , Singh Sarvpreet , Bhandari Pamita
Published: November 2021

For the protection of anthocyanins from berries of Berberis lycium Royle, the freeze dried microencapsulation method was used in five different combinations of chitosan (CH), Prunus cerasoides gum exudate (PG) and galactomannan as wall material with anthocyanin (ANS) as core material. The microencapsulated powders with different proportions of wall material showed encapsulation efficiency in the range of 90.51%–94.60%. Fourier‐transform infrared spectroscopy confirmed the cross‐linking interactions between ANS and wall materials. Enhanced thermal stability of the ANS with wall materials was indicated by thermogravimetric analysis. The stability of microcapsules and ANS was evaluated by spectrophotometric and liquid chromatographic methods at two conditions (4 °C and room temperature) during 90 days. The results revealed that ANS encapsulated with CH‐PG/ANS (4/1) exhibited maximum retention of anthocyanins (72.88% and 60.02%) and enhanced the stability and antioxidant potential of anthocyanins.
First human infection of avian influenza A(H5N6) virus reported in Lao People's Democratic Republic, February–March 2021
Authors: Sengkeopraseuth Bounthanom , Co Kim Carmela , Leuangvilay Phetdavanh , Mott Joshua A. , Khomgsamphanh Boungnasith , Somoulay Virasack , Tsuyuoka Reiko , Chiew May , Ketmayoon Pakapak , Jones Joyce , Pusch Elizabeth , Jang Yunho , Barnes John , Davis Charles Todd , Phommachanh Phouvong , Khamphaphongphane Bouaphanh , Olsen Sonja J. , Xangsayyarath Phonepadith
Published: November 2021

In March 2021, Lao People's Democratic Republic (Laos) reported an avian influenza A(H5N6) virus infection in a 5‐year‐old child identified through sentinel surveillance. This was the first human A(H5N6) infection reported outside of China. A multidisciplinary investigation undertook contact tracing and enhanced human and animal surveillance in surrounding villages and live bird markets. Seven Muscovy ducks tested positive for highly pathogenic avian influenza A(H5N6) viruses. Sequenced viruses belonged to clade 2.3.4.4h and were closely related to viruses detected in poultry in Vietnam and to previous viruses detected in Laos. Surveillance and coordinated outbreak response remain essential to global health security.
Epidemiology, aetiology and knowledge, attitudes, and practices relating to burn injuries in Palestine: A community‐level research
Authors: Abu Ibaid Ali H. , Hebron Caitlin A. , Qaysse Hana'a A. , Coyne Melanie J. , Potokar Tom S. , Shalltoot Fikr A. , Shalabi Mahmoud A.
Published: November 2021

The aim of this study was to identify the epidemiology, aetiology as well as the knowledge, attitudes, and practices relating to burn injuries in Palestine. A mixed‐method approach was used. A survey was distributed to a total of 1500 households selected by randomised approach. The survey was standardised based on World Health Organisation's guidelines for conducting community surveys on injury. Additionally, there were 12 focus group discussions and 10 key informant interviews to collect rich qualitative data. In the West Bank and Gaza, 1.5% of Palestinians had experienced serious burn injuries in the 12 months. The total sample of 1500 yields a margin of error (plus/minus) = 2.5% at a 95% level of confidence and a response distribution (P = 50%) with 3% non‐response rate. Of the 1500 households approached, 184 reported a total of 196 burn injuries, with 87.2% occurring inside the home: 69.4% were females and 39.3% were children. The main source of reported cause of burn was heat and flame (36%), electric current (31.6%), hot liquid (28.6%), and chemicals (2.7%). The most common first aid for burns was pouring water (74.7%). People in rural, refugee, and Bedouin settings had the highest incidence of burns. This study provides the burn prevalence rate, explanatory factors that contribute to the frequency of burns in Palestine. Making burn prevention a higher priority within the national policy is crucial.
What is in a name? Definitions of insomnia in people with intellectual disabilities
Authors: van den Broek Naomi , Festen Dederieke , Tan Francis , Overeem Sebastiaan , Pillen Sigrid
Published: November 2021

Background

The reported prevalence of insomnia symptoms in people with intellectual disabilities varies greatly, possibly due to the lack of a common definition. This article provides an overview of the different definitions used and formulates key points for a general definition.

Methods

A literature search was performed. An overview of the definitions used was given and compared to the third edition of the international classification of sleep disorders.

Results

The search yielded 16 studies. No uniform definition was used. Terminology and cut‐off points of insomnia symptoms differed. Insomnia symptoms were mostly described as night‐time problems. A minority of studies incorporated daytime consequences.

Conclusion

An insomnia disorder entails more than merely night‐time complaints and should include daytime consequences. A general definition is warranted. This definition should focus on night‐time and daytime insomnia symptoms, incorporate subjective features, and discuss the use of objective measurements and influence of environmental circumstances.
Association between non‐alcoholic fatty liver disease with the susceptibility and outcome of COVID‐19: A retrospective study
Authors: Wang Guyi , Wu Shangjie , Wu Chenfang , Zhang Quan , Wu Fang , Yu Bo , Zhang Siye , Wu Chao , Wu Guobao , Zhong Yanjun
Published: November 2021

This study aims to evaluate the effect of non‐alcoholic fatty liver disease (NAFLD) on the susceptibility and consequences of coronavirus disease 2019 (COVID‐19). We retrospectively collected data from 218 adult COVID‐19 patients who showed no evidence of excessive alcohol consumption and underwent abdominal ultrasound examinations. Of these patients, 39.4% patients had been diagnosed with NAFLD, which indicates a much higher prevalence of NAFLD than that reported in the general population. Significantly elevated white blood cell count (p = 0.008), alanine aminotransferase (p = 0.000), aspartate aminotransferase (p = 0.006) and C reactive protein (p = 0.012) were found in the patients with NAFLD. These patients also had significantly higher proportions of hypertension (p = 0.006) and diabetes (p = 0.049) than the non‐NAFLD cases. No significant differences existed in the severity, mortality, viral shedding time and length of hospital stay between patients with or without NAFLD in the sample population. However, subgroup analyses found that in patients with normal body mass index (BMI), NAFLD sufferers were more likely to experience a severe event (30.0% vs 11.5%, p = 0.021). Kaplan‐Meier curve (log‐rank p = 0.017) and Cox regression (HR = 3.26, 95% CI: 1.17–9.04, p = 0.023) analyses confirmed that before and after adjusting for gender, age and comorbidities, NAFLD patients with normal BMI had a higher incidence of suffering severe events. People with NAFLD may have a higher proportion of COVID‐19. NAFLD may be correlated with the severity of COVID‐19 patients in the normal BMI group.
Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review
Authors: Gotfredsen Klaus , Rimborg Susie , Stavropoulos Andreas
Published: November 2021

Aim

The aim of this systematic review was to answer the following focused question: “In partially edentulous patients with periodontitis, are removable dental prostheses (RDPs) more efficacious than no prosthetic treatment, treatment to a shortened dental arch (SDA), or tooth‐supported fixed dental prostheses (FDPs)?”

Materials and methods

A systematic literature search was performed electronically for the period 1966–2020. Two authors independently assessed the studies for eligibility according to the PRISMA guidelines. Risk assessment was performed using RoB 2.0 and the Newcastle–Ottawa Scale.

Results

Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis. Prospective studies found that RDPs could be maintained without any significant periodontal destruction on a long‐term basis. Owing to the heterogeneity of the data, no meta‐analysis could be performed. Several studies indicated that RDP increased plaque accumulation. RDPs had only a limited effect on masticatory efficiency and nutritional status. RDPs may improve oral‐health‐related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA.

Conclusions

There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss. RDPs do not inevitably improve masticatory efficiency but improve OHRQoL, although less than for patients treated with FDPs including resin‐bonded FDPs.
Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta‐analysis
Authors: Gennai Stefano , Izzetti Rossana , Pioli Maria C. , Music Larisa , Graziani Filippo
Published: November 2021

Aim

To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral‐health‐related quality of life (OHRQoL) and systemic health.

Materials and methods

A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP‐14] and OHIP‐49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health‐related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health‐related outcomes. Meta‐analysis was conducted on available quantitative data.

Results

The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta‐analysis showed significant improvement of OHIP‐49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP‐14 = 10.52, OHIP‐49 = 56.02, GOHAI = 5.40, p < .01 for all). Non‐rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution.

Conclusions

Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.
Belonging beyond the binary: from Byzantine eunuchs and Indian hijras to gender‐fluid and non‐binary identities
Authors: GONZALEZ‐SALZBERG DAMIAN A. , PERISANIDI MAROULA
Published: November 2021

While the majority of Western legal systems continue to insist on the existence of only two genders, a demand for the recognition of non‐binary gender identities has become increasingly visible. Numerous individuals have gone to court demanding recognition of their identities beyond the binary, with varying degrees of success. This article provides a novel lens through which to consider these contemporary legal claims. Through an exploration of historical and cultural examples of gender beyond the binary, more specifically Byzantine eunuchs and Indian hijras, this article analyses the regulatory forces that permit and promote the existence of non‐binary genders. A better understanding of societies that have carved out a space for genders beyond the binary can offer important insights into both the benefits and the dangers of the legal recognition of a third gender.
‘Victims not wrongdoers’: the legal consciousness of rejected asylum seekers in Norway
Authors: HADDELAND HANNA BUER
Published: November 2021

Drawing on in‐depth interviews, observation, and legal sources, this article examines how rejected asylum seekers experience their status and the legal regulations related to it, and how they react as a result. Their legal consciousness must be understood in the light of their illegal status, which makes them keenly aware that legal regulations and power structures decisively affect their everyday lives. They are ‘outside the law’ yet struggling to become insiders. While they all use legal services in their individual struggles, their engagement in collective counter‐hegemonic struggles is greatly affected by social relations, networks, and culture. Honneth's theory of recognition is used to expand the narrative of ‘dissenting collectivism’ within legal consciousness scholarship and capture the collective resistance of the marginalized. Unlike studies portraying these migrants as fearful of any involvement with the authorities, this article demonstrates that individual experiences of injustice and violated expectations of recognition can lead to collective resistance and mobilization.
Environmental risk factors for inflammatory bowel disease: A case control study in Southeast Asian children
Authors: Lee Way S , Song Zhi L , Wong Sean Y , Gan Chai W , Koay Zhong L , Em Jun M , Chong Sze Y , Lim Chooi B , Wong Shin Y , Chew Kee S , Kam Choy C
Published: November 2021

Aim

Early‐life environmental exposure, which has important implications in the pathogenesis of inflammatory bowel disease (IBD), is not well understood in Asian children. We examined environmental factors prior to the development of childhood IBD in a Southeast Asian population.

Methods

We conducted a case control study in IBD diagnosed before 18 years of age and controls matched by gender, age and ethnicity. A questionnaire recording medical, family, dietary and social histories, home environment, childhood diseases and immunisation status was used.

Results

In a multivariate analysis involving 70 children with IBD (Crohn's disease (CD) = 38; ulcerative colitis (UC) = 32) and 140 controls, childhood acute gastroenteritis (odds ratio (OR): IBD 6.9; CD 7.8; UC 5.8) and excessive antibiotic usage in early childhood (OR: IBD 5.3; CD 4.2; UC 4.8) were significantly associated with IBD, CD and UC. Having a fish or turtle aquarium (OR 6.0), major stressful life events (OR 5.6) and attending the same school concurrently with a sibling (OR 2.9) were significant risk factors for IBD. Duration of breastfeeding >6 months (OR: IBD 0.4; UC 0.2) and safe water consumption (OR: IBD 0.2; UC 0.2) reduced the odds of having IBD and UC, respectively. Being vaccinated for rotavirus reduced the odds of developing IBD (OR 0.1).

Conclusions

Several risk and protective factors were identified in this environmental risk study in Southeast Asian children with IBD. This knowledge has important implications in understanding disease aetiology and future prevention strategies to reduce the development of IBD in Southeast Asian children.
Sleep‐spindle frequency: Overnight dynamics, afternoon nap effects, and possible circadian modulation
Authors: Bódizs Róbert , Horváth Csenge G. , Szalárdy Orsolya , Ujma Péter P. , Simor Péter , Gombos Ferenc , Kovács Ilona , Genzel Lisa , Dresler Martin
Published: November 2021

Homeostatic and circadian processes play a pivotal role in determining sleep structure, timing, and quality. In sharp contrast with the wide accessibility of the electroencephalogram (EEG) index of sleep homeostasis, an electrophysiological measure of the circadian modulation of sleep is still unavailable. Evidence suggests that sleep‐spindle frequencies decelerate during biological night. In order to test the feasibility of measuring this marker in common polysomnographic protocols, the Budapest‐Munich database of sleep records (N = 251 healthy subjects, 122 females, age range: 4–69 years), as well as an afternoon nap sleep record database (N = 112 healthy subjects, 30 females, age range: 18–30 years) were analysed by the individual adjustment method of sleep‐spindle analysis. Slow and fast sleep‐spindle frequencies were characterised by U‐shaped overnight dynamics, with highest values in the first and the fourth‐to‐fifth sleep cycle and the lowest values in the middle of the sleeping period (cycles two to three). Age‐related attenuation of sleep‐spindle deceleration was evident. Estimated phases of the nadirs in sleep‐spindle frequencies were advanced in children as compared to other age groups. Additionally, nap sleep spindles were faster than night sleep spindles (0.57 and 0.39 Hz difference for slow and fast types, respectively). The fine frequency resolution analysis of sleep spindles is a feasible method of measuring the assumed circadian modulation of sleep. Moreover, age‐related attenuation of circadian sleep modulation might be measurable by assessing the overnight dynamics in sleep‐spindle frequency. Phase of the minimal sleep‐spindle frequency is a putative biomarker of chronotype.
‘[P]oets unhoused’: Modernism, homelessness and precarity
Authors: Ryan Laura
Published: November 2021

In the past 2 or 3 decades, modernist scholarship has largely moved beyond and certainly challenged the mythologised trope of the alienated, exiled modernist writer. Such figures were generally exiled by choice and ‘homeless’ only metaphorically, but their experiences have long been lauded as the ideal conditions for modernist formal innovations. This essay explores the ways in which issues of homelessness and precarity have been considered thus far in modernist scholarship, arguing that more work is needed to account for the particular experiences of writers I here call the ‘homeless modernists’ and the impact of unstable housing upon modernist aesthetics and themes.
Connections within the seemingly inevitable triad of self, social and situation
Authors: Eva Kevin W.
Published: November 2021

Seeing links others have missed? Our Editor‐in‐chief offers a challenge to health professional education scholars to draw Connections between Medical Education articles that offer new insights for the field.
Imagining the future: Social connections and new methodologies
Authors: Wozniak Helen , Philip Robyn L.
Published: November 2021

Wozniak and Philip encourage us to examine old problems from new perspectives, incorporating sociocultural perspectives to cultivate creative interprofessional health care teams for the future.
Beyond competence: Towards a more holistic perspective in medical education
Authors: Kämmer Juliane E. , Hautz Wolf E.
Published: November 2021

The authors draw connections between four State of the Science articles that encourage diversity in our field while worrying about heterogeneity of terminology impeding theory integration and practical impact.
Building Community Through Ethnography in Action to Catalyze Student, Faculty, and Community Collaborations
Authors: McCormack Penske , Johns Zoi , Neiss Kassandra , Kinyon Kamila , Cerón Alejandro
Published: November 2021

Since its initial conception in 2017, the University of Denver Ethnography Lab (DUEL) has aimed to catalyze collaborations between students, faculty, and community organizations. Inspired by community–campus partnerships implemented in the past across the United States, DUEL seeks to cultivate a community of practice centered on ethnography in action, and to draw on strengths and opportunities specific to our university. In this article, we present the process that channeled the energies and ideas of 30 faculty and students from 10 different departments into the creation of DUEL, we share examples from our experience so far, and we identify challenges and opportunities for DUEL's future.
Nursing students' experience of providing frontline COVID‐19 support: A qualitative study
Authors: Vázquez‐Calatayud Mónica , Rumeu‐Casares Carmen , Olano‐Lizarraga Maddi , Regaira Martínez Elena
Published: November 2021

Understanding the unique experience of nursing students providing frontline support in COVID‐19 hospital wards is crucial for the design of strategies to improve crisis management and mitigate future pandemic outbreaks. Limited research concerning this phenomenon has been published. This qualitative study aimed to understand the experience of providing support from COVID‐19 frontline nursing students' perspective. Online interviews were conducted with nine nursing students from April to May 2020; interview data were analyzed by content analysis using Burnard's method. Six main categories emerged from the data analysis: “experiencing a rapid transition from student to professional,” “fear and uncertainty of the unknown,” “resilience throughout the crisis,” “sense of belonging to a team,” “shared responsibility,” and “importance of the profession.” Based on these findings, multicomponent strategies that function in parallel with practical contexts should be developed to enable students to diligently adapt their abilities to their new role and cope with health crises.
MicroRNA482/2118, a miRNA superfamily essential for both disease resistance and plant development
Authors: Zhang Yanqing , Waseem Muhammad , Zeng Zaohai , Xu Jing , Chen Chengjie , Liu Yuanlong , Zhai Jixian , Xia Rui
Published: November 2021

MicroRNAs (miRNAs) are a class of 21–24 nucleotides (nt) noncoding small RNAs ubiquitously distributed across the plant kingdom. miR482/2118, one of the conserved miRNA superfamilies originating from gymnosperms, has divergent main functions in core‐angiosperms. It mainly regulates NUCLEOTIDE BINDING SITE‐LEUCINE‐RICH REPEAT (NBS‐LRR) genes in eudicots, functioning as an essential component in plant disease resistance; in contrast, it predominantly targets numerous long noncoding RNAs (lncRNAs) in monocot grasses, which are vital for plant reproduction. Usually, miR482/2118 is 22‐nt in length, which can trigger the production of phased small interfering RNAs (phasiRNAs) after directed cleavage. PhasiRNAs instigated from target genes of miR482/2118 enhance their roles in corresponding biological processes by cis‐regulation on cognate genes and expands their function to other pathways via trans activity on different genes. This review summarizes the origin, biogenesis, conservation, and evolutionary characteristics of the miR482/2118 superfamily and delineates its diverse functions in disease resistance, plant development, stress responses, etc.
A prospective evaluation of the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service across five areas in England
Authors: Swystun Alexander G , Davey Christopher J
Published: November 2021

Purpose

Although urgent primary eye care schemes exist in some areas of England, their current safety is unknown. Accordingly, the aim of the present study was to quantify the clinical safety and effectiveness of a COVID‐19 Urgent Eyecare Service (CUES) across Luton, Bedford, Hull, East Riding of Yorkshire and Harrogate.

Methods

Consenting patients with acute onset eye problems who had accessed the service were contacted to ascertain what the optometrist's recommendation was, whether this worked, if they had to present elsewhere and how satisfied they were with the CUES.

Results

A total of 27% (170/629) and 6.3% (28/445) of patients managed virtually and in person, respectively, did not have their acute eye problem resolved. Regression analysis revealed that patients who attended a face‐to‐face consultation were 4.66 times more likely to be correctly managed [Exp (β) = 5.66], relative to those solely managed virtually. Optometrists' phone consultations failed to detect conditions such as stroke, intracranial hypertension, suspected space occupying lesions, orbital cellulitis, scleritis, corneal ulcer, wet macular degeneration, uveitis with macular oedema and retinal detachment. Of referrals to hospital ophthalmology departments, in total, 19% were false‐positives. Patients, however, were typically very satisfied with the service. Uptake was associated with socioeconomic status.

Conclusion

The present study found that a virtual assessment service providing optometrist tele‐consultations was not effective at resolving patients' acute‐onset eye problems. The range and number of pathologies missed by tele‐consultations suggests that the service model in the present study was detrimental to patient safety. To improve this, optometrists should follow evidence based guidance when attempting to manage patients virtually, or in person. For example, patients presenting with acute‐onset symptoms of flashing lights and/or floaters require an urgent dilated fundus examination. Robust data collection on service safety is required on an ongoing basis.
‘It’s like having a core belief that’s able to speak back to you’: Therapist accounts of dialoguing with auditory hallucinations
Authors: Longden Eleanor , Branitsky Alison , Jones Wendy , Peters Sarah
Published: November 2021

Purpose

To investigate the clinical perspectives and experiences of therapists when engaging in direct dialogue with auditory hallucinations.

Method

Therapist accounts were explored via a qualitative study nested within a pilot randomized controlled trial of a novel intervention for supporting distressed voice‐hearers (Talking with Voices). Five therapists were involved, none of whom had substantive previous experience of the technique. All agreed to take part in two semi‐structured, in‐depth interviews which were arranged prior to delivering therapy and again after therapists had experience of conducting dialogues. Data were analysed using inductive thematic analysis.

Results

Participants described their impressions of seeking to improve the relationship between voice(s) and voice‐hearer using dialogue. The findings are organized within three main themes and associated subthemes: (1) Commitment to delivery (professional values, mentorship, professional growth); (2) Communication and collaboration (therapeutic alliance, relationships with voices, managing clinical perceptions); and (3) Challenges of delivery (client/voice engagement, impact of trauma, systemic issues). A series of recommendations are derived from the findings to support implementation and guide the practice of therapists undertaking dialogue work with clients who hear voices.

Conclusion

Despite clinical challenges, therapists also identified professional gains from conducting their work. Their accounts demonstrate that it is possible for practitioners with no previous formal experience to engage in direct communication with voices within a context of appropriate training and supervision.

Practitioner points

Therapists with no previous experience of dialogue work can be trained and supported to verbally engage with the voices heard by people experiencing psychosis.

Therapeutic alliance and therapist values are important components of successful therapy.

Confidence for dialoguing with voices can be increased through drawing on therapist’s existing transferable clinical skills.

The emotional and practical needs of therapists undertaking such work should be addressed through training and regular group supervision.
The effects of sexual harassment training on proximal and transfer training outcomes: A meta‐analytic investigation
Authors: Roehling Mark V. , Wu Dongyuan , Choi Mahl Geum , Dulebohn James H.
Published: November 2021

Widespread agreement that training can play a key role in addressing workplace sexual harassment (SH) has led to a dramatic increase in employer‐provided SH training around the world. However, summaries of published research have been qualitative in nature and have yielded inconsistent assessments of SH training's effectiveness in fulfilling that role. The study helps address those uncertain and sometimes conflicting assessments by providing the first meta‐analytic investigation of the relationships between SH training and changes in trainees. We found that the largest SH training effect was on declarative knowledge learning (δ = 1.06), followed by attitude change (δ = 0.41), procedural knowledge‐skills learning (δ = 0.39), and transfer outcomes (δ = 0.14). Significant moderating effects were found for scope of training, instructional method, and gender of trainees; however, the results varied by training outcome. The effect of SH training did not vary significantly as a function of the training delivery media, training duration, or training setting. Theoretical implications, directions for future research, and practical implications are discussed.
Alternative capstone nursing experience to scale up testing and case investigation
Authors: Diamond‐Caravella Monica , Fox Alison , Clark Marissa , Goodstone Lori , Glaser Christine
Published: November 2021

Background

Surges related to the SARS‐COV2 virus in the United States have underscored the critical importance of large‐scale testing, case investigation and contact tracing. Baccalaureate nursing students have the potential to serve as surge capacity workforce in mitigation measures during this public health emergency.

Methods

Over the course of eight weeks (September‐December 2020) baccalaureate senior capstone nursing students served as case investigators for a local health department (LHD) on Long Island, New York and surveillance pooled saliva testers for their college to ensure compliance with a state‐wide COVID‐19 testing mandate. To determine student perceptions working in these concurrent novel academic‐partnerships during the COVID‐19 pandemic, a descriptive survey of open‐ended interview questions was completed by student participants (n = 10).

Results

Analysis of aggregate responses revealed common themes across the data set linking student learning and appreciation of the “eye‐opening” experience to a sense of purpose, the value of communication, education and teamwork—all within the structure of public health nursing.

Conclusions

Baccalaureate nursing students can effectively serve as an untapped workforce within an academic partnership to support surveillance testing and case investigation during the COVID‐19 pandemic and future public health crises. This partnership had the added benefit of exposing nursing students to the critical nature of public health nursing during this historic time in our nation.
A Radical Vision of Radicalism: Political Cynicism, not Incrementally Stronger Partisan Positions, Explains Political Radicalization
Authors: Van Hiel Alain , Van Assche Jasper , Haesevoets Tessa , De Cremer David , Hodson Gordon
Published: November 2021

Is political radicalization a product of increased issue position polarization, by which left and right‐wing attitudes become ever more extreme? We argue that this is not the best explanation. Indeed, radical left and right supporters are not so much “left” or “right” in terms of their ideological attitudes. Instead, we argue that political cynicism is a relevant ideological attitude, with radicals being characterized by distinctly high levels, making them truly distinct from moderates. Radicals are primarily driven by anger, more than by anxiety, meaning that their information processing is heavily focused on consistency and closure. We discuss that political cynics have become highly effective as a political force, and we offer suggestions for how traditional parties may overcome the “trust crisis” in politics. It is concluded that issue‐position polarization is a phenomenon that operates to an equal extent in moderate voters than in adherents of radical and populist parties. The abyss between moderates and radicals concerns whether or not “to be in the political system” at all.