bluuebunny/crossref_metadata_2025 huggingface dataset:
GATA2 regulates mast cell identity and responsiveness to antigenic stimulation by promoting chromatin remodeling at super-enhancers
Authors: Li Yapeng , Gao Junfeng , Kamran Mohammad , Harmacek Laura , Danhorn Thomas , Leach Sonia M. , O’Connor Brian P. , Hagman James R. , Huang Hua
Published: September 2020

Mast cells (MCs) are critical effectors of allergic inflammation and protection against parasitic infections. We previously demonstrated that transcription factors GATA2 and MITF are the MC lineage-determining factors (LDTFs). However, it is unclear whether these LDTFs regulate chromatin accessibility at MC enhancer regions. In this study, we demonstrate that GATA2 promotes chromatin accessibility at the super-enhancers of MC identity genes and primes both typical and super-enhancers at genes that respond to antigenic stimulation. We found that the number and densities of GATA2-but not MITF-bound sites at the super-enhancers were several folds higher than that at the typical enhancers. Our studies revealed that GATA2 promotes robust gene transcription to maintain MC identity and respond to antigenic stimulation by binding to super-enhancer regions with dense GATA2 binding sites available at key MC genes.
Evaluation of nafamostat mesylate safety and inhibition of SARS-CoV-2 replication using a 3-dimensional human airway epithelia model
Authors: Kirkpatrick D. Lynn , Millard Jeffrey
Published: September 2020

In the current COVID-19 pandemic context, Ensysce and its subsidiary Covistat have been working to repurpose nafamostat mesylate as an effective oral and inhalation treatment against SARS-CoV-2 infection. Prior reports used cell lines to demonstrate the antiviral potential of nafamostat against coronaviral infections and determined its mechanism of action through inhibition of transmembrane protease serine 2 (TMPRSS2). We selected a biologically relevant pre-clinical experimental model of SARS-CoV-2 lung infection using a 3D human reconstituted airway epithelial model of nasal origin to characterize the effects of nafamostat on tissue-level cellular ultrastructure and viral infection kinetics. Our results confirm the not only the relevance of this model for the preclinical evaluation of safety and efficacy of antiviral candidates, but also the highly potent nature of nafamostat SARS-CoV-2 antiviral activity. The studies described herein provided evidence demonstrating the therapeutic potential of nafamostat against COVID-19, as well as its safety upon exposure to lung airway cellular.

One Sentence Summary

Using a human airway model, study demonstrates the powerful inhibitory effect of nafamostat on SARS-CoV-2 genome copy detection when applied apically.
Computational Circuit Mechanisms Underlying Thalamic Control of Attention
Authors: Gu Qinglong L. , Lam Norman H. , Wimmer Ralf D. , Halassa Michael M. , Murray John D.
Published: September 2020

The thalamus engages in attention by amplifying relevant signals and filtering distractors. Whether architectural features of thalamic circuitry offer a unique locus for attentional control is unknown. We developed a circuit model of excitatory thalamocortical and inhibitory reticular neurons, capturing key observations from task-engaged animals. We found that top-down inputs onto reticular neurons regulate thalamic gain effectively, compared to direct thalamocortical inputs. This mechanism enhances downstream readout, improving detection, discrimination, and cross-modal performance. The model revealed heterogeneous thalamic responses that enable decoding top-down versus bottom-up signals. Spiking activity from task-performing mice supported model predictions, with a similar coding geometry in auditory thalamus and readout strategy in auditory cortex. Dynamical systems analysis explained why reticular neurons are potent sites for control, and how lack of excitatory connectivity among thalamocortical neurons enables separation of top-down from bottom-up signals. Our work reveals mechanisms for attentional control and connects circuit architectures to computational functions.
The DNA replication fork suppresses CMG unloading from chromatin before termination
Authors: Low Emily , Chistol Gheorghe , Zaher Manal S. , Kochenova Olga V. , Walter Johannes C.
Published: September 2020

When converging replication forks meet during replication termination, the CMG (Cdc45–MCM2–7–GINS) helicase is polyubiquitylated by CRL2Lrr1 and unloaded from chromatin by the p97 ATPase. Here, we investigate the signal that triggers CMG unloading in Xenopus egg extracts using single-molecule and ensemble approaches. We show that converging CMGs pass each other and keep translocating at the same speed as before convergence, whereafter they are rapidly and independently unloaded. When CMG unloading is blocked, diverging CMGs do not support DNA synthesis, indicating that after bypass CMGs encounter the nascent lagging strands of the converging fork and then translocate along double-stranded DNA (dsDNA). However, translocation on dsDNA is not required for CMG's removal from chromatin because in the absence of nascent strand synthesis, converging CMGs are still unloaded. Moreover, recombinant CMG added to nuclear extract undergoes ubiquitylation and disassembly in the absence of any DNA, and DNA digestion triggers CMG ubiquitylation at stalled replication forks. Our findings suggest that DNA suppresses CMG ubiquitylation during elongation and that this suppression is relieved when CMGs converge, leading to CMG unloading.
ASB13 inhibits breast cancer metastasis through promoting SNAI2 degradation and relieving its transcriptional repression of YAP
Authors: Fan Huijuan , Wang Xuxiang , Li Wenyang , Shen Minhong , Wei Yong , Zheng Hanqiu , Kang Yibin
Published: September 2020

Transcription factor SNAI2 plays key roles during development and has also been known to promote metastasis by inducing invasive phenotype and tumor-initiating activity of cancer cells. However, the post-translational regulation of SNAI2 is less well studied. We performed a dual-luciferase-based, genome-wide E3 ligase siRNA library screen and identified ASB13 as an E3 ubiquitin ligase that targets SNAI2 for ubiquitination and degradation. ASB13 knockout in breast cancer cells promoted cell migration and decreased F-actin polymerization, while overexpression of ASB13 suppressed lung metastasis. Furthermore, ASB13 knockout decreased YAP expression, and such regulation is dependent on an increased protein level of SNAI2, which in turn represses YAP transcription. YAP suppresses tumor progression in breast cancer, as YAP knockout increases tumorsphere formation, anchorage-independent colony formation, cell migration in vitro, and lung metastasis in vivo. Clinical data analysis reveals that ASB13 expression is positively correlated with improved overall survival in breast cancer patients. These findings establish ASB13 as a suppressor of breast cancer metastasis by promoting degradation of SNAI2 and relieving its transcriptional repression of YAP.
Deubiquitinase USP20 promotes breast cancer metastasis by stabilizing SNAI2
Authors: Li Wenyang , Shen Minhong , Jiang Yi-Zhou , Zhang Ruina , Zheng Hanqiu , Wei Yong , Shao Zhi-Ming , Kang Yibin
Published: September 2020

SNAI2/SLUG, a metastasis-promoting transcription factor, is a labile protein that is degraded through the ubiquitin proteasome degradation system. Here, we conducted comprehensive gain- and loss-of-function screens using a human DUB cDNA library of 65 genes and an siRNA library of 98 genes, and identified USP20 as a deubiquitinase (DUB) that regulates SNAI2 ubiquitination and stability. Further investigation of USP20 demonstrated its function in promoting migration, invasion, and metastasis of breast cancer. USP20 positively correlates with SNAI2 protein level in breast tumor samples, and higher USP20 expression is associated with poor prognosis in ER− breast cancer patients.
The influence of corporate governance on intellectual capital efficiency: evidence from Islamic banks of OIC countries
Authors: Aslam Ejaz , Haron Razali
Published: September 2020

Purpose

The purpose of this study is to examine the impact of corporate governance (CG) on intellectual capital efficiency (ICE) in Islamic banks (IBs) of Organisation of Islamic Cooperation (OIC) countries.

Design/methodology/approach

A sample of 129 IBs is drawn from the 29 OIC countries from 2008 to 2017. A two-step system of the generalised method of moments has been employed to account for the unobserved endogeneity and heteroscedasticity issue that arose due to time-variant and time-invariant variables.

Findings

The results revealed that CG measures, namely board size, non-executive directors do explain the extent and quality of ICE in the expected direction. In contrast, CEO duality, Shariah board and audit committee are negatively associated with the ICE. Moreover, the authors observed that male CEO in IBs has negative, but foreign ownership has a positive association with ICE in determining the extent of ICE in IBs. This study contributes specifically to the stakeholder theory and the literature of ICE and CG.

Research limitations/implications

The findings of the study provide insight into how a larger board can overcome skill deficiency and how making more investment in ICE would help to enhance productivity. Hence, bank managers, regulators, policymakers and shareholders have strong interest in designing the appropriate CG structure to develop ICE in banks.

Originality/value

This is one of the few studies which provide empirical evidence of CG mechanism to boost the ICE in the perspective of IBs of the OIC countries.
Recency effects in the buffering of negative news by corporate social responsibility advertising
Authors: Han Joon Hye , Davies Gary , Grimes Anthony
Published: September 2020

Purpose

Drawing from the theory of how relevant items are processed in memory when making judgements, this study aims to test for recency effects between CSR advertising and related, negative news on how a company is perceived and the explanatory roles of environmentalism, attribution and both feelings and attitudes towards the advertising itself.

Design/methodology/approach

This study uses between-subjects experimental design with pretests.

Findings

Order effects exist, which, when ads and news are similarly influential, evidence a recency effect. The process is explained by both the mediating influence of attribution of blame and the moderation of this influence by attitude towards the environment. Differences between the effectiveness of ads are explained by the mediating influence of attitudes towards and feelings about the ad together with the moderation of this influence by involvement in the ad context.

Practical implications

Corporate social responsibility (CSR) ads should be pretested in the context of related but negative news, and not just on their own, to ensure they can buffer such news. CSR ads can be more effective when following rather than preceding such news and should not be withdrawn if such a crisis occurs.

Originality/value

The research first attempts to explain recency effects theoretically from the influence of CSR ads on negative CSR-related news. It also shows the determining factors in how such effects influence consumers by considering attribution, environmentalism, attitude to the context and attitude and feelings towards CSR ads.
The “Right” recipes for security culture: a competing values model perspective
Authors: Kam Hwee-Joo , Mattson Thomas , Kim Dan J.
Published: September 2020

Purpose

This study argues that the effect of perceived organizational culture on the formation of security-related subjective norms and the level of compliance pressure will vary based on how the employees perceive their organization's cultural values. These perceptions reflect on the assumptions and principles that organizations use to guide their security-related behaviors. To make these arguments, we adopt the competing values model (CVM), which is a model used to understand the range of organizational values and resulting cultural archetypes.

Design/methodology/approach

This study conducted a survey of working professionals in the banking and higher education industries and used partial least squares (PLS)-structural equation model (SEM) to analyze the data. In a series of post hoc analyses, we ran a set of multi-group analyses to compare the perceived organizational cultural effects between the working professionals in both industries.

Findings

Our study reveals that perceived organizational cultures in favor of stability and control promoted more positive security-related behaviors. However, the different effects were more pronounced when comparing the effects between the working professionals in both industries.

Originality/value

This study is one of the few that examines which cultural archetypes are more effective at fostering positive security behaviors. These findings suggest that we should be cautious about generalizing the effects of organizational culture on security-related actions across different contexts and industries.
Using online travel agent platforms to determine factors influencing hotel guest satisfaction
Authors: Wong Elise , Rasoolimanesh S. Mostafa , Pahlevan Sharif Saeed
Published: September 2020

Purpose

This study aims to investigate the relationships between service quality, perceived value and hotel guest satisfaction, drawing upon data from TripAdvisor – an online travel agent (OTA) platform. The study also investigates the mediating role of perceived value on the relationship between service quality and satisfaction, as well as the moderating role of hotel star ratings on all direct and indirect relationships.

Design/methodology/approach

Data for this study were collected via Web scraping from August–October 2018. Data were collected from 192 three- to five star-rated hotels in Kuala Lumpur, Malaysia. Partial least squares – structural equation modeling was used for data analysis. Furthermore, importance-performance map analysis (IPMA) was performed to identify the most important items of service quality and perceived value in improving customer satisfaction.

Findings

The findings of this study provide support for all direct and indirect relationships for three-star and four- and five-star hotels. Moreover, the results indicate that perceived value mediates the relationship between service quality and customer satisfaction. These results support the moderating role of hotel star ratings for the relationship between service quality and perceived value. The results also show that after perceived value, three-star hotels looking to improve customer satisfaction should prioritize improving the quality of their services, sleep quality, cleanliness and rooms. Four- and five-star hotels, on the other hand, should prioritize service, cleanliness, room and sleep quality.

Originality/value

OTA platforms collect a wealth of data pertaining to large number of hotels; nevertheless, few studies to date have drawn on this data to examine a pre-determined conceptual framework developed based on the literature. As such, this study makes a valuable methodological contribution to the tourism and hospitality literature. In terms of theoretical contributions, this study examines the mediating role of perceived value between service quality and satisfaction using OTA data. In addition, this study assesses the moderating role of hotel star ratings for the direct and indirect effects of service quality on satisfaction. Using IPMA, this study compares the importance and performance of service quality indicators to generate satisfaction between three-star and four- and five-star hotels.
Government responses to the coronavirus in the United States: immediate remedial actions, rising debt levels and budgetary hangovers
Authors: Joyce Philip G. , Suryo Prabowo Aichiro
Published: September 2020

Purpose

This paper reviews the response of both the national and state governments in the United States to the coronavirus pandemic and discusses budgetary challenges that are likely to be faced by the country over the next several years.

Design/methodology/approach

The paper uses government sources, analysis by internal and external think tanks and contemporaneous media accounts to describe both the problem and the governmental responses.

Findings

Since the first cases appeared in the US in early 2020, and particularly as the numbers started to expand substantially by March of that year, governments at all levels have worked to both respond to the immediate public health crisis and mitigate the economic effects of the pandemic. This included some immediate actions by the Federal Reserve to introduce more liquidity and four separate pieces of legislation passed in March and April 2020. The effect of this legislation has been to add $2.5 tr to 2020 and 2021 deficits. State and local governments, meanwhile, face years of budget shortfalls, which will require them ultimately to raise taxes and cut spending and may also require additional fiscal stimulus from the federal government. The magnitude of the fiscal effects will be driven by whether there is a second wave, how long the recession lasts, and what additional responses will be necessary in order to get the pandemic under control and deal with its aftermath.

Originality/value

The paper is likely the first to summarize the information about the federal and state responses, and the likely future impacts, in a single place.
Cyberloafing in public sector of developing countries: job embeddedness as a context
Authors: Karimi Mazidi Ahmadreza , Rahimnia Fariborz , Mortazavi Saeed , Lagzian Mohammad
Published: September 2020

Purpose

This study aims to investigate the possible negativity of job embeddedness in developing countries. Operationally, the study aimed to configure the relationship between job embeddedness and cyberloafing with respect to both contextual (job satisfaction) and individual (internet addiction) factors.

Design/methodology/approach

Incorporating the conservation of resources theory and reactance theory into the theory of job embeddedness, the present study adopted a resource-based approach to job embeddedness to examine its main and moderated effects on cyberloafing in a three-way interaction model. With the focus on public organizations, 500 administrative employees from an Iranian university were surveyed using self-reporting measures, and the collected data were analyzed using partial least squares–structural equation modeling and hierarchical moderated multiple regression.

Findings

As predicted, job embeddedness was positively associated with cyberloafing; however, in contrast with predictions, job satisfaction had no inverse impact on the job embeddedness–cyberloafing relationship, and its role was limited to neutralizing the increasing effect of internet addiction.

Practical implications

Consideration should be given to how job embeddedness interacts with contextual and individual moderators to affect cyberloafing. In particular, this study implicated some practical procedures to provide employees with on- and off-the-job resources and avoid fighting over the organization's resources. Additionally, this study provides insights into embeddedness-satisfaction interplay to provide employees with propitious work conditions in line with organizational productivity.

Originality/value

There is little research on the association between job embeddedness and counterproductive work behaviors, and the findings are inconsistent. A review of the literature revealed no study addressing cyberloafing implications of job embeddedness. This study expands the literature by theoretically and empirically correlating job embeddedness and cyberloafing in a non-western developing country. Accordingly, the significance of this study is its capability in mitigating cyberloafing behaviors by promoting the adverse job embeddedness.
“Colleague postgraduate supervision” and the production of space in higher education: a duoethnographic analysis
Authors: Madikizela-Madiya Nomanesi , Atwebembeire John Mushomi
Published: September 2020

Purpose

In this paper we contribute knowledge to the postgraduate supervision discourses by reflecting on our socio-spatial experiences of being supervised by colleagues, a process that we refer to as colleague postgraduate supervision (CPS).

Design/methodology/approach

We followed a duoethnographic research design by dialogically presenting and exploring our lived experiences of CPS and critiquing and questioning the meanings we give to those experiences. The experiences shared arose from two different contexts: a contact university and an open distance learning university.

Findings

The reflection suggests that social values of trust, compassion and care in CPS can outrun the spatial constraints for the benefit of the supervisees in the relationship. However, the colleagues in the CPS can also experience some subtle power dynamics and tensions that produce a constraining space, if the CPS process is not well communicated.

Originality/value

While CPS is a common practice in some universities, there is limited research that pays attention to its socio-spatiality, that is, the interaction between the social and the spatial aspects of this practice.
Micro‐geographic shift between negligible and actuarial senescence in a wild snake
Authors: Tully Thomas , Le Galliard Jean‐François , Baron Jean‐Pierre
Published: September 2020

While it has long been known that species have contrasted life expectancy (pace of mortality) and generation time (pace of reproduction), recent studies have also uncovered that the shape of adult age trajectories of mortality and reproduction can vary remarkably among species along a continuum of senescence ranging from strong deterioration (senescence), insignificant deterioration (negligible senescence) to improvement with advancing age (negative senescence).

As for many long‐lived ectotherms with asymptotic growth and increasing reproductive output with age, snakes are good candidates for negligible senescence to occur. Yet, intraspecific variation in the pace and shape of actuarial and reproductive senescence across wild populations of these species remains to be explored.

Here, we used 37 years of mark–recapture data in two nearby habitats inside a meadow viper Vipera ursinii population to quantify life expectancies, generation times and the shape of actuarial and reproductive senescence.

Female vipers maintained stable reproductive performances at old ages, even when accounting for the predicted increase of fertility with body size, providing evidence for negligible reproductive senescence in both habitats.

Males had a higher adult mortality and a shorter life expectancy on average than females and actuarial senescence shifted from negligible senescence in the optimal habitat to strong senescence in the sub‐optimal habitat.

Overall, these results demonstrate that micro‐geographic environmental variation can generate qualitative shifts in actuarial senescence patterns. This highlights that taking into account the within‐species plasticity of age‐dependent trajectories could prove useful in better understanding what determines the evolution of life‐history age trajectories.
Does financial development reduce the size of the informal economy in sub‐Saharan African countries?
Authors: Njangang Henri , Nembot Luc Ndeffo , Ngameni Joseph Pasky
Published: September 2020

This paper contributes to the literature in an attempt to understand the determinants of the informal economy by investigating the relationship between financial development and the size of the informal economy using an unbalanced panel data of 41 sub‐Saharan African (SSA) countries over the period 1991–2015. The paper applies different techniques such as ordinary least squares, fixed effects, system generalized method of moments, and quantile regression. The results show that financial development and its square are important determinants of the informal economy in SSA. Across a number of specifications, we find that financial development reduces the size of the informal economy and that there is a U‐shaped relationship between financial development and the informal economy.
Electoral participation and household food insecurity in sub‐Saharan Africa
Authors: Olabiyi Olayemi M.
Published: September 2020

This paper analyses the impact of household food insecurity on electoral participation in 30 sub‐Sahara African countries with the aid of micro‐level data drawn from the sixth round of the Afrobarometer survey. Estimates from logistic regression indicate that being food insecure reduces the likelihood of electoral participation by 7%. Notably, results from the endogenous binary‐variable regression, which controlled for potential reverse causality, confirm that household food insecurity is a crucial driver of voter turnout in sub‐Saharan Africa. Further analysis reveals that voting behaviour was much higher and statistically significant amongst voters who were intermittently food insecure than those that were always food insecure. Finally, it appears that turnout at national elections depends mostly on the severity of food insecurity. Therefore, it can be argued that the implementation of policies aimed at stemming household food insecurity could play an essential role in increasing voter turnout.
Impact of insect‐resistant transgenic rice on above‐ground non‐target arthropods in Korea
Authors: Amin Md Ruhul , Oh Sung‐Dug , Bae Eunji , Park Soo‐Yun , Suh Sang Jae
Published: September 2020

Transgenic rice (Bt‐T event) shows resistance against rice leaf roller (Cnaphalocrocis medinalis) by expressing a toxic protein (mCry1Ac1) mediated from the soil bacteriumBacillus thuringiensis. Environmental risk assessment of Bt‐T event, in addition to the parent variety Dongjin‐byeo and cultivar Ilmi‐byeo, was performed during the rice cultivation seasons of 2016 and 2017 at LMO quarantine fields in Gunwi and Jeonju, Korea. Non‐target arthropods (insects and spiders) were captured using an aspirator from the three rice ecosystems of both locations, and in total 39,734 individuals of 57 families and 11 orders were collected. The numbers of individuals collected from the Bt‐T, Dongjin‐byeo and Ilmi‐byeo rice ecosystems were 12,899, 12,730, and 14,105, respectively, which did not differ significantly among rice ecosystems. The dominance, diversity, evenness, and richness indices of the collected insects were not statistically different among the rice ecosystems, but significant variations between the two locations and survey years were detected. Principal component analysis showed that insects and spiders in the Bt‐T, Dongjin‐byeo, and Ilmi‐byeo rice ecosystems were separated by the study locations and years irrespective of rice variety. In conclusion, results obtained in two consecutive years from two non‐genetically modified rice ecosystems and a Bt‐T rice ecosystem showed that the Bt‐T rice had no significant negative impacts on the above‐ground insect and spider communities.
Impact of COVID‐19 outbreak on rheumatic patients’ perceptions and behaviors: A cross‐sectional study
Authors: Hassen Lena Mostafa , Almaghlouth Ibrahim A. , Hassen Ikhlass Mostafa , Daghestani Maha H. , Almohisen Amal A. , Alqurtas Eman M. , Alkhalaf Abdulaziz , Bedaiwi Mohammed K. , Omair Mohammed A. , Almogairen Sultan M. , Alarfaj Hussein F. , Alarfaj Abdulrahman S.
Published: September 2020

Aim

The dynamics of coronavirus disease 2019 (COVID‐19) pandemic has become of special concern to the rheumatology community. Rheumatic patients are required to engage in effective health management but their behavior is often influenced by intrinsic and extrinsic factors. This cross‐sectional study aims to examine patients’ experiences during the current pandemic and its implication on their health perception and behavior.

Method

A patient‐centered electronic survey was used, randomly sampling rheumatic patients in Saudi Arabia during March and April 2020. Questions included patients’ socio‐demographics, diseases, medications, COVID‐19 knowledge, source of information, fear level, disease activity perception, health care utilization, medication accessibility, and therapeutic compliance (measured using a modified version of Medication Adherence Reporting Scale). Correlation and regression coefficients were used to evaluate associations among the aforementioned variables.

Results

A total of 637 respondents were included. The majority were rheumatoid arthritis patients (42.7%). Patients' knowledge about COVID‐19 was correlated with social media use (P = .012). Fear of COVID‐19 infection correlated with healthcare facility for follow‐up visits (P = .024) and fear of disease deterioration if contracting the infection correlated with patients’ levels of knowledge (P = .035). Both types of fear did not correlate with patients’ perceptions of disease activity. However, patients’ perceptions of worsened disease activity were correlated with unplanned healthcare visits (P < .001), medication non‐adherence, and difficulty accessing medication (P = .010 and .006, respectively).

Conclusion

The COVID‐19 pandemic and surrounding public health measures could affect rheumatic patients’ health management which might contribute to disease flare‐up and subsequently taxing healthcare systems even further.
Consensus on predictors of clinical deterioration in emergency departments: A Delphi process study
Authors: Boier Tygesen Gitte , Kirkegaard Hans , Raaber Nikolaj , Trøllund Rask Mette , Lisby Marianne
Published: September 2020

Aim

The study aim was to determine relevance and applicability of generic predictors of clinical deterioration in emergency departments based on consensus among clinicians.

Methods

Thirty‐three predictors of clinical deterioration identified from literature were assessed in a modified two‐stage Delphi‐process. Sixty‐eight clinicians (physicians and nurses) participated in the first round and 48 in the second round; all treating hospitalized patients in Danish emergency departments, some with pre‐hospital experience. The panel rated the predictors for relevance (relevant marker of clinical deterioration) and applicability (change in clinical presentation over time, generic in nature and possible to detect bedside). They rated their level of agreement on a 9‐point Likert scale and were also invited to propose additional generic predictors between the rounds. New predictors suggested by more than one clinician were included in the second round along with non‐consensus predictors from the first round. Final decisions of non‐consensus predictors after second round were made by a research group and an impartial physician.

Results

The Delphi‐process resulted in 19 clinically relevant and applicable predictors based on vital signs and parameters (respiratory rate, saturation, dyspnoea, systolic blood pressure, pulse rate, abnormal electrocardiogram, altered mental state and temperature), biochemical tests (serum c‐reactive protein, serum bicarbonate, serum lactate, serum pH, serum potassium, glucose, leucocyte counts and serum haemoglobin), objective clinical observations (skin conditions) and subjective clinical observations (pain reported as new or escalating, and relatives’ concerns).

Conclusion

The Delphi‐process led to consensus of 19 potential predictors of clinical deterioration widely accepted as relevant and applicable in emergency departments.
Anti‐inflammatory treatment rescues memory deficits during aging in nfkb1−/− mice
Authors: Fielder Edward , Tweedy Clare , Wilson Caroline , Oakley Fiona , LeBeau Fiona E. N. , Passos João F. , Mann Derek A. , von Zglinicki Thomas , Jurk Diana
Published: September 2020

Chronic inflammation is a common feature of many age‐related conditions including neurodegenerative diseases such as Alzheimer's disease. Cellular senescence is a state of irreversible cell‐cycle arrest, thought to contribute to neurodegenerative diseases partially via induction of a chronic pro‐inflammatory phenotype. In this study, we used a mouse model of genetically enhanced NF‐κB activity (nfκb1−/−), characterized by low‐grade chronic inflammation and premature aging, to investigate the impact of inflammaging on cognitive decline. We found that during aging, nfkb1−/− mice show an early onset of memory loss, combined with enhanced neuroinflammation and increased frequency of senescent cells in the hippocampus and cerebellum. Electrophysiological measurements in the hippocampus of nfkb1−/− mice in vitro revealed deficits in gamma frequency oscillations, which could explain the decline in memory capacity. Importantly, treatment with the nonsteroidal anti‐inflammatory drug (NASID) ibuprofen reduced neuroinflammation and senescent cell burden resulting in significant improvements in cognitive function and gamma frequency oscillations. These data support the hypothesis that chronic inflammation is a causal factor in the cognitive decline observed during aging.
Non‐native plants and nitrogen addition have little effect on pollination and seed set in 3‐year‐old restored woodland
Authors: Johnson Bridget , Standish Rachel , Hobbs Richard
Published: September 2020

Human activities can disrupt the insect pollination process, which can trigger a decline in pollination and plant reproductive output. Floral visitors are not equally effective pollinators, and it is unknown how multiple changes to an environment further change the effectiveness of insect pollination for native plants. We investigated how herbicide treatment, the presence of non‐native plants and addition of nitrogen fertiliser change the relative importance of different species of floral visitors to four native plant species: Callistemon phoeniceus, Calothamnus quadrifidus, Hakea lissocarpha and Banksia sessilis. Our field site was a large‐scale revegetation site in south‐west Western Australia in which the presence of non‐native plants and nitrogen deposition were experimentally manipulated. Experimental exclusion of floral visitors revealed pollinators were likely required for the seed set of three of the native species, and none of the four plant species were pollen‐limited. We observed 8936 floral visitors of 249 morphospecies from 14 insect orders on four native and two non‐native plant species. From PIV calculations, 57% of floral visitors were potential pollinators, with the remainder considered just visitors due to their low Pollinator Importance Value (PIV). The introduced Apis mellifera (European honey bee, Apidae) was the most frequent floral visitor and the most effective pollinator of all four native plant species. The presence of two non‐native plant species and addition of nitrogen fertiliser did not affect the effectiveness of the potential pollinators, or the viable seeds produced by the four native plant species.
Impact of the COVID‐19 national lockdown on emergency general surgery: Auckland City Hospital's experience
Authors: McGuinness Matthew J. , Hsee Li
Published: September 2020

Background

The New Zealand Government announced a four‐level COVID‐19 alert system soon after the first confirmed case in the country. New Zealand moved swiftly to the highest alert level 4, described as lockdown, as the epidemic curve quickly accelerated. Auckland City Hospital saw a temporary change in acute surgical admissions. The aim of this study is to evaluate the impact of the national lockdown on emergency general surgery.

Methods

A retrospective analysis was performed of all patients admitted to Auckland City Hospital via the Acute Surgical Unit during lockdown from 26 March to 27 April 2020. A comparison group was collected from the 33 days prior to lockdown, 22 February to 25 March 2020.

Results

The number of admissions decreased by 26% (P‐value 0.000). A 56.8% decrease in patients presenting with trauma was found (P‐value 0.002). After exclusion of trauma patients, no statistical difference in discharge diagnosis was found. There was a 43.6% reduction in operations performed (P‐value 0.037). There was a difference found in the management of appendicitis and cholecystitis (P‐value 0.003). Median length of stay was decreased from 1.8 to 1.3 days (P‐value 0.031).

Conclusion

Auckland City Hospital had a decrease in admissions and operations during the COVID‐19 lockdown. These findings suggest people with serious pathology were staying at home untreated or being treated in the community. This is a snapshot of our experience in managing emergency general surgical patients in this unusual period.
Parental Wealth and Children’s Cognitive Ability, Mental, and Physical Health: Evidence From the UK Millennium Cohort Study
Authors: Moulton Vanessa , Goodman Alissa , Nasim Bilal , Ploubidis George B. , Gambaro Ludovica
Published: September 2020

This article investigates the influence of wealth, a frequently neglected aspect of the economic circumstances of families, on children’s development. Using the UK Millennium Cohort Study, it explores whether parental wealth (net total wealth, net housing wealth, net financial wealth, and house value) is associated with children’s cognitive ability, mental, and physical health at age 11 (N = 8,645), over and above parental socioeconomic status and economic resources, in particular permanent income. Housing wealth was associated with fewer emotional and behavioral problems, independent of the full set of controls. Children’s verbal cognition and general health were more strongly associated with family permanent income and socioeconomic characteristics than with wealth.
Gut microbiota interacts with intrinsic brain activity of patients with amnestic mild cognitive impairment
Authors: Liu Ping , Jia Xi‐Ze , Chen Yi , Yu Yang , Zhang Kan , Lin Ya‐Jie , Wang Bao‐Hong , Peng Guo‐Ping
Published: September 2020

Aims

To explore the potential relationships among gut microbiota (GM), local brain spontaneous activity, and neuropsychological characteristics in amnestic mild cognitive impairment (aMCI) patients.

Methods

Twenty aMCI and 22 healthy control (HC) subjects were recruited. The GM composition was determined by 16S ribosomal RNA gene sequencing. Resting‐state functional magnetic resonance imaging scans were performed, and fractional amplitude of low‐frequency fluctuations (fALFF) was calculated across different frequencies. The Spearman or Pearson correlation analysis was used to analyze the relationship between spontaneous brain activity and cognitive function, and GM composition.

Results

aMCI patients had altered GM state and local spontaneous brain activity as compared with HC subjects. Correlation analysis showed that aMCI and HC groups had different “GM‐intrinsic brain activity interaction” patterns. In aMCI group, at the typical band (0.01‐0.08 Hz), the relative abundance (RA) of Bacteroides from phylum to genus level was negatively correlated with fALFF value of cerebellar vermis IV‐V, and the Ruminococcaceae RA was negatively correlated with fALFF values of left lenticular nucleus and pallidum. The Clostridiaceae RA and Blautia RA were positively correlated with the left cerebellum lobules IV‐V at the slow‐4 band (0.027‐0.073 Hz). The Veillonellaceae RA was positively correlated with fALFF values of left precentral gyrus at the slow‐5 band (0.073‐0.08 Hz). Correlation analysis showed that Clostridium members (Lachnospiraceae and Blautia) were positively, while Veillonellaceae was negatively, correlated with cognition test. Bacteroides was positively correlated with attention and computation, and negatively correlated with the three‐stage command score.

Conclusions

aMCI patients have a specific GM‐intrinsic brain activity‐cognitive function interaction pattern.
Acceptance of and six‐month adherence to continuous positive airway pressure in patients with moderate to severe obstructive sleep apnea
Authors: Luo Kun , Zhang Li , Zhang Xiaolei , Han Teng , Li Yiming , Wang Chen
Published: September 2020

Background

Continuous positive airway pressure (CPAP) is the most effective treatment for moderate to severe obstructive sleep apnea (OSA). Acceptance of and adherence to CPAP are crucial for optimal treatment outcomes. The aim of this study was to investigate the factors influencing patients’ acceptance of and adherence to CPAP treatment.

Methods

One hundred eighty‐eight patients with moderate to severe OSA who had received CPAP titration from October 2017 to September 2018 were recruited. They were interviewed at 2 weeks and at 6 months to assess CPAP use and barriers to acceptance and adherence.

Results

One hundred fourteen patients (60.6%) accepted CPAP treatment. Disease severity, assessed by apnea‐hypopnea index (AHI) (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.01‐1.08), subjective satisfaction of titration (OR, 12.83; 95% CI, 3.83‐42.99), initial intention of CPAP therapy (OR, 3.33; 95% CI, 1.05‐10.51) and short‐term home CPAP trial (OR, 9.40; 95% CI, 2.85‐31.08) were associated with acceptance of CPAP treatment. Two‐third of the 98 CPAP acceptors reported good CPAP adherence at 6 months follow‐up. Average hours of CPAP use per day for the first 2 weeks (OR, 1.88; 95% CI, 1.28‐3.04) and the global problems associated with CPAP use (OR, 0.82; 95% CI, 0.73‐0.91) were independent predictors of the six‐month CPAP adherence.

Conclusions

Nearly 40% of patients with moderate to severe OSA did not accept CPAP treatment, and one‐third of those CPAP acceptors had poor adherence to CPAP treatment. Improvement in disease awareness, comfortable titration experience, short‐term home CPAP trial may be of help to increase CPAP acceptance and early experience with CPAP is important for long‐term adherence. The differences in predicting factors for CPAP acceptance and adherence highlight the importance of focusing on specific aspects during the whole process management of OSA.
Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events
Authors: Hughes Dempsey L. , Rice Jonathan D. , Burton James R. , Jin Ying , Peterson Ryan A. , Ambardekar Amrut V. , Pomposelli James J. , Pomfret Elizabeth A. , Kriss Michael S.
Published: September 2020

The impact of coronary artery disease (CAD) among liver transplant candidates (LTC) on post‐LT clinical outcomes remains unclear. The aim of this study is to determine association of presence and severity of CAD on post‐LT major adverse cardiac events (MACE) including cardiac‐associated mortality. We conducted a retrospective cohort analysis of 231 patients who underwent diagnostic coronary angiogram (DCA) during their LT evaluation at a tertiary medical center from 2012‐2017. Patients were analyzed based on degree of CAD (no CAD, non‐obstructive CAD [< 50% stenosis], obstructive CAD [≥50% stenosis]) per DCA results. MACE were noted at 30 days, 1 year, 3 years, and 5 years post‐LT, and Kaplan‐Meier curves were used to determine post‐LT MACE‐free probability. LTC with any CAD, including non‐obstructive CAD, had lower MACE‐free probability at all post‐LT time points (0.94 vs 0.65 at 30 days, P = .001; 0.87 vs 0.59 at 1 year, P = .002; 0.87 vs 0.41 at 3 years, P < .001; 0.87 vs 0.37 at 5 years, P < .001). Identification of and medical intervention for non‐obstructive CAD should be considered in all LTC, though further studies are necessary to determine optimal medical interventions to mitigate MACE risk in this cohort.
Coronary artery disease in lung transplant patients
Authors: Sinha Neeraj , Balayla Galit , Braghiroli Joao
Published: September 2020

Coronary artery disease (CAD) is a pathology often found in patients with end‐stage lung disease. Although in the past CAD might have been considered an absolute contraindication, modern revascularization techniques have helped increase the number of transplants performed in this population. However, discrepancies in the guidelines for perioperative evaluation and risk mitigation strategies for the ischemic cardiac burden are present in the current literature. This is a review of the available data regarding perioperative evaluation, revascularization tactics, postoperative management, and survival rate that patients with different grades of coronary artery disease present after lung transplantation.
Acute heart failure after liver transplantation: A narrative review
Authors: Sharma Sonal , Sonny Abraham , Dalia Adam A. , Karamchandani Kunal
Published: September 2020

Acute heart failure (AHF) is an under recognized yet potentially lethal complication after liver transplantation (LT) surgery. The increase in incidence of liver transplantation amongst high‐risk patients and the leniency in the criteria for transplantation, predisposes these patients to postoperative AHF and the antecedent morbidity and mortality. The inability of conventional preoperative cardiovascular testing to accurately identify patients at risk for post‐LT AHF poses a considerable challenge to clinicians caring for these patients. Even if high‐risk patients are identified, there is considerable ambiguity in the candidacy for transplantation as well as optimization strategies that could potentially prevent the development of AHF in the postoperative period. The intraoperative and postoperative management of patients who develop AHF is also challenging and requires a well‐coordinated multidisciplinary approach. The use of mechanical circulatory support in patients with refractory heart failure has the potential to improve outcomes but its use in this complex patient population can be associated with significant complications and requires a stringent risk‐benefit analysis on a case‐by‐case basis.
SARS‐CoV‐2 infection among patients with haematological disorders: Severity and one‐month outcome in 66 Danish patients in a nationwide cohort study
Authors: Glenthøj Andreas , Jakobsen Lasse H. , Sengeløv Henrik , Ahmad Syed A. , Qvist Kristian , Rewes Annika , Poulsen Christian B. , Overgaard Ulrik M. , Mølle Ingolf , Severinsen Marianne T. , Strandholdt Casper N. , Maibom Jack , Kodahl Annette R. , Ryg Jesper , Ravn Pernille , Johansen Isik S. , Helsø Søren N. , Jensen‐Fangel Søren , Kisielewicz Jacek , Wiese Lothar , Helleberg Marie , Kirk Ole , Clausen Michael R. , Frederiksen Henrik
Published: September 2020

Objectives

Patients with haematological disorders may be particularly vulnerable to respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection; however, this is unknown.

Methods

We conducted a prospective, nationwide study including 66 patients in follow‐up at Danish haematology departments with a malignant or non‐malignant haematological disorder and with verified SARS‐CoV‐2 infection. Outcomes were intensive care unit (ICU) admission and one‐month survival rate.

Results

Mean age was 66.7 years, 60.6% were males, 90.9% had comorbidity, and 13.6% had a BMI ≥ 30. The most frequent diagnoses were chronic lymphocytic leukaemia/lymphoma (47.0%), multiple myeloma (16.7%) and acute leukaemia/myelodysplastic syndrome (AL/MDS) (12.1%). Treatment for the haematological disease was ongoing in 59.1% of cases. Neutropenia was present in 6.5%, lymphopenia in 46.6% and hypogammaglobulinaemia in 26.3%. The SARS‐CoV‐2 infection was mild in 50.0%, severe in 36.4% and critical in 13.6%. After one month, 21.2% had been admitted to ICU, and 24.2% died. Mortality was highest in older patients, patients with severe/critical SARS‐CoV‐2 infection, high comorbidity score or high performance status score, purine analogue treatment and with AL/MDS. Although older patients and patients with comorbidities had the highest mortality rates, mortality was considerable among all haematological patients.

Conclusion

Haematological patients with SARS‐CoV‐2 infection has a severe clinical course.