bluuebunny/crossref_metadata_2025 huggingface dataset:
Pre-equilibrium biosensors: A new approach towards rapid and continuous molecular measurements
Authors: Maganzini Nicolò , Thompson Ian , Wilson Brandon , Soh Hyongsok Tom
Published: March 2022

Almost all biosensors that use ligand-receptor binding operate under equilibrium conditions. However, at low ligand concentrations, the equilibration with the receptor (e.g., antibodies and aptamers) become slow and thus equilibrium-based biosensors are inherently limited in making measurements that are both rapid and sensitive. In this work, we provide a theoretical foundation for a novel method through which biosensors can quantitatively measure ligand concentration before reaching equilibrium. Rather than only measuring receptor binding at a single time-point, the pre-equilibrium approach leverages the receptor’s kinetic response to instantaneously quantify the changing ligand concentration. Importantly, analyzing the biosensor output in frequency domain, rather than in the time domain, we show the degree to which noise in the biosensor affects the accuracy of the pre-equilibrium approach. Through this analysis, we provide the conditions under which the signal-to-noise ratio of the biosensor can be maximized for a given target concentration range and rate of change. As a model, we apply our theoretical analysis to continuous insulin measurement and show that with a properly selected antibody, the pre-equilibrium approach could make the continuous tracking of physiological insulin fluctuations possible.
Intact maternal buffering of stress response in infant rats despite altered responsivity towards maternal olfactory cues in the valproic acid model of autism-like behavior
Authors: White Amanda M. , An Xianli , Debiec Jacek
Published: March 2022

Disrupted processing of social cues and altered social behaviors are among the core symptoms of autism spectrum disorders (ASDs), and they emerge as early as the first year of life. These differences in sensory abilities may affect the ability of children with ASDs to securely attach to a caregiver and experience caregiver buffering of stress. Prenatal exposure to valproic acid (VPA) has been used to model some aspects of ASDs in rodents. Here, we asked whether prenatal VPA exposure altered infant rats’ behavioral responsivity to maternal olfactory cues in an odor preference test and affected maternal buffering of infants’ stress responsivity to shock. In the odor preference test, one-week old rats treated with VPA during pregnancy appeared to have impaired social recognition and/or may be less motivated to approach social odors in early infancy. These effects were particularly prominent in female pups. In two-week old rats, VPA-exposed pups and saline-exposed pups showed similar preferences for home cage bedding. Although VPA-exposed pups may initially have a deficit in this attachment-related behavior they do recover typical responses to home cage bedding in later infancy. Both control and VPA-exposed pups showed robust stress hormone responses to repeated shocks, an effect which was blocked when a calm mother was present during shock exposure. No sex differences in the effect of maternal presence on the stress response to shock and no interactions between sex and prenatal drug exposure were observed. Although VPA-exposed pups may show impaired responsivity to maternal cues in early infancy, maternal presence is still capable of regulating the stress response in VPA-exposed pups. In this study we demonstrate the importance of utilizing multiple batteries of tests in assessing behavior, dissecting the behavior on one test into different components. Our results inform about the underlying behavioral characteristics of some of the ASD phenotypes, including sex differences reported by clinical studies, and could shed light on potential opportunities for intervention.
Building community resilience during COVID‐19: Learning from rural Bangladesh
Authors: Ahmad Farooq , Chowdhury Rashedur , Siedler Benjamin , Odek Wilson
Published: March 2022

The COVID‐19 pandemic has brought overwhelming challenges to developing countries which are already resource‐constrained and lack adequate social safety nets. Specifically, lockdown has adversely impacted marginalized communities (e.g., labourer, fish wholesaler and small business owner) and informal sector employees who rely on meager daily wages for their survival. Set in the contested climate of the emergency response to the COVID‐19 outbreak in Phulbari, Dinajpur, Bangladesh, we examine the early response of the community to the pandemic. Drawing on 24 in‐depth interviews with members of this community, we find that the existing central and regional government structure has failed to deal with the crisis. Yet, we show how collective effort at the local community level, led by volunteers and community leaders, is crucial in the fight against hardship during lockdown.
Using a structural vulnerability framework to understand the impact of COVID‐19 on the lives of Medicaid beneficiaries receiving substance use treatment in New York City
Authors: Zhen‐Duan Jenny , Gade Neerav , Falgas‐Bagué Irene , Sue Kimberly L. , DeJonckheere Melissa , Alegría Margarita
Published: March 2022

Objective

To investigate how the COVID‐19 pandemic impacted low‐income individuals with substance use disorder (SUD) in New York City (NYC) during the beginning of the pandemic, using a structural competency and structural vulnerability theoretical framework and a qualitative research approach.

Data Sources

Primary qualitative data were collected from racial/ethnic minority adults enrolled in Medicaid receiving outpatient substance use treatment (e.g., medication, counseling) in NYC.

Study Design

Semi‐structured in‐depth qualitative interviews (N = 20) were conducted during “stay‐at‐home” orders in NYC, the first epicenter of the COVID‐19 pandemic in the United States. Interviews were conducted over the phone during the earlier stages of the pandemic, between April 2020 and June 2020.

Data Collection/Extraction Methods

Semi‐structured in‐depth interviews were conducted and audio recorded, transcribed, and analyzed using a thematic analysis approach.

Principal Findings

Three themes were yielded from our thematic analysis: (1) COVID‐19 heightened food insecurity and housing conditions increased risks of infection; (2) stay‐at‐home orders limited access to resources but had positive impacts in strengthening social relationships and reducing substance use triggers; and (3) although COVID‐19 created challenges for treatment, most described that SUD care improved during the pandemic.

Conclusions

While COVID‐19 exacerbated numerous structural vulnerabilities among low‐income individuals with SUD, programmatic adaptations to COVID‐19 SUD care, including telehealth and loosening restrictions around medications for opioid use disorders mitigated past difficulties that patients had faced. Reducing structural vulnerabilities for Medicaid patients will require continuation of telehealth treatment delivery, retaining flexible medication regulations, and mobilizing community resources to mitigate economic disparities.
Application of emerging technologies to obtain legume protein isolates with improved techno‐functional properties and health effects
Authors: Bou Ricard , Navarro‐Vozmediano Paola , Domínguez Rubén , López‐Gómez Miguel , Pinent Montserrat , Ribas‐Agustí Albert , Benedito José J. , Lorenzo José M. , Terra Ximena , García‐Pérez José V. , Pateiro Mirian , Herrera‐Cervera José A. , Jorba‐Martín Rosa
Published: March 2022

Current demand of consumers for healthy and sustainable food products has led the industry to search for different sources of plant protein isolates and concentrates. Legumes represent an excellent nonanimal protein source with high‐protein content. Legume species are distributed in a wide range of ecological conditions, including regions with drought conditions, making them a sustainable crop in a context of global warming. However, their use as human food is limited by the presence of antinutritional factors, such as protease inhibitors, lectins, phytates, and alkaloids, which have adverse nutritional effects. Antitechnological factors, such as fiber, tannins, and lipids, can affect the purity and protein extraction yield. Although most are removed or reduced during alkaline solubilization and isoelectric precipitation processes, some remain in the resulting protein isolates. Selection of appropriate legume genotypes and different emerging and sustainable facilitating technologies, such as high‐power ultrasound, pulsed electric fields, high hydrostatic pressure, microwave, and supercritical fluids, can be applied to increase the removal of unwanted compounds. Some technologies can be used to increase protein yield. The technologies can also modify protein structure to improve digestibility, reduce allergenicity, and tune technological properties. This review summarizes recent findings regarding the use of emerging technologies to obtain high‐purity protein isolates and the effects on techno‐functional properties and health.
Sperm‐oviduct interactions: Key factors for sperm survival and maintenance of sperm fertilizing capacity
Authors: Kölle Sabine
Published: March 2022

Background

Although millions or even billions of sperm are deposited in the female genital tract, only very few sperm reach the oocyte, and only one single spermatozoon will successfully fertilize. During the journey of the sperm within the female genital tract, the interactions between spermatozoa and fallopian tube are critical for sperm selection, sperm survival, and maintenance of sperm fertilizing capacity.

Results

This review will provide a comprehensive overview of the latest findings regarding sperm transport and behavior of sperm within the oviduct, sperm selection in the oviduct, the formation of the sperm reservoir, and the release of sperm in the presence of the oocyte. It will primarily focus on recent novel insights on sperm‐oviduct interactions, which have been obtained by cutting‐edge technologies under in vivo or near in vivo conditions.

Conclusions

The comprehensive analysis of the findings to date will elucidate the complex molecular changes in the tubal epithelium, which are induced by the presence of the sperm and will highlight how the epithelial cells of this organ affect transport, behavior, and function of sperm. This knowledge is essential for scientists and clinicians involved in assisted reproductive technologies.
A survey among healthcare professionals from seven countries reported diverse nutritional practices of late preterm infants
Authors: Cheang Hon Kit , Yeung Chun‐Yan , Cheah Irene , Tjipta Guslihan Dasa , Lubis Bugis Mardiana , Garza‐Bulnes Raul , Delgado‐Franco Dagoberto , Ayede Adejumoke Idowu , Ezeaka Chinyere V. , Al Mohammad Abullah Mamun , Owolabi Adedotun , Schaafsma Anne , Kudla Urszula , Muhardi Leilani , Low Jia Ming , Lee Le Ye
Published: March 2022

Aim

To gain insight into nutritional practices and expected growth outcomes of infants born between 34 and 36 gestational weeks defined as late preterm infants (LPT).

Methods

An anonymous online survey among paediatricians and neonatologists from Bangladesh, Indonesia, Mexico, Nigeria, Malaysia, Singapore and Taiwan was conducted from March until October 2020. The questionnaire consisted of 40 questions on the nutritional management and expected growth outcomes of LPT in and after‐hospital care.

Results

Healthcare professionals from low to high Human Development (HDI) countries (n = 322) and very high HDI countries (n = 169) participated in the survey. Human milk was the preferred feeding, resulting in an adequate growth of LPT (weight, length and occipitofrontal circumference), according to a majority of respondents (low to high HDI, 179/265, 68% vs. very high HDI, 73/143, 51%; p = 0.002). The expected growth outcome was higher after‐hospital discharge. Less than half of healthcare professionals started enteral feeding during the 1st hour of life. Lactation difficulties, limited access to human milk fortifiers and donor human milk, especially among low to high HDI countries, were reported as major hurdles.

Conclusion

Human milk is the first feeding choice for LPT. The diverse opinions on nutritional practices and expected growth outcomes among healthcare professionals indicate the necessity to develop general nutritional guidelines for LPT.
Assessing the quality of acne and rosacea treatment information on YouTube
Authors: Gorrepati Pavane L. , Smith Gideon P.
Published: March 2022

Cutaneous lupus erythematosus has different manifestation depending on the type. In this study, discoid lupus, extensive skin lesions, fairer skin types and scalp involvement were found to be positive predictive factors for more severe disease.
Topical steroid withdrawal through the lens of social media
Authors: Bowe Stephanie , Masterson Sophie , Murray Gregg , Haugh Isabel
Published: March 2022

The term ‘topical steroid withdrawal’ (TSW) describes an adverse effect that generally occurs with inappropriate prolonged use of high-potency topical corticosteroids (TCS). The presence of user-generated content relating to TSW on social media (SoMe) has not been well-defined to date. We aimed to explore content relating to topical steroid withdrawal on SoMe. Using a data analytics platform, we retrospectively analysed the hashtag #topicalsteroidwithdrawal on SoMe over a 5-year period from 8 February 2016 until 8 February 2021. We assessed interactions, performance, shares, likes, mentions, language and country of origin using descriptive statistics. Across all SoMe platforms, there was a 274% increase in mentions of the hashtag #topicalsteroidwithdrawal in the year 2020 (n = 7992) compared with the year 2016 (n = 2138). The top associated hashtags included #TSW, #eczema and #topicalsteroidaddiction. On Instagram, we found a 288% increase in number of mentions and a 592% increase in performance of #topicalsteroidwithdrawal in 2020 (n = 618 354) compared with 2016 (n = 89 390). Our results confirm an increase in the presence of user-generated content relating to TSW on SoMe and also highlight its extent. Large numbers of patients are exposed to this content, which could influence their engagement with TCS.
Emollient prescribing formularies and guidelines in England, 2021: a cross-sectional study
Authors: Amakye Nana Yaa T. , Chan Jonathan , Ridd Matthew J.
Published: March 2022

Background

Emollients are a mainstay of treatment for dry skin conditions. In the UK, prescribers are usually expected to follow local National Health Service (NHS) formularies. A previous study in 2018 showed that the recommended emollients across England and Wales varied widely. Evidence has since emerged that bath additives provide no additional clinical benefit in eczema.

Aim

To compare emollient formularies and guidelines in England.

Methods

Clinical Commissioning Group (CCG) formularies and guidelines were identified in April–May 2021, compiled and then analysed descriptively.

Results

In total, 105 CCGs, 72 emollient formularies and 47 emollient prescribing guidelines were identified. There were internal inconsistencies between formularies and their accompanying guidelines in 19% of cases. The majority (68%) of formularies/guidelines were organized using a ranking system. In total, 126 different leave-on emollients were named. Creams and ointments were universally available and were the most recommended first-line types. Cost was more likely than patient choice to be recommended as a criterion for selecting which emollient to prescribe. Aqueous cream was the leave-on emollient most commonly not recommended. Nearly three-quarters (74%) of formularies stated that bath additives should not be prescribed.

Conclusion

All CCGs in England have an emollient formulary/guideline, but there is still great variability between them in their recommendations. Although the number of formularies/guidelines has reduced since 2017, there has been an increase in the total number of unique recommended leave-on emollients. Most CCGs are no longer recommending bath emollients for eczema.
A simple modification to prevent the cross-infection by dermoscopy
Authors: Zhang Li-wen , Fu Li-xin , Wang Wen-ju , Chen Tao
Published: March 2022

Because sterilization of imaging probes is commonly impossible, the issue of probe contamination and cross-infection becomes an issue when using dermoscopy in the clinic. We describe a simple modification to reduce cross-infection during dermoscopy.
Immunophenotypic profile of macrophages in generalized pustular psoriasis and deficiency of the interleukin-36 receptor antagonist
Authors: Magalhães Renata Ferreira , Assis Gabriela Della Ripa Rodrigues , Espindola Ana Cecília Versiani Duarte , Witzler Maria Luiza Camprigher , Anton Andreea , Kubba Faris , Cintra Maria Letícia , Teixeira Fernanda
Published: March 2022

M2 macrophages are copious in generalized pustular psoriasis (GPP). M2 macrophages seem to acquire new skills and share common characteristics in GPP. HAM56 may play a role in attracting immature neutrophils to the inflammatory environment in GPP.
Perceptual learning modules in undergraduate dermatology teaching
Authors: Salava Alexander , Salmela Viljami
Published: March 2022

Background

Dermatological diagnosis depends highly on visual skills, and implicit nonanalytical proficiency plays a key role. To correctly diagnose skin diseases, the clinician needs visual skills, and intuitive recognition plays a key role.

Aim

To investigate the effectiveness of digital perceptual learning modules (PLMs) in undergraduate teaching, and how these affect medical students' learning about skin diseases.

Methods

This was a study performed in Finland, which enrolled 39 students of an undergraduate dermatology course. Online PLMs designed for dermatology, using different pictures of skin diseases were performed three times: before, during and at the end of the course. The modules provided four outcome measures: diagnostic accuracy (percentage of correct responses), a rating of confidence about the decision, fluency (response/decision time) and a list of features on which the decision was based.

Results

As the number of PLMs and the course duration increased, there were also improvements in the four measures, with a significant increase in diagnostic accuracy [from 66% to 94%; P < 0.001; partial η2 (η2p) = 0.92], fluency (as measured by a decrease in response time (from 10 to 6 s; P < 0 0.001; η2p = 0.69) and self-perceived confidence (2.5 to 4.3; P < 0 0.001, η2p = 0.86) with subsequent PLMs and course duration. There was a diversification of recognized features, an increase in pattern recognition, and better attention to localization and contextual association. Based on student feedback, the PLMs functioned well online, and enhanced motivation and learning.

Conclusion

PLMs increased diagnostic accuracy, had a positive effect on learning outcomes and were easily integrated alongside clinical teaching. Considering the current era of digital technologies, we believe that there is potential for wider use of PLMs to improve visual skills and strengthen implicit learning in dermatology.
Development of upper visual field bias for faces in infants
Authors: Tsurumi Shuma , Kanazawa So , Yamaguchi Masami K. , Kawahara Jun‐ichiro
Published: March 2022

The spatial location of the face and body seen in daily life influences human perception and recognition. This contextual effect of spatial locations suggests that daily experience affects how humans visually process the face and body. However, it remains unclear whether this effect is caused by experience, or innate neural pathways. To address this issue, we examined the development of visual field asymmetry for face processing, in which faces in the upper visual field were processed preferentially compared to the lower visual field. We found that a developmental change occurred between 6 and 7 months. Older infants aged 7–8 months showed bias toward faces in the upper visual field, similar to adults, but younger infants of 5–6 months showed no such visual field bias. Furthermore, older infants preferentially memorized faces in the upper visual field, rather than in the lower visual field. These results suggest that visual field asymmetry is acquired through development, and might be caused by the learning of spatial location in daily experience.
Care in Europe after presenting to the emergency department with a seizure; position paper and insights from the European Audit of Seizure Management in Hospitals
Authors: Taylor Claire , Tudur‐Smith Catrin , Dixon Pete , Linehan Christine , Gunko Aleksei , Christensen Jakob , Pearson Mike , Tomson Torbjorn , Marson Anthony ,   the ESBACE consortium and EuroNASH collaborators
Published: March 2022

Background and purpose

This position paper makes recommendations following an audit of care provided to people presenting with a seizure to emergency departments (EDs) in Europe.

Methods

Participating countries were asked to include five hospitals agreeing to identify 50 consecutive seizure patients presenting to their ED between 1 August 2016 and 31 August 2017. Anonymous data were collected to a web database. Where quoted, percentages are mean site values and ranges are the 10th–90th centile.

Results

Data were collected on 2204 ED visits (47 sites, up to six per country, across 15 countries): 1270 (58%) known epilepsy, 299 (14%) previous blackouts but no epilepsy diagnosis, 634 (29%) with a first seizure. Wide variability was identified for most variables. Of those with known epilepsy, 41.2% (range 26.2%–59.6%) attended the ED in the previous 12 months, but only 64.7% (range 37.2%–79.8%) had seen an epilepsy specialist in the previous 12 months. 67.7% (range 34.0%–100%) were admitted, 53.1% to a neurology ward (range 0.0%–88.9%). Only 37.5% first seizure patients (range 0.0%–71.4%) were given advice about driving.

Conclusions and recommendations

It is recommended that in Europe guidance is agreed on the management and onward referral of those presenting to the ED with a seizure; a referral process is created that can be easily implemented; it is ensured that the seizure services receive referrals and see the patients within a short time period; and a simple system is developed and implemented to allow continuous monitoring of key indices of epilepsy care.
The effect of trait‐based diversity on productivity results mainly from intraspecific trait variability in the macrophyte community
Authors: Ma Fei , Zuo Zhenjun , Yang Lei , Li Dexiang , Wang Huiyuan , Li Fuchao , Fan Shufeng , Liu Chunhua , Yu Dan
Published: March 2022

Trait‐based methods are key to understanding the biodiversity–productivity relationship (BPR) of macrophyte communities. Community‐weighted mean traits (i.e., community trait structure) have been proven to have more influence on macrophyte community productivity than species richness. However, the underlying mechanism by which community trait structure variation affects macrophyte community productivity along an environmental gradient is still not well understood.

A mesocosm experiment was used to investigate how community trait structure shapes macrophyte community productivity along the water depth gradient. Three submerged macrophyte species (Myriophyllum spicatum, Vallisneria natans and Potamogeton malaianus) were assembled into all possible combinations (one, two and three species per community) at three different water depths (1, 2.5 and 4 m). We fitted the relationships between community‐weighted mean traits and community productivity, and between species richness and community productivity as a comparison. We compared functional traits under different water depths and species composition at the species and community levels and disentangled the community trait structure into species turnover and intraspecific trait variability effects.

The results showed that community trait structure had various influences on macrophyte community productivity, which was based on traits per se. However, species richness had a non‐significant impact on macrophyte community productivity. Water depth had a significant impact on most traits of the three species at the species level, whereas both water depth and species composition had significant impacts on community trait structure which was mainly affected by intraspecific trait variability along the water depth gradient.

Our findings highlight the importance of considering intraspecific trait variability and species turnover under water depth gradients to understand the relationship between trait‐based biodiversity and productivity.
High spatiotemporal variability of methane concentrations challenges estimates of emissions across vegetated coastal ecosystems
Authors: Roth Florian , Sun Xiaole , Geibel Marc C. , Prytherch John , Brüchert Volker , Bonaglia Stefano , Broman Elias , Nascimento Francisco , Norkko Alf , Humborg Christoph
Published: March 2022

Coastal methane (CH4) emissions dominate the global ocean CH4 budget and can offset the “blue carbon” storage capacity of vegetated coastal ecosystems. However, current estimates lack systematic, high‐resolution, and long‐term data from these intrinsically heterogeneous environments, making coastal budgets sensitive to statistical assumptions and uncertainties. Using continuous CH4 concentrations, δ13C‐CH4 values, and CH4 sea–air fluxes across four seasons in three globally pervasive coastal habitats, we show that the CH4 distribution is spatially patchy over meter‐scales and highly variable in time. Areas with mixed vegetation, macroalgae, and their surrounding sediments exhibited a spatiotemporal variability of surface water CH4 concentrations ranging two orders of magnitude (i.e., 6–460 nM CH4) with habitat‐specific seasonal and diurnal patterns. We observed (1) δ13C‐CH4 signatures that revealed habitat‐specific CH4 production and consumption pathways, (2) daily peak concentration events that could change >100% within hours across all habitats, and (3) a high thermal sensitivity of the CH4 distribution signified by apparent activation energies of ~1 eV that drove seasonal changes. Bootstrapping simulations show that scaling the CH4 distribution from few samples involves large errors, and that ~50 concentration samples per day are needed to resolve the scale and drivers of the natural variability and improve the certainty of flux calculations by up to 70%. Finally, we identify northern temperate coastal habitats with mixed vegetation and macroalgae as understudied but seasonally relevant atmospheric CH4 sources (i.e., releasing ≥ 100 μmol CH4 m−2 day−1 in summer). Due to the large spatial and temporal heterogeneity of coastal environments, high‐resolution measurements will improve the reliability of CH4 estimates and confine the habitat‐specific contribution to regional and global CH4 budgets.
Implementation of the Recovery Guide in inpatient mental health services in Sweden—A process evaluation study
Authors: Bejerholm Ulrika , Allaskog Conny , Andersson Jessica , Nordström Linda , Roe David
Published: March 2022

Background

Involving service users in inpatient care and recovery planning has gained interest worldwide. Our purpose was to evaluate the process of implementation of a coproduced Recovery Guide (RG) intervention in 22 inpatient wards in Sweden, in terms of context, implementation process and mechanisms of impact over 12 months.

Methods

A mixed method design and a process evaluation framework were used to guide data collection and to deductively analyze perspectives and descriptive statistics of delivery from three stakeholder groups.

Results

Results showed that although initial contextual barriers were present (e.g., lack of resources, and interest, uncertainty in the organization, a dominant illness perspective), it was possible to implement the RG in 14 wards, where 53% of admitted service users received the intervention. Legitimacy of the intervention, engaged managers and staff, capacity of staff and ward organization, coproduction and continuous support from user organization were critical mediators. Mechanisms of impact concerned (1) a new perspective on mental health, well‐being and recovery, (2) capacity building of a recovery approach in inpatient settings and (3) a meaningful outlet for users' thoughts and feelings on recovery, sharing narratives and influencing care and goals.

Conclusions

The RG intervention has the potential to promote a recovery approach in inpatient mental health services (MHSs). Coproduction among stakeholders created trust and a sustainable implementation that made it possible for wards to resume implementation when contextual barriers had been resolved.

Patient and Public Contribution

The current study involved stakeholders including a service user organization, the public, first‐line managers and staff (including peer support workers) in inpatient and community MHS and researchers, who greatly contributed to the implementation programme, including codesign of the RG intervention as well as coproduction of the implementation in inpatient MHS. All authors have their own lived experiences of mental health problems as a service user or as a relative.
Representation in participatory health care decision‐making: Reflections on an Application‐Oriented Model
Authors: Holetzek Tim , Holmberg Christine
Published: March 2022

Context

The involvement of lay people in health care decision‐making processes is now the norm in many countries. However, one important aspect of participation has not received sufficient attention in the past and remains underexplored: representation.

Objective

This paper explores the question of how public participation efforts in collective health care decision‐making processes can attempt to aim for legitimate representation so that those individuals or groups not present can be taken into account in the decisions affecting them. This paper argues that to make decisions that effectively address those affected, representation needs to be seen as a relevant part of any participatory setting. To support this argument, the paper outlines the concepts of participation and representation and transfers them to health care contexts.

Results

A conceptual reflection on responsiveness and the characteristics of representative actors in representative‐participatory settings is introduced, which could provide actors planning to conduct participatory health care projects with tools to reflect on the merits and possible flaws of participatory constellations.

Patient or Public Contribution

The paper contributes to improving public participation in health care decision‐making.
Novels and newspapers in Piketty's Capital and Ideology
Authors: Tworek Heidi
Published: March 2022

This article explores the use of textual sources in Thomas Piketty's Capital and Ideology as seriously as others have examined Piketty's use of statistics. Although a commendable attempt to engage with non‐quantitative sources, the book focuses on elite novels, selects works unsystematically, and takes an old‐fashioned approach to media. Ironically, Piketty's use of literature perpetuates the same focus on the upper classes that he wishes to guard against. In this response, I suggest how a book on capital and ideology might examine novels and newspapers rigorously. First, I look at how a broader understanding of literary production as a business and a focus on non‐elite books might inform the use of novels. Second, I consider how to employ big‐data techniques to study newspapers. Overall, I argue, taking novels and newspapers seriously shows the importance of non‐elite sources and of incorporating big‐data techniques often pioneered by literary scholars.
Clinical outcomes of HIV–syphilis coinfection among patients with no neurological symptoms: a retrospective cohort study
Authors: Henriques Barbara L. , Cortez André L. , Nunes Nathália N. , Vidal José E. , Avelino‐Silva Vivian I.
Published: March 2022

Objective

Our objective was to describe and compare the occurrence of neurological outcomes and neurosyphilis in people living with HIV with incident syphilis and no neurological symptoms who underwent early screening for asymptomatic neurosyphilis (ANS) or regular clinical management without a lumbar puncture.

Methods

This was a retrospective cohort study in a single referral centre of Sao Paulo, Brazil. Patients with incident syphilis diagnosed between January 2000 and August 2016 and meeting the adapted criteria for ANS investigation suggested by Marra et al. (CD4+ T‐cell counts ≤350 cells/mm³ and/or venereal disease research laboratory test results ≥1:16) were identified. Those with no neurological symptoms and immediately referred for lumbar puncture were categorized as group 1, and those not referred for cerebrospinal fluid collection were categorized as group 2. We compared the occurrence of neurological symptoms and neurosyphilis diagnoses between the groups using incidence rates and Kaplan–Meier curves.

Results

We included 425 participants with a median follow‐up of 6 years. The incidence rate of neurological symptoms was 36.5/1000 person‐years in group 1 and 40.6/1000 person‐years in group 2 (incidence rate ratio [IRR] 0.90; 95% confidence interval [CI] 0.57–1.39; p = 0.62). The incidence rate of neurosyphilis was 15.0 cases/1000 person‐years in group 1 and 6.7 cases/1000 person‐years in group 2 (IRR 2.26; 95% CI 0.93–5.68; p = 0.05).

Conclusions

We found no statistically significant differences between groups in the incidence rates of neurological symptoms and neurosyphilis. Our findings support the current guidelines, which suggest a less invasive approach regarding ANS investigation among people living with HIV with incident syphilis.
Aflatoxins contamination in nuts for direct human consumption: analytical findings from three years of official control in Italy
Authors: Vita Valeria , Franchino Cinzia , Iammarino Marco , De Pace Rita
Published: March 2022

In this study, an Enzyme‐Linked Immuno Assay (ELISA) was used to detect the presence of aflatoxin B1 (AFB1) and total aflatoxins (AFTs) in 200 samples of nuts for human consumption. The analytical technique was validated, with detection limit equal to 1 µg kg‐1 and recovery percentage exceeding 90% for both AFB1 and AFT. The percentage of samples with aflatoxins concentration higher than legal limits amounted to 9% and 10% for AFB1 for AFT, respectively, and they were composed of almond and pistachio. Three samples of almond and 15 of pistachio resulted as non‐complaint for AFB1. Other 2 samples of pistachio were non‐compliant only for AFT. Taking into account that the levels exceeded up to five times the maximum permitted limits set by European Commission (AFT maximum concentration: 52.8 µg kg‐1), the results of this survey confirmed the need of official control and the reliability of ELISA as sensitive screening method.
Surgical and focal treatment for metastatic renal cell carcinoma: A literature review
Authors: Naito Sei , Kato Tomoyuki , Tsuchiya Norihiko
Published: March 2022

Accompanied by the development of systemic therapy for metastatic renal cell carcinoma, the concept of focal treatment, including surgical treatment, has been changing. Although immediate cytoreductive nephrectomy was essentially considered for synchronous metastatic renal cell carcinoma patients, the CARMENA trial and SURTIME trial revealed the negative impact of immediate cytoreductive nephrectomy. Therefore, immediate cytoreductive nephrectomy is currently considered only for a limited number of patients. Besides, deferred cytoreductive nephrectomy seems to have efficacy for overall survival in prior retrospective studies. Two randomized controlled trials, the PROBE trial (NCT04510597) and the NORDIC‐SUN trial (NCT03977571), are underway to elucidate deferred cytoreductive nephrectomy. Metastasectomy is also considered in metastatic renal cell carcinoma patients because previous studies demonstrated the overall survival benefit of metastasectomy. However, since all reports were retrospective studies, physicians could exclude the patients who were not expected to show the efficacy of metastasectomy. Therefore, an adequate patient selection for metastasectomy is important. A common factor predicting better overall survival was complete resection. Radiotherapies for metastatic lesions during systemic therapy showed approximately 90% local disease control rate at 1 year. However, no report has demonstrated that radiotherapy improves survival so far. Since surgical and focal treatments for metastatic renal cell carcinoma patients generally have minimal evidence, further investigations are needed.
Thermal performance regulation of high‐entropy rare‐earth disilicate for thermal environmental barrier coating materials
Authors: Wang Xu , He Yuxuan , Wang Chao , Bai Yu , Zhang Fan , Wu Yusheng , Song Guihong , Wang Zhan Jie
Published: March 2022

We prepared the novel high‐entropy (xRE1/x)2Si2O7 (RE = Y, Yb, Er, Sc, Gd and Eu, x = 2–6) ceramics by a two‐step method for the application of thermal environmental barrier coatings (TEBCs), and the effect of configuration entropy and lattice distortion on microstructures and thermal properties at high temperature were investigated. The results showed that the configuration entropy resulted from mass disorder can only contribute to the stability of thermal properties and microstructure. Lattice distortion should be responsible for reduction in thermal properties, which may be due to the enhancement of atomic nonharmonic vibration, resulting in intensified phonon scattering and hindering atomic amplitude oscillation. As‐prepared high‐entropy (Y1/6Yb1/6Er1/6Sc1/6Gd1/6Eu1/6)2Si2O7 ceramic exhibited the relatively low thermal diffusivity, thermal conductivity and coefficient of thermal expansion, which were 0.89–0.50 mm2 s–1, 1.99–2.50 W m–1 K–1 and (3.01–3.78) × 10–6 K–1 in the temperature range of 293–1373 K, respectively. This work provides a solid guarantee for the application of TEBC materials.
Effects of multi‐metal exposure on the risk of diabetes mellitus among people aged 40–75 years in rural areas in southwest China
Authors: Zhang Jing , Yin Huanhuan , Zhu Xuemei , Xiang Rong , Miao Yeqiu , Zhang Yu , Song Yang , Chen Jinyao , Zhang Lishi
Published: March 2022

Aims/Introduction

Metals play an important role in diabetes mellitus. This cross‐sectional study aimed to evaluate the overall, individual and interactive effects of multi‐metal exposure on the prevalence of diabetes mellitus, impaired fasting glucose (IFG) rate and fasting blood glucose (FBG) levels.

Materials and Methods

The FBG levels of a study population from a cadmium (Cd)‐polluted area (n = 250) and an unpolluted area (n = 204), and the metal levels, including magnesium, calcium (Ca), iron (Fe), zinc (Zn), arsenic (As), Cd, copper and lead (Pb) in blood and urine were detected. The study population was divided into a normal fasting glucose group, an IFG group and a diabetes mellitus group on the basis of FBG levels.

Results

The IFG rate and diabetes mellitus prevalence were negatively associated with blood Cd and urine Zn levels (IFG rate: odds ratio [OR] 0.780, 95% confidence interval [CI] 0.655–0.928; OR 0.622, 95% CI 0.465–0.831. Diabetes mellitus prevalence: OR 0.506, 95% CI 0.288–0.888; OR 0.609, 95% CI 0.395–0.939), the IFG rate was positively associated with urine Fe levels (OR 1.876, 95% CI 1.290–2.778), and diabetes mellitus prevalence was positively associated with urine Pb and blood Fe levels (OR 1.185, 95% CI 1.022–1.376; OR 1.008, 95% CI 1.001–1.014). A linear negative correlation was observed between FBG levels and blood Cd, and non‐linear inverted U‐shaped associations were found between FBG levels and Zn, Pb and copper in urine.

Conclusions

This research suggests that multi‐metal exposure, especially Cd, Fe, Zn, copper and Pb, is linked to diabetes mellitus, and the interactive effects of multiple metals require further exploration.
Elevated prolactin secretion during proestrus in mice: Absence of a defined surge
Authors: Phillipps Hollian R. , Khant Aung Zin , Grattan David R.
Published: March 2022

Throughout the reproductive cycle in rodents, prolactin levels are generally low. In some species, including rats, a prolactin surge occurs on proestrus with peak concentrations coinciding with the preovulatory luteinizing hormone (LH) surge. In mice, however, there are conflicting reports relating to the occurrence and timing of a proestrous prolactin surge. To gain further insight into the incidence and characteristics of this surge in mice, we have used serial tail tip blood sampling and trunk blood collection from both C57BL/6J (inbred) and Swiss Webster (outbred) mouse strains to build a profile of prolactin secretion during proestrus in individual mice. A clearly defined LH surge was detected in most animals, suggesting the blood sampling approach was suitable for detecting patterns of hormone secretion on proestrus. Despite this, levels of prolactin were quite variable between individuals. Overall both mouse strains showed a generalized rise in prolactin levels on the day of proestrus compared with levels seen in diestrus. This pattern is quite distinct from the discreet, circadian‐entrained surge observed in rats.
Oral tranexamic acid with a triple combination cream versus oral tranexamic acid monotherapy in the treatment of severe melasma
Authors: Martinez‐Rico Jessica Carolina , Chavez‐Alvarez Sonia , Herz‐Ruelas Maira Elizabeth , Sosa‐Colunga Sergio Axel , Ocampo‐Candiani Jorge , Suro‐Santos Yeudiel , Vazquez Martinez Osvaldo
Published: March 2022

Background

Melasma is an acquired pigmentation disorder with a complex multifactorial etiopathogenesis. Oral tranexamic acid (TA) is a promising drug for its treatment and may enhance outcomes when used in combination.

Objective

To provide evidence of the efficacy and safety of oral TA as a monotherapy, and in combination with a triple combination cream, for treating melasma in the Hispanic population.

Methods

Forty‐four female Hispanic patients with melasma were randomly assigned to receive 325 mg of oral TA every 12 h plus f‐TCC (fluocinolone‐based triple combination cream) every 24 h (group A) or 325 mg of oral TA every 12 h (group B) for 8 weeks, after which both groups were crossed‐over, and treated for an additional 8 weeks. Evaluations of the mMASI score, the melanin index, and the MelasQoL were made at baseline and Weeks 4, 8, 12, and 16.

Results

There was a 50.04% and 65.45% improvement in mMASI at Weeks 4 and 8, respectively, in group A, compared to baseline, while for Week 16, an improvement of 76.85% was achieved in group B compared to baseline. Highest scores were consistent with the use of the combined treatment modality in both groups, and were evidenced by the values of the melanin index obtained. There was no significant difference in MelasQoL scores between the 2 groups. No serious side effects were observed.

Conclusion

The combination of oral TA and f‐TCC is more effective than oral TA alone in the treatment of severe melasma in Hispanic patients.
Fully Closed: Individual Responses to Realized Gains and Losses
Authors: MEYER STEFFEN , PAGEL MICHAELA
Published: March 2022

We analyze how individuals reinvest realized capital gains and losses exploiting plausibly exogenous sales due to mutual fund liquidations. Individuals reinvest 83% if a forced sale results in a gain relative to the initial investment; but reinvest only 40% in the event of a loss. This difference is statistically significant for more than six months and arises because many individuals forced to realize a loss choose not to reinvest anything and some even exit the stock market altogether. Individuals treat realized losses differently from paper losses and are discouraged from investing more and participating in the stock market.
The Limits of Model‐Based Regulation
Authors: BEHN MARKUS , HASELMANN RAINER , VIG VIKRANT
Published: March 2022

Using loan‐level data from Germany, we investigate how the introduction of model‐based capital regulation affected banks' ability to absorb shocks. The objective of this regulation was to enhance financial stability by making capital requirements responsive to asset risk. Our evidence suggests that banks “optimized” model‐based regulation to lower their capital requirements. Banks systematically underreported risk, with underreporting more pronounced for banks with higher gains from it. Moreover, large banks benefitted from the regulation at the expense of smaller banks. Overall, our results suggest that sophisticated rules may have undesired effects if strategic misbehavior is difficult to detect.
Bacterial meningitis: Aetiology, risk factors, disease trends and severe sequelae during 50 years in Sweden
Authors: Block Nils , Naucler Pontus , Wagner Philippe , Morfeldt Eva , Henriques‐Normark Birgitta
Published: March 2022

Background

Bacterial meningitis (BM) is a rare but severe infection. Few population‐based studies have characterised BM episodes and sequelae over long periods.

Methods

This was a population‐based observational cohort study with national coverage, using data on aetiological pathogens, sex, premorbid conditions, steroid pretreatment, severe sequelae and birth, death and diagnosis dates collected from 10,339 patients with BM reported to the National Board of Health and Welfare in Sweden between 1964 and 2014.

Results

During the 50‐year study period, the incidence of BM decreased in young children, but not in the elderly. The most common cause of BM was pneumococci (34%), followed by Haemophilus influenzae (26%), and meningococci (18%), mainly community acquired. Premorbid conditions were found in 20%. After the H. influenzae type b vaccine was introduced in 1993, the BM incidence decreased by 36%. Following pneumococcal conjugated vaccine introduction in 2009, the incidence and 30‐day mortality from pneumococcal meningitis decreased by 64% and 100%, respectively, in previously healthy children, and the 30‐day mortality decreased by 64% among comorbid adults. The BM incidence in immunosuppressed patients increased by 3% annually post vaccine introduction. The 30‐day mortality was 3% in children and 14% in adults, and the rate of severe sequelae was 44%. On average, patients lost 11 years of healthy life due to BM.

Conclusion

The introduction of conjugated vaccines into the childhood vaccination program has reduced the incidence of BM in young children, but not in adults. Post vaccine introduction, patients present with more premorbid conditions and other bacterial causes of BM, emphasising the need for a correct diagnosis when treating these infections.
Anatomical, behavioural and physiological analyses of craniofacial development by cineradiographic imaging in marmosets
Authors: de Oliveira Luciana Rezende , Borges Luana Siqueira , Sarmet Max , Kagiyama Kensuke , Silva Brena Oliveira , Picinato‐Pirola Melissa , Takehara Sachiko , Kumei Yasuhiro , Zeredo Jorge Luís Lopes
Published: March 2022

Background

Non‐human primates are the closest animal models to humans regarding genetics, physiology and behaviour. Marmoset monkeys in particular are one of the most versatile species for biomedical research.

Objective

To assess the craniofacial growth and development of the masticatory function in the common marmoset (Callithrix jacchus), from birth to the fourth month of life through minimally invasive cineradiographic imaging.

Methods

Ten individuals were followed‐up from 0 to 4 months of age regarding craniofacial growth and masticatory function assessed by cineradiography. For the experimental procedure, we used a microfocal X‐ray source apparatus and a beryllium fast‐response image‐intensifier.

Results

The duration of the masticatory cycles was stable across age groups. Chewing a very soft Castella cake or the slightly harder Marshmallow did not change the masticatory cycle in the time domain. On the other hand, linear and angular measurements of the jaw‐opening movement showed a tendency for bigger movements at the latter stages of craniofacial growth. Qualitative analysis showed that marmosets had a small preference for Castella over Marshmallow, that they most often bit off pieces of food to chew with their posterior teeth, that they manipulated the food with their hands, and that they chewed the food continuously.

Conclusion

We observed critical developmental events during the first 3 months of life in marmosets. Cineradiographic imaging in marmosets may provide valuable information on craniofacial form and function for basic and preclinical research models.