bluuebunny/crossref_metadata_2025 huggingface dataset:
Encoding laboratory testing data: case studies of the national implementation of HHS requirements and related standards in five laboratories
Authors: Cholan Raja A , Pappas Gregory , Rehwoldt Greg , Sills Andrew K , Korte Elizabeth D , Appleton I Khalil , Scott Natalie M , Rubinstein Wendy S , Brenner Sara A , Merrick Riki , Hadden Wilbur C , Campbell Keith E , Waters Michael S
Published: April 2022

Objective

Assess the effectiveness of providing Logical Observation Identifiers Names and Codes (LOINC®)-to-In Vitro Diagnostic (LIVD) coding specification, required by the United States Department of Health and Human Services for SARS-CoV-2 reporting, in medical center laboratories and utilize findings to inform future United States Food and Drug Administration policy on the use of real-world evidence in regulatory decisions.

Materials and Methods

We compared gaps and similarities between diagnostic test manufacturers’ recommended LOINC® codes and the LOINC® codes used in medical center laboratories for the same tests.

Results

Five medical centers and three test manufacturers extracted data from laboratory information systems (LIS) for prioritized tests of interest. The data submission ranged from 74 to 532 LOINC® codes per site. Three test manufacturers submitted 15 LIVD catalogs representing 26 distinct devices, 6956 tests, and 686 LOINC® codes. We identified mismatches in how medical centers use LOINC® to encode laboratory tests compared to how test manufacturers encode the same laboratory tests. Of 331 tests available in the LIVD files, 136 (41%) were represented by a mismatched LOINC® code by the medical centers (chi-square 45.0, 4 df, P < .0001).

Discussion

The five medical centers and three test manufacturers vary in how they organize, categorize, and store LIS catalog information. This variation impacts data quality and interoperability.

Conclusion

The results of the study indicate that providing the LIVD mappings was not sufficient to support laboratory data interoperability. National implementation of LIVD and further efforts to promote laboratory interoperability will require a more comprehensive effort and continuing evaluation and quality control.
A Genetic Bottleneck of Mitochondrial DNA During Human Lymphocyte Development
Authors: Tang Zhongjie , Lu Zhaolian , Chen Baizhen , Zhang Weixing , Chang Howard Y. , Hu Zheng , Xu Jin
Published: April 2022

Mitochondria are essential organelles in eukaryotic cells that provide critical support for energetic and metabolic homeostasis. Although the elimination of pathogenic mitochondrial DNA (mtDNA) mutations in somatic cells has been observed, the mechanisms to maintain proper functions despite their mtDNA mutation load are poorly understood. In this study, we analyzed somatic mtDNA mutations in more than 30,000 single human peripheral and bone marrow mononuclear cells. We observed a significant overrepresentation of homoplasmic mtDNA mutations in B, T, and natural killer (NK) lymphocytes. Intriguingly, their overall mutational burden was lower than that in hematopoietic progenitors and myeloid cells. This characteristic mtDNA mutational landscape indicates a genetic bottleneck during lymphoid development, as confirmed with single-cell datasets from multiple platforms and individuals. We further demonstrated that mtDNA replication lags behind cell proliferation in both pro-B and pre-B progenitor cells, thus likely causing the genetic bottleneck by diluting mtDNA copies per cell. Through computational simulations and approximate Bayesian computation (ABC), we recapitulated this lymphocyte-specific mutational landscape and estimated the minimal mtDNA copies as <30 in T, B, and NK lineages. Our integrative analysis revealed a novel process of a lymphoid-specific mtDNA genetic bottleneck, thus illuminating a potential mechanism used by highly metabolically active immune cells to limit their mtDNA mutation load.
Monitoring the Increase in the U.S. Smoking Cessation Rate and Its Implication for Future Smoking Prevalence
Authors: Méndez David , Le Thuy T T , Warner Kenneth E
Published: April 2022

Introduction

We calculate the U.S. adult smoking cessation rate for 2014–2019, compare it to the historical trend, and estimate the implication for future smoking prevalence.

Methods

We repeated an earlier analysis, which examined the cessation rate from 1990 to 2014, extending the period to 2019. Employing National Health Interview Survey (NHIS) and National Survey on Drug Use and Health (NSDUH) data, we estimated the adult cessation rate in 6-year intervals, using weighted nonlinear least squares. We then employed a meta-regression model to test whether the cessation rate has increased beyond expectation. We used cessation rate estimates and smoking initiation rate estimates to project smoking prevalence in 2030 and eventual steady-state prevalence.

Results

The annual cessation rate increased 29% using NHIS data (from 4.2% in 2008–2013 to 5.4% in 2014–2019) and 33% with NSDUH data (4.2%–5.6%). The cessation rate increase accounts for 60% of a smoking prevalence decline in the most recent period exceeding the 1990–2013 predicted trend. The remaining 40% owes to declining smoking initiation. With current initiation and cessation rates, smoking prevalence should fall to 8.3% in 2030 and eventually reach a steady state of 3.53%.

Conclusions

The smoking cessation rate continued to increase during 2014–2019. NHIS and NSDUH results are practically identical. The larger share (60%) of the smoking prevalence decrease, beyond expectation, attributable to the increased cessation rate is encouraging since the positive health effects of cessation occur much sooner than those derived from declining initiation.

Implications

The smoking cessation rate in the United States continues to increase, accelerating the decline in smoking prevalence. This increase suggests that the Healthy People 2030 goal of 5% adult smoking prevalence, while ambitious, is attainable. Our findings can be used in simulation and statistical models that aim to predict future prevalence and population health effects due to smoking under various scenarios.
Political Networks and Stock Price Comovement: Evidence from Network-Connected Firms in China
Authors: Piotroski Joseph D , Wong T J , Zhang Tianyu
Published: April 2022

In this article, we examine whether comovement in the stock prices of pairs of Chinese firms connected to the same political network are systematically shaped by the prevailing coordination versus competition incentives of that network’s politicians. We find strong evidence from 2000 to 2012 (Jiang’s and Hu’s regimes) that stock price comovement is affected by the embeddedness of the firm–politician ties within the network. Among pairs of firms connected to a network through a common politician, we document an increase in stock price comovement. For those pairs of firms connected to a common network via separate politicians (rather than a common politician), we document a relative decrease in stock price comovement. This negative effect suggests that politicians’ relationships within these political networks are generally adversarial rather than cooperative in nature. These results become significantly weaker during Xi’s regime from 2013 to 2017, suggesting that Xi’s anti-corruption campaign and state-owned enterprise reforms may have attenuated these political network effects on the firms. Our additional tests also show that stock price comovement becomes even more positive (negative) in settings which are expected to increase the coordination or decrease the competition (decrease the coordination or increase the competition) of the politicians.
Usability of Microsoft Teams and Stream in Nursing Education
Authors: Hebert Michael , Upshaw Antionella , Rossie Jennifer
Published: April 2022

This manuscript presents a technology acceptance and usability evaluation of an online software platform utilized for educating nursing students. Online nursing education is a complex and multifaceted process requiring nurse educators to be competent in technical informatics. Increasingly, nurse educators are asked to transform the traditional face-to-face classroom to include remote or hybrid experiences with little or no formal training. The pandemic may have created an atmosphere of stress and confusion while forcing a transition to an online learning environment. Recent trends in nursing education call for the increased use of technology that enhances the learning experience and mimic clinical practice. As the pandemic's restrictions are removed, nursing education will continue to require technological innovations. Variables measured during the study were usability (System Usability Scale), perceived usefulness, and perceived ease of use. The results of the study suggest participants perceived Microsoft Teams and Stream as useful and easy to use. In this situation, the use of technology positively supported the teaching-learning process.
PRAME Expression in Junctional Melanocytic Proliferations of the Conjunctiva: A Potential Biomarker for Primary Acquired Melanosis/Conjunctival Melanocytic Intraepithelial Lesions
Authors: Huang Yuan Y. , Hrycaj Steven M. , Chan May P. , Stagner Anna M. , Patel Rajiv M. , Bresler Scott C.
Published: April 2022

Conjunctival melanocytic proliferations are diagnostically challenging, often complicated by small specimen size, and are separated into 3 broad categories. The first group includes benign nevi and primary acquired melanosis (PAM) without atypia. The second group includes junctional melanocytic proliferations with a risk of progression to invasive melanoma (PAM with atypia). The last category is conjunctival melanoma, of which 65% of tumors arise in the setting of PAM with atypia. Preferentially expressed antigen in melanoma (PRAME) immunohistochemistry has been widely adopted to differentiate cutaneous nevi and melanoma. However, there are limited studies on its utility in the evaluation of conjunctival melanocytic proliferations with little data regarding its potential utility in stratifying PAM. Twenty-eight clinically annotated cases (14 PAM without atypia and 14 PAM with atypia) were retrospectively evaluated with PRAME/MART-1 duplex immunohistochemistry and were assigned the commonly used PRAME immunoreactivity score: 0 for no staining, 1+ for 1%–25% of cells positive, 2+ for 26%–50%, 3+ for 51%–75%, and 4+ for >75%. PAM without atypia showed low (0–3+) PRAME expression in 14 of 14 cases (100%). PAM with atypia showed strong and diffuse (4+) PRAME expression in 12 of 14 cases (86.7%). Seven of eight (87.5%) PAM with severe atypia, 4 of 4 PAM (100%) with moderate atypia, and 1 of 2 PAM (50%) with mild atypia showed 4+ PRAME expression. In addition, all 5 cases that recurred or progressed (all classified as PAM with atypia) showed 4+ PRAME expression. Although additional larger studies are needed, PRAME seems to be a useful adjunct in evaluating junctional melanocytic proliferations of the conjunctiva.
Association Between Dietary Salt Intake and Open Angle Glaucoma in the Thessaloniki Eye Study
Authors: Tseng Victoria L. , Topouzis Fotis , Yu Fei , Keskini Christina , Pappas Theofanis , Founti Panayiota , Anastasopoulos Eleftherios , Harris Alon , Wilson M. Roy , Coleman Anne L.
Published: April 2022

Précis:

In the Thessaloniki Eye Study (TES) incidence phase population, frequent dietary salt intake was potentially associated with increased risk of open angle glaucoma in antihypertensive users.

Purpose:

The aim was to examine the association between dietary salt intake and glaucoma by antihypertensive use in the TES population.

Materials and Methods:

The study population included TES incidence phase participants. Dietary salt intake frequency was assessed by self-report. Outcomes included prevalence of any open angle glaucoma (OAG), primary open angle glaucoma (POAG), and pseudoexfoliation (PEX). Covariates included demographics, cardiovascular disease, migraines, diabetes, steroid use, smoking, history of cataract surgery, central corneal thickness, intraocular pressure, blood pressure, and antihypertensive use. Logistic regression was used to examine associations between frequency of salt intake and glaucoma, controlling for covariates and stratified by antihypertensive use.

Results:

The study included 1076 participants 80.5±4.4 years old, of whom 518 were female. There were 89/1076 (8.3%) participants with any OAG, 46/789 (5.8%) with POAG, and 287/1030 (27.9%) with PEX. In participants with antihypertensive use, frequent versus never salt intake was associated with increased risk of any OAG [adjusted odds ratio (aOR)=2.65, 95% confidence interval (CI)=1.12, 6.28; n=784] and POAG (aOR=3.59, 95% CI=1.16, 11.11; n=578) overall, and additionally in participants with diastolic blood pressure <90 mm Hg (aOR=2.42, 95% CI=1.00, 5.84; n=735) for OAG. There were no statistically significant adjusted associations between salt intake and PEX, or in participants without antihypertensive use.

Conclusions:

In TES participants assessed for OAG in the prevalence and incidence phases, frequent salt intake may be associated with increased OAG in those who take antihypertensive medication. Further investigation is needed of salt intake and glaucoma in hypertensive individuals.
Electrocardiogram Changes Associated With a Case of COVID-19 Infection
Authors: Davis Wesley D. , Abbey Judith Louise , Gamberi Brittany , Vezina Lindsay , Whiteaker Kaili S.
Published: April 2022

SARS-CoV-2 is the virus that causes COVID-19 and COVID pneumonia and is known to cause cardiovascular abnormalities with electrocardiogram (ECG) disturbances in affected patients. A 47-year-old male patient presented to the emergency department (ED) for the management of COVID-like symptoms. Initial diagnostics included an ECG, which showed significant rhythm changes. Progression of COVID-19 disease compounds myocardial injury with corresponding new-onset ECG anomalies such as QT-segment changes, bundle branch blocks, ST-segment disturbances, and other rhythm abnormalities. This case presentation illustrates ECG changes associated with cardiovascular disease progression.
Reduced Emergency Department Length of Stay and Proportion of Patients Who Left Without Being Seen Following Implementation of an Interprofessional Vertical Flow Track With Pivot Triage
Authors: Leggio William J. , Carhart Elliot , Bruckner Alison A. , Crowe Remle , Costanzo Cindy
Published: April 2022

Our objective was to assess change in length of stay and patients who left without being seen following implementation of a pivot triage and interprofessional vertical flow track process at a midwestern academic medical center emergency department. The intervention leveraged an existing interprofessional staffing model including a registered nurse and a paramedic to staff a vertical flow track daily from 1100 to 2300. Pre- and postintervention data were retrospectively abstracted from the electronic charting software. Outcomes included emergency department length of stay and percentage of patients leaving without being seen. Visits for patients during the postintervention period (May 10, 2019, to August 31, 2019) were compared with a corresponding preintervention time period 1 year prior (May 10, 2018, to August 31, 2018). The percentage of patients routed to the vertical flow track increased from 5% to 22% following the process intervention. Median emergency department length of stay decreased from 199 (interquartile range [IQR]: 129–282) to 159 (IQR: 98–232) min. The percentage of patients leaving without being seen decreased from 2.9% to 0.5%; between 1100 and 2300, these changes were more pronounced. Odds of a patient experiencing emergency department length of stay under 180 min increased nearly twofold (odds ratio [OR]: 1.92, 95% confidence interval [CI]: 1.79–2.08) and odds that a patient stayed to be seen by a medical professional increased sixfold (OR: 5.94, 95% CI: 4.08–8.63). Overall, more than 20% of patients were routed through the vertical flow track following the process change. Implementation of an emergency department pivot triage approach with a dedicated interprofessional vertical flow track was associated with significantly shorter emergency department length of stay and reduced patients leaving without being seen.
A shift towards household lending during the Fintech era: the role of financial literacy and credit information sharing
Authors: Le Tu DQ
Published: April 2022

Purpose

This study aims to investigate the determinants of a shift in lending towards household sectors during the growth of fintech credit using a sample of 41 countries between 2015 and 2018.

Design/methodology/approach

This study uses a fixed-effects model by adding indicators for geographic areas and year dummy variables to achieve this objective.

Findings

The findings show that the household credit to firm credit ratio is positively associated with credit information sharing and financial literacy, emphasising the importance of credit information sharing mechanism and financial literacy to household credit growth. More interestingly, the findings show that fintech credit development plays a more critical role in the evolution of firm credit than household credit. Nonetheless, fintech credit development may complement the growth of conventional lending. The results still hold when using several robustness checks.

Originality/value

This is the first attempt to examine the roles of credit information sharing, financial literacy and fintech credit development in a shift in lending activities towards households.
Last mile delivery in logistics and supply chain management: a bibliometric analysis and future directions
Authors: Ha Nghiep Tuan , Akbari Mohammadreza , Au Bill
Published: April 2022

Purpose

The main objective of this paper is to provide a systematic literature review (SLR) and structured insight into last mile delivery, ultimately identifying gaps in current knowledge and proposing a framework for future research direction in terms of sustainability in the area.

Design/methodology/approach

This paper identifies and synthesizes information from academic journals and examines “Journals and Publishing place,” “Geographic location,” “Year of Publication,” “University and Author Affiliation,” “Themes and Sub-themes,” “Theory,” “Research Design, Methods and Area” and “Industry Involvement.” A collection of online databases from 2005 to 2020 were explored, using the keywords “Last mile delivery,” “Last mile logistics,” “Last mile transportation,” “Last mile fulfillment,” “Last mile operations” and “Last mile distribution” in their title and/or abstract and/or keywords. Accordingly, a total of 281 journal articles were found in this discipline area, and data were derived from a succession of variables.

Findings

There has been significant growth in published articles concerning last mile delivery over the last 15 years (2005–2020). An in-depth review of the literature shows five dimensions of the last mile: last mile delivery, transportation, operations, distribution and logistics. Each of these dimensions is interrelated and possess clustered characteristics. For instance, last mile operations, last mile transportation and last mile delivery are operational, whereas last mile distribution is tactical, and last mile logistics possess strategic characteristics. The findings also indicate that even though the sustainability concept can be incorporated into all levels of the last mile, the current literature landscape mainly concentrates on the operational level.

Research limitations/implications

This review is limited to academic sources available from Emerald Insight, Science Direct, Taylor and Francis, Springer, MDPI and IEEE containing the mentioned keywords in the title and/or abstract/or keywords. Furthermore, only papers from high-quality, peer-reviewed journals were evaluated. Other sources such as books and conference papers were not included.

Practical implications

This study dissects last mile delivery to produce a framework that captures and presents its complex characteristics and its interconnectedness with various related components. By analyzing last mile delivery in its entirety, the framework also helps practitioners pinpoint which levels of last mile delivery (operation, tactical or strategic) they can incorporate the concept of sustainability.

Originality/value

The research findings enrich the contemporary literature landscape and future work by providing a conceptual framework that incorporates the “economic,” “environmental” and “social” pillars of sustainability in all dimensions of the last mile delivery.
Chatbots in the frontline: drivers of acceptance
Authors: Aslam Wajeeha , Ahmed Siddiqui Danish , Arif Imtiaz , Farhat Kashif
Published: April 2022

Purpose

By extending the service robot acceptance model (sRAM), this study aims to explore and enhance the acceptance of chatbots. The study considered functional, relational, social, user and gratification elements in determining the acceptance of chatbots.

Design/methodology/approach

By using the purposive sampling technique, data of 321 service customers, gathered from millennials through a questionnaire and subsequent PLS-SEM modeling, was applied for hypotheses testing.

Findings

Findings revealed that the functional elements, perceived usefulness and perceived ease of use affect acceptance of chatbots. However, in social elements, only perceived social interactivity affects the acceptance of chatbots. Moreover, both user and gratification elements (hedonic motivation and symbolic motivation) significantly influence the acceptance of chatbots. Lastly, trust is the only contributing factor for the acceptance of chatbots in the relational elements.

Practical implications

The study extends the literature related to chatbots and offers several guidelines to the service industry to effectively employ chatbots.

Originality/value

This is one of the first studies that used newly developed sRAM in determining chatbot acceptance. Moreover, the study extended the sRAM by adding user and gratification elements and privacy concerns as originally sRAM model was limited to functional, relational and social elements.
Successful treatment with dacarbazine against a parathyroid hormone‐related protein‐producing melanoma causing hypercalcemia after immune checkpoint inhibitor failure
Authors: Waki Yuma , Nobeyama Yoshimasa , Katsumata Fuminori , Asahina Akihiko
Published: April 2022

Cancer‐associated hypercalcemia commonly occurs through abnormal secretions of parathyroid hormone‐related protein (PTHrP) from cancer cells. Several cases of PTHrP‐producing melanoma causing hypercalcemia have been reported; however, effective management of PTHrP‐producing BRAF wild‐type melanoma causing hypercalcemia after immune checkpoint inhibitor (ICI) failure is unclear. We report a case of PTHrP‐producing BRAF wild‐type melanoma leading to oncological emergency by hypercalcemia that was successfully treated with dacarbazine after ICI failure. A 65‐year‐old Japanese woman had advanced BRAF wild‐type melanoma that was refractory to ICI, and then led to hypoxia through exacerbated lung metastases and pleural effusion. Moreover, hypercalcemia appeared in parallel with increase of the serum PTHrP level. Dacarbazine was administered, and after the first administration, the pleural effusion was gradually decreased and hypoxia rapidly disappeared, and the serum calcium and PTHrP levels were improved within normal limits. Dacarbazine after ICI failure is potentially a useful option for oncological emergency due to progression of BRAF wild‐type melanoma including PTHrP‐producing types. Dacarbazine should be reevaluated as a therapeutic option for oncological emergency in patients with BRAF wild‐type melanoma after ICI failure.
Functional traits and foraging behaviour: Avian vampire fly larvae change the beak and fitness of their Darwin's finch hosts
Authors: Kleindorfer Sonia , Colombelli‐Négrel Diane , Common Lauren K. , O'Connor Jody A. , Peters Katharina J. , Katsis Andrew C. , Dudaniec Rachael Y. , Sulloway Frank J. , Adreani Nicolas M.
Published: April 2022

The avian beak is a key morphological trait used for foraging. If parasites alter beak shape, we may expect changes in host foraging behaviour. Larvae of the avian vampire flyPhilornis downsicause naris enlargement in Darwin's finch nestlings when first and second instar larvae consume keratin, blood and tissue from inside the beak of the developing host. This naris malformation persists into adulthood, where nares that are >15% of total beak length are considered enlarged.

We measured effects of parasite‐induced naris enlargement on foraging behaviour, foraging niche overlap and body condition in Darwin's finches on Floreana Island. Foraging behaviour was ranked by the stress per foraging technique exerted on the beak and ranged from least stress for ‘gleaning’ to most stress for ‘chip off bark’.

Naris enlargement occurred in 34% of adult birds. The most common foraging technique differed among species: medium tree finches (Camarhynchus pauper) often chipped off bark to extract subsurface prey, small tree finches (C. parvulus) often gleaned surface prey from foliage, hybrids gleaned prey from bark and foliage, and small ground finches (Geospiza fuliginosa) mostly foraged on the ground. InC. pauper, birds with naris enlargement did more gleaning and less subsurface prey excavation. Foraging niche across species was most similar in birds with naris enlargement. Finally, body condition was lower in insectivorous tree finches with malformed beaks.

A novel aspect of this study is the idea that parasite‐induced alterations to phenotype affect ecological processes and interspecific interactions at large temporal and spatial scales. The parasitism occurs early in life but the ecological effects of this parasitism, if causative, are happening later.

Read the freePlain Language Summaryfor this article on the Journal blog.
Impact of COVID‐19 vaccinations on emergency department presentations
Authors: Brichko Lisa , Van Breugel Lila , Underhill Andrew , Tran Huyen , Mitra Biswadev , Cameron Peter A , Smit De Villiers , Giles Michelle L , McCreary David , Paton Andrew , O'Reilly Gerard M
Published: April 2022

Objective

The aim of the present study was to describe the burden of patients presenting to the ED with symptoms occurring after receiving a COVID‐19 vaccination.

Methods

This was a retrospective cohort study performed over a 4‐month period across two EDs. Participants were eligible for inclusion if it was documented in the ED triage record that their ED attendance was associated with the receipt of a COVID‐19 vaccination. Data regarding the type of vaccine (Comirnaty or ChAdOx1) were subsequently extracted from their electronic medical record. Primary outcome was ED length of stay (LOS) and secondary outcomes included requests for imaging and ED disposition destination.

Results

During the study period of 22 February 2021 to 21 June 2021, 632 patients were identified for inclusion in the present study, of which 543 (85.9%) had received the ChAdOx1 vaccination. The highest proportion of COVID‐19 vaccine‐related attendances occurred in June 2021 and accounted for 21 (8%) of 262 total daily ED attendances. Patients who had an ED presentation related to ChAdOx1 had a longer median ED LOS (253 vs 180 min, P < 0.001) compared to Comirnaty and a higher proportion had haematology tests and imaging requested in the ED. Most patients (n = 588, 88.8%) were discharged home from the ED.

Conclusion

There was a notable proportion of ED attendances related to recent COVID‐19 vaccination administration, many of which were associated with lengthy ED stays and had multiple investigations. In the majority of cases, the patients were able to be discharged home from the ED.
Correlates of persistence in remnant populations of two Critically Endangered cockatoos
Authors: Reuleaux A. , Collar N. J. , Jones M. J. , Limu R. N. D. , Mardiastuti A. , Pinto P. , Siregar B. A. , Marsden S. J.
Published: April 2022

A challenge with species that have disappeared from most of their range is to identify the correlates of local persistence. With species decimated by trade, site‐specific trapping risk is hard to capture by remotely accessed predictors. The recently split yellow‐crested cockatooCacatua sulphureaand citron‐crested cockatooC. citrinocristatahave undergone catastrophic declines due to habitat loss and especially trapping, and are now extinct in much of their former range across Indonesia. Of 144 sites on 30 islands known to contain the species in 1950, only 76 on 27 islands did so in 2017–2019, with many of the other 68 experiencing extinctions between 1985 and 2000. We compared socio‐ecological conditions such as forest cover and loss, human population density and infrastructure, and protected area status between the occupied and unoccupied sites, using ‘random forests’ within decreasing time intervals 1950–2015. Populations on Sulawesi and West Nusa Tenggara were more likely to become extinct than those on Sumba, Timor‐Leste and small remote islands. Sites retaining cockatoos had high proportions of tree cover, low road density and low human densities. The relative importance of these factors changed little over time, but road density and human density became respectively more and less important in recent years. The examination of local conditions at ‘false negative’ sites (where cockatoos survived contrary to model predictions) showed that, particularly in recent years, cockatoo survival has been promoted by site‐specific protection due to traditional beliefs, NGO activities, dedicated individual residents and local topographic barriers. Some of these local influences add complexity to the task of conserving cockatoo strongholds, but also offer exciting possibilities for low‐cost conservation prescriptions tailored to individual sites. Studies combining field and remotely sensed data, and examining false negative sites for beneficial location‐specific conditions, have broad application for the conservation of taxa with once‐large ranges.
Outcomes and success of new tiered perinatal transfer policy within a tertiary level obstetric unit in Australia
Authors: Brown James , Busz Felicity , Alahakoon Thushari I. , Zen Monica
Published: April 2022

Background

New South Wales Health introduced the new Tiered Networking Arrangements for Perinatal Care in New South Wales policy directive (TPN Policy), which defined key performance and quality indicators after implementation.

Aims

This study aims to assess the success of the TPN Policy implementation in the Western Sydney TPN in accordance with key performance indicators.

Materials and Methods

This is a retrospective cohort study of acute perinatal transfers within the Western Sydney TPN between 1 December 2019 to 31 December 2020. The primary outcome is compliance with objectives of the TPN Policy, as measured as an Aggregate Compliance Score comprising the five measures. Secondary outcomes include clinical, neonatal and logistics outcomes.

Results

There were 181 acute perinatal transfers within, into or out of the Western Sydney TPN between 1 December 2019 to 31 December 2020. There were 122 transfers within the network, 40 into the TPN and 19 were out of the TPN. All groups were at least partially compliant with the TPN Policy. No transfers in any of groups scored below three (‘partially compliant’). A quarter of transfers gave birth within 24 h of transfer. Over half of those who were transferred and admitted went on to give birth prior to discharge or transfer.

Conclusions

Overall, the TPN Policy met its objectives after implementation in the Western Sydney TPN, while maintaining appropriate neonatal outcomes. All women arrived at an appropriate facility prior to giving birth, although the majority did not give birth within 24 h. Neonatal intensive care unit bed availability is a key limitation to future improvement.
Association between early change in neutrophil‐to‐lymphocyte ratio after radical cystectomy and treatment outcomes
Authors: Herzberg Haim , Lifshitz Karin , Golan Shay , Baniel Jack , Malshy Kamil , Hoffman Azik , Amiel Gilad E. , Zreik Rani , Freifeld Yuval , Dekel Yoram , Lasmanovich Rinat , Lazarovich Alon , Rosenzweig Barak , Dotan Zohar , Yossepowitch Ofer , Mano Roy
Published: April 2022

Objectives

To evaluate the associations of peri‐operative neutrophil‐to‐lymphocyte ratio (NLR) and change in NLR with survival after radical cystectomy.

Patients and Methods

We retrospectively reviewed a multicentre cohort of patients with bladder cancer who underwent radical cystectomy between 2010 and 2020. Preoperative NLR, postoperative NLR, delta‐NLR (postoperative minus preoperative NLR) and NLR change (postoperative divided by preoperative NLR) were calculated. Patients were stratified based on elevation of preoperative and/ or postoperative NLR above the median values. Multivariable Cox regression models were used to evaluate the associations of peri‐operative NLR and NLR change with survival.

Results

The study cohort included 346 patients with a median age of 69 years. The median (interquartile range) preoperative NLR, postoperative NLR, delta‐NLR and NLR change were 2.55 (1.83, 3.90), 3.33 (2.21, 5.20), 0.43 (−0.50, 2.08) and 1.2 (0.82, 1.96), respectively. Both preoperative and postoperative NLR were elevated in 110 patients (32%), 126 patients (36%) had an elevated preoperative or postoperative NLR, and 110 patients (32%) did not have an elevated NLR. On multivariable analysis, increased preoperative and postoperative NLR were significantly associated with decreased survival. While delta‐NLR and NLR change were not associated with outcome, patients with elevations in both preoperative and postoperative NLR had the worst overall (hazard ratio [HR] 2.97, 95% confidence interval [CI] 1.78, 4.95; P < 0.001) and cancer‐specific survival rates (HR 2.41, 95% CI 1.3, 4.4; P = 0.004).

Conclusions

Preoperative and postoperative NLR are significant predictors of survival after radical cystectomy; patients in whom both NLR measures were elevated had the worst outcomes. Future studies should evaluate whether an increase in NLR during long‐term follow‐up may precede disease recurrence.
The functional form of specialised predation affects whether Janzen–Connell effects can prevent competitive exclusion
Authors: Smith Daniel J. B.
Published: April 2022

Janzen–Connell effects (JCEs), specialised predation of seeds and seedlings near conspecific trees, are hypothesised to maintain species richness. While previous studies show JCEs can maintain high richness relative to neutral communities, recent theoretical work indicates JCEs may weakly inhibit competitive exclusion when species exhibit interspecific fitness variation. However, recent models make somewhat restrictive assumptions about the functional form of specialised predation—that JCEs occur at a fixed rate when offspring are within a fixed distance of a conspecific tree. Using a theoretical model, I show that the functional form of JCEs largely impacts their ability to maintain coexistence. If predation pressure increases additively with adult tree density and decays exponentially with distance, JCEs maintain considerably higher species richness than predicted by recent models. Loosely parameterising the model with data from a Panamanian tree community, I elucidate the conditions under which JCEs are capable of maintaining high species richness.
Ustekinumab reduces serum protein levels associated with cardiovascular risk in psoriasis vulgaris
Authors: Koschitzky Merav , Navrazhina Kristina , Garshick Michael S. , Gonzalez Juana , Han Joseph , Garcet Sandra , Krueger James G.
Published: April 2022

Psoriasis increases the risk of cardiovascular disease (CVD). Biomarkers for cardiovascular (CV) risk stratification in psoriasis are lacking, and the effects of psoriasis biologics on CV risk reduction remain unclear. The goal of this study was to identify biomarkers of CV risk in psoriasis blood that are reduced by ustekinumab. We quantified 276 inflammatory and CV‐related serum proteins with Olink's multiplex assay in 10 psoriasis patients (vs. 18 healthy controls) and after 12 weeks of ustekinumab treatment. For each protein down‐regulated after treatment, the literature was reviewed for studies assessing the protein's association with CVD. Data were collected from each study to calculate CV risk thresholds for each protein, which were compared with protein levels in psoriasis patients before and after treatment. Our results showed that 43 out of 276 proteins were down‐regulated after treatment, 25 of which were initially up‐regulated at baseline (vs. controls, all p‐values ≤0.1). 8 down‐regulated proteins were initially elevated above thresholds associated with enhanced CV risk in the literature (myeloperoxidase, C‐X‐C motif chemokine 10, E‐selectin, interleukin‐6, cystatin B, von Willebrand factor, tumor necrosis factor receptor 1 and N‐terminal prohormone brain natriuretic peptide). Treatment lowered these proteins to below their risk thresholds, except for IL‐6, which was lowered but remained at its risk threshold despite successful psoriasis skin treatment. In summary, 12 weeks of ustekinumab treatment reduced serum proteins present at levels associated with CV risk in psoriasis patients. Further studies can evaluate these proteins as potential ustekinumab‐modulated biomarkers of CV risk in psoriasis and the impact of ustekinumab on CV risk reduction.
Development of a fixative protocol using formaldehyde and gluteraldehyde for preservation of microbial art on agar plates
Authors: Wilson Sammi , Law Samantha P. , McEwan Neil R. , Wright Rebecca , Macaskill Jenny S.
Published: April 2022

Aims

Agar art bridges the gap between science and art using microbes instead of paint. Afterwards, the art can change in response to microbial fluctuation, meaning preservation of the original art is essential. Here, formaldehyde and glutaraldehyde were investigated as preservatives, involving techniques used in healthcare settings to preserve samples.

Methods and Results

Formaldehyde was tested at 1.0%, 2.0% and 3.7%, w/v, whereas glutaraldehyde was tested at 1% and 2.5%, w/v. Both compounds and respective concentrations were tested for different time periods. Escherichia coli, Serratia marcescens, Staphlococcus aureus and Micrococcus luteus were used as bacteria for “drawing” the works of art. The effectiveness of fixation was determined using integrated densities and visual assessment. Initially, both compounds showed potential promise, albeit with a loss of bacteria. Ser. marcescens was prone to colour changes and glutaraldehyde caused discolouration of agar and bacteria. These could be caused by a pH decrease in the agar, due to residual free aldehyde groups. Reduction of this was tested using 300 mM sodium metabisulfite to neutralize excess aldehydes. This initially led to reduced bacterial loss and avoided colour changes, however measurements 24 h post-fixation showed colour loss to some bacterial clusters.

Conclusions

Here, at least 2% formaldehyde for a short fixation period, typically 1 min, depending on the species, was most promising for the preservation of art. Given the success of this with different bacteria, it would make a good starting combination for anyone trying to fix agar art, although methodology refinement may be needed for optimisation depending on the bacterial species used.

Significance and Impact of Study

This study shows, for the first time, successful fixation and preservation of different bacterial species on agar. The impact of this is to preserve agar art while making it safe and non-infective to those in contact with the microbial art.
Early life programming of health and disease: The long‐term consequences of obesity in pregnancy
Authors: Langley‐Evans Simon C.
Published: April 2022

The prevalence of overweight and obesity is rising in all parts of the world and, among young women, it presents a very clear danger during pregnancy. Women who are overweight or who gain excessive weight during pregnancy are at greater risk of complications in pregnancy and labour, and are more likely to lose their child to stillbirth or die themselves during pregnancy. This narrative review considers the evidence that, in addition to increasing risk of poor pregnancy outcomes, obesity has the capacity to programme foetuses to be at greater risk of cardiometabolic disorders later in life. An extensive body of evidence from prospective and retrospective cohorts, as well as record linkage studies, demonstrates associations of maternal obesity and/or gestational diabetes with cardiovascular disease, as well as type 1 and type 2 diabetes. Studies in animals suggest that these associations are underpinned by adaptations that occur in foetal life, which remodel the structures of major organs, including the brain, kidney and pancreas.
Dream‐enactment behaviours during the COVID‐19 pandemic: an international COVID‐19 sleep study
Authors: Liu Yaping , Partinen Eemil , Chan Ngan Yin , Dauvilliers Yves , Inoue Yuichi , De Gennaro Luigi , Plazzi Giuseppe , Bolstad Courtney J. , Nadorff Michael R. , Merikanto Ilona , Bjorvatn Bjørn , Han Fang , Zhang Bin , Cunha Ana Suely , Mota‐Rolim Sérgio , Léger Damien , Matsui Kentaro , Espie Colin A. , Chung Frances , Morin Charles M. , Sieminski Mariusz , Penzel Thomas , Holzinger Brigitte , Partinen Markku , Wing Yun Kwok
Published: April 2022

There has been increasing concern about the long‐term impact of coronavirus disease 2019 (COVID‐19) as evidenced by anecdotal case reports of acute‐onset parkinsonism and the polysomnographic feature of increased rapid eye movement sleep electromyographic activity. This study aimed to determine the prevalence and correlates of dream‐enactment behaviours, a hallmark of rapid eye movement sleep behaviour disorder, which is a prodrome of α‐synucleinopathy. This online survey was conducted between May and August 2020 in 15 countries/regions targeting adult participants (aged ≥18 years) from the general population with a harmonised structured questionnaire on sleep patterns and disorders, COVID‐19 diagnosis and symptoms. We assessed dream‐enactment behaviours using the Rapid Eye Movement Sleep Behaviour Disorder Single‐Question Screen with an additional question on their frequency. Among 26,539 respondents, 21,870 (82.2%) answered all items that were analysed in this study (mean [SD] age 41.6 [15.8] years; female sex 65.5%). The weighted prevalence of lifetime and weekly dream‐enactment behaviours was 19.4% and 3.1% and were found to be 1.8‐ and 2.9‐times higher in COVID‐19‐positive cases, respectively. Both lifetime and weekly dream‐enactment behaviours were associated with young age, male sex, smoking, alcohol consumption, higher physical activity level, nightmares, COVID‐19 diagnosis, olfactory impairment, obstructive sleep apnea symptoms, mood, and post‐traumatic stress disorder features. Among COVID‐19‐positive cases, weekly dream‐enactment behaviours were positively associated with the severity of COVID‐19. Dream‐enactment behaviours are common among the general population during the COVID‐19 pandemic and further increase among patients with COVID‐19. Further studies are needed to investigate the potential neurodegenerative effect of COVID‐19.
The impact of wheat cultivar mixtures on virulence dynamics in Zymoseptoria tritici populations persists after interseason sexual reproduction
Authors: Orellana‐Torrejon Carolina , Vidal Tiphaine , Saint‐Jean Sébastien , Suffert Frédéric
Published: April 2022

This study follows on from a previous study showing that binary mixtures of wheat cultivars affect the evolution of Zymoseptoria tritici populations within a field epidemic from the beginning (t1) to the end (t2) of a growing season. Here, we focused on the impact of interseason sexual reproduction on this evolution. We studied mixtures of susceptible and resistant cultivars (carrying Stb16q, a recently broken‐down resistance gene) in proportions of 0.25, 0.5 and 0.75, and their pure stands. We determined the virulence status of 1440 ascospore‐derived strains collected from each cultivar residue by phenotyping on seedlings. Virulence frequencies in the ascospore‐derived population were lower in mixtures than in pure stands of the resistant cultivar, especially in the susceptible cultivar residues, as at t2, revealing that the impact of mixtures persisted until the next epidemic season (t3). Surprisingly, after sexual reproduction the avirulence frequencies on the resistant cultivar residues increased in mixtures where the proportion of the susceptible cultivar was higher. Our findings highlight two epidemiological processes: selection within the pathogen population between t1 and t2 driven by asexual cross‐contamination between cultivars (previous study) and sexual crosses between avirulent and virulent strains between t2 and t3 driven by changes in the probabilities of physical encounters (this study). Mixtures therefore appear to be a promising strategy for the deployment of qualitative resistances, not only to limit the intensity of Septoria tritici blotch epidemics, but also to reduce the erosion of resistances by managing evolution of the pathogen population at a pluriannual scale.
A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review
Authors: van Dongen Dorien H.E. , Havermans Demi , Deckers Kay , Olff Miranda , Verhey Frans , Sobczak Sjacko
Published: April 2022

Posttraumatic stress disorder (PTSD) is a prevalent disorder worldwide and often co‐occurs in dementia. Both have a major impact on disease burden and quality of life. PTSD may be difficult to recognize in dementia and a structured diagnostic method is lacking. In order to get insight into the clinical diagnostics of PTSD in dementia, this systematic literature review evaluates the clinical presentation of PTSD and other relevant symptoms in people with dementia. PubMed, PsycINFO, Embase, and CINAHL were searched for all publications through 30 December 2021. Articles were included which met the following criteria: (i) description of at least one case with a current diagnosis of dementia and co‐morbid PTSD; (ii) clinical presentation of symptoms being adequately described; (iii) no difference being made between chronic PTSD, PTSD with re‐activation, and delayed onset PTSD. Of the 947 identified abstracts, 13 papers met the inclusion criteria and were included (describing 30 cases). Based on our rating, only one case completely fulfilled the DSM‐5 criteria of PTSD. Avoidance was only described in three cases. Most commonly described symptoms were irritability and anger (E1, 9%), persistent negative emotional state (D4, 9%), and sleep disturbances (E6, 8%). In 93% of the case reports, other symptoms were also described, i.e. memory problems (58%), screaming (33.3%), and wandering (22.2%). People with dementia who have experienced a traumatic event seem to present, based on our rating method, with insufficient symptoms to meet all criteria for a PTSD DSM‐5 diagnosis. The DSM‐5 core symptom of avoidance was absent in most of the cases. Clinical presentation consists mainly of symptoms of irritability, anger, persistent negative emotional state, and sleep disturbances, often accompanied by other symptoms. These findings suggest that older people with dementia may have other symptom presentations than people without dementia.