bluuebunny/crossref_metadata_2025 huggingface dataset:
Using environmental nudges to reduce academic cheating in young children
Authors: Zhao Li , Zheng Yi , Mao Haiying , Zheng Jiaxin , Compton Brian J. , Fu Genyue , Heyman Gail D. , Lee Kang
Published: April 2021

Previous research on nudges conducted with adults suggests that the accessibility of behavioral options can influence people's decisions. The present study examined whether accessibility can be used to reduce academic cheating among young children. We gave children a challenging math test in the presence of an answer key they were instructed not to peek at, and manipulated the accessibility of the answer key by placing various familiar objects on top of it. In Study 1, we used an opaque sheet of paper as a two‐dimensional occluder, and found that it significantly reduced cheating compared to a transparent plastic sheet. In Study 2, we used a three‐dimensional occluder in the form of a tissue box to make the answer key appear even less accessible, and found it was significantly more effective in reducing cheating than the opaque paper. In Study 3, we used two symbolic representations of the tissue box: a realistic color photo and a line drawing. Both representations were effective in reducing cheating, but the realistic photo was more effective than the drawing. These findings demonstrate that manipulating accessibility can be an effective strategy to nudge children away from cheating in an academic context. They further suggest that different types of everyday objects and their symbolic representations can differentially impact children's moral behavior.
The rise and fall of government support for small‐scale voluntary development organizations—and their remarkable resilience
Authors: Kinsbergen Sara , Molthof Mieke
Published: April 2021

Motivation

The aid architecture for international development has undergone significant change in recent years, but it remains unclear how the established order has responded to the emergence of new actors in this field.

Purpose

The article closely analyses the entry of small‐scale, voluntary development organizations to gain a better understanding of the changing aid architecture.

Methods and approach

Through extensive policy tracing over a 15‐year period, combined with analysis of primary, longitudinal data, we study how private development initiatives (PDIs) have been received by the Ministry of Foreign Affairs and established development organizations in the Netherlands. We focus on the type of support provided to PDIs and the (changing) rationale underlying this support.

Findings

After many years of generous support, PDIs are no longer part of the Dutch policy agenda as a result of vanishing attention to the rationale of public support. The professionalization agenda underlying both the financial and non‐financial support provided to PDIs also prompted these organizations to move away from the traditional order. PDIs successfully sought alternative allies, surviving as actors in their own right. These two developments have resulted in mutual disengagement between the established order and PDIs, with increasingly less co‐operation and interaction.

Policy implications

PDIs have not been genuinely included in the traditional development order in the Netherlands, making it questionable whether their emergence contributed to a more plural community as envisaged by the Dutch Ministry of Foreign Affairs at the turn of the century. To make use of the value of actively involved citizens, policy‐makers will have to set up appropriate frameworks that recognize and preserve the distinctive nature of these organizations and, in so doing, capitalize on the comparative advantages of PDIs.
High‐mobility group AT‐hook 2 promotes growth and metastasis and is regulated by miR‐204‐5p in oesophageal squamous cell carcinoma
Authors: Zhang Hongdian , Wu Xianxian , Sui Zhilin , Ma Zhao , Gong Lei , Meng Bin , Tang Peng , Yu Zhentao
Published: April 2021

Background

To investigate the expression of high‐mobility group AT‐hook 2 (HMGA2) and miR‐204‐5p in oesophageal squamous cell carcinoma (ESCC) and their biological roles in ESCC development and progression.

Methods

HMGA2 and miR‐204‐5p expression levels in ESCC tissues and cell lines were detected by qRT‐PCR, Western blotting and immunohistochemical staining. ESCC cell lines were transfected with a small interfering RNA for HMGA2 and miR‐204‐5p mimic to downregulate and upregulate the expression levels of HMGA2 and miR‐204‐5p, respectively. The growth, migration and invasion abilities of ESCC cells were assessed by MTT, colony formation, wound‐healing and Transwell assays, respectively. A luciferase reporter gene assay was used to determine whether the 3′‐untranslated coding regions of HMGA2 could be directly bound by miR‐204‐5p.

Results

HMGA2 expression was markedly upregulated (P < .001), while miR‐204‐5p expression was markedly downregulated (P = .003) in ESCC tissues compared with adjacent normal tissues. HMGA2 expression was correlated with tumour size, invasion depth, lymph node metastasis and tumour‐node‐metastasis stage (all P < .05) and was identified as an independent prognostic factor for ESCC patients. The expression levels of HMGA2 and miR‐204‐5p were negatively correlated (r2 = 0.609, P < .001). HMGA2 knockdown or miR‐204‐5p overexpression markedly inhibited ESCC cell growth, migration and invasion (P < .05). In addition, restoration of HMGA2 expression partly reversed the inhibitory effects of miR‐204‐5p overexpression on migration and invasion (P < .05). The luciferase reporter gene assay suggested that HMGA2 is a direct downstream target of miR‐204‐5p.

Conclusion

HMGA2 functions as an oncogene in the growth and metastasis of ESCC and is negatively regulated by miR‐204‐5p.
Caspase‐9 acts as a regulator of necroptotic cell death
Authors: Molnár Tamás , Pallagi Petra , Tél Bálint , Király Róbert , Csoma Eszter , Jenei Viktória , Varga Zsófia , Gogolák Péter , Odile Hueber Anne , Máté Zoltán , Erdélyi Ferenc , Szabó Gábor , Pettkó‐Szandtner Aladár , Bácsi Attila , Virág László , Maléth József , Koncz Gábor
Published: April 2021

Necroptosis is a regulated necrotic‐like cell death modality which has come into the focus of attention since it is known to contribute to the pathogenesis of many inflammatory and degenerative diseases as well as to tumor regulation. Based on current data, necroptosis serves as a backup mechanism when death receptor‐induced apoptosis is inhibited or absent. However, the necroptotic role of the proteins involved in mitochondrial apoptosis has not been investigated. Here, we demonstrated that the stimulation of several death and pattern recognition receptors induced necroptosis under caspase‐compromised conditions in wild‐type, but not in caspase‐9‐negative human Jurkat and murine MEF cells. Cerulein‐induced pancreatitis was significantly reduced in mice with acinar cell‐restricted caspase‐9 gene knockout. The absence of caspase‐9 led to impaired association of receptor‐interacting serine/threonine‐protein kinase 1 (RIPK1) and RIPK3 and resulted in decreased phosphorylation of RIP kinases, but the overexpression of RIPK1 or RIPK3 rescued the effect of caspase‐9 deficiency. Inhibition of either Aurora kinase A (AURKA) or its known substrate, glycogen synthase kinase 3β (GSK3ß) restored necroptosis sensitivity of caspase‐9‐deficient cells, indicating an interplay between caspase‐9 and AURKA‐mediated pathways to regulate necroptosis. Our findings suggest that caspase‐9 acts as a newly identified regulator of necroptosis, and thus, caspase‐9 provides a promising therapeutic target to manipulate the immunological outcome of cell death.
UnderstandingBactrocera dorsalistrapping to calibrate area‐wide management
Authors: Chailleux Anaïs , Thiao Dado Sene , Diop Samba , Bouvery Frédéric , Ahmad Sohel , Caceres‐Barrios Carlos , Faye Emile , Brévault Thierry , Diatta Paterne
Published: April 2021

Knowing the dispersal of released insects and estimating the size of field populations are keys to the successful implementation of area‐wide management (AWM) programmes based on the sterile insect technique (SIT), as they determine the release strategy of sterile males. Mark–release–recapture (MRR) is a common method used to estimate field populations and spatiotemporal dynamics. However, the extent to which the pest is attracted to lures is often difficult to identify, thereby biasing extrapolation to movement patterns and population size. We performed MRR experiments on the Oriental fruit fly,Bactrocera dorsalis(Hendel) (Diptera: Tephritidae), in a fruit‐growing area in Senegal. Methyl eugenol and protein baits were used to trap males and females, respectively. After studying the suitability of markingB. dorsaliswith fluorescent pigments at the laboratory, two releases of marked sterile flies were organized in the centre of an organic mango orchard, first in the late mango fruiting stage and second in the fruit setting stage. Traps were placed symmetrically along a 250 and 500 m radius from the release point. A very small fraction of the released individuals was recaptured: 0.45% in the first release and 3.08% in the second. Trapping of both sterile and wild flies was completely anisotropic. Sterile flies were mostly trapped at a relatively short distance (250 m) from the release point, in the first two days. Male trapping using methyl eugenol was highly effective, whereas the response of females to food bait traps was low. The direction of the wind was the main driver of recapture, with flies heading upwind. The results underline the importance of taking the odour plume around the traps into account when estimating populations, and the heterogeneous spread of the wild population in the landscape for the set‐up of the release strategy of sterile insects for SIT‐based AWM.
Human immunodeficiency virus‐1/simian immunodeficiency virus infection induces opening of pannexin‐1 channels resulting in neuronal synaptic compromise: A novel therapeutic opportunity to prevent NeuroHIV
Authors: Gorska Anna Maria , Donoso Maribel , Valdebenito Silvana , Prideaux Brendan , Queen Suzanne , Scemes Eliana , Clements Janice , Eugenin Eliseo
Published: April 2021

In healthy conditions, pannexin‐1 (Panx‐1) channels are in a close state, but in several pathological conditions, including human immunodeficiency virus‐1 (HIV) and NeuroHIV, the channel becomes open. However, the mechanism or contribution of Panx‐1 channels to the HIV pathogenesis and NeuroHIV is unknown. To determine the contribution of Panx‐1 channels to the pathogenesis of NeuroHIV, we used a well‐established model of simian immunodeficiency virus (SIV) infection in macaques (Macaca mulatta) in the presence of and absence of a Panx‐1 blocker to later examine the synaptic/axonal compromise induced for the virus. Using Golgi's staining, we demonstrated that SIV infection compromised synaptic and axonal structures, especially in the white matter. Blocking Panx‐1 channels after SIV infection prevented the synaptic and axonal compromise induced by the virus, especially by maintaining the more complex synapses. Our data demonstrated that targeting Panx‐1 channels can prevent and maybe revert brain synaptic compromise induced by SIV infection.

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A Novel Digital Implant Planning Workflow in Patients with Preexisting Metal Restorations: A Technical Report
Authors: Ballo Ahmed M. , Sim Jae Won
Published: April 2021

A prosthetically‐driven virtual implant plan is considered a challenging procedure depending on accurate registration of the three‐dimensional optical surface scan and 3D volumetric rendering reconstructed from cone‐beam computed tomography (CBCT) images. However, the presence of preexisting metal restorations may significantly negatively influence the registration process. This technical report describes a novel digital workflow to optimize the implant planning outcome for the partially edentulous patient with preexisting metal restorations by accurately aligning the standard triangle language data of the intraoral scanner with the CBCT rendering using a dual‐scan technique and an appliance with radiographic markers.
Legal socialization: Understanding the obligation to obey the law
Authors: Fine Adam D. , van Rooij Benjamin
Published: April 2021

During the emergence of the legal socialization field, the obligation to obey the law was central in theoretical and empirical approaches. Scholars in the last 50 years often noted that the obligation to obey the law (OOL) is vital for compliance, yet studies rarely empirically examined factors that promote the OOL. This study used data from 1000 adults stratified sampled to be nationally representative of the United States to examine how personal characteristics (i.e., impulsivity and morality), perceptions of the nonlegal social context (i.e., social bonds, teacher legitimacy, and parent legitimacy), and perceptions of the legal system context (i.e., deterrence and police procedural justice, distributive justice, bias, and legitimacy) are associated with the OOL. The results indicated that impulsivity, teacher legitimacy, deterrence, and perceptions of police legitimacy and bias were associated with the OOL. Implications for the next 50 years of legal socialization research are discussed.
Survey of clinical staff knowledge on the long‐term outcomes of very preterm infants delivered in a tertiary referral hospital
Authors: Abdul Aziz Safiyyah , Athalye‐Jape Gayatri , Agrawal Sachin , Sharp Mary
Published: April 2021

Aim

To assess knowledge of our neonatal intensive care unit clinical staff regarding preterm neurodevelopmental outcomes using the 33‐item Preterm Birth Knowledge Scale (PB‐KS).

Methods

An anonymous convenience sampling survey of clinical staff in the Neonatal Directorate was conducted between July and December 2019. PB‐KS, demographic information and prior staff education on long‐term outcomes in very preterm infants were collected.

Results

There were 56 responses (five neonatologists, eight paediatric trainees, 41 neonatal nurses and two allied health staff). Responses were scored as correct or incorrect. The mean score on the PB‐KS was 19.5 (range: 4–29 out of 40) with 50% correct answers. Accuracy was highest (96%) for rates of cerebral palsy and lowest (11%) for estimation of quality of life among preterm survivors. Staff reported training in long‐term outcomes of preterm infants through attending a conference/seminar (20%) or a combination of formal training and seminars (41.1%). Over half of our clinical staff reported a lack of formal training. Formally trained clinical staff scored significantly better in this survey. Didactic seminars were indicated as preferred choice for staff education.

Conclusions

Results of our survey will assist in developing a customised educational programme to address identified gaps in the knowledge of clinical staff as our survey also showed significantly better scores among staff who were formally trained about long‐term outcomes in very preterm infants. Staff responses indicated that knowledge on long‐term outcomes was variable but more accurate with regard to more severe disabilities and shorter‐term developmental outcomes.
Distinct TERT promoter C228T and C250T mutations in a patient with an oligodendroglioma: A case report
Authors: Ishi Yukitomo , Okada Hiromi , Okamoto Michinari , Motegi Hiroaki , Tanaka Shinya , Mitsuhashi Tomoko , Yamaguchi Shigeru
Published: April 2021

The majority of oligodendroglial tumors harbor mutations in the telomerase reverse transcriptase (TERT) gene (TERT) promoter and the isocitrate dehydrogenase 1/2 (IDH1/2) gene (IDH1/2), as well as 1p/19q codeletion. Generally, TERT promoter mutations, C250T and C228T, are mutually exclusive. We present a case of oligodendroglioma harboring both C250T and C228T mutations in TERT promoter. A 38‐year‐old man presented with grand mal seizures and underwent a resection surgery for a left frontal lobe tumor. He was pathologically diagnosed as having oligodendroglioma and was carefully observed. At 48 years of age, he underwent another resection surgery due to tumor regrowth, with the pathological diagnosis of anaplastic oligodendroglioma. Genetic analysis of the initial tumor specimen revealed IDH1 R132H mutation and both C250T and C228T mutations in TERT promoter. Using mutation‐specific primers, two mutations were considered to be distributed in different alleles. In the tumor specimen obtained during the second surgery, IDH1 R132H mutation was detected to be similar to that of the initial specimen; however, only C228T mutation was detected in TERT promoter. The 1p/19q codeletion was detected in both the initial and recurrent tumor specimens. According to the sequencing data from the two tumor specimens, although TERT promoter mutation has been considered to be an early genetic event in the tumorigenesis of oligodendroglial tumors, it is likely that the C250T and C228T mutations in TERT promoter are subclonally distributed in the same tumor specimen of the present case.
Identification of autophagy‐related gene and lncRNA signatures in the prognosis of HNSCC
Authors: Li Qilin , Wang Jing , Meng Xinyao , Chen Weimin , Feng Jiexiong , Mao Jing
Published: April 2021

Objective

The aim of this study was to identify prognostic autophagy‐related genes and lncRNAs to predict clinical outcomes in head and neck squamous cell carcinoma (HNSCC).

Subjects and methods

Differentially expressed autophagy‐related genes and autophagy‐related lncRNAs were identified by comparing pare‐carcinoma and carcinoma samples of HNSCC. And then, we constructed an ARG and an AR‐lncRNA signature risk score. Receiver operating characteristic (ROC) curve analyses were performed to assess the prognostic prediction capacity. Gene Set Enrichment Analysis (GSEA) and Gene Ontology (GO) functional annotation were used to analysis the functions of ARGs and AR‐lncRNAs.

Results

Six ARGs and thirteen AR‐lncRNAs were identified in the ARG and AR‐lncRNA signatures, and overall survival (OS) in the high‐risk group was significantly shorter than the low‐risk group. ROC analysis showed the ARG and AR‐lncRNA signatures have excellent ability of predicting the total OS of patients with HNSCC. What's more, GSEA and GO functional annotation proved that autophagy‐related pathways are mainly enriched in the high‐risk group.

Conclusions

These findings indicated that our ARG signature and AR‐lncRNA signature could be considered to predict the prognosis of patients with HNSCC and provide a deep understanding of the biological mechanisms of autophagy in HNSCC.
Epistemic Gradualism Versus Epistemic Absolutism
Authors: Lai Changsheng
Published: April 2021

Epistemic absolutism holds that knowledge‐that is ungradable, while epistemic gradualism argues the opposite. This paper purports to remodel the gradualism/absolutism debate. The current model initiated by Stephen Hetherington fails to capture the genuine divergence between the two views, which makes the debate equivocal, and the gradualist side lacks appeal. I propose that the remodeled debate should focus on whether knowledge‐that is a ‘threshold concept’ or a ‘spectrum concept’. That is, whether there is a threshold distinguishing knowledge from non‐knowledge. The reconstructed model enjoys significant advantages as it enables the debate to be more balanced and philosophically interesting.
Clinical impact of multiple DNA virus infections in nondepleted haploidentical and unrelated allogeneic hematopoietic stem cell transplantation
Authors: Kerbauy Mariana N. , Ribeiro Andreza A. F. , Arcuri Leonardo J. , Kerbauy Lucila N. , da Silva Cinthya C. , Camargo Luis Fernando A. , Machado Clarisse M. , Hamerschlak Nelson
Published: April 2021

Few studies have compared the clinical impact of multiple DNA‐virus infections in haploidentical hematopoietic stem cell transplantation (haplo‐HSCT) with posttransplant cyclophosphamide (PTCy) and unrelated donor allogeneic hematopoietic stem cell transplantation (UD‐HSCT) with thymoglobulin, so we retrospectively analyzed viral infections in the first 6 mo posttransplant in these scenarios. Fifty‐nine patients underwent to haplo‐HSCT, and 68 to UD‐HSCT. The most frequent infection was cytomegalovirus (CMV) (76.3% in haplo‐HSCT and 69.1% in UD‐HSCT) (P = .878) and in the group of patients with CMV reactivation, maximal CMV viral load over 2500 UI/ml correlated with worse overall survival‐hazard ratio (HR) 1.93 (95% confidence interval [CI] 1.04‐3.59) P = .03. The cumulative incidence of multiple DNA virus within 180 d of posttransplant was 78.7% for one virus and 28.4% for two or more viruses with no difference regarding the type of transplant. Viral infections, age, and acute graft versus host disease (GVHD) grades II–IV were risk factors for worse overall survival in multivariate analyses: one virus HR 2.53 (95% CI 1.03‐6.17) P = .04, two or more viruses HR 3.51 (95% CI 1.37‐9) P < .01, age HR 1.03 (95% CI 1.02‐1.05) P < .01 and acute GVHD II–IV HR 1.97 (95% CI 1.13‐3.43) P = .01. Also, age over 50 y HR 4.25 (95% CI 2.01‐8.97) P < .001, second CMV reactivation or having both CMV and BK polyomavirus (BKV) HR 2.65 (95% CI 1.26‐5.56) P = .01 and acute GVHD grades II–IV HR 2.23 (95% CI 1.12‐4.43) P = .022 were risk factors for nonrelapse mortality in the multivariate analyses. In conclusion, multiple DNA‐virus infections are frequent in both haplo‐HSCT and UD‐HSCT and a risk factor for worse overall survival.
Melanin‐concentrating hormone‐producing neurons in the hypothalamus regulate brown adipose tissue and thus contribute to energy expenditure
Authors: Izawa Shuntaro , Yoneshiro Takeshi , Kondoh Kunio , Nakagiri Shohei , Okamatsu‐Ogura Yuko , Terao Akira , Minokoshi Yasuhiko , Yamanaka Akihiro , Kimura Kazuhiro
Published: April 2021

Key points

Melanin‐concentrating hormone (MCH) neuron‐ablated mice exhibit increased energy expenditure and reduced fat weight.

Increased brown adipose tissue (BAT) activity and locomotor activity‐independent energy expenditure contributed to body weight reduction in MCH neuron‐ablated mice.

MCH neurons send inhibitory input to the medullary raphe nucleus to modulate BAT activity.

Hypothalamic melanin‐concentrating hormone (MCH) peptide robustly affects energy homeostasis. However, it is unclear whether and how MCH‐producing neurons, which contain and release a variety of neuropeptides/transmitters, regulate energy expenditure in the central nervous system and peripheral tissues. We thus examined the regulation of energy expenditure by MCH neurons, focusing on interscapular brown adipose tissue (BAT) activity. MCH neuron‐ablated mice exhibited reduced body weight, increased oxygen consumption, and increased BAT activity, which improved locomotor activity‐independent energy expenditure. Trans‐neuronal retrograde tracing with the recombinant pseudorabies virus revealed that MCH neurons innervate BAT via the sympathetic premotor region in the medullary raphe nucleus (MRN). MRN neurons were activated by MCH neuron ablation. Therefore, endogenous MCH neuron activity negatively modulates energy expenditure via BAT inhibition. MRN neurons might receive inhibitory input from MCH neurons to suppress BAT activity.
SspABCD-SspFGH Constitutes a New Type of DNA Phosphorothioate-Based Bacterial Defense System
Authors: Wang Shiwei , Wan Mengping , Huang Ruolin , Zhang Yujing , Xie Yuqing , Wei Yue , Ahmad Mustafa , Wu Dan , Hong Yue , Deng Zixin , Chen Shi , Li Zhiqiang , Wang Lianrong
Published: April 2021

We recently found that SspABCD, catalyzing single-stranded (ss) DNA phosphorothioate (PT) modification, coupled with SspE provides protection against phage infection. SspE performs both PT-simulated NTPase and DNA-nicking nuclease activities to damage phage DNA, rendering SspA-E a PT-sensing defense system.
Antibiotic use for acute respiratory infections among under-5 children in Bangladesh: a population-based survey
Authors: Hassan Md Zakiul , Monjur Mohammad Riashad , Biswas Md Abdullah Al Jubayer , Chowdhury Fahmida , Kafi Mohammad Abdullah Heel , Braithwaite Jeffrey , Jaffe Adam , Homaira Nusrat
Published: April 2021

Introduction

Despite acute respiratory infections (ARIs) being the single largest reason for antibiotic use in under-5 children in Bangladesh, the prevalence of antibiotic use in the community for an ARI episode and factors associated with antibiotic use in this age group are unknown.

Methods

We analysed nationally representative, population-based, household survey data from the Bangladesh Demographic and Health Survey 2014 to determine the prevalence of antibiotic use in the community for ARI in under-5 children. Using a causal graph and multivariable logistical regression, we then identified and determined the sociodemographic and antibiotic source factors significantly associated with the use of antibiotics for an episode of ARI.

Results

We analysed data for 2 144 children aged <5 years with symptoms of ARI from 17 300 households. In our sample, 829 children (39%) received antibiotics for their ARI episode (95% CI 35.4% to 42.0%). Under-5 children from rural households were 60% (adjusted OR (aOR): 1.6; 95% CI 1.2 to 2.1) more likely to receive antibiotics compared with those from urban households, largely driven by prescriptions from unqualified or traditional practitioners. Private health facilities were 50% (aOR: 0.5; 95% CI 0.3 to 0.7) less likely to be sources of antibiotics compared with public health facilities and non-governmental organisations. Age of children, sex of children or household wealth had no impact on use of antibiotics.

Conclusion

In this first nationally representative analysis of antibiotic use in under-5 children in Bangladesh, we found almost 40% of children received antibiotics for an ARI episode. The significant prevalence of antibiotic exposure in under-5 children supports the need for coordinated policy interventions and implementation of clinical practice guidelines at point of care to minimise the adverse effects attributed to antibiotic overuse.
Magnitude of internalised stigma and associated factors among people with bipolar disorder at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study
Authors: Shumet Shegaye , W/Michele Bethlehem , Angaw Dessie , Ergete Temesgen , Alemnew Nigus
Published: April 2021

Objectives

To assess the magnitude of internalised stigma and associated factors among patients with bipolar disorder attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Design

Institution-based cross-sectional study design.

Setting

Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

Participants

We recruited about 418 participants using systematic sampling technique for an interview during the study period.

Measurement

Data were collected by face-to-face interviews. Internalized Stigma of Mental Illness scale was used to measure internalised stigma. The Rosenberg Self-Esteem Scale and the Oslo-3 Social Support were instruments used to assess the associated factors. Bivariate and multivariate logistic regressions were performed to identify factors associated with the outcome variable. ORs with 95% CI were computed to determine the level of significance.

Results

The magnitude of internalised stigma was 24.9% (95% CI: 21.2% to 28.9%). In the multivariate analysis, unemployed (adjusted OR (AOR)=2.3, 95% CI: 1.0 to 5.0), unable to read and write (AOR=3.3, 95% CI: 1.05 to 10.7), poor social support (AOR=5.3, 95% CI: 1.9 to 15.0), ≥4 previous hospitalisations due to bipolar disorder (AOR=2.6, 95% CI: 1.1 to 6.1) and low self-esteem (AOR=2.4, 95% CI: 1.1 to 5.1) had a significant association with internalised stigma.

Conclusions

One in four patients with bipolar disorder reported high internalised stigma. Unemployment, low educational status, low self-esteem, poor social support and being hospitalised more than three times before were significantly associated with internalised stigma. Thus, a stigma-reduction programme focusing on self-esteem improvement and psychological health of patients to increase their stigma resistance to counteracting effects of internalised stigma is essential.
Randomised controlled trial of a just-in-time adaptive intervention (JITAI) smoking cessation smartphone app: the Quit Sense feasibility trial protocol
Authors: Naughton Felix , Brown Chloë , High Juliet , Notley Caitlin , Mascolo Cecilia , Coleman Tim , Barton Garry , Shepstone Lee , Sutton Stephen , Prevost A Toby , Crane David , Greaves Felix , Hope Aimie
Published: April 2021

Introduction

A lapse (any smoking) early in a smoking cessation attempt is strongly associated with reduced success. A substantial proportion of lapses are due to urges to smoke triggered by situational cues. Currently, no available interventions proactively respond to such cues in real time. Quit Sense is a theory-guided just-in-time adaptive intervention smartphone app that uses a learning tool and smartphone sensing to provide in-the-moment tailored support to help smokers manage cue-induced urges to smoke. The primary aim of this randomised controlled trial (RCT) is to assess the feasibility of delivering a definitive online efficacy trial of Quit Sense.

Methods and analyses

A two-arm parallel-group RCT allocating smokers willing to make a quit attempt, recruited via online adverts, to usual care (referral to the NHS SmokeFree website) or usual care plus Quit Sense. Randomisation will be stratified by smoking rate (<16 vs ≥16 cigarettes/day) and socioeconomic status (low vs high). Recruitment, enrolment, baseline data collection, allocation and intervention delivery will be automated through the study website. Outcomes will be collected at 6 weeks and 6 months follow-up via the study website or telephone, and during app usage. The study aims to recruit 200 smokers to estimate key feasibility outcomes, the preliminary impact of Quit Sense and potential cost-effectiveness, in addition to gaining insights on user views of the app through qualitative interviews.

Ethics and dissemination

Ethics approval has been granted by the Wales NHS Research Ethics Committee 7 (19/WA/0361). The findings will be disseminated to the public, the funders, relevant practice and policy representatives and other researchers.

Trial registration number

ISRCTN12326962.
WHO mental health gap action programme (mhGAP) intervention guide: updated systematic review on evidence and impact
Authors: Keynejad Roxanne , Spagnolo Jessica , Thornicroft Graham
Published: April 2021

Question

There is a large worldwide gap between the service need and provision for mental, neurological and substance use disorders. WHO’s Mental Health Gap Action Programme (mhGAP) intervention guide (IG), provides evidence-based guidance and tools for assessment and integrated management of priority disorders. Our 2017 systematic review identified 33 peer-reviewed studies describing mhGAP-IG implementation in low-income and middle-income countries.

Study selection and analysis

We searched MEDLINE, Embase, PsycINFO, Web of Knowledge, Scopus, CINAHL, LILACS, ScieELO, Cochrane, PubMed databases, 3ie, Google Scholar and citations of our review, on 24 November 2020. We sought evidence, experience and evaluations of the mhGAP-IG, app or mhGAP Humanitarian IG, from any country, in any language. We extracted data from included papers, but heterogeneity prevented meta-analysis.

Findings

Of 2621 results, 162 new papers reported applications of the mhGAP-IG. They described mhGAP training courses (59 references), clinical applications (n=49), research uses (n=27), contextual adaptations (n=13), economic studies (n=7) and other educational applications (n=7). Most were conducted in the African region (40%) and South-East Asia (25%). Studies demonstrated improved knowledge, attitudes and confidence post-training and improved symptoms and engagement with care, post-implementation. Research studies compared mhGAP-IG-enhanced usual care with task-shared psychological interventions and adaptation studies optimised mhGAP-IG implementation for different contexts. Economic studies calculated human resource requirements of scaling up mhGAP-IG implementation and other educational studies explored its potential for repurposing.

Conclusions

The diverse, expanding global mhGAP-IG literature demonstrates substantial impact on training, patient care, research and practice. Priorities for future research should be less-studied regions, severe mental illness and contextual adaptation of brief psychological interventions.
Effectiveness of intravenous r-tPA versus UK for acute ischaemic stroke: a nationwide prospective Chinese registry study
Authors: Wang Xinhong , Li Xiaoqiu , Xu Yuming , Li Runhui , Yang Qingcheng , Zhao Yong , Wang Fengyun , Sheng Baoying , Wang Runqing , Chen Shaoyuan , Wang Lihua , Shen Liying , Hou Xiaowen , Cui Yu , Wang Duolao , Peng Bin , Anderson Craig S , Chen Huisheng
Published: April 2021

Background

Intravenous recombinant tissue plasminogen activator (r-tPA) and urokinase (UK) are both recommended for the treatment of acute ischaemic stroke (AIS) in China, but with few comparative outcome data being available. We aimed to compare the outcomes of these two thrombolytic agents for the treatment of patients within 4.5 hours of onset of AIS in routine clinical practice in China.

Methods

A pre-planned, prospective, nationwide, multicentre, real-world registry of consecutive patients with AIS (age ≥18 years) who received r-tPA or UK within 4.5 hours of symptom onset according to local decision-making and guideline recommendations during 2017–2019. The primary effectiveness outcome was the proportion of patients with an excellent functional outcome (defined by modified Rankin scale scores 0 to 1) at 90 days. The key safety endpoint was symptomatic intracranial haemorrhage according to standard definitions. Multivariable logistic regression was used for comparative analysis, with adjustment according to propensity scores to ensure balance in baseline characteristics.

Results

Overall, 4130 patients with AIS were registered but 320 had incomplete or missing data, leaving 3810 with available data for analysis of whom 2666 received r-tPA (median dose 0.88 (IQR 0.78–0.90) mg/kg) and 1144 received UK (1.71 (1.43–2.00)×104international unit per kilogram). There were several significant intergroup differences in patient characteristics: r-tPA patients were more educated, had less history of stroke, lower systolic blood pressure, greater neurological impairment and shorter treatment times from symptom onset than UK patients. However, in adjusted analysis, the frequency of excellent outcome (OR 1.18, 95% CI 1.00 to 1.40, p=0.052) and symptomatic intracranial haemorrhage (OR 0.70, 95% CI 0.33 to 1.47, p=0.344) were similar between groups.

Conclusions

UK may be as effective and carry a similar safety profile as r-tPA in treating mild to moderate AIS within guidelines in China.

Registration

http://www.clinicaltrials.gov. unique identifier:NCT02854592.
Remote ischaemic conditioning for stroke: unanswered questions and future directions
Authors: Baig Sheharyar , Moyle Bethany , Nair Krishnan Padmakumari Sivaraman , Redgrave Jessica , Majid Arshad , Ali Ali
Published: April 2021

Remote ischaemic conditioning (RIC) refers to a process whereby periods of intermittent ischaemia, typically via the cyclical application of a blood pressure cuff to a limb at above systolic pressure, confers systemic protection against ischaemia in spatially distinct vascular territories. The mechanisms underlying this have not been characterised fully but have been shown to involve neural, hormonal and systemic inflammatory signalling cascades. Preclinical and early clinical studies have been promising and suggest beneficial effects of RIC in acute ischaemic stroke, symptomatic intracranial stenosis and vascular cognitive impairment. Through systematic searches of several clinical trials databases we identified 48 active clinical trials of RIC in ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage. We summarise the different RIC protocols and outcome measures studied in ongoing clinical trials and highlight which studies are most likely to elucidate the underlying biological mechanisms of RIC and characterise its efficacy in the near future. We discuss the uncertainties of RIC including the optimal frequency and duration of therapy, target patient groups, cost-effectiveness, the confounding impact of medications and the absence of a clinically meaningful biomarker of the conditioning response. With several large clinical trials of RIC expected to report their outcomes within the next 2 years, this review aims to highlight the most important studies and unanswered questions that will need to be addressed before this potentially widely accessible and low-cost intervention can be used in clinical practice.
Nano-oxides immobilize cadmium, lead, and zinc in mine spoils and contaminated soils facilitating plant growth
Authors: Indraratne Srimathie P. , Pierzynski Gary M. , Baker Lucas R. , Vara Prasad P.V.
Published: April 2021

Nanoparticles with high reactivity can be applied as amendments to remediate soil metal contaminations by immobilizing toxic elements. Nano-oxides of Fe have been studied but Al and Ti nano-oxides have not been tested for their remediation capacity of toxic metals. The potential of synthesized iron (Fe-O), aluminum (Al-O), and titanium (Ti-O) nano-oxides for stabilizing Cd, Pb, and Zn in mine spoil (Chat) and contaminated soil was compared using adsorption studies and a greenhouse experiment. Chat and soil were amended with nano-oxides at two rates (25 and 50 g·kg−1) and a pot experiment was conducted with sorghum (Sorghum bicolor L. Moench). Leachates were collected twice per week from plant emergence to harvest at maturity and metals were compared against an unamended control. Chat was contaminated with Cd, Pb, and Zn at 84, 1583, and 6154 mg·kg−1, and soil at 15, 1260, and 3082 mg·kg−1, respectively. Adsorption conformed to the Langmuir linear isotherm and adsorption maxima of metals were in the order of Al-O > Ti-O ≥ Fe-O. Nano-oxides reduced Cd concentration by 28% (Fe-O) to 87% (Ti-O) and Zn concentration by 14% (Fe-O) to 85% (Al-O) in plant tissues compared with unamended Chat. Nano-oxides significantly reduced Cd, Pb, and Zn in leachates and available Cd and Zn in Chat/soil relative to the respective unamended controls. Nano-oxides can be used to remediate heavy metal contaminated Chat and soil and facilitate plant growth under proper nutrient supplements. Nano-oxides of Al-O and Ti-O remediated metals more effectively than Fe-O.
Identification and characterization of heat-responsive microRNAs at the booting stage in two rice varieties, 9311 and Nagina 22
Authors: Luo Ying , Wang Tao , Yang Dan , Luo Biao , Wang Wei-Ping , Yu Dong , He Fu-Lin , Wang Qi-Ming , Rao Li-Qun
Published: April 2021

MicroRNAs (miRNAs) are small, non-coding, regulatory RNAs that play important roles in abiotic stress responses in plants, but their regulatory roles in the adaptive response to heat stress at the booting stage in two rice varieties, 9311 and Nagina 22, remain largely unknown. In this study, 464 known miRNAs and 123 potential novel miRNAs were identified. Of these miRNAs, a total of 90 differentially expressed miRNAs were obtained with 9311 libraries as the control group, of which 54 were upregulated and 36 were downregulated. To gain insight into functional significance, 2773 potential target genes of these 90 differentially expressed miRNAs were predicted. GO enrichment analysis showed that the predicted target genes of differentially expressed miRNAs included NACs, LACs, CSD, and Hsp40. KEGG pathway analysis showed that the target genes of these differentially expressed miRNAs were significantly enriched in the plant hormone signal transduction pathway. The expression levels of 10 differentially expressed miRNAs and their target genes obtained by qRT-PCR were largely consistent with the sequencing results. This study lays a foundation for the elucidation of the miRNA-mediated regulatory mechanisms in rice at elevated temperatures.
Anticipation-induced social tipping: can the environment be stabilised by social dynamics?
Authors: Müller Paul Manuel , Heitzig Jobst , Kurths Jürgen , Lüdge Kathy , Wiedermann Marc
Published: April 2021

In the past decades, human activities caused global Earth system changes, e.g., climate change or biodiversity loss. Simultaneously, these associated impacts have increased environmental awareness within societies across the globe, thereby leading to dynamical feedbacks between the social and natural Earth system. Contemporary modelling attempts of Earth system dynamics rarely incorporate such co-evolutions and interactions are mostly studied unidirectionally through direct or remembered past impacts. Acknowledging that societies have the additional capability for foresight, this work proposes a conceptual feedback model of socio-ecological co-evolution with the specific construct of anticipation acting as a mediator between the social and natural system. Our model reproduces results from previous sociological threshold models with bistability if one assumes a static environment. Once the environment changes in response to societal behaviour, the system instead converges towards a globally stable, but not necessarily desired, attractor. Ultimately, we show that anticipation of future ecological states then leads to metastability of the system where desired states can persist for a long time. We thereby demonstrate that foresight and anticipation form an important mechanism which, once its time horizon becomes large enough, fosters social tipping towards behaviour that can stabilise the environment and prevents potential socio-ecological collapse.
Physical invariant measures and tipping probabilities for chaotic attractors of asymptotically autonomous systems
Authors: Ashwin Peter , Newman Julian
Published: April 2021

Physical measures are invariant measures that characterise “typical” behaviour of trajectories started in the basin of chaotic attractors for autonomous dynamical systems. In this paper, we make some steps towards extending this notion to more general nonautonomous (time-dependent) dynamical systems. There are barriers to doing this in general in a physically meaningful way, but for systems that have autonomous limits, one can define a physical measure in relation to the physical measure in the past limit. We use this to understand cases where rate-dependent tipping between chaotic attractors can be quantified in terms of “tipping probabilities”. We demonstrate this for two examples of perturbed systems with multiple attractors undergoing a parameter shift. The first is a double-scroll system of Chua et al., and the second is a Stommel model forced by Lorenz chaos.
Study on space absorbing of multilayer MWCNTs/Fe3O4/NBR composites
Authors: Xinhua Song , Haiyang Zhou , Tiejun Zhao , Xiaojie Li , Honghao Yan
Published: April 2021

In order to meet the requirements of “wide, thin, strong and light” for military stealth materials, it is of great practical value to study the absorbing characteristics of multi-layer MWCNTs/Fe3O4/NBR absorbing materials in space. First, we use the large-scale software COMSOL Multiphysics to simulate the absorbing characteristics of the composite thin plate in space. Then the four-port network matrix is used to calculate the absorbing characteristics of the composite plate in space. Finally, the Free-Space method is used to measure the reflection attenuation loss, and the results of the three methods are compared and analyzed. The results show that when the frequency is 10 GHz, the reflection loss of multi-layer MWCNTs/Fe3O4/NBR reaches the maximum value of −27.91, −27.01 and −22.56 dB by COMOSL numerical simulation, four-port network the matrix and Free-Space experimental measurement. The results of the three methods show that the reflection loss is less than −10 dB in the frequency band of 6–14 GHz.
Visual network analysis of the Baidu-index data on greenhouse gas
Authors: Zhu Xueyan , Xia Chengyi
Published: April 2021

Baidu search engine is the most common one adopted by Chinese Internet users, and Baidu index provides a platform to capture the behaviors of massive users on Baidu, which is one important statistical tool to mine the Internet users’ behaviors and characteristics in China. Here, we utilize the Baidu index data on greenhouse gas from January 1, 2011 to November 29, 2019, to perform the related statistical analyses at first. Then, on the basis of Baidu index time series data, the corresponding network is constructed by use of the visibility graph method. Finally, the topology of the generated network is analyzed from different perspectives. Our results indicate that people’s attention to greenhouse gases obeys the power-law distribution, and we can identify the significant nodes and find some outliers in time series data by use of the topological properties of networks. Taking together, the current model offers a novel means to represent and depict the time series data of Baidu index through the complex network analysis.
EFFECTS OF COATING PROPERTIES ON CONTROLLED DELIVERY FROM AN EMBEDDED DRUG-ELUTING STENT: A SIMULATION STUDY
Authors: SARIFUDDIN  , ALSEMIRY REIMA D. , MANDAL PRASHANTA KUMAR
Published: April 2021

The present investigation deals with the effects of biodegradable, biodurable and polymer-free coating of a stent on the release mechanism of the drug in a porous medium. The Brinkman equations for the interstitial fluid, the unsteady convection-diffusion-reaction equation for the transport of free drug in the tissue and the unsteady reaction equations for the bound as well as the internalized drug have been considered. In the coating, the transport of drug has been modeled as a diffusion process. Effects of different percentages of the embedment, convection and various coating properties of the stent on the transport of free drug, its retention and the internalization of the bound drug have been studied. Immersed Boundary Method (IBM) in the staggered grid formulation (IBM-MAC) has been used to tackle numerically the system of nonlinear governing equations. Simulated results predict the fastest release of drug from a biodegradable coating, but the averaged concentrations of all drug forms do reach a quasi-steady state in case of a biodurable coating irrespective of the degrees of embedment. Moreover, for all embedment levels of the stent, a biodegradable coating is superior to that of biodurable and polymer-free coating in the presence/absence of convection for larger times, but this superiority is lost for smaller times. Unlike biodurable coating, it is also predicted that the more the embedment level does not necessarily imply the more the effectiveness of delivery for biodegradable and polymer-free coatings of a stent.