bluuebunny/crossref_metadata_2025 huggingface dataset:
Patterns of methamphetamine production among an international sample of methamphetamine ‘cooks’
Authors: Puljević Cheneal , Zahnow Renee , Benfer Isabella , Winstock Adam R. , Maier Larissa J. , Barratt Monica J. , Ferris Jason
Published: November 2020

Introduction and Aims

The illicit manufacture of methamphetamine in clandestine laboratories is associated with significant risks to the community and environment. Currently little is known about clandestine laboratories or the individual ‘cooks’ who operate them; current research directly engaging with cooks is limited to three qualitative studies with small samples (n < 24) of cooks based in the USA. This descriptive brief report starts to address this knowledge gap by exploring characteristics of an international sample of self‐identified methamphetamine cooks.

Design and Methods

Using data from the 2017 and 2018 Global Drug Surveys, we identified 125 individuals from 24 countries who reported past manufacture of methamphetamine. We explored respondents' socio‐demographic characteristics and patterns of methamphetamine production using descriptive statistics.

Results

The majority of methamphetamine cooks were male (82%) and Caucasian (70%) and, contrary to previous studies, 43% were employed and 51% had at least a high school certificate. Cooks most commonly sourced precursors from pharmacies (50%), followed by friends (24%). Almost half of the cooks (47%) produced methamphetamine exclusively for self‐consumption.

Discussion and Conclusions

The heterogeneous nature of the sample and varying precursor sources reflect the limitations of existing regulations aimed at limiting methamphetamine production. These findings point to the need for innovative and multi‐faceted efforts aimed at reducing and preventing the harms associated with methamphetamine manufacture.
Regional coordination between riparian dependence and atmospheric demand in willows (Salix L.) of western North America
Authors: Butterfield Bradley J. , Palmquist Emily C. , Hultine Kevin R.
Published: November 2020

Aim

Plants vary in their hydrological and climatic niches. How these niche dimensions covary among closely related species can help identify co‐adaptations to hydrological and climatic factors, as well as predict biodiversity responses to environmental change.

Location

Western United States.

Methods

Relationships between riparian dependence and climate niches of willows (Salix L.) were assessed, incorporating phylogenetics and functional traits to understand the adaptive nature of those relationships. The riparian dependence niche was estimated as the mean distance between georeferenced occurrence records and the nearest stream based on the National Hydrography Database. Results were compared to oaks (Quercus L.), a less riparian‐dependent clade, with the expectation of different niche relationships.

Results

Willows generally occurred closer to streams than expected by chance, but riparian dependence varied substantially among species. Riparian dependence was positively correlated with mean annual temperature and diurnal temperature range niche, both indicators of atmospheric demand on evapotranspiration. Phylogenetic independent contrast correlations for these relationships were significant as well, and the high degree of niche convergence among species indicated evolutionarily labile co‐adaptations to riparian dependence and atmospheric demand. Plant height increased with mean annual temperature niche, and specific leaf area increased with residual variation in height, indicating underlying morphological correlates of niche variation. Oaks, on the other hand, exhibited no relationship between atmospheric demand and riparian dependence, and weaker niche relationships with riparian dependence overall.

Main conclusions

These results support the assertion that hydric‐adapted, woody riparian plants compensate for increased atmospheric demand on transpiration with a reliable supply of water provided by riparian habitats and that this trade‐off may be unique from mesic–xeric woody plants. Conservation of warm‐adapted riparian trees and shrubs under increasing temperatures and atmospheric demand may necessitate reversal of groundwater depletion. Cool‐adapted species may be best conserved through maintenance or expansion of riparian buffers as they become more riparian obligate with warming.
Pricing during Disruptions: Order Variability versus Profit
Authors: Feng Xiaojing , Rong Ying , Shen Zuo‐Jun Max , Snyder Lawrence V.
Published: November 2020

When supply disruptions occur, firms want to employ an effective pricing strategy to reduce losses. However, firms typically do not know precisely how customers will react to price changes in the short term, during a disruption. In this article, we investigate the customer's order variability and the firm's profit under several representative heuristic pricing strategies, including no change at all (fixed pricing strategy), changing the price only (naive pricing strategy), and adjusting the belief and price simultaneously (one‐period correction [1PC] and regression pricing strategies). We show that the fixed pricing strategy creates the most stable customer order process, but it brings lower profit than the naive pricing strategy in most cases. The 1PC pricing strategy produces a more volatile customer order process and smaller profit than the naive one does. Although the regression pricing strategy is a more advanced approach, it leads to lower profit and greater customer order variability than the naive pricing strategy (but the opposite when compared to the 1PC strategy). We conclude that (i) completely eliminating the customer order variability by employing a fixed pricing strategy is not advisable and adjusting the price to match supply with demand is necessary to improve the profit; (ii) frequently adjusting the belief about customer behaviors under imperfect information may increase the customer's order variability and reduce the firm's profit. The conclusions are robust to the inventory assumption (i.e., without or with inventory carryover) and the firm's objective (i.e., market clearance or profit maximization).
Increasing medical student numbers in resource constrained settings: Ethical and legal complexities intersecting patients’ rights and responsibilities
Authors: Menezes Colin , Dhai Ames
Published: November 2020

There is a need to increase the number of practicing medical doctors in South Africa. We examine the ethical implications of patients’ rights being affected in medical education in a South African context.

The South African legal framework advocates public healthcare access. Yet, the State’s ethical obligations when it comes to guaranteeing public healthcare access, conflict with its utilitarian policy, that allows for medical education to help achieve the State’s public healthcare commitments, at the cost of eroding patients’ rights, and accepts that certain actions are imperative, in line with Ubuntu, which is tenable yet nuanced. A patient treated by a licenced doctor today, benefits because other patients have allowed themselves to be used as hands‐on learning material for medical students yesterday.

Healthcare institutions need to take cognisance of the numbers of medical students that patients can reasonably be expected to endure. There is a need for the Health Professions Council of South Africa and medical schools to adopt guidelines on reasonable levels of medical student‐patient interaction, and medical student‐to‐patient ratios in healthcare delivery.
In vitro egg hatching of Diaphorina citri, the vector of Huanglongbing
Authors: Santos‐Ortega Yulica , Killiny Nabil
Published: November 2020

Citrus greening (Huanglongbing, HLB) is a destructive disease associated with the uncultivable, phloem‐limited, gram‐negative bacteria Candidatus Liberibacter spp., which affects citrus crops and other Rutaceae species. HLB is rapidly transmitted by the Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae). We developed an artificial medium on which D. citri eggs can hatch and first‐instar nymphs can feed. The medium could be used to study insect physiology and screen molecules that may interfere with egg hatching and nymph development.
Age‐related decrements in cortical gyrification: Evidence from an accelerated longitudinal dataset
Authors: Madan Christopher R.
Published: November 2020

Cortical gyrification has been found to decrease due to aging, but thus far this has only been examined in cross‐sectional samples. Interestingly, the topography of these age‐related differences in gyrification follows a distinct gradient along the cortex relative to age effects on cortical thickness, likely suggesting a different underlying neurobiological mechanism. Here I examined several aspects of gyrification in an accelerated longitudinal dataset of 280 healthy adults aged 45–92 with an interval between first and last MRI sessions of up to 10 years (total of 815 MRI sessions). Results suggest that age changes in sulcal morphology underlie these changes in gyrification.
Neural generators involved in visual cue processing in children with attention‐deficit/hyperactivity disorder (ADHD)
Authors: Zarka David , Leroy Axelle , Cebolla Ana Maria , Cevallos Carlos , Palmero‐Soler Ernesto , Cheron Guy
Published: November 2020

Event‐related potentials (ERP) studies report alterations in the ongoing visuo‐attentional processes in children with attention‐deficit/hyperactivity disorder (ADHD). We hypothesized that the neural generators progressively recruited after a cue stimulus imply executive‐related areas well before engagement in executive processing in children with ADHD compared to typically developed children (TDC). We computed source localization (swLORETA) of the ERP and ERSP evoked by the Cue stimulus during a visual Cue‐Go/Nogo paradigm in 15 ADHD compared to 16 TDC. A significant difference in N200/P200 amplitude over the right centro‐frontal regions was observed between ADHD and TDC, supported by a stronger contribution of the left visuo‐motor coordination area, premotor cortex, and prefrontal cortex in ADHD. In addition, we recorded a greater beta power spectrum in ADHD during the 80–230 ms interval, which was explained by increased activity in occipito‐parieto‐central areas and lower activity in the left supramarginal gyrus and prefrontal areas in ADHD. Successive analysis of the ERP generators (0–500 ms with successive periods of 50 ms) revealed significant differences beginning at 50 ms, with higher activity in the ventral anterior cingulate cortex, premotor cortex, and fusiform gyrus, and ending at 400–500 ms with higher activity of the dorsolateral prefrontal cortex and lower activity of the posterior cingulate cortex in ADHD compared to TDC. The areas contributing to ERP in ADHD and TDC differ from the early steps of visuo‐attentional processing and reveal an overinvestment of the executive networks interfering with the activity of the dorsal attention network in children with ADHD.
Responsivity to light in familial hemiplegic migraine type 1 mutant mice reveals frequency‐dependent enhancement of visual network excitability
Authors: Perenboom Matthijs J. L. , Schenke Maarten , Ferrari Michel D. , Terwindt Gisela M. , van den Maagdenberg Arn M. J. M. , Tolner Else A.
Published: November 2020

Migraine patients often report (inter)ictal hypersensitivity to light, but the underlying mechanisms remain an enigma. Both hypo‐ and hyperresponsivity of the visual network have been reported, which may reflect either intra‐individual dynamics of the network or large inter‐individual variation in the measurement of human visual evoked potential data. Therefore, we studied visual system responsivity in freely behaving mice using combined epidural electroencephalography and intracortical multi‐unit activity to reduce variation in recordings and gain insight into visual cortex dynamics. For better clinical translation, we investigated transgenic mice that carry the human pathogenic R192Q missense mutation in the α1A subunit of voltage‐gated CaV2.1 Ca2+ channels leading to enhanced neurotransmission and familial hemiplegic migraine type 1 in patients. Visual evoked potentials were studied in response to visual stimulation paradigms with flashes of light. Following intensity‐dependent visual stimulation, FHM1 mutant mice displayed faster visual evoked potential responses, with lower initial amplitude, followed by less pronounced neuronal suppression compared to wild‐type mice. Similar to what was reported for migraine patients, frequency‐dependent stimulation in mutant mice revealed enhanced photic drive in the EEG beta‐gamma band. The frequency‐dependent increases in visual network responses in mutant mice may reflect the context‐dependent enhancement of visual cortex excitability, which could contribute to our understanding of sensory hypersensitivity in migraine.
Nitric Oxide Synthase inhibition counteracts the stress‐induced DNA methyltransferase 3b expression in the hippocampus of rats
Authors: de Sousa Maciel Izaque , Sales Amanda J. , Casarotto Plinio C. , Castrén Eero , Biojone Caroline , Joca Sâmia R. L.
Published: November 2020

It has been postulated that the activation of NMDA receptors (NMDAr) and nitric oxide (NO) production in the hippocampus is involved in the behavioral consequences of stress. Stress triggers NMDAr‐induced calcium influx in limbic areas, such as the hippocampus, which in turn activates neuronal NO synthase (nNOS). Inhibition of nNOS or NMDAr activity can prevent stress‐induced effects in animal models, but the molecular mechanisms behind this effect are still unclear. In this study, cultured hippocampal neurons treated with NMDA or dexamethasone showed an increased of DNA methyltransferase 3b (DNMT3b) mRNA expression, which was blocked by pre‐treatment with nNOS inhibitor nω‐propyl‐l‐arginine (NPA). In rats submitted to the Learned Helplessness paradigm (LH), we observed that inescapable stress increased DNMT3b mRNA expression at 1h and 24h in the hippocampus. The NOS inhibitors 7‐NI and aminoguanidine (AMG) decreased the number of escape failures in LH and counteracted the changes in hippocampal DNMT3b mRNA induced in this behavioral paradigm. Altogether, our data suggest that NO produced in response to NMDAr activation following stress upregulates DNMT3b in the hippocampus.
SMART syndrome: retrospective review of a rare delayed complication of radiation
Authors: Singh Tarun D. , Hajeb Mania , Rabinstein Alejandro A. , Kunchok Amy C. , Pittock Sean J. , Krecke Karl N. , Bartleson John D. , Black David F.
Published: November 2020

Background

SMART (stroke‐like migraine attacks after radiation therapy) is a rare, delayed complication of brain radiation. In this study, we wanted to review the spectrum of symptoms, neuroradiological findings, autoimmune status, and outcomes in SMART syndrome patients.

Methods

We conducted a retrospective cohort study of all consecutive adult patients (≥18 years) diagnosed with SMART syndrome at Mayo Clinic, Rochester between January 1995 and December 2018.

Results

We identified 25 unique patients with SMART syndrome and a total of 31 episodes and 15 (60%) patients were male. The median age at onset was 46 (interquartile range [IQR] 43–55) years and the median latency of onset after the initial radiation was 21.6 (IQR 14.4–28.2) years. Magnetic resonance imaging (MRI) showed gyral edema and enhancement in all cases with the temporal (25, 80.6%) and parietal (23, 74.2%) lobes being the most commonly affected. The median follow‐up of the patients in our cohort was 10 (IQR 6–32) weeks. On univariate analysis, factors associated with an increased risk of recurrent SMART episodes were female gender (odds ratio [OR] 8.1, 95% confidence interval [95% CI] 1.1–52.6, p = 0.019) and absence of electrographic seizure discharges during initial symptoms (OR 7.4, 95% CI 1.1–45.9, p = 0.032). We could not identify an autoimmune etiology. Longer duration of symptoms (>10 weeks) correlated with an older age (p = 0.049), temporal lobe involvement (p < 0.001), and diffusion restriction (p = 0.043).

Conclusions

SMART is a syndrome with characteristic imaging findings and clinical features. Incomplete recovery by 10 weeks occurred in one‐third of individuals and was associated with older age, temporal lobe involvement, and restricted diffusion on MRI.
Urban evolution comes into its own: Emerging themes and future directions of a burgeoning field
Authors: Miles Lindsay S. , Carlen Elizabeth J. , Winchell Kristin M. , Johnson Marc T. J.
Published: November 2020

Urbanization has recently emerged as an exciting new direction for evolutionary research founded on our growing understanding of rapid evolution paired with the expansion of novel urban habitats. Urbanization can influence adaptive and nonadaptive evolution in urban‐dwelling species, but generalized patterns and the predictability of urban evolutionary responses within populations remain unclear. This editorial introduces the special feature “Evolution in Urban Environments” and addresses four major emerging themes, which include: (a) adaptive evolution and phenotypic plasticity via physiological responses to urban climate, (b) adaptive evolution via phenotype–environment relationships in urban habitats, (c) population connectivity and genetic drift in urban landscapes, and (d) human–wildlife interactions in urban spaces. Here, we present the 16 articles (12 empirical, 3 review, 1 capstone) within this issue and how they represent each of these four emerging themes in urban evolutionary biology. Finally, we discuss how these articles address previous questions and have now raised new ones, highlighting important new directions for the field.
A C6/C5 co‐fermentingSaccharomyces cerevisiaestrain with the alleviation of antagonism between xylose utilization and robustness
Authors: Wei Fangqing , Li Menglei , Wang Ming , Li Hongxing , Li Zailu , Qin Wensheng , Wei Tiandi , Zhao Jianzhi , Bao Xiaoming
Published: November 2020

During second‐generation bioethanol production from lignocellulosic biomass, the desired traits for fermenting microorganisms, such asSaccharomyces cerevisiae, are high xylose utilization and high robustness to inhibitors in lignocellulosic hydrolysates. However, as observed previously, these two traits easily showed the antagonism, one rising and the other falling, in the C6/C5 co‐fermentingS. cerevisiaestrain. In this study, LF1 obtained in our previous study is an engineered budding yeast strain with a superior co‐fermentation capacity of glucose and xylose, and was then mutated by atmospheric and room temperature plasma (ARTP) mutagenesis to improve its robustness. The ARTP‐treated cells were grown in 50% (v/v) leachate from lignocellulose pretreatment with high inhibitors content for adaptive evolution. After 30 days, the generated mutant LF1‐6 showed significantly enhanced tolerance, with a six‐fold increase in cell density in the above leachate. Unfortunately, its xylose utilization dropped markedly, indicating the recurrence of the negative correlation between xylose utilization and robustness. To alleviate this antagonism, LF1‐6 cells were iteratively mutated with ARTP mutagenesis and then anaerobically grown using xylose as the sole carbon source, and xylose utilization was restored in the resulting strain 6M‐15. 6M‐15 also exhibited increased co‐fermentation performance of xylose and glucose with the highest ethanol productivity reported to date (0.525 g g−1 h−1) in high‐level mixed sugars (80 g L−1glucose and 40 g L−1xylose) with no inhibitors. Meanwhile, its fermentation time was shortened by 8 h compared to that of LF1. During the fermentation of non‐detoxified lignocellulosic hydrolysate with high inhibitor concentrations at pH ~3.5, 6M‐15 can efficiently convert glucose and xylose with an ethanol yield of 0.43 g g−1. 6M‐15 is also regarded as a potential chassis cell for further design of a customized strain suitable for production of second‐generation bioethanol or other high value‐added products from lignocellulosic biomass.
Partial least squares regression and importance–satisfaction analyses of the strategic drivers of happiness: A quality of life survey in Seoul, Korea
Authors: Gim Tae‐Hyoung T.
Published: November 2020

Using survey data by the Seoul Metropolitan Government for 5 years (n = 228,103 individuals), this study analyzes the magnitudes of the impacts of major grouping variables on variations in the overall happiness through partial least squares regression analysis. This study then uses the importance–satisfaction analysis to explore how the between‐group variations can be reduced according to the current satisfaction as well as the ultimate importance of the five happiness components (health, finance, relationships with close relatives/friends, home life, and social life). The regression finds that self‐respect‐as‐a‐Seoul‐citizen, social class recognition, years (other than 2014), household income, and not being elderly have a positive difference in happiness. The importance of the social class recognition over the objective income suggests the validity of soft policies for increasing happiness as a subjective concept. The low happiness level in 2014 may reflect history effects or events that occurred in that year. The importance–satisfaction analysis presents customized strategies by group. Specifically, policies oriented to financial happiness are prioritized for groups with low values on self‐respect, class recognition, household income, and age while health‐ and home life‐related policies should be additionally arranged for the older population.
Impact of different regenerative techniques and materials on the healing outcome of endodontic surgery: a systematic review and meta‐analysis
Authors: Liu T. J. , Zhou J. N. , Guo L. H.
Published: November 2020

Background

Regenerative techniques are increasingly applied in endodontic surgery, but different materials used in regenerative techniques may have varying impacts on wound healing.

Objectives

This study evaluated the effects of different regenerative techniques and materials on the outcome of endodontic surgery. Participants: patients with persistent periapical lesions, treated with root‐end surgery. Control: endodontic surgery without the use of regenerative techniques/materials. Intervention: endodontic surgery with the use of regenerative techniques/materials. Outcome: combined clinical and radiographic results.

Methods

PubMed, Web of Science, Embase, SinoMed and the CENTRAL Cochrane were searched up to 10th July 2020, followed by a manual search. Detailed eligibility criteria were applied. Cochrane’s risk‐of‐bias tool 2.0 was used to assess the risk of bias of the eligible studies. Meta‐analysis was conducted using RevMan software. Subgroup analyses were performed based on the regenerative materials used in endodontic surgery.

Results

Eleven eligible randomized controlled trials (RCTs) were included in the meta‐analysis: two had a low risk of overall bias, and nine had some concerns of overall bias. Generally, the use of regenerative techniques significantly improved the outcome of endodontic surgery (risk ratio [RR]: 0.42; 95% confidence interval [CI], 0.26–0.68;P < 0.001). On subgroup analysis, the use of expanded polytetrafluoroethylene (e‐PTFE) membranes alone had no added benefits (RR: 2.00; 95% CI, 0.22–18.33;P = 0.54). The application of collagen membranes or autologous platelet concentrates (APCs) alone was associated with a trend for better outcomes (RR: 0.51; 95% CI, 0.20–1.25;P = 0.14) (RR: 0.55; 95% CI, 0.18–1.71;P = 0.30). The combined use of collagen membranes and bovine‐derived hydroxyapatite significantly improved the outcome (RR: 0.35; 95% CI, 0.17–0.75;P = 0.007).

Discussion

This systematic review evaluated the effects of collagen membranes, e‐PTFE membranes, APCs and bone grafting materials, providing detailed information about the risks and benefits of using each regenerative technique/material or its combination in endodontic surgery.

Conclusions

Regenerative techniques improve periapical lesion healing after endodontic surgery. The combined use of collagen membranes and bovine‐derived hydroxyapatite may be beneficial as an adjunct to endodontic surgery. In contrast, the positive efficacy of e‐PTFE membranes or APCs alone remains doubtful.
Management of voiding dysfunction associated with pelvic malignancies
Authors: Stabholz Yariv , Sandhu Jaspreet S
Published: November 2020

Voiding dysfunction is common after surgical and radiation treatments in patients diagnosed with non‐urological pelvic malignancies. Presentation might vary with lower urinary tract symptoms and/or overactive bladder, urinary retention, or incontinence. We reviewed the most recent literature with the aim of describing various types of urinary dysfunction that manifest after radical treatments for non‐urological pelvic malignancies. Radical surgical or radiation treatment adversely affect other adjacent pelvic organ function, including viscera, pelvic musculature and the peripheral nervous system. This results in direct organ and indirect functional damage to the genitourinary tract. Multiple surgical and radiation modifications are available nowadays, allowing urologists to offer various treatments for better functional lower urinary tract outcomes. Diagnosing and understanding the type and severity of voiding dysfunction plays a key role in tailoring an appropriate treatment plan. The objective to better functional results relies on maintaining adequate bladder compliance and capacity while permitting volitional emptying, ideally through voiding. Management should routinely start with conservative measures, including pelvic floor muscle training with or without a combination of oral medication for urgency incontinence and clean intermittent catheterization for the management of urinary retention. Concomitant or isolated urinary incontinence can be further managed through multiple established surgical approaches. We attempted to address various treatment available for known lower urinary tract symptoms that might have been caused secondary to non‐urological pelvic surgery or radiation. We discuss different diagnostic and treatment modalities individualized for patients with various entities, to help achieve optimal urinary function and improve quality of life.
Mesh exposure after transvaginal mesh prolapse surgery: Out of permissible range?
Authors: Kato Kumiko , Suzuki Shoji , Ishiyama Akinobu , Kawanishi Hideji , Matsui Hirotaka , Kato Takashi , Hirabayashi Hiroki , Hattori Ryohei
Published: November 2020

Objectives

To investigate the prevalence of postoperative complications after transvaginal mesh prolapse surgery, and whether modified transvaginal mesh prolapse surgery (without transobturator arms or posterior mesh) has less prevalence of mesh exposure compared with conventional transvaginal mesh prolapse surgery.

Methods

Medical charts were retrospectively examined for 2648 patients who underwent transvaginal mesh prolapse surgery in a general hospital (2006–2017). Conventional transvaginal mesh prolapse surgery (Prolift‐type, n = 2258) was used, with a shift from 2015 to modified transvaginal mesh prolapse surgery (Uphold‐type, n = 330). Patients were instructed to have >2 years of follow up and to report if they had problems regarding the operation.

Results

The prevalence of mesh exposure was 34 out of 2648 (1.28%); 18 vagina (0.68%), 10 bladder (0.38%), two ureter (0.08%) and four rectum (0.15%). The modified transvaginal mesh prolapse surgery group had only one case with vaginal exposure. Vaginal exposure was managed transvaginally or followed by observation. Rectal exposure was managed transvaginally without colostomy. Bladder exposure was managed by transurethral resection with saline. Open ureterocystostomy was carried out to treat ureteral exposure. In the conventional transvaginal mesh prolapse surgery group, three cases of ureteral stenosis and one case with vaginal evisceration of the small intestine were managed transvaginally. The prevalence of postoperative chronic pain was 13 out of 2648 (0.49%; with one patient in the modified transvaginal mesh prolapse surgery group). The patients underwent pharmacotherapy, and one patient underwent additional surgical treatment.

Conclusions

The reoperation rate as a result of complications after transvaginal mesh prolapse surgery seems to be low. The reoperation rate as a result of prolapse recurrence is also low. A shift from conventional transvaginal mesh prolapse surgery to modified transvaginal mesh prolapse surgery might contribute to a further decrease in the risk of complications.
Case manager perceptions of emergency department use by patients with non‐fatal suicidal behaviour
Authors: Baker Debra , Blyth Deborah , Stedman Terry , Meehan Tom
Published: November 2020

Repeat presentations to the emergency department (ED) for non‐fatal suicidal behaviour (NFSB) are common in Australia and overseas. The challenges faced by mental health services in managing this sub‐group of patients have not been fully explored. In this qualitative study, we consider how case managers view frequent ED use by patients with NFSB. Individual interviews with case managers were audio‐recorded, transcribed verbatim, and subjected to thematic analysis. Four main themes emerged: a logical place to go; not a lot of benefit from an ED visit; focus on managing risk; and building a life outside of the ED. The case managers noted that patients with NFSB tend to have complex presentations that are challenging to address in the ED. The focus tends to be on assessment of risk with referral to community support agencies. The findings point to the need to identify more intensive care options that support patients to reduce their dependency on the ED. Insights gleaned from the study have implications for those working with NFSB patients.
Circulating exosomal small RNAs are promising non‐invasive diagnostic biomarkers for gastric cancer
Authors: Ge Lichen , Zhang Nan , Li Dandan , Wu Yingmin , Wang Hongsheng , Wang Junjun
Published: November 2020

Dysregulation of small non‐coding RNA (ncRNA) is associated with various human diseases including cancer. This study aimed to evaluate the circulating exosomal small RNAs including microRNAs (miRNAs) and P‑element‑induced wimpy testis (PIWI)‐interacting RNAs (piRNAs) as sensitive and specific non‐invasive biomarkers for gastric cancer (GC) diagnosis. Serum exosomal small RNA transcriptome was examined using unique molecular identifiers (UMI) small RNA sequencing. Dysregulated miRNAs and piRNAs were verified in 70 GC patients and 60 healthy controls (HC) by reverse transcription quantitative PCR. The expressions of miR‐1307‐3p, piR‐019308, piR‐004918 and piR‐018569 in serum exosomes were significantly increased in GC group as compared to those in HC group. Moreover, GC patients with metastasis had significantly higher expression levels of piR‐004918 and piR‐019308 than GC patients without metastasis. The area under the curve (AUC) for miR‐1307‐3p, piR‐019308, piR‐004918 and piR‐018569 in the GC group was 0.845, 0.820, 0.754 and 0.732, respectively. The combination of carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 199 can improve the AUC of miR‐1307‐3p to 0.902 and piR‐019308 to 0.914 for GC diagnosis. In conclusion, our findings indicate that serum exosomal piRNAs are promising non‐invasive diagnostic biomarkers for GC patients and potential markers for monitoring metastasis.
Automatic surface defects classification of Kinnow mandarins using combination of multi‐feature fusion techniques
Authors: Hadimani Lingaraj , Garg Neerja Mittal
Published: November 2020

Analyzing the quality of biological products is a difficult task, as their physicochemical properties such as size, shape, color, and texture change over time. Among many quality attributes, automatic classification of defects is a challenging work due to similarity or diversity of defects in terms of shape, color, and texture within intra and inter cultivars. In this work, an image analysis and machine learning‐based method to identify and classify four defects of Kinnow mandarins is proposed. A simple and fast adaptive thresholding technique was used to segment the defects. Defects discriminatory abilities of three prevalent texture descriptors namely local binary patterns, gray level co‐occurrence matrix (GLCM), and gray level run length matrix (GLRLM) were explored. In order to measure the effectiveness of color models in food analysis techniques, texture features were extracted on individual and combined color channels of three popular color models, that is, RGB, HSV, and CIELAB. Two machine‐learning techniques: random forest (RF) and artificial neural networks (ANNs) classifiers were trained with extracted features to predict the defects. The highest accuracies of 93.5 and 89.3% and average accuracies of 88.95 and 80.67% were achieved by ANN and RF classifiers, respectively, for the feature set {GLCM, GLRLM} on {H,S,V} color set.

Practical applications

Kinnow mandarins' cultivation area occupies around 50% of the total citrus farming regions in India. Currently, the expert laborers manually carry out the grading of Kinnow fruits based on the existence of external defects. This process is labor‐intensive, inefficient, and time‐consuming. However, now this labor‐intensive task can be replaced with automatic fruit classification machines based on computer vision (CV) and machine learning (ML) technologies. Presently, there is a scarcity of studies as well as algorithms to automate the process of Kinnow fruit defects classification. The developed CV‐ and ML‐based algorithm is capable to identify and discriminate four types of external defects pertaining to Kinnow mandarins. The classification accuracy and other performance measures achieved on the developed algorithm make it ideal for real‐time online Kinnow defects classification systems.
Key competences of outpatient nurses, as perceived by patients attending nurse‐led clinics – An integrative review
Authors: Pleh Denise Nana , Rosted Elizabeth , Thomsen Thora Grothe
Published: November 2020

Aim

The aim of this review was to identify key competences of outpatient nurses, as perceived by patients attending nurse‐led clinics.

Background

The increased demand for nurses to manage treatment and care in hospital outpatient clinics requires a better understanding of nurses' competences important to outpatients.

Design

An integrative review using Whittemore and Knafl's five‐stage model.

Methods

Relevant studies were located by systematically searching PubMed, CINAHL and Scopus. A group of three researchers assessed the studies found and the quality of the included studies using the CASP tool. Data were extracted and analysed by thematic analyses. The current study was evaluated using PRISMA checklist.

Results

Nine studies met the inclusion criteria. Three key competences emerged: providing access, sharing knowledge and establishing relationships. The key competences were supported by ten sub‐themes that were characterised by nurses' actions and qualities, derived from the included studies.

Conclusions

The identified key competences reflected a holistic approach that encompasses knowledge, skills and attitudes, indicating outpatient nurses being able to manage different ways of involving patients, which may lead to the consideration of outpatient consultations as a kind of negotiation, based on a respectful dialogue.

Relevance to clinical practice

The findings are usable when optimising the performance and quality of the health workforce, including outpatient nurses, as recommended by WHO (World Health Organization, Global strategy on human resources for health: Workforce 2030, 2016). Furthermore, the identified knowledge emphasises the need for clinical skills training and academic education, specially targeted outpatient nurses, in order to enable the nurses to become experts in specific practice settings.
Is intelligence related to perfectionism? Multidimensional perfectionism and parental antecedents among adolescents across varying levels of cognitive ability
Authors: Lavrijsen Jeroen , Soenens Bart , Vansteenkiste Maarten , Verschueren Karine
Published: November 2020

Objective

Although intellectually gifted individuals are often portrayed as perfectionists, evidence for an association between cognitive ability and perfectionism is inconclusive. This study investigates the relations between cognitive ability and two distinct dimensions of perfectionism and addresses the role of parental antecedents of perfectionism in adolescents at different levels of cognitive ability.

Method

In a community sample of 3,168 adolescents and their parents, cognitive ability was assessed and perfectionism levels and parenting practices were surveyed.

Results

Adolescents higher in cognitive ability reported higher levels of Personal Standards (i.e., setting ambitious objectives) but lower levels of Concern over Mistakes (i.e., worrying excessively about mistakes). Parental criticism, high parental expectations, and conditionally regarding parenting were associated positively with Concern over Mistakes, and high parental expectations were related positively to Personal Standards. These associations were generally independent of adolescents' cognitive ability. Parents of adolescents higher in cognitive ability relied less on parenting practices associated with the development of perfectionism.

Conclusion

Cognitive ability is related to a higher pursuit of personal standards, yet does not constitute a risk factor for excessive concerns about mistakes. Parental antecedents were related similarly and in theoretically meaningful ways to adolescent perfectionism across different levels of cognitive ability.
Psychosocial Correlates and Consequences of Adolescents’ Self‐Generated Academic Goals and Appraisals
Authors: Brumley Lauren D. , Nauphal Maya , Schwartz Lisa A. , Jaffee Sara R.
Published: November 2020

The current study examined whether characteristics of adolescents (i.e., externalizing problems) and their environments (i.e., social support, adverse childhood experiences) relate to academic goal setting, appraisals, and outcomes. Adolescents (n = 99; 87% Black/African American) 13–16 years old completed baseline interviews, and 80% also completed follow‐up interviews. Adolescents with more externalizing problems set fewer academic goals, and youth with social networks characterized by greater support (and less strain) appraised their academic goals as more supported and achievable. Adolescents’ appraisals of their academic goals, but not how many academic goals they had, predicted grades at follow‐up. Increasing social support (and reducing social strain) may foster adolescents’ positive appraisals of their academic goals, which may promote academic achievement.
Predictors of hospital readmission in infants less than 3 months old
Authors: Mace Ariel O , Barnes Rosanne , Blyth Christopher C , Martin Andrew C , Richmond Peter C , Snelling Tom L , Moore Hannah C
Published: November 2020

Aim

To examine rates and predictors of 7‐day readmission in infants hospitalised before 3 months of age with infectious and non‐infectious conditions.

Methods

Retrospective population‐based data‐linkage study of 121 854 infants from a 5‐year metropolitan birth cohort (2008–2012). Cox proportional hazard models were used to examine associations between infant and maternal factors with 7‐day readmission.

Results

A total of 11 669 (9.6%) infants were hospitalised at least once by 3 months of age (median 23 days old, 56% male) with 12 602 total index hospitalisations. Infection‐related conditions accounted for 29.4% (n = 3705). Readmission within 7 days occurred after 4.8% of all index hospitalisations and 5.4% of infection‐related hospitalisations. Age ≤21 days was the strongest readmission risk factor (hazard ratio 7.7 (95% confidence interval 4.7–12.7) compared to infants 61–90 days old). Other risk factors included shorter index hospitalisations, younger maternal age and multi‐gravidity.

Conclusion

Hospitalisations and readmissions occur for many young infants. Risk factors for readmission should inform risk‐based management guidelines.
Ontogeny of hepatic methionine catabolic enzyme activities (Transmethylation and Transsulphuration) and associated physiological amino acids in E10‐21 chick embryos and D1‐49 broilers
Authors: Lu Jianwei , Weil Jordan Taylor , Cerrate Sandro , Coon Craig Nelson
Published: November 2020

Developmental changes in hepatic methionine adenosyltransferase, cystathionine β‐synthase, cystathionase, and glycine N‐methyltransferase were determined in broiler chick embryos and hatched chicks by using radiometric and spectrometric methods. Hepatic free methionine, S‐adenosylmethionine, S‐adenosylhomocysteine, homocysteine, cystathionine, and cysteine levels were also investigated. Results showed an increase in hepatic MAT activity from E10 to E21 during embryogenesis, suggesting greater transmethylation rates throughout the rapid embryonic growth and development period. A strong positive correlation between embryo BW and MAT activity also supports this idea. The MAT specific activity continued to increase after hatching, but there was a negative correlation between chick BW and MAT activities from D1 to D49. This may indicate different MAT isozymes exist for chick embryo hepatic tissue compared to hepatic tissue of hatched chick and growing broilers. The developmental pattern of MAT isozymes could be critical for methionine metabolism to cope with the demand imposed on the embryo, chicks, and growing broilers. Additionally, the specific activity of hepatic CBS in chick embryos was determined to be lower compared to that observed in older broilers (35 and 49 days). Since liver CBS specific activity is at the lowest point from D1‐7 in young chicks, the ability to convert adequate homocysteine to cysteine through transsulphuration may be limiting for cysteine synthesis at this time. Steady‐state hepatic homocysteine levels in chick embryos and chicks may be a function of the rates of homocysteine formation, remethylation, and catabolism via the transsulphuration pathway. The present study indicates young chicks from D1 to D7 may have a limited ability for adequate transsulphuration; therefore, dietary cystine may be needed for optimum performance.
Neutrophil extracellular traps enhance procoagulant activity and thrombotic tendency in patients with obstructive jaundice
Authors: Zhang Jinming , Yu Muxin , Liu Biou , Zhou Peng , Zuo Nan , Wang Yufeng , Feng Yiming , Zhang Yue , Wang Jiaojiao , He Yujing , Wu Yinsong , Dong Zengxiang , Hong Luojia , Shi Jialan
Published: November 2020

Background & Aims

Patients with obstructive jaundice (OJ) are considered to be prothrombotic with increased risk of thromboembolism complications. The role of neutrophil extracellular traps (NETs) in procoagulant activity (PCA) and thrombosis risk in patients with OJ is unclear. In this study, we investigated NETs formation in OJ patients and the role of elevated unconjugated bilirubin (UCB) in inducing NETs, resulting in enhanced PCA and endothelial injury.

Methods

NETs of OJ patients and healthy controls were measured. NETs PCA was assessed via coagulation time (CT), fibrin formation and purified coagulation complex production assays. Visualization of NETs and mitochondrial reactive oxygen species (MitoROS) were performed with a fluorescence microscope. We further used confocal microscopy to quantify the exposure of phosphatidylserine (PS), fibrin strands and FVa/Xa on Human umbilical vein endothelial cells (HUVECs).

Results

Assessment of NETs components levels revealed greater NETs production in OJ patients than in healthy controls. Importantly, OJ‐NETs were responsible for enhanced PCA. UCB induced NETs formation via MitoROS accumulation and mitochondrial mobilization. HUVECs cocultured with OJ NETs lost their cell–cell junctions and consequently converted to a procoagulant phenotype. The PCA was attenuated by using DNase I alone or in combination with lactadherin.

Conclusions

Our results suggest that UCB‐induced NETs play a prominent role in promoting the hypercoagulable and prothrombotic state in OJ patients. The increased MitoROS accumulation in neutrophils initiated NETosis. NETs are promising targets for indicating or improving coagulation disorders in OJ patients.
How to resolve the enigma of diurnal malate remobilisation from the vacuole in plants with crassulacean acid metabolism?
Authors: Ceusters Nathalie , Borland Anne M. , Ceusters Johan
Published: November 2020

Opening of stomata in plants with crassulacean acid metabolism (CAM) is mainly shifted to the night period when atmospheric CO2 is fixed by phosphoenolpyruvate carboxylase and stored as malic acid in the vacuole. As such, CAM plants ameliorate transpirational water losses and display substantially higher water‐use efficiency compared with C3 and C4 plants. In the past decade significant technical advances have allowed an unprecedented exploration of genomes, transcriptomes, proteomes and metabolomes of CAM plants and efforts are ongoing to engineer the CAM pathway in C3 plants. Whilst research efforts have traditionally focused on nocturnal carboxylation, less information is known regarding the drivers behind diurnal malate remobilisation from the vacuole that liberates CO2 to be fixed by RuBisCo behind closed stomata. To shed more light on this process, we provide a stoichiometric analysis to identify potentially rate‐limiting steps underpinning diurnal malate mobilisation and help direct future research efforts. Within this remit we address three key questions: Q1 Does light‐dependent assimilation of CO2 via RuBisCo dictate the rate of malate mobilisation? Q2: Do the enzymes responsible for malate decarboxylation limit daytime mobilisation from the vacuole? Q3: Does malate efflux from the vacuole set the pace of decarboxylation?
Root traits as drivers of plant and ecosystem functioning: current understanding, pitfalls and future research needs
Authors: Freschet Grégoire T. , Roumet Catherine , Comas Louise H. , Weemstra Monique , Bengough A. Glyn , Rewald Boris , Bardgett Richard D. , De Deyn Gerlinde B. , Johnson David , Klimešová Jitka , Lukac Martin , McCormack M. Luke , Meier Ina C. , Pagès Loïc , Poorter Hendrik , Prieto Iván , Wurzburger Nina , Zadworny Marcin , Bagniewska‐Zadworna Agnieszka , Blancaflor Elison B. , Brunner Ivano , Gessler Arthur , Hobbie Sarah E. , Iversen Colleen M. , Mommer Liesje , Picon‐Cochard Catherine , Postma Johannes A. , Rose Laura , Ryser Peter , Scherer‐Lorenzen Michael , Soudzilovskaia Nadejda A. , Sun Tao , Valverde‐Barrantes Oscar J. , Weigelt Alexandra , York Larry M. , Stokes Alexia
Published: November 2020

The effects of plants on the biosphere, atmosphere and geosphere are key determinants of terrestrial ecosystem functioning. However, despite substantial progress made regarding plant belowground components, we are still only beginning to explore the complex relationships between root traits and functions. Drawing on the literature in plant physiology, ecophysiology, ecology, agronomy and soil science, we reviewed 24 aspects of plant and ecosystem functioning and their relationships with a number of root system traits, including aspects of architecture, physiology, morphology, anatomy, chemistry, biomechanics and biotic interactions. Based on this assessment, we critically evaluated the current strengths and gaps in our knowledge, and identify future research challenges in the field of root ecology. Most importantly, we found that belowground traits with the broadest importance in plant and ecosystem functioning are not those most commonly measured. Also, the estimation of trait relative importance for functioning requires us to consider a more comprehensive range of functionally relevant traits from a diverse range of species, across environments and over time series. We also advocate that establishing causal hierarchical links among root traits will provide a hypothesis‐based framework to identify the most parsimonious sets of traits with the strongest links on functions, and to link genotypes to plant and ecosystem functioning.