bluuebunny/crossref_metadata_2025 huggingface dataset:
Heat treatment effect on fatigue behavior of 3D-printed maraging steels
Authors: Tezel Tugce , Kovan Volkan
Published: August 2021

Purpose

This study aims to reveal that fatigue life is improved using heat treatment in the rotational bending fatigue test, which determines the fatigue behavior closest to service conditions.

Design/methodology/approach

It is essential to know the mechanical behavior of the parts produced by additive manufacturing under service conditions. In general, axial stress and plane bending tests are used by many researchers because they are practical: the service conditions cannot be sufficiently stimulated. For this reason, the rotating bending fatigue test, which represents the conditions closest to the service conditions of a load-bearing machine element, was chosen for the study. In this study, the rotational bending fatigue behavior of X3NiCoMoTi18-9–5 (MS1) maraging steel specimens produced by the selective laser melting (SLM) technique was experimentally investigated under various heat treatments conditions.

Findings

As a result of the study, MS1 produced by additive manufacturing is a material suitable for heat treatment that has enabled the heat treatment to affect fatigue strength positively. Cracks generally initiate from the outer surface of the sample. Fabrication defects have been determined to cause all cracks on the sample surface or regions close to the surface.

Research limitations/implications

While producing the test sample, printing was vertical to the print bed, and various heat treatments were applied. The rotating bending fatigue test was performed on four sample groups comprising as-fabricated, age-treated, solution-treated and solution + age-treated conditions.

Originality/value

Most literature studies have focused on the axial fatigue strength, printing orientation and heat treatment of maraging steels produced with Direct Metal Laser Sintering (DMLS); many studies have also investigated crack propagation behaviors. There are few studies in the literature covering conditions of rotating bending fatigue. However, the rotating bending loading state is the service condition closest to modern machine element operating conditions. To fill this gap in the literature, the rotating bending fatigue behavior of the alloy, which was maraging steel (X3NiCoMoTi18-9–5, 1.2709) produced by SLM, was investigated under a variety of heat treatment conditions in this study.
Machining of Ti-6Al-4V biomedical alloy by WEDM: investigation and optimization of MRR and Rz using grey-harmony search
Authors: Sharma Neeraj , Gupta Rahul Dev , Khanna Rajesh , Sharma Rakesh Chandmal , Sharma Yogesh Kumar
Published: August 2021

Purpose

The purpose of this paper is to investigate the optimized setting of wire-cut electrical discharge machining (WEDM) parameters at which material removal rate (MRR) and mean roughness depth (Rz) set a compromise. The problem in the processing of Ti-6Al-4V by conventional processes is a high strength, high hardness, high tool wear. Due to which WEDM is adopted to machine Ti-6Al-4V biomedical alloy. Ti-6Al-4V alloy has a number of applications in the engineering and medical industries due to its high strength biocompatibility.

Design/methodology/approach

The effect of control factors (i.e. pulse on-time: Pon; pulse off-time: Poff; servo voltage: SV) on the MRR and Rz is investigated in the present research. The planning of experiments is done using a Taguchi-based L9 orthogonal array. The percentage influence of each factor on responses is also evaluated. The multi-objective optimization is done using the grey approach initially. After that, the results were also calculated using harmony search (HS). Therefore, a hybrid approach of grey and HS is used to find the optimized values of MRR and Rz.

Findings

The maximum value of grade calculated by grey-HS is 0.7879, while in the case of the experimental run the maximum value of grey grade is 0.7239. The optimized setting after improvisation at this grade value is Pon: 130 µs; Poff: 45 µs and SV: 70 V for MRR and Rz collectively. The validation of the suggested setting is completed by experimentation. The values of MRR and Rz are coming out to be 6.4 mm3/min and 13.84 µm, which represents improvised results after the implementation of the HS algorithm.

Originality/value

The integration of the grey approach with the HS principle in the manufacturing domain is yet to be explored. Therefore, in the present research hybrid approach of grey-HS is implemented in the manufacturing domain having applications in medical industries.
Crop heterogeneity is positively associated with beneficial insect diversity in subtropical farmlands
Authors: Priyadarshana Tharaka S. , Lee Myung‐Bok , Ascher John S. , Qiu Lu , Goodale Eben
Published: August 2021

Increasing crop configurational heterogeneity—smaller crop fields with more field margins—has been repeatedly found to support farmland biodiversity. But research on compositional crop heterogeneity—the number and evenness of crop types—has usually shown only weak effects. However, much of this research has been conducted in large‐scale temperate agroecosystems.

We examined smallholder subtropical agroecosystems in southern China to assess the effects of crop heterogeneity on beneficial insect biodiversity. In addition to pollinators (bees, apoid and vespid wasps, and butterflies), we studied dung beetles and dragonflies/damselflies, which are not usually considered in cropland heterogeneity studies, but are abundant in these multi‐functional agroecosystems. We sampled these taxa in 468 transects placed inside 52 farms across three seasons (summer, spring and winter), collecting data on 27,245 insects belonging to 160 species.

We found a strong positive effect of crop compositional heterogeneity (measured by Shannon–Wiener index) on dung beetle and dragonfly/damselfly diversity. Bee/wasp and butterfly diversity, conversely, was positively affected by crop configurational heterogeneity (measured by cumulative field margin length).

Field margin type, categorized by the structure of the dominant crop types, was consistently an important explanatory variable, with weedy margins having high insect diversity. The presence of a vegetable crop on one side of the field margin, compared to non‐vegetable monocultures on both sides, increased diversity in 3/4 taxon‐season comparisons made for rice and 6/9 comparisons made for sugarcane or corn.

Synthesis and applications. We demonstrate that crop compositional heterogeneity can support insects that respond to differences among crop types, including taxa that play a key role in nutrient cycling (dung beetles) and natural pest control (dragonflies/damselflies). Incorporating structurally diverse crops into monoculture Asian agroecosystems can reduce the adverse effects these intensive systems have on beneficial insects, and increase crucial ecosystem services.
‘Some Very Queer Couples’: Gender Migrants and Intimacy in Nineteenth‐Century America
Authors: Bayker Jesse
Published: August 2021

This article contends that the term gender migrant – which describes a person who changed gender on a long‐term basis in their everyday life – offers a useful tool for grappling with the ambiguities of nineteenth‐century transgender history. Examining four cases of gender change that circulated in the popular press between the antebellum era and the turn of the twentieth century, the article brings to light intimate relationships that do not fit within the categories of female husbands or sexual inverts that have become familiar to historians of sexuality. Some female‐assigned gender migrants lived as men and sought same‐gender intimacy in the company of other men. Reading ambiguous cases of love and marriage from multiple angles provides insight into the strategies that resourceful gender migrants used to legitimise their public gender identities.
Candidate evaluations across the aisle: Cross‐cultural evidence that out‐partisans value candidate warmth more than in‐partisans
Authors: BOR ALEXANDER , LAUSTSEN LASSE
Published: August 2021

Partisans view their own candidates through rose‐coloured glasses and see competing candidates much more negatively. However, recent advances in political behaviour reveal that such directional motivated reasoning is not simply about love and hate, but also about more nuanced shifts in preferences. Combining two insights from the psychological sciences – coalitional reasoning and a general dislike of self‐interested leaders – we form the novel prediction that voters pay more attention to out‐party than to in‐party candidates’ warmth. We show firm evidence for this prediction relying on election studies data with candidate warmth impressions from 27 elections from seven countries (Australia, Denmark, Germany, Norway, Sweden, the United Kingdom and the United States) between 1984 and 2016; and a re‐analysis of existing experimental data (total N = 140K). Our paper reveals sophisticated psychological mechanisms regulating the importance of candidate warmth and implies that candidates seeking to reduce the partisan gap should establish a warm image.
Applications of novel processing technologies to enhance the safety and bioactivity of milk
Authors: Soni Aswathi , Samuelsson Linda M. , Loveday Simon M. , Gupta Tanushree B
Published: August 2021

Bioactive compounds in food can have high impacts on human health, such as antioxidant, antithrombotic, antitumor, and anti‐inflammatory activities. However, many of them are sensitive to thermal treatments incurred during processing, which can reduce their availability and activity. Milk, including ovine, caprine, bovine, and human is a rich source of bioactive compounds, including immunoglobulins, vitamins, and amino acids. However, processing by various novel thermal and non‐thermal technologies has different levels of impacts on these compounds, according to the studies reported in the literature, predominantly in the last 10 years. The reported effect of these technologies either covers microbial inactivation or the bioactive composition; however, there is a lack of comprehensive compilation of studies that compare the effect of these technologies on bioactive compounds in milk (especially, caprine and ovine) to microbial inactivation at similar settings. This research gap makes it challenging to conclude on the specific processing parameters that could be optimized to achieve targets of microbial safety and nutritional quality at the same time. This review covers the effect of a wide range of thermal and non‐thermal processing technologies including high‐pressure processing, pressure‐assisted thermal sterilization, pulsed‐electric field treatment, cold plasma, microwave‐assisted thermal sterilization, ultra‐high‐pressure homogenization, ultrasonication, irradiation on the bioactive compounds as well as on microbial inactivation in milk. Although a combination of more than one technology could improve the reduction of bacterial contaminants to meet the required food safety standards and retain bioactive compounds, there is still scope for research on these hurdle approaches to simultaneously achieve food safety and bioactivity targets.
Ionotropic receptor 8a is involved in the attraction of Helicoverpa armigera to acetic acid
Authors: Zhang Xia‐Xuan , Yang Bin , Sun Dong‐Dong , Guo Meng‐Bo , Zhang Jie , Wang Gui‐Rong
Published: August 2021

Ionotropic receptors (IRs) were first found in Drosophila melanogaster, and derive from ionotropic glutamate receptors (iGluRs), which are implicated in detecting acids, ammonia, amine, temperature and humidity. Although IRs are involved in sensing acid odors in a few insects, such as D. melanogaster, Aedes aegypti, and Manduca sexta, the function of IRs in Helicoverpa armigera is still unknown. IR8a was confirmed to be a co‐receptor associated with acid detection. From the results of phylogenetic analysis, HarmIR8a displayed high similarity compared to homologs in D. melanogaster, M. sexta, and A. aegypti, suggesting that HarmIR8a might have a consistent function as a co‐receptor for acid detection. In this study, clustered regularly interspaced palindromic repeats (CRISPR) / CRISPR‐associated protein 9 (Cas9)‐mediated genome editing was implemented to knockout HarmIR8a for in vivo functional analysis. Electrophysiological and behavioral assays were performed to compare the differences between HarmIR8a knockout mutants and wild type individuals. From electroantennogram (EAG) analysis, we found that wild type H. armigera adults could detect short‐chain carboxylic acids. In addition, wind tunnel experiments showed that 1% acetic acid attracted wild type H. armigera adults. However, acid sensing and attraction were reduced or abolished in the HarmIR8a knockout mutants. Our data suggest that HarmIR8a is important for H. armigera to detect short‐chain carboxylic acids and mediate attraction behavior to acetic acid.
Herbivory shapes the rhizosphere bacterial microbiota in potato plants
Authors: Malacrinò Antonino , Wang Mingyuan , Caul Sandra , Karley Alison J. , Bennett Alison E.
Published: August 2021

Plant‐associated microbiomes assist their host in a variety of activities, spanning from nutrition to defence against herbivores and diseases. Previous research showed that plant‐associated microbiomes shift their composition when plants are exposed to stressors, including herbivory. However, existing studies explored only single herbivore‐plant combinations, whereas plants are often attacked by several different herbivores, but the effects of multiple herbivore types on the plant microbiome remain to be determined. Here, we first tested whether feeding by different herbivores (aphids, nematodes and slugs) produces a shift in the rhizosphere bacterial microbiota associated with potato plants. Then, we expanded this question asking whether the identity of the herbivore produces different effects on the rhizosphere microbial community. While we found shifts in microbial diversity and structure due to herbivory, we observed that the herbivore identity does not influence the diversity or community structure of bacteria thriving in the rhizosphere. However, a deeper analysis revealed that the herbivores differentially affected the structure of the network of microbial co‐occurrences. Our results have the potential to increase our ability to predict how plant microbiomes assemble and aid our understanding of the role of plant microbiome in plant responses to biotic stress.
Aversive drug cues reduce cigarette craving and increase prefrontal cortex activation during processing of cigarette cues in quitting motivated smokers
Authors: Kunas Stefanie L. , Bermpohl Felix , Plank Irene S. , Ströhle Andreas , Stuke Heiner
Published: August 2021

Aversive drug cues can be used to support smoking cessation and create awareness of negative health consequences of smoking. Better understanding of the effects of aversive drug cues on craving and the processing of appetitive drug cues in abstinence motivated smokers is important to further improve their use in cessation therapy and smoking‐related public health measures. In this study, 38 quitting motivated smokers underwent functional magnetic resonance imaging (fMRI) scanning while performing a novel extended cue‐reactivity paradigm. Pictures of cigarettes served as appetitive drug cues, which were preceded by either aversive drug cues (e.g., smokers' leg) or other cues (neutral or alternative reward cues). Participants were instructed to rate their craving for cigarettes after presentation of drug cues. When aversive drug cues preceded the presentation of appetitive drug cues, behavioural craving was reduced and activations in prefrontal (dorsolateral prefrontal cortex) and paralimbic (dorsal anterior cingulate cortex [dACC] and anterior insulae) areas were enhanced. A positive association between behavioural craving reduction and neurofunctional activation changes was shown for the right dACC. Our results suggest that aversive drug cues have an impact on the processing of appetitive drug cues, both on a neurofunctional and a behavioural level. A proposed model states that aversive drug‐related cues activate control‐associated brain areas (e.g., dACC), leading to increased inhibitory control on reward‐associated brain areas (e.g., putamen) and a reduction in subjective cravings.
Comparison of saliva cotinine and exhaled carbon monoxide concentrations when smoking and after being offered dual nicotine replacement therapy in pregnancy
Authors: Slaich Bhavandeep , Claire Ravinder , Emery Joanne , Lewis Sarah , Cooper Sue , Thomson Ross , Phillips Lucy , Kinahan‐Goodwin Darren , Naughton Felix , McDaid Lisa , Clark Miranda , Dickinson Anne , Coleman Tim
Published: August 2021

Background and Aims

Although English Stop Smoking Services routinely offer dual nicotine replacement therapy (NRT) to help pregnant women to quit smoking, little is known about how nicotine and tobacco smoke exposures following this compare with that from smoking. We compared, in pregnant women when smoking and after being offered dual NRT, saliva cotinine and exhaled carbon monoxide (CO) concentrations and numbers of daily cigarettes smoked.

Design and Setting

Secondary analysis of data from three sequential, observational, mixed‐methods cohort studies conducted as part of the Nicotine Replacement Effectiveness and Delivery in Pregnancy programme. Participants were recruited on‐line or in Nottingham University Hospitals (UK) antenatal clinics between June 2019 and September 2020.

Participants

Forty pregnant women, who agreed to try stopping smoking.

Intervention

Participants were offered dual NRT, agreed a smoking quit date and received an intervention to improve adherence to NRT.

Measurements

Saliva cotinine and exhaled CO concentrations and reported number of cigarettes smoked per day.

Findings

There were no differences in saliva cotinine concentrations at baseline and day 7 post quit date [n = 20, mean difference = −32.31 ng/ml, 95% confidence interval (CI) = −68.11 to 3.5 ng/ml; P = 0.074, Bayes factor = 0.04]. There were reductions in the reported number of cigarettes smoked per day (n = 26, mean difference = −7 cigarettes, 95% CI = −8.35 to −5.42 cigarettes, P < 0.001) and concurrently in exhaled CO concentrations (n = 17, ratio of geometric means = 0.30 p.p.m., 95% CI = 0.17–0.52 p.p.m.; P < 0.001).

Conclusion

Pregnant women who smoke and are offered dual nicotine replacement therapy (NRT) appear to show no change in their exposure to cotinine compared with their pre‐NRT exposure levels but they report smoking fewer cigarettes, as validated by reductions in exhaled carbon monoxide concentrations.
Rethink My Drink: study protocol for a 12‐month randomised controlled trial comparing a brief internet‐delivered intervention to an online patient information booklet in reducing risky alcohol consumption among older adults in Australia
Authors: Hoy Nicholas , Newton Nicola , Kochan Nicole A. , Sunderland Matthew , Baillie Andrew , Chapman Cath , Winter Virginia , Sachdev Perminder , Teesson Maree , Mewton Louise
Published: August 2021

Background and Aims

Alcohol consumption is increasing among older adults. Rethink My Drink is a brief internet‐delivered intervention to reduce alcohol consumption and related harms, adapted specifically for older adults. This protocol for a large‐scale randomised controlled trial will evaluate whether Rethink My Drink is effective in reducing alcohol consumption and cognitive decline in a sample of older risky drinkers, compared with an active control.

Design

1:1 parallel group, randomised controlled trial.

Setting

Online trial in Australia.

Participants

Hazardous or harmful drinkers (defined as those scoring ≥5 on the Alcohol Use Disorders Identification Test [AUDIT]) age 60 to 75 years old (n = 842). Participants will be recruited from August 2021 to August 2022 through online social media advertisements and community networks.

Intervention and Comparator

Participants will be randomly allocated to receive access to Rethink My Drink (intervention) or Alcohol: The Facts (comparator), an online patient information booklet provided by New South Wales (NSW) Health.

Measurements

Primary outcomes include (i) average weekly standard drinks and (ii) rate of cognitive decline. Secondary outcomes include (i) typical quantity of drinks per drinking day; (ii) heavy episodic drinking; (iii) age‐specific risky drinking; (iv) alcohol‐related harms; (v) subjective cognitive complaints; and (vi) quality of life. All primary and secondary outcomes will be assessed at baseline, post‐intervention (4 weeks) and 12 months. Effectiveness will be evaluated using multilevel linear regression, adjusting for baseline demographic differences. Bonferroni adjustments will be used to control for multiple comparisons. Multiple imputation, regression weighting and sensitivity analyses will assess the effect of attrition.

Comments

This will be the first large‐scale trial, internationally, to examine whether a brief internet‐delivered intervention is effective in reducing alcohol consumption and cognitive decline among older adults. If successful, the intervention will provide an accessible and highly scalable treatment to reduce risky alcohol consumption in older adulthood.
Factors associated with dual and polytobacco use among people in residential substance use disorder treatment
Authors: Nguyen Nhung , Kapiteni Kwinoja , Straus Elana R. , Guydish Joseph
Published: August 2021

Background and Objectives

Little is known about whether people in substance use disorder (SUD) treatment are at risk for multiple‐tobacco use. We examined the factors associated with dual‐ and polytobacco use among clients in SUD treatment.

Methods

A cross‐sectional survey was conducted in 2019 among 562 clients (Mage = 39, 74% male) in 20 residential SUD treatment programs in California, USA. The outcomes included single‐, dual‐ (use of two products), and polytobacco use (use of three of more products). Independent variables were nicotine dependence, quitting‐related factors, blunt/spliff use, and health‐related factors. A multinomial model examined associations between the independent variables and the outcome, controlling for demographics, and time in treatment.

Results

Overall, 32.6%, 18.9%, and 14.0% of the sample were single‐, dual‐, and polytobacco users, respectively. Factors associated with increased odds of polytobacco use included greater nicotine dependence (adjusted odds ratio [AOR] = 1.60; 95% CI = 1.19, 2.16), ever using e‐cigarettes for quitting (AOR = 4.56; 95% CI = 2.23, 9.34), and past 30‐day use of blunt/spliff (AOR = 2.96; 95% CI = 1.48, 5.89). Factors associated with increased odds of dual use were ever using e‐cigarettes for quitting (AOR = 3.19; 95% CI = 1.79, 5.66) and reporting more mentally unhealthy days (AOR = 1.05; 95% CI = 1.02, 1.07).

Conclusion and Scientific Significance

This study extends the literature on tobacco use among people in SUD treatment by revealing the high prevalence of dual‐ and polytobacco use and the unique characteristics of users. The findings have implications for interventions reducing all types of tobacco use in this understudied population.
Management of allergic diseases in pregnancy
Authors: Pfaller Birgit , Bendien Sarah , Ditisheim Agnès , Eiwegger Thomas
Published: August 2021

Allergic diseases like asthma, allergic rhinitis, food allergy, hymenoptera allergy, or atopic dermatitis are highly prevalent in women of childbearing age and may affect up to 30% of this age group. This review focuses on the management of allergic diseases during pregnancy. Furthermore, we discuss the challenges of counseling women with allergic diseases in the reproductive age, including considerations relevant to the ongoing SARS‐CoV‐2 pandemic. To create the optimal milieu for the unborn child, a multitude of immunological changes occur during pregnancy which may favor type 2 responses and aggravate disease phenotypes. In co‐occurrence with suboptimal preconception disease control, this elevated Th2 responses may aggravate allergic disease manifestations during pregnancy and pose a risk for mother and child. Due to limitations in conducting clinical trials in pregnant women, safety data on anti‐allergic drugs during pregnancy are limited. The lack of information and concerns among pregnant patients demands counseling on the benefits of anti‐allergic drugs and the potential and known risks. This includes information on the risk for mother and child of disease aggravation in the absence of treatment. By doing so, informed decisions and shared decision‐making can take place.
Association of human leukocyte antigen‐B*13:01 with dapsone‐induced liver injury
Authors: Devarbhavi Harshad , Patil Mallikarjun , Menon Mahesh
Published: August 2021

Human leukocyte antigens (HLA) have been linked to adverse drug reactions. Generally, HLA association is phenotype specific and is related to either liver or skin injury. HLA‐A*13:01 has been linked to dapsone‐induced severe cutaneous drug reactions and its role in drug‐induced liver injury (DILI) is unclear. In our series, all of the four patients with immunoallergic dapsone DILI were carrying HLA‐B*13:01 compared to its prevalence of 1–12% among Indians. HLA‐B*13:01 plays a role not only in dapsone‐induced severe cutaneous adverse reaction (SCAR) but also in dapsone‐induced liver injury with immunoallergic features and highlights the role of adaptive immune response in the pathogenesis of both liver and skin injury and associated other organ involvement.
Handle with care: Assessing performance measures of medical AI for shared clinical decision‐making
Authors: Holm Sune
Published: August 2021

In this article I consider two pertinent questions that practitioners must consider when they deploy an algorithmic system as support in clinical shared decision‐making. The first question concerns how to interpret and assess the significance of different performance measures for clinical decision‐making. The second question concerns the professional obligations that practitioners have to communicate information about the quality of an algorithm's output to patients in light of the principles of autonomy, beneficence, and justice. In the article I review the four standard performance measures used to evaluate and validate algorithms, outline their role in the discussion of algorithmic fairness, and discuss the professional responsibilities that practitioners face when communicating information about these measures to patients.
Parental educational aspirations and children’s academic self‐concept: Disentangling state and trait components on their dynamic interplay
Authors: Buchmann Marlis , Grütter Jeanine , Zuffianò Antonio
Published: August 2021

The dynamic interplay of parental educational aspirations and children's academic self‐concept was examined from late childhood through mid‐adolescence within a transactional socialization framework. Parental and child data were gained from a representative Swiss sample within 3‐year intervals (NT1 = 1118; 51% females; 28% migration background; Mage T1 = 9.26, Mage T2 = 12.14, Mage T3 = 15.32). Results from a random intercept cross‐lagged panel model revealed positive associations between the two constructs at the between‐ and within‐person level. Findings showed general and time‐specific associations between children and parents and reciprocal spill‐over effects, whereby higher than usual aspirations predicted higher than usual academic self‐concept over time and vice versa, highlighting transactional processes in the context of educational transitions.
Perceived stress, resources and adaptation in relation to the COVID‐19 lockdown in Spanish foster and non‐foster families
Authors: Bernedo Isabel M. , Oliver Jesús , Urbano‐Contreras Antonio , González‐Pasarín Lucía
Published: August 2021

The lockdown imposed as a result of the COVID‐19 pandemic has placed unprecedented stress on families. The family is a key system in relation to child development, and when birth families are unable to meet their child's needs, foster carers become an important source of support in their development. The Double ABC‐X Model of family stress and adaptation considers that a family's capacity to cope with stressful situations is influenced by pile‐up of stressors, family resources and perception of the situation. Following this model, the study aimed to determine the impact of the COVID‐19 lockdown on family stress and functioning. The sample comprised 347 Spanish adults (100 with foster families and 247 with non‐foster families) who completed a survey during lockdown. The results showed that certain sociodemographic variables (gender, income, working from home, characteristics of the home and children with special educational needs) were associated with stressors during lockdown, perception of the lockdown, and family adaptation to stress during lockdown. Associations were also found between stressors, family resources, perception of lockdown, and family adaptation in foster and non‐foster families, with the former having a more positive perception of the lockdown experience. The relevance of the results and their implications are discussed.
Quantifying displacement of urogenital organs after abdominoperineal resection for rectal cancer
Authors: Sharabiany Sarah , Strijk Gaby J. , Blok Robin D. , Ferrett Colin G. , Stoker Jaap , Cunningham Christopher , van der Bilt Jarmila D. W. , van Geloven Anna A. W. , Bemelman Wilhelmus A. , Hompes Roel , Musters Gijsbert D. , Tanis Pieter J.
Published: August 2021

Aim

This study aimed to quantify displacement of urogenital organs after abdominoperineal resection (APR), and to explore patient and treatment characteristics associated with displacement.

Method

Patients from 16 centres who underwent APR for primary or recurrent rectal cancer (2001–2018) with evaluable preoperative and 6–18 months postoperative radiological imaging were included in the study. Anatomical landmarks on sagittal images were related to a coordinate system based on reference lines between fixed bony structures and absolute displacements were calculated using the Pythagorean theorem. Rotation of landmarks was measured relative to a pubic‐S5 reference line.

Results

There were 248 patients included of which 171 were men and 77 women. The median displacement of the internal urethral orifice was 25 mm in men (maximum 65), and 17 mm in women (maximum 50). Rotation of the internal urethral orifice was in a caudal direction in 160/170 (94%) of men and 65/73 (89%) of women, with a median of 32 degrees (maximum 85) and 33 degrees (maximum 83), respectively. Displacements of the posterior bladder wall, distal end of prostatic urethra and cervix were significantly correlated with the internal urethral orifice. In linear regression analysis, biological mesh reconstruction of the pelvic floor and visceral interposition were significantly associated with increased displacement of the internal urethral orifice, and female gender and any filling of the presacral space with decreased displacement.

Conclusions

Substantial absolute displacement and rotation of urogenital organs after APR for rectal cancer were observed, but with high variability among both men and women, and being significantly associated with reconstructive interventions.
Leadership, management, quality, and innovation in organ donation: 2019 Kunming recommendations for One Belt & One Road countries
Authors: Ballesté Chloe , Navarro Aurora , Escalante José Luis , Quiralte Arantxa , Vera Elisa , França Ana , Avsec Danica , Leitchman Alan , Valero Ricard , Istrate Melania , Gómez María Paula , Zhou Minkang , Arredondo Estephan , Boni Reginaldo , Domínguez‐Roldán José María , Zhao Hongtao , Wang Haibo , Pu Miao , Lu Wei , Li Li , Manyalich Martí ,   The Kunming Recommendations Group
Published: August 2021

The findings and recommendations of the 2019 consensus conference in organ donation, held in Kunming, China, are here reported. The main objective of the conference was to gather relevant information from experts involved in the field. The data and opinions provided allowed to propose a series of recommendations for “One Belt & One Road Countries” on how to achieve self‐sufficiency in organ donation. Leadership in organ donation should be results‐oriented and goal‐driven based on the principles of excellence, empowerment, and engagement, providing the means, resources, and strategies necessary to reach the goal in earnest. Management includes good governance and transparency of a national registry of patients in the waiting list, donors, transplants, transplant teams, quality, and safety programs with continuous educational training of health care professionals. Mandatory monitoring, auditing and evaluation of quality must be incorporated into donation practices as relevant points in innovation, as well as the adoption of already established and novel processes and technologies. Achievement of self‐sufficiency in organ donation is a crucial step to fight against transplant tourism and to prevent organ trafficking. Based on recommendations arising from the conference, each country could review and develop individualized action plans adjusted to its own circumstances and reality.
Prickly Skink (Gnypetoscincus queenslandiae) use of supplemental coarse woody debris in rainforest restoration sites
Authors: Freeman Amanda N. D. , Freeman Alastair B. , Shoo Luke P.
Published: August 2021

Coarse woody debris (CWD) is a critical resource for some rainforest reptiles but is slow to develop in restoration sites. In four restoration plantings in north Queensland, Australia, salvaged log and fence post piles were added to facilitate the return of reptiles, particularly the log‐specialist Prickly Skink (Gnypetoscincus queenslandiae). Between one year and six and a half years after supplemental CWD installation, the reporting rate of Prickly Skink individuals in CWD piles had increased from 6.7 and 0% to 12.5 and 37.5% for log and post piles, respectively. This coincided with substantial increases in the level of decay of CWD piles, particularly logs that had mostly decayed to particulate matter rendering them unsuitable for the Prickly Skink. CWD addition can be a useful tool to accelerate the development of rainforest reptile communities in young restoration sites. However, the persistence of supplementary CWD in a rainforest environment can be modest due to the high rates of CWD decay. As such, we recommend using high‐density salvaged logs where possible and to make allowances for future replenishment of supplementary CWD if the volume of natural CWD in a restoration site remains low.
Nitrous oxide‐induced myeloneuropathy
Authors: Swart Grace , Blair Christopher , Lu Zhong , Yogendran Solomon , Offord Joanna , Sutherland Emily , Barnes Stephanie , Palavra Natalie , Cremer Phillip , Bolitho Samuel , Michael Halmagyi Gabor
Published: August 2021

Background and purpose

Nitrous oxide misuse is a recognized issue worldwide. Prolonged misuse inactivates vitamin B12, causing a myeloneuropathy.

Methods

Twenty patients presenting between 2016 and 2020 to tertiary hospitals in Sydney with myeloneuropathy due to nitrous oxide misuse were reviewed.

Results

The average age was 24 years, and mean canister consumption was 148 per day for 9 months. At presentation, paresthesias and gait unsteadiness were common, and seven patients were bedbound. Mean serum B12 was normal (258 pmol/L, normal range [NR] = 140–750) as was active B12 (87 pmol/L, normal > 35). In contrast, mean serum homocysteine was high (51 μmol/L, NR = 5–15). Spinal magnetic resonance imaging (MRI) showed characteristic dorsal column T2 hyperintensities in all 20 patients. Nerve conduction studies showed a predominantly axonal sensorimotor neuropathy (n = 5). Patients were treated with intramuscular vitamin B12, with variable functional recovery. Three of the seven patients who were bedbound at presentation were able to walk again with an aid at discharge. Of eight patients with follow‐up data, most had persistent paresthesias and/or sensory ataxia. Mobility scores at admission and discharge were not significantly correlated with the serum total and active B12 levels or cumulative nitrous oxide use. There were no significant trends between serum active B12 level and cumulative nitrous oxide use (Spearman rho = −0.331, p = 0.195).

Conclusions

Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients.
The accuracy of ACTH as a biomarker for pituitary pars intermedia dysfunction in horses: A systematic review and meta‐analysis
Authors: Meyer James C. , Hunyadi László M. , Ordóñez‐Mena José M.
Published: August 2021

Background

Accuracy of baseline ACTH for the diagnosis of PPID in horses varies between studies.

Objectives

To estimate the diagnostic accuracy of ACTH as a biomarker for PPID in adult horses and appraise potential causes of heterogeneity.

Study design

Systematic review and meta‐analysis.

Methods

A literature review identified studies reporting diagnostic accuracy data for extraction. Risk of bias was evaluated using QUADAS‐2. Two random‐effects models, the hierarchical summary receiver operating curve (HSROC) and the bivariate binomial normal model (BBN) were used to pool accuracy measurements. We performed meta‐regression using study‐level variables. The impact of diagnostic test accuracy on the frequency of false‐positive and false‐negative results at various pretest probabilities was calculated using the BBN model's accuracy results.

Results

Patient selection and index test evaluation demonstrated significant risk of bias. Mean and 95% confidence intervals for sensitivity and specificity for all studies (n = 11) based upon the HSROC model were (0.72, 95% CI: 0.62 to 0.82) and (0.88, 95% CI: 0.79 to 0.93), respectively. When studies with a common positivity threshold of 35 pg/mL ACTH were evaluated (n = 6), sensitivity and specificity were (0.66, 95% CI:0.54 to 0.77) and (0.87, 95% CI: 0.74 to 0.94). In a hypothetical group of one thousand horses with PPID prevalence of 2%, 20%, and 90%, the frequency of resulting false‐positive and false‐negatives would be (127 and 7), (104 and 68) and (13 and 306), respectively. Factors leading to increased accuracy were case‐control design, clinical reference standard and data‐driven choice of ACTH threshold.

Main limitations

A small number of primary studies (n = 11) were available, demonstrating significant biases.

Conclusions

Less biased studies examining diagnostic accuracy of ACTH are needed. In horses with a high pretest probability of PPID, ACTH may be a functional “rule‐in” test. Baseline ACTH is not recommended for screening purposes or use in horses without clinical signs of PPID.
The mitochondrial coenzyme Q junction and complex III: biochemistry and pathophysiology
Authors: Banerjee Rishi , Purhonen Janne , Kallijärvi Jukka
Published: August 2021

Coenzyme Q (CoQ, ubiquinone) is the electron‐carrying lipid in the mitochondrial electron transport system (ETS). In mammals, it serves as the electron acceptor for nine mitochondrial inner membrane dehydrogenases. These include the NADH dehydrogenase (complex I, CI) and succinate dehydrogenase (complex II, CII) but also several others that are often omitted in the context of respiratory enzymes: dihydroorotate dehydrogenase, choline dehydrogenase, electron‐transferring flavoprotein dehydrogenase, mitochondrial glycerol‐3‐phosphate dehydrogenase, proline dehydrogenases 1 and 2, and sulfide:quinone oxidoreductase. The metabolic pathways these enzymes are involved in range from amino acid and fatty acid oxidation to nucleotide biosynthesis, methylation, and hydrogen sulfide detoxification, among many others. The CoQ‐linked metabolism depends on CoQ reoxidation by the mitochondrial complex III (cytochrome bc1 complex, CIII). However, the literature is surprisingly limited as for the role of the CoQ‐linked metabolism in the pathogenesis of human diseases of oxidative phosphorylation (OXPHOS), in which the CoQ homeostasis is directly or indirectly affected. In this review, we give an introduction to CIII function, and an overview of the pathological consequences of CIII dysfunction in humans and mice and of the CoQ‐dependent metabolic processes potentially affected in these pathological states. Finally, we discuss some experimental tools to dissect the various aspects of compromised CoQ oxidation.
Iowa World Language teachers’ attitudes regarding inclusion
Authors: DeVault Ann
Published: August 2021

This mixed‐methods study investigates the attitudes of middle and high school World Language (WL) teachers in Iowa regarding teaching students with disabilities (SWDs) as well as factors that relate to these attitudes. The study uses data from surveys of 41 Iowa WL teachers and semistructured interviews with eight. Survey data were analyzed using descriptive and inferential statistics and interview data were analyzed using thematic analysis. These findings were then combined for mixed methods analysis of WL teachers’ attitudes toward teaching SWDs and factors related to differences in attitudes. Findings suggested middle and high school WL teachers in Iowa had positive attitudes toward the inclusion of SWDs in their classes, but there were nuances to this support. Several factors were found to relate to participants’ attitudes, including their perceptions of the usefulness of their preservice and in‐service training, the level of administrative support, and the structure of the WL program.
The irony of choice in the “New Development Financing Landscape”
Authors: Taggart Jack , Power Marcus
Published: August 2021

The so‐called “New Development Financing Landscape” has heralded claims of an “Age of Choice” for developing countries. Here, more diverse sources of development finance have undercut the monopoly of influence held by “traditional” donors: opening up greater “choice” or “policy space” for developing countries. This narrative, we argue, is a fiction. Instead, the field is characterised by scarcity, not abundance. Further, Northern and (re)emerging Southern donors have tended toward convergence; reducing the scope for recipients to play these actors off one another while restricting recipient agency to properly shape and direct agendas. These trends compel recipient states to compete for scarce public and skittish private finance in a (de)regulatory race to the bottom where they must either reform in a manner conducive to the exigencies of global capital or be “left behind”; the anathema of the 2030 Agenda for Sustainable Development.
Efficacy and safety of endoscopic retrograde cholangiopancreatography in the very elderly by using a combination of intravenous midazolam, ketamine and pethidine
Authors: Tokmak Salih , Cetin Mehmet F , Torun Serkan
Published: August 2021

Aim

The number of therapeutic endoscopic procedures in elderly individuals keeps increasing and this population has a high risk of adverse events related to sedation and general anesthesia. However, there is a paucity on data about the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in this population.

Methods

In total, 417 consecutive ERCP procedures were performed in 362 patients between September 2018 and January 2020. Of these, 59 patients (74 sessions) were aged ≥80 years (Group A) and 173 patients (193 procedures) were aged ≤65 years (Group B). We analyzed the prospectively collected data of patient‐ and procedure‐related variables.

Results

The procedure time was significantly longer in Group A (P < 0.05). The prevalence of comorbidities, use of anticoagulants and American Society of Anesthesiologists (ASA) physical status classification levels were significantly higher in Group A (P < 0.05). The incidence of periampullary diverticula, malignancy, rate of difficult cannulation, mean number of stones, use of biliary stents and stent dysfunction was also significantly higher in Group A (P < 0.05). The medication doses used were significantly higher and emergence symptoms were significantly more frequent in Group B (P < 0.05). The rates of bleeding, pancreatitis, perforation, cholangitis, hypoxia, hypotension and the length of hospital stay did not significantly differ between the two groups. The overall success rate of the procedure was comparable in the two groups (P = 0.874).

Conclusions

ERCP can be safely performed in elderly patients using a combination of midazolam and ketamine without propofol. The incidence of complications is comparable with that observed in younger patients. Geriatr Gerontol Int 2021; 21: 887–892.
Screening for psychological distress on Indonesian type 2 diabetes: A validation study
Authors: Wicaksana Anggi Lukman , Pramono Raden Bowo , Irianti Sevia Rani , Khusna Rohmah Puriana , Rahayu Fatimah Putri , Aini Fiska Nur , Noviyantini Ni Putu Ayu , Pangastuti Heny Suseani
Published: August 2021

Aim

This study aimed to test the validity and reliability of a four‐item patient health questionnaire as a psychological distress screening tool for patients with type 2 diabetes in Indonesia.

Methods

This cross‐cultural adaptation study was applied in five public health‐care centres in Indonesia in August–October 2018 using a four‐item patient health questionnaire. The content, convergent and factorial validity were assessed, and Cronbach's alpha coefficient was the reliability indicator.

Results

A total of 147 participants were involved. Content validity resulted in acceptable outcomes (item and scale content validity indexes were 0.95 and 0.75, respectively). Anxiety and depression were associated with total score and psychological distress status (P < 0.001), supporting the convergent validity outcomes. Principal component analysis using varimax rotation revealed two factors, explaining 76.14% of variance (P < 0.001). Cronbach's alpha coefficients for anxiety, depression and total score were 0.780, 0.500 and 0.713, respectively.

Conclusions

The study demonstrated adequate validity and reliability for the Indonesian version of a four‐item patient health questionnaire among patients with type 2 diabetes. Therefore, it is applicable as a screening tool for psychological distress in this population.
Anxiety in the Wesleyan Spirit: A Core Theological Theme?
Authors: Cunningham Joseph W.
Published: August 2021

Eighteenth‐century writer and reformer John Wesley does not use ‘anxiety’ in its modern philosophical or psychological sense. However, Wesley carefully distinguishes between forms of religious fear and ‘nervous disorders’ throughout his published theological and medical works, indicating the felt quality of anxiety as a central theme. This is evinced in his published journals, sermons such as ‘The Spirit of Bondage and of Adoption’ (1746), ‘The Wilderness State’ and ‘Heaviness through Manifold Temptations’ (both published in 1760), and less‐conspicuous works such as Primitive Physic (1747), ‘Thoughts on Nervous Disorders’ (1786), as well as his publication on electricity, The Desideratum: Or Electricity Made Plain and Useful (1759). Wesley’s treatment of ‘anxiety‐qualia’ as religious predicament and physical disorder is instructive in terms of placing Wesley vis‐à‐vis the backdrop of Enlightenment Europe and its scientific and philosophical interests, which has been the subject of recent historical and theological scholarship related to Wesley. Wesley was a preacher and revivalist to be certain, whose emphasis on perceptible inspiration and the assurance of faith cultivated a global Protestant denomination, but he was also a curious thinker with a fondness for science and faith, steeped in the intellectual developments of the North Atlantic, early‐modern world.