bluuebunny/crossref_metadata_2025 huggingface dataset:
Working, living and dying in COVID times: perspectives from frontline adult social care workers in the UK
Authors: Briggs Daniel , Telford Luke , Lloyd Anthony , Ellis Anthony
Published: August 2021

Purpose

This paper aims to explore 15 UK adult social care workers’ experiences during the COVID-19 pandemic.

Design/methodology/approach

This paper’s 15 open-ended interviews with adult social care workers are complemented by digital ethnography in COVID-19 social media forums. This data set is taken from a global mixed-methods study, involving over 2,000 participants from 59 different countries.

Findings

Workers reported a lack of planning, guidance and basic provisions including personal protective equipment. Work intensification brought stress, workload pressure and mental health problems. Family difficulties and challenges of living through the pandemic, often related to government restrictions, intensified these working conditions with precarious living arrangements. The workers also relayed a myriad of challenges for their residents in which, the circumstances appear to have exacerbated dementia and general health problems including dehydration, delirium and loneliness. Whilst COVID-19 was seen as partially responsible for resident deaths, the sudden disruptions to daily life and prohibitions on family visits were identified as additional contributing factors in rapid and sudden decline.

Research limitations/implications

Whilst the paper’s sample cohort is small, given the significance of COVID-19 at this present time the findings shed important light on the care home experience as well as act as a baseline for future study.

Social implications

Care homes bore the brunt of illness and death during the first and second COVID-19 waves in the UK, and many of the problems identified here have still yet to be actioned by the government. As people approach the summer months, an urgent review is required of what happened in care homes and this paper could act as some part of that evidence gathering.

Originality/value

This paper offers revealing insights from frontline care home workers and thus provides an empirical snapshot during this unique phase in recent history. It also builds upon the preliminary/emerging qualitative research evidence on how the COVID-19 pandemic impacted care homes, care workers and the residents.
Diagnosis and prognostic stratification of cutaneous lymphoma
Authors: Miyagaki Tomomitsu
Published: August 2021

Primary cutaneous lymphomas are a heterogenous group of non‐Hodgkin’s lymphoma of both T/natural killer‐cell and B‐cell origin and defined to primarily present in the skin without extracutaneous involvement at diagnosis. In contrast to nodal non‐Hodgkin’s lymphoma, cutaneous T‐cell lymphomas (CTCL) are more generally seen than cutaneous B‐cell lymphomas (CBCL). CTCL and CBCL have various subtypes and each subtype has specifically characteristic clinical, pathological, and prognostic features. The diagnostic methods and staging evaluation of cutaneous lymphomas is mostly common in various guidelines created by professional societies. The diagnosis is made comprehensively based on clinical, pathological, laboratory, radiological, and genetic findings. On the other hand, definite prognostic stratification has not been completely established yet in most cutaneous lymphomas. This article focuses on the general and novel diagnostic methods and the current findings about prognostic factors and stratification in cutaneous lymphomas.
Phosphorus availability increases pathobiome abundance and invasion of rhizosphere microbial networks by Ralstonia
Authors: Li Pengfa , Liu Ming , Li Guilong , Liu Kai , Liu Tianshun , Wu Meng , Saleem Muhammad , Li Zhongpei
Published: August 2021

Soil disease‐suppressiveness depends on complex interactions among pathogens, native microbiota, and physicochemical properties, while these interactions remain understudied. Comparing field and microcosm experiments, we investigated the significance of these interactions in disease emergence or suppression using structural equation modelling (SEM) and receiver operating characteristic curve (ROC) analyses. We observed significant differences in the relative abundance of pathogenic and beneficial microbes, alpha and beta diversity indices between disease‐conducive and ‐suppressive rhizosphere soils. The pathogenic (Ralstonia) and beneficial (Bacillus) taxa dominated disease‐conducive and ‐suppressive rhizosphere soils, respectively. Moreover, the co‐occurrences of Ralstonia with native microorganisms were positive and negative in the disease‐conducive and ‐suppressive soils, respectively. These results suggest the supportive (Rudaea) and suppressive (Enterobacter, Bacillus) role of indigenous microbes in the invasion of soil and plant systems by Ralstonia. The SEM and ROC analysis predicted that Ralstonia invaded rhizospheric microbial networks and caused peanut wilt under high than low soil phosphorus conditions. Our results suggest the importance of soil phosphorus availability in altering the microbial interactions, thus leading to soil invasion by Ralstonia. Thus, we conclude by saying that feeding soil with high amounts of available phosphorus could deplete plant‐beneficial microbes and increase the pathobiome abundance that may compromise plant health.
The NDR kinase–MOB complex FgCot1‐Mob2 regulates polarity and lipid metabolism in Fusarium graminearum
Authors: Liu Na , Wang Jing , Yun Yingzi , Wang Jinli , Xu Chaoyun , Wu Siqi , Xu Luona , Li Baohua , Kolodkin‐Gal Ilana , Dawood Dawood H. , Zhao Youfu , Ma Zhonghua , Chen Yun
Published: August 2021

Members of the NDR (nuclear Dbf2‐related) protein‐kinase family are essential for cell differentiation and polarized morphogenesis. However, their functions in plant pathogenic fungi are not well understood. Here, we characterized the NDR kinase FgCot1 and its activator FgMob2 in Fusarium graminearum, a major pathogen causing Fusarium head blight (FHB) in wheat. FgCot1 and FgMob2 formed a NDR kinase–MOB protein complex. Localization assays using FgCot1‐GFP or FgMob2‐RFP constructs showed diverse subcellular localizations, including cytoplasm, septum, nucleus and hyphal tip. ΔFgcot1 and ΔFgmob2 exhibited serious defects in hyphal growth, polarity, fungal development and cell wall integrity as well as reduced virulence in planta. In contrast, lipid droplet accumulation was significantly increased in these two mutants. Phosphorylation of FgCot1 at two highly conserved residues (S462 and T630) as well as five new sites synergistically contributed its role in various cellular processes. In addition, non‐synonymous mutations in two MAPK (mitogen‐activated protein kinase) proteins, FgSte11 and FgGpmk1, partially rescued the growth defect of ΔFgmob2, indicating a functional link between the FgCot1–Mob2 complex and the FgGpmk1 signalling pathway in regulating filamentous fungal growth. These results indicated that the FgCot1–Mob2 complex is critical for polarity, fungal development, cell wall organization, lipid metabolism and virulence in F. graminearum.
The bacterium Pseudomonas protegens antagonizes the microalga Chlamydomonas reinhardtii using a blend of toxins
Authors: Rose Magdalena M. , Scheer Daniel , Hou Yu , Hotter Vivien S. , Komor Anna J. , Aiyar Prasad , Scherlach Kirstin , Vergara Fredd , Yan Qing , Loper Joyce E. , Jakob Torsten , van Dam Nicole M. , Hertweck Christian , Mittag Maria , Sasso Severin
Published: August 2021

The unicellular alga Chlamydomonas reinhardtii and the bacterium Pseudomonas protegens serve as a model to study the interactions between photosynthetic and heterotrophic microorganisms. P. protegens secretes the cyclic lipopeptide orfamide A that interferes with cytosolic Ca2+ homeostasis in C. reinhardtii resulting in deflagellation of the algal cells. Here, we studied the roles of additional secondary metabolites secreted by P. protegens using individual compounds and co‐cultivation of algae with bacterial mutants. Rhizoxin S2, pyrrolnitrin, pyoluteorin, 2,4‐diacetylphloroglucinol (DAPG) and orfamide A all induce changes in cell morphology and inhibit the growth of C. reinhardtii. Rhizoxin S2 exerts the strongest growth inhibition, and its action depends on the spatial structure of the environment (agar versus liquid culture). Algal motility is unaffected by rhizoxin S2 and is most potently inhibited by orfamide A (IC50 = 4.1 μM). Pyrrolnitrin and pyoluteorin both interfere with algal cytosolic Ca2+ homeostasis and motility whereas high concentrations of DAPG immobilize C. reinhardtii without deflagellation or disturbance of Ca2+ homeostasis. Co‐cultivation with a regulatory mutant of bacterial secondary metabolism (ΔgacA) promotes algal growth under spatially structured conditions. Our results reveal how a single soil bacterium uses an arsenal of secreted antialgal compounds with complementary and partially overlapping activities.
Historical forest disturbance mediates soil microbial community responses to drought
Authors: Osburn Ernest D. , Badgley Brian D. , Aylward Frank O. , Barrett J. E.
Published: August 2021

Despite the abundance of studies demonstrating the effects of drought on soil microbial communities, the role of land use legacies in mediating these drought effects is unclear. To assess historical land use influences on microbial drought responses, we conducted a drought‐rewetting experiment in soils from two adjacent and currently forested watersheds with distinct land use histories: an undisturbed ‘reference’ site and a ‘disturbed’ site that was clear‐cut and converted to agriculture ~60 years prior. We incubated intact soil cores at either constant moisture or under a drought‐rewet treatment and characterized bacterial and fungal communities using amplicon sequencing throughout the experiment. Bacterial alpha diversity decreased following drought‐rewetting while fungal diversity increased. Bacterial beta diversity also changed markedly following drought‐rewetting, especially in historically disturbed soils, while fungal beta diversity exhibited little response. Additionally, bacterial beta diversity in disturbed soils recovered less from drought‐rewetting compared with reference soils. Disturbed soil communities also exhibited notable reductions in nitrifying taxa, increases in putative r‐selected bacteria, and reductions in network connectivity following drought‐rewetting. Overall, our study reveals historical land use to be important in mediating responses of soil bacterial communities to drought, which will influence the ecosystem‐scale trajectories of these environments under ongoing and future climate change.
From overkill to beheading: A case report of a schizophrenic matricide
Authors: Petroni Giulia , Mandarelli Gabriele , Marasco Maurizio , Catanesi Roberto , Tavone Alessandro Mauro , Potenza Saverio , Marsella Luigi Tonino , Marella Gian Luca
Published: August 2021

Initial evidence exists on a subtype of matricide committed by subjects suffering from severe mental disorders. Matricide perpetrators often undergo a forensic psychiatric evaluation during the subsequent criminal trial because of supposed legal insanity. The few studies on matricide by mentally disordered perpetrators suggested a possible association between such extreme form of violence and schizophrenia spectrum disorders, especially in case of active delusions or hallucinations. Methods: we analyze a case of a young male with a recent diagnosis of psychotic disorder who committed matricide by inflicting multiple injuries and beheading. Data emerging from the forensic pathological analysis of the victim, as well as the forensic psychiatric analysis of the matricide perpetrator are discussed within an interdisciplinary perspective. Results: the autopsy revealed multiple stab wounds in the regions of the upper limbs, abdomen, chest, and neck, the latter determining beheading. The forensic psychiatric evaluation yielded a diagnosis of schizophrenia and clarified the causal role in the homicidal behavioral of active psychotic symptoms. Conclusion: the specific type of delusional content, and perpetrator‐victim relationship might contribute explaining a subtype of extremely violent homicide in recent onset schizophrenia.
PIWI‐interacting RNAs are aberrantly expressed and may serve as novel biomarkers for diagnosis of lung adenocarcinoma
Authors: Li Juan , Wang Nan , Zhang Fang , Jin Shan , Dong Yaqi , Dong Xiangjun , Chen Yuqing , Kong Xue , Tong Yao , Mi Qi , Zhao Yinghui , Zhang Yi
Published: August 2021

Background

Lung adenocarcinoma (LUAD) is the main subtype of primary lung cancer and is a leading cause of cancer‐related death worldwide. PIWI‐interacting RNAs (piRNAs) are a type of small non‐coding RNAs that may play crucial roles in cancer progression and serve as biomarkers for tumor detection. This study aimed to explore the expression profiles and diagnostic values of piRNAs in LUAD.

Methods

Small RNA sequencing was performed to investigate tissue piRNA profiles of LUAD. The expression of selected upregulated piRNAs were detected in tissues and serum exosome samples by quantitative real‐time polymerase chain reaction (qRT‐PCR). Serum exosomes were identified by transmission electron microscope, nanoparticle tracking analysis, and western blot analysis. Receiver operating characteristic (ROC) curve was adopted to quantify the diagnostic potentials of piRNAs in LUAD. Finally, a piRNA panel was developed by multivariate logistic regression model.

Results

We identified that 76 piRNAs were overexpressed and 9 piRNAs were underexpressed in LUAD tissues compared with adjacent non‐tumor tissues. Among the top 10 overexpressed piRNAs, 4 piRNAs (piR‐hsa‐26925, piR‐hsa‐5444, piR‐hsa‐30636, and piR‐hsa‐8757) were verified by qRT‐PCR to be significantly upregulated in LUAD tissues. Moreover, piR‐hsa‐26925 and piR‐hsa‐5444 had a significantly higher level in serum exosome samples of LUAD patients than those of healthy controls. We finally established a 2‐piRNA panel composed of piR‐hsa‐26925 and piR‐hsa‐5444, which showed higher diagnostic performance for LUAD with an AUC of 0.833.

Conclusions

Our finding revealed the abnormally expressed piRNAs in LUAD, and serum exosomal piR‐hsa‐26925 and piR‐hsa‐5444 could serve as potential biomarkers for LUAD diagnosis.
Firm innovation and local bank efficiency in Italy: Does the type of bank matter?
Authors: Barra Cristian , Ruggiero Nazzareno
Published: August 2021

In this study, we use a conventional Probit model to investigate the effects of banks’ cost efficiency on innovation in Italy. In particular, we assess whether the efficiency–innovation relation depends on the type of banking institutions, as we partition them according to whether they are cooperatives or non‐cooperatives. When we examine the two types of financial intermediaries simultaneously, the higher efficiency among cooperative banks has a positive and significant effect on R&D collaborations with firms and consultants and process innovation, while higher efficiency among non‐cooperative banks has a positive and significant effect on product innovation. When we consider each individually, the effect holds for cooperatives, but the opposite holds for non‐cooperatives, as the positive and significant effect on product innovation vanishes. To deal with the likely endogeneity of bank efficiency, we also propose the application of an Instrumental Variable Probit (IV Probit) model. When we again jointly examine cooperative and non‐cooperative banks, our evidence indicates that higher efficiency among non‐cooperative banks enhances in‐house R&D and both product and process innovations, while we find a non‐significant effect for cooperative banks. However, when we individually examine the efficiency of each intermediary, we find evidence of a positive and significant effect on the process innovation for cooperative banks and of a positive relation between non‐cooperative banks’ efficiency, in‐house R&D and product and process innovations.
Needs‐driven talent and competency development for the next generation of regulatory scientists in Africa
Authors: Semete‐Makokotlela Boitumelo , Mahlangu Gugu N. , Mukanga David , Darko Delese Mimi , Stonier Peter , Gwaza Luther , Nkambule Portia , Matsoso Precious , Lehnert Regine , Rosenkranz Bernd , Pillai Goonaseelan (Colin)
Published: August 2021

Capacity building programmes for African regulators should link education, training and research with career development in an approach that combines an academic base and experiential learning aligned within a competency framework. A regulatory ecosystem that engages with a broad range of stakeholders will mean that expertise in the ever‐expanding field of regulatory science filters into teaching and research in a symbiotic way. In this way capacity development interventions will be a collaborative approach between the learning context (academic and training institutions) and the performance context (regulatory agencies and industry), which will ultimately best serve the patients. Monitoring and evaluation of capacity development interventions will be essential to show value of investments and ultimately guide continued funding and sustainability.

This paper reviews the skills and human capacity gaps, reports on regulatory assessment pathways used in Ghana, South Africa and Zimbabwe and outlines a staged tactical approach for Africa that builds on previous efforts to strengthen African regulatory ecosystems.
When looking ‘hot’ means not feeling cold: Evidence that self‐objectification inhibits feelings of being cold
Authors: Felig Roxanne N. , Jordan Jessica A. , Shepard Samantha L. , Courtney Emily P. , Goldenberg Jamie L. , Roberts Tomi‐Ann
Published: August 2021

Self‐objectification, the internalization of an observer’s appearance‐based perspective of one’s body, has been theorized and demonstrated to reduce body awareness among women. In this field study, we propose self‐objectification as the mechanism to explain the oft‐observed phenomenon where women wearing little clothing appear unbothered by cold weather, positing that self‐objectification obstructs women’s feelings of cold. We surveyed women outside nightclubs on cold nights, assessed self‐objectification, and asked participants to report how cold they felt. Anonymous photos were taken and coded for amount of skin exposure. We hypothesized that self‐objectification would moderate the relationship between clothing coverage and reports of feeling cold. Our hypothesis was supported: women low in self‐objectification showed a positive, intuitive, relationship between skin exposure and perceptions of coldness, but women more highly focused on their appearance did not feel colder when wearing less clothing. These findings offer support for the relationship between self‐objectification and awareness of bodily sensations in the context of a naturalistic setting. We discuss implications of these findings, and also consider limitations, an alternative explanation, and directions for future research.
Geomorphology and sedimentology of features formed at the outlet during the final drainage of the Baltic Ice Lake
Authors: Johnson Mark D. , Öhrling Christian , Bergström Adrian , Dreyer Isaksson Oskar , Pizarro Rajala Emma
Published: August 2021

We present a conceptual model for the character of the 11.6 cal. ka BP drainage of the Baltic Ice Lake in the outlet area based on a new geomorphological map as well as new sedimentological information. We combine this new information with a review of the previous work on this well‐studied area. The model includes the premise of remnant ice in the Lången valley as suggested by previous workers and indicates the drainage began subglacially. Cobbly sediment on northeast Billingen formerly interpreted as beach sediment is interpreted to be a subglacial lag deposit. The ridge at Timmersdala is composed of drainage sediment from the initial phases of the drainage, deposited in a subglacial tunnel that emptied out on to central Klyftamon. Continued drainage widened the tunnel by frictional melting, eventually lifting and fracturing the ice. Pendant bars, expansion bars and boulder sheets on central and southern Klyftamon formed during the drainage event. Cobbly and bouldery drainage sediment in the bars, which is massive and poorly sorted, was deposited as bedload from sediment‐charged water. Imbrication, bar orientation, and changes in grain size and Cambrian‐clast content indicate flow to the west–northwest. Most sediment in the bars was derived from erosion on Klyftamon, but Cambrian rock from Billingen is present, delivered directly by the flood waters and/or from debris‐rich icebergs from the broken‐up remnant ice. This flood event is distinguished from other Quaternary megafloods by being sediment‐supply limited and having a short, subaerial floodway (20 km).
Development of the Oral Health Literacy Profile (OHLP)—Psychometric properties of the oral health and dental health system knowledge scales
Authors: Spinler Kristin , Valdez Richelle , Aarabi Ghazal , Dingoyan Demet , Reissmann Daniel Ralph , Heydecke Guido , von dem Knesebeck Olaf , Kofahl Christopher
Published: August 2021

Objectives

Current oral health literacy (OHL) instruments vary in focus, methodology, administration time and burden. The widely used word recognition tests fail to encompass important OHL domains, while others exceed time frames for use in practical settings, require an interviewer or mainly measure self‐assessments. This paper describes the development of the Oral Health Literacy Profile (OHLP), introduces its components and evaluates the psychometric properties of its two core modules, the knowledge tests.

Methods

A preliminary version of the questionnaire was developed and assessed for content validity, relevance and redundancy by an expert panel. It was tested in a convenience sample (n = 95) leading to the creation of a 28‐item questionnaire, which was afterwards tested in a second convenience sample (n = 193). Item difficulty, discrimination, internal reliability and construct validity were assessed for the oral health knowledge (OHK) and dental health system knowledge (DHSK) modules.

Results

The items showed acceptable range of difficulty (ideal: 7 items; easy: 5 items; and difficult: 3 items) and good to very good discriminatory power (the point‐biserial index (PBI) > 0.30: all items). Construct validity was considered to be fulfilled when 75% of the hypotheses of expected group differences were met. Satisfactory internal reliability was observed.

Conclusion

With all its components, the OHLP is a suitable short instrument to assess the most relevant dimensions of the multifaceted construct of OHL.

Practice implication

The OHLP can be widely used in research, especially suitable in practical settings, and thereby identify patients who may benefit from oral health education.
Computer‐based multimodal training module facilitates standardization of complete mesocolic excision technique for right‐sided colon cancer: Long‐term oncological outcomes
Authors: Kutlu Burak , Benlice Cigdem , Kocaay Firat , Gungor Yigit , Ismail Erkin , Akyol Cihangir , Yilmaz Mehmet , Ozdemir Mehtap , Acar Halil Ibrahim , Elhan Atilla Halil , Kuzu Mehmet Ayhan
Published: August 2021

Aim

The aim of this study is to demonstrate our video training tool developed to teach and standardize complete mesocolic excision (CME) for right‐sided colon cancer and also to present our long‐term oncological outcomes.

Method

Educational narrative videos were produced to demonstrate the technical steps of CME. First, a three‐dimensional animation video was prepared. Then cadaveric dissections were recorded in a step‐by‐step fashion, following the sequences of open and minimally invasive surgery. These were followed by videos of real‐life demonstrations of surgical procedures, enhanced by superimposed animations of key anatomical structures. In order to demonstrate the impact of this training module on outcomes of patients undergoing CME, we retrospectively queried data from before (2005–2010) and after (2011–2019) implementation of standardized CME in our practice.

Results

A total of 180 consecutive patients underwent right hemicolectomy between 2005 and 2019. Fifty‐four patients underwent surgery before and 126 patients after CME principles were elaborated and standardized. Of those patients who had surgery after the training module, 58 (46%) underwent open surgery and 68 (54%) underwent laparoscopic colectomy. Demographics, perioperative parameters and morbidity were comparable between the groups. The 5‐year overall and disease‐free survival rates were significantly improved after implementation of CME training (p = 0.059 and p = 0.041, respectively). Also, 5‐year overall and disease‐free survival rates for all patients were considerably better than our reported national outcomes.

Conclusion

Our comprehensive step‐by‐step training video module for the CME technique demonstrates surgical anatomical planes and important vascular structures and variations. The video also helps standardization of the CME technique and should contribute to improved histopathological and oncological outcomes.
A phase I clinical trial of human embryonic stem cell‐derived retinal pigment epithelial cells for early‐stage Stargardt macular degeneration: 5‐years' follow‐up
Authors: Li Shi‐Ying , Liu Yong , Wang Lei , Wang Fang , Zhao Tong‐Tao , Li Qi‐You , Xu Hai‐Wei , Meng Xiao‐Hong , Hao Jie , Zhou Qi , Wang Liu , Yin Zheng‐Qin
Published: August 2021

Objectives

To evaluate the long‐term biosafety and efficacy of transplantation of human embryonic stem cells‐derived retinal pigment epithelial (hESC‐RPE) cells in early‐stage of Stargardt macular degeneration (STGD1).

Materials and methods

Seven patients participated in this prospective clinical study, where they underwent a single subretinal transplantation of 1 × 105 hESC‐RPE cells in one eye, whereas the fellow eye served as control. These patients were reassessed for a 60‐month follow‐up through systemic and ophthalmic examinations.

Results

None of the patients experienced adverse reactions systemically or locally, except for two who had transiently high intraocular pressure post‐operation. Functional assessments demonstrated that all of the seven operated eyes had transiently increased or stable visual function 1‐4 months after transplantation. At the last follow‐up visit, two of the seven eyes showed visual function loss than the baseline; however, one of them showed a stable visual acuity when compared with the change of fellow eye. Obvious small high reflective foci in the RPE layer were displayed after the transplantation, and maintained until the last visit. Interestingly, three categories of patients who were classified based on autofluorescence, exhibited distinctive patterns of morphological and functional change.

Conclusions

Subretinal transplantation of hESC‐RPE in early‐stage STGD1 is safe and tolerated in the long term. Further investigation is needed for choosing proper subjects according to the multi‐model image and function assessments.
Uptake of slow‐release oral morphine as opioid agonist treatment among hospitalised patients with opioid use disorder
Authors: Brothers Thomas D. , Fraser John , MacAdam Emily , Morgan Brendan , Webster Duncan
Published: August 2021

Introduction

Buprenorphine and methadone are highly effective first‐line medications for opioid agonist treatment (OAT) but are not acceptable to all patients. We aimed to assess the uptake of slow‐release oral morphine (SROM) as second‐line OAT among medically ill, hospitalised patients with opioid use disorder who declined buprenorphine and methadone.

Methods

This study included consecutive hospitalised patients with untreated moderate‐to‐severe opioid use disorder referred to an inpatient addiction medicine consultation service, between June 2018 and September 2019, in Nova Scotia, Canada. We assessed the proportion of patients initiating first‐line OAT (buprenorphine or methadone) in‐hospital, and the proportion initiating SROM after declining first‐line OAT. We compared rates of outpatient OAT continuation (i.e., filling outpatient OAT prescription or attending first outpatient OAT clinic visit) by medication type, and compared OAT selection between patients with and without chronic pain, using χ2 tests.

Results

Thirty‐four patients were offered OAT initiation in‐hospital; six patients (18%) also had chronic pain. Twenty‐one patients (62%) initiated first‐line OAT with buprenorphine or methadone. Of the 13 patients who declined first‐line OAT, seven (54%) initiated second‐line OAT with SROM in‐hospital. Rates of outpatient OAT continuation after hospital discharge were high (>80%) and did not differ between medications (P = 0.4). Patients with co‐existing chronic pain were more likely to choose SROM over buprenorphine or methadone (P = 0.005).

Discussion and Conclusions

The ability to offer SROM (in addition to buprenorphine or methadone) increased rates of OAT initiation among hospitalised patients. Increasing access to SROM would help narrow the opioid use disorder treatment gap of unmet need.
Causality and initiation of alcohol control policy. A response to Allamani
Authors: Rehm Jürgen , Purshouse Robin C.
Published: August 2021

In a recent commentary, Allamani asked how one can establish causality in epidemiological research, and specifically about causality as it relates to alcohol control policy. Epidemiology customarily uses a sufficient‐component cause model, where a sufficient cause for an outcome is determined by a set of minimal conditions and events that inevitably produce the stated outcome. While this model is theoretically clear, its operationalisation often involves probabilistic elements. Recent advances in agent‐based modelling may improve operationalisation. The implications for alcohol control policy from this model are straightforward: the so‐called alcohol‐attributable fraction denotes the cases of morbidity or mortality which would not have happened in the absence of alcohol use.
Multiple myeloma with cardiac involvement accompanied by partial superior vena cava obstruction: A case report and literature review
Authors: Wang Shuzhen , Zhao Ruohan , Tan Kunyue , Liu Chunxia , Zhang Lijuan , Xu Min , Xiong Feng
Published: August 2021

Multiple myeloma is a malignant proliferative disorder of plasma cells. Extramedullary involvement of the endocardium is rare in multiple myeloma. Here, we reported a 57‐year‐old male, once was diagnosed with multiple myeloma. The echocardiography reveled multiple solid masses in the right atrium, along with partial obstruction of superior vena cava. The mass resection alleviated the edema of upper limbs and identified the mass as extramedullary plasmablastic transformation and endocardial involvement. We also conducted a literature review and summary analysis of space‐occupying lesions in the heart in 12 patients with multiple myeloma (including the current case) in the last 10 years. Echocardiography is the preferred radiologic examination method for diagnosis and follow‐up in multiple myeloma with cardiac involvement, and surgical resection is effective for alleviating symptoms.
Association between elevated left ventricular mass index and increased cardiovascular events in patients with acute coronary syndrome: A sub‐analysis of the HIJ‐PROPER study
Authors: Sone Maiko , Saito Chihiro , Arashi Hiroyuki , Yamaguchi Junichi , Ogawa Hiroshi , Hagiwara Nobuhisa
Published: August 2021

Aim

This study aimed to assess the association between left ventricular mass index (LVMI) and cardiovascular events in patients with acute coronary syndrome (ACS) under standard ACS management.

Methods and results

This study is the sub‐analysis of the HIJ‐PROPER study. A total of 299 patients who had echocardiographic LVMI data were included in the current analysis. The participants were divided into four groups according to the LVMI quartile [quartile 1 (Q1), 77 (25.8%); quartile 2 (Q2), 73 (24.4%); quartile 3 (Q3), 74 (24.7%); and quartile 4 (Q4), 75 (25.1%)]. The incidence of cardiovascular events was compared among the four groups. The primary endpoint was defined as the composite endpoint of all‐cause death, non‐fatal myocardial infarction, non‐fatal stroke, and hospitalization for heart failure. Mean LVMI in the four groups was 68.1±8.6, 86.2±3.8, 101.1±4.9, and 126.0±18.5 g/m2, respectively. The primary endpoint was noted in 4, 4, 7, and 14 patients in Q1, Q2, Q3, and Q4, corresponding to an incidence of 5.2%, 5.5%, 9.5%, and 18.7%, respectively (p = 0.03 for difference among four groups). The cumulative incidence of the primary endpoint was significantly higher in patients in Q4 than in those in Q1 and Q2 [hazard ratio (HR) 3.75; 95% confidence interval (CI), 1.23–11.4; p = 0.02 for Q4 vs Q1; HR 3.43; 95% CI, 1.13–10.4; p = 0.03 for Q4 vs Q2]. This tendency was noted even after adjusting for patient characteristics and echocardiography parameters (p = 0.039 for Q4 vs Q1).

Conclusion

Elevated LVMI was associated with increased cardiovascular events in patients with ACS under standard management. Adequately powered studies are warranted to validate these findings.
Seizing balance and success during your PhD experience
Authors: Rodrigues Rui S.
Published: August 2021

Doing a PhD is a long, yet rewarding, expedition. Amid that journey, several decisions must be made to position yourself and stand out within a tough system as well as to align your personal goals and interests with those of supervisors, teams, and institutions. Many challenges will arise throughout that PhD journey and a degree of uneasiness and uncertainty will sometimes linger. In this opinion article, I put forth a personal and honest view of how to seize balance and success during your PhD experience. I reflect on issues such as failure, planning, work‐life balance, and personal drive. All in all, I highlight difficulties shared among all PhD students while discussing personalized strategies and coping mechanisms to deal with adversity. Taken together, this is a timely piece that aims to raise awareness about the problems affecting most PhD students and, in parallel, to inspire and empower fellow PhD students. Notably, this is also a call to the research community to be sensitive to these struggles and to foster practices that enable PhD students to live to their full potential.
Brain network excitatory/inhibitory imbalance is a biomarker for drug‐naive Rolandic epilepsy: A radiomics strategy
Authors: Dai Xi‐Jian , Liu Heng , Yang Yang , Wang Yongjun , Wan Feng
Published: August 2021

Objective

Seizure occurs when the balance between excitatory and inhibitory (E/I) inputs to neurons is perturbed, resulting in abnormal electrical activity. This study investigated whether an existing E/I imbalance in neural networks is a useful diagnostic biomarker for Rolandic epilepsy by a resting‐state dynamic causal modeling‐based support vector machine (rs‐DCM‐SVM) algorithm.

Methods

This multicenter study enrolled a discovery cohort (76 children with Rolandic epilepsy and 76 normal controls [NCs]) and a replication cohort (59 children with Rolandic epilepsy and 60 NCs). Spatial independent component analysis was used to seven canonical neural networks, and a total of 25 regions of interest were selected from these networks. The rs‐DCM‐SVM classifier was used for individual classification, consensus feature selection, and feature ranking.

Results

The rs‐DCM‐SVM classifier showed that the E/I imbalance in brain networks is a useful neuroimaging biomarker for Rolandic epilepsy, with an accuracy of 88.2% and 81.5% and an area under curve of .92 and .83 in the discovery and the replication cohorts, respectively. Consensus brain regions with the highest contributions to the classification were located within the epilepsy‐related networks, indicating that this classifier was suitable. Consensus functional connection pairs with the highest contributions to the classification were associated with an excitation network loop and an inhibition network loop. The excitation loop mediated the integration of advanced cognitive networks (subcortex, dorsal attention, default mode, executive control, and salience networks), whereas the inhibition loop was involved in the segregation of sensorimotor and language networks. The two loops showed functional segregation.

Significance

Brain E/I imbalance has potential to serve as a biomarker for individual classification in children with Rolandic epilepsy, and might be an important mechanism for causing seizures and cognitive impairment in children with Rolandic epilepsy.
Antiseizure effects of Anacyclus pyrethrum in socially isolated rats with and without a positive handling strategy
Authors: Manouze Houria , Ghestem Antoine , Bennis Mohamed , Sokar Zahra , Benoliel Jean‐Jacques , Becker Chrystel , Ba‐M'hamed Saadia , Bernard Christophe
Published: August 2021

Objective

Aqueous extract of Anacyclus pyrethrum (AEAPR) is used in traditional medicine to treat epilepsy, but whether it has antiseizure properties has not been established. Because extracts of the plant have antioxidant properties, we hypothesized that it may be particularly potent in conditions associated with oxidative stress, in particular social isolation.

Methods

We addressed these objectives in the pilocarpine experimental model of epilepsy using socially isolated rats maintaining contacts with (handled) and without (unhandled) positive handling strategy. Both groups were further divided into treated (AEAPR was added to the drinking water) and untreated groups. Continuous (24/7) electroencephalography (EEG) recordings started in the sixth week after status epilepticus (SE) with a predrug control period of 3 weeks, followed by 3 weeks of daily treatment with AEAPR or water, and finally a postdrug control period of 3 weeks. At the end of the experimental procedure, we measured lipid peroxidation, superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase activities in the hippocampus to assess oxidative stress.

Results

A. pyrethrum treatment significantly reduced seizure frequency by 51% and 57%, duration by 30% and 33%, and severity by 31% and 26% in isolated handled and unhandled rats, respectively. The beneficial effects on seizures were still present 3 weeks after the end of the treatment. The treatment reduced lipid peroxidation as well as SOD, GPx, and catalase activities.

Significance

We conclude that A. pyrethrum has antiseizure and antioxidant properties, even in social isolation conditions.
Emerging roles for thiol dioxygenases as oxygen sensors
Authors: Gunawardana Dona M. , Heathcote Karen C. , Flashman Emily
Published: August 2021

Cysteine dioxygenases, 3‐mercaptopropionate dioxygenases and mercaptosuccinate dioxygenases are all thiol dioxygenases (TDOs) that catalyse oxidation of thiol molecules to sulphinates. They are Fe(II)‐dependent dioxygenases with a cupin fold that supports a 3xHis metal‐coordinating triad at the active site. They also have other, broadly common features including arginine residues involved in substrate carboxylate binding and a conserved trio of residues at the active site featuring a tyrosine important in substrate binding catalysis. Recently, N‐terminal cysteinyl dioxygenase enzymes (NCOs) have been identified in plants (plant cysteine oxidases, PCOs), while human 2‐aminoethanethiol dioxygenase (ADO) has been shown to act as both an NCO and a small molecule TDO. Although the cupin fold and 3xHis Fe(II)‐binding triad seen in the small molecule TDOs are conserved in NCOs, other active site features and aspects of the overall protein architecture are quite different. Furthermore, the PCOs and ADO appear to act as biological O2 sensors, as shown by kinetic analyses and hypoxic regulation of the stability of their biological targets (N‐terminal cysteine oxidation triggers protein degradation via the N‐degron pathway). Here, we discuss the emergence of these two subclasses of TDO including structural features that could dictate their ability to bind small molecule or polypeptide substrates. These structural features may also underpin the O2‐sensing capability of the NCOs. Understanding how these enzymes interact with their substrates, including O2, could reveal strategies to manipulate their activity, relevant to hypoxic disease states and plant adaptive responses to flooding.
The effect of mobilization protocol on mobilization start time and patient care outcomes in patients undergoing abdominal surgery
Authors: Koyuncu Fadime , Iyigun Emine
Published: August 2021

Aim

To evaluate the effect of mobilization protocol on mobilization start time, maintenance of mobilization and patient care outcomes in patients who underwent major abdominal open surgery.

Background

Early mobilization in the first 24 hours postoperatively is recommended. Early mobilization is one of the evidence‐based, effective nursing interventions that improve patient care outcomes.

Design

A quasi‐experimental non‐randomised design was used in the study.

Methods

In the study, the groups were followed sequentially and the data of the control group (n = 21) were collected before the intervention group (n = 21). The patients in the control group were mobilised postoperatively by the nurses according to the decision of the nurse and physician in the intensive care unit (ICU) on the day of the operation. There was no standard protocol for mobilization in the ICU. Mobilization training was given to the patients in the intervention group by the researcher nurse the evening before the operation, and a mobilization protocol was applied on the 0th postoperative day. Data on patient care outcomes were collected until the day when the patient was discharged from the hospital. The TREND checklist was followed.

Results

According to the postoperative comparison of the patients in the intervention group to those in the control group, patients in the intervention group started mobilization earlier after admission in intensive care unit (6.22 ± 1.95 hours versus 12.21 ± 3.76 hours), had higher postoperative 0th‐day total mobilization time (128 minutes versus 34 minutes), had a shorter passage of flatus time and length of intensive care unit and hospital stay and had higher sleep quality and satisfaction scores.

Conclusions

The structured mobilization protocol is effective in the management of early mobilization and improvement of patient care outcomes.

Relevance to clinical practice

mobilization protocols ensure that the mobilization process is maintained effectively.
Leverage Regulation and Market Structure: A Structural Model of the U.K. Mortgage Market
Authors: BENETTON MATTEO
Published: August 2021

I develop a structural model of mortgage demand and lender competition to study how leverage regulation affects the U.K. mortgage market. Using variation in risk‐weighted capital requirements across lenders and mortgages with different loan‐to‐values (LTVs), I show that a 1‐percentage‐point increase in risk‐weighted capital requirements increases lenders' marginal cost of originating mortgages by about 26 basis points (11%) on average. I use the estimated model to study proposed leverage regulations. Counterfactual analyses show that large lenders exploit a regulatory cost advantage, which increases concentration by about 20%, and suggest that banning high‐LTV mortgages may reduce large lenders' equity buffer.
Strength and Surface Properties of a 3D‐Printed Denture Base Polymer
Authors: Gad Mohammed M. , Fouda Shaimaa M. , Abualsaud Reem , Alshahrani Faris A. , Al‐Thobity Ahmad M. , Khan Soban Q. , Akhtar Sultan , Ateeq Ijlal Shahrukh , Helal Mohamed A. , Al‐Harbi Fahad A.
Published: August 2021

Purpose

This in vitro study evaluated the flexural strength, impact strength, hardness, and surface roughness of 3D‐printed denture base resin subjected to thermal cycling treatment.

Materials and Methods

According to ISO 20795‐1:2013 standards, 120 acrylic resin specimens (40/flexural strength test, 40/impact strength, and 40/surface roughness and hardness test, n = 10) were fabricated and distributed into two groups: heat‐polymerized; (Major.Base.20) as control and 3D‐printed (NextDent) as experimental group. Half of the specimens of each group were subjected to 10,000 thermal cycles of 5 to 55°C simulating 1 year of clinical use. Flexural strength (MPa), impact strength (KJ/m2), hardness (VHN), and surface roughness (μm) were measured using universal testing machine, Charpy's impact tester, Vickers hardness tester, and profilometer, respectively. Data were analyzed by ANOVA and Tukey honestly significant difference (HSD) test (α = 0.05).

Results

The values of flexural strength (MPa) were 86.63 ± 1.0 and 69.15 ± 0.88; impact strength (KJ/m2)—6.32 ± 0.50 and 2.44 ± 0.31; hardness (VHN)—41.63 ± 2.03 and 34.62 ± 2.1; and surface roughness (μm)—0.18 ± 0.01 and 0.12 ± 0.02 for heat‐polymerized and 3D‐printed denture base materials, respectively. Significant differences in all tested properties were recorded between heat‐polymerized and 3D‐printed denture base materials (P < 0.001). Thermal cycling significantly lowered the flexural strength (63.93 ± 1.54 MPa), impact strength (2.40 ± 0.35 KJ/m2), and hardness (30.17 ± 1.38 VHN) of 3D‐printed resin in comparison to thermal cycled heat‐polymerized resin, but surface roughness showed non‐significant difference (p = 0.262).

Conclusion

3D‐printed resin had inferior flexural strength, impact strength, and hardness values than heat‐polymerized resin, but showed superior surface roughness. Temperature changes (thermal cycling) significantly reduced the hardness and flexural strength and increased surface roughness, but did not affect the impact strength.
Breeding a series of new rice restorer lines with blast resistance and low‐to‐intermediate apparent amylose contents by integrating marker‐assisted and phenotypic selection
Authors: Qin Peng , Jiang Nan , Hu Xiaochun , Zhu Yuxuan , Deng Zhao , Bai Zhenan , Fu Jun , Zhang Xuanwen , Wang Kai , Chen Sheyuan , Yang Yuanzhu
Published: August 2021

Hybrid rice, as one of the most successful crops exploiting heterosis, has greatly contributed to global food security. Due to its high‐yield potential, approximately half of the rice‐growing area in China is planted with hybrid rice varieties. However, the extreme vulnerability of hybrid rice to various diseases and poor grain quality pose great challenges to rice breeders. Here, we report the development of five new restorer lines pyramiding the broad‐spectrum blast resistance gene Pigm and low/intermediate amylose content‐associated gene Wxb by marker‐assisted and phenotypic selection. All these new restorer lines showed enhanced blast resistance in the disease nursery compared with the original restorer lines and had low‐to‐intermediate apparent amylose contents, ranging from 11.3% to 14.2%. Genetic background analysis based on next‐generation sequencing indicated that the proportion of Gumei 4 (donor of Pigm) genome in the five new restorer lines ranged from 9.89% to 21.69%. Eight of their derived hybrid combinations, which exhibited better grain quality and higher levels of blast resistance, have been certificated for commercial release in different ecological regions of China. Among them, Jing‐Liang‐You 3189, Yue‐Liang‐You 3189, Jing‐Liang‐You 1074 and Long‐Liang‐You 3188 meet the national standards for superior‐quality rice in China. These results confirmed the success of developing elite restorer lines through marker‐assisted and phenotypic selection, and these new restorer lines have great potential in developing more elite hybrid rice combinations.