bluuebunny/crossref_metadata_2025 huggingface dataset:
Single incision laparoscopic repair for late‐onset congenital diaphragmatic hernia using oval‐shaped multichannel port device (E•Z ACCESS oval type)—2 months infantile case of Bochdalek hernia
Authors: Ieiri Satoshi , Hino Yuko , Irie Keiko , Taguchi Tomoaki
Published: May 2021

Introduction

Late‐onset congenital diaphragmatic hernia constitutes 10%‐36% of congenital diaphragmatic hernias. They qualify for endoscopic treatment including both thoracoscopic and laparoscopic approaches because this type of patient is in relatively stable condition compared with neonatal cases. However, single incision laparoscopic approach has not been reported. We herein report an infantile case of late‐presenting diaphragmatic hernia who underwent single incision laparoscopic repair using an oval‐shaped multichannel port device.

Materials and Surgical Technique

A 2 month old female infant had sudden onset dyspnea with cyanosis and was diagnosed as having left diaphragmatic hernia (Bochdalek hernia) by chest X‐ray. As her respiratory condition became stable under conservative treatment using combination of decompression of the gastrointestinal tract and mild sedation, we electively planned laparoscopic repair. Preoperative enhanced computed tomography imaging found that herniated organs were stomach, spleen, pancreatic tail, small intestine and right colon. The patient also had an umbilical hernia, so we decided to perform single incision repair through this umbilical hernia. Three trocars were introduced using an oval‐shaped multichannel port device and herniated organs were reduced by gentle manipulation. The defect of the diaphragm was closed by bi‐hand needle driving for upper and lower limb using a stay suture. The umbilical hernia was also repaired. Postoperative course was uneventful and no recurrence was recognized.

Discussion

Wider trocar separation was achieved using the oval‐shaped device, making the needle driving easier to perform. By using an oval‐shaped multichannel port device and ingenuity of needle driving, single incision repair of infant diaphragmatic hernia was enabled.
Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
Authors: Mekonnen Alemayehu B , Redley Bernice , de Courten Barbora , Manias Elizabeth
Published: May 2021

Aims

To synthesise associations of potentially inappropriate prescribing (PIP) with health‐related and system‐related outcomes in inpatient hospital settings.

Methods

Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA and Cochrane library. Studies published between 1 January 1991 and 31 January 2021 investigating associations between PIP and health‐related and system‐related outcomes of older adults in hospital settings, were included. A random effects model was employed using the generic inverse variance method to pool risk estimates.

Results

Overall, 63 studies were included. Pooled risk estimates did not show a significant association with all‐cause mortality (adjusted odds ratio [AOR] 1.10, 95% confidence interval [CI] 0.90–1.36; adjusted hazard ratio 1.02, 83% CI 0.90–1.16), and hospital readmission (AOR 1.11, 95% CI 0.76–1.63; adjusted hazard ratio 1.02, 95% CI 0.89–1.18). PIP was associated with 91%, 60% and 26% increased odds of adverse drug event‐related hospital admissions (AOR 1.91, 95% CI 1.21–3.01), functional decline (AOR 1.60, 95% CI 1.28–2.01), and adverse drug reactions and adverse drug events (AOR 1.26, 95% CI 1.11–1.43), respectively. PIP was associated with falls (2/2 studies). The impact of PIP on emergency department visits, length of stay, and health‐related quality of life was inconclusive. Economic cost of PIP reported in 3 studies, comprised various cost estimation methods.

Conclusions

PIP was significantly associated with a range of health‐related and system‐related outcomes. It is important to optimise older adults' prescriptions to facilitate improved outcomes of care.
Why the other‐race effect matters: Poor recognition of other‐race faces impacts everyday social interactions
Authors: McKone Elinor , Dawel Amy , Robbins Rachel A. , Shou Yiyun , Chen Nan , Crookes Kate
Published: May 2021

What happens to everyday social interactions when other‐race recognition fails? Here, we provide the first formal investigation of this question. We gave East Asian international students (N = 89) a questionnaire concerning their experiences of the other‐race effect (ORE) in Australia, and a laboratory test of their objective other‐race face recognition deficit using the Cambridge Face Memory Test (CFMT). As a ‘perpetrator’ of the ORE, participants reported that their problems telling apart Caucasian people contributed significantly to difficulties socializing with them. Moreover, the severity of this problem correlated with their ORE on the CFMT. As a ‘victim’ of the ORE, participants reported that Caucasians' problems telling them apart also contributed to difficulties socializing. Further, 81% of participants had been confused with other Asians by a Caucasian authority figure (e.g., university tutor, workplace boss), resulting in varying levels of upset/difficulty. When compared to previously established contributors to international students' high rates of social isolation, ORE‐related problems were perceived as equally important as the language barrier and only moderately less important than cultural differences. We conclude that the real‐world impact of the ORE extends beyond previously identified specialized settings (eyewitness testimony, security), to common everyday situations experienced by all humans.
A stealth antigen SPESP1, which is epigenetically silenced in tumors, is a suitable target for cancer immunotherapy
Authors: Kosaka Akemi , Yajima Yuki , Hatayama Mayumi , Ikuta Katsuya , Sasaki Takaaki , Hirai Noriko , Yasuda Syunsuke , Nagata Marino , Hayashi Ryusuke , Harabuchi Shohei , Ohara Kenzo , Ohara Mizuho , Kumai Takumi , Ishibashi Kei , Hirata‐Nozaki Yui , Nagato Toshihiro , Oikawa Kensuke , Harabuchi Yasuaki , Celis Esteban , Okumura Toshikatsu , Ohsaki Yoshinobu , Kobayashi Hiroya , Ohkuri Takayuki
Published: May 2021

Recent studies have revealed that tumor cells decrease their immunogenicity by epigenetically repressing the expression of highly immunogenic antigens to survive in immunocompetent hosts. We hypothesized that these epigenetically hidden “stealth” antigens should be favorable targets for cancer immunotherapy due to their high immunogenicity. To identify these stealth antigens, we treated human lung cell line A549 with DNA methyltransferase inhibitor 5‐aza‐2′‐deoxycytidine (5Aza) and its prodrug guadecitabine for 3 d in vitro and screened it using cDNA microarray analysis. We found that the gene encoding sperm equatorial segment protein 1 (SPESP1) was re‐expressed in cell lines including solid tumors and leukemias treated with 5Aza, although SPESP1 was not detected in untreated tumor cell lines. Using normal human tissue cDNA panels, we demonstrated that SPESP1 was not detected in normal human tissue except for testis and placenta. Moreover, we found using immunohistochemistry SPESP1 re‐expression in xenografts in BALB/c‐nu/nu mice that received 5Aza treatment. To assess the antigenicity of SPESP1, we stimulated human CD4+ T‐cells with a SPESP1‐derived peptide designed using a computer algorithm. After repetitive stimulation, SPESP1‐specific helper T‐cells were obtained; these cells produced interferon‐γ against HLA‐matched tumor cell lines treated with 5Aza. We also detected SPESP1 expression in freshly collected tumor cells derived from patients with acute myeloid leukemia or lung cancer. In conclusion, SPESP1 can be classified as a stealth antigen, a molecule encoded by a gene that is epigenetically silenced in tumor cells but serves as a highly immunogenic antigen suitable for cancer immunotherapy.
Lymphadenopathy at the crossroad between immunodeficiency and autoinflammation: An intriguing challenge
Authors: Costagliola Giorgio , Consolini Rita
Published: May 2021

Lymphadenopathies can be part of the clinical spectrum of several primary immunodeficiencies, including diseases with immune dysregulation and autoinflammatory disorders, as the clinical expression of benign polyclonal lymphoproliferation, granulomatous disease or lymphoid malignancy. Lymphadenopathy poses a significant diagnostic dilemma when it represents the first sign of a disorder of the immune system, leading to a consequently delayed diagnosis. Additionally, the finding of lymphadenopathy in a patient with diagnosed immunodeficiency raises the question of the differential diagnosis between benign lymphoproliferation and malignancies. Lymphadenopathies are evidenced in 15–20% of the patients with common variable immunodeficiency, while in other antibody deficiencies the prevalence is lower. They are also evidenced in different combined immunodeficiency disorders, including Omenn syndrome, which presents in the first months of life. Interestingly, in the activated phosphoinositide 3-kinase delta syndrome, autoimmune lymphoproliferative syndrome, Epstein–Barr virus (EBV)-related lymphoproliferative disorders and regulatory T cell disorders, lymphadenopathy is one of the leading signs of the entire clinical picture. Among autoinflammatory diseases, the highest prevalence of lymphadenopathies is observed in patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) and hyper-immunoglobulin (Ig)D syndrome. The mechanisms underlying lymphoproliferation in the different disorders of the immune system are multiple and not completely elucidated. The advances in genetic techniques provide the opportunity of identifying new monogenic disorders, allowing genotype–phenotype correlations to be made and to provide adequate follow-up and treatment in the single diseases. In this work, we provide an overview of the most relevant immune disorders associated with lymphadenopathy, focusing on their diagnostic and prognostic implications.
Prevalence of thyroid dysfunction in postpartum women with suboptimal iodine and selenium and adequate iron status
Authors: Jin Ying , Coad Jane , Zhou Shao J. , Skeaff Sheila , Ramilan Thiagarajah , Brough Louise
Published: May 2021

Objective

Postpartum women experience thyroid dysfunction at twice the prevalence of the general population. Adequate biosynthesis of thyroid hormones depends on three trace elements: iodine, selenium and iron. This study aimed to investigate thyroid dysfunction within a cohort of women at six months postpartum in relation to iodine, selenium and iron status.

Design

This cross‐sectional study was part of an observational longitudinal cohort Mother and Infant Nutrition Investigation; data obtained at six months postpartum are reported.

Subjects

Mother‐infant pairs (n = 87) were recruited at three months postpartum and followed up at six months postpartum (n = 78).

Measurements

Thyroid hormones (free triiodothyronine, free thyroxine, thyroid‐stimulating hormone) and thyroid peroxidase antibodies were measured. Urinary iodine concentration, breast milk iodine concentration, serum thyroglobulin, plasma selenium, serum ferritin and serum soluble transferrin receptors were determined. Nonparametric data were expressed as median (25th, 75th percentile).

Results

Thyroid dysfunction was found in 18% of women, and 4% of women had iron deficiency. Median urinary iodine concentration was 85 (43, 134) µg/L, median breast milk iodine concentration was 59 (39, 109) µg/L, and median serum thyroglobulin at 11.4 (8.6, 18.6) µg/L, indicating iodine deficiency. Median plasma selenium concentration was 105.8 (95.6, 115.3) µg/L. Women with marginally lower plasma selenium concentration were 1.12% times more likely to have abnormal TSH concentrations (p = .001).

Conclusions

There was a high prevalence of thyroid dysfunction. Plasma selenium concentration was the only significant predictor of the likelihood that women had thyroid dysfunction within this cohort, who were iodine deficient and mostly had adequate iron status. Strategies are required to improve both iodine and selenium status to better support maternal thyroid function.
Genetic Polymorphisms of Cytotoxic T‐Lymphocyte Antigen 4 (CTLA‐4) and clinical outcomes post‐allogeneic hematopoietic stem cell transplantation: A systematic review and meta‐analysis
Authors: Najafi Ahmad , Alizadeh‐Navaei Reza , Rahimi Siavash , Valadan Reza , Tehrani Mohsen
Published: May 2021

Background and Objective

Although HLA matching is considered as a key genetic predictor of allo‐HSCT outcomes, genetic polymorphisms in non‐HLA genes, especially in genes encoding immunoregulatory proteins, have also been proposed as additional risk factors linked to the occurrence of transplant complications. This study aimed to carry out a systematic review and meta‐analysis from all eligible cohort studies to determine the effect of CTLA‐4 gene polymorphisms, including rs231775, rs3087243, rs4553808, rs5742909, and rs733618, on clinical outcomes in patients receiving an allo‐HSCT.

Methods

A systematic literature search in PubMed, Web of Science, and Scopus was performed to identify the relevant studies, and related information was extracted. The effect size (ES) and corresponding 95% confidence intervals (CIs) were calculated to estimate the association.

Results

16 studies were eligible and included in the meta‐analysis. The pooled results showed that only the dominant models of rs3087243 were significantly associated with chronic GVHD (cGVHD), while other SNPs were not significantly associated with overall survival, disease‐free survival, relapse, and GVHD.

Conclusions

Our study represents, for the first time, a comprehensive meta‐analysis on the role of CTLA‐4 polymorphisms on outcomes after allo‐HSCT. The results indicate that the CT60 CTLA‐4 polymorphism could be a significant risk factor for cGVHD.
Extreme winter weather: A force to be remembered in dermatopathology
Authors: Dreher Katie , Zaladonis Angela , Valdes‐Rodriguez Rodrigo
Published: May 2021

It is important for the dermatopathologist to be adept in differentiating tissue artifacts from normal tissue variants and pathologies. Numerous tissue artifacts have been described to date; however, once we are familiar with the common artifacts that appear in our practice, we may not immediately recognize other confounders. For example, dermatopathologists in more temperate regions of the country may not be familiar with freezing artifact. In this case series, we present three common diagnoses in dermatopathology that were obscured by the extreme winter weather that severely impacted the Southern United States in February 2021 and discuss methods to prevent these artifacts.
Summarising the impacts of the Queensland Alcohol‐related violence and Night‐Time Economy (QUANTEM) project
Authors: Miller Peter G. , Coomber Kerri , de Andrade Dominique , Livingston Michael , Puljević Cheneal , Vakidis Thea , Carah Nicholas , Taylor Nicholas , Burn Michele , Curtis Ashlee , Room Robin , Clough Alan , Najman Jake , Scott Debbie , Mayshak Richelle , Ferris Jason
Published: May 2021

This closing commentary to the special section presents an overview of the Queensland Alcohol‐related violence and Night‐Time Economy Monitoring evaluation findings in comparison to those from other jurisdictions where similar interventions have been implemented (such as Sydney and Newcastle), and especially with previous studies that have used similar evaluation methodologies, such as the Dealing with Alcohol and the Night‐Time Economy study. Overall, the articles documented promising reductions in alcohol‐related harm, building on the existing evidence base for multi‐pronged interventions in entertainment districts. Importantly, this is the first comprehensive investigation to also look at impacts on nightlife‐related business and findings demonstrated, that there were improvements for many businesses. There are substantial policy implications for Queensland and other jurisdictions (nationally and globally) wanting to reduce late night alcohol‐related harm in entertainment districts.
No more hypoglycaemia on days with physical activity and unrestricted diet when using a closed‐loop system for 12 weeks: A post hoc secondary analysis of the multicentre, randomized controlled Diabeloop WP7 trial
Authors: Franc Sylvia , Benhamou Pierre‐Yves , Borot Sophie , Chaillous Lucy , Delemer Brigitte , Doron Maeva , Guerci Bruno , Hanaire Hélène , Huneker Erik , Jeandidier Nathalie , Amadou Coralie , Renard Eric , Reznik Yves , Schaepelynck Pauline , Simon Chantal , Thivolet Charles , Thomas Claire , Hannaert Patrick , Charpentier Guillaume
Published: May 2021

A post hoc analysis of the Diabeloop WP7 multicentre, randomized controlled trial was performed to investigate the efficacy of the Diabeloop Generation‐1 (DBLG1) closed‐loop system in controlling the hypoglycaemia induced by physical activity (PA) in real‐life conditions. Glycaemic outcomes were compared between days with and without PA in 56 patients with type 1 diabetes (T1D) using DBLG1 for 12 weeks. After the patient announces a PA, DBLG1 reduces insulin delivery and, if necessary, calculates the amount of preventive carbohydrates (CHO). Daily time spent in the interstitial glucose range less than 70 mg/dL was not significantly different between days with and without PA (2.0% ± 1.5% vs. 2.2% ± 1.1%), regardless of the intensity or duration of the PA. Preventive CHO intake recommended by the system was significantly higher in days with PA (41.1 ± 35.5 vs. 21.8 ± 28.5 g/day; P < .0001), and insulin delivery was significantly lower (31.5 ± 10.5 vs. 34.0 ± 10.5 U/day; P < .0001). The time spent in hyperglycaemia and the glycaemic variation coefficient increased significantly on days with PA. In real‐life conditions, the use of DBLG1 avoids PA‐induced hypoglycaemia. Insulin adjustments and preventive CHO recommendation may explain this therapeutic benefit.
Potential kidney protection with liraglutide and semaglutide: Exploratory mediation analysis
Authors: Mann Johannes F. E. , Buse John B. , Idorn Thomas , Leiter Lawrence A. , Pratley Richard E. , Rasmussen Søren , Vilsbøll Tina , Wolthers Benjamin , Perkovic Vlado
Published: May 2021

Aims

To investigate whether effects on chronic kidney disease risk factors could explain the apparent reduction in kidney outcomes (composite of macroalbuminuria, doubling of serum creatinine, renal replacement therapy, or renal death), primarily driven by changes in albuminuria, after treatment with the glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) liraglutide and semaglutide in patients with type 2 diabetes in the LEADER and SUSTAIN 6 trials.

Materials and Methods

We evaluated the mediation effect of glycated haemoglobin (HbA1c), systolic blood pressure (BP), and body weight on the kidney effects of GLP‐1RAs. Diastolic BP, haemoglobin, heart rate, low‐density lipoprotein and total cholesterol, and white blood cell count were also investigated. The mediation effect was estimated by the novel Vansteelandt statistical method. Subgroups with estimated glomerular filtration rate (eGFR) <60 and ≥60 mL/min/1.73 m2 were examined in LEADER.

Results

We observed that HbA1c mediated 25% (95% confidence interval [CI] −7.1; 67.3) and 26% (95% CI noncalculable), and systolic BP 9% (95% CI 2.8; 22.7) and 22% (95% CI noncalculable) of kidney effects of GLP‐1RAs in LEADER and SUSTAIN 6, respectively. Small or no mediation was observed for the other parameters; for example, body weight mediated 9% (95% CI −7.9; 35.5) in the former and did not mediate effects in the latter study. Mediation by HbA1c was greater in patients with eGFR ≥60 mL/min/1.73 m2 (57%) versus those with eGFR <60 mL/min/1.73 m2 (no mediation).

Conclusions

Our results suggest that HbA1c and systolic BP may moderately mediate kidney benefits of liraglutide and semaglutide, with all other variables having a small to no effect. Potential kidney benefits may be driven by other mediators or potentially by direct mechanisms.
Emerging from Crisis: How Organizations Can Use Futures Thinking to Design for Emergence
Authors: Corthell Liz Possee , Messervy Lindsey
Published: May 2021

The Covid‐19 pandemic has taught us a lot of life lessons—some welcome, others not—but amidst these lessons are that there are consequences to not thinking about the future.

As organizations cope with the pandemic, the need to consider the future—how to plan for its uncertainty and the challenges that come with it—has grown in importance.
Co‐Designing a Meaningful, Empathetic, and Safer Future Experience for Volvo Latin America
Authors: Machado Romeu Biscaia , Kindinger Deise , Wasman Karen , Skora Taciane
Published: May 2021

Working with people you can trust to be genuine and transparent is fundamental to launching a project with a scope that encompasses connecting missing pieces, breaking silos, and seeking opportunities to build a collaborative environment.

Research, empathy, rhythm, and balance are vital components in design and innovation. Using them to improve customer experience, employee experience, and service design at Volvo has been transformational.
Forging Resilient Designers: An Educator's Perspective
Authors: Price Rebecca
Published: May 2021

We need resilient designers who can overcome setbacks, critique, and uncertainty throughout their prospective careers. Without such resilience, there can be no focus on subsequent adaptation.

Designers are known for being versatile professionals, but the pandemic has tested this trait, particularly among design students.
Evolvability under climate change: Bone development and shape plasticity are heritable and correspond with performance in Arctic charr (Salvelinus alpinus)
Authors: Campbell Calum S. , Adams Colin E. , Bean Colin W. , Pilakouta Natalie , Parsons Kevin J.
Published: May 2021

Environmental conditions can impact the development of phenotypes and in turn the performance of individuals. Climate change, therefore, provides a pressing need to extend our understanding of how temperature will influence phenotypic variation. To address this, we assessed the impact of increased temperatures on ecologically significant phenotypic traits in Arctic charr (Salvelinus alpinus). We raised Arctic charr at 5°C and 9°C to simulate a predicted climate change scenario and examined temperature‐induced variation in ossification, bone metabolism, skeletal morphology, and escape response. Fish reared at 9°C exhibited less cartilage and bone development at the same developmental stage, but also higher bone metabolism in localized regions. The higher temperature treatment also resulted in significant differences in craniofacial morphology, changes in the degree of variation, and fewer vertebrae. Both temperature regime and vertebral number affected escape response performance, with higher temperature leading to decreased latency. These findings demonstrate that climate change has the potential to impact development through multiple routes with the potential for plasticity and the release of cryptic genetic variation to have strong impacts on function through ecological performance and survival.
Bottom‐up and top‐down forces in plant‐gall relationships: testing the hypotheses of resource concentration, associational resistance, and host fitness reduction
Authors: Martini Vitor C. , Raymundo Diego , Prado‐Junior Jamir , Oliveira Denis C.
Published: May 2021

1. The abundance of insect galls may be influenced by the local host abundance as well as by the structure of the surrounding plant community, while insect galls may reduce host fitness. So far, few studies have been done in order to understand the relationship between galling insect abundance and the surrounding non‐host plant community.

2. In the present study, we explored the relationship between galling insect abundance and plant community structure and diversity. We tested the bottom‐up forces of host and non‐host plant density and non‐host diversity on gall abundance. We also tested the top‐down force of gall abundance on host fitness.

3. We sampled all trees, measured their basal area, and estimated gall abundance in 25 plots (1 ha in total) located in a Brazilian savanna. In addition, we recorded the presence of flowers and fruits in all trees studied.

4. We found a positive relationship between host basal area per plot and gall abundance and a negative relationship between non‐host basal area and species diversity with gall abundance. We also observed a negative association between gall abundance and the probability of the host plant to have flowers or fruits.

5. Our data provide evidence that plant communities in which one host species dominates can be more susceptible to herbivore pressures than communities with less host dominance and more non‐host neighbours, and that the non‐host species create disruptive cues limiting galling insect infestation.
Developing a theoretical framework for persistent cannabis use among young adults with first episode psychosis
Authors: Marino Leslie , Jankowski Samantha E. , Kent Rick , Birnbaum Michael L. , Nossel Ilana , Alves‐Bradford Jean‐Marie , Dixon Lisa
Published: May 2021

Aim

Cannabis use is common among individuals with first episode psychosis (FEP) and persistent use is associated with worse outcomes. The purpose of this qualitative study is to identify factors pertaining to onset of cannabis use and persistent use among young adults with early psychosis receiving coordinated specialty care (CSC) in the United States and begin to develop a theoretical framework to drive further study and hypothesis testing and inform the approach to treatment of cannabis use disorder in this setting.

Methods

Participants were ages 16–30 years with early psychosis attending a CSC program in New York State. Interviews were conducted in December 2018. Coding and analysis was conducted in Atlas.ti and themes were identified via a thematic analysis approach.

Results

Thirteen individuals completed the interview. The mean age in years was 20.7 and the majority were male (n = 10). Almost half (46%) were Black, non‐Hispanic and 39% were Hispanic. Seven participants indicated they were currently using cannabis and six participants indicated they had stopped for at least 6 months at the time of the interview. Several themes emerged including the influence of family and social norms, motivating factors for persistent use and for reduced use or abstinence, and ambivalence regarding the impact of cannabis use on mental health.

Conclusion

A theoretical framework emerged which may help identify future research in this area and inform the approach to treatment of cannabis use disorder in this setting.
Baseline serum B‐cell maturation antigen levels predict time to disease progression for patients with smoldering multiple myeloma
Authors: Bujarski Sean , Goldwater Marissa‐Skye , Regidor Bernard Sean , Jew Scott , Daniely David , Swift Regina A. , Eades Benjamin M. , Emamy‐Sadr Marsiye , Souther Eric , Li Mingjie , Wang Cathy , Xu Ning , Chen Haiming , Spektor Tanya M. , Berenson James R.
Published: May 2021

Multiple myeloma (MM) patients with smoldering (S) disease are defined by a lack of CRAB/SLiM criteria but may transform into disease requiring treatment. The International Myeloma Working Group risk stratification model for SMM uses serum M‐protein, serum‐free light chain ratio, and bone marrow plasma cell percentage. We investigated whether baseline serum B‐cell maturation antigen (sBCMA) levels are predictive of disease progression among 65 patients with SMM.

A receiver operating characteristic curve was used to establish a definition for high‐risk baseline sBCMA. Mantel Byar analysis was used to examine whether high‐risk sBCMA was correlated with shorter time to transformation, and a time‐dependent cox proportional hazard was used to determine whether it is independent of other risk factors. A z test for proportions was used to compare the percentage of patients that progressed among high‐risk versus low‐risk sBCMA patients.

A baseline sBCMA level ≥137.5 mg/ml was found to be the optimal cutoff between high‐ and low‐risk SMM patients. Patients with high‐risk sBCMA levels had a shorter time to transformation (P = .000332). sBCMA was also higher at the time of transformation than baseline levels (P = .0116). sBCMA was the only variable found to be significantly predictive of time to transformation and additionally was found to be independent of other risk factors.

In this study, we have shown for the first time that sBCMA levels predict transformation of SMM to active disease and that these levels increase at the time of transformation. These results are consistent with other studies showing that active MM patients undergoing therapy with higher baseline sBCMA levels are more likely to progress early and its levels increase at the time of disease progression.
Meaning Co‐Construction: Facilitating Shared Family Meaning‐Making in Bereavement
Authors: Barboza Jessica , Seedall Ryan , Neimeyer Robert A.
Published: May 2021

Meaning‐oriented approaches to grief therapy have made substantial contributions by defining the internal processes of meaning‐making and, more recently, clinical scholars have introduced relational approaches as means for continuing bonds with the deceased and increasing social support for the bereaved. However, the complicated interactive processes of interpersonal meaning‐making pose added challenges as family members attempt to coregulate each other’s grief experiences. While systemic therapists have consistently emphasized the essential role of familial relationships in fostering resilience through interpersonally constructed meaning, there remains a need for clarity in terms of the specific processes by which this occurs. The Meaning Reconstruction Model and Emotionally Focused Therapy provide process‐oriented therapeutic strategies for facilitating interpersonal interactions that foster deep relational connection and self‐identity transformation. In this article, we explore how these models can be integrated and applied to the dynamic needs of families who are adjusting to loss. Future clinical and research directions are also discussed.
Autophagy in the retinal pigment epithelium: a new vision and future challenges
Authors: Intartaglia Daniela , Giamundo Giuliana , Conte Ivan
Published: May 2021

The retinal pigment epithelium (RPE) is a highly specialized monolayer of polarized, pigmented epithelial cells that resides between the vessels of the choriocapillaris and the neural retina. The RPE is essential for the maintenance and survival of overlying light‐sensitive photoreceptors, as it participates in the formation of the outer blood–retinal barrier, phagocytosis, degradation of photoreceptor outer segment (POS) tips, maintenance of the retinoid cycle, and protection against light and oxidative stress. Autophagy is an evolutionarily conserved ‘self‐eating’ process, designed to maintain cellular homeostasis. The daily autophagy demands in the RPE require precise gene regulation for the digestion and recycling of intracellular and POS components in lysosomes in response to light and stress conditions. In this review, we discuss selective autophagy and focus on the recent advances in our understanding of the mechanism of cell clearance in the RPE for visual function. Understanding how this catabolic process is regulated by both transcriptional and post‐transcriptional mechanisms in the RPE will promote the recognition of pathological pathways in genetic disease and shed light on potential therapeutic strategies to treat visual impairments in patients with retinal disorders associated with lysosomal dysfunction.
Clinically used JAK inhibitor blunts dsRNA‐induced inflammation and calcification in aortic valve interstitial cells
Authors: Parra‐Izquierdo Iván , Sánchez‐Bayuela Tania , Castaños‐Mollor Irene , López Javier , Gómez Cristina , San Román J. Alberto , Sánchez Crespo Mariano , García‐Rodríguez Carmen
Published: May 2021

Calcific aortic valve disease (CAVD) is the most prevalent valvulopathy worldwide. Growing evidence supports a role for viral and cell‐derived double‐stranded (ds)‐RNA in cardiovascular pathophysiology. Poly(I:C), a dsRNA surrogate, has been shown to induce inflammation, type I interferon (IFN) responses, and osteogenesis through Toll‐like receptor 3 in aortic valve interstitial cells (VIC). Here, we aimed to determine whether IFN signaling via Janus kinase (JAK)/Signal transducers and activators of transcription (STAT) mediates dsRNA‐induced responses in primary human VIC. Western blot, ELISA, qPCR, calcification, flow cytometry, and enzymatic assays were performed to evaluate the mechanisms of dsRNA‐induced inflammation and calcification. Poly(I:C) triggered a type I IFN response characterized by IFN‐regulatory factors gene upregulation, IFN‐β secretion, and STAT1 activation. Additionally, Poly(I:C) promoted VIC inflammation via NF‐κB and subsequent adhesion molecule expression, and cytokine secretion. Pretreatment with ruxolitinib, a clinically used JAK inhibitor, abrogated these responses. Moreover, Poly(I:C) promoted a pro‐osteogenic phenotype and increased VIC calcification to a higher extent in cells from males. Inhibition of JAK with ruxolitinib or a type I IFN receptor blocking antibody blunted Poly(I:C)‐induced calcification. Mechanistically, Poly(I:C) promoted VIC apoptosis in calcification medium, which was inhibited by ruxolitinib. Moreover, Poly(I:C) co‐operated with IFN‐γ to increase VIC calcification by synergistically activating extracellular signal‐regulated kinases and hypoxia‐inducible factor‐1α pathways. In conclusion, JAK/STAT signaling mediates dsRNA‐triggered inflammation, apoptosis, and calcification and may contribute to a positive autocrine loop in human VIC in the presence of IFN‐γ. Blockade of dsRNA responses with JAK inhibitors may be a promising therapeutic avenue for CAVD.
Linking phylogenetic niche conservatism to soil archaeal biogeography, community assembly and species coexistence
Authors: Jiao Shuo , Chen Weimin , Wei Gehong
Published: May 2021

Aim

A predictive understanding of the mechanisms underlying microbial biogeographical patterns is of great interest, particularly with respect to phylogenetic distributions of their ecological adaptations. Here, we test whether phylogenetic information can predict the biogeographical distributions, community assembly and species co‐occurrence of soil archaea.

Location

Northern China.

Time period

July and August 2017.

Major taxa studied

Archaeal communities.

Methods

By conducting a large‐scale (transect intervals of 1,257.6 km) study across agricultural field, forest, wetland, grassland and desert biomes, we applied the phylogenetic framework of niche conservatism to investigate archaeal biogeography, community assembly and network topology. We examined the phylogenetic signal based on Blomberg's K to test whether the environmental preference of a given archaeal taxon was related to the phylogeny, corresponding to the degree of phylogenetic conservatism for environmental niches across complex environmental gradients. We evaluated the assembly processes of archaeal communities based on null model and Sloan neutral model analyses. We then explored the major factors that influenced the species coexistence and assembly processes of soil archaeal communities.

Results

Soil archaeal taxa exhibited strong climate‐related niche conservatism of ecological preferences. Mean annual precipitation (MAP) had the strongest phylogenetic signal, and this mediated both community assembly processes and species coexistence, with stronger deterministic assembly and less species coexistence in environments with lower precipitation. Phylogenetic diversity was closely linked to the balance of community assembly processes; that is, stochastic assembly processes were dominant in low‐diversity communities, whereas variable selection of deterministic processes promoted high phylogenetic diversity.

Main conclusions

We conclude that strong phylogenetic niche conservatism of soil archaea drives their biogeographical distributions. Our findings represent a considerable advance in linking phylogenetic niche conservatism to soil archaeal biogeography, community assembly and species coexistence, and therefore forecasting soil archaeal evolutionary adaptations in response to ongoing environmental changes.
Gendered workload allocation in universities: A feminist analysis of practices and possibilities in a European University
Authors: Steinþórsdóttir Finnborg S. , Carmichael Fiona , Taylor Scott
Published: May 2021

The negotiated allocation of teaching and institutional service workload in universities is a key determinant of the quantity and quality of all work for academic staff. There is abundant quantitative evidence that women and men experience differential outcomes from faculty, school, or departmental workload allocation processes and convincing theoretical explanations as to why this happens. We add to this knowledge through feminist analysis of a mixed methods case study of an academic unit in a European University, focusing on gendered dynamics in the workload allocation processes there. Our analysis follows the “sweaty concept” methodology proposed by Sara Ahmed as a means of developing feminist theory that is founded on embodied experiences of discomfort in worlds that are not welcoming. The concept we develop through this is “inequitable modeling”; it suggests that while workload allocation processes are understood by model designers as a managerial tool to enable transparency and fairness (forms of procedural equity), the managed, especially women, experience them as opaque and unfair (forms of lived inequity). We conclude by questioning the principles and outcomes of such tools in achieving gender equity, and then describe how a feminist approach to workload modeling and allocation might be implemented.
Epigenetic gene regulation in plasma cells
Authors: Patterson Dillon G. , Kania Anna K. , Zuo Zhihong , Scharer Christopher D. , Boss Jeremy M.
Published: May 2021

Humoral immunity provides protection from pathogenic infection and is mediated by antibodies following the differentiation of naive B cells (nBs) to antibody‐secreting cells (ASCs). This process requires substantial epigenetic and transcriptional rewiring to ultimately repress the nB program and replace it with one conducive to ASC physiology and function. Notably, these reprogramming events occur within the framework of cell division. Efforts to understand the relationship of cell division with reprogramming and ASC differentiation in vivo have uncovered the timing and scope of reprogramming, as well as key factors that influence these events. Herein, we discuss the unique physiology of ASC and how nBs undergo epigenetic and genome architectural reorganization to acquire the necessary functions to support antibody production. We also discuss the stage‐wise manner in which reprogramming occurs across cell divisions and how key molecular determinants can influence B cell fate outcomes.
Pandemics and firms: Drawing lessons from history
Authors: Cevik Serhan , Miryugin Fedor
Published: May 2021

The COVID‐19 pandemic caused an unprecedented and synchronized contraction in the global economy. To assess the likely evolution of firm performance going forward, this paper investigates empirically the impact of past pandemics using firm‐level data on more than 537,000 nonfinancial companies from 14 developing countries during the period 1998–2018. The analysis indicates that the prevalence of infectious diseases has an economically and statistically significant negative effect on nonfinancial corporate performance. This adverse impact is particularly pronounced on smaller and younger firms, compared to larger and more established corporations. We also find that a higher number of infectious‐disease cases in the population increases the probability of failure among nonfinancial firms, particularly for small and young firms. In the case of COVID‐19, the magnitude of these effects will be much greater, given the unprecedented scale of the outbreak and strict policy responses to contain its spread.
Nurses back pain beliefs, coping strategies and factors associated with participant activation for self‐management of back pain
Authors: Nkhata Loveness A. , Brink Yolandi , Ernstzen Dawn , Louw Quinette A.
Published: May 2021

Aims

To determine the back pain beliefs, coping strategies and factors associated with participant activation for self‐management of back pain amongst nurses working in peri‐urban district healthcare centres.

Design

A descriptive cross‐sectional study design.

Methods

Data were collected between February and March 2020 using a self‐administered questionnaire. Descriptive data analysis was done in Stata version 20.0. Back pain beliefs, participant activation and coping strategies were presented using relative frequencies and percentages. Odds ratios at 5% significance level were used to test association of factors for participant activation for self‐management of back pain.

Results

Majority of the participants had experienced back pain which lasted 3 days for half of the participants. Further, pain medication was commonly used to cope with back pain. In addition, age, gender and work‐setting were significantly associated with participant activation for self‐management of back pain.

Conclusion

Participants’ coping strategies for back pain were linked to the conveyed back pain beliefs which demonstrate that participants believed in rest and lengthy periods of time off work for back pain. However, participants acknowledged that taking an active role in determining one's health and function is vital. This highlights the importance of self‐management support for health behaviour change amongst nurses.

Impact

The study addressed back pain beliefs, coping strategies and participant activation for self‐management of back pain amongst nurses in peri‐urban healthcare centres. Majority of the participants experienced back pain which lasted 3 days. Pain medication was commonly used to cope with back pain. Age, gender and work‐setting were significantly associated with participant activation for self‐management of back pain. Although this study was conducted in Zambia, outcomes from this study may be of benefit to nurses in similar settings. Further, the research provides insight to the international body of knowledge on the process and appropriateness of international research in resource‐constrained settings.
Sex differences in psychiatric comorbidity and clinical presentation in youths with conduct disorder
Authors: Konrad Kerstin , Kohls Gregor , Baumann Sarah , Bernhard Anka , Martinelli Anne , Ackermann Katharina , Smaragdi Areti , Gonzalez‐Madruga Karen , Wells Amy , Rogers Jack C. , Pauli Ruth , Clanton Roberta , Baker Rosalind , Kersten Linda , Prätzlich Martin , Oldenhof Helena , Jansen Lucres , Kleeven Anneke , Bigorra Aitana , Hervas Amaia , Kerexeta‐Lizeaga Iñaki , Sesma‐Pardo Eva , Angel Gonzalez‐Torres Miguel , Siklósi Réka , Dochnal Roberta , Kalogerakis Zacharias , Pirlympou Mara , Papadakos Leonidas , Cornwell Harriet , Scharke Wolfgang , Dikeos Dimitris , Fernández‐Rivas Aranzazu , Popma Arne , Stadler Christina , Herpertz‐Dahlmann Beate , De Brito Stephane A. , Fairchild Graeme , Freitag Christine M.
Published: May 2021

Background

Conduct disorder (CD) rarely occurs alone but is typically accompanied by comorbid psychiatric disorders, which complicates the clinical presentation and treatment of affected youths. The aim of this study was to investigate sex differences in comorbidity pattern in CD and to systematically explore the ‘gender paradox’ and ‘delayed‐onset pathway’ hypotheses of female CD.

Methods

As part of the FemNAT‐CD multisite study, semistructured clinical interviews and rating scales were used to perform a comprehensive phenotypic characterization of 454 girls and 295 boys with CD (9–18 years), compared to 864 sex‐ and age‐matched typically developing controls.

Results

Girls with CD exhibited higher rates of current major depression, anxiety disorders, post‐traumatic stress disorder and borderline personality disorder, whereas boys with CD had higher rates of current attention‐deficit/hyperactivity disorder. In line with the ‘gender paradox’ hypothesis, relative to boys, girls with CD showed significantly more lifetime psychiatric comorbidities (incl. Alcohol Use Disorder), which were accompanied by more severe CD symptoms. Female and male youths with CD also differed significantly in their CD symptom profiles and distribution of age‐of‐onset subtypes of CD (i.e. fewer girls with childhood‐onset CD). In line with the ‘delayed‐onset pathway’ hypothesis, girls with adolescent‐onset CD showed similar levels of dimensional psychopathology like boys with childhood‐onset CD, while boys with adolescent‐onset CD had the lowest levels of internalizing psychopathology.

Conclusions

Within the largest study of CD in girls performed to date, we found compelling evidence for sex differences in comorbidity patterns and clinical presentation of CD. Our findings further support aspects of the ‘gender paradox’ and ‘delayed‐onset pathway’ hypotheses by showing that girls with CD had higher rates of comorbid lifetime mental disorders and functional impairments, and they usually developed CD during adolescence. These novel data on sex‐specific clinical profiles of CD will be critical in informing intervention and prevention programmes.
The ‘Flood Resilience Rose’: A management tool to promote transformation towards flood resilience
Authors: Karrasch Leena , Restemeyer Britta , Klenke Thomas
Published: May 2021

Coping with the growing impacts of flooding in EU countries, a paradigm shift in flood management can be observed, moving from safety‐based towards risk‐based approaches and holistic perspectives. Flood resilience is a common denominator of most of the approaches. In this article, we present the ‘Flood Resilience Rose’ (FRR), a management tool to promote harmonised action towards flood resilience in European regions and beyond. The FRR is a result of a two‐step process. First, based on scientific concepts as well as analysis of relevant policy documents, we identified three ‘levels of operation’. The first level refers to the EU Floods Directive and an extended multi‐layer safety approach, comprising the four different layers of protection, prevention, preparedness and recovery, and related measures to be taken. This level is not independent but depends both on the institutional (second level) and the wider (third level) context. Second, we used surveys, semi‐structured interviews and group discussions during workshops with experts from Belgium, Denmark, Germany, the Netherlands and the United Kingdom to validate the definitions and the FRR's practical relevance. The presented FRR is thus the result of rigorous theoretical and practical consideration and provides a tool capable to strengthen flood risk management practice.
Let your past define your future? How recalling successful financial experiences can increase beliefs of self‐efficacy in financial planning
Authors: Hoffmann Arvid O. I. , Plotkina Daria
Published: May 2021

Financial self‐efficacy, or the perceived ability to succeed in managing one's personal financial affairs, is fundamental to effective consumer financial decision making. However, little is known about how to improve consumers' financial self‐efficacy and which consumers are more or less responsive to potential policy interventions. We address these questions through an experimental study among US consumers. We find that asking consumers to recall and analyze successful (unsuccessful) experiences regarding the management of their personal finances is associated with higher (lower) financial self‐efficacy. We provide insight into the underlying process of this effect through moderation and mediation analyses. In particular, we show that the effect of a recall and analyze intervention utilizing a successful previous experience is more pronounced for consumers with a more optimistic personality. Finally, consumers who develop greater financial self‐efficacy as a result of our intervention display more self‐control, leading to a higher financial planning propensity and actual planning.