bluuebunny/crossref_metadata_2025 huggingface dataset:
An overview of the burden of oral cancer in Sri Lanka and its inequalities in the face of contemporary economic and social malaise
Authors: Perera Irosha , Amarasinghe Hemantha , Jayasinghe Ruwan D. , Udayamalee Iresha , Jayasuriya Nadeena , Warnakulasuriya Saman , Johnson Newell W.
Published: June 2023

Objectives

Over the past several decades, oral cancer has been the most common malignancy among Sri Lankan males and the top 10 cancer among females, disproportionately affecting low socio‐economic groups. Sri Lanka is a lower‐middle‐income developing country (LMIC), currently striking through an economic crisis, and social and political unrest. Occurring at an accessible body site and predominantly attributed to potentially modifiable health‐related behaviours, oral cancer should be preventable and controllable. Unfortunately, broader contextual factors that are socio‐cultural, environmental, economic, and political and mediated through social determinants of people's lives consistently hinder progress. Many LMICs with a high burden of oral cancer are now gripped by economic crises, consequent social and political unrest, all compounded by reduced public health investments. The aim of this review is to provide a critical commentary on key aspects of oral cancer epidemiology including inequalities, using Sri Lanka as a case study.

Methods

The review synthesizes evidence from multiple data sources, such as published studies, web‐based national cancer incidence data, national surveys on smokeless tobacco (ST) and areca nut use, smoking and alcohol consumption, poverty headcount ratios, economic growth, and Gross Domestic Product (GDP) health expenditure. National trends in the oral cancer, ST use, smoking and alcohol consumption in Sri Lanka are identified alongside inequalities.

Results

Using these evidence sources, we discuss ‘where are we now?’, together with the availability, accessibility and affordability of oral cancer treatment services, oral cancer prevention and control programmes, tobacco and alcohol control policies, and finally, outline macroeconomic perspectives of Sri Lanka.

Conclusions

Finally, we speculate, ‘where to next?’ Our overarching goal of this review is to initiate a critical discourse on bridging the gaps and crossing the divides to tackle oral cancer inequalities in LMIC such as Sri Lanka.
Prioritizing global tall forests toward the 30 × 30 goals
Authors: Huang Qiongyu , Xu Jin , Wong Jesse Pan , Radeloff Volker C. , Songer Melissa
Published: June 2023

The Global Deal for Nature sets an ambitious goal to protect 30% of Earth's land and ocean by 2030. The 30 × 30 initiative is a way to allocate conservation resources and extend protection to conserve vulnerable and underprotected ecosystems while reducing carbon emissions to combat climate change. However, most prioritization methods for identifying high‐value conservation areas are based on thematic attributes and do not consider vertical habitat structure. Global tall forests represent a rare vertical habitat structure that harbors high species richness in various taxonomic groups and is associated with large amounts of aboveground biomass. Global tall forests should be prioritized when planning global protected areas toward reaching the 30 × 30 goals. We examined the spatial distribution of global tall forests based on the Global Canopy Height 2020 product. We defined global tall forests as areas with the average canopy height above 3 thresholds (20, 25, and 30 m). We quantified the spatial distribution and protection level of global tall forests in high‐protection zones, where the 30 × 30 goals are being met or are within reach, and low‐protection zones, where there is a low chance of reaching 30 × 30 goals. We quantified the protection level by computing the percentage of global tall forest area protected based on the 2017 World Database on Protected Areas. We also determined the global extent and protection level of undisturbed, mature, tall forests based on the 2020 Global Intact Forest Landscapes mask. In most cases, the percentage of protection decreased as forest height reached the top strata. In the low‐protection zones, <30% of forests were protected in almost all tall forest strata. In countries such as Brazil, tall forests had a higher percentage of protection (consistently >30%) compared to forests of lower height, presenting a more effective conservation model than in countries such as the United States, where forest protection was almost uniformly <30% across height strata. Our results show an urgent need to target forest conservation in the greatest height strata, particularly in high‐protection areas, where most global tall forests are found. Vegetation vertical structure can inform the decision‐making process toward the 30 × 30 goals because it can be used to identify areas of high conservation value for biodiversity protection which also contribute to carbon sequestration.
Indicators to monitor the status of the tree of life
Authors: Gumbs Rikki , Chaudhary Abhishek , Daru Barnabas H. , Faith Daniel P. , Forest Félix , Gray Claudia L. , Kowalska Aida , Lee Who‐Seung , Pellens Roseli , Pipins Sebastian , Pollock Laura J. , Rosindell James , Scherson Rosa A. , Owen Nisha R.
Published: June 2023

Following the failure to fully achieve any of the 20 Aichi biodiversity targets, the future of biodiversity rests in the balance. The Convention on Biological Diversity's Kunming–Montreal Global Biodiversity Framework (GBF) presents the opportunity to preserve nature's contributions to people (NCPs) for current and future generations by conserving biodiversity and averting extinctions. There is a need to safeguard the tree of life—the unique and shared evolutionary history of life on Earth—to maintain the benefits it bestows into the future. Two indicators have been adopted within the GBF to monitor progress toward safeguarding the tree of life: the phylogenetic diversity (PD) indicator and the evolutionarily distinct and globally endangered (EDGE) index. We applied both to the world's mammals, birds, and cycads to show their utility at the global and national scale. The PD indicator can be used to monitor the overall conservation status of large parts of the evolutionary tree of life, a measure of biodiversity's capacity to maintain NCPs for future generations. The EDGE index is used to monitor the performance of efforts to conserve the most distinctive species. The risk to PD of birds, cycads, and mammals increased, and mammals exhibited the greatest relative increase in threatened PD over time. These trends appeared robust to the choice of extinction risk weighting. EDGE species had predominantly worsening extinction risk. A greater proportion of EDGE mammals (12%) had increased extinction risk compared with threatened mammals in general (7%). By strengthening commitments to safeguarding the tree of life, biodiversity loss can be reduced and thus nature's capacity to provide benefits to humanity now and in the future can be preserved.
How reliable is restaging MRI after neoadjuvant therapy in rectal cancer?
Authors: Gefen Rachel , Garoufalia Zoe , Horesh Nir , Freund Michael R. , Emile Sameh Hany , Parlade Albert , Berho Mariana , Allende Daniela , DaSilva Giovanna , Wexner Steven D.
Published: June 2023

Background

Despite the pivotal role of magnetic resonance imaging (MRI) in rectal cancer staging and evaluation, the reliability of restaging MRI after neoadjuvant therapy is still debatable. This study aimed to assess the accuracy of restaging MRI by comparing post‐neoadjuvant MRI findings with those of the final pathology.

Methods

This study was a retrospective review of the medical records of adult rectal cancer patients who had restaging MRI following neoadjuvant therapy and prior to rectal cancer resection in a NAPRC‐certified rectal cancer centre between 2016 and 2021. The study compared findings of preoperative, post‐neoadjuvant MRI with final pathology relative to T stage, N stage, tumour size, and circumferential resection margin (CRM) status.

Results

A total of 126 patients were included in the study. We found fair concordance (kappa −0.316) for T stage between restaging MRI and pathology report, and slight concordance for N stage and CRM status (kappa −0.11, kappa = 0.089, respectively). Concordance rates were lower for patients following total neoadjuvant treatment (TNT) or with a low rectal tumour. In total, 73% of patients with positive N pathology status had negative N status in the restaging MRI. Sensitivity and specificity regarding positive CRM in post‐neoadjuvant treatment MRI were 45.45% and 70.4%, respectively.

Conclusion

We found low concordance levels between restaging MRI and pathology regarding TN stage and CRM status. Concordance levels were even lower for patients after TNT regimen and with a low rectal tumour. In the era of TNT and watch‐and‐wait approach, we should not rely solely on restaging MRI to make post‐neoadjuvant treatment decisions.
Anticipating where are unknown aquatic insects in Europe to improve biodiversity conservation
Authors: Sánchez‐Campaña Carlota , Múrria Cesc , Hermoso Virgilio , Sánchez‐Fernández David , Tierno de Figueroa J. Manuel , González Marcos , Millán Andrés , Moubayed Joel , Ivković Marija , Murányi Dávid , Graf Wolfram , Derka Tomáš , Mey Wolfram , Sipahiler Füsun , Pařil Petr , Polášková Vendula , Bonada Núria
Published: June 2023

Aim

Understanding biodiversity patterns is crucial for prioritizing future conservation efforts and reducing the current rates of biodiversity loss. However, a large proportion of species remain undescribed (i.e. unknown biodiversity), hindering our ability to conduct this task. This phenomenon, known as the ‘Linnean shortfall’, is especially relevant in highly diverse, yet endangered, taxonomic groups, such as insects. Here we explore the distributions of recently described freshwater insect species in Europe to (1) infer the potential location of unknown biodiversity hotspots and (2) determine the variables that can anticipate the distribution of unknown biodiversity.

Location

The European continent, including western Russia, Cyprus and Turkey.

Methods

Georeferenced information of all sites where new aquatic insect species were described across Europe from 2000 to 2020 was compiled. In order to understand the observed spatial patterns in richness of recently described species, spatial units were defined (level 6 of HydroBASINS) and associated with a combination of a set of socioeconomic, environmental and sampling effort descriptors. A zero‐inflated Poisson regression approach was used to model the richness of newly described species within each spatial unit.

Results

Nine hundred and sixty‐six recently described species were found: 398 Diptera, 362 Trichoptera, 105 Coleoptera, 66 Plecoptera, 28 Ephemeroptera, 3 Neuroptera, 2 Lepidoptera and 2 Odonata. The Mediterranean Basin was the region with the highest number of recently described species (74%). The richness of recently described species per spatial unit across Europe was highest at mid‐elevation areas (between 400 and 1000 m), latitudes between 40 and 50° and in areas with yearly average precipitation levels of 500–1000 mm, a medium intensity of sampling effort and low population density. The percentage of protected areas in each study unit was not significantly related to the richness of recently described species. In fact, 70% of the species were found outside protected areas.

Main conclusions

The results highlight the urgent need to concentrate conservation efforts in freshwater ecosystems located at mid‐altitude areas and out of protected areas across the Mediterranean Basin. The highest number of newly described species in those areas indicates that further monitoring efforts are required to ensure the aquatic biodiversity is adequately known and managed within a context of growing human impacts in freshwater ecosystems.
A blended future? A cross‐sectional study demonstrating the impacts of the COVID‐19 pandemic on student experiences of well‐being, teaching and learning
Authors: Chilton John K. , Hanks Sally , Watson Helen R.
Published: June 2023

Introduction

The COVID‐19 pandemic necessitated emergency changes to teaching, learning and assessment across higher education. Healthcare courses were particularly affected because of their interdependence with overstretched health services. We used this unprecedented situation to provide insight into how students react to unexpected crises and how institutions can most effectively support them.

Materials and Methods

This cohort study explored students' experiences of the pandemic across programmes and stages from five schools (medicine, dentistry, biomedical sciences, psychology and health professions) in a health faculty in a UK university. We carried out an inductive thematic analysis on the data collected.

Results

Many students reported fluctuating emotions and struggled to adapt to home working. Students' changes in motivation and coping strategies varied, many found structure, recreation and social interaction important. Opinions on how well online learning worked relative to face‐to‐face diverged across programmes.

Conclusion

A one‐size‐fits‐all blended learning response is unlikely to be appropriate. Our study shows students across one faculty, within one institution, responded diversely to an emergency affecting them all. Educators need to be flexible and dynamic in delivering curricula and supporting students responding to an unexpected crisis during their higher education.
Age and an obesogenic diet affect mouse behaviour in a sex‐dependent manner
Authors: Mort Emily J. , Fordington Surina , Heritage Sophie , Fowden Abigail L. , Jones Susan , Camm Emily J.
Published: June 2023

Obesity is rising globally and is associated with neurodevelopmental and psychiatric disorders among children, adolescents and young adults. Whether obesity is the cause or the consequence of these disorders remains unclear. To examine the behavioural effects of obesity systematically, locomotion, anxiety and social behaviour were assessed in male and female C57Bl/6J mice using the open field, elevated plus maze and social preference task. First, the effects of age and sex were examined in control mice, before investigating post‐weaning consumption of a high fat–high sugar diet commonly consumed in human populations with high rates of obesity. In the open field and elevated plus maze, locomotor activity and anxiety‐related behaviours reduced with aging in both sexes, but with different sex‐specific profiles. The high fat–high sugar diet reduced food and calorie intake and increased body mass and fat deposition in both sexes. In the open field, both male and female mice on the obesogenic diet showed reduced locomotion; whereas, in the elevated plus maze, only females fed with the obesogenic diet displayed reduced anxiety‐related behaviours. Both male and female mice on the obesogenic diet had a significantly higher social preference index than the control group. In conclusion, the findings demonstrate that the behavioural effects of age and diet‐induced obesity all depend on the sex of the mouse. This emphasises the importance of considering the age of the animal and including both sexes when assessing behavioural phenotypes arising from dietary manipulations.
Crisis risk and risk management
Authors: Stulz René M.
Published: June 2023

We assess the state of knowledge about crisis risk and its implications for risk management. Data that became available after the global financial crisis show that some types of crises are predictable when accounting for interactions between risks. However, other types of crises do not seem predictable. There is no evidence that the frequency of economic and financial crises is increasing. While data show that an economic crisis is more likely following a political crisis, there is no comparable evidence for climate events. Strategies that increase firm operational and financial flexibility reduce the adverse impact of crises on firms.
Navigating uncertainty: The resilience of third‐sector organizations and socially oriented small‐ and medium‐sized enterprises during the COVID‐19 pandemic
Authors: Liñares‐Zegarra José M. , Wilson John O. S.
Published: June 2023

This paper investigates the impact of the COVID‐19 pandemic on U.K. third‐sector (nonprofit organizations and social enterprises) and socially oriented small‐ and medium‐sized enterprises (SMEs), and provides insights regarding their organizational resilience. Using data from the Longitudinal Small Business Survey, the results of an extensive empirical analysis suggest that relative to commercial (for‐profit) SMEs, social enterprises were less likely, and socially oriented SMEs more likely to perceive the pandemic as an obstacle to business success. Third‐sector and socially oriented SMEs were more likely to increase their activities compared to commercial SMEs. Moreover, the COVID‐19 pandemic appears to have had a differential impact on the future plans of third‐sector and socially oriented SMEs relative to commercial SMEs. Third‐sector organizations were less likely to use government‐backed loans, suggesting a need for alternative forms of support or financing to weather economic disruptions. Overall, our analysis suggests a resiliency and versatility among third‐sector and socially oriented SMEs in dealing with unexpected and significant external shocks.
The attachment adaptation process model: Developing attachment security after experiencing addiction in the family
Authors: Coffman Everette , Swank Jacqueline , Bayne Hannah B.
Published: June 2023

Objective

The purpose of this study is to explore the adaptation processes of building attachment security later in life when one's attachment style has been affected by growing up in a household with a parent who uses substances.

Background

Parental substance use may have negative effects on children who grow up in those homes, including developing an insecure attachment style. Limited studies have focused on adult children of alcoholics/addicts' (ACOAs) attachment adaptation processes into adulthood.

Method

Using a constructivist grounded theory approach, we explored the process ACOA's use to build attachment security. The first author interviewed 14 participants using a semistructured interview format through the video conferencing platform Zoom.

Results

Through analysis of the data, we identified a four‐phase process: (a) confusion, (b) transition, (c) restoration, and (d) dedication. This information provides a framework to show clients the attachment adaptation process model (AAPM), developed in this study, and helps them to visualize the process by which they may learn to develop more attachment security.

Conclusion

ACOAs may incur adverse experiences in childhood that influence their attachment development later in life. The researchers in this study built a model of how ACOAs build attachment security later in life.

Implications

Practitioners can help clients connect with community support groups, places of worship, and other small groups that the participants identified as instrumental in the healing process. Overall, helping clients find a place for safe and healthy connections is crucial during their journey to attachment security.
To moonlight or not to moonlight: The role of organisational commitment dimensions in secondary employment decisions among higher education teachers
Authors: Sai Manogna Bommakanti , Swamy T. N. V. R.
Published: June 2023

This study aims to explore the relationship between organisational commitment dimensions and moonlighting intentions. Using a sample of 189 teachers from various higher educational institutions (HEIs), the study employs Structural Equation Modelling (SEM) to examine the impact of organisational commitment dimensions (affective, continuance, normative) on moonlighting intentions. The results of the study indicate a negative relationship between organisational commitment dimensions and moonlighting intentions, suggesting that higher education institutions can reduce moonlighting intentions among faculty members by fostering a positive work environment that promotes organisational commitment. The findings of this study have implications for organisations, as they suggest that increasing employees' affective and normative commitments decrease their intentions to engage in moonlighting. Additionally, the study highlights the importance of understanding the antecedents of moonlighting intentions, as it can help organisations to implement policies and practices that reduce the likelihood of employee moonlighting.
Structural, optical, microstructure, and giant dielectric behavior of parent, Cu and Sr doped La0.55Li0.35TiO3‐δ
Authors: Siddiqui Saiqua , Singh Divyanshu , Singh Priyanka , Singh Brajendra
Published: June 2023

Optimization of energy storage performance in dielectric ceramics has been a focus in recent decades due to the benefits of high energy storage density, efficiency, and exceptional temperature stability. In this work, we report huge dielectric constant in La0.55Li0.35TiO3‐δand sharp decrease in its value with the substitution of Sr and Cu at Ti position. These samples La0.55Li0.35TiO3‐δ(LLTO), La0.55Li0.35Ti0.9Cu0.1O3‐δ(LLTCO) and La0.55Li0.35Sr0.1Ti0.9O3‐δ(LLSTO) were prepared by solid state reaction method. The interfacial polarization of lithium ion aggregation close to the grain boundaries and the dipoles of Li ions in the sample are suggested to be the source of the enormous dielectric values. Parent composition (LLTO) shows highest dielectric constant value (6.29 × 105at frequency 10 Hz, 7.30×104at 1 kHz) recorded at room temperature while the lowest dielectric loss value (0.124) was observed for LLSTO at frequency 1 kHz. Structural characterization has been done using X‐ray diffraction (XRD) technique to investigate the crystal structure of the prepared compositions. The XRD patterns show the similar crystal structure for all the compositions with the parent composition LLTO. The optical band gap is calculated by Kulbeka Munk function and Tauc plot using UV–visible diffuse reflectance spectroscopy technique. The maximum band gap value (3.32 eV) is obtained for parent composition while doping of Cu and Sr at Ti site in La0.55Li0.35TiO3‐δdecreases the band gap value. Optical microscopy shows the micron size grains in these samples. Doping of Sr and Cu in perovskite structure of LLTO brings tunability in dielectric and optical properties.
Joint analysis of WES and RNA‐Seq identify signature genes related to metastasis in prostate cancer
Authors: Xiang Chongjun , Li Yue , Wang Wenting , Tao Huiying , Liang Ning , Wu Shuang , Yu Tianxi , Cui Xin , Xie Yaqi , Zuo Hongwei , Lin Chunhua , Xu Fuyi
Published: June 2023

Prostate cancer (PCa) has a certain degree of heritability, and metastasis occurs as cancer progresses. However, its underlying mechanism remains largely unknown. We sequenced four cases of cancer without metastasis, four metastatic cancer, and four benign hyperplasia tissues as controls. A total of 1839 damaging mutations were identified. Pathway analysis, gene clustering, and weighted gene co‐expression network analysis were employed to find characteristics associated with metastasis. Chr19 had the most mutation density and 1p36 had the highest mutation frequency across the genome. These mutations occurred in 1630 genes, including the most frequently mutated genes TTN and PLEC, and dozens of metastasis‐related genes, such as FOXA1, NCOA1, CD34, and BRCA2. Ras signalling and arachidonic acid metabolism were uniquely enriched in metastatic cancer. Gene programmes 10 and 11 showed the signatures indicating the occurrence of metastasis better. A module (135 genes) was specifically associated with metastasis. Of them, 67.41% reoccurred in program 10, with 26 genes further retained as the signature genes related to PCa metastasis, including AGR3, RAPH1, SOX14, DPEP1, and UBL4A. Our study provides new molecular perspectives on PCa metastasis. The signature genes and pathways could be served as potential therapeutic targets for metastasis or cancer progression.
Pressure–temperature evolution of the basement and cover sequences on Ios, Greece: Evidence for subduction of the Hercynian basement
Authors: Wolfe Oliver M. , Spear Frank S. , Thomas Jay B. , Hasegawa Eric M. , Libby Grant T. , Cheney John T.
Published: June 2023

High‐pressure rocks from the island of Ios in the Greek Cyclades were examined to resolve the P–T conditions reached during subduction of the two distinct lithotectonic units that are separated by the South Cycladic Shear Zone (SCSZ)—the footwall complex composed of Hercynian basement gneisses, schists and amphibolites, and the hangingwall complex composed of blueschists and eclogites. A combination of elastic tensor quartz inclusion in garnet (QuiG) barometry and Zr‐in‐rutile (ZiR) trace element thermometry was used to constrain minimum garnet growth conditions. Garnet from the hangingwall (blueschist) unit record formation pressures that range from 1.5 to 1.9 GPa and garnet from the footwall basement complex record garnet formation pressures of 1.65–2.05 GPa. ZiR thermometry on rutile inclusions within garnet establishes the minimum temperature for garnet formation to be ~480–500°C. That is, there is no evidence in the QuiG and ZiR results that the rocks of the blueschist hangingwall and basement experienced different metamorphic histories during subduction. This is the first reported observation of blueschist facies metamorphism in the Hercynian basement complex. A model is proposed in which initial subduction occurred along a relatively shallow P–T trajectory of ~11°C/km and then transitioned to a steeper, nearly isothermal trajectory at a depth of ~45 km reaching similar peak metamorphic conditions of ~500–525°C at 2.0 GPa for all samples. Such a change in the subduction path could be accomplished by either an increase in the rate of subduction or an increase in the angle of the subduction zone. The present juxtaposition of samples with contrasting mineral assemblages and garnet growth histories is interpreted to have arisen from differences in bulk compositions and variations in the preservation of high‐pressure prograde mineral assemblages during exhumation. The existence of similar P–T conditions and prograde paths in the two units does not require that the rocks were all metamorphosed at the same time and that the SCSZ experienced little movement. Rather, it is suggested that the two units experienced prograde and peak metamorphism at different times and were subsequently juxtaposed along the SCSZ.
Identifying subgroups of attention‐deficit/hyperactivity disorder from the psychopathological and neuropsychological profiles
Authors: Zhang Shan‐hong , Yang Tian‐xiao , Wu Zhao‐min , Wang Yu‐feng , Lui Simon S. Y. , Yang Bin‐rang , Chan Raymond C. K.
Published: June 2023

The Research Domain Criteria (RDoC) advocates the dimensional approach in characterizing mental disorders. We followed RDoC to characterize children with ADHD using profiling based on the cognitive and psychopathological domains. We aimed to identify and validate ADHD subtypes with different clinical characteristics and functional impairments. We recruited 362 drug‐naïve children with ADHD and 103 typically developing controls. The cluster analysis was used to identify subgroups based on the Child Behaviour Checklist (CBCL) and the Behaviour Rating Inventory of Executive Function (BRIEF). The subgroups' clinical characteristics and functional impairments were assessed using the WEISS Functional Impairment Rating Scale‐Parent Report (WFIRS‐P) and the Conners Parent Symptom Questionnaire (PSQ). The cluster analysis yielded four subgroups: (1) ADHD with severe impairment in psychopathology and executive functions (EF), (2) ADHD with mild executive dysfunctions and normal‐level psychopathology, (3) ADHD with severe externalizing problems and (4) ADHD with severe executive dysfunctions. These subgroups showed different clinical characteristics and degrees of functional impairment. The EF impairment group displayed more serious learning problems and worse life skills than the externalizing group. The two groups with externalizing problems (i.e. the severe impairment group and the externalizing group) both exhibited higher rates of the combined subtype of ADHD and higher rates of comorbid ODD. Different subtypes of ADHD displayed different profiles of internalizing and externalizing problems and levels of executive dysfunctions. In particular, the subtype with severe impairment in EF exhibited more learning problems and worse life skills, suggesting EF is a critical target for intervention in children with ADHD.
Educational intervention for family caregivers of older adults with delirium: An integrative review
Authors: Lee JuHee , Yeom Insun , Yoo Subin , Hong Soomin
Published: June 2023

Aim

To propose educational strategies to prevent delirium in older adults.

Design

Integrative review.

Methods

This review followed the methodology of Whittemore and Knafl (J Adv Nurs 52(5):546–553, 2005. 10.1111/j.1365‐2648.2005.03621.x).

Data Sources

A literature search was performed of the PubMed, CINAHL, Embase, Cochrane Library CENTRAL, and Scopus databases on 8 July 2022.

Results

Three themes of educational interventions were identified: capacity building, resource provision and enhancement of relationships, collectively termed Fa‐CARE. Educational interventions improved family caregivers' knowledge about delirium, their anxiety; depression; self‐efficacy; and attitudes. Among older adults, these interventions improved the duration, severity and incidence of delirium; functional abilities; and length of hospital stay.

Conclusion

Providing education to family caregivers benefits both those caregivers and the older adults. When planning educational intervention, diverse and innovative approaches need to be considered.

Implications for the profession and/or patient care

This study can guide family education regarding the care of older adults with delirium.

Impact

Educational interventions positively impacted both family caregivers and older adults with delirium.

Educational interventions provide family caregivers with resources, improve their capacity for delirium management, and enhance their relationships with older adults.

This study suggests future directions in education for family caregivers of older adults with delirium.

Reporting method

This review adhered to the EQUATOR guidelines by using the PRISMA 2020 checklist.

Patient or public contribution

No patient or public contribution.
Characteristics associated with receipt of treatment among patients diagnosed with chronic hepatitis C virus
Authors: Gordon Stuart C. , Kaushik Ankita , Chastek Benjamin , Anderson Amy , Yehoshua Alon
Published: June 2023

Although current guidelines recommend that nearly all patients with chronic hepatitis C virus (HCV) infection receive treatment, a substantial proportion remain untreated. We conducted an administrative claims analysis to provide real‐world data on treatment patterns and characteristics of treated versus untreated patients among individuals with HCV in the United States. Adults with an HCV diagnosis from 01 July 2016 through 30 September 2020 and continuous health plan enrolment for 12 months before and ≥1 month after the diagnosis date were identified in the Optum Research Database. Descriptive and multivariable analyses were conducted to evaluate the association between patient characteristics and the rate of treatment. Of 24,374 patients identified with HCV, only 30% initiated treatment during follow‐up. Factors associated with increased rate of treatment included younger age versus age 75+ (hazard ratio [HR] 1.50–1.83 depending on age group), commercial versus Medicare insurance (HR 1.32), and diagnosis by a specialist versus a primary care physician (HR 2.56 and 2.62 for gastroenterology and infectious disease or hepatology, respectively) (p < .01 for all). Several baseline comorbidities were associated with decreased rate of treatment, including psychiatric disorders (HR 0.87), drug use disorders (HR 0.85) and cirrhosis (HR 0.42) (p < .01 for all). These findings highlight existing HCV treatment inequities, particularly among older patients and those with psychiatric disorders, substance use disorders or chronic comorbidities. Targeted efforts to increase treatment uptake in these populations could mitigate a considerable future burden of HCV‐related morbidity, mortality and healthcare costs.
Incidence and predictors of urinary incontinence rates post‐holmium laser enucleation of prostate
Authors: Elsaqa Mohamed , Zhang Yu , Papaconstantinou Harry , Tayeb Marawan M. El
Published: June 2023

Introduction

One of the main adverse outcomes following Holmium laser enucleation of the prostate (HoLEP) is the development of transient de novo urinary incontinence (UI). We aimed to evaluate the correlation of multiple risk factors to UI rates post‐HoLEP.

Methods

A review of prospectively maintained 7 year database for HoLEP patients in a single center was performed. UI data at 6 week, 3 month, and 1 year follow‐up intervals were assessed with bivariate and multivariate analysis of multiple potential risk factors.

Results

The study included 666 patients with median (IQR) age of 72 (66–78) years old and median (IQR) preoperative prostate volume of 89 (68–126) gm. UI was seen in 287 (43%), 100 (15%) and 26 (5.8%) at 6 week, 3 month, and 1 year follow up occasions respectively. At 6 weeks follow up, UI type was stress, urge and mixed in 121 (18.16%), 118 (17.72) and 48 (7.21%) patients respectively. Using a multivariate regression analysis, obesity and pre‐operative UI were associated with postoperative UI rate at both 6 week (p = .0065, .031) and 3 month (p = .0261, .044) follow up encounters respectively. Also, larger specimen weight was another predictor for 6 week UI (p = .0399) while higher frailty score was a predictor for UI at 3 month occasion (p = .041).

Conclusion

Patients with preoperative UI, obesity, frailty, and large prostate volume are at higher risk of short‐term UI post‐HoLEP up to 3 months. Patients with one or more of these risk factors should be counseled regarding the higher risk of UI.
Recovery of vegetation on former alpine roads: how long does it take?
Authors: Evju Marianne , Hagen Dagmar , Olsen Siri Lie , Mehlhoop Anne Catriona
Published: June 2023

Alpine areas worldwide are under heavy land‐use pressure and degradation. Active restoration treatments can contribute to accelerating recovery of degraded areas. However, monitoring data are needed to understand the contribution of restoration treatments to long‐term management and to predict time to recovery (TR). In this study, we used monitoring data on removed roads in an alpine area in Norway to investigate TR of three vegetation‐based indicators. Four restoration treatments were tested: 1) removal of added gravel down to original terrain surface, and stirring of topsoil; 2) adding fertilizer to the stirred topsoil; 3) adding seeds to the fertilized topsoil; and 4) no removal of added gravel, but stirring of top layer (gravel and soil). The restoration of roads took place in 2002, and monitoring of permanent plots was carried out in 2004, 2009, 2014, and 2019. Reference plots in intact vegetation next to removed roads were monitored in 2014 and 2019. We used species composition and species richness of vascular plants as well as total vegetation cover as indicators of restoration outcome and investigated predicted TR for these indicators under different restoration treatments. Species composition changed significantly with time since restoration in all treatments, approaching that of the reference vegetation. The recovery of species composition was slowest in fertilized and seeded plots, where estimated TR was 2–3 times longer (> 45 years) than in the other treatments (< 20 years). Species richness of vascular plants was restored quickly (< 5 years) within all restoration treatments, whereas recovery of vegetation cover varied more (20–30 years). Our study confirms that vegetation recovery in alpine environments is a long‐term process, but that adding seeds and nutrients is unnecessary for, and even inhibits, the recovery of narrow, disturbed sites such as former roads.
Modeling the mechanisms of conifer mortality under seawater exposure
Authors: Ding Junyan , McDowell Nate , Fang Yilin , Ward Nicholas , Kirwan Matthew L. , Regier Peter , Megonigal Patrick , Zhang Peipei , Zhang Hongxia , Wang Wenzhi , Li Weibin , Pennington Stephanie C. , Wilson Stephanie J. , Stearns Alice , Bailey Vanessa
Published: June 2023

Relative sea level rise (SLR) increasingly impacts coastal ecosystems through the formation of ghost forests. To predict the future of coastal ecosystems under SLR and changing climate, it is important to understand the physiological mechanisms underlying coastal tree mortality and to integrate this knowledge into dynamic vegetation models.

We incorporate the physiological effect of salinity and hypoxia in a dynamic vegetation model in the Earth system land model, and used the model to investigate the mechanisms of mortality of conifer forests on the west and east coast sites of USA, where trees experience different form of sea water exposure.

Simulations suggest similar physiological mechanisms can result in different mortality patterns. At the east coast site that experienced severe increases in seawater exposure, trees loose photosynthetic capacity and roots rapidly, and both storage carbon and hydraulic conductance decrease significantly within a year. Over time, further consumption of storage carbon that leads to carbon starvation dominates mortality. At the west coast site that gradually exposed to seawater through SLR, hydraulic failure dominates mortality because root loss impacts on conductance are greater than the degree of storage carbon depletion.

Measurements and modeling focused on understanding the physiological mechanisms of mortality is critical to reducing predictive uncertainty.
A module centered on the transcription factor Msn2 from arbuscular mycorrhizal fungus Rhizophagus irregularis regulates drought stress tolerance in the host plant
Authors: Fan Xiaoning , Xie Hongyun , Huang Xinru , Zhang Shuyuan , Nie Yuying , Chen Hui , Xie Xianan , Tang Ming
Published: June 2023

Arbuscular mycorrhizal (AM) fungi can form mutualistic endosymbiosis with > 70% of land plants for obtaining fatty acids and sugars, in return, AM fungi promote plant nutrients and water acquisition to enhance plant fitness. However, how AM fungi orchestrate its own signaling components in response to drought stress remains elusive.

Here, we identify a transcription factor containing C2H2 zinc finger domains, RiMsn2 from Rhizophagus irregularis. To characterize the RiMsn2, we combined heterologous expression, subcellular localization in yeasts, and biochemical and molecular studies with reverse genetics approaches during the in planta phase.

The results indicate that RiMsn2 is highly conserved across AM fungal species and induced during the early stages of symbiosis. It is significantly upregulated in mycorrhizal roots under severe drought conditions. The nucleus‐localized RiMsn2 regulates osmotic homeostasis and trehalose contents of yeasts. Importantly, gene silencing analyses indicate that RiMsn2 is essential for arbuscule formation and enhances plant tolerance to drought stress. Results from yeasts and biochemical experiments suggest that the RiHog1‐RiMsn2‐STREs module controls the drought stress‐responsive genes in AM fungal symbiont.

In conclusion, our findings reveal that a module centered on the transcriptional activator RiMsn2 from AM fungus regulates drought stress tolerance in host plant.
Assessment of optical quality of ready‐made reading spectacles for presbyopic correction
Authors: Asare Frederick A. , Ahiakwao Godwin A. , Oduro Bright A. , Nti Augustine N.
Published: June 2023

Purpose

Many presbyopic patients in both developed and developing countries use ready‐made reading spectacles for their near vision correction even though the quality of these spectacles cannot always be assured. This study assessed the optical quality of ready‐made reading spectacles for presbyopic correction in comparison with relevant international standards.

Methods

A total of 105 ready‐made reading spectacles with powers ranging from +1.50 to +3.50 dioptres (D) in +0.50 D steps were randomly procured from open markets in Ghana and assessed for their optical quality, including induced prisms and safety markings. These assessments were done in line with the International Organization for Standardization (ISO 16034:2002 [BS EN 14139:2010]) as well as the standards used in low‐resource countries.

Results

All lenses (100%) had significant induced horizontal prism that exceeded the tolerance levels stipulated by the ISO standards, while 30% had vertical prism greater than the specified tolerances. The highest prevalence of induced vertical prism was seen in the +2.50 and +3.50 D lenses (48% and 43%, respectively). When compared with less conservative standards, as suggested for use in low‐resource countries, the prevalence of induced horizontal and vertical prism reduced to 88% and 14%, respectively. While only 15% of spectacles had a labelled centration distance, none had any safety markings per the ISO standards.

Conclusion

The high prevalence of ready‐made reading spectacles in Ghana that fail to meet optical quality standards indicates the need for more robust, rigorous and standardised protocols for assessing their optical quality before they are sold on the market. This will alleviate unwanted side effects including asthenopia associated with their use. There is also the need to intensify public health awareness on the use of ready‐made reading spectacles, especially by patients with significant refractive errors and ocular pathologies.
Selective anatomical catheter ablation of left atrial ganglionated plexus for vasovagal syncope: Left superior and right anterior ganglionated plexus ablation
Authors: Lin Jianwei , Liu Qiang , Jiang Ruhong , Chen Shiquan , Yu Lu , Jiang Chenyang
Published: June 2023

Background

Vasovagal syncope (VVS) is one of the most common causes of syncope. Traditional treatment has not achieved satisfactory results. The purpose of this study was to assess the feasibility and efficacy of selective anatomical catheter ablation of left atrial ganglionated plexus (GP) as a therapeutic strategy for the patients of symptomatic VVS.

Methods

A total of 70 patients with at least once recurrent syncopal episode of VVS with a positive head‐up tilt test were enrolled. They were divided into GP ablation group and control group. Patients in GP ablation group received anatomical catheter ablation of left superior ganglionated plexus (LSGP) and right anterior ganglionated plexus (RAGP). Patients in the control group were guideline‐directed conventional therapy. The primary endpoint was VVS recurrences. The secondary endpoint was the recurrence of syncope and prodrome events.

Results

There were no statistical differences in clinical characteristics between the ablation group (n = 35) and the control group (n = 35). Over a follow‐up of 12 months, the ablation group had significantly lower syncope recurrence compared with the control group (5.7% vs. 25.7%, p = .02), and the ablation group had significantly lower syncope and prodrome recurrence compared with the control group (11.4% vs. 51.4%, p < .001). In GP ablation, 88.6% of the patients showed significant vagal response during LSGP ablation, and 88.6% of the patients showed significantly increased heart rate during RAGP ablation.

Conclusions

For patients with recurrent VVS, selective anatomical catheter ablation of LSGP and RAGP is superior to conventional therapy in reducing syncope recurrence.
Migration Policies and Immigrants’ Language Acquisition in EU‐15: Evidence from Twitter
Authors: Gil‐Clavel Sofia , Grow André , Bijlsma Maarten J.
Published: June 2023

In response to the increasingly complex and heterogeneous immigrant communities settling in Europe, European countries have adopted various civic integration measures. Measures aiming to facilitate language acquisition are considered crucial for integration and cooperation between immigrants and natives. Simultaneously, the rapid expansion of social media usage is believed to change the factors affecting immigrants’ language acquisition. However, only a few previous studies have analyzed whether this is the case. This article uses a novel longitudinal data source derived from Twitter to (1) analyze differences in the pace of immigrants’ language acquisition depending on the migration policies of destination countries and (2) study how the relative sizes of the migrant groups in destination countries, and the linguistic and geographical distances between origin and destination countries, are associated with language acquisition. Results show that immigrants who live in countries with strict language acquisition requirements for immigrants and conservative citizenship policies have the highest median times until language acquisition. Based on Twitter data, we also find that language acquisition is associated with classic explanatory variables, such as the size of the immigrant group in the destination country and the linguistic and geographical distance between origin and destination country similar to the previous studies.
Comparison of BNT162b2 and mRNA1273 vaccines in solid organ transplant recipients: Post‐Hoc analysis of a Japanese national prospective study
Authors: Yoshikawa Mikiko , Natori Yoichiro , Oki Rikako , Unagami Kohei , Ohfuji Satoko , Imamura Ryoichi , Ishida Hideki , Takahara Shiro , Hirota Yoshio , Egawa Hiroto
Published: June 2023

The coronavirus disease‐19 (COVID‐19) vaccine efficacy and immunogenicity in the immunocompetent population are well established. However, in solid organ transplant (SOT) recipients, because of their use of immunosuppressive medication, the immunogenicity of these severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines remains suboptimal. Both BNT162b2 and mRNA1273 have been used for some time, but their immunogenicity has not been directly compared in this immunocompromised patient group. We performed a post‐hoc analysis of a previous prospective cohort study. The inclusion criteria were adult SOT recipients with active grafts at least 1 month after SOT. After giving consent, participants chose to receive either BNT162b2 or mRNA1273 vaccine. Anti‐spike‐protein‐S antibody against SARS‐CoV‐2 was measured. Propensity scores were calculated via logistic regression to transform the probability of having received either BNT162b2 or mRNA1273 vaccine, and a model was developed. We enrolled 623 SOT recipients. In the propensity score‐matched analysis, 100 recipients were selected for BNT162b2 and 100 for mRNA1273. SARS‐CoV‐2 anti‐spike protein antibody positivity with BNT162b2 versus mRNA1273 at 3 weeks after the first dose, 1 month after the second dose, 3 months after the second dose, and 6 months after the second dose were 10% versus 19% (P = .07), 51% versus 58% (P = .30), 74% versus 88% (P = .01), and 78% versus 87% (P = .13), respectively. We conducted a propensity score‐matched comparison of BNT162b2 and mRNA1273 vaccines as the primary series of COVID‐19 vaccines in SOT recipients. We found significantly better immunogenicity with the mRNA1273 vaccine than with BNT162b2.
Characterization of the novel HLA‐DPA1*02:03:05 allele by next generation sequencing
Authors: Liacini Abdelhamid , Peters Lindsey , Mancini Shannon , Gravante Christopher , Geier Steven
Published: June 2023

HLA‐DPA1*02:03:05 differs from HLA‐DPA*02:03:04 by three nucleotide substitution located in exon 3.
Characterization of the novel HLA‐C*12:384 allele by sequencing‐based typing
Authors: Cargou Marine , Elsermans Vincent , Top Isabelle , Wojciechowski Elodie , Visentin Jonathan
Published: June 2023

HLA‐C*12:384 differs from HLA‐C*12:03:01:02 by one nucleotide substitution in codon 42 in exon 2.