bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral oxygen desaturation events during and functional outcomes after prehospital anaesthesia: A prospective pilot study
Authors: Nurmi Jouni , Laukkanen‐Nevala Päivi , Kirves Hetti , Raatiniemi Lasse , Toivonen Tuukka , Tommila Miretta , Piiroinen Heini , Setälä Piritta , Karhivuori Pamela , Tukia Simo , Olkinuora Anna
Published: March 2022

Background

During prehospital anaesthesia, oxygen delivery to the brain might be inadequate to match the oxygen consumption, with unknown long‐term functional outcomes. We aimed to evaluate the feasibility of monitoring cerebral oxygenation during prehospital anaesthesia and determining the long‐term outcomes.

Methods

We performed a prospective observational feasibility study in two helicopter emergency medical services units. Frontal lobe regional oxygen saturation (rSO2) of adult patients undergoing prehospital anaesthesia was monitored with near‐infrared spectroscopy (NIRS) by a Nonin H500 oximeter. The outcome was evaluated with a modified Rankin Scale (mRS) at 30 days and 1 year. Health‐related quality of life (HRQoL) was measured with a 15D instrument at 1 year.

Results

Of 101 patients enrolled, 83 were included. The mean baseline rSO2 was 79% (73–84). Desaturation for at least 5 min to rSO2 below 50% or a decrease of 10% from baseline occurred in four (5%, 95% CI 2%–12%) and 19 (23%, 95% CI 15–93) patients. At 1 year, 32 patients (53%, 95% CI 41–65) achieved favourable neurological outcomes. The median 15D score was 0.889 (Q1–Q3, 0.796–0.970).

Conclusion

Monitoring cerebral oxygenation with a hand‐held oximeter during prehospital anaesthesia and collecting data on functional outcomes and HRQoL are feasible. Only half of the patients achieved a favourable functional outcome. The effects of cerebral oxygenation on outcomes during prehospital critical care need to be assessed in future studies.
Asymptomatic inguinal hernia: does it need surgical repair? A systematic review and meta‐analysis
Authors: Cirocchi Roberto , Burini Gloria , Avenia Stefano , Tebala Giovanni , Palumbo Piergaspare , Cianci Maria Chiara , Morabito Antonino , Bruzzone Paolo
Published: March 2022

Background

The aim of this review is to compare the outcomes of surgical repair versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias.

Methods

Preferred reporting items for systematic reviews and meta‐analyses guidelines were employed. We analysed primary outcomes: pain, quality of life, pain during daily activities and visual analogue scale (VAS that measures pain at rest and on movement) and secondary outcomes: postoperative complications and recurrence.

Results

Pain and quality of life were not comparable due to differences in the parameters used in different articles. Pain interfering with normal daily activity was evaluated in one study and appears more favourable in the post‐repair group respect to the watchful waiting (WW) group (5.1% versus 2.2%). VAS, measured in one study, at 6 months was more favourable in the surgery group (37% versus 44%). After 12 months the outcome was better in the control group than in the repair group (28% versus 30%). Conversion rate of the patient cohorts from watchful waiting to elective surgery was between 35.03% and 57.8%. The meta‐analysis did not find significant statistical differences in the two groups examined for postoperative complications [RR = 0.95, 95% CI (0.50, 1.80), P = 0.88], as for hernia recurrence [RR = 1.01, 95% CI (0.50, 2.02), P = 0.98].

Conclusion

WW seems to be an acceptable option for the patient with asymptomatic or minimally symptomatic inguinal hernias. Delaying surgical repair until symptoms appear is safe. Acute hernia incarcerations are not particularly frequent. The incidence of chronic pain after the repair is high. Physicians must select patients carefully and explain to them the risks and benefits of surgery.
The changing face of cosmetic surgery regulation: a review of controversies and potential reforms
Authors: Jobson Dale , Freckelton Ian
Published: March 2022

Cosmetic surgery is becoming increasingly popular in Australia with the industry estimated to be worth over 1 billion dollars annually. Regulators both in Australia and internationally have been criticized for not keeping up with the rapidly changing field and keeping patients sufficiently safe in an environment that is problematically entrepreneurial. In this article, we explore the current regulation of and controversies surrounding cosmetic surgery in Australia, including the use of the title ‘cosmetic surgeon’, consent processes and the phenomenon of medical tourism. Lastly, we review the potential future reforms in Australia and how other countries have regulated the industry to keep patients safe.
Retinal detachment after cataract surgery: a population‐based study
Authors: Thylefors Joakim , Jakobsson Gunnar , Zetterberg Madeleine , Sheikh Rafi
Published: March 2022

Purpose

To analyse the risk of rhegmatogenous retinal detachment (RRD) after cataract surgery, and to identify possible risk factors.

Method

Observational cohort study of patients undergoing cataract surgery in Region Skåne, southern Sweden, during 2015–2017 were retrieved from the Swedish National Cataract Register. These were then cross‐referenced with cases of retinal detachment surgery performed at the Skåne University Hospital in Lund from 2015 to 2020. The main outcome was RRD after cataract surgery. The influence of sex, age, axial length of the eye, rupture of the posterior capsule, patient comorbidity and other cataract complications were analysed.

Results

Among the 58 624 cases of cataract surgery, a total of 298 RRDs (0.51%) were identified up to the end of 2020. The mean time from cataract surgery to RRD was 667 days. The mean age was 65.3 years, compared to 74 years in the control group. A strong correlation was found between RDD and age: <60 years, incidence = 0.50%; 60–75 years, incidence = 0.14%; and >75 years, incidence = 0.04%. The correlation with axial length was also very strong: mean value 23.73 mm in those without RRD, and 25.13 mm in those with RRD (p < 0.001). Sex was also strongly correlated to RDD; 68.8% of cases of RRD being men. Among men younger than 60 years of age, with an axial length ≥25 mm, 9.46% exhibited RRD within the follow‐up period (mean 4.7 years). Rupture of the posterior capsule was found in 2.01% of RRD patients compared to 0.74% in the control group. Diabetes, glaucoma or pseudoexfoliation had no impact on the prevalence of RRD.

Conclusions

The three main risk factors for RRD following cataract surgery were found to be sex, age and axial length. The highest incidence of RRD (9.46%) were identified among men younger than 60 years of age and an axial length ≥25 mm.
lncRNA MEG3 restrained the M1 polarization of microglia in acute spinal cord injury through the HuR/A20/NF‐κB axis
Authors: Zhou Heng‐Jun , Wang Li‐Qing , Zhan Ren‐Ya , Zheng Xiu‐Jue , Zheng Jie‐Sheng
Published: March 2022

The M1 polarization of microglia and neuroinflammation restrict the treatment of acute spinal cord injury (ASCI), and long non‐coding ribonucleic acid (lncRNA) maternally expressed gene 3 (MEG3) expression is lessened in ASCI. However, the function and mechanism of lncRNA MEG3 in the M1 polarization of microglia and neuroinflammation in ASCI are unclear. The expressions of lncRNA MEG3 in ASCI mouse spinal cord tissues and lipopolysaccharide (LPS)‐treated primary microglia and BV2 cells were quantified through a quantitative real‐time polymerase chain reaction. In‐vitro assays were conducted to explore the function of lncRNA MEG3 in the M1 polarization of microglia and neuroinflammation in ASCI. RNA degradation, RNA immunoprecipitation, RNA pull‐down, cycloheximide‐chase, and ubiquitination analyses were carried out to probe into the mechanism of lncRNA MEG3 in the M1 polarization of microglia and neuroinflammation in ASCI. The lncRNA MEG3 expression was lessened in the ASCI mouse spinal cord tissues and LPS‐treated primary microglia and BV2 cells, and the overexpression of lncRNA MEG3 restrained the M1 polarization of microglia and the neuroinflammation by regulating the NF‐κB signaling pathway. For the investigation of the potential mechanism of such, the overexpression of lncRNA MEG3 restrained the M1 polarization of microglia through the HuR/A20/NF‐κB axis and boosted the motor function recovery and neuroinflammation relief in the mice with SCI. The overexpression of lncRNA MEG3 restrained the M1 polarization of microglia through the HuR/A20/NF‐κB axis.
Five decades of misunderstanding in the socialHymenoptera: a review and meta‐analysis ofMichener's paradox
Authors: Jeanne Robert L. , Loope Kevin J. , Bouwma Andrew M. , Nordheim Erik V. , Smith Michael L.
Published: March 2022

In a much‐cited 1964 paper entitled “Reproductive efficiency in relation to colony size in hymenopterous societies,” Charles Michener investigated the correlation between a colony's size and its reproductive efficiency – the ability of its adult females to produce reproductives, measured asper‐capitaoutput. Based on his analysis of published data from destructively sampled colonies in 18 species, he reported that in most of these species efficiency decreased with increasing colony size. His conclusion that efficiency is higher in smaller groups has since gained widespread acceptance. But it created a seeming paradox: how can natural selection maintain social behaviour when a female apparently enjoys her highestper‐capitaoutput by working alone? Here we treat Michener's pattern as a hypothesis and perform the first large‐scale test of its prediction across the eusocial Hymenoptera. Because data on actual output of reproductives were not available for most species, Michener used various proxies, such as nest size, numbers of brood, or amounts of stored food. We show that for each of Michener's data sets the reported decline inper‐capitaproductivity can be explained by factors other than decreasing efficiency, calling into question his conclusion that declining efficiency is the cause of the pattern. The most prominent cause of bias is the failure of the proxy to capture all forms of output in which the colony invests during the course of its ontogeny. Other biasing factors include seasonal effects and a variety of methodological flaws in the data sets he used. We then summarize the results of 215 data sets drawn from post‐1964 studies of 80 species in 33 genera that better control for these factors. Of these, 163 data sets are included in two meta‐analyses that statistically synthesize the available data on the relationship between colony size and efficiency, accounting for variable sample sizes and non‐independence among the data sets. The overall effect, and those for most taxonomic subgroups, indicates no loss of efficiency with increasing colony size. Two exceptional taxa, the halictid bees and independent‐founding paper wasps, show negative trends consistent with the Michener hypothesis in some species. We conclude that in most species, particularly those with large colony sizes, the hypothesis of decreasing efficiency with increasing colony size is not supported. Finally, we explore potential mechanisms through which the level of efficiency can decrease, be maintained, or even increase, as colonies increase in size.
Differences in complete denture longevity and replacement in public and private dental services: A propensity score‐matched analysis of subsidised dentures in adult Australians across 20 years
Authors: Taylor Marietta , Masood Mohd , Mnatzaganian George
Published: March 2022

Objectives

To examine the differences in treatment outcomes for patients who received subsidized complete dentures in private dental clinics and in public dental clinics over 20 years in Victoria, Australia.

Methods

Between 2000 and 2019, 187 227 complete dentures were provided to eligible public patients by the Victorian public dental system. Of these, approximately 52% were provided to public patients in private clinics through the voucher system. Of the 97 107 participants who received denture care in private clinics, 70 818 were matched 1:1 by propensity score (PS) quantiles with participants who received denture care in public clinics. The PS matching balanced the characteristics between these two groups. Subsequently, a conditional logistic regression model investigated the binary outcome of denture replacement whilst a conditional Poisson regression modelled the number of years to denture replacement. A frailty Cox regression after PS matching investigated denture survival over time.

Results

Dentures provided in public clinics had a mean time to replacement of 5.5 years (SD: 34.0) and 25.9% were replaced during the observation period. In the first year of denture service, incidence rate per person year (IR) for complete denture replacement in public clinics was 0.04 (95% CI: 0.04–0.04). Dentures provided in private clinics had a mean time to replacement of 6.5 years (SD: 3.8) with 29.4% replaced during the observation period. In the first year of denture service, the IR for complete denture replacement in private clinics was 0.02 (95% CI: 0.02–0.02), which was less than half that of the public IR. Multivariate analyses found that although private dentures were more likely to be replaced during the observation period than those provided in the public sector (odds ratio [OR]: 1.31, 95% CI: 1.28–1.35, p < .001), they had greater longevity (incidence rate ratio [IRR]: 1.23, 95% CI: 1.23–1.24, p < .001). Longer longevity of private dentures was also supported by the frailty Cox regression showing that private dentures had a reduced hazard of denture replacement over time (better survival) in comparison to public dentures (hazard ratio [HR]: 0.94, 95% CI: 0.92–0.97, p < .001). Probabilistic sensitivity analysis supported the study findings.

Conclusions

Increased denture longevity, higher rates of denture replacement and lower rates of early denture replacement were associated with receiving denture care in private clinics as compared with dentures provided in the public sector.
Trade‐offs between economic development and biodiversity conservation on a tropical island
Authors: Pagani‐Núñez Emilio , Xu Yang , Yan Mingxiao , He Jiekun , Jiang Zifei , Jiang Haisheng
Published: March 2022

Resolving trade‐offs between economic development and biodiversity conservation needs is crucial in currently developing countries and in particularly sensitive systems harboring high biodiversity. Yet, such a task is challenging because human activities have complex effects on biodiversity. We assessed the effects of intense economic development on Hainan Island (southern China) on different components of biodiversity. This highly biodiverse tropical island has undergone extensive economic development and conversion of forest to agriculture and urban area. We identified 3 main transformation areas (low, medium, and high transformation) based on land‐use, local‐climate, and economic changes across 145 grids (10 × 10 km), and estimated changes in avian biodive6rsity from 1998 to 2013. We recorded ongoing taxonomic biotic homogenization throughout the island. Differences between traditional and directional alpha diversity decreased by 5%. Phylogenetically clustering increased by 0.5 points (W = 7928, p < 0.01), and functional overdispersion increased by 1 point (W = 16,411, p < 0.01). Initial taxonomic, phylogenetic, and functional scores correlated negatively with changes in these scores across all transformation areas (all ps < 0.01). At the local scale, economic and environmental indicators showed complex and divergent effects across transformation areas and biodiversity components. These effects were only partially ameliorated in an ecological function conservation area in the mountainous central part of the island. We found complex effects of economic development on different biodiversity dimensions in different areas with different land uses and protection regimes and between local and regional spatial scales. Profound ecosystem damage associated with economic development was partially averted, probably due to enhanced biodiversity conservation policies and law enforcement, but not without regional‐scale biotic homogenization and local‐scale biodiversity loss.
Effects of aquaculture on the maintenance of waterbird populations
Authors: Cheng Chuyu , Liu Jiajia , Ma Zhijun
Published: March 2022

The global aquaculture industry has expanded rapidly and is increasingly important for maintaining food security and providing habitat for many waterbirds. Clarifying how waterbirds use aquafarms and how aquafarm use affects waterbird population maintenance can help improve management of the aquafarm landscape such that it can provide habitat for waterbirds. We investigated aquafarm use by waterbirds in China, the world's largest producer of aquaculture products. We used data from the literature on and expert knowledge (questionnaire survey) of waterbird use of aquafarms in China and Bayesian phylogenetic generalized linear mixed models to analyze the relationship between the degree of aquafarm use and population trends of waterbirds. Sixty‐nine percent of waterbird species in China have been recorded at aquafarms. Approximately one quarter of all waterbird species and about the same proportion of threatened species were found to forage at aquafarms, consuming either cultured aquatic products or other food stuffs. In general, species with a high degree of aquafarm use were unlikely to exhibit a population decline over the past 2 decades, when rapid loss of natural habitat occurred in China. This relationship was not detected in threatened species, despite there being no significant difference in the degree of aquafarm use between threatened and nonthreatened species. Our results suggest that the large and expanding aquaculture industry is important for maintaining waterbird populations in China. However, aquafarms are not a replacement for natural habitats because threatened species benefited less from aquafarm use. Given that aquafarms often negatively affect natural wetlands, the degree to which aquafarms compensate for natural habitat loss probably depends on the quality of aquafarm habitat and the habitat requirements of waterbirds. We recommend an integrated ecological and economic analysis to formulate management policies that help conserve wildlife within the constraints and opportunities associated with maintaining human livelihoods.
Mapping the corporate governance scholarship: Current state and future directions
Authors: Pandey Nitesh , Andres Christian , Kumar Satish
Published: March 2022

Research Question/Issues

We conduct a comprehensive analysis of all scholarly publications in the field of corporate governance (CG) since the Enron scandal of 2001. Using bibliometric methods, we identify prominent themes that have served as the foundation of CG research, prominent topics in the field along with their temporal developments, and recent trends in CG research. In addition, we identify the authors and journals that have had the biggest impact in the field.

Research Findings/Insights

We document that the number of annual publications in CG has increased by a factor of eight since the early 2000s, with research articles being published in a wide variety of general interest journals, as well as in outlets specialized in the field of CG. We identify six research themes as the foundation of CG research: the theoretical foundations of CG, ownership, CG mechanisms and firm outcomes, disclosures, the board of directors, and family firms. We further find 19 major bibliographic keyword clusters that have been explored by researchers in the past 20 years. Research on corporate social responsibility (CSR) and sustainability, governance mechanisms, control mechanisms and disclosures, board diversity, CG in family firms, and CG in the Chinese context are the most dynamic areas of research in recent years.

Theoretical/Academic Implications

We systematically analyze the literature on CG and outline theoretical foundations, structuring academic contributions by keyword clusters. Links between keyword clusters as well as the most dynamic research areas are identified. The analysis provides guidance for researchers regarding suitable outlets for the different thematic clusters and helps as a basis to identify research opportunities.

Practitioner/Policy Implications

We document growing research interest in the field of CSR and sustainability. The growing body of literature in these areas can inform CG and CSR policies in the future. Our comprehensive bibliographic analysis provides an overview of CG research themes across research disciplines and streams of the literature.
Nevus, melanoma, or something else? Mesenchymal neoplasms with melanocytic differentiation
Authors: Evangelou Zoi , Linos Konstantinos
Published: March 2022

The overwhelming majority of cutaneous neoplasms with melanocytic differentiation are nevi, melanomas, or less commonly melanocytomas. Nevertheless, there is also a group of mesenchymal neoplasms with genuine melanocytic differentiation which can create diagnostic difficulties with significant repercussions. These can rarely present as primary or metastatic cutaneous lesions. The ones that are relevant to a dermatopathologist include malignant melanotic nerve sheath tumor, perivascular epithelioid cell neoplasm, and clear cell sarcoma. This work will provide a thorough review of clinical presentation, morphologic and immunohistochemical features as well as molecular pathogenesis of these tumors. We hope to familiarize the general dermatopathology readership with a group of neoplasms of mesenchymal lineage exhibiting melanocytic differentiation and ultimately avoid diagnostic misadventures.
Effectiveness of Extrinsic Incentives for Promoting Rural Waste Sorting in Developing Countries: Evidence from China
Authors: Zhao Aidong , Zhang Limin , Ma Xianlei , Gao Fugang , Zhu Honggen
Published: March 2022

Rural areas in many developing countries lack an effective waste management system, leading to poor environmental hygiene. As an initial but integral step toward sustainable waste management, fostering better household compliance with waste‐sorting regulation has become an important policy agenda. This paper devotes attention to evaluating the effectiveness of extrinsic incentives, more specifically, reward–penalty schemes, on promoting rural households' participation in waste sorting. By exploiting an original survey of 1,058 rural households conducted in the Taihu Basin of China, we empirically find that (1) reward–penalty scheme considerably promotes rural households' engagement with waste sorting; (2) the more stringently the scheme is implemented, the higher the probabilities of more frequent sorting; and (3) point reward, which can be exchanged for vouchers used in local stores, is the most effective extrinsic incentive for promoting waste sorting. The findings provide insights for enhancing rural waste sorting in the developing world.
The Second World War, Inequality and the Social Contract in Britain
Authors: Heldring Leander , Robinson James A. , Whitfill Parker
Published: March 2022

What is the impact of warfare on inequality and the social contract? Using local data on bombing, the evolution of wealth inequality and vote shares for the Labour Party in Britain around the Second World War, we establish two results. First, on average, we find no impact of bombing on inequality. However, there is considerable heterogeneity, and this result is driven by southern Britain. In northern Britain, bombing led to significant falls in inequality. Second, heavier bombing led to a significant increase in the vote share for Labour after the war everywhere, but this effect is transitory in the south while it is permanent in the north. Our results obtain both in a simple difference‐in‐differences framework as well as in a panel‐regression discontinuity framework in which we exploit the limited range of German fighter escort planes. Our results provide novel causal evidence for the inequality‐reducing impact of warfare, and we interpret them as consistent with the notion that the impact of the war also led to a reconfiguration of the social contract in Britain.
The mycobacterial guaB1 gene encodes a guanosine 5′‐monophosphate reductase with a cystathionine‐β‐synthase domain
Authors: Knejzlík Zdeněk , Doležal Michal , Herkommerová Klára , Clarova Kamila , Klíma Martin , Dedola Matteo , Zborníková Eva , Rejman Dominik , Pichová Iva
Published: March 2022

Mycobacteria express enzymes from both the de novo and purine‐salvage pathways. However, the regulation of these processes and the roles of individual metabolic enzymes have not been sufficiently detailed. Both Mycobacterium tuberculosis (Mtb) and Mycobacterium smegmatis (Msm) possess three guaB genes, but information is only available on guaB2, which encodes an essential inosine 5′‐monophosphate dehydrogenase (IMPDH) involved in de novo purine biosynthesis. This study shows that guaB1, annotated in databases as a putative IMPDH, encodes a guanosine 5′‐monophosphate reductase (GMPR), which recycles guanosine monophosphate to inosine monophosphate within the purine‐salvage pathway and contains a cystathionine‐β‐synthase domain (CBS), which is essential for enzyme activity. GMPR activity is allosterically regulated by the ATP/GTP ratio in a pH‐dependent manner. Bioinformatic analysis has indicated the presence of GMPRs containing CBS domains across the entire Actinobacteria phylum.
Outcomes of long‐term von Willebrand factor prophylaxis use in von Willebrand disease: A systematic literature review
Authors: El Alayli Abdallah , Brignardello Petersen Romina , Husainat Nedaa M. , Kalot Mohamad A. , Aljabiri Yazan , Turkmani Hani , Britt Alec , El‐Khechen Hussein , Shahid Shaneela , Roller John , Motaghi Shahrzad , Mansour Razan , Tosetto Alberto , Abdul‐Kadir Rezan , Laffan Michael , Weyand Angela , Leebeek Frank W.G. , Arapshian Alice , Kouides Peter , James Paula , Connell Nathan T. , Flood Veronica H. , Mustafa Reem A.
Published: March 2022

Background

Von Willebrand Disease (VWD) is a common inherited bleeding disorder. Patients with VWD suffering from severe bleeding may benefit from the use of secondary long‐term prophylaxis.

Aim

Systematically summarize the evidence on the clinical outcomes of secondary long‐term prophylaxis in patients with VWD and severe recurrent bleedings.

Methods

We searched Medline and EMBASE through October 2019 for relevant randomized clinical trials (RCTs) and comparative observational studies (OS) assessing the effects of secondary long‐term prophylaxis in patients with VWD. We used Cochrane Risk of Bias (RoB) tool and the RoB for Non‐Randomized Studies of interventions (ROBINS‐I) tool to assess the quality of the included studies. We conducted random‐effects meta‐analyses and assessed the certainty of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.

Results

We included 12 studies. Evidence from one placebo controlled RCT suggested that VWD prophylaxis as compared to no prophylaxis reduced the rate of bleeding episodes (Rate ratio [RR], .24; 95% confidence interval [CI], .17–.35; low certainty evidence), and of epistaxis (RR, .38; 95%CI, .21–.67; moderate certainty evidence), and may increase serious adverse events RR 2.73 (95%CI .12–59.57; low certainty). Evidence from four before‐and‐after studies in which researchers reported comparative data suggested that VWD prophylaxis reduced the rate of bleeding (RR .34; 95%CI, .25–.46; very low certainty evidence).

Conclusion

VWD prophylaxis treatment seems to reduce the risk of spontaneous bleeding, epistaxis, and hospitalizations. More RCTs should be conducted to increase the certainty in these benefits.
Major revision version 11.0 of the European AIDS Clinical Society Guidelines 2021
Authors: Ryom Lene , De Miguel Rosa , Cotter Aoife Grace , Podlekareva Daria , Beguelin Charles , Waalewijn Hylke , Arribas Josè R , Mallon Patrick W. G. , Marzolini Catia , Kirk Ole , Bamford Alasdair , Rauch Andri , Molina Jean Michel , Kowalska Justyna Dominika , Guaraldi Giovanni , Winston Alan , Boesecke Christoph , Cinque Paola , Welch Steven , Collins Simon , Behrens Georg M. N. ,   the EACS Governing Board
Published: March 2022

Background

The European AIDS Clinical Society (EACS) Guidelines were revised in 2021 for the 17th time with updates on all aspects of HIV care.

Key points of the Guidelines update

Version 11.0 of the Guidelines recommend six first‐line treatment options for antiretroviral treatment (ART)‐naïve adults: tenofovir‐based backbone plus an unboosted integrase inhibitor or plus doravirine; abacavir/lamivudine plus dolutegravir; or dual therapy with lamivudine or emtricitabine plus dolutegravir. Recommendations on preferred and alternative first‐line combinations from birth to adolescence were included in the new paediatric section made with Penta. Long‐acting cabotegravir plus rilpivirine was included as a switch option and, along with fostemsavir, was added to all drug–drug interaction (DDI) tables. Four new DDI tables for anti‐tuberculosis drugs, anxiolytics, hormone replacement therapy and COVID‐19 therapies were introduced, as well as guidance on screening and management of anxiety disorders, transgender health, sexual health for women and menopause. The sections on frailty, obesity and cancer were expanded, and recommendations for the management of people with diabetes and cardiovascular disease risk were revised extensively. Treatment of recently acquired hepatitis C is recommended with ongoing risk behaviour to reduce transmission. Bulevirtide was included as a treatment option for the hepatitis Delta virus. Drug‐resistant tuberculosis guidance was adjusted in accordance with the 2020 World Health Organization recommendations. Finally, there is new guidance on COVID‐19 management with a focus on continuance of HIV care.

Conclusions

In 2021, the EACS Guidelines were updated extensively and broadened to include new sections. The recommendations are available as a free app, in interactive web format and as an online pdf.
Present status and future directions – irrigants and irrigation methods
Authors: Boutsioukis Christos , Arias‐Moliz Maria Teresa
Published: March 2022

Irrigation is considered the primary means of cleaning and disinfection of the root canal system. The purpose of this review was to set the framework for the obstacles that irrigation needs to overcome, to critically appraise currently used irrigants and irrigation methods, to highlight knowledge gaps and methodological limitations in the available studies and to provide directions for future developments. Organization of bacteria in biofilms located in anatomic intricacies of the root canal system and the difficulty to eliminate them is the main challenge for irrigants. Sodium hypochlorite remains the primary irrigant of choice, but it needs to be supplemented by a chelator. Delivery of the irrigants using a syringe and needle and activation by an ultrasonic file are the most popular irrigation methods. There is no evidence that any adjunct irrigation method, including ultrasonic activation, can improve the long‐term outcome of root canal treatment beyond what can be achieved by instrumentation and syringe irrigation. It is necessary to redefine the research priorities in this field and investigate in greater depth the penetration of the irrigants, their effect on the biofilm and the long‐term treatment outcome. New studies must also focus on clinically relevant comparisons, avoid methodological flaws and have sufficiently large sample sizes to reach reliable conclusions. Future multidisciplinary efforts combining the knowledge from basic sciences such as Chemistry, Microbiology and Fluid Dynamics may lead to more effective antimicrobials and improved activation methods to bring them closer to the residual biofilm in the root canal system.
Distilled grape pomace as a functional ingredient in vegan muffins: effect on physicochemical, nutritional, rheological and sensory aspects
Authors: Bianchi Federico , Cervini Mariasole , Giuberti Gianluca , Rocchetti Gabriele , Lucini Luigi , Simonato Barbara
Published: March 2022

Wheat‐based vegan muffins were formulated with increasing levels (0, 5 and 10 g per 100 g substitutes to flour) of dried grape pomace powder obtained after distillation (DGPP). The DGPP‐muffins showed a greater (P < 0.05) total dietary fibre and a lower (P < 0.05) total starch content to the control. The inclusion of DGPP influenced (P < 0.05) both the batter's rheological properties and the baked muffins' technological characteristics, including the baking loss, the volume, the firmness, the spread ratio and the colour. The in vitro antioxidant activity and the phenolic content increased (P < 0.05) following DGPP inclusion. The untargeted phenolic profiling by UHPLC‐HRMS revealed an (P < 0.05) increase of several phenolic classes (i.e. free and bound fractions) following the inclusion of DGPP in the recipe. Flavonoids, mainly anthocyanins, were the most abundant compounds. A quantitative descriptive sensory analysis detected the DGPP‐vegan muffins showed good sensory acceptability. The vegan muffin with 5 g per 100 g of DGPP obtained the highest overall acceptability score by the panellists.
Processing properties of yogurt as affected by the EPS produced by Leuconostoc mesenteroides XR1
Authors: Wang Liang , Gu Yachun , Lv Zili
Published: March 2022

The aim of this study was to examine the fermentation characteristics of a novel Leuconostoc mesenteroides strain (XR1) and to investigate the effect of XR1 exopolysaccharides (EPS) on the microstructure, texture and rheological properties of yoghurt. The novel Leuconostoc mesenteroides strain (XR1) was isolated from wild kefir grains obtained from Xinjiang Province. The results showed that XR1 had good EPS production capacity and favourable fermentation performance. The addition of XR1 EPS to fermented milk effectively improved the water‐holding capacity (WHC) of the fermented milk and changed its microstructure. In subsequent fermentation studies, the XR1 strain was found to be a compatible strain, and the steric barrier formed between XR1 EPS and the fermented milk proteins enhanced its viscoelastic properties. Rheology studies indicated that fermented milk supplemented with EPS possessed a higher modulus (G’, G’’ ) and complex viscosity. Thus, these results indicate that XR1 EPS are useful as a natural organic additive that can replace chemical additives in dairy products.
Restrictions on citizens’ exits reconsidered: Taiwan, young democracy under threat
Authors: Fan Hsiu‐Yu (Tori)
Published: March 2022

This article explores how Taiwan strictly regulated its citizens’ exits and re‐entries during the martial law years and why this young democracy still closely monitors citizens’ departure at exit ports and tracks their time of absence from the country. Contextualizing the various uses of border controls and the construction of membership in its authoritarian years, this article associates Taiwan's international status, Beijing's aggression and the problematic nature of membership in Taiwan with the continued exit controls on citizens. With an extensive documentary review and interviews with immigration officers, this article explores why a successfully transformed East Asian democracy continues to control the movements of its citizens.
Effect of different dosages of sodium butyrate and niacin on growth, faecal microbiota and Vitamin B metabolism in weaned piglets
Authors: Zhen Rui , Liu Chunyan , Wei Chongwan , Luo Yunyan , Hu Xuxu , Liu Gangyi , Yi Hongbo , Huang Yanna
Published: March 2022

Aims

Our study aimed to evaluate the effects of different dosages of sodium butyrate and niacin on the growth performance, faecal Vitamin B and microbiota in weaned piglets.

Methods and Results

Seventy-two weaned piglets (Duroc × Landrace × Yorkshire, age of 21 days) were randomly assigned to one of six treatments (12 pigs/treatment); the control (CT) group was administered a basal diet. The groups in which concentration ratios of sodium butyrate to niacin were 100: 1, 100: 2, 100: 4, 100: 8 and 100: 16 (BN1, BN2, BN4, BN8 and BN16) were administered a basal diet supplemented with 2000 mg kg−1 sodium butyrate and 20, 40, 80, 160 or 320 mg·kg−1 niacin. After 14-day treatment, the samples were collected. The results showed that feed conversion rate (FCR) was reduced and average daily gain (ADG) was increased in BN2 (p < 0.05). The diarrhoea index of pigs decreased with the low supplement. Additionally, compared with the CT group, other groups significantly increased (p < 0.05) the abundance of Firmicutes (BN4, phylum), Lactobacillaceae (BN8, family), Megasphaera (BN8, genus) and Lactobacillus (BN8, genus). Furthermore, the sodium butyrate and niacin supplementation influence Vitamin B1, Vitamin B2, pyridoxine, niacin, nicotinamide and Vitamin B12 (p < 0.05). Correlation analysis of the association of micro-organisms with Vitamin B indicated that changes of Vitamin B metabolism have a potential correlation with alterations of faecal microbiota in weaned piglets.

Conclusions

The results indicated that adding sodium butyrate and niacin in the diet could promote the performance and improve the faecal microbiota and Vitamin B metabolism in weaned piglets.

Significance and Impact of the Study

Our study might provide clues to the research of correlations between faecal bacteria and faecal Vitamin B, and these findings will contribute to the direction of future research in weaned piglets.
Novel encapsulation approaches for phytosterols and their importance in food products: A review
Authors: Pavani Mekala , Singha Poonam , Dash Dibya Ranjan , Asaithambi Niveditha , Singh Sushil Kumar
Published: March 2022

Phytosterols are naturally occurring plant cell membranes, which have received greater attention in food industries due to their potential health benefits especially lowering low‐density lipoprotein (LDL) cholesterol levels within the human body. However, the application of phytosterols in various foods (aqueous‐based) is challenging due to their low water solubility and poor stability resulting in poor bioavailability/bioaccessibility. The encapsulation technique is considered as an alternative approach to protect phytosterols from various factors, thus improving their bioavailability and stability. This review aims in presenting a detailed study on techniques and technologies currently employed to encapsulate phytosterols. Based on recent studies, mostly used techniques are spray drying, freeze drying, spray chilling, emulsification, liposome entrapment, extrusion, electro‐spinning, and electro‐spraying. Various processing factors affecting phytosterol stability in fortified food have been outlined as well.

Practical Applications

Phytosterols are plant‐based bioactive compounds that have been commonly linked to having anti‐diabetic, anti‐inflammatory properties and cholesterol‐lowering effects. Consumption of processed and ready‐to‐eat foods lowers the intake of plant sterols in the human diet. Additionally, their availability in plant‐based foods is also limited. Phytosterol fortified foods are now available to fulfill the phytosterol requirement in our diet. The consumption of phytosterol enriched foods or supplements can be an alternative option to lower cholesterol levels in the human body. However, phytosterols are insoluble in water which results in poor bioavailability and stability. Furthermore, the incorporation of phytosterols in food products is difficult due to the probability of oxidation at higher processing temperatures and storage. Hence, encapsulation is an alternative approach to enhance phytosterols' stability and bioavailability.
Novel framework for assessing long‐term flood risk management pathways focusing on river channel improvement and amenity policies
Authors: Tanaka Tomohiro , Yokomatsu Muneta , Ashino Masato , Ichikawa Yutaka
Published: March 2022

Many urban areas at higher flood risk owing to climate change, and mitigating these risks requires a combination of structural and nonstructural adaptation measures. Previous studies assessing adaptation measures are limited in quantifying the effects of climatic and social changes. As an interdisciplinary approach, this study developed an agent‐based model of household locational choices and combined an advanced method for deriving on‐site analytical flood risk curves (90 m resolution) to explicitly reflect the present/future flood risk on the flood insurance rate. To evaluate river channel improvements and amenity policies, the proposed framework was applied to a middle stream area of the Yodo River basin, Japan. The simulation results indicated that (1) both the design level and river pathway improvements influence the flood risk (2) developing wider areas over low‐ and no‐risk areas rather than the intensive induction to limited no‐risk areas lead to a more effective reduction in flood risk. In addition, (3) an appropriate amenity policy may contribute to the attenuation of the inequality of flood risk among regions owing to the pathway of improvement. The proposed interdisciplinary approach will help decision makers in long‐term flood risk management.
No increased risk of flare in ulcerative colitis patients in corticosteroid‐free remission after stopping 5‐aminosalicylic acid: A territory‐wide population‐based study
Authors: Mak Joyce W Y , Yuen Nobel T K , Yip Terry C F , Lam Ray H M , Lam Brian K H , Cheng Cherry T Y , Wong Grace L H , Chan Francis K L , Ng Siew C
Published: March 2022

Background and Aim

Whether 5‐aminosalicylic acid (ASA) can be stopped in patients with stable ulcerative colitis (UC) remains unclear. We aimed to examine whether 5‐ASA can be safely withdrawn in UC patients who have been in corticosteroid‐free clinical remission for ≥ 1 year.

Methods

This is a retrospective cohort study using territory‐wide healthcare database in Hong Kong. Primary outcome was development of UC flare, defined as new corticosteroid use or UC‐related hospitalizations within 5 years. UC patients on oral 5‐ASA ≥ 2 g daily for ≥ 1 year with C‐reactive protein (CRP) < 10 mg/dL and no 5‐ASA dosage escalation, UC‐related hospitalization or corticosteroid use in the past year were included. Patients on biological agents were excluded. Patients were classified as “stopping” if 5‐ASA was withdrawn for ≥ 90 days within follow‐up period. We performed multivariable Cox regression models adjusting for demographics, blood parameters and immunosuppressants used. Adjusted hazard ratio (aHR) with 95% confidence interval (CI) was reported comparing stopping and continuous‐use groups.

Results

A total of 1408 patients were included with a median follow‐up duration of 41.8 months (interquartile range [IQR]: 17.2–60.0 months). Stopping 5‐ASA was not associated with an increased risk of UC flare (aHR 0.91; 95% CI 0.64–1.31; P = 0.620). A higher CRP levels at the time of stopping 5‐ASA (aHR 1.15; 95% CI: 1.01–1.30; P = 0.037) were associated with increased risk of flare.

Conclusion

Stopping 5‐ASA in UC patients in corticosteroid‐free remission for ≥ 1 year was not associated with increased risk of flare. Future prospective trials should evaluate the role of stopping 5‐ASA in stable UC patients.
Building connection and improving health for Indigenous elders: Findings from the Title VI evaluation
Authors: Clarke Gretchen S. , Douglas Elizabeth B. , Campos Sofia , House Marnie J. , Vaughn Elizabeth E. , Hudgins Kristen E. G.
Published: March 2022

Background

As the older Indigenous population in the United States expands, there is a growing demand for programs to address age‐related needs. Although Title VI of the OAA provides culturally responsive strategies to support elders through home‐ and community‐based nutrition services, these programs have not been the subject of a national evaluation; our study is the first.

Methods

We conducted a mixed‐methods study to assess the impact of the Title VI programs on elders. We used quantitative data from a national survey of Indigenous elders (n = 1175) and qualitative data collected through interviews (n = 36) and focus groups (18, n = 161) with a subgroup of elders receiving services. We compared outcomes for social and cultural connectedness and physical and mental well‐being for different subgroups within our sample of elders based on elders' use of Title VI services and the level of services provided to these elders. Results were adjusted for community characteristics.

Results

Elders receiving Title VI services had significantly fewer hospitalizations and falls per year (hospitalizations: 0.9 vs. 1.2, p < 0.05; falls: 1.0 versus 1.1, p < 0.05) and significantly more social and cultural engagements per month (social engagements: 92.6% vs. 75.6%, p < 0.05; cultural practices: 78.8% vs. 64.8%, p < 0.05) compared with elders who did not participate in Title VI services. These findings were confirmed by our qualitative data.

Conclusions

Our findings highlight the vital role that the Title VI program plays in promoting elders' overall health and well‐being through decreased hospitalizations and falls and increased connectedness.
Qualifying Violence: Visible Data, Invisible Lives in Recife, Brazil
Authors: Haynes Marta‐Laura
Published: March 2022

This article brings attention to the rise of digital computing in policing in Brazil, where new technologies have been integrated into the criminal justice apparatus to surveil, manage, and police criminalized communities. I examine a reformist public policy called the Pacto pela Vida (Pact for Life) in Recife and foreground the process of collecting and interpreting data at crime scenes as a means by which to analyze how criminality is understood and conceptualized. Drawing on extensive ethnographic research, I explore how data collected by the police link racial identifiers, places, and different types of offenses. Hence, I argue that the Pacto governmentality infers a preexisting logic of power and control over the Black poor using new technologies and policing models mainly imported from the United States. When police collect data at crime scenes and categorize it according to provided standards, the sociocultural context in which events occur become invisible.
Double‐Layer Masking of Suffering After Pregnancy Loss: A Grounded Theory Study from a Male Perspective
Authors: Fernández‐Basanta Sara , Coronado Carmen , Movilla‐Fernández María‐Jesús
Published: March 2022

Introduction

Men can express different responses after pregnancy loss. This loss can interfere with their expectation of parenthood, new life, and future hopes. Expectations from the social construction of gender can encourage them to maintain an image that contradicts their actual feelings. This can lead to isolation, distancing, and difficulties in seeking support. The scarcity and low representation of men in previous studies makes research that captures the complexity of their experience necessary. The aim of this study was to explore how men confront the suffering caused by pregnancy loss.

Methods

This study is part of a larger research project focusing on the experiences of parents and midwives following pregnancy loss. In this study, 22 cisgender and white heterosexual men who experienced pregnancy losses participated in semistructured interviews. Data were analyzed iteratively using constructivist grounded theory methods.

Results

The substantive theory of double‐layer masking of suffering emerged as way to explain the confrontation of suffering after pregnancy loss from the male perspective. The themes, (1) suffering beyond physical loss, (2) rationalization in the search for meaning, and (3) keeping a façade with others, show the impact that this loss had on men, which was masked by the meaning they gave to the situation and by its social expression.

Discussion

The findings provide a theoretical conceptualization of the masking these men use to deal with the suffering they experienced from this situation. These aspects provide reasons for including these individuals in the assistance given by midwives after a pregnancy loss. Collaboration between specialized and primary care, along with staff training and support, is necessary for the provision of couple‐centered care after pregnancy loss.