bluuebunny/crossref_metadata_2025 huggingface dataset:
Rituximab on lung, skin, and joint involvement in patients with systemic sclerosis: A case series study and review of the literature
Authors: Yarkan Tuğsal Handan , Zengin Berrin , Kenar Gökçe , Önen Fatoş , Birlik Merih
Published: May 2022

Objectives

To evaluate the effectiveness of rituximab (RTX) in systemic sclerosis (SSc) patients.

Methods

Data were collected from patient charts before and after RTX administration for 1 year of follow‐up time. An updated review of the literature was also done.

Results

Of 8 patients enrolled (mean age: 62.4 years; mean disease duration: 16.7 years), 2 patients with pulmonary arterial hypertension (PAH) died after the first RTX cycle. The follow‐up data of the remaining 6 patients were evaluated. There was a significant improvement in arthritis of Disease Activity Score of 28 joints – C‐reactive protein and Clinical Disease Activity Index compared with baseline. The median change in modified Rodnan Skin Score (mRSS), forced vital capacity (FVC), and carbon monoxide diffusing capacity between baseline and 12 months were similar. Lung involvement was detected in 5/6 of survivor patients, FVC was improved in 2/5, worsened in 1/5, and remained stable in 2/5 at the end of 1 year. Among the 5 diffuse cutaneous SSc patients, none of the patients’ mRSS deteriorated by more than 5 points, while one patient's mRSS improved by greater than 5 points.

Conclusion

This study suggests that RTX is effective for arthritis in patients with SSc. Also, the effectiveness of RTX in skin and lung involvement of SSc was predominantly toward stable disease or improvement. Despite the long disease duration, the presence of patients who showed improvement in skin and lung involvement after RTX treatment suggests the need to investigate predictors of RTX response.
Should platforms be allowed to sell on their own marketplaces?
Authors: Hagiu Andrei , Teh Tat‐How , Wright Julian
Published: May 2022

A growing number of digital platforms operate in a dual mode: running marketplaces for third‐party products, while selling their own products on those marketplaces. We build a model to explore the implications of this controversial practice. We analyze the tradeoffs that arise from a regulatory ban on the dual mode, showing how such a ban can harm consumer surplus and welfare even when the platform would otherwise engage in product imitation and self‐preferencing. In the empirically most relevant scenarios, policies that prevent platform imitation and self‐preferencing generate better outcomes than an outright ban on the dual mode.
Ineffective health management in people with hypertension: Accuracy study
Authors: da Silva Ricardo Costa , de Lima Nathália Xavier , Lopes Marcos Venícios de Oliveira , da Silva Viviane Martins , Cavalcante Agueda Maria Ruiz Zimmer
Published: May 2022

Purpose

To analyze the accuracy of the clinical indicators of the nursing diagnosis Ineffective Health Management in people with hypertension.

Methods

This is a cross‐sectional diagnostic accuracy study. The ineffective health management was investigated in 120 people with hypertension in a referral public outpatient clinic in Brazil between August and November 2020. The accuracy measures were analyzed using Rasch analysis, considering the difficulty of clinical indicator and person's ability.

Results

Ineffective health management is probably present in 37.5% of people with hypertension. ‘Failure to include treatment regimen in daily living’ was the clinical indicator with the highest sensitivity value, and ‘failure to take action to reduce risk factor’ had the highest specificity value.

Conclusions

Rasch analysis demonstrated that all clinical indicators contribute significantly to estimating the presence of ineffective health management in people with hypertension in the outpatient scenario.

Implications for Nursing Practice

This research contributes by providing accurate clinical indicators of ineffective health management, helping nurses prescribe and deliver the appropriate nursing interventions for people with hypertension by telenursing.
Can mild cognitive impairment and Alzheimer’s disease be diagnosed by monitoring a miRNA triad in the blood?
Authors: Wei Zhuang‐Yao D. , Shetty Ashok K.
Published: May 2022

Objectively diagnosing age‐related cognitive impairment (ACI), mild cognitive impairment (MCI), and early‐stage Alzheimer's disease (AD) is a difficult task, as most cognitive impairment is clinically established via questionnaires, history, and physical examinations. A recent study has suggested that monitoring a miRNA triad, miR‐181a‐5p, miR‐146a‐5p, and miR‐148a‐3p can identify ACI and its progression to MCI and AD (Islam et al., EMBO Mol Med. 13: e14997, 2021). This commentary deliberates findings from this article, such as elevated levels of the miRNA triad in the brain impairing neural plasticity and cognitive function, the efficiency of measuring the miRNA triad in the circulating blood diagnosing MCI and AD, and the promise for improving cognitive function in MCI and AD by inhibiting this miRNA triad. Additional studies required prior to employing this miRNA triad in clinical practice are also discussed.
Phylogenetic community structure and stable isotope analysis of the parasitoid community associated with Eastern spruce budworm,Choristoneura fumiferana(Lepidoptera: Tortricidae)
Authors: Greyson‐Gaito Christopher J. , Dolson Sarah J. , Forbes Glen , Lamb Rosanna , MacKinnon Wayne E. , McCann Kevin S. , Smith M. Alex , Eveleigh Eldon S.
Published: May 2022

Eastern spruce budworm,Choristoneura fumiferanaClemens (Lepidoptera: Tortricidae), is a major pest of eastern North American forests. Outbreaks of spruce budworm occur every 30–40 years, causing high tree mortality.

Researchers have established that higher proportions of hardwood trees within stands (higher hardwood content) may reduce the defoliation and mortality of balsam fir and spruces during spruce budworm outbreaks. One mechanism posited to explain these patterns is that hardwood trees positively impact the parasitoids of spruce budworm. Indeed, parasitism of spruce budworm by parasitoids has been found to be impacted by hardwood content. However, more research is needed to understand how hardwood content impacts the parasitoid community as a whole.

In this study, we trialled the use of two analyses, phylogenetic community structure and stable isotope analysis, to examine how hardwood content influenced the parasitoid community associated with spruce budworm.

We found that phylogenetic community structure differed between forest stands with different hardwood content. Furthermore, the trophic relationships between several parasitoids and caterpillars on balsam fir or hardwood trees changed within and between years.

Our study highlights the potential of these two analyses for understanding how hardwood content influences the parasitoid community associated with spruce budworm.
Canopy cover and seasonality are associated with variation in native bee assemblages across a mixed pine‐juniper woodland
Authors: Davis Thomas Seth , Comai Nathan
Published: May 2022

Pollinator community responses to changing conditions are a concern for ecosystem managers, but it remains poorly understood how shifts in forest structure impact pollinators across small scales. To address this, bee assemblages were sampled in arid woodland habitat in the southwestern United States (Colorado) to evaluate effects of canopy cover and seasonality on bee diversity and composition.

>2500 specimens were captured representing 5 families and 30 genera. Bee composition shifted seasonally; early‐season assemblages were predominated by Halictidae (Lasioglossum and Halictus); late‐season assemblages were predominated by Apidae.

More bees were captured in canopy gaps early‐season, but differences due to canopy openness declined by late‐season. Bee diversity was higher in open‐canopy sites and bee assemblage composition varied across canopy openness.

Low cover was positively associated with large‐bodied bees and negatively associated with solitary, polylectic ground‐nesting bees. Parasitic bee taxa were more abundant when the canopy was composed of pinyon pine; ponderosa pine‐dominant canopies were associated with large‐bodied bees with variable nesting habits.

We conclude that canopy cover and seasonality both predict abundance and diversity of bee assemblages in arid woodlands, and bee functional traits are responsive to canopy cover and dominant overstory species across small spatial scales.
Averting neonatal abstinence syndrome and treating addiction among rural, opioid‐using young women
Authors: Cooper Robert L. , Crosby Richard A. , Martin Peter R. , Edgerton Ryan
Published: May 2022

Background and Objectives

America's opioid epidemic has spawned an epidemic of neonatal abstinence syndrome (NAS). Studies have not tested approaches to promoting contraceptive services for women with opioid use disorder (OUD) along with treatment for this disorder. This pilot study examined the promotion of medication for OUD (MOUD) treatment and contraception use, primarily long‐acting reversible contraception (LARC), for women with OUD.

Methods

In Appalachia, a peer‐delivered contraception and MOUD promotion intervention was delivered to a sample of 30 women with OUD. Primary outcomes were attendance of initial appointments to receive MOUD and counseling about contraceptive options. Peer recovery coaches also offered to help the women schedule appointments and attend the appointment with them or give them a ride if necessary and requested by the patients.

Results

Two‐thirds experienced all seven symptoms of opioid dependence. Within 30 days of a brief counseling session, over one‐half of the women (56.7%) were referred to MOUD, with all of them initiating treatment within 30 days. Just under one‐half of the women (46.7%) were referred to a contraception consultation, with 85.7% of those receiving a LARC implant.

Discussions and Conclusions

Study findings indicate the potential efficacy of a single‐session, peer‐delivered counseling intervention for linking women with OUD and at high risk of unintended pregnancy to MOUD and to services that provide women with highly reliable contraceptives.

Scientific Significance

This study is unique in exploring the efficacy of linking high‐risk opioid‐using women to contraceptive options and treatment for MOUD to prevent NAS.
Is empathy associated with more prosocial behaviour? A meta‐analysis
Authors: Yin Yingying , Wang Yong
Published: May 2022

Empathy is an important prerequisite for prosocial behaviour (PB). However, different concepts and methodological tools have been used in research on the relationship between empathy and PB, leading to ambiguous results. This study used a meta‐analysis to explore this relationship and to identify the moderating variables. After a literature search, 62 studies and 146 samples with 71,310 participants were included. Our random effects model revealed a positive correlation of PB with both cognitive empathy (r = .32) and affective empathy (r = .30). In addition, the relationship between empathy and PB is moderated by culture, publication type, education level, and empathy measures. Our conclusion is that there is a significant correlation between empathy and PB that is influenced by sample characteristics and methodological factors.
Group representation concerns and network formation
Authors: Melguizo Isabel
Published: May 2022

This paper studies processes of integration and segregation using a connections model in which individuals form valuable links that also entail a cost. Individuals belong to two different groups and care about whether their own group represents a sufficient fraction in their neighborhood. Concerns for representation promote the segregation of societies as even for small linking costs individuals do not link to different others because of the threat that their group becomes under‐represented. For certain cost ranges, concerns for representation also determine efficient networks because forming links with members of the opposite group entails a utility loss due to under‐representation.
Growth arrest‐specific transcript 5 represses endometrial cancer development by promoting antitumor function of tumor‐associated macrophages
Authors: Tu Jiajie , Tan Xuewen , Chen Yu , Chen Yu , Li Zhe , Zhang Yuanyuan , Chen Xiaochun , Yang Huan , Chen He , Yu Zhiying
Published: May 2022

The tumor‐suppressor role of long noncoding RNA (lncRNA) growth arrest‐specific transcript 5 (GAS5) has been proven in various types of cancer. However, the specific function of GAS5 in tumor‐associated macrophages (TAMs) of endometrial cancer (EC) is elusive. Quantitative PCR results showed that GAS5 expression decreased in EC tissues and primary TAMs from EC tumors. Tumor‐associated macrophage infiltration was significantly positively associated with the developmental stage of EC. Direct coculture of GAS5‐overexpressing TAMs and EC cells showed that GAS5 enhanced phagocytosis, antigen presentation, and activation of cytotoxic T cells, and repressed “Don’t eat me” signals between TAMs and EC cells. Tumor formation in immunodeficient mice showed that GAS5‐overexpressing macrophages could repress EC formation in vivo. GAS5 promoted M1 polarization by activating the microRNA‐21– phosphatase and tensin homolog (PTEN)–AKT signaling pathway and directly repressing the nuclear accumulation and phosphorylation of oncogenic yes‐associated protein 1 (YAP1) in TAMs. GAS5 inhibited the development of EC from both innate and adaptive immunity by transforming TAMs from a protumor to an antitumor phenotype. These antitumor effects of GAS5 on TAMs were mediated by the activation of the miR‐21‐PTEN‐AKT pathway and inhibition of YAP1.
Comparison of the accuracy of two different dynamic navigation system registration methods for dental implant placement: A retrospective study
Authors: Ma Feifei , Sun Feng , Wei Tai , Ma Yu
Published: May 2022

Background

Dynamic navigation approaches are widely employed in the context of implant placement surgery, with registration being integral to the accuracy of such navigation. Relatively few studies to date, however, have compared different registration approaches, and such a comparison has the potential to guide the development of more accurate and reliable clinical registration methodology.

Purpose

This study was developed to compare the accuracy of dynamic navigation‐based dental implant placement conducted using either U‐tube or cusp registration methods.

Materials and Methods

Medical records from all patients that had undergone implant surgery between August 2019 and October 2020 in the First Clinical Division of the Peking University Hospital of Stomatology were retrospectively reviewed, with 64 patients and 99 implants ultimately meeting with study inclusion criteria. Implant placement accuracy was gauged via the superimposition of the planned implant position in preoperative cone‐beam computed tomography (CBCT) images with the true postoperative implant position in postoperative CBCT images. Accuracy was measured based upon the angular deviation, entry deviation (3‐dimensional [3D] deviation in the coronal aspect of the alveolar ridge), and apex deviation (3D deviation in the apical area of the implant) when comparing these two positions.

Results

The angular deviation, entry deviation, and apex deviation of all analyzed implants were 3.29 ± 0.17°, 1.29 ± 0.07 mm, and 1.43 ± 0.08 mm, respectively, while in the cusp registration group these respective values were 3.25 ± 1.58°, 1.28 ± 0.60 mm, and 1.34 ± 0.63 mm as compared to 3.35 ± 1.78°, 1.30 ± 0.78 mm, 1.55 ± 0.9 mm in the U‐tube group, respectively. No significant differences in accuracy were observed when comparing these two registration techniques.

Conclusion

Dynamic computer‐assisted surgical systems can facilitate accurate implantation, and both the U‐tube and cusp registration methods exhibit similar levels of accuracy. As the cusp registration technique can overcome some of the limitations of the U‐tube strategy without the need for an additional registration device, it may be more convenient for clinical use and warrants further research.
Acute urinary retention and urinary tract infection after short‐course urinary drainage in colon or high rectum anastomoses: Post hoc analysis of a multicentre prospective database from the GRACE group
Authors: Venara Aurélien , Hamel Jean François , Régimbeau Jean‐Marc , Gillet Julien , Joris Jean , Cotte Eddy , Slim Karem ,   the GRACE group
Published: May 2022

Aim

The aim was to define the risk factors for acute urinary retention (AUR) and urinary tract infections (UTIs) in colon or high rectum anastomosis patients based on the absence of a urinary catheter (UC) or the early removal of the UC (<24 h).

Method

This is a multicentre, international retrospective analysis of a prospective database including all patients undergoing colon or high rectum anastomoses. Patients were part of the enhanced recovery programme audit, developed by the Francophone Group for Enhanced Recovery after Surgery, and were included if no UC was inserted or if a UC was inserted for <24 h.

Results

In all, 9389 patients had colon or high rectum anastomoses using laparoscopy, open surgery or robotic surgery. Among these patients, 4048 were excluded because the UC was left in place >24 h (43.1%) and 97 were excluded because the management of UC was unknown (1%). Among the 5244 colon or high rectum anastomoses patients included, AUR occurred in 5.2% and UTI occurred in 0.7%. UCs were in place for <24 h in 2765 patients (52.7%) and 2479 did not have UCs in place (47.3%). Multivariate analysis showed that management of the UC was not significantly associated with the occurrence of AUR and that risk factors for AUR were male gender, ≥65 years old, having an American Society of Anesthesiologists score ≥3 and receiving epidural analgesia. Conversely, being of male gender was a protective factor of UTI, while being ≥65 years old, having open surgery and receiving epidural analgesia were risk factors for UTIs. The management of the UC was not significantly associated with the occurrence of UTIs but the occurrence of AUR was a more significant risk factor for UTIs.

Conclusion

UCs in place for <24 h did not reduce the occurrence of AUR or UTI compared to the absence of UCs.
Ginsenoside Rh2 mitigates doxorubicin‐induced cardiotoxicity by inhibiting apoptotic and inflammatory damage and weakening pathological remodelling in breast cancer‐bearing mice
Authors: Hou Jingang , Yun Yeejin , Cui Changhao , Kim Sunchang
Published: May 2022

Objectives

There are presently a few viable ways to reduce cardiotoxicity of doxorubicin (Dox). The combination of chemotherapy agents with natural compounds delivers greater efficacy and reduces adverse effects in recent researches for cancer treatment. Here, we examined the potential effect of ginsenoside Rh2 on a Dox‐based regimen in chemotherapy treatment.

Materials and Methods

Human breast tumour (MDA‐MB‐231) xenograft nude mice, human cardiac ventricle fibroblasts, and human umbilical vein endothelial cells (HUVEC) were employed in the present study. Histology, immunohistochemistry, immunofluorescence, western blot, antibody array, and RNA‐sequencing analyses were utilized to assess the protective effect of Rh2 on cardiotoxicity induced by Dox and the underlying mechanisms.

Results

Rh2‐reduced cardiotoxicity by inhibiting the cardiac histopathological changes, apoptosis and necrosis, and consequent inflammation. Pathological remodelling was attenuated by reducing fibroblast to myofibroblast transition (FMT) and endothelial–mesenchymal transition (EndMT) in hearts. RNA‐sequencing analysis showed that Dox treatment predominantly targets cell cycle and attachment of microtubules and boosted tumour necrosis, chemokine and interferon‐gamma production, response to cytokine and chemokine, and T cell activation, whereas Rh2 regulated these effects. Intriguingly, Rh2 also attenuated fibrosis via promoting senescence in myofibroblasts and reversing established myofibroblast differentiation in EndMT.

Conclusions

Rh2 regulates multiple pathways in the Dox‐provoked heart, proposing a potential candidate for cancer supplement and therapy‐associated cardiotoxicity.
Consistent signals of a warming climate in occupancy changes of three insect taxa over 40 years in central Europe
Authors: Engelhardt Eva Katharina , Biber Matthias F. , Dolek Matthias , Fartmann Thomas , Hochkirch Axel , Leidinger Jan , Löffler Franz , Pinkert Stefan , Poniatowski Dominik , Voith Johannes , Winterholler Michael , Zeuss Dirk , Bowler Diana E. , Hof Christian
Published: May 2022

Recent climate and land‐use changes are having substantial impacts on biodiversity, including population declines, range shifts, and changes in community composition. However, few studies have compared these impacts among multiple taxa, particularly because of a lack of standardized time series data over long periods. Existing data sets are typically of low resolution or poor coverage, both spatially and temporally, thereby limiting the inferences that can be drawn from such studies. Here, we compare climate and land‐use driven occupancy changes in butterflies, grasshoppers, and dragonflies using an extensive data set of highly heterogeneous observation data collected in the central European region of Bavaria (Germany) over a 40‐year period. Using occupancy models, we find occupancies (the proportion of sites occupied by a species in each year) of 37% of species have decreased, 30% have increased and 33% showed no significant trend. Butterflies and grasshoppers show strongest declines with 41% of species each. By contrast, 52% of dragonfly species increased. Temperature preference and habitat specificity appear as significant drivers of species trends. We show that cold‐adapted species across all taxa have declined, whereas warm‐adapted species have increased. In butterflies, habitat specialists have decreased, while generalists increased or remained stable. The trends of habitat generalists and specialists both in grasshoppers and semi‐aquatic dragonflies, however did not differ. Our findings indicate strong and consistent effects of climate warming across insect taxa. The decrease of butterfly specialists could hint towards a threat from land‐use change, as especially butterfly specialists' occurrence depends mostly on habitat quality and area. Our study not only illustrates how these taxa showed differing trends in the past but also provides hints on how we might mitigate the detrimental effects of human development on their diversity in the future.
Lulu's Smile: An Archive of Trauma in Die Büchse der Pandora (1929)
Authors: Schwebel Shoshana
Published: May 2022

This article focuses on Lulu, the protagonist of G. W. Pabst's 1929 film Die Büchse der Pandora, and argues that her frequent smiles are a post‐traumatic affect. From the little information that the audience is given about Lulu, it can be deduced that she is a survivor of sex trafficking. Lulu's smile, with its incongruity and automatic nature, is where her past becomes most legible. I read Lulu's smiles throughout the film as an archive of trauma, as conceptualized by scholars from queer studies and Black studies such as Ann Cvetkovich, Christina Sharpe, and Saidiya Hartman. While Weimar film scholarship often considers Lulu as a femme fatale or a Neue Frau, her implicitly traumatic past is seldom addressed, let alone read as a central trait of her character. This article presents a new reading of Lulu in relation to trauma studies.
ADAMTS‐4 as a possible distinguishing indicator between osteoarthritis and haemophilic arthropathy
Authors: Kalebota Natasa , Salai Grgur , Peric Porin , Hrkac Stela , Novak Rudjer , Durmis Kristina Kovac , Grgurevic Lovorka
Published: May 2022

Introduction

Osteoarthritis (OA) and haemophilic arthropathy (HA) are clinically similar, but pathologically distinct conditions which result in joint pain and loss of function. Distinguishing their disease mechanisms is therefore a key step in the development of curative therapy, as opposed to current symptomatic treatments. A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS) 4 is a metzincin‐family member proteoglycan with known local involvement in OA pathogenesis.

Aim

To investigate the potential differences and discriminatory potential of ADAMTS‐4 between OA and HA patients.

Methods

We determined ADAMTS‐4 plasma concentrations by ELISA in patients with HA and OA. This pilot cross‐sectional study included N = 40 male participants equally divided across four subgroups: haemophilia patients with severe or mild HA and control subjects with severe or mild/no OA.

Results

Our study showed a striking elevation in plasma ADAMTS‐4 expression levels in HA patients as compared to OA, as well as an increase in patients with severe as compared to mild HA. By performing the binomial logistical analysis and fitting the receiver–operator curve (ROC) (cut‐off probability .5), ADAMTS‐4 had a sensitivity of 95% and specificity of 50% in discriminating between HA and OA among our study participants.

Conclusion

Uncovering the marked differences in plasma levels of ADAMTS‐4 in patients with HA versus OA potentially sheds new light on the mechanisms of HA pathogenesis and could foster more research into the roles ADAMTS‐4 and other matrix metalloproteinases (MMPs) play in HA versus OA.
Increased multimorbidity is associated with impaired cerebral and peripheral hemodynamic stabilization during active standing
Authors: Pérez‐Denia Laura , Claffey Paul , Byrne Lisa , Rice Ciara , Kenny Rose Anne , Finucane Ciarán
Published: May 2022

Background

Age‐related morbidities and frailty are associated with impaired blood pressure (BP) and heart rate (HR) recovery after standing. Here we investigate how multimorbidity affects cerebral and peripheral hemodynamics during standing in a large sample of older patients.

Methods

Patients were recruited from a national Falls and Syncope Unit. They underwent an active stand test (5–10 min lying +3 min standing) with monitoring of continuous BP, HR, total peripheral resistance (TPR), stroke volume (SV), and a near‐infrared spectroscopy (NIRS) derived cerebral tissue saturation index (TSI). A multimorbidity count was derived from a 26‐item list of conditions. Features derived from the signals included: nadir, overshoot, value at 30 s, steady‐state and recovery rate. Robust linear regression was used to assess the association between multimorbidity, TSI and peripheral hemodynamics while correcting for covariates. A p‐value <0.05 was considered statistically significant.

Results

Multimorbidity was associated with poorer recovery of TSI at 30 s after standing (β: −0.15, CI:[−0.25–0.06], p = 0.009) independent of all peripheral hemodynamics. Impaired diastolic BP (DBP) recovery at 30s (β:−1.34, CI:[−2.29–0.40], p = 0.032), DBP steady‐state (β:−1.18, CI:[−2.04–0.32], p = 0.032), TPR overshoot‐to‐nadir difference (β:−0.041, CI:[−0.070–0.013], p = 0.045), and SV at 30s (β:1.30, CI:[0.45 2.15], p = 0.027) were also associated with increasing multimorbidity. After sex stratification, only females demonstrated impaired TSI with multimorbidity at overshoot (β: −0.19, CI: [−0.32 ‐0.07], p = 0.009), 30 s (β: −0.22 [−0.35–0.10], p = 0.005) and steady‐state (β: −0.20, CI:[−0.35–0.04], p = 0.023), independent of peripheral hemodynamics.

Conclusions

Transient cerebral oxygenation and peripheral hemodynamic responses are impaired with multimorbidity (frailty) in older patients, particularly in females. This study demonstrates the feasibility of using NIRS in this clinical context and may inform the development of clinical management strategies targeting both cerebral oxygenation and blood pressure impairments in patients with faints and falls.
Effect of educational interventions on level of epilepsy knowledge in children with epilepsy and parents: Systematic review and meta‐analysis
Authors: Turan Fatma D. , Yangöz Şefika T.
Published: May 2022

Aim and Objectives

The aim of the study was to synthesise the effect of educational interventions on the level of epilepsy knowledge in children with epilepsy and parents.

Background

Educational interventions are commonly used to provide knowledge about epilepsy management. One of the most important responsibilities of nurses is to inform children with epilepsy and parents in a skilful way.

Design

Systematic review and meta‐analysis based on PRISMA 2020.

Methods

We searched CINAHL, Cochrane Library, Science Direct, Web of Science, Ovid, PubMed, Scopus, Springer Link, ProQuest, TR Index ending March 2021. The review followed the PRISMA guidelines. This meta‐analysis was analysed in Comprehensive Meta‐Analysis version 3 software. The risk of bias of included studies was assessed with the Cochrane handbook. The results were the level of epilepsy knowledge of children and parents.

Results

Ten studies meeting the inclusion criteria were included in this meta‐analysis, including four randomised studies and six non‐randomised studies. Educational interventions had large effect on improving the level of epilepsy knowledge in children with epilepsy (p < .001, Hedge's g = 1.19) and parents (p < .001, Hedge's g = 1.41). As a result of the subgroup analyses, significant differences were found only in the type of educational intervention. It was found that traditional education is more effective than technology‐based education in improving the level of epilepsy knowledge in parents (p = .005, Hedge's g = 1.77).

Conclusion

Educational interventions have high and beneficial effect on the level of epilepsy knowledge in the children with epilepsy and parents; can be used as effective interventions in the epilepsy management. However, due to low number of randomised controlled studies, further high‐quality randomised controlled studies are needed about this topic.

Relevance to clinical practice

The findings will contribute to the use of educational interventions in the epilepsy management for health professionals, especially nurses. Thus these interventions will contribute to improving epilepsy management of children with epilepsy and parents.
Ruminal responses, digestibility, and blood parameters of beef cattle fed diets without forage with different hybrids and processing of the corn
Authors: da Mata Débora G. , Ítavo Luís C. V. , Ferreira Ítavo Camila C. B. , Ferreira João D. de Jesus , Paulino Pedro V. R. , de Moraes Gabriella J. , Niwa Marcus V. G. , Kozerski Noemila D. , Leal Eduardo S. , Mioto da Costa Marlova C.
Published: May 2022

The objective of this study was to evaluate the effects of corn hybrid and processing methods on intake and digestibility of nutrients, rumen fermentation and blood metabolites of steers fed no‐forage finishing diets. Four ruminally fistulated Nellore castrated steers (502 ± 15 kg initial body weight) were distributed in a 4 × 4 Latin square design with a 2 × 2 factorial arrangement consisting of two corn hybrids (semi‐dent and flint) and two processing methods (dry milled and high moisture grain). Interactions of hybrid and processing methods were observed on intake of dry matter (DM), organic matter (OM) and crude protein (CP), as well as on digestibility of DM and CP, rumen pH and ammonia nitrogen (N‐NH3). There was no interaction between hybrid and processing for the volatile fatty acids (VFA) total, acetate (C2), propionate (C3), isobutyric (iC4) and valeric (nC5) concentrations. VFA total concentration shown an average of 103.4 mmol/L. The C2 and C3 concentrations had no effect of the hybrid or processing with averages of 58.7 mmol/L for C2, and 31.3 mmol/l for C3. There was an effect of the processing method on starch consumption and fecal pH, the highest values were observed in grains with high moisture content. Starch digestibility was 0.89 g/g in dry milled and 0.96 g/g in high moisture corn. The greatest digestibility of starch in high moisture corn, irrespective of the corn hybrid, provided evidence of an increase in the energy supply, which may improve the feed efficiency and growth performance of cattle fed no‐roughage finishing diets.
Safety of oral afoxolaner formulated with or without milbemycin oxime in homozygousMDR1‐deficient collie dogs
Authors: Drag Marlene , Tielemans Eric , Mitchell Elizabeth
Published: May 2022

Afoxolaner, an insecticide and acaricide compound of the isoxazoline class, is available for dogs as an oral ectoparasiticide medicine (NexGard®) and as an oral endectoparasiticide medicine in combination with milbemycin oxime (MO), a macrocyclic lactone (NexGard® Spectra). The safety of these two compounds, alone or in combination, was investigated in homozygous MDR1‐deficient collie dogs, in two studies. Overall, 30 adult collie dogs were treated once orally, 9 with a placebo, 9 with afoxolaner, 6 with MO, and 6 with a combination of afoxolaner and MO. For afoxolaner, the mean investigated dosage corresponded to 3.8 and 4.7 multiples of the maximum recommended therapeutic doses (RTD) in NexGard® and NexGard® Spectra, respectively. For MO, the mean investigated dosage corresponded to 4.7 multiples of the maximum RTD in NexGard® Spectra. Dogs were closely monitored for adverse reactions on the day of treatment and for the following two days. No significant adverse reaction was observed in any dog from the afoxolaner or the afoxolaner + MO groups; in the MO‐only treated group, mild and transient neurological signs were observed during the 4–8 h post‐treatment window. These studies demonstrated a high level of safety of oral afoxolaner, alone or in combination with milbemycin oxime, in homozygous MDR1‐deficient dogs.
The UvrA‐like protein Ecm16 requires ATPase activity to render resistance against echinomycin
Authors: Erlandson Amanda , Gade Priyanka , Menikpurage Inoka P. , Kim Chu‐Young , Mera Paola E.
Published: May 2022

Bacteria use various strategies to become antibiotic resistant. The molecular details of these strategies are not fully understood. We can increase our understanding by investigating the same strategies found in antibiotic‐producing bacteria. In this work, we characterize the self‐resistance protein Ecm16 encoded by echinomycin‐producing bacteria. Ecm16 is a structural homolog of the nucleotide excision repair protein UvrA. Expression of ecm16 in the heterologous system Escherichia coli was sufficient to render resistance against echinomycin. Ecm16 binds DNA (double‐stranded and single‐stranded) using a nucleotide‐independent binding mode. Ecm16’s binding affinity for DNA increased by 1.7‐fold when the DNA is intercalated with echinomycin. Ecm16 can render resistance against echinomycin toxicity independently of the nucleotide excision repair system. Similar to UvrA, Ecm16 has ATPase activity, and this activity is essential for Ecm16’s ability to render echinomycin resistance. Notably, UvrA and Ecm16 were unable to complement each other's function. Together, our findings identify new mechanistic details of how a refurbished DNA repair protein Ecm16 can specifically render resistance to the DNA intercalator echinomycin.
Biodiversity for resilience—What is needed for allergic children
Authors: Haahtela Tari
Published: May 2022

What is needed for our children facing unprecedented challenges of modern time? Biodiversity, both for immunological and psychological well‐being and resilience. That is also the keyword for the children with allergies and asthma. The cultural evolution with advanced technology and medicine along with major move to urban environment has profoundly changed our lifestyle and surroundings. We are increasingly disconnected from our evolutionary home, soil, natural waters, and air we used to breathe. The ecosystem of human body and mind has been tested, survived, and evolved closely in relation with other ecosystems. For balance and tolerance, immune regulatory circuits need training by microbes, biogenic chemicals, and close relation to natural environment throughout life. This is addressed by the biodiversity hypothesis of tolerance/resilience for health, supported by the pioneering real‐world interventions and a few controlled studies. No need to go “back to nature,” but we must take natural elements back to our everyday life to breathe, eat, drink, and touch. The change for better is plausible and cost‐effective, as shown by the Finnish and other European initiatives, but needs contribution of the whole society.
Genetic variation in CaTIFY4b contributes to drought adaptation in chickpea
Authors: Barmukh Rutwik , Roorkiwal Manish , Garg Vanika , Khan Aamir W. , German Liam , Jaganathan Deepa , Chitikineni Annapurna , Kholova Jana , Kudapa Himabindu , Sivasakthi Kaliamoorthy , Samineni Srinivasan , Kale Sandip M. , Gaur Pooran M. , Sagurthi Someswar Rao , Benitez‐Alfonso Yoselin , Varshney Rajeev K.
Published: May 2022

Chickpea production is vulnerable to drought stress. Identifying the genetic components underlying drought adaptation is crucial for enhancing chickpea productivity. Here, we present the fine mapping and characterization of ‘QTL‐hotspot’, a genomic region controlling chickpea growth with positive consequences on crop production under drought. We report that a non‐synonymous substitution in the transcription factor CaTIFY4b regulates seed weight and organ size in chickpea. Ectopic expression of CaTIFY4b in Medicago truncatula enhances root growth under water deficit. Our results suggest that allelic variation in ‘QTL‐hotspot’ improves pre‐anthesis water use, transpiration efficiency, root architecture and canopy development, enabling high‐yield performance under terminal drought conditions. Gene expression analysis indicated that CaTIFY4b may regulate organ size under water deficit by modulating the expression of GRF‐INTERACTING FACTOR1 (GIF1), a transcriptional co‐activator of Growth‐Regulating Factors. Taken together, our study offers new insights into the role of CaTIFY4b and on diverse physiological and molecular mechanisms underpinning chickpea growth and production under specific drought scenarios.
The irony of Confucius
Authors: Amarantidou Dimitra
Published: May 2022

In this article, I present different readings of Confucius's irony in theAnalects(orLunyu論語) and expand on the implications of irony for how we perceive Confucius. Scholars who have appreciated the irony of Confucius tend to see it as distinctive of an unsagely, everyday man, often juxtaposed to the dominant image of the Master as a hyperserious sage. Moreover, irony is considered a pedagogical tool. These readings mainly recognizeverbal irony(Confucius means the opposite of what he says). I discuss a second type of irony:complex irony(Confucius both means and does not mean what he says). I argue that sageliness is not incompatible with irony, and further propose that complex irony can be found beyond the sentence level; it can be the feature of the relation between specific sayings. Adapting to his interlocutors' diverse personalities and needs, and to a constantly changing world, Confucius sometimes provides different and even conflicting answers to the same questions, based on contextual appropriateness. Each answer is meant to be taken literally and fits one concrete situation. The same answer, however, can be simultaneously ineffective or even dangerous in another albeit seemingly similar context. Thus Confucius sometimes both means what he says and does not mean it in an absolute sense.
Treating people where they are: Nurse‐led micro‐elimination of hepatitis C in supported housing sites for networks of people who inject drugs in Victoria, Canada
Authors: Selfridge Marion , Barnett Tamara , Lundgren Karen , Guarasci Kellie , Milne Rozalyn , Drost Anne , Fraser Chris
Published: May 2022

To achieve the World Health Organization's goal of eliminating hepatitis C (HCV) by 2030 requires enhanced HCV testing and treatment among people who use drugs (PWUD). Micro‐elimination of HCV is a strategy to target HCV testing and treatment efforts to specific segments of the population. From February to December 2018 nurses initiated a “seek & treat” micro‐elimination approach, increasing outreach and removing barriers to accessing HCV treatment in a clinic setting by testing and treating individuals, including PWUD, where they live. The aim of this study was to evaluate the proportion of clients with HCV antibodies and HCV RNA and the response to direct acting agent (DAA therapy) among people who live at or have social connections to local supportive housing sites through this nurse‐led micro‐elimination project in Victoria, Canada. A chart review of electronic medical records and case management documentation was used to collect relevant data of participants treated with DAA therapy, identified through specific housing site testing and outreach interventions. In total, 180 people were tested for HCV antibodies, 72 (40%) were antibody positive: 51 (28%) were RNA positive, 13 (7%) had spontaneously cleared and 8 (4%) had been previously treated. Of the 51 that were currently living with HCV, 43 people were started on treatment, 39 have achieved sustained virologic response (SVR). By providing treatment to clients in their homes and with their friends, clinicians have been able to treat clients, including those with limited contact with the health care system.
Fear, Hope, and COVID‐19: Emotional Elite Rhetoric and Its Impact on the Public During the First Wave of the COVID‐19 Pandemic
Authors: Widmann Tobias
Published: May 2022

Research shows that emotions matter in politics, and they matter during a public health crisis. Yet, a comprehensive analysis of emotional political rhetoric during the COVID‐19 crisis is still missing. Based on parties' position in the political arena (government versus populist radical parties), I expect differences in how specific emotions are employed and in how these messages actually influence the public. To test my hypotheses, I use word embeddings and neural network classifiers to measure fear and hope appeals in social media messages of political parties in four European countries. Furthermore, I rely on more than 1,400,000 public tweets of random citizens to estimate the impact of party messages. To do so, I employ vector autoregression (VAR) analysis to compare retweet volumes of political messages to emotional expressions in public tweets. Results indicate two main findings, (1) populist radical parties communicate less about the pandemic and decrease fear and increase hope appeals while COVID case numbers are rising whereas government parties exhibit the opposite pattern; (2) increased diffusion of party tweets consistently precedes change in partisans' emotional expressions the following day. The findings can carry important implications for (affective) polarization and the level of protective behavior among the population.
Inequality, Redistribution, and the Financial Crisis: Evidence from Distributional National Accounts for Austria
Authors: Jestl Stefan , List Emanuel
Published: May 2022

In this paper, we provide novel findings regarding the distributional effects of the global financial and economic crisis and how redistribution operated during this time, using detailed data for Austria. We construct distributional national accounts for the period 2004–2016 by combining survey data, tabulated tax data, and detailed national accounts data. The comprehensive data set allows us to analyze the distribution of macroeconomic income growth across the income distribution and to explore the evolution of income inequality over time. Our results suggest that as the distribution of growth changed over time, this had considerable repercussions for inequality, which started to decline at the very beginning of the economic and financial crisis, but increased again after 2012. We find that capital income largely determined both the level and the dynamics of income inequality. Government spending was found to play a key role for redistributive effects across the income distribution. In particular, in‐kind transfers redistributed pre‐tax income to a large extent. Our results show further that individuals with lower educational levels and younger individuals faced negative growth in pre‐tax income over the years and also benefited considerably from redistribution.
An One-Factor Copula Mixed Model for Joint Meta-Analysis of Multiple Diagnostic Tests
Authors: Nikoloulopoulos Aristidis K.
Published: May 2022

As meta-analysis of multiple diagnostic tests impacts clinical decision making and patient health, there is an increasing body of research in models and methods for meta-analysis of studies comparing multiple diagnostic tests. The application of the existing models to compare the accuracy of three or more tests suffers from the curse of multi-dimensionality, that is, either the number of model parameters increases rapidly or high dimensional integration is required. To overcome these issues in joint meta-analysis of studies comparing T > 2 diagnostic tests in a multiple tests design with a gold standard, we propose a model that assumes the true positives and true negatives for each test are conditionally independent and binomially distributed given the 2T-variate latent vector of sensitivities and specificities. For the random effects distribution, we employ a one-factor copula that provides tail dependence or tail asymmetry. Maximum likelihood estimation of the model is straightforward as the derivation of the likelihood requires bi-dimensional instead of 2T-dimensional integration. Our methodology is demonstrated with an extensive simulation study and an application example that determines which is the best test for the diagnosis of rheumatoid arthritis.
The surgical management of a patient with chronic renal failure and macrothrombocytopenia related to the MYH9 gene mutation: A case report
Authors: Costa Rafael Fiorese , Bucharles Sérgio Gardano Elias , Kagueiama Douglas Eiji , Kus Cintia Pereira , Andrade Ariane de Almeida , Dirschnabel Acir José , de Araujo Melissa Rodrigues , de Lima Antonio Adilson Soares
Published: May 2022

MYH9 disease is a rare genetic disorder in which there is a mutation in the gene for the non‐muscle myosin heavy chain IIA. It initially causes macrothrombocytopenia followed by other clinical manifestations. When the patient reaches adulthood, he can develop chronic kidney failure. Thus, the risk of suffering a hemorrhage, difficulty in repairing and, infections increases in individuals with this disease. In addition, the use of drugs in these patients should be carefully evaluated. An adult patient sought dental care with a complaint associated with a tooth with advanced dental caries. He had severe thrombocytopenia (7000 platelets/mm3), hearing loss, and chronic kidney failure. The diagnosis of MYH9 disease was confirmed through genotyping. After clinical examination, extraction was planned. Local and systemic procedures were used to prevent hemorrhage, especially postoperatively. Although the patient had an infection at the surgical wound site and no episode of postoperative bleeding, the repair process occurred normally. The purpose of this article is to report the surgical management of a patient with MYH9 disease.