bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of drug survival: A cohort study comparing anti‐tumour necrosis factor agents using the Swedish inflammatory bowel disease quality register
Authors: Visuri Isabella , Eriksson Carl , Olén Ola , Cao Yang , Mårdberg Emelie , Grip Olof , Gustavsson Anders , Hjortswang Henrik , Karling Pontus , Montgomery Scott , Myrelid Pär ,   the SWIBREG study group, Ludvigsson Jonas F. , Halfvarson Jonas
Published: July 2021

Background

Whether long‐term effectiveness differs between anti‐tumour necrosis factor (anti‐TNF) agents is unknown.

Aims

To examine drug survival of first‐line anti‐TNF agents and identify predictors of discontinuation. To reduce channelling bias, we also compared drug survival of the second anti‐TNF.

Methods

Biologic‐naïve patients (N = 955) recorded in the Swedish IBD Quality Register (SWIBREG) were examined. We used propensity score matching, comparing drug survival over up to three years of follow‐up. Cox regression estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs).

Results

In Crohn's disease, discontinuation because of lack/loss of response was 32% [95%CI = 26%‐38%] for infliximab versus 16% [95%CI = 11%‐21%] for adalimumab. Infliximab [vs adalimumab; aHR = 1.96; 95%CI = 1.20‐3.21] and colonic disease (L2) [vs no L2; aHR = 2.17; 95% CI = 1.26‐3.75] were associated with higher discontinuation rates, whereas normalised CRP at three months [aHR = 0.40; 95% CI = 0.19‒0.81] with a lower rate. Consistently, patients who switched from adalimumab to infliximab (vs infliximab to adalimumab) had earlier discontinuation (P = 0.04). Concomitant use of immunomodulators was associated with a lower adverse drug reaction‐mediated discontinuation rate [aHR = 0.46; 95% CI = 0.28‐0.77], in part explained by fewer infusion reactions [aHR = 0.27; 95% CI = 0.08‐0.89]. In ulcerative colitis, the probability of discontinuation because of lack/loss of response was 40% [95% CI = 33%‐47%] for infliximab versus 37% [95% CI = 21%‐53%] for adalimumab. Disease duration ≥10 years [aHR = 0.25; 95% CI = 0.10‐0.58] and normalised CRP after three months [aHR = 0.39; 95% CI = 0.18‒0.84] were associated with lower discontinuation rates.

Conclusions

Clinical characterisation of patients may aid decision‐making on anti‐TNF treatment. The consistently shorter drug survival for infliximab (vs adalimumab) in Crohn's disease, suggests a potential difference between the two drugs.
Modifiable predictors of breastfeeding status and duration at 6 and 12 months postpartum
Authors: Xu Huilan , Marshall Sarah , Jones Jennifer M. , Phongsavan Philayrath , Wen Li Ming
Published: July 2021

Background

Breastfeeding practices are determined by complex multilevel factors. This study assessed pregnant women's knowledge of breastfeeding and intention to breastfeed and investigated modifiable predictors for breastfeeding status (exclusive or any breastfeeding) and duration at 6 and 12 months postpartum.

Materials and Methods

Longitudinal data were extracted from a trial in Sydney, Australia, 2017‐19. Women (n = 1155) were recruited from antenatal clinics and followed up for telephone interviews at baseline (third trimester), then at 6 and 12 months postpartum. Data collected included mothers’ demographics; knowledge of breastfeeding and intention to breastfeed; work status; support from caregivers; breastfeeding environment; breastfeeding status and duration. Multiple logistic and Cox regression models were built to identify predictors for breastfeeding.

Results

At baseline, most mothers knew the recommendation to exclusively breastfeed until 6 months (66%) and the benefits (65%). The modifiable predictors for breastfeeding duration at 12 months included the following: mothers’ knowledge of the recommendation (adjusted hazard ratio (AHR) 0.73, 95% confidence interval (CI) 0.60‐0.90) and the benefits of exclusive breastfeeding (AHR 0.68, 95% CI 0.55‐0.82), intention to meet the recommendation (AHR 0.76, 95% CI 0.63‐0.93), and intention to breastfeed for two years (AHR 0.38, 95% CI 0.27‐0.52) measured at baseline; mothers not working or studying (AHR 0.70, 95% CI 0.55‐0.89), having support from other caregivers (AHR 0.64, 95% CI 0.43‐0.96), and having breastfeeding women around (AHR 0.80, 95% CI 0.65‐0.98) measured at 6 months.

Conclusions

Support for women to meet the breastfeeding recommendations should commence during pregnancy and focus on breastfeeding education and enabling environments.
Child language brokering as a family care practice: Reframing the ‘parentified child’ debate
Authors: Crafter Sarah , Iqbal Humera
Published: July 2021

This paper explores the perspectives of 29 child language brokers living in the UK who interpret for their family following migration. They were presented with vignette stories depicting a potentially conflictual situation between a language broker, a parent and an adult ‘other’ in a position of power or authority. Drawing on debates about language brokering as a family care practice, the ‘parentified child’ and discussions about non‐normative childhoods, the analysis highlights how the role played by the adult ‘other’, coupled with a sometimes‐hostile sociocultural context, can exaggerate tensions or facilitate interactions in the parent–child relationship. The young people's views and experiences illuminate how they navigate these complexities.
The effect of overweight/obesity on diastolic function in children and adolescents: A meta‐analysis
Authors: Burden Samuel , Weedon Benjamin , Whaymand Luke , Rademaker Josefien , Dawes Helen , Jones Alexander
Published: July 2021

Left ventricular diastolic function (LVDF) is an important marker of early cardiovascular remodelling, which has not been well summarized in young people with overweight/obesity. Weighted, random‐effects regression was used to determine the strength of associations of both body mass index (BMI) and homeostatic model assessment of insulin resistance (HOMA‐IR) with LVDF measures, adjusting for age and sex. Six databases were searched after PROSPERO registration (CRD42020177470) from inception to July 2020 for studies that compared LVDF between overweight/obesity and control groups aged ≤24 years, yielding 70 studies (9983 individuals). Quality and risk of bias were assessed using NHLBI tools, with scores of good, fair, and poor for 6, 48, and 16 studies, respectively. Increased BMI was associated with worse LVDF in all measures except early mitral inflow deceleration time, with septal early diastolic tissue peak velocity to late diastolic tissue peak velocity ratio having the strongest association (n = 13 studies, 1824 individuals; r = −0.69; P < 0.001). Elevated HOMA‐IR was also associated with worse LVDF. Although we could not determine the causality of reduced LVDF in young people, our findings should aid the development of paediatric guidelines for the assessment of LVDF and support further work to address the longitudinal consequences of childhood obesity and IR on LVDF.
Hyperpolarized 3helium MRI measured apparent diffusion coefficient and its correlations with pulmonary functions tests in patients with chronic obstructive pulmonary disease: A meta‐analysis
Authors: Meng Xian‐feng , Lin Qing‐yan , Yin Honglei , Li Zeng‐qi
Published: July 2021

Background

This study evaluates role of hyperpolarized 3helium (3He) MRI measured apparent diffusion coefficient (ADC) in examining pulmonary function of chronic obstructive pulmonary disease (COPD) patients.

Methods

After literature search in electronic databases, studies were selected by following precise eligibility criteria. Meta‐analyses were performed to estimate mean difference in ADC between COPD patients and healthy individuals and to seek correlations between lung ADC and pulmonary function. Metaregression analyses were performed to seek relationships between ADC and age, gender, BMI, cigarette pack‐years, and pulmonary function tests.

Results

Twenty‐five studies (622 COPD patients and 469 healthy controls) were included. Lung ADC was 0.402 (95% confidence interval [CI]: 0.374, 0.429) in COPD patients and 0.228 (95% CI: 0.205, 0.252) in healthy individuals (mean difference 0.160 [95% CI: 0.127, 0.193]; p < 0.001). In metaregression, age (coefficient: 0.006; p = 0.004), pack‐years (coefficient: 0.005; p = 0.018), forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio (coefficient: −1.815; p = 0.007), percent predicted diffusion capacity of carbon monoxide (DLCO) (coefficient: −0.004; p = 0.008), and percent predicted inspiratory capacity (coefficient: −0.004; p = 0.012) were significantly associated with ADC in COPD patients. In meta‐analysis of correlation coefficients, ADC was significantly correlated with FEV1 (r = −0.62; p < 0.00001), FEV1/FVC (r = −0.80; p < 0.00001), DLCO (r = −0.85; p < 0.00001), functional residual capacity (r = 0.71; p < 0.00001), reserve volume (r = 0.53; p = 0.0001), and emphysema index (r = 0.89; p < 0.00001).

Conclusion

Hyperpolarized 3He MRI measured ADC was higher in COPD patients than in healthy individuals and was inversely associated with FEV1, FEV1/FVC, DLCO, and inspiratory capacity.
Comparison between tools for measuring breathlessness: Cross‐sectional validation of the Japanese version of the Dyspnoea‐12
Authors: Nishimura Koichi , Oga Toru , Nakayasu Kazuhito , Taniguchi Hiroyuki , Ogawa Tomoya , Watanabe Fumiko , Arizono Shinichi , Kusunose Masaaki , Sanda Ryo , Shibayama Ayumi , Okamoto Sawako , Yorke Janelle
Published: July 2021

Introduction

The Dyspnoea‐12 (D‐12) is a brief, easy to complete questionnaire for measuring breathlessness.

Objectives

To facilitate further efforts to measure dyspnoea in real clinical settings, the authors aimed to develop and validate a Japanese version of the D‐12 and also compare the D‐12 with the Baseline Dyspnea Index (BDI) and the Activity component of the St. George's Respiratory Questionnaire (SGRQ).

Methods

The standardized procedure in accordance with international guidelines was used to create the translation. A validation study with a cross‐sectional observational design was conducted on 122 subjects with stable chronic obstructive pulmonary disease (COPD).

Results

The internal consistency of the D‐12 was high (Cronbach's coefficient α = 0.883) and similar to that of the BDI (α = 0.824) and SGRQ Activity (α = 0.872). The relationships between tools were statistically significant (|Rs| = 0.53 to 0.66). Although the scores obtained from all three tools were skewed toward the milder end of the respective scales, this deviation was most prominent in the D‐12 with a floor effect of 48.4%.

Conclusion

The Japanese version of the D‐12 was successfully validated, but we should be careful of any floor effect and marked skew to the mild end of the scale, especially in subjects with mild COPD.
Genetic diversity and structure in Arizona pronghorn following conservation efforts
Authors: Hahn Erin E. , Culver Melanie
Published: July 2021

Arizona pronghorn (Antilocapra americana) population numbers have declined over the last century due to unregulated‐harvest, population fragmentation, urban expansion, and habitat loss. Captive breeding, reintroductions, and translocations have helped to curb decline and boost population numbers of the endangered Sonoran subspecies (A. a. sonoriensis). To assess the effect of on‐going management actions on the Sonoran subspecies, we collected multi‐locus genotype data and performed tests of genetic differentiation and population structure in comparison to the non‐endangered American subspecies (A. a. americana). We provide updated estimates of genetic diversity and relatedness to serve as a benchmark for future management toward further recovery of Sonoran pronghorn. Management actions have upheld distinction between the two subspecies in Arizona and stemmed further genetic diversity loss while avoiding an increase in inbreeding within the captive‐bred Sonoran population.
Altered gray matter development in pre‐reading children with a family history of reading disorder
Authors: Ostertag Curtis , Reynolds Jess E. , Dewey Deborah , Landman Bennett , Huo Yuankai , Lebel Catherine
Published: July 2021

Reading disorders are common in children and can impact academic success, mental health, and career prospects. Reading is supported by network of interconnected left hemisphere brain regions, including temporo‐parietal, occipito‐temporal, and inferior‐frontal circuits. Poor readers often show hypoactivation and reduced gray matter volumes in this reading network, with hyperactivation and increased volumes in the posterior right hemisphere. We assessed gray matter development longitudinally in pre‐reading children aged 2–5 years using magnetic resonance imaging (MRI) (N = 32, 110 MRI scans; mean age: 4.40 ± 0.77 years), half of whom had a family history of reading disorder. The family history group showed slower proportional growth (relative to total brain volume) in the left supramarginal and inferior frontal gyri, and faster proportional growth in the right angular, right fusiform, and bilateral lingual gyri. This suggests delayed development of left hemisphere reading areas in children with a family history of dyslexia, along with faster growth in right homologues. This alternate development pattern may predispose the brain to later reading difficulties and may later manifest as the commonly noted compensatory mechanisms. The results of this study further shows our understanding of structural brain alterations that may form the neurological basis of reading difficulties.
A higher taxonomic richness does not ensure the functional resilience of saproxylic beetle communities in evergreenQuercusforests
Authors: Pérez‐Sánchez Diana , Mason Norman W. H. , Brustel Hervé , Galante Eduardo , Micó Estefanía
Published: July 2021

1. Despite the fact that insects are suffering a global decline, little is known about the extent to which species loss affects functional diversity. Thus, to understand the relationship between taxonomic and functional diversity metrics, we focused on saproxylic beetles, which perform vital functions in forest ecosystems.

2. Beetles were collected monthly for a year using flight interception traps placed in three protected areas of mature evergreen MediterraneanQuercusforests. Five morphological traits, one phenological trait, and one physiological surrogate trait were measured, and trophic guild identities were determined. Two taxonomic and six functional metrics were assessed to determine their relationships.

3. Taxonomic and functional diversity patterns, as well as trait patterns, differed depending on the protected areas, as they were influenced by habitat and microhabitat characteristics. Generally, a high number of species tended to support high values of functional richness, but did not ensure high values of functional redundancy, thus affecting the resilience of communities.

4. A 5% of species loss strongly affected the functional redundancy of communities, making them more vulnerable. Functional richness, however, was not affected, since it was associated with a high number of redundant species. Thus, the way species loss affected communities is highly dependent on the presence of rare or redundant species.

5. Taxonomic and functional diversity metrics should be used as complementary tools for conservation purposes. In this way, the comparative analysis of taxonomic and functional patterns may help to predict the vulnerability of saproxylic assemblages to changes or disturbances.
Motor impairments in early onset schizophrenia
Authors: Byrial Pernille , Nyboe Lene , Thomsen Per Hove , Clausen Loa
Published: July 2021

Aim

Motor impairments are frequent both at and before diagnosis. In childhood, impairments in general fine and gross motor function are among others identified using test batteries, and while elements of coordination are assessed in onset schizophrenia, the assessment of general motor functions is absent. Thus, we aimed to assess general motor function including childhood motor function in adolescents with schizophrenia in comparison with healthy controls and examine clinical correlates to general motor function.

Method

General fine and gross motor function was assessed using two standardized age‐normed test batteries and a questionnaire in 25 adolescents with schizophrenia compared with age and gender‐matched controls using t‐test and χ2‐test. Stepwise linear regression assessed potential developmental predictors on motor function including complications during childbirth, reported childhood motor function, executive function including false discovery rate q‐values. Associations with schizophrenia symptom severity, executive function, cognitive function were assessed using Pearson's correlation and the impact of antipsychotic medication using t‐test.

Result

All measures of motor function but one significantly differentiated adolescents with schizophrenia from healthy controls. The presence of schizophrenia (β =4.41, β = 10.96), explained the main part of the variance however, childhood motor function (β = .08) also added significantly to motor function. Executive function (β = −.45) was important for childhood motor function. Severity of schizophrenia was associated with strength (p < .0011) and manual coordination (p = .0295), and receiving antipsychotics affected manual dexterity (p = .0378).

Conclusion

The documentation of significant differences in general motor function in early onset schizophrenia compared with healthy controls highlights the need for general motor assessments and potential interventions.
Young people's attitudes towards integrating physical activity as part of mental health treatment: A cross‐sectional study in youth mental health services
Authors: Parker Alexandra G. , Trott Emma , Bourke Matthew , Klepac Pogrmilovic Bojana , Dadswell Kara , Craike Melinda , McLean Sîan A. , Dash Sarah , Pascoe Michaela
Published: July 2021

Introduction

Due to the significant burden associated with mental disorders that have their onset in youth, there is a critical need to improve treatments and treatment outcomes. Given the evidence for physical activity (PA) as an effective intervention for reducing depression and anxiety symptoms in young people, we examined young people's attitudes towards and acceptability of PA as part of mental health treatment, predictors of current engagement in PA and predictors of attitudes towards PA as a treatment option.

Methods

Participants in this cross‐sectional study were 88 young people (15–25 years) who were engaged in treatment at youth mental health services in Melbourne, Australia.

Results

Young people's attitudes towards PA as a treatment option were generally positive. The acceptance of PA as a treatment option was predicted by fewer perceived barriers and more benefits to exercise, higher autonomous motivation and lower amotivation; whereas, the only significant predictor of current engagement in PA was autonomous motivation.

Discussion

The integration of PA interventions within mental health treatment appears to be acceptable to young people; however, acceptance of PA as a treatment option is influenced by perceived barriers and benefits of PA and autonomous motivation. A focus on increasing autonomous motivation by enhancing the perceived value of PA and choosing preference‐based, enjoyable activities may assist in addressing the complex range of factors that impact the ability of these young people to become more physically active. Addressing these factors may assist with implementing PA interventions within psychological treatments for mental disorders.
Topic modelling in precision medicine with its applications in personalized diabetes management
Authors: Ni Ki Chong , Hosseinian‐Far Amin , Daneshkhah Alireza , Salari Nader
Published: July 2021

Advances in Internet of Things (IoT) and analytic‐based systems in the past decade have found several applications in medical informatics, and have significantly facilitated healthcare decision making. Patients' data are collected through a variety of means, including IoT sensory systems, and require efficient, and accurate processing. Topic Modelling is an unsupervised machine learning algorithm for Natural Language Processing (NLP) that identifies relationships and associations within textual data. The application of Topic Modelling has been widely used on raw text data, where meaningful clusters (topics) are generated by the model. The purpose of this paper is to explore the varying methods of Topic Modelling, mostly the Latent Dirichlet allocation (LDA) model, and its applicability on personalized diabetes management. The proposed study evaluates the possibility of applying topic modelling methods on diabetes literature and genomic data in order to achieve precision medicine.
Dr. Alexander Wlodawer—celebrating five decades of service to the structural biology community
Authors: Minor Wladek , Jaskolski Mariusz , Martin Seamus J. , Dauter Zbigniew
Published: July 2021

This 75th birthday tribute to our Editorial Board member Alexander Wlodawer recounts his decades‐long service to the community of structural biology researchers. His former and current colleagues tell the story of his upbringing and education, followed by an account of his dedication to quality and rigor in crystallography and structural science. The FEBS Journal Editor‐in‐Chief Seamus Martin further highlights Alex's outstanding contributions to the journal's success over many years.
Going with the flow: Spatio‐temporal drift patterns of larval fish in a large alpine river
Authors: Nagel Christoffer , Mueller Melanie , Pander Joachim , Stoeckle Bernhard C. , Kuehn Ralph , Geist Juergen
Published: July 2021

Fish larval drift is an essential step in the life cycle of riverine fish species as it determines dispersal and colonisation. Anthropogenic flow alterations and interruption of longitudinal and lateral connectivity by river damming and straightening can severely affect larval drift patterns. In this study, we characterised spatio‐temporal drift patterns of fish larvae in the heavily regulated large alpine River Inn and within a constructed nature‐like fish bypass.

Drift was investigated in the main reproduction period of the fish fauna in this river, ranging from mid‐April to end of June. Diel patterns were assessed by samples taken during day, dusk, night, and dawn each day of sampling. To obtain robust species identification, we used DNA barcoding for genetic verification of phenotypically pre‐sorted groups.

From a total of 1,069 fish larvae and 283 fish eggs caught, DNA barcoding revealed 16 species from five families, including several target species of conservation. We found strong evidence that several endangered species, such as Chondrostoma nasus, Thymallus thymallus, Cottus gobio, and Aspius aspius successfully reproduced in the bypass system. Genetic species verification showed a high level of homogeneity in most phenotypically pre‐sorted groups.

Distinct seasonal patterns were observed, with the majority of fish species in the drift observed in mid‐June. Thymallus thymallus and Cottus gobio dominated larval drift at the beginning of the observation followed by mainly unimodal abundance peaks of several Cyprinid species. Nocturnal drift prevailed in all species.

Our results on the spatial occurrence and abundances of fish larvae highlight the importance of bypass systems in heavily modified waterbodies to provide valuable spawning habitats and drift corridors around dams. Moreover, the distinct species‐specific time patterns of larval drift represent a first basis to direct future discharge and river management plans in large alpine rivers towards a protection of the sensitive larval stages of specific target species of conservation. This includes bypass and turbine operation modes in the period of highest drift activity, as well as the construction of nature‐like bypass systems and creation of spawning grounds therein.
Unrecognized threat to global soil carbon by a widespread invasive species
Authors: O’Bryan Christopher J. , Patton Nicholas R. , Hone Jim , Lewis Jesse S. , Berdejo‐Espinola Violeta , Risch Derek R. , Holden Matthew H. , McDonald‐Madden Eve
Published: July 2021

Most of Earth's terrestrial carbon is stored in the soil and can be released as carbon dioxide (CO2) when disturbed. Although humans are known to exacerbate soil CO2 emissions through land‐use change, we know little about the global carbon footprint of invasive species. We predict the soil area disturbed and resulting CO2 emissions from wild pigs (Sus scrofa), a pervasive human‐spread vertebrate that uproots soil. We do this using models of wild pig population density, soil damage, and their effect on soil carbon emissions. Our models suggest that wild pigs are uprooting a median area of 36,214 km2 (mean of 123,517 km2) in their non‐native range, with a 95% prediction interval (PI) of 14,208 km2–634,238 km2. This soil disturbance results in median emissions of 4.9 million metric tonnes (MMT) CO2 per year (equivalent to 1.1 million passenger vehicles or 0.4% of annual emissions from land use, land‐use change, and forestry; mean of 16.7 MMT) but that it is highly uncertain (95% PI, 0.3–94 MMT CO2) due to variability in wild pig density and soil dynamics. This uncertainty points to an urgent need for more research on the contribution of wild pigs to soil damage, not only for the reduction of anthropogenically related carbon emissions, but also for co‐benefits to biodiversity and food security that are crucial for sustainable development.
Does obesity lead to loneliness and perceived social isolation in the second half of life? Findings from a nationally representative study in Germany
Authors: Hajek André , König Hans‐Helmut
Published: July 2021

Aim

Little is known about the link between obesity and loneliness as well as perceived social isolation. Therefore, the objective of this longitudinal study is to clarify whether the onset and the end of obesity is associated with changes in perceived social isolation as well as loneliness (stratified by sex) in older age.

Methods

Longitudinal data were used from wave 5 (year 2014) and 6 (year 2017) of the German Ageing Survey – a nationally representative sample of community‐dwelling individuals aged ≥40 years in Germany. Established tools were used to quantify loneliness and perceived social isolation. A body mass index ≥30 kg/m2 was used to classify individuals as being obese. Asymmetric fixed effects regressions were used.

Results

Regressions showed that the end of obesity was associated with decreases in perceived social isolation among women (β = −0.24, P = 0.01), but not in men (with significant sex differences). The onset of obesity was not associated with changes in perceived social isolation. Neither the beginning of obesity nor the end of obesity was associated with changes in loneliness.

Conclusions

Our findings emphasize the importance of overcoming obesity for women in the second half of life. As most of the existing studies were conducted in Germany, studies from other countries are of importance to understand this association better. Geriatr Gerontol Int 2021; 21: 836–841.
Treatment patterns and medical costs after hepatectomy in real‐world practice for patients with hepatocellular carcinoma in Japan
Authors: Terashima Takeshi , Higashibeppu Yoichi , Yamashita Tatsuya , Sakata Yukinori , Azuma Mie , Fujimoto Kenichi , Munakata Hiroaki , Ishii Mika , Kaneko Shuichi
Published: July 2021

Aim

To examine the treatment patterns and medical costs in real‐world practice among patients who received hepatectomy for hepatocellular carcinoma (HCC) in Japan.

Methods

Data of patients who underwent hepatectomy as an initial therapy for primary HCC were extracted from a Japanese medical claims database from April 2008 to December 2019. The types of additional treatments for recurrent HCC and medical costs for up to 3 years from the first hepatectomy were analyzed. The average cumulative cost per patient starting on the date of the first hepatectomy was calculated using the Kaplan‐Meier sample‐average method.

Results

Data from 2 342 patients (median age, 71 years) were analyzed. Overall, 35.6% of patients received at least one HCC treatment within 3 years of the first hepatectomy. The total average cumulative 3‐years medical cost was JPY 4 993 300 (95% confidence interval [CI]: 4 804 100 to 5 220 500). Surgical procedures were the most costly components in the first month after hepatectomy, whereas the costs of drugs, which mainly included antiviral and antineoplastic medications, increased thereafter. Patients with advanced stage HCC, hepatitis C, or a higher Charlson Comorbidity Index at hepatectomy, or those who required additional treatment, especially with antineoplastic drugs for recurrent HCC, incurred higher medical costs.

Conclusions

Patients with HCC after hepatectomy experienced a large economic burden, which was more serious for those with advanced stage HCC, higher comorbidities, and hepatitis at baseline and for patients treated with antineoplastic drugs. A treatment selection that considers its medical cost burden would help to reduce some of these economic burdens.
Fertility and reproductive technology use in testicular cancer survivors in Japan: A multi‐institutional, cross‐sectional study
Authors: Yamashita Shinichi , Kakimoto Kenichi , Uemura Motohide , Kishida Takeshi , Kawai Koji , Nakamura Terukazu , Goto Takayuki , Osawa Takahiro , Yamada Shigeyuki , Nishimura Kazuo , Nonomura Norio , Kojo Kosuke , Shiraishi Takumi , Ukimura Osamu , Ogawa Osamu , Shinohara Nobuo , Suzukamo Yoshimi , Ito Akihiro , Arai Yoichi
Published: July 2021

Objective

To evaluate fertility and use of reproductive technology of testicular cancer survivors in a multi‐institutional, cross‐sectional study.

Methods

This study recruited testicular cancer survivors who were followed after treatment for testicular cancer at eight high‐volume institutions between 2018 and 2019. The participants completed the questionnaires on marital status, fertility and use of reproductive technology.

Results

A total of 567 testicular cancer survivors, with a median age of 43 years, responded to the questionnaire. Chemotherapy was given to 398 survivors, including three cycles of cisplatin‐based chemotherapy in 106 patients and four cycles in 147 patients. Among 153 survivors who attempted sperm cryopreservation, 133 (87%) could preserve sperm. Of the 28 survivors whose cryopreserved sperm was used, 17 (61%) fathered children. Of the 72 survivors who fathered children without the use of cryopreserved sperm, 59 (82%) fathered naturally. Whereas 33 (20%) of 169 survivors treated without chemotherapy fathered children without using cryopreserved sperm, 39 (10%) of 398 treated with chemotherapy fathered children (P < 0.05). Furthermore, the paternity rate was 12% and 5% in testicular cancer survivors with three and four cycles of cisplatin‐based chemotherapy, respectively (P < 0.05). However, of 121 survivors who wanted to have children, 14 (12%) received counseling about infertility treatment.

Conclusions

Testicular cancer survivors preserving their sperm have a higher paternity rate after chemotherapy, especially after four cycles, than those not using cryopreserved sperm. Physicians who give chemotherapy for testicular cancer need to take particular care not only with respect to recurrence of testicular cancer, but also to post‐treatment fertility.
Comparison of robot‐assisted partial nephrectomy for complex (RENAL scores ≥10) and non‐complex renal tumors: A single‐center experience
Authors: Wakita Naoto , Hinata Nobuyuki , Suzuki Kotaro , Bando Yukari , Okamura Yasuyoshi , Hara Takuto , Terakawa Tomoaki , Furukawa Junya , Harada Kenichi , Fujisawa Masato
Published: July 2021

Objectives

To compare functional and surgical outcomes of robot‐assisted partial nephrectomy for complex tumors with RENAL scores ≥10 and non‐complex tumors at a single academic institution.

Methods

We retrospectively analyzed the data of all patients who underwent robot‐assisted partial nephrectomy at Kobe University Hospital (Kobe, Hyogo, Japan) from 2011 to 2020. Functional and surgical outcomes for complex tumors (RENAL score ≥10) were compared with those of patients with non‐complex tumors (RENAL <10). Outcomes analyzed included blood loss, warm ischemia time, console time, perioperative complications, and preoperative and postoperative renal function.

Results

A total of 348 patients were included in our present study, with a median follow‐up time of 35.1 months. Of these, 299 patients (85.9%) had non‐complex tumors and 49 patients (14.1%) had complex tumors. Warm ischemia time and console time were significantly longer in the complex tumors group. Major perioperative complications (Clavien–Dindo classification system ≥3) were significantly more frequent in the complex tumors group than the non‐complex tumor group (16.3% vs 5.7%, P = 0.018). Postoperative preservation of estimated glomerular filtration rate and percentage of chronic kidney disease upstage by 1 year were significantly inferior in the complex tumors group. The positive surgical margin rate was 0% and 0.3% in the complex and non‐complex tumor groups, respectively. There were no significant differences in recurrence‐free survival between the two groups (P = 0.11).

Conclusions

Robot‐assisted partial nephrectomy for complex renal tumors is safe, with no difference in oncological outcomes, although more postoperative complications and decreased renal function can be observed than non‐complex tumors.
Management of diabetes‐related foot disease in the outpatient setting during the COVID‐19 pandemic
Authors: Pang Bingyan , Shah Priyal M. , Manning Laurens , Ritter J. Carsten , Hiew Jonathan , Hamilton Emma J.
Published: July 2021

The use of telephone and/or video consultation in routine management of acute diabetes‐related foot disease (DFD) before the coronavirus disease 2019 (COVID‐19) pandemic at a tertiary hospital is unprecedented. In March 2020, the Diabetes Feet Australia (DFA) released a national guideline to inform DFD management during the COVID‐19 pandemic. The present study aimed to describe the adherence to the DFA guideline of managing acute DFD using telephone and/or video consultation at a Western Australian tertiary hospital during this period. We found >80% adherence rate to the DFA guideline and the management of active DFD using telephone and/or video consultations was feasible and acceptable in carefully selected patients.
Changes in prescribing habits for the treatment of metastatic renal clear cell carcinoma (mRCC) in Australia
Authors: Balasubramanian Adithya , Qu Liang , Weickhardt Andrew , Bolton Damien , Perera Marlon
Published: July 2021

The availability of efficacious systemic therapies for metastatic clear cell renal cell carcinoma has heralded improved survival for Australians. The Pharmaceutical Benefits Schedule registry was interrogated to assess nation‐wide prescribing patterns. Sunitinib remained the most commonly prescribed agent. Prescribing rates were significantly lower in Northern Territory than in other states, raising questions of disparities in access to care.
Advanced glass seals for implantable medical devices
Authors: Thom Andrew J. , Tischendorf Brad C. , Lohstreter Lance B.
Published: July 2021

Lanthanum Borate (LaBor) glass is used as the insulating glass seal material in feedthroughs used in implantable medical devices. Guided by finite element analysis modeling, alumina was selected as a promising additive for the LaBor glass to tailor its material properties for glass seals that are better matched with lower CTE pin materials. Thermal expansion and elastic properties were measured for LaBor glass containing up to 20 wt% alumina. Trends for thermal expansion and elastic modulus were reasonably predicted by literature descriptions. As predicted by finite element modeling, the modified glass showed good resistance to crack growth and the hermetic behavior of the seal was confirmed by helium leak detection and fluorescent dye observations.
Milestones in the journey: The story of refugees becoming registered nurses in Australia
Authors: Ng Chok Harrison , Lewis Peter , Mannix Judy , Dickson Cathy , Wilkes Lesley
Published: July 2021

Aims

To explore the experiences of refugees who became registered nurses after arriving to Australia.

Design

Qualitative description using a naturalistic inquiry framework.

Methods

Between February 2018 and September 2019, the lead author conducted semi‐structured interviews with employed registered nurses (RNs) that are former refugees and English‐speaking. Interviews were 45–90 min' duration and digitally recorded. Participants provided voluntary informed consent and were sent questions beforehand. Data were collected and coded into themes. Rigor was achieved with multiple transcript readings by the research team to confirm common themes.

Results

Twelve participants discussed their story. Three major themes were identified: (1) Milestone of being a refugee; (2) Milestone of resettling in Australia; (3) Milestone of becoming a RN.

Conclusion

Each participant's story started at a place of disadvantage. They progressed successfully through the three milestones; despite living with traumatic experiences, they learned new skills, developed English literacy, became a RN and juggled the demands of life. This paper highlights the poorly understood pockets of the current Australian RN workforce.

Impact statement

The nuanced stories of RNs with refugee backgrounds in this study move beyond trauma and struggle and demonstrate the important journey this particular group of health professionals undertake. Increasing the contextual knowledge of the complex lives of former refugees turned nursing professionals will raise public awareness of the diversity of life experiences of RNs working in Australia.
Effectiveness of self‐care educational programme on clinical outcomes and self‐care behaviour among heart failure peoples—A randomized controlled trial: Study protocol
Authors: D’Souza Prima J. J. , Devasia Tom , Paramasivam Ganesh , Shankar Ravi , Noronha Judith A. , George Linu S.
Published: July 2021

Aim

To evaluate the effectiveness of a self‐care education programme on clinical outcomes, self‐care behaviour and knowledge on heart failure (HF) among peoples with HF.

Design

Randomized controlled trial.

Methods

The participants (N = 160) will be randomly assigned (1:1) to the intervention and the control arms using block randomization. The participants assigned to the intervention arm will receive educational intervention on HF self‐care comprising video‐assisted teaching with teach‐back technique, tailored teaching at discharge and a guide on self‐care followed by telephonic calls and text messages after discharge for 6 months along with standard care. The participants in the control arm will receive only a guide on self‐care with standard care. The clinical outcomes such as health‐related quality of life, hospital readmissions, N‐terminal pro‐brain natriuretic peptide levels, symptom perception, functional status, left ventricular ejection fraction, Seattle HF score, self‐care behaviour and knowledge on HF will be measured at the baseline, after 1 and 6 months of the intervention.

Discussion

Several studies conducted on self‐care education interventions have shown positive effects, whereas few studies have shown no effect on the people outcomes. Providing the printed self‐care guide alone may not improve behaviour associated with self‐care and clinical outcomes. These peoples need continuous reinforcement on self‐care. If this self‐care educational intervention shows beneficial effects, it will contribute to the clinical practice and improve clinical outcomes.

Impact

This research will contribute to the evidence on the effectiveness of an educational intervention on self‐care among peoples with HF. The results would assist the nurses caring for peoples with HF. They can also implement this intervention for improving the peoples’ self‐care behaviour.

Trial registration

The trial is registered with the Clinical Trial Registry India and the reference ID number CTRI/2019/10/021724.
Utilizing blockchain technology for supply chain transparency: A resource orchestration perspective
Authors: Gligor David Marius , Davis‐Sramek Beth , Tan Albert , Vitale Alex , Russo Ivan , Golgeci Ismail , Wan Xiang
Published: July 2021

Driven by pressures from multiple stakeholders, supply chain transparency (SCT) has emerged as a phenomenon of increased interest. To address concerns about practices and processes at point of origin locations for raw materials in global supply chains, blockchain technology (BCT) has the potential to enhance SCT. Supply chain research has started to advance the field's understanding of SCT, but many questions remain, including how SCT should be conceptualized, how firms can effectively facilitate it, and the benefits of providing it, especially when BCT is utilized. The gaps suggest the need for fundamental theoretical development about the resources and capabilities underlying the development, application, and derived value of SCT. This research designed a case study around a BCT implementation project between a small artisan coffee producer and a startup BCT service provider. Using the resource orchestration perspective, the findings result in theoretical insights about how the mechanisms in structuring, bundling, and leveraging processes operate to offer SCT to stakeholders, and the value creation derived as a result.
The regulatory effect of acetylation of HMGN2 and H3K27 on pyocyanin‐induced autophagy in macrophages by affecting Ulk1 transcription
Authors: Du Yu , Guo Hongjun , Guo Lijuan , Miao Junming , Ren Hongyu , Liu Keyun , Ren Laibin , He Jinchen , Wang Xiaoying , Chen Junli , Li Jingyu , Wang Yi , Wang Ji , Huang Ning
Published: July 2021

Pyocyanin (PYO) is a major virulence factor secreted by Pseudomonas aeruginosa, and autophagy is a crucial homeostatic mechanism for the interaction between the pathogens and the host. It remains unknown whether PYO leads to autophagy in macrophages by regulating histone acetylation. The high mobility group nucleosomal binding domain 2 (HMGN2) has been reported to regulate the PYO‐induced autophagy and oxidative stress in the epithelial cells; however, the underlying molecular mechanism has not been fully elucidated. In this study, PYO was found to induce autophagy in macrophages, and the mechanism might be correlated with the up‐regulation of HMGN2 acetylation (HMGN2ac) and the down‐regulation of H3K27 acetylation (H3K27ac) by modulation of the activities of acetyltransferases and deacetylases. Moreover, we further demonstrated that the up‐regulated HMGN2ac enhances its recruitment to the Ulk1 promoter, while the down‐regulation of H3K27ac reduces its recruitment to the Ulk1 promoter, thereby promoting or inhibiting the transcription of Ulk1. In conclusion, HMGN2ac and H3K27ac play regulatory roles in the PYO‐induced autophagy in macrophages.
Evolutionary biology and development model of medicines: A necessary ‘pas de deux’ for future successful bacteriophage therapy
Authors: Froissart Rémy , Brives Charlotte
Published: July 2021

The increase in frequency of multidrug‐resistant bacteria worldwide is largely the result of the massive use of antibiotics in the second half of the 20th century. These relatively recent changes in human societies revealed the great evolutionary capacities of bacteria towards drug resistance. In this article, we hypothesize that the success of future antibacterial strategies lies in taking into account both these evolutionary processes and the way human activities influence them. Faced with the increasing prevalence of multidrug‐resistant bacteria and the scarcity of new antibacterial chemical molecules, the use of bacteriophages is considered as a complementary and/or alternative therapy. After presenting the evolutionary capacities of bacteriophages and bacteria, we show how the development model currently envisaged (based on the classification of bacteriophages as medicinal products similar to antibacterial chemical molecules) ignores the evolutionary processes inherent in bacteriophage therapy. This categorization imposes to bacteriophage therapy a specific conception of what a treatment and a therapeutic scheme should be as well as its mode of production and prescription. We argue that a new development model is needed that would allow the use of therapeutic bacteriophages fully adapted (after in vitro ‘bacteriophage training’) to the aetiologic bacteria and/or aimed at rendering bacteria either avirulent or antibiotic‐susceptible (‘bacteriophage steering’). To not repeat the mistakes made with antibiotics, we must now think about and learn from the ways in which the materialities of microbes (e.g. evolutionary capacities of both bacteriophages and bacteria) are intertwined with those of societies.
Genetic diversity of the carp oedema virus in France
Authors: Baud Marine , Pallandre Laurane , Almeras Fabrice , Maillet Loeiz , Stone David , Bigarré Laurent
Published: July 2021

The koi sleepy disease of carp caused by the carp oedema virus (CEV) was observed on farms and in ponds in France since the 2010s. Samples of CEV collected in France over a period of eight years were characterized at the molecular level by sequencing the partial p4a gene. All the sequences, except one, fell into two well‐defined genogroups. Sequences obtained from CEV detected in common carp generally clustered in genogroup I and sequences from CEV detected in the koi were assigned to genogroup II. A particular sample was different to the others and represented a putative new genogroup possibly arose from a recombination event between a genogroup II sequence and one from an unknown genogroup. Compared with sequences from CEV of other countries, most of the French sequences exhibited high degree of DNA identities with those published previously, indicating identical sources of viruses. The sequence diversity suggests multiple introductions of the viruses in France. Among the French sequences, two genogroup‐specific molecular markers were identified. One was an insertion/deletion identified within a microsatellite and other was a group of single nucleotide polymorphisms. CEV seems to generate genetic diversity via diverse mechanisms: substitutions, indels and recombination events.
Risk assessment of multireservoir joint flood control system under multiple uncertainties
Authors: Wang Quansen , Zhou Jianzhong , Dai Ling , Huang Kangdi , Zha Gang
Published: July 2021

Multireservoir joint flood control operation is an important nonstructural measure for flood control in some basins. Owing to the existence of uncertainties in flood control operation, various degrees of risk can be shown in flood control operation systems. Examining these uncertainties and the resulting risk of failure in multireservoir operation systems is extremely beneficial and indispensable for basin flood mitigation. In this study, different stochastic simulation methods were employed to generate streamflow series at multiple stations and other uncertainties such as the flood forecast errors, discharge capacity, and reservoir storage. Then, the Monte Carlo framework was established based on the simulation sequence to estimate the risk of a failure of each flood control unit in the flood control system. Furthermore, a comprehensive risk assessment indicator was proposed to consider the failure probability and failure consequences at the same time. The Xiluodu‐Xiangjiaba‐Three Gorges cascade reservoirs were selected as a case study. Results show that the applied probabilistic simulation methods could simulate various uncertainties in a multireservoir flood control system effectively, and the proposed risk analysis method could comprehensively evaluate the risks of reservoir overtopping, flood flows exceeding a standard, and flood diversion from the perspective of overall watershed security.