bluuebunny/crossref_metadata_2025 huggingface dataset:
A preliminary investigation of gamification from the young consumer’s perspective
Authors: Hass Danielle , Hass Ashley , Joseph Mathew
Published: February 2021

Purpose

Over the past decade, gamification’s popularity has broadened into many industries and has become embedded in consumers’ lives. As privacy protection and how firms utilize users’ data has been at the forefront of consumers’ minds, practitioners and academics alike need to understand consumers’ perceptions of the ethics of gamification. This paper aims to explore and provide preliminary evidence on young consumers’ perceptions of gamification and the ethics involved in these strategies used by firms.

Design/methodology/approach

The authors conducted two studies using a mixed-methods approach to gain a foundational understanding of young consumers’ perceptions of gamification. In Study 1, interviews provided initial insights and helped inform an exploratory survey administered in Study 2 to 161 young consumers attending a university in the southwest region of the USA.

Findings

The findings indicate that consumers have positive attitudes toward gamification tactics as long as the rewards are sufficient. Further, consumers do not find gamification as unethical as long as they have control over having the ability to opt-in.

Originality/value

Previous research has examined gamification from several contexts including health care, education and the workplace. However, there is little research that focuses on gamification from the consumers’ perspective, specifically the young consumer. As more firms are using gamification tactics such as on their mobile applications, it is critical to understand how young consumers perceive gamification and how that can impact the consumer-brand relationship. This research offers two studies as a first step in investigating young consumers’ perceptions of gamification tactics firms use and offers several future directions.
The relevance between anti‐rods/rings antibody and different treatment regimens in chronic hepatitis C virus infection
Authors: Peker Bilal Olcay , Şener Aslı Gamze , Topal Firdevs , Sarıtaş Yüksel Elif
Published: February 2021

The antibodies and other issues associated with immunity in chronic hepatitis C virus (HCV) have been widely investigated, especially non‐organ‐specific antinuclear antibodies. Rods–rings (RR) antibody patterns are frequently observed due to pegylated IFN‐α (PEG‐IFN)/ribavirin (RBV) treatment by indirect immunofluorescence (IIF). We evaluated the relevance between anti‐RR and PEG‐IFN/RBV and/or direct‐acting antiviral (DAA) regimens in chronic HCV. Sampling was done after achieving a sustained virological response (SVR) for 178 patients (aged >18 years). Patients were grouped according to treatment protocols (Group 1 [G1]: PEG‐IFN/RBV [n = 53], Group 2 [G2]: PEG‐IFN/RBV and Telaprevir or Boceprevir [n = 31], Group 3 [G3]: second‐ and third‐wave DAA and previously received PEG‐IFN/RBV (n = 38), and Group 4 [G4]: second‐ and third‐wave DAA [n = 56]). Anti‐RR was investigated by IIF (Euroimmun AG) test. Overall, 27 (15.16%) patients were anti‐RR positive and received PEG‐IFN/RBV. The numbers of anti‐RR positivity for G1/2/3/4 (%) were 16/3/8/0 (30.2/9.6/21/0), respectively (p < .001). The anti‐RR positivity rate for G1/2/3 was 22.13% (27/122, p = .088). Anti‐RR was positive in 17.5% (11/63) of G1/2/3 patients who did not achieve SVR after the first treatment. This rate was 27.1% (16/59) in patients with SVR after the first treatment in G1/2 and there was no difference between these two classified groups in terms of antibody titers (p = .915). Anti‐RR was detected up to 172 months after SVR. In summary, anti‐RR was positive in high rates in patients receiving PEG‐IFN/RBV therapy. Frequent monitoring is needed during patient follow‐up to get more data on the relationship between anti‐RR titer, treatment regimens, and SVR.
Stress priming affects fungal competition ‐ evidence from a combined experimental and modelling study
Authors: Wesener Felix , Szymczak Aleksandra , Rillig Matthias C. , Tietjen Britta
Published: February 2021

Priming, an inducible stress defence strategy that prepares an organism for an impending stress event, is common in microbes and has been studied mostly in isolated organisms or populations. How the benefits of priming change in the microbial community context and, vice versa, whether priming influences competition between organisms, remain largely unknown. In this study, we grew different isolates of soil fungi that experienced heat stress in isolation and pairwise competition experiments and assessed colony extension rate as a measure of fitness under priming and non‐priming conditions. Based on this data, we developed a cellular automaton model simulating the growth of the ascomycete Chaetomium angustispirale competing against other fungi and systematically varied fungal response traits to explain similarities and differences observed in the experimental data. We showed that competition changes the priming benefit compared with isolated growth and that it can even be reversed depending on the competitor's traits such as growth rate, primeability and stress susceptibility. With this study, we transfer insights on priming from studies in isolation to competition between species. This is an important step towards understanding the role of inducible defences in microbial community assembly and composition.
Nitrous oxide versus lidocaine versus no analgesic for in‐office hysteroscopy: a randomised clinical trial
Authors: Solano Calvo JA , del Valle Rubido C , Rodríguez‐Miguel A , de Abajo FJ , Delgado Espeja JJ , González Hinojosa J , Fernández Muñoz L , Zapico Goñi Á
Published: February 2021

Objective

To compare the effect of inhaled nitrous oxide (INO) on pain control during in‐office hysteroscopy with 1% lidocaine paracervical infiltration and no analgesic.

Design

Single‐blind stratified randomised clinical trial with masked assessment by a third party.

Setting

Department of Obstetrics and Gynaecology in a Spanish hospital.

Population

Women who underwent hysteroscopy.

Methods

Patients were stratified into three groups according to the purpose of the hysteroscopy (biopsy, polypectomy or tubal sterilisation) and then assigned to different treatment groups through a permuted‐blocks randomisation within strata. Pain scale was provided by a gynaecologist totally blinded to procedures and treatments. Effects were assessed using a one‐way analysis of variance following an intention‐to‐treat approach.

Main outcome measures

Visual analogue scale (VAS) from 0 to 100 mm.

Results

A total of 314 women were included: 105 to INO, 104 to 1% lidocaine and 105 to no analgesic. Baseline characteristics were comparable. Mean VAS score after the procedure was 34.7 ± 25.8 mm, 36.1 ± 22.9 mm (P = 1.0) and 47.3 ± 28.2 mm (P = 0.001) for INO, 1% lidocaine and no analgesic, respectively. No adverse events were reported in 91 (86.7%) patients in the INO group compared with 79 (76%) in the 1%‐lidocaine group (P = 0.04) and 85 (81%) in the no‐analgesic group (P = 0.26).

Conclusion

INO was as effective as 1% lidocaine in pain control for in‐office hysteroscopy and was better tolerated. The no‐analgesic group presented the poorer results, so was the least recommended clinical option.
Obstetric anal sphincter injury after episiotomy in vacuum extraction: an epidemiological study using an emulated randomised trial approach
Authors: Ankarcrona V , Zhao H , Jacobsson B , Brismar Wendel S
Published: February 2021

Objective

To emulate a randomised controlled trial investigating whether lateral or mediolateral episiotomy compared with no episiotomy reduces the prevalence of obstetric anal sphincter injury (OASIS) in nulliparous women delivered with vacuum extraction.

Design

A population‐based observational study.

Setting

Sweden.

Population

63 654 nulliparous women delivered with vacuum extraction derived from the Swedish Medical Birth Register 2000–2011, with a live singleton baby with no known malformations in cephalic presentation in gestational week ≥34+0, and subject to lateral or mediolateral episiotomy or no episiotomy.

Methods

The effect of episiotomy was calculated using a causal doubly robust estimation method based on propensity scores. Results are presented as the average treatment effect and numbers needed to treat (NNT).

Main outcome measures

OASIS (third‐ and fourth‐degree perineal injury) in nulliparous women delivered with vacuum extraction.

Results

Episiotomy was associated with a reduction in OASIS from 15.5% to 11.8%, average treatment effect of –3.66% (95% CI −4.31 to −3.01) and NNT 27. Third‐degree perineal injuries were reduced from 14.0% to 10.9% (−3.08, 95% CI −3.71 to −2.42) with NNT 32. Fourth‐degree perineal injuries were reduced from 1.6% to 1.0 % (−0.58%, 95% CI −0.79 to −0.37) with NNT 172.

Conclusions

Lateral or mediolateral episiotomy reduced the prevalence of OASIS in nulliparous women delivered with vacuum extraction, compared to women with no episiotomy.

Tweetable abstract

To prevent one case of OASIS in first‐time mothers delivered with vacuum, 27 episiotomies had to be performed.
Prescription medication use by emergency department doctors to improve work and academic performance, and to manage stress and anxiety
Authors: Eggink Karin M , Taylor Simone E , Judkins Simon , Taylor David McD
Published: February 2021

Objective

To determine medications used by ED doctors to improve work and academic performance, and to manage stress and anxiety.

Methods

We undertook an online, voluntary, anonymous survey of ACEM fellows and trainees.

Results

One hundred and thirty‐nine (46.5%) respondents used a medication under examination. Sleep aids included melatonin (19.1% of respondents) and benzodiazepines (8.7%). Medications to improve performance included modafinil (4.7%), pseudoephedrine (2.0%), melatonin (2.0%) and beta blockers (1.3%). Some medications were taken prior to shifts. Medications to manage stress and anxiety included benzodiazepines (3.0%) and beta blockers (2.0%).

Conclusion

Medication use is common and support for some doctors may be required.
A chromosome‐level assembly of the harlequin ladybird Harmonia axyridis as a genomic resource to study beetle and invasion biology
Authors: Chen Mengyao , Mei Yang , Chen Xu , Chen Xi , Xiao Da , He Kang , Li Qiang , Wu Mengmeng , Wang Su , Zhang Fan , Li Fei
Published: February 2021

The harlequin ladybird, Harmonia axyridis (Pallas), is a well‐known model organism for genetic studies and is also a well‐studied natural enemy used for pest control. It became an invasive species after being introduced to North America and Europe as a pest control agent. Though two genome assemblies for this insect have been previously reported, a high‐quality genome assembly at the chromosome level is still not available. Here, we obtained a new chromosome‐level genome assembly of H. axyridis by combining various sequencing technologies, namely Illumina short reads, PacBio long reads, 10X Genomics and Hi‐C. The chromosome‐level genome assembly is 423 Mb with a scaffold N50 of 45.92 Mb. Using Hi‐C data 1,897 scaffolds were anchored to eight chromosomes. A total of 730,068 repeat sequences were identified, making up 51.2% of the assembled genome. After masking these repeat sequences, we annotated 22,810 protein‐encoding genes. The X chromosome and Y‐linked scaffolds were also identified by resequencing male and female genomes and calculating the male to female coverage ratios. Two gene families associated with environmental adaptation, odorant receptor and cytochrome P450, were analysed and showed no obvious expansion in H. axyridis. We successfully constructed a putative biosynthesis pathway of harmonine, a defence compound in the haemolymph of H. axyridis, which is a key factor for H. axyridis strong immunity. The chromosome‐level genome assembly of H. axyridis is a helpful resource for studies of beetle biology and invasive biology.
Panoramic: A package for constructing eukaryotic pan‐genomes
Authors: Glick Lior , Mayrose Itay
Published: February 2021

The study of intraspecific genomic variation in eukaryotic species has been the focus of numerous genome resequencing projects in recent years. One emerging approach for the analysis of intraspecific diversity uses the concept of a pan‐genome, which theoretically represents the full set of genomic sequences and coding genes from all individuals of a given species. This approach has many advantages over reference‐based methods and has been successfully applied to study both prokaryotic and eukaryotic species. However, the process of pan‐genome construction still presents considerable scientific and technical challenges, especially for eukaryotic species with large and complex genomes. Although general approaches for the construction of pan‐genomes have been devised, currently available software tools implement only certain modules of the entire computational procedure. Therefore, each pan‐genome project requires the development of tailored analysis pipelines, thus complicating and prolonging the process and impairing research reproducibility and comparison across studies. Here, we present Panoramic, a software package for the automatic construction of eukaryotic pan‐genomes. Panoramic takes raw sequencing reads as input and applies two alternative approaches for pan‐genome construction. Panoramic makes pan‐genome construction a considerably easier task by providing simple user interface and efficient data processing algorithms. We demonstrate the use of Panoramic by constructing the pan‐genome of the model plant species Arabidopsis thaliana from sequencing data of 20 diverse ecotypes.
Genome insights give cause for optimism in the ongoing battle to save the vaquita
Authors: Whibley Annabel
Published: February 2021

Whilst the global threat to biodiversity is accelerating, recent advances in sequencing and assembly technologies, along with decreasing costs, are ushering in a golden age for biodiversity genomics. In a From the Cover article in this issue of Molecular Ecology Resources, Morin et al. report an exceptionally high‐quality draft genome assembly of the vaquita (Phocoena sinus), a porpoise first described in 1958 and currently numbering fewer than 20 individuals in the wild. On the brink of extinction and described as critically endangered by the International Union for the Conservation of Nature (IUCN), a precipitous population decline since the 1990 s has been due to bycatch in gillnets in the Upper Gulf of California.
Social norms as a predictor of smoking uptake among youth: a systematic review, meta‐analysis and meta‐regression of prospective cohort studies
Authors: East Katherine , McNeill Ann , Thrasher James F. , Hitchman Sara C.
Published: February 2021

Background and aims

Social norms towards smoking are a key concept in tobacco control policy and research. However, the influence and strength of different types of social norms on youth smoking uptake is unclear. This study aimed to examine, quantify and compare evidence of the longitudinal associations between different types of social norms towards smoking and youth smoking uptake (initiation and escalation).

Methods

Systematic review searching four databases (MEDLINE, EMBASE, PsycInfo, CINAHL) from January 1998 to October 2020. Evidence synthesis via narrative review, meta‐analysis pooling unadjusted associations (initiation only, due to heterogeneity in escalation outcomes) and meta‐regression comparing effect sizes by norm type and study characteristics. Studies included observational prospective cohort studies using survey methodology with youth aged ≤24 years. Measurements included longitudinal associations between descriptive norms (perceived smoking behaviour) and injunctive norms (perceived approval/disapproval of smoking) among social network(s) and subsequent smoking initiation or escalation.

Results

Thirty articles were identified. In the narrative review, smoking initiation (but not escalation) was consistently predicted by two norms: parental and close friend smoking. Associations between smoking uptake and other descriptive norms (smoking among siblings, family/household, partner, peers, adults) and all injunctive norms (perceived approval of smoking among parents, siblings, close friends/peers, partner, teachers, people important to you, the public) were less consistent or inconclusive. In the meta‐analysis pooling unadjusted associations, 17 articles were included (n = 27 767). Smoking initiation was predicted by the following descriptive norms: smoking among parents [Odds Ratio (OR) = 1.88, 95% Confidence Interval (CI) = 1.56–2.28], close friends (OR = 2.53, 95% CI = 1.99–3.23), siblings (OR = 2.44, 95% CI = 1.93–3.08), family/household (OR = 1.55, 95% CI = 1.36–1.76) and adults (OR = 1.34, 95% CI = 1.02–1.75), but not peers (OR = 1.14, 95% CI = 0.92–1.42). Smoking initiation was also predicted by two injunctive norms, perceived approval of smoking among parents (OR = 1.74, 95% CI = 1.27–2.38) and the public (OR = 4.57, 95% CI = 3.21–6.49), but not close friends/peers (OR = 2.36, 95% CI = 0.86–6.53) or people important to the individual (OR = 1.24, 95% CI = 0.98–1.58).

Conclusions

In this systematic review (narrative and meta‐analysis), descriptive norms of parents’ and close friends’ smoking behaviour appeared to be consistent predictors of youth smoking initiation, more so than the descriptive norms of more distal social networks and injunctive norms.
Pathogenesis of uteroplacental acute atherosis: An update on current research
Authors: Li Shu , Hu Yan‐Wei
Published: February 2021

Uteroplacental acute atherosis is a type of arterial vascular disease that affects the placenta during pregnancy and predominates in the maternal spiral arteries in the decidua basalis layer of the pregnant uterus. This condition is characterized by fibrin‐like necrosis of the blood vessel walls, the accumulation of macrophages containing fat (foam cells), and the infiltration of macrophages around blood vessels. Uteroplacental acute atherosis is rare in normal pregnancy but occurs more frequently in patients with pregnancy complications, including preeclampsia, spontaneous preterm labor, preterm prelabor rupture of membranes, mid‐trimester spontaneous abortion, fetal death, and small‐for‐gestational age. It is believed that the mechanisms underlying the development of uteroplacental acute atherosis are related to the incomplete physiological transformation of spiral arteries, placental inflammation, abnormal lipid metabolism, and oxidative stress. In this review, we describe the pathogenesis of uteroplacental acute atherosis to provide reference guidelines for the future prevention and treatment of uteroplacental acute atherosclerotic disease.
Translating antenatal magnesium sulphate neuroprotection for infants born <28 weeks' gestation into practice: A geographical cohort study
Authors: Doyle Lex W. , Spittle Alicia J. , Olsen Joy E. , Kwong Amanda , Boland Rosemarie A. , Lee Katherine J. , Anderson Peter J. , Cheong Jeanie L. Y. ,   for the Victorian Infant Collaborative Study Group
Published: February 2021

Background

Magnesium sulphate was introduced for fetal neuroprotection in Australia in 2010. The aim of this study was to determine how often antenatal magnesium sulphate is used currently and its association with cerebral palsy in children born <28 weeks' gestation.

Materials and Methods

Participants comprised all survivors born <28 weeks' gestational age in the state of Victoria in 2016‐17, and earlier, in 1991‐92, 1997, 2005. Rates of cerebral palsy, diagnosed at two years for the 2016‐17 cohort, and at eight years in the earlier cohorts, were compared across eras. Within 2016‐17, the proportions of children exposed to antenatal magnesium sulphate were determined, and rates of cerebral palsy were compared between those with and without exposure to magnesium sulphate.

Results

Overall, cerebral palsy was present in 6% (11/171) of survivors born in 2016‐17, compared with 12% (62/499) of survivors born in the three earlier eras (odds ratio (OR) 0.48, 95% confidence interval (CI) 0.25–0.94; P = 0.032). Data were available for 213/215 (99%) survivors born in 2016‐17, of whom 147 (69%) received magnesium sulphate. Data on cerebral palsy at two years were available for 171 (80%) survivors with magnesium data. Cerebral palsy was present in 5/125 (4%) children exposed to magnesium sulphate and in 6/46 (13%) of those not exposed (OR 0.28, 95% CI 0.08–0.96; P = 0.043).

Conclusions

Antenatal magnesium sulphate is being translated into clinical practice for infants born <28 weeks' gestation, but there is room for improvement. It is associated with lower rates of cerebral palsy in survivors.
Trans‐urethral snare stent removal: a novel, self‐constructed innovation for simultaneous ureteral stent removal and safety guidewire insertion
Authors: Adam Ahmed , Bhattu Amit S. , Lawrentschuk Nathan
Published: February 2021

Background

Ureteral stent insertion and subsequent removal remains one of the most common procedures performed in endourology. We aimed to evaluate a novel, one‐step method, permitting simultaneous stent removal and guidewire passage using a self‐constructed suture snare via standard cystoscopy. This method should be used prior to ureteroscopy, in cases of minimal stent encrustation and peri‐ureteral mucosal oedema, where identification and subsequent cannulation of the ureteral orifice may be a challenge.

Methods

A self‐constructed suture snare is constructed using an open‐ended ureteral catheter to facilitate this novel ‘Switch’ technique. Operative duration, cost feasibility and potential complications with this novel method were assessed in patients with an indwelling stent duration above 100 days.

Results

Age inclusion in this study ranged from 21 to 35 years, with kidney, ureter and bladder scores below 6, in the five patients assessed. Previous ureteral stent indwelling time ranged from 106 to 315 days. Reasons for (pre‐stented) ureteroscopy were mostly stone related. The overall recorded procedure time for the Switch technique was successfully performed in less than 96 s (range 68–95 s) in all cases within this series. No procedure‐related complications were reported.

Conclusion

Utilizing the suture snare, the novel Switch technique was successfully performed in all cases assessed. This method is both time and cost feasible and could be easily utilized in resource‐limited areas, regional centres or in cases where a stent grasper is not available, may have malfunctioned or cannot adequately approximate due to distal ureteral stent encrustation.
Thirty years of mirena: A story of innovation and change in women’s healthcare
Authors: Gemzell‐Danielsson Kristina , Kubba Ali , Caetano Cecilia , Faustmann Thomas , Lukkari‐Lax Eeva , Heikinheimo Oskari
Published: February 2021

Since its introduction in 1990, the levonorgestrel‐releasing intrauterine system (LNG‐IUS) has played a key role in shaping the healthcare landscape of women. Here we explore the development of the first LNG‐IUS (Mirena®) and the early clinical trials that demonstrated its potential. We highlight the contraceptive and therapeutic benefits of Mirena®, and discuss how clinical practice has been changed since the introduction of LNG‐IUS and other long‐acting reversible contraceptive methods. The history of Mirena® is rich in innovation and has also paved the way to the development of smaller intrauterine systems with lower hormone doses. Along with Mirena®, these newer LNG‐IUS contribute to improving contraceptive choices for women, allowing them to select the option that is right for them and that meets their needs no matter their age, parity or circumstances.
Norwegian parents avoid placing infants in prone sleeping positions but frequently share beds in hazardous ways
Authors: Osberg Silje , Kalstad Trine Giving , Stray‐Pedersen Arne
Published: February 2021

Aim

Campaigns to prevent prone sleeping and other modifiable risk factors have greatly reduced the incidence of sudden infant death syndrome in Norway. Sleep‐related infant deaths still occur sporadically and may be preventable. We studied infants’ sleeping environments and whether parents followed safe sleep recommendations.

Methods

Parents with infants up to 12 months of age were invited to complete an online questionnaire from May to December 2018. It was publicised by health centres and on websites and social media.

Results

We received 4886 responses and 4150 met the age criteria and were included. Just under two‐thirds (62.7%) reported routine bed‐sharing, and this practice was associated with increased nocturnal breastfeeding, single parents and having more than one child. A small number of infants under six months were occasionally placed prone when they were laid down to sleep (2.1%) and 29.7% were placed on their side. Nearly three‐quarters (72.6%) of the 2330 parents with infants under six months of age reported previous high‐risk behaviour, such as sleeping together on a sofa or bed‐sharing after smoking or drinking.

Conclusion

Norwegian parents rarely used prone sleeping positions for infants. However, bed‐sharing was common, including high‐risk scenarios such as smoking, alcohol use and sofas.
Role of oculocerebrorenal syndrome of Lowe (OCRL) protein in megakaryocyte maturation, platelet production and functions: a study in patients with Lowe syndrome
Authors: Egot Marion , Lasne Dominique , Poirault‐Chassac Sonia , Mirault Tristan , Pidard Dominique , Dreano Elise , Elie Caroline , Gandrille Sophie , Marchelli Aurore , Baruch Dominique , Rendu John , Fauré Julien , Flaujac Claire , Gratacap Marie‐Pierre , Sié Pierre , Gaussem Pascale , Salomon Rémi , Baujat Geneviève , Bachelot‐Loza Christilla
Published: February 2021

Lowe syndrome (LS) is an oculocerebrorenal syndrome of Lowe (OCRL1) genetic disorder resulting in a defect of the OCRL protein, a phosphatidylinositol‐4,5‐bisphosphate 5‐phosphatase containing various domains including a Rho GTPase‐activating protein (RhoGAP) homology domain catalytically inactive. We previously reported surgery‐associated bleeding in patients with LS, suggestive of platelet dysfunction, accompanied with a mild thrombocytopenia in several patients. To decipher the role of OCRL in platelet functions and in megakaryocyte (MK) maturation, we conducted a case‐control study on 15 patients with LS (NCT01314560). While all had a drastically reduced expression of OCRL, this deficiency did not affect platelet aggregability, but resulted in delayed thrombus formation on collagen under flow conditions, defective platelet spreading on fibrinogen and impaired clot retraction. We evidenced alterations of the myosin light chain phosphorylation (P‐MLC), with defective Rac1 activity and, inversely, elevated active RhoA. Altered cytoskeleton dynamics was also observed in cultured patient MKs showing deficient proplatelet extension with increased P‐MLC that was confirmed using control MKs transfected with OCRL‐specific small interfering(si)RNA (siOCRL). Patients with LS also had an increased proportion of circulating barbell‐shaped proplatelets. Our present study establishes that a deficiency of the OCRL protein results in a defective actomyosin cytoskeleton reorganisation in both MKs and platelets, altering both thrombopoiesis and some platelet responses to activation necessary to ensure haemostasis.
Geologically constrained evolutionary geomechanical modelling of diapir and basin evolution: A case study from the Tarfaya basin, West African coast
Authors: Hooghvorst Jean Joseph , Nikolinakou Maria A. , Harrold Toby W. D. , Fernandez Oscar , Flemings Peter B. , Marcuello Alejandro
Published: February 2021

We systematically incorporate burial history, sea floor geometry and tectonic loads from a sequential kinematic restoration model into a 2D evolutionary geomechanical model that simulates the formation of the Sandia salt diapir, Tarfaya basin, NW African Coast. We use a poro‐elastoplastic description for the sediment behaviour and a viscoplastic description for the salt. Sedimentation is coupled with salt flow and regional shortening to determine the sediment porosity and strength and to capture the interaction between salt and sediments. We find that temporal and spatial variation in sedimentation rate is a key control on the kinematic evolution of the salt system. Incorporation of sedimentation rates from the kinematic restoration at a location east of Sandia leads to a final geomechanical model geometry very similar to that observed in seismic reflection data. We also find that changes in the variation of shortening rates can significantly affect the present‐day stress state above salt. Overall, incorporating kinematic restoration data into evolutionary models provides insights into the key parameters that control the evolution of geologic systems. Furthermore, it enables more realistic evolutionary geomechanical models, which, in turn, provide insights into sediment stress and porosity.
Provenance of Neogene sandstones in western Taiwan traced with garnet geochemistry and zircon geochronology
Authors: Garzanti Eduardo , Barbarano Marta , Andò Sergio , Lenzi Maura , Deng Kai , Yang Shouye
Published: February 2021

In this study, we use provenance analysis to shed light on the Neogene evolution of river drainage and sediment dispersal in eastern Asia as a consequence of the Himalayan orogeny and topographic rise of the Tibetan Plateau. As an attempt to envisage how sediment‐routing systems operated in the past, and to identify the ultimate source of siliciclastic detritus originally generated in mainland China and now incorporated in, and recycled from, the western Taiwan accretionary prism, we have used Raman spectroscopy of detrital garnet in modern river sands and upper Neogene sandstones, complemented by detrital‐zircon geochronology and by petrographic and heavy‐mineral analysis. Garnet grains are relatively abundant and largely represented by almandine with various percentages of pyrope molecules in Yangtze sand as in western Taiwan sandstones and modern river sand derived from them. Instead, they are rare and largely represented by grossular or andradite in the sand of the Pearl River and of coastal rivers of SE China facing the Taiwan Strait. This finding supports the result of detrital geochronology, which documents a sharp difference between U‐Pb age spectra of Pearl River and coastal SE China zircons (characterised by a Paleozoic‐Mesozoic triple peak) and Yangtze and western Taiwan zircons (characterised by prominent Neoproterozoic, Paleoproterozoic, and latest Archean clusters). The Pearl River and minor rivers facing the Taiwan Strait are thus ruled out as ultimate sources of upper Neogene sandstones exposed today along the western front of the Taiwan fold‐thrust belt. In the envisaged scenario, sand mostly supplied by the paleo‐Yangtze River was entrained for ~ca.1,000 km southward by longshore currents and deposited on the Chinese passive margin before being accreted along the front of the Taiwan orogen since ~6 Ma. Littoral sand drift represents a major factor of long‐distance sediment transport in modern shelves and needs to be taken into full account in source‐to‐sink studies and paleogeographic reconstructions.
Climate and soil mediate the effects of liana density on forest dynamics
Authors: Maia Vinícius Andrade , Santos Alisson Borges Miranda , de Aguiar‐Campos Natália , Souza Cléber Rodrigo de , Morel Jean Daniel , Oliveira Matheus Coutinho Freitas de , Alencar Fagundes Nathalle Cristine , Gianasi Fernanda Moreira , Fontes Marco Aurélio Leite , Santos Rubens Manoel dos
Published: February 2021

Forest community dynamics is a topic of great interest in times when the global carbon budget is a widespread concern due to climate change. Among its effects, longer periods of drought and liana proliferation, coupled with land use change, may endanger tropical forest carbon sinks. Here, in a 10.3 ha sampling of six Atlantic semideciduous forests, we investigated the effects of liana crown occupancy and large‐stemmed lianas, as well as their interactions with climate and soil, on forest dynamics. We expected that harsh environmental conditions would enhance the negative effects of lianas on forest productivity. Our hypothesis was corroborated by the findings that the positive effect of lianas on tree mortality increases under drier conditions, as well as their negative effect on tree recruitment. In addition, liana crown occupancy was the best predictor of net aboveground woody biomass productivity, which decreases as liana crown occupancy increases. Our study provides additional evidence of indirect climate change impacts on the tropical forest carbon sink by increasing the negative effects of liana crown occupancy on tree biomass productivity.

Abstract in Portuguese is available with online material.
Clinical evaluation of type 2 disease status in a real‐world population of difficult to manage asthma using historic electronic healthcare records of blood eosinophil counts
Authors: Azim Adnan , Newell Colin , Barber Clair , Harvey Matthew , Knight Deborah , Freeman Anna , Fong Wei Chern Gavin , Dennison Paddy , Haitchi Hans Michael , Djukanovic Ratko , Kurukulaaratchy Ramesh , Howarth Peter
Published: February 2021

Background

Blood eosinophil measurement is essential for the phenotypic characterization of patients with difficult asthma and in determining eligibility for anti‐IL‐5/IL‐5Rα biological therapies. However, assessing such measures over limited time spans may not reveal the true underlying eosinophilic phenotype, as treatment, including daily oral corticosteroid therapy, suppresses eosinophilic inflammation and asthma is intrinsically variable.

Methods

We interrogated the electronic healthcare records of patients in the Wessex AsThma CoHort of difficult asthma (WATCH) study (UK). In 501 patients being evaluated in this tertiary care centre for difficult to control asthma, all requested full blood count test results in a 10‐year retrospective period from the index WATCH assessment were investigated (n = 11,176).

Results

In 235 biological therapy‐naïve participants who had 10 or more measures in this time period, 40.3% were eosinophilic (blood eosinophils ≥300 cells/µl) at WATCH enrolment whilst an additional 43.1%, though not eosinophilic at enrolment, demonstrated eosinophilia at least once in the preceding decade. Persistent eosinophilia was associated with worse post‐bronchodilator airway obstruction and higher Fractional exhaled Nitric Oxide (FeNO). In contrast, the 16.6% of patients who never demonstrated eosinophilia at this blood eosinophil threshold showed preserved lung function and lower markers of Type 2 inflammation.

Conclusions

This highlights the central role that type 2 inflammation, as indicated by blood eosinophilia, has in difficult asthma and suggests that longitudinal electronic healthcare record analysis can be an important tool in clinical asthma phenotyping, providing insight that may help understand disease progression and better guide more specific treatment approaches.
Innate and adaptive immune responses to SARS-CoV-2 in humans: relevance to acquired immunity and vaccine responses
Authors: Jordan S C
Published: February 2021

The factors responsible for the spectrum of coronavirus 19 (COVID-19) disease severity and the genesis and nature of protective immunity against COVID-19 remain elusive. Multiple studies have investigated the immune responses to COVID-19 in various populations, including those without evidence of COVID-19 infection. Information regarding innate and adaptive immune responses to the novel severe respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved rapidly. Data are accumulating defining disease phenotypes that aid in rational and informed development of new therapeutic approaches for the treatment of patients infected with SARS-CoV-2 and the development of novel vaccines. In this paper, data on important innate immune responses are summarized, including cytokines, specifically interleukin (IL)-6 and complement, and potential treatments are explored. Adaptive immune responses and derivative therapeutics such as monoclonal antibodies directed at spike proteins are also examined. Finally, data on real-time assessments of adaptive immune responses are explored, which include CD4+/CD8+ T cells, natural killer (NK) T cells, memory B cells and T follicular cells with specificities for COVID-19 peptides in infected and normal individuals. Data of two novel vaccines have been released, both showing > 95% efficacy in preventing SARS-CoV-2 infection. Analysis of humoral and cellular responses to the vaccines will determine the robustness and durability of protection. In addition, long-term assessment of SARS-CoV-2 memory B and T cell-mediated immune responses in patients recovering from an infection or those with cross-reactive immunological memory will help to define risk for future SARS-CoV infections. Finally, patients recovering from SARS-CoV-2 infection may experience prolonged immune activation probably due to T cell exhaustion. This will be an important new frontier for study.
Standardization of thyroid ultrasound reporting in the community setting decreases biopsy rates
Authors: Ghazizadeh Shabnam , Kelly Tracy L. , Khajanchee Yashodhan S. , Fleser Jessica , Rozenfeld Yelena , Neuman Michael , Hammill Chet W. , Orr Lauren , Aliabadi‐Wahle Shaghayegh
Published: February 2021

Objective

With the rising incidence of thyroid cancer, a standardized approach to the evaluation of thyroid nodules is essential. Despite the presence of multiple national guidelines detailing evaluation and management of these nodules, significant variability exists in the information that is collected and reported to clinicians from diagnostic imaging. The aim of this study was to evaluate the impact of thyroid ultrasound standardization on thyroid cancer detection in a community practice setting.

Design

As part of a physician‐driven quality improvement project, a multidisciplinary team created an electronic worksheet to be utilized by sonographers to capture suspicious findings based on societal guidelines and agreed on institutional criteria for recommending fine needle aspiration (FNA) of thyroid nodules.

Patients

For a one‐year period prior to and after the intervention, all ultrasounds performed for suspected thyroid pathology, excluding patients undergoing follow‐up imaging, were reviewed at two affiliated community hospitals served by a single radiology and pathology group.

Measurements

The number of fine needle biopsies recommended and performed, as well as the percentage of FNAs positive for malignancy were evaluated.

Results

A total of 608 and 675 ultrasounds were reviewed in pre‐ and post‐standardization periods, respectively. Following standardization, there was a similar percentage of FNAs recommended (35% vs. 37%, p = .68), fewer FNAs per total ultrasounds performed (36% vs. 31%, p = .03), fewer FNAs performed when FNA was not explicitly recommended (9.9% vs. 2.8%, p = .000046) and an increased detection of cytology consistent with, or suspicious for, malignancy (5% vs. 11.5%, p = .0028).

Conclusions

Standardization of thyroid imaging protocol and management recommendations can reduce the number of FNAs performed and increase the percentage of positive tests in a community setting.
Development and reliability of the revised Patterson Edema Scale
Authors: Starmer Heather M. , Drinnan Michael , Bhabra Mandeep , Watson Laura‐Jayne , Patterson Joanne
Published: February 2021

Objective

The Patterson Edema scale was developed in 2007 to address the lack of a reliable, sensitive scale to measure laryngeal and pharyngeal oedema in patients with head and neck cancer. The objective of this study was to revise the existing Patterson scale to improve its reliability and utility.

Design

Prospective investigation.

Setting

Academic medical center.

Participants

Speech‐Language Pathologists, Otolaryngologists, and Radiation Oncologists.

Main outcome measures

Ratings using the Revised Patterson Edema Scale.

Methods

A consensus group reviewed existing literature regarding the performance of the original Patterson scale and revised the existing scale in regard to items to be included and descriptors for each severity level. The scale was then utilised by 18 speech language pathologists from the US and UK with >2 years‐experience working with dysphagia and dysphonia with endoscopy. Each SLP rated a total of eight parameters (epiglottis, vallecula, pharyngoepiglottic folds, aryepiglottic folds, arytenoids, false vocal folds, true vocal folds and pyriform sinuses) using the Revised Patterson Edema Scale. Feedback was solicited from raters regarding areas where clarity was lacking for further scale revision. Scale revisions were completed and additional ratings were completed by otolaryngologists, radiation oncologists and less experienced SLP providers to establish reliability across disciplines. Quadratic weighted Kappa values were obtained to establish interrater reliability.

Results

Feedback received from raters included suggestions for clarification of how to rate unilateral oedema, use of a standard task battery to visualise and rate structures consistently, and clarification of true vocal fold oedema rating parameters. Overall interrater reliability was established using quadratic weighted Kappa with good agreement noted for the epiglottis, vallecula, arytenoids and false vocal folds; moderate agreement noted for aryepiglottic folds, pharyngoepiglottic folds and pyriform sinuses; and fair agreement noted for true vocal folds.

Conclusions

The Revised Patterson Edema Scale demonstrates moderate‐substantial interrater reliability for most parameters across multiple disciplines and experience levels, with the exception of the true vocal folds where agreement was fair. We believe the Revised Patterson Oedema Scale provides a reliable tool for clinicians and researchers to rate oedema in the supraglottic larynx and pharynx following treatment for head and neck cancer.
Risk factors for readmission with dehydration after ileostomy formation: A systematic review and meta‐analysis
Authors: Liu Chen , Bhat Sameer , Sharma Puja , Yuan Lance , O’Grady Gregory , Bissett Ian
Published: February 2021

Aim

Ileostomy formation is a commonly performed procedure with substantial associated morbidity. Patients with an ileostomy experience high rates of unplanned hospital readmission with dehydration, and such events have a long‐term health and economic impact. Reports of the significant risk factors associated with these readmissions have been inconsistent. This study aimed to identify the significant risk factors for readmission with dehydration following ileostomy formation.

Method

A systematic search was conducted using the Medline, Embase, Cochrane and CINAHL databases. All original research articles reporting risk factors for readmission with dehydration following ileostomy formation in adults were included. The primary outcome was the pooled risk ratio of clinically relevant variables potentially associated with dehydration‐related readmission following ileostomy formation. The secondary outcome was the incidence of dehydration‐related readmission.

Results

Ten studies (27 089 patients) were included. The incidences of 30‐ and 60‐day readmission with dehydration were 5.0% (range 2.1%–13.2%) and 10.3% (range 7.3%–14.1%), respectively. Eight variables were found to be significantly associated with dehydration‐related readmission: age ≥65 years, body mass index ≥30 kg/m2, diabetes mellitus, hypertension, renal comorbidity, regular diuretic use, ileal pouch–anal anastomosis procedure and length of stay after index admission. A preoperative diagnosis of colorectal cancer was less likely to result in readmission with dehydration.

Conclusion

Readmission with dehydration following ileostomy formation is a significant issue with several risk factors. Awareness of these risk factors will help inform the design of future studies addressing risk prediction, allow risk stratification of ileostomates and aid in the development of personalized prevention strategies.
Transcutaneous PCO2‐based dead space ventilation at submaximal exercise accurately discriminates healthy controls from patients with chronic obstructive pulmonary disease
Authors: Leprat Thibault , Ivanes Fabrice , Bernard Anne , Marchand‐Adam Sylvain , Plantier Laurent
Published: February 2021

Background

Increased physiological dead space ventilation (VD/VT) at exercise reflects pulmonary gas exchange impairment and is a sensitive marker of cardio‐respiratory disease.

VD/VT is typically not measured during routine cardiopulmonary exercise testing (CPET) because its calculation requires arterial blood gas analysis for determination of PaCO2. Instead, dead space ventilation is indirectly evaluated as a determinant of the ventilation (VE)/VCO2 relationship, which also depends on the PaCO2 set point. We hypothesized that VD/VT calculations based on non‐invasive transcutaneous PCO2 (PtcCO2) measurement had better diagnostic characteristics than the VE/VCO2 slope for the discrimination of healthy subjects from patients with COPD, a common disease associated with impaired pulmonary gas exchange.

Methods

Retrospective study of 19 healthy controls and 24 COPD patients who underwent CPET with continuous PtcCO2 monitoring. Areas under receiver operating characteristics curves (AUC) were calculated to assess diagnostic accuracy of CPET measurement for the discrimination of COPD and Controls.

Results

The AUC for PtcCO2‐based VD/VT at VT1 (0.977) was significantly higher than for the VE/VCO2 slope (0.660), SpO2 at peak exercise (0.913), decrease in inspiratory capacity (0.719), and ventilatory reserve (0.708). At a threshold of 0.24, the sensitivity and specificity of PtcCO2‐based VD/VT for the discrimination of COPD patients and healthy Controls were 100% and 84%, respectively. All Control subjects had PtcCO2‐based VD/VT ≤ 0.25.

Conclusions

PtcCO2‐based VD/VT was the most accurate measurement to discriminate healthy controls from subjects with COPD, a chronic lung disease associated with altered pulmonary gas exchange. Non‐invasive monitoring of PtcCO2 may be useful for routine CPET.
A case of lymphomatoid papulosis type E in a young adult: An uncommon entity
Authors: Rajashekara Swamy Meghana , Pollock Samara , J. Goldberg Lynne , Shen Lisa
Published: February 2021

Lymphomatoid papulosis (LyP) type E is a rare variant of the primary cutaneous CD30+ lymphoproliferative disorders, characterized clinically by large necrotic eschar‐like lesions and histopathologically by angiodestructive and angioinvasive infiltrates of CD30+ lymphocytes. As in other forms of lymphomatoid papulosis, type E lesions may undergo spontaneous regression after weeks, with frequent recurrences. We report a 21‐year old male with an angiodestructive infiltrate of CD30+ lymphocytes manifesting as a papular eruption rather than ulceration, and suggest that this clinical phenotype might be related to the presence of CD4+ lymphocytes in the inflammatory cell infiltrate.
For the church community after COVID‐19
Authors: Cho Anna
Published: February 2021

COVID‐19 is changing everyday life. COVID‐19 is also changing the look of the church. The church is a community of people who gather for worship, fellowship, and sharing. However, due to the coronavirus, the church is no longer able to gather and worship together. Moreover, because of the coronavirus, social distancing with as little as possible face‐to‐face contact has been recommended worldwide. If this situation is prolonged, the church community interactions will have difficulty in surviving. Therefore, this article seeks ways to maintain and strengthen the church community in and after the coronavirus era through insight into speech act theory.
Cognitive outcome in drug‐resistant childhood epilepsy
Authors: Lagae Lieven
Published: February 2021

This commentary is on the original article by Puka and Smith on pages 690–696 of this issue.
Recent developments in classifying and assessing dysarthria in children
Authors: Kuschmann Anja
Published: February 2021

This commentary is on the original articles by Schölderle et al. and Veenhuis et al. on pages 444–449 and 450–456 of this issue.