bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of metformin monotherapy in US veterans with type 2 diabetes and preexisting chronic kidney disease stage 3
Authors: Gosmanov Aidar R. , Gemoets Darren E. , Kaminsky Laurence S. , Kovesdy Csaba P. , Gosmanova Elvira O. 
Published: April 2021

AbstractAimTo evaluate the glycaemic efficacy of metformin in people with type 2 diabetes (T2D) and stage 3 chronic kidney disease (CKD3).Participants and methodsThis was a retrospective study including 145980 US veterans with T2D and an estimated glomerular filtration rate (eGFR) ≥30 mL/min/1.73 m2 who initiated metformin monotherapy between November 1999 and July 2017. Propensity‐score‐matched cohorts were generated based on baseline variables associated with CKD3 (eGFR 30‐59 mL/min/1.73 m2) to evaluate the independent association between CKD3 and metformin discontinuation, the addition of a second hypoglycaemic agent, and changes in glycated haemoglobin (HbA1c) from baseline in those with and without CKD3. Associations were examined using the Kaplan‐Meier method and multivariable regression models, adjusted for baseline and 12‐month average metformin dose.ResultsThe mean age of the entire cohort was 60.7 years, and 95% of the cohort were men, 21% were African American and 9% had CKD3. In the adjusted analyses, patients with CKD3 had a higher risk of metformin discontinuation or addition of a second hypoglycaemic agent, as compared with patients without CKD (hazard ratio [HR] 1.22, 95% confidence interval [CI] 1.19‐1.26, and HR 1.26, 95% CI 1.13‐1.40, respectively). Among metformin monotherapy users, there were no differences in the average HbA1c reduction from baseline to 12 or 24 months between patients with and without CKD3.ConclusionsIndividuals with CKD3 and T2D were at increased risk of metformin monotherapy failure. However, the HbA1c‐lowering efficacy of metformin was similar in patients with and without CKD3, highlighting that metformin is a valuable treatment option for newly treated individuals with T2D and CKD3.
Prevalence/potential risk factors for motoric cognitive risk and its relationship to falls in elderly Chinese people: a cross‐sectional study
Authors: Yuan Jing‐lin , Zhao Rui‐xue , Ma Ya‐jun , Li Xiao‐dong , Zhou Xiao‐mei , Wang Xiao‐feng , Jiang Xiao‐yan , Li Shu‐juan 
Published: April 2021

AbstractBackground and purposeMotoric cognitive risk syndrome (MCR) is characterized by slow walking speed and subjective memory complaints (SMCs). This study investigated the prevalence and potential risk factors of MCR and its association with falls in Chinese community‐dwelling older adults.MethodsThe analysis was based on data from the Rugao Longevity and Aging Study (RuLAS). MCR was defined as the presence of both SMCs and slow walking speed in participants free of major neurocognitive disorders. SMCs were determined according to a positive answer to the question ‘Do you feel you have more problems with memory than most?’ in the 15‐item Geriatric Depression Scale. Slow walking speed was defined as one standard deviation or more below the mean value for patients’ age and sex. Data on falls were derived from a standardized questionnaire.ResultsThe prevalence of SMCs, slow walking speed and MCR in the RuLAS cohort (N = 1592) was 51.9%, 15.6% and 8.3%, respectively. After adjusting for other covariates, an occupation of farming (odds ratio [OR] 2.358, 95% confidence interval [CI] 1.007–5.521, p = 0.048), history of cerebrovascular disease (OR 2.215, 95% CI 1.032–4.752, p = 0.041) and hospitalization (OR 2.008, 95% CI 1.120–3.602, p = 0.019) were risk factors for MCR. Binary logistic regression analysis indicated that the risk of falls was increased by MCR (OR 1.547, 95% CI 1.009–2.371), SMC (OR 1.308, 95% CI 1.003–1.707) and slow walking speed (OR 1.442, 95% CI 1.030–2.017).ConclusionsEarly identification of potential risk factors of MCR can prevent the occurrence of adverse health events such as falls in the elderly.
What it takes to have a successful new Blue Card scheme: The practitioner's viewpoint
Authors: Antoons Jo , Ghimis Andreia 
Published: April 2021

AbstractThe future skills and labour workforce shortages, together with the demographic challenges, and the economic impact of the COVID‐19 sanitary crisis will increase the EU's need for highly skilled migration. In this comment, we argue that a successful reform of the EU Blue Card scheme should include more flexible eligibility criteria, process facilitations and generous intra‐EU mobility provisions not only for business travel, but also for short‐term work and, in some cases, for movement to a second Member State for employment purposes. Parallel national schemes should be allowed for those that do not qualify for the EU Blue Card scheme. Without these essential changes the administrative cost and time invested into reforming the current schemes at EU and national level will not bring about the expected positive impact on EU's attractiveness for highly skilled third‐country nationals.
Prevalence, clinical features, and esophagogastroduodenoscopy (EGD) findings of non‐Helicobacter pylori Helicobacter infection: A study of 50 cases at a single facility in Japan
Authors: Tsukadaira Toshihisa , Hayashi Seiichi , Ota Hiroyoshi , Kobayashi Natsuko , Sekiguchi Yasuhiro , Kodaira Himiko , Matsumoto Takehisa , Horiuchi Kazuki , Negishi Tatsuya , Kurahashi Mari 
Published: April 2021

AbstractBackground and aimThere are only a few reports of non‐Helicobacter pylori Helicobacter (NHPH) gastritis in Japanese patients. We aimed to examine its prevalence, clinical features, and esophagogastroduodenoscopy (EGD) findings based on 50 patients encountered in one facility.Materials and methodsSubjects were all patients who had undergone gastric mucosal biopsy endoscopically at Kenwakai Hospital for approximately 10 years. NHPH infection was diagnosed by microscopic findings of Giemsa staining performed on all specimens. PCR analysis of urease genes was performed to detect and identify NHPH, when informed consent was obtained. Helicobacter pylori‐diagnostic tests were also performed. NHPH‐infected patients were questioned about symptoms and animal contact.ResultsNHPH gastritis was found in 50 of 3847 patients (1.30%). The percentage increased to 3.35% (30 of 896 patients) in the latter 2 years and 4 months with increasing recognition of its characteristic endoscopic findings by endoscopists. PCR analysis, performed in 30 patients, detected NHPH in 28 patients: 26 as Helicobacter suis and 2 as Helicobacter heilmanii/Helicobacter ailurogastricus. Helicobacter pylori‐diagnostic tests were almost negative. However, anti‐H. pylori antibody showed high‐negative titer (3.0–9.9 U/ml) in 12. Of 50 patients (consisting of 49 men and 1 woman), almost all were asymptomatic, and 25 were keeping pets. Regarding EGD findings, in all 50 patients, “crack‐like mucosa” and/or nodular gastritis was noted in gastric antrum, and regular arrangement of collecting venules (RAC) was noted in gastric corpus. None of the patients infected with NHPH were co‐infected with H. pylori.ConclusionsThe prevalence was finally estimated to be approximately 3.35%. Helicobacter suis was the most common NHPH species. “Crack‐like mucosa” and/or nodular gastritis in gastric antrum, RAC in gastric corpus, and H. pylori‐negativity by H. pylori‐diagnostic tests especially containing a high‐negative titer of anti‐H. pylori antibody may indicate NHPH infection.
Maximizing the impact of exposure to scientific role models: Testing an intervention to increase science identity among adolescent girls
Authors: Merritt Sally K. , Hitti Aline , Van Camp Amanda R. , Shaffer Emily , Sanchez Michelle H. , O'Brien Laurie T. 
Published: April 2021

AbstractA field experiment tested an intervention to maximize the impact of a science outreach program by encouraging early adolescent girls (N = 240, Mage =12) to adopt female role models. Girls participated in workshops led by female role models who were scientific experts in their field. Afterward, they were randomly assigned to choose and write about their favorite workshop leader or to write about the first workshop leader. We hypothesized that the intervention would benefit girls who chose and wrote about a favorite leader. However, girls in both conditions experienced significant increases in science identity. Girls demonstrated strong role model identification with the workshop leaders; moreover, role model identification was associated with increases in science identity. Girls in the chosen leader condition focused on her competence and supportiveness more than girls in the assigned leader condition. There was no difference in science identity between girls from well‐represented and underrepresented minority (URM) ethnic groups in scientific fields. URM girls, surprisingly, identified more with the workshop leader than well‐represented girls. Science workshops led by female role models with relevant expertise may facilitate science identification among early adolescent girls from diverse ethnic backgrounds.
The habitat amount hypothesis predicts that fragmentation poses a threat to biodiversity: A reply to Fahrig
Authors: Saura Santiago 
Published: April 2021

AbstractIn Saura (Journal of Biogeography, 48, 11–22, 2021), I showed that the habitat amount hypothesis (HAH) has been considerably misinterpreted in several ways. In her response to my findings, Fahrig (Journal of Biogeography, 2021) admits that some predictions that were previously attributed to the HAH do not logically derive from it. She has however one main objection to my conclusions: that there are some cases where the HAH predicts higher site‐level species richness with more fragmentation in a region. I here explain why this is a partial and questionable observation that distracts and potentially misleads our understanding of the HAH predictions. It does not appropriately represent the fundamental and overwhelming negative effects of fragmentation on site‐level species richness that are predicted by the HAH. The HAH predicts that the highest site‐level species richness in a region will happen when all habitat is found in a single and compact habitat patch. Any departure from this zero‐fragmentation case, as well as any additional increase in the number, isolation, elongation or perforation of patches per se, will always have negative effects on site‐level species richness according to the HAH. I more briefly discuss a relatively minor comment by Fahrig on the possible slopes of the species–area relationship when the HAH holds. I conclude that the views and interpretations that have prevailed since the HAH was proposed—that the HAH negates the importance of fragmentation—can no longer be maintained. The HAH predicts that habitat configuration matters for conservation and that fragmentation is a threat to biodiversity.
Retrospective analysis of clinicopathological characteristics of 19 ovarian juvenile granulosa cell tumor cases
Authors: Ndhlovu Elijah , Liu Lili , Dai Jun , Dong Xiyuan , Zhang Wen , Chen Biao 
Published: April 2021

AbstractAimTo describe the clinical and pathological characteristics, diagnosis, treatment, and outcomes of juvenile granulosa cell tumor (JGCT).MethodsWe retrospectively analyzed the data of 19 patients with histopathologically confirmed juvenile granulosa cell tumors treated in two medical centers in Wuhan city of China between 1999 and 2019.ResultsTotally, 19 patients were included during the period. The median age at diagnosis was 8.25 years (range, 0.25–28 years). The most common clinical presentation was abdominal pain, five out of 10 prepubertal children presented with precocious puberty. Three patients underwent radical surgery (including total hysterectomy, bilateral salpingo‐oophorectomy, omentectomy, and pelvic and para‐aortic lymphadenectomy), the other 16 patients had fertility‐sparing surgery (cystectomy or ipsilateral salpingo‐oophorectomy with or without omentectomy and lymphadenectomy). Eighteen patients had the international federation of gynecology and obstetrics (FIGO) stage I tumors, one patient had FIGO stage II disease. Twelve patients received postoperative adjuvant chemotherapy. The median follow‐up time from the time of diagnosis was 35 months (range, 13–250 months). One patient experienced relapse and died of the disease 32 months after the initial diagnosis. Eighteen patients were alive and had not experienced recurrence during the follow‐up period. The reproductive age patients that received fertility‐sparing surgery had regular menstruation.ConclusionsA majority of JGCTs are diagnosed as FIGO stage I tumors and have favorable clinical outcomes. Adjuvant chemotherapy seems to improve outcomes for patients with advanced‐stage JGCTs; however, the value of chemotherapy in stage Ic patients is still unknown. Fertility sparing surgery should be considered in young patients who wish to bear children.
Conservation genomics of a critically endangered brown seaweed
Authors: Mamo Lea T. , Wood Georgina , Wheeler David , Kelaher Brendan P. , Coleman Melinda A. 
Published: April 2021

Seaweeds provide valuable ecosystem services, but many are undergoing global decline due to climate and anthropogenic stressors. The brown macroalga, Nereia lophocladia (hereafter called Nereia), is among only a handful of seaweeds globally to be listed as critically endangered and is only described from two known locations, but there exists little knowledge about this species. Here, we combine field surveys to verify the distribution of Nereia, with cutting‐edge genomics to determine genetic diversity and population structure, and inform ongoing conservation actions. We expand Nereia's known distribution from one to seven locations along a 70‐km long coastal stretch in New South Wales but reveal small population sizes at some sites (as few as 8 individuals despite extensive searching). A total of 1,261 genome‐wide SNPs were retained from 70 individuals after filtering, and 304 outlier loci under putative selection were detected by one of three methods. Populations showed low genetic diversity (mean expected heterozygosity HE = 0.055 ± 0.014) and high levels of inbreeding within populations (mean FIS = 0.721 ± 0.085), along with high genetic differentiation among sites (mean FST = 0.276), which may increase susceptibility to future environmental change and decrease the species' ability to recover after loss. Given these findings, we recommend the consideration of both in situ and ex situ conservation measures for Nereia, as well as further research into the species' ecology and biology. Nereia remains of conservation concern and its listing as critically endangered is justified until further investigation elucidates the full distribution and adaptive capacity of the species.
Repressor for hire! The vital roles of TOPLESS‐mediated transcriptional repression in plants
Authors: Plant Alastair Robert , Larrieu Antoine , Causier Barry 
Published: April 2021

SummaryTranscriptional corepressors play important roles in establishing the appropriate levels of gene expression during growth and development. The TOPLESS (TPL) family of corepressors are critical for all plant life. TPLs are involved in numerous developmental processes and in the response to extrinsic challenges. As such these proteins have been the focus of intense study since Long and colleagues first described the TPL corepressor in 2006. In this review we will explore the evolutionary history of these essential plant‐specific proteins, their mechanism of action based on recent structural analyses, and the myriad of pathways in which they function. We speculate how relatively minor changes in the peptide sequence of transcriptional regulators allowed them to recruit TPL into new processes, driving innovation and resulting in TPL becoming vital for plant development.
A Little Bit Pregnant? Productive Ambiguity and Fertility Research
Authors: Bell Suzanne O. , Fissell Mary E. 
Published: April 2021

AbstractFertility researchers rely upon a simple binary: pregnant versus not pregnant. However, this conceptualization does not capture many women's experiences, both historically and in numerous settings today. We suggest that pregnancy status may be a much more ambiguous state, and that such ambiguity is often productive for women. Building a culturally sensitive understanding of what we are calling “productive ambiguity” can foster more rigorous studies of fertility that better capture potential pregnancy and the range of post‐coital fertility‐inhibiting actions women take, both intentionally and not. In this paper, we aim to: 1) describe the ambiguity that exists around pregnancy; 2) explain the ways in which this ambiguity is productive for women; 3) analyze two concrete examples of such ambiguity in practice: the case of menstrual regulation and the unexpected conceptual overlaps between contraception and early abortion in a variety of settings, and finally; 4) suggest ways that this more nuanced understanding might inform fertility research, including abortion measurement research. We combine recent qualitative and quantitative data with historical sources to analyze the cultural logics and power dynamics of this ambiguity.
Cerebrovascular function response to prolonged sitting combined with a high‐glycemic index meal: A double‐blind, randomized cross‐over trial
Authors: Burnet Kathryn , Blackwell Jade , Kelsch Elizabeth , Hanson Erik D. , Stone Keeron , Fryer Simon , Credeur Daniel , Palta Priya , Stoner Lee 
Published: April 2021

AbstractAcute prolonged sitting leads to cerebrovascular disruptions. However, it is unclear how prolonged sitting interacts with other common behaviors, including high‐ (HGI) and low‐glycemic index (LGI) meals. Using a double‐blind randomized cross‐over design, this study evaluated the effects of prolonged (3 hr) sitting, with a high‐ (HGI; GI: 100) or low‐glycemic index (LGI; GI: 19) meal on total brain blood flow (QBrain) and executive function. Eighteen young, healthy, active participants (22.6 [3.1] y, 33% F, 24.3 [3.7] kg/m2) sat for 3 hr after consuming an HGI or LGI meal. Using Doppler ultrasound to measure internal carotid (ICA) and vertebral (VA) artery blood flow, QBrain was calculated: (ICA blood flow + VA blood flow) × 2. Executive function was assessed using the Stroop Test and Trail Making Test—Part B. Brain fog was measured using a modified Borg Category Scale with Ratio properties (CR10). Following 3 hr of sitting, there was a significant decrease in QBrain with time (p = .001, ES = −0.26), though there were nonsignificant interaction (p = .216) and condition effects (p = .174). Brain fog increased (p = .024, ES = 0.27) and Stroop reaction time worsened with time (p = .001, ES: −0.40), though there were nonsignificant condition effects for brain fog (p = .612) and the Stroop test (p = .445). There was a nonsignificant condition effect (p = .729) for the Trail Making Test—Part B, but completion time improved with time (p = .001, ES = −0.40). In conclusion, 3 hr of prolonged sitting decreases QBrain and executive function independent of glycemic index in young, healthy adults.
A qualitative study portraying nurses’ perspectives on transitional care between intensive care units and hospitals wards
Authors: Herling Suzanne Forsyth , Brix Helene , Andersen Lise , Jensen Liz Daugaard , Handesten Rie , Knudsen Heidi , Bove Dorthe Gaby 
Published: April 2021

AbstractIntroductionThe transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care.AimThe aim was to explore ICU and ward nurses’ views on assignments in relation to patients’ transition between ICU and hospital ward.MethodsWe conducted a qualitative study with 20 semi‐structured interviews with ICU nurses and ward nurses and analysed data by content analysis.SettingA university hospital with 690 beds and an 11‐bed mixed medical/surgical ICU.FindingsThe overarching themes were (1) ‘Ritual of hand over’ with the categories: (a) ‘Ready, able and willing’, (b) ‘Transfer of responsibility’ and (c) ‘Nice to know versus need to know’ and (2) ‘From lifesaving care to rehabilitative care’ with the categories: (a) ‘Complex care needs persist’, (b) ‘Fight or flight mode’ and (c) ‘“Weaning” the family’.Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients’ complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty – this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in ‘fight mode’ and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.
Fatty acid desaturase activity in mature red blood cells and implications for blood storage quality
Authors: Thomas Tiffany , Cendali Francesca , Fu Xiaoyun , Gamboni Fabia , Morrison Evan J. , Beirne Jonathan , Nemkov Travis , Antonelou Marianna H. , Kriebardis Anastasios , Welsby Ian , Hay Ariel , Dziewulska Karolina H. , Busch Michael P. , Kleinman Steven , Buehler Paul W. , Spitalnik Steven L. , Zimring James C. , D'Alessandro Angelo 
Published: April 2021

AbstractBackgroundIncreases in the red blood cell (RBC) degree of fatty acid desaturation are reported in response to exercise, aging, or diseases associated with systemic oxidant stress. However, no studies have focused on the presence and activity of fatty acid desaturases (FADS) in the mature RBC.Study design and methodsSteady state metabolomics and isotope‐labeled tracing experiments, immunofluorescence approaches, and pharmacological interventions were used to determine the degree of fatty acid unsaturation, FADS activity as a function of storage, oxidant stress, and G6PD deficiency in human and mouse RBCs.ResultsIn 250 blood units from the REDS III RBC Omics recalled donor population, we report a storage‐dependent accumulation of free mono‐, poly‐(PUFAs), and highly unsaturated fatty acids (HUFAs), which occur at a faster rate than saturated fatty acid accumulation. Through a combination of immunofluorescence, pharmacological inhibition, tracing experiments with stable isotope‐labeled fatty acids, and oxidant challenge with hydrogen peroxide, we demonstrate the presence and redox‐sensitive activity of FADS2, FADS1, and FADS5 in the mature RBC. Increases in PUFAs and HUFAs in human and mouse RBCs correlate negatively with storage hemolysis and positively with posttransfusion recovery. Inhibition of these enzymes decreases accumulation of free PUFAs and HUFAs in stored RBCs, concomitant to increases in pyruvate/lactate ratios. Alterations of this ratio in G6PD deficient patients or units supplemented with pyruvate‐rich rejuvenation solutions corresponded to decreased PUFA and HUFA accumulation.ConclusionFatty acid desaturases are present and active in mature RBCs. Their activity is sensitive to oxidant stress, storage duration, and alterations of the pyruvate/lactate ratio.