bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinct kin strategies of the legume soybean and the non‐legume balsam by accomplishing different nitrogen acquisition and rhizosphere microbiome composition
Authors: Li Jie , Zhao Qingxia , Li Weilin , He Jizheng , Xu Xingliang 
Published: December 2021

SUMMARYKin selection has been proposed vvto be an important mechanism for plant relatives growing together. To reveal kin recognition, we used15N labeling to assess the short‐term nitrogen (N) acquisition (uptake of nitrate and ammonium), long‐term N utilization (recovery of added urea), N‐use efficiency (NUE) and rhizosphere microbiome in leguminousGlycine maxand non‐leguminousImpatiens balsamina. Individuals of each species were planted pairwise with either a sibling or a stranger. Enzyme activity and soil microbial composition were compared between kinship groups. Compared with strangers,G. maxsiblings increased aboveground biomass, NUE, and nitrogenase activity, whereasI. balsaminasiblings decreased root biomass and increased uptake rate of nitrate and potential nitrification rate. Plant kinship affected soil bacterial communities by enriching specific groups possessing explicit eco‐functions (Rhizobiales forG. maxandNitrospiraforI. balsamina). Kinship‐sensitive operational taxonomic units formed independent modules in the bacterial co‐occurrence network and were positively correlated with plant growth performance, N acquisition and enzymatic activity. Plant kin recognition may depend on the growth strategies of the plant species. Kin selection was dominant inG. maxby enhancing biological N fixation through the enrichment of symbiotic rhizobia (demonstrated by aboveground growth and NUE superiority among siblings). Kin selection and niche partitioning occurred simultaneously inI. balsamina, expressed through reduced root allocation but increased nitrate uptake, and enhanced soil N nitrification, by enriching functional microbial groups. Kin recognition responses are the consequence of complex interactions among the host plant, the microbiome, and soil nutrient cycling and utilization processes.
The 2021 IXA Keith Reemtsma Lecture: Moving xenotransplantation to the clinic
Authors: Cooper David K. C. 
Published: December 2021

AbstractKeith Reemtsma was a pioneer in xenotransplantation, the Honorary Founding President of the International Xenotransplantation Association (in 1998), and a wonderful personality. It is a privilege to be invited to give this lecture in his memory.If he were alive today, he would be delighted to see the progress that has been made in pig organ transplantation into nonhuman primate recipients. This progress has largely resulted from two major advances: (i) the increasing availability of pigs with multiple genetic manipulations aimed at protecting the cells of the organ from the primate immune response and (ii) the introduction of novel immunosuppressive agents that block the CD40/CD154 costimulation pathway.There is strong evidence from numerous in vitro studies that the transplantation of a triple‐knockout pig organ, particularly if expressing several human protective proteins, into a patient is likely to be significantly more successful than if that same organ is transplanted into a nonhuman primate recipient. With this fact in mind, and in view of the advances currently being made, the time has surely come when we need to consider moving from the laboratory to the clinic.However, there are still questions we need to definitively resolve: (i) What exact genetic modifications do we need in the organ‐source pig? (ii) What exact immunosuppressive regimen will we choose? (iii) How will we monitor the immune response and diagnose and treat rejection? and (iv) How do we plan to prevent or treat potential infectious complications? Furthermore, when these matters have been resolved, which patients will be offered a pig organ in the first trial? We have suggested that patients who are very unlikely to survive until a suitable deceased human donor kidney becomes available are those who should be considered for the initial trials. Assessing public attitudes to xenotransplantation is also important before embarking on a clinical trial.I suggest that progress is much more likely to be made from a small clinical trial than if we persist in carrying out experiments in an animal model that no longer mimics the clinical situation.
Relationship Among 3 Different Core Stability Tests in Healthy Young Adults: Validity and Gender Differences
Authors: Kuniki Masahiro , Iwamoto Yoshitaka , Yamagiwa Daiki , Kito Nobuhiro 
Published: December 2021

Context: Core stability is important for preventing injury and improving performance. Although various tests for evaluating core stability have been reported to date, information on their relationship and the effect of gender differences is limited. This study aimed to (1) identify correlations among the 3 core stability tests and to examine the validity of each test and (2) identify gender differences in the test relationship and determine whether gender influenced test selection. Design: Cross-sectional study. Methods: Fifty-one healthy volunteers (27 men and 24 women) participated in the study. The participants underwent the following 3 tests: Sahrmann Core Stability Test (SCST), the lumbar spine motor control tests battery (MCBT), and Y Balance Test (YBT). Each parameter was analyzed according to all parameters and gender using the Spearman rank correlation coefficient. Results: Overall, there was a strong positive correlation between SCST and MCBT and moderate positive correlations between SCST and YBT and between MCBT and YBT. Conversely, gender-specific analyses revealed no significant correlations between YBT and SCST and between YBT and MCBT in women, although significantly strong correlations were found among all tests in men. Conclusion: Although these 3 tests evaluated interrelated functions and may be valid as core stability tests, the results should be carefully interpreted when performing YBT in women.
Safety of add-on sulfonylurea therapy in patients with type 2 diabetes using metformin: a population-based real-world study
Authors: Hougen Ingrid , Whitlock Reid H , Komenda Paul , Rigatto Claudio , Clemens Kristin K , Tangri Navdeep 
Published: December 2021

IntroductionMetformin is the initial oral antihyperglycemic agent (OHA) of choice for most patients with type 2 diabetes (T2D). However, more than one agent is often required for optimal glucose control. As the choice of preferred second OHAs is less well defined, we sought to compare the real-world safety of sulfonylureas to other OHAs as add-on therapy to metformin in patients with T2D.Research design and methodsThis retrospective cohort study included adults in Manitoba, Canada with T2D from 2006 to 2017. Using a new-user design, we divided patients who started on metformin into two groups: add-on therapy with a sulfonylurea and add-on therapy with a different OHA. Outcomes included all-cause mortality, cardiovascular events, and major hypoglycemic episodes. We calculated propensity scores and applied inverse probability of treatment weights to each individual. We compared groups using Cox proportional hazards regression and explored differences in HRs between pre-2008 (acarbose, meglitinides, and thiazolidinediones) and post-2008 (dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose linked transporter-2 inhibitors) OHAs.ResultsOur cohort included 32 576 individuals (28 077 metformin plus sulfonylurea and 4499 metformin plus ‘other’). Patients newly prescribed a sulfonylurea in the setting of metformin had a higher risk of all-cause mortality (HR 1.44, 95% CI 1.12 to 1.84, p=0.005) and major hypoglycemic episodes (HR 2.78, 95% CI 1.66 to 4.66, p<0.001) than those prescribed an ‘other’ OHA. No differences in cardiovascular events were observed (HR 0.99, 95% CI 0.81 to 1.22, p=0.92). In subgroup analyses, mortality and cardiovascular event risk was higher in patients prescribed sulfonylureas versus post-2008 OHAs.ConclusionsSulfonylureas as add-on therapy to metformin are associated with increased risk of all-cause mortality and major hypoglycemic episodes compared with ‘other’ OHAs. Post hoc analysis suggests newer OHAs may be preferred to sulfonylureas as second-line therapy for glycemic control.
A pilot feasibility trial of cognitive–behavioural therapy for insomnia in people with inflammatory bowel disease
Authors: Salwen-Deremer Jessica K , Smith Michael T , Aschbrenner Kelly A , Haskell Hannah G , Speed Brittany C , Siegel Corey A 
Published: December 2021

ObjectivePoor sleep is common in inflammatory bowel disease (IBD), associated with worse overall disease course and predominantly attributable to insomnia. While cognitive–behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment for chronic insomnia, it is untested in IBD. It is unclear if CBT-I will be as effective in this group given the extent of night-time symptoms people with IBD experience. Thus, we evaluated the feasibility and preliminary efficacy of CBT-I in IBD.DesignWe comprehensively assessed sleep in people with mild-to-moderately active IBD using questionnaires, daily diaries and actigraphy. People with significant insomnia symptoms were allocated to a single-arm, uncontrolled pilot feasibility study of gold-standard CBT-I treatment. They were then reassessed post-treatment.Results20 participants with IBD completed a baseline assessment. 10 were experiencing insomnia and were allocated to CBT-I. All participants who were offered CBT-I elected to complete it, and all completed 5/5 sessions. Participants rated treatment acceptability highly and daily diary and actigraphy completion rates were>95%. At baseline, participants with insomnia evidenced significantly worse sleep than participants without insomnia. Following CBT-I, participants reported significant improvements in diary and actigraphy measures of sleep continuity, dysfunctional sleep-related beliefs and IBD disease activity.ConclusionCBT-I was feasible and acceptable and demonstrated a signal for efficacy in the treatment of insomnia in IBD. Importantly, the improvements in sleep continuity were consistent with the extant literature. Future fully powered randomised controlled studies should evaluate whether treatment of insomnia can improve other aspects of IBD, including pain and inflammation.Trial registration numberNCT04132024.
Cord blood microRNA-376c and microRNA-1268a as biomarkers for neonatal hypoxic-ischaemic encephalopathy: a diagnostic accuracy study
Authors: Midan Dina Abdel Razek , Bahbah Wael A , Fayed Doaa Ahmed , Tantawy Ibrahim , Abdel Barry Hamed Mohamed , Ellaithy Manal Abd El-Monem , Elhefnawy Sally Mohammed 
Published: December 2021

BackgroundHypoxic-ischaemic encephalopathy (HIE) is one of the most common causes of morbidity and mortality among neonates. There is a critical need for non-invasive novel biomarkers to detect HIE early, predict its outcomes and monitor its progression. We conducted this observational study to assess the relative expression of miRNA-376c and miRNA-1268a in cord blood as potential diagnostic and prognostic biomarkers for HIE.MethodsA total of 100 neonates divided into two independent groups were included. The case group included 50 neonates with HIE, while the control group included 50 matched healthy neonates. Relative expressions of miRNA-376c and miRNA-1268a were measured in whole cord blood at birth using real-time PCR.ResultsCompared with the control group, patients with HIE had a significantly lower median level of miRNA-376c (0.168, IQR=0.011–0.411 vs 1, IQR=0.80–1.20) and a higher median level of miRNA-1268a (13.46, IQR=2.7–22.8 vs 1, IQR=0.4–1.6). Comparing neonates with HIE who survived versus those who did not survive, no statistically significant difference between the groups in terms of miRNA-376c and miRNA-1268a (p=0.124 and p=0.279) was elicited. Our diagnostic analysis showed that, at 0.90 points, miRNA-376c has a sensitivity and a specificity of 88% and 68.40%, with an area under the curve of 84%. At 2.70 points, miRNA-1268a has a sensitivity and a specificity of 76% and 100%, with an area under the curve of 96%.ConclusionThe relative expression of miRNA-376c and miRNA-1268a was altered in the cord blood of neonates with HIE. In addition, they have moderate diagnostic accuracy in detecting HIE.
Telehealth for patients with interstitial lung diseases (ILD): results of an international survey of clinicians
Authors: Althobiani Malik , Alqahtani Jaber S , Hurst John R , Russell Anne-Marie , Porter Joanna 
Published: December 2021

IntroductionClinicians and policymakers are promoting widespread use of home technology including spirometry to detect disease progression for patients with interstitial lung disease (ILD); the COVID-19 pandemic has accelerated this. Data collating clinicians’ views on the potential utility of telehealth in ILD are limited.AimThis survey investigated clinicians’ opinions about contemporary methods and practices used to monitor disease progression in patients with ILD using telehealth.MethodsClinicians were invited to participate in a cross-sectional survey (SurveyMonkey) of 13 questions designed by an expert panel. Telehealth was defined as home monitoring of symptoms and physiological parameters with regular automatic transmission of data from the patient’s home to the clinician. Data are presented as percentages of respondents.ResultsA total of 207 clinicians from 23 countries participated in the survey. A minority (81, 39%) reported using telehealth. 50% (n=41) of these respondents completed a further question about the effectiveness of telehealth. A majority of respondents (32, 70%) rated it to be quite or more effective than face-to-face visit. There were a greater number of respondents using telehealth from Europe (94, 45%) than Asia (51, 25%) and America (24%). Clinicians reported the most useful telehealth monitoring technologies as smartphone apps (59%) and wearable sensors (30%). Telehealth was most frequently used for monitoring disease progression (70%), quality of life (63%), medication use (63%) and reducing the need for in-person visits (63%). Clinicians most often monitored symptoms (93%), oxygen saturation (74%) and physical activity (72%). The equipment perceived to be most effective were spirometers (43%) and pulse oximeters (33%). The primary barriers to clinicians’ participation in telehealth were organisational structure (80%), technical challenges (63%) and lack of time and/or workload (63%). Clinicians considered patients’ barriers to participation might include lack of awareness (76%), lack of knowledge using smartphones (60%) and lack of confidence in telehealth (56%).ConclusionThe ILD clinicians completing this survey who used telehealth to monitor patients (n=81) supported its’ clinical utility. Our findings emphasise the need for robust research in telehealth as a mode for the delivery of cost-effective healthcare services in ILD and highlight the need to assess patients’ perspectives to improve telehealth utility in patients with ILD.
Palliative care volunteer roles in Nordic countries: qualitative studies—systematic review and thematic synthesis
Authors: Stoelen Karen Marie Sangild , Raunkiaer Mette , Winther Kirstine , Grubert Maria Vilhelm , Bøgeskov Benjamin Olivares 
Published: December 2021

BackgroundGiven limited palliative care resources, volunteers can be viewed as essential. To better understand the contribution of volunteers, it is useful to look at their roles in care systems with high level of financed public welfare, such as those found in Nordic countries.AimTo develop research-based knowledge of experiences related to volunteer roles in palliative care in Nordic countries with similar welfare systems.DesignSystematic review and thematic synthesis of qualitative studies.Data sourcesCinahl, APA PsycInfo, SocINDEX, Idunn, Cristin, SwePub, SweMed+, Doria and Danish Research Database from 2005 to 2020.Eligibility criteriaQualitative peer-reviewed studies reporting first-hand experience of volunteers in palliative care in hospital, community (homecare and nursing home) and hospice settings (hospice institution and hospice home care); English abstract and available full text.ResultsOf 1521 citations, 11 articles were included in the review: seven Norwegian articles, three Swedish articles and one Danish article. Three overall themes emerged from analysis: (1) volunteers offered something different than professionals, (2) volunteering took place in professionals’ domain, (3) volunteers were motivated by personal gains.ConclusionVolunteers provide valuable support to patients and next of kin that differs from professionals’ support. Volunteers are motivated by direct interaction with patients and next of kin. Opportunities for interactions depend on the healthcare setting and professionals’ understandings of volunteers’ role. Formal training of volunteers is limited and supportive available professionals important to volunteers. Professionals’ understandings of volunteers’ role should be improved to strengthen volunteers’ role in palliative care in Nordic countries.PROSPERO registration numberCRD42020222695.
Prostate cancer: unmet supportive and palliative care needs: national survey of patients and family carers
Authors: Johnson Miriam J , Huang Chao , Chen Hong , Jones Lesley , Twiddy Maureen 
Published: December 2021

ObjectivesMen living with prostate cancer have supportive and palliative needs. However, few studies detail unmet needs (vs quality of life measurement) or include data from those with advanced disease. We aimed to identify unmet needs of people living with prostate cancer (men, family carers), including those with advanced disease.MethodsMixed-methods national survey (patient Supportive Care Needs Survey; Carer Support Needs Assessment Tool) and health status (EuroQol Visual Analogue Scale). Quantitative data were explored using regression analysis. Free text data were subjected to thematic analysis.Results216 men (mean age 65±8.5 years; active cancer 136 [63%]) and 97 carers (68 (70%) spouse/partner) provided data. 133 men (62%) reported moderate-to-high need which was more likely in advanced disease. Men’s health status was worse with active vs remitted disease (mean difference −11; 95% CI −17 to −5; p<0.001). 85 (88%) carers reported at least one unmet need relating to ‘enabling them to care’ and 83 (86%) relating to ‘their own well-being’. Carers with chronic illnesses had more unmet needs (p=0.01 to p=0.04) and patient receipt of palliative care independently predicted higher unmet carer needs (p=0.02).Free text data demonstrated widespread burden with: (1) poor communication/information, including about palliative care; (2) poorly managed symptoms/concerns and (3) poor care co-ordination. Incontinence, sexual dysfunction and hormone side-effects were serious problems, often left unaddressed.ConclusionsMany living with prostate cancer continue with wide-ranging concerns. Lack of systematic, ongoing needs assessment and poor communication compound inadequate clinical pathways. Person-centred care, interdisciplinary working and integrated palliative care should be resourced.
I need an exact margin measurement for this basal cell carcinoma!
Authors: Katz Ian , Irwig Les , McGeehan Kevin , Bell Katy 
Published: December 2021

Background/objectivesPathology laboratories are required to determine or estimate the measurement uncertainty for all quantitative results, but there is no literature on the uncertainty in margin measurements for skin cancer excisions.MethodsSix pathologists measured 4–14 histological margins in each of 10 basal cell carcinoma.ResultsThe mean of measurements from all the margins from all the cases was 1.8 mm (range 0 and 6 mm). Regarding the overall variance in margin measurements across the ten cases, 25% was from variation within cases (differences in margin measurement for a given case, because of different margins and different pathologists measuring each margin, SD 0.7 mm). For a given case, we estimate that 95% of margin measurements would fall approximately within±1.4 mm of the mean measurement for that case. When only pathologists’ closest margin for each case were included (for the six cases with uninvolved margins), 6% of the overall variance was from differences within cases (because of different pathologists’ measurements of the closest margin, SD 0.2 mm). For a given case without an involved margin, 95% of closest margin measurements would fall approximately within±0.5 mm of the mean closest measurement for that case.ConclusionsClinicians should be aware there is uncertainty in reported histological margins.
Board affiliate pilot: leadership and innovation—creating new opportunities to deliver better patient care
Authors: Medlock Rebecca M 
Published: December 2021

BackgroundLeadership and management have become a key facet of medical training. However, there remains enormous variation in the quality and effectiveness of medical leadership training. This article describes an innovative pilot programme that aimed to prove a new method of developing clinical leaders.MethodsWe undertook a 12-month pilot integrating a doctor in training onto our trust board in a role called the ‘board affiliate’. We collected qualitative and quantitative data throughout our pilot programme.ResultsQualitative data demonstrated a clear positive impact of this role on senior management and clinical staff. Our staff survey results increased from 47.4% to 50.3%. The pilot programme has had such an impact on our organisation that we have expanded the single pilot role into two positions.ConclusionThis pilot programme has demonstrated a new and effective method of developing clinical leaders.
Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica
Authors: Alhanti Brooke , van Wendel de Joode Berna , Soto Martinez Manuel , Mora Ana M , Córdoba Gamboa Leonel , Reich Brian , Lindh Christian H , Quirós Lépiz Marcela , Hoppin Jane A 
Published: December 2021

ObjectivesThis research evaluates whether environmental exposures (pesticides and smoke) influence respiratory and allergic outcomes in women living in a tropical, agricultural environment.MethodsWe used data from 266 mothers from the Infants’ Environmental Health cohort study in Costa Rica. We evaluated environmental exposures in women by measuring seven pesticide and two polycyclic aromatic hydrocarbons metabolites in urine samples. We defined ‘high exposure’ as having a metabolite value in the top 75th percentile. We collected survey data on respiratory and allergic outcomes in mothers as well as on pesticides and other environmental exposures. Using logistic regression models adjusted for obesity, we assessed the associations of pesticide exposure with multiple outcomes (wheeze, doctor-diagnosed asthma, high (≥2) asthma score based on symptoms, rhinitis, eczema and itchy rash).ResultsCurrent pesticide use in the home was positively associated with diagnosed asthma (OR=1.99 (95% CI=1.05 to 3.87)). High urinary levels of 5-hydroxythiabendazole (thiabendazole metabolite) and living in a neighbourhood with frequent smoke from waste burning were associated with a high asthma score (OR=1.84 (95%CI=1.05 to 3.25) and OR=2.31 (95%CI=1.11 to 5.16), respectively). Women who worked in agriculture had a significantly lower prevalence of rhinitis (0.19 (0.01 to 0.93)), but were more likely to report eczema (OR=2.54 (95%CI=1.33 to 4.89)) and an itchy rash (OR=3.17 (95%CI=1.24 to 7.73)).ConclusionsWhile limited by sample size, these findings suggest that environmental exposure to both pesticides and smoke may impact respiratory and skin-related allergic outcomes in women.