bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of local flow ratios and velocities in a femoral venous cannula with computational fluid dynamics and 4D flow‐sensitive magnetic resonance imaging: A method validation
Authors: Rauh Patrick , Benk Christoph , Beyersdorf Friedhelm , Russe Maximilian
Published: November 2020

Cannulas with multi‐staged side holes are the method of choice for femoral cannulation in extracorporeal therapies today. A variety of differently designed products is available on the market. While the preferred tool for the performance assessment of such cannulas are pressure‐flow curves, little is known about the flow and velocity distribution. Within this work flow and velocity patterns of a femoral venous cannula with multi‐staged side holes were investigated. A mock circulation loop for cannula performance evaluation was built and reproduced using a computer‐aided design system. With computational fluid dynamics, volume flows and fluid velocities were determined quantitatively and visually with hole‐based precision. In order to ensure the correctness of the flow simulation, the results were subsequently validated by determining the same parameters with four‐dimensional flow‐sensitive magnetic resonance imaging. Measurement data and numerical solution differed 7% on average throughout the data set for the examined parameters. The highest inflow and velocity were detected at the most proximal holes, where half of the total volume flow enters the cannula. At every hole stage a Y‐shaped inflow profile was detected, forming a centered stream in the middle of the cannula. Simultaneously, flow separation creates zones with significant lower flow velocities. Numerical simulation, validated with four‐dimensional flow‐sensitive magnetic resonance imaging, is a valuable tool to examine flow and velocity distributions of femoral venous cannulas with hole‐based accuracy. Flow and velocity distribution in such cannulas are not ideal. Based on this work future cannulas can be effectively optimized.
Laparoscopic transabdominal preperitoneal repair for recurrent groin hernia after failed anterior‐posterior repair
Authors: Tazaki Tatsuya , Sasaki Masaru , Kohyama Mohei , Sugiyama Yoichi , Yamaguchi Takuro , Takahashi Shinya , Nakamitsu Atsushi
Published: November 2020

Introduction

The International Guidelines for Groin Hernia Management recommends an anterior repair after a failed posterior repair, and laparoscopic repair after a failed anterior tissue repair or Lichtenstein repair. However, there are not enough studies to guide decision‐making for patients with recurrent hernia patients after combined anterior‐posterior repair. We investigate the safety and usefulness of transabdominal preperitoneal repair (TAPP) for recurrent hernia patients after failed anterior‐posterior repair.

Methods

We conducted a retrospective analysis of 13 consecutive patients with recurrent groin hernia who underwent TAPP after prior anterior preperitoneal mesh repair (that created anterior and posterior scarring) between September 2013 and October 2018. The control group comprised 45 patients who underwent TAPP for recurrent hernia after anterior repair (43 nonmesh repairs and two Lichtenstein repairs).

Results

There were no intraoperative complications, and chronic pain was not reported by the patients with prior anterior preperitoneal mesh repair. The mean operative time was 113 ± 31.3 minutes, and the mean postoperative stay was 1.62 ± 0.87 days. The Wong–Baker FACES rating scale score for pain on postoperative day 1 was 1.91 ± 1.5; on postoperative day 7, the score was 1.0 ± 0.89. None of these findings was significantly different from the findings in patients who had a prior anterior repair. A single patient experienced a further recurrence and underwent repeat TAPP.

Conclusions

The use of TAPP after failed combined anterior‐posterior mesh repair may be feasible and safe for recurrent groin hernia. Further study is needed to determine long‐term outcomes.
A local criterion of fairness in sport: Comparing the property advantages of Caster Semenya and Eero Mäntyranta with implications for the construction of categories in sport
Authors: Camporesi Silvia , Hämäläinen Mika
Published: November 2020

This paper aims to bring a novel approach to the discussion of unfair advantages in sport by looking for a local criterion of fairness instead of a universal criterion. A local criterion of fairness would not solve the general dispute over what counts as an unfair advantage, but it would be beneficial in evaluating specific cases and could guide further discussion about them. We seek a local criterion of fairness by comparing the specific property advantages of Caster Semenya and Eero Mäntyranta. South African Semenya is a middle‐distance runner whose right to compete in the female category has been challenged owing to her assumed difference of sex development and related high level of testosterone. Finnish Mäntyranta was a cross‐country skier with an exceptionally high haematocrit level. We examine whether there is a relevant difference between their advantages that would justify treating the athletes differently. We propose that the criterion ‘not attainable by other athletes in the same category’ could stand as a local criterion of fairness under certain conditions. However, its proper application requires further discussion on how to justify categories in sport.
From sink to source: Using offshore thermochronometric data to extract onshore erosion signals in Namibia
Authors: Wildman Mark , Gallagher Kerry , Chew David , Carter Andrew
Published: November 2020

Products of onshore passive continental margin erosion are best preserved in offshore sedimentary basins. Therefore, these basins potentially hold a recoverable record of the onshore erosion history. Here, we present apatite fission track (AFT) data for 13 samples from a borehole in the southern Walvis basin, offshore Namibia. All samples show AFT central ages older or similar to their respective stratigraphic ages, while many single grain ages are older, implying none of the samples has been totally annealed post‐deposition. Furthermore, large dispersion in single grain ages in some samples suggests multiple age components related to separate source regions. Using Bayesian mixture modelling we classify single grain ages from a given sample to particular age components to create ‘subsamples’ and then jointly invert the entire dataset to obtain a thermal history. For each sample, the post‐depositional thermal history is required to be the same for all age components, but each component (‘subsample’) has an independent pre‐depositional thermal history. With this approach we can resolve pre‐ and post‐depositional thermal events and identify changes in sediment provenance in response to the syn‐ and post‐rift tectonic evolution of Namibia and southern Africa. Apatite U‐Pb and compositional data obtained during the acquisition of LA‐ICP‐MS FT data are also presented to help track changes in provenance with time. We constrain multiple thermal events linked to the exhumation and burial history of the continental and offshore sectors of the margin over a longer timescale than has been possible using only onshore AFT thermochronological data.
Roles of cytokines and T cells in the pathogenesis of myasthenia gravis
Authors: Uzawa A , Kuwabara S , Suzuki S , Imai T , Murai H , Ozawa Y , Yasuda M , Nagane Y , Utsugisawa K
Published: November 2020

Myasthenia gravis (MG) is characterized by muscle weakness and fatigue caused by the presence of autoantibodies against the acetylcholine receptor (AChR) or the muscle-specific tyrosine kinase (MuSK). Activated T, B and plasma cells, as well as cytokines, play important roles in the production of pathogenic autoantibodies and the induction of inflammation at the neuromuscular junction in MG. Many studies have focused on the role of cytokines and lymphocytes in anti-AChR antibody-positive MG. Chronic inflammation mediated by T helper type 17 (Th17) cells, the promotion of autoantibody production from B cells and plasma cells by follicular Th (Tfh) cells and the activation of the immune response by dysfunction of regulatory T (Treg) cells may contribute to the exacerbation of the MG pathogenesis. In fact, an increased number of Th17 cells and Tfh cells and dysfunction of Treg cells have been reported in patients with anti-AChR antibody-positive MG; moreover, the number of these cells was correlated with clinical parameters in patients with MG. Regarding cytokines, interleukin (IL)-17; a Th17-related cytokine, IL-21 (a Tfh-related cytokine), the B-cell-activating factor (BAFF; a B cell-related cytokine) and a proliferation-inducing ligand (APRIL; a B cell-related cytokine) have been reported to be up-regulated and associated with clinical parameters of MG. This review focuses on the current understanding of the involvement of cytokines and lymphocytes in the immunological pathogenesis of MG, which may lead to the development of novel therapies for this disease in the near future.
A case of sporadic late‐onset nemaline myopathy without monoclonal gammopathy of unknown significance/human immunodeficiency virus successfully treated with intravenous gamma globulin
Authors: Fukazawa Ryosuke , Cho Masanori , Hidaka Yukihiro , Takezawa Hidesato , Ogasawara Masashi , Nishino Ichizo , Fujii Akihiro
Published: November 2020

Background

Sporadic late‐onset nemaline myopathy (SLONM) is an acquired form of nemaline myopathy developed in adulthood. Due to its rarity, standard treatment has not been established albeit some reports suggest treatment efficacy.

Case presentation

A 75‐year‐old woman developed progressive muscle weakness in her extremities 3 years previously. Muscle biopsy revealed nemaline bodies, which led to the diagnosis of SLONM. M protein, human immunodeficiency virus (HIV) antigen/antibody, and urine Bence‐Jones protein were all negative. Muscle strength gradually improved after receiving two courses of intravenous immunoglobulin (IVIg).

Conclusions

IVIg may be effective in SLONM without monoclonal gammopathy of unknown significance or HIV infection by improving symptoms and suppressing the progression.
Asymmetrical manifestation of faciobrachial dystonic seizures in leucine‐rich, glioma‐inactivated 1 antibody encephalitis: A case report
Authors: Harada Shizuka , Inatomi Yuichiro , Nakajima Makoto , Nakane Shunya , Matsubara Soichiro , Takamatsu Kotaro , Yonehara Toshiro
Published: November 2020

Background

Leucine‐rich, glioma‐inactivated (LGI1) antibody encephalitis is a rare autoimmune encephalitis characterized by faciobrachial dystonic seizures (FBDS), temporal lobe epilepsy, prominent short‐term memory deficits and altered mental status. FBDS are very brief, frequent stereotypical dystonic seizures of the ipsilateral face, arms and legs. FBDS are often initially unilateral and evolve bilaterally or asynchronously.

Case presentation

A 49‐year‐old woman developed frequent FBDS of her right side. Fluid attenuated inversion recovery imaging showed hyperintense lesions in the right striatum. She was treated with only anti‐epileptic agents. FBDS emerged on her left side soon after cessation of FBDS on her right side. LGI1 antibody was positive in the serum and cerebrospinal fluid. Steroid therapy was added on day 157, and thereafter, FBDS subsided completely, although cognitive impairment remained.

Conclusions

A case of LGI1 antibody encephalitis with asymmetrical manifestation of FBDS after resolution of the first unilateral symptoms was described. This case suggests that LGI1 antibody encephalitis can affect each side of the brain asymmetrically and asynchronously.
You Love Them, but You Don’t Know Them: Recognizing and Welcoming Lived Experiences
Authors: Isselhardt Tiffany , Cross Lauren
Published: November 2020

In 2016, Lisa Gilbert explored issues central to museums: inclusion, diversity, and relevance, which museums seek as they embrace their identities as truly democratic institutions. Yet, museums struggle with these issues because of “loving, knowing ignorance,” a feminist stance that Gilbert expands to include museums that assume authority over a subject yet fail to recognize the subject’s self‐knowledge and agency. Using Gilbert’s example, we explore Curator articles which address this ignorance through example and methodology, with a focus on museums who have successfully addressed their own ignorance as it relates to diversity within exhibition practice.
Boys’ advantage on the fractions number line is mediated by visuospatial attention: Evidence for a parietal‐spatial contribution to number line learning
Authors: Geary David C. , Scofield John E. , Hoard Mary K. , Nugent Lara
Published: November 2020

The study tested the hypotheses that boys will have an advantage learning the fractions number line and this advantage will be mediated by spatial abilities. Fractions number line and, as a contrast, fractions arithmetic performance were assessed for 342 adolescents, as was their intelligence, working memory, and various spatial abilities. Boys showed smaller placement errors on the fractions number line (d = −0.22) and correctly solved more fractions arithmetic problems (d = 0.23) than girls. Working memory and intelligence predicted performance on both fractions measures, and a measure of visuospatial attention uniquely predicted number line performance and fully mediated the sex difference. Visuospatial working memory uniquely predicted fractions arithmetic performance and fully mediated the sex difference. The results help to clarify the nuanced relations between spatial abilities and formal mathematics learning and the sex differences that often emerge in mathematical domains that have a visuospatial component.
Cytokine dysregulation in children with cerebral palsy
Authors: Zareen Zunera , Strickland Tammy , Fallah Lida , McEneaney Victoria , Kelly Lynne , McDonald Denise , Molloy Eleanor J
Published: November 2020

Aim

To examine pro‐ and anti‐inflammatory cytokines in children with cerebral palsy (CP) at baseline and in response to endotoxin (lipopolysaccharide), and correlate outcomes compared with age‐matched comparisons, to evaluate their ability to mount an immune response.

Method

Serum cytokines were assessed in 12 children (eight males, four females; mean age 10y 1mo [SD 1y 8mo], 6–16y) with CP against 12 age‐matched comparisons (eight males, four females; mean age 9y 1mo [SD 1y 1mo]). Pro‐ and anti‐inflammatory cytokines (interleukin‐1β, interleukin‐2, interleukin‐6, interleukin‐8, interleukin‐10, interleukin‐18, tumour necrosis factor [TNF]‐α, TNF‐β, interferon‐γ, granulocyte‐macrophage colony‐stimulating factor [GM‐CSF], vascular endothelial growth factor [VEGF], erythropoietin, and interleukin‐1 receptor antagonist) were measured at baseline and in response to in vitro simulation with lipopolysaccharide by multiplex enzyme‐linked immunosorbent assay.

Results

Significantly higher erythropoietin was found at baseline in children with CP compared with the comparison group. There was a strong response to lipopolysaccharide for interleukin‐8, VEGF, TNF‐α, and GM‐CSF in both children with CP and the comparison group; however, there was significant lipopolysaccharide hyporesponsiveness in children with CP compared with the comparison group for interleukin‐1α, interleukin‐1β, interleukin‐2, and interleukin‐6.

Interpretation

Altered cytokine responses in children with CP compared with the comparison group demonstrate an altered inflammatory state that may contribute to ongoing sequelae and could be a target for therapy.

What this paper adds

Altered inflammatory responses persist in children with cerebral palsy (CP).

Erythropoietin is elevated in children with CP compared with the comparison group.

Children with CP have reduced interleukin‐1α, interleukin‐1β, interleukin‐2, and interleukin‐6 inflammatory responses to lipopolysaccharide.
Clinical tools used in young infants born very preterm to predict motor and cognitive delay (not cerebral palsy): a systematic review
Authors: Caesar Rebecca , Colditz Paul B , Cioni Giovanni , Boyd Roslyn N
Published: November 2020

Aim

This systematic review evaluates the accuracy of clinical tools used at a corrected age of 6 months or younger to predict motor and cognitive delay (not cerebral palsy) at 24 months’ corrected age, in infants born very preterm.

Method

Six databases were searched. Quality was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool. Predictive analysis included calculation of sensitivity and specificity, inspection of summary receiver operating characteristics curves, and bivariate meta‐analysis.

Results

Six assessments were identified in 10 studies of 992 infants. Overall prevalence of motor delay was 13.8% and cognitive delay was 11.7%. Methodological quality was variable for patient selection, reference standard, flow, and timing. All studies had a low risk of bias for the index test. General Movement Assessment (GMA) predicted motor and cognitive outcomes with good accuracy for mild, moderate, and severe delays (fidgety age: pooled diagnostic odds ratio=12.3 [5.9–29.8]; hierarchical summary receiver operating characteristics curve=0.733). The Hammersmith Infant Neurological Examination (HINE) demonstrated excellent predictive accuracy for severe motor delay (3mo and 6mo; sensitivity 93% [68–100%], specificity 100% [96–100%]) but showed limited ability to predict milder delays.

Interpretation

In the population of infants born very preterm, few assessment tools used at 6 months or younger corrected age have proven predictive accuracy for cognitive and motor delay at 24 months’ corrected age. Only the GMA and HINE demonstrated useful predictive validity.

What this paper adds

General movements have predictive validity for both motor and cognitive dysfunction in infants born very preterm.

The Hammersmith Infant Neurological Examination showed the highest predictive accuracy for severe motor delay.

The General Movement Assessment was the best tool to predict mild‐to‐moderate motor and cognitive delays.
Cardiovascular outcomes and safety with linagliptin, a dipeptidyl peptidase‐4 inhibitor, compared with the sulphonylurea glimepiride in older people with type 2 diabetes: A subgroup analysis of the randomized CAROLINA trial
Authors: Espeland Mark A. , Pratley Richard E. , Rosenstock Julio , Kadowaki Takashi , Seino Yutaka , Zinman Bernard , Marx Nikolaus , McGuire Darren K. , Andersen Knut Robert , Mattheus Michaela , Keller Annett , Weber Maria , Johansen Odd Erik
Published: November 2020

Aim

To compare the cardiovascular (CV) safety of linagliptin with glimepiride in older and younger participants in the CAROLINA trial in both prespecified and post hoc analyses.

Materials and Methods

People aged 40 to 85 years with relatively early type 2 diabetes, inadequate glycaemic control and elevated CV risk were randomly assigned to linagliptin 5 mg or glimepiride 1 to 4 mg. The primary endpoint was time to first occurrence of three‐point major adverse CV events (MACE: CV death, non‐fatal myocardial infarction, or non‐fatal stroke). We evaluated clinical and safety outcomes across age groups.

Results

Of 6033 participants, 50.7% were aged <65 years, 35.3% were aged 65 to 74 years, and 14.0% were aged ≥75 years. During the 6.3‐year median follow‐up, CV/mortality outcomes did not differ between linagliptin and glimepiride overall (hazard ratio [HR] for three‐point MACE 0.98, 95.47% confidence interval [CI] 0.84, 1.14) or across age groups (interaction P >0.05). Between treatment groups, reductions in glycated haemoglobin were comparable across age groups but moderate‐to‐severe hypoglycaemia was markedly reduced with linagliptin (HR 0.18, 95% CI 0.15, 0.21) with no differences among age groups (P = 0.23). Mean weight was −1.54 kg (95% CI –1.80, –1.28) lower for linagliptin versus glimepiride. Adverse events increased with age, but were generally balanced between treatment groups. Significantly fewer falls or fractures occurred with linagliptin.

Conclusions

Linagliptin and glimepiride were comparable for CV/mortality outcomes across age groups. Linagliptin had significantly lower risk of hypoglycaemia and falls or fractures than glimepiride, including in “older‐old” individuals for whom these are particularly important treatment considerations.
Effects of oral semaglutide on energy intake, food preference, appetite, control of eating and body weight in subjects with type 2 diabetes
Authors: Gibbons Catherine , Blundell John , Tetens Hoff Søren , Dahl Kirsten , Bauer Robert , Bækdal Tine
Published: November 2020

Aim

To evaluate the effect of oral semaglutide on energy intake and appetite in subjects with type 2 diabetes (T2D).

Materials and Methods

In this randomized, double‐blind, placebo‐controlled, two‐period cross‐over trial, 15 subjects with T2D received 12 weeks of treatment with once‐daily oral semaglutide (4‐week dose escalation from 3 to 7 to 14 mg) followed by placebo, or vice versa. Energy intake was measured during an ad libitum lunch, evening meal and snack box after a standard breakfast. Appetite ratings were measured using a visual analogue scale after standard and fat‐rich breakfasts. Other assessments included eating and craving control (using the Control of Eating Questionnaire), and changes in body weight and composition.

Results

Following a standard breakfast, total daily ad libitum energy intake was significantly lower (38.9%) with oral semaglutide versus placebo in 13 evaluable subjects (estimated treatment difference, −5096.0 kJ; 95% CI –7000.0, −3192.1; P = .0001). After a fat‐rich breakfast, there were significant differences in favour of oral semaglutide versus placebo for measures of satiety, hunger and for overall appetite score, with no significant differences following a standard breakfast. Fewer food cravings and better eating control were seen with oral semaglutide versus placebo. Overall, mean body weight decreased by 2.7 kg with oral semaglutide and 0.1 kg with placebo, mostly attributable to body fat mass loss.

Conclusion

After 12 weeks of treatment, ad libitum energy intake was lower with oral semaglutide versus placebo, resulting in reduced body fat mass, and was associated with increased satiety and fullness after a fat‐rich breakfast, and improved eating control.

Trial registration number

NCT02773381
Association between malocclusion and the severity of dental trauma in primary teeth
Authors: da Silva Rauane Machado , Mathias Fernanda Burkert , da Costa Catiara Terra , da Costa Vanessa Polina Pereira , Goettems Marília Leão
Published: November 2020

Background/Aims

The literature does not clearly state whether the type of malocclusion is associated with a specific type of trauma and the severity of the injury. Hence, the aim of this retrospective study was to assess the occlusal condition in children with traumatic dental injuries of the primary teeth, and the association between the occlusal characteristics and the type and severity of these injuries.

Material and Methods

Data were collected from records of children treated at a dental trauma center in Brazil over a period of 16 years. The data included age, gender, etiology of the trauma, place of occurrence, number of affected teeth, type of trauma, and injury severity. The occlusal condition was assessed by a trained dentist using photographs of the patients from their first visit. Chi‐square tests and Poisson regression were used for data analyses.

Results

This study included 209 patients, and most were aged between 2‐4 years (50.55%). Multivariate regression analysis showed that children with an anterior open bite had a 47% higher prevalence of severe trauma than those who did not have an anterior open bite, and those with class II canines had a 56% higher prevalence of severe trauma than those with class I and III canines. Children with an anterior open bite had a 46% higher prevalence of injuries affecting multiple teeth than those without an anterior open bite.

Conclusions

Anterior open bite and class II canine relationship were associated with a higher prevalence of severe traumatic dental injury in primary teeth, and anterior open bite was associated with trauma affecting multiple teeth.
The reproduction of gender differences in early career choices and professional identity of young dentist in Finland
Authors: Karaharju‐Suvanto Terhi , Choroszewicz Marta , Näpänkangas Ritva , Suominen Anna Liisa , Tolvanen Mimmi , Koivumäki Jaakko
Published: November 2020

Introduction

For over the last 20 years, approximately 70% of working dentists in Finland have been women. However, there is internal division of the profession along gender lines. Female dentists work more often in the public sector and male dentists in the private sector. The aim of this study was to investigate the gender differences in young dentists’ early career choices, specialization plans, values and perceptions of professional identity.

Materials and methods

The data were taken from a national e‐mail questionnaire study called “Young Dentist,” which was sent to 458 dentists who had received their licence to practise dentistry in 2014‐2016 from all four universities with dental curricula in Finland. A total of 52% young dentists (n = 238) answered the questionnaire.

Results and discussion

The results indicated that whereas female dentists were more likely to perceive themselves as comforters, social workers and health promoters, male dentists tended to perceive themselves as technicians. These professional identities were interrelated with early‐stage career choices in which female dentists worked more often in the public than in the private sector when compared to male dentists. There were also clear gender differences in the importance of values and the specialization plans of the young dentists.

Conclusion

Young dentists in Finland make career choices and develop professional identity in accordance with the attributes traditionally associated with cultural ideals related to femininity and masculinity.
Gut microbiota and metabolome distinctive features in Parkinson disease: Focus on levodopa and levodopa‐carbidopa intrajejunal gel
Authors: Melis Marta , Vascellari Sarah , Santoru Maria Laura , Oppo Valentina , Fabbri Margherita , Sarchioto Marianna , Murgia Daniela , Zibetti Maurizio , Lopiano Leonardo , Serra Alessandra , Palmas Vanessa , Pisanu Silvia , Perra Daniela , Madau Veronica , Cusano Roberto , Uva Paolo , Mereu Alessandra , Contu Paolo , Morelli Micaela , Atzori Luigi , Melis Maurizio , Manzin Aldo , Cossu Giovanni
Published: November 2020

Background and purpose

Recent data suggest that imbalances in the composition of the gut microbiota (GM) could exacerbate the progression of Parkinson disease (PD). The effects of levodopa (LD) have been poorly assessed, and those of LD‐carbidopa intestinal gel (LCIG) have not been evaluated so far. The aim of this study was to identify the effect of LD and LCIG, in particular, on the GM and metabolome.

Methods

Fecal DNA samples from 107 patients with a clinical diagnosis of PD were analyzed by next‐generation sequencing of the V3 and V4 regions of the 16S rRNA gene. PD patients were classified in different groups: patients on LCIG (LCIG group, n = 38) and on LD (LD group, n = 46). We also included a group of patients (n = 23) without antiparkinsonian medicaments (Naïve group). Fecal metabolic extracts were evaluated by gas chromatography mass spectrometry.

Results

The multivariate analysis showed a significantly higher abundance in the LCIG group of Enterobacteriaceae, Escherichia, and Serratia compared to the LD group. Compared to the Naïve group, the univariate analysis showed a reduction of Blautia and Lachnospirae in the LD group. Moreover, an increase of Proteobacteria, Enterobacteriaceae, and a reduction of Firmicutes, Lachnospiraceae, and Blautia was found in the LCIG group. No significant difference was found in the multivariate analysis of these comparisons. The LD group and LCIG group were associated with a metabolic profile linked to gut inflammation.

Conclusions

Our results suggest that LD, and mostly LCIG, might significantly influence the microbiota composition and host/bacteria metabolism, acting as stressors in precipitating a specific inflammatory intestinal microenvironment, potentially related to the PD state and progression.
Financial Boundary Ambiguity Among Military Spouses
Authors: McCoy Megan , O'Neal Catherine Walker , Gale Jerry , Goetz Joseph , Mancini Jay A.
Published: November 2020

Objective

The military lifestyle of extended training programs and deployments creates a need to clearly define each partner's roles and responsibilities after each departure and reunion.

Background

Previous researchers have discovered that the less ambiguity that occurs when an individual enters or departs the family system, the less likely the family is to experience strain or crisis. One challenging area of boundary definition is finances, as couples tend to avoid talking about money which may contribute to financial boundary ambiguity.

Methods

This study applies the contextual model of family stress to examine financial boundary ambiguity and its association with marital quality in the post‐deployment stage. This article presents a theory‐driven exploration of financial boundary ambiguity using the actor–partner interdependence model and structural equation modeling.

Results

Study findings indicate that role flexibility, as well as clear and open communication, are related to less financial boundary ambiguity. This, in turn, is related to higher marital quality, although there are differences in the actor and partner effects between financial boundary ambiguity and marital relations.

Conclusion

To more fully understand coping and resilience among military couples, the authors applied the contextual model of family stress focused on financial elements to clarify the significance of how the couples navigated their roles and interactions.

Implications

Programs focused on financial and relational health should focus on fostering communication around financial roles during periods of transition, such as the deployment cycle. In particular, programs should be oriented around strategies for reducing the stress that surrounds financial uncertainties and strain, in addition to teaching effective financial management.
Interferon‐stimulated gene products as regulators of central carbon metabolism
Authors: Ebrahimi Kourosh H. , Gilbert‐Jaramillo Javier , James William S. , McCullagh James S.O.
Published: November 2020

In response to viral infections, the innate immune system rapidly activates expression of several interferon‐stimulated genes (ISGs), whose protein and metabolic products are believed to directly interfere with the viral life cycle. Here, we argue that biochemical reactions performed by two specific protein products of ISGs modulate central carbon metabolism to support a broad‐spectrum antiviral response. We demonstrate that the metabolites generated by metalloenzymes nitric oxide synthase and the radical S‐adenosylmethionine (SAM) enzyme RSAD2 inhibit the activity of the housekeeping and glycolytic enzyme glyceraldehyde 3‐phosphate dehydrogenase (GAPDH). We discuss that this inhibition is likely to stimulate a range of metabolic and signalling processes to support a broad‐spectrum immune response. Based on these analyses, we propose that inhibiting GAPDH in individuals with deteriorated cellular innate immune response like elderly might help in treating viral diseases such as COVID‐19.
Grow wider canopies or thicker stems: Variable response of woody plants to increasing dryness
Authors: Ding Jingyi , Travers Samantha K. , Eldridge David J.
Published: November 2020

Aim

Woody plants vary greatly from tall trees to branching shrubs with increasing dryness. Variation in plant allometry is driven by both biotic and abiotic factors, reflecting different plant adaptation strategies in different environments. Here, we explore how aboveground allometry of different woody plants responds to increasing dryness along an extensive aridity gradient.

Location

Eastern Australia.

Time period

2018–2019.

Major taxa studied

Woody plants.

Methods

We surveyed the aboveground allometry of woody plants (e.g., canopy, height, stem diameter, branches) at 150 sites along a 1,500‐km aridity gradient from humid to arid areas. We used regression analyses and structural equation modelling to explore the variation in woody allometry with increasing aridity, and the abiotic (resource availability) and biotic (aboveground competition) mechanisms driving such changes.

Results

Plant height declined, but branching, canopy width and canopy depth increased with increasing aridity. Woody responses to dryness varied among genera, with increasing aridity associated with wider canopies inEucalyptusandCallitrisspp., thicker stems inAcaciaspp., but no clear differences inAllocasuarinaspp. Biotic and abiotic factors exerted different effects on the allometry of different genera, withEucalyptusandCallitrisspp. constrained by resource availability, whileAcaciaandAllocasuarinaspp. were regulated mainly by aboveground competition.

Main conclusions

As aridity increased, we found genus‐specific responses in allometric changes and driving mechanisms (resource availability cf. aboveground competition). Rather than merely shrinking in size, our results suggest that woody plants allocate resources to either canopies or stems to cope with increasing dryness. Increasing stem or canopy size, and altering branching might be a useful strategy for woody plants to compensate for biomass reduction and maintain functions while growing shorter under hotter and drier climates.
Perceptions of patients undergoing percutaneous coronary intervention on pre‐operative education in China: A qualitative study
Authors: Zhuo Qiqi , Liang Hongmin , Bai Yangjuan , Hu Qiulan , Hanum Ardani Latifah , Yang Mingfang , Wang Yanjiao , Wei Wei , Ding Lan , Ma Fang
Published: November 2020

Objectives

To explore the perceptions of patients undergoing percutaneous coronary intervention (PCI) regarding their pre‐operative health education.

Methods

A qualitative study using semi‐structured, in‐depth interviews was conducted in one cardiology unit in China from July 2019 to December 2019. Purposeful sampling of 17 patients undergoing PCI was interviewed about their perceptions of pre‐operative health education. Thematic analysis of the transcribed data was then used to identify the themes.

Results

Four themes emerged from the data:(a) triple roles of pre‐operative education with the categories of relief (reliving fear); burden (leading to stress); and meaningless (changing nothing); (b) family member involvement with the categories of shared responsibility and family members’ duty; (c) facilitators in the process of pre‐operative health education with the categories of emotional support, plain language and individualized pre‐operative education; (d) inhibitors in the process of pre‐operative health education with the categories of contradiction and threatening words.

Conclusions

Pre‐operative health education for patients undergoing PCI should be aligned with the individual patients’ information‐seeking styles and personal differences, emphasizing individualized patient education. Traditional Chinese philosophy should be considered in the practice of pre‐operative education for patients undergoing PCI, which emphasizes family member involvement; at the same time, patient empowerment and self‐care should also be stressed. In addition, emotional support and plain language from health professionals are important in pre‐operative health education for patients undergoing PCI; contradiction should be avoided, and threatening words should be used with caution and with consideration for cultural variations during pre‐operative education for patients undergoing PCI.
Toward the Physical Internet—Logistics Service Modularity and Design Implications
Authors: Sternberg Henrik S. , Denizel Meltem
Published: November 2020

The Physical Internet (PI) is a modularization of logistics services: standardized protocols, full interoperability and standardized packaging, PI‐containers, and encapsulated freight. The PI‐containers are a core component of the PI; however, previous PI studies have not addressed those containers’ repositioning, despite its importance and effect on the PI network efficiency. In this paper, we analyze how the PI‐containers’ design and characteristics will determine the containers’ flows in a domestic network context. The flows are studied strategically using a linear programming model minimizing flow imbalances between hubs and simulating the effect of PI‐container compatibility. The model is tested using inter‐regional freight data from Sweden, and the results are framed using modularity theory. Our analysis reveals that PI‐container compatibility in terms of forward and reverse flows determines whether PI presents increased or decreased empty runs compared with the existing conventional logistics system. Departing from modularization theory, we discuss our results, emphasizing not only the importance of keeping synergistic specificity low but also how the characteristics will affect the urgency of technology use. Our implications are important to supply chain managers and policymakers for the future research on the Physical Internet, PI‐container repositioning and routing, and packaging design.
Chronic shift‐lag promotes NK cell ageing and impairs immunosurveillance in mice by decreasing the expression of CD122
Authors: Zeng Xiaokang , Liang Caiying , Yao Jie
Published: November 2020

Long‐term subjection to shift work increases the risk of cancer. The purpose of the present study was to explore the mechanism by which chronic circadian disruption impairs natural killer (NK) cell immunosurveillance. Mice were subjected to light‐dark reverse every 4 days for 12 weeks to disrupt normal circadian rhythm. NK cell development and function were evaluated by flow cytometry. The mRNA and protein levels of period 1 (per1) and per2 were suppressed, while circadian locomotor output cycle kaput (CLOCK) was increased in the shifted mice, indicating successful generation of the circadian rhythm disruption mouse model. Chronic shift‐lag promoted NK cell ageing, which is likely due to the reduction in Ly49 family receptor expression in shifted NK. We further studied the effects of circadian rhythm disruption on NK cell function. Chronic shift‐lag inhibited NK cell secretion of granular CD107a and interferon gamma. Moreover, chronic shift‐lag attenuated the clearance of MHC‐I–deficient tumour cells by NK cells in vivo and promoted lung metastasis of B16F10 melanomas. Furthermore, chronic shift‐lag reduced NK cell killing function, which may be due to the suppression of Eomes transcription factor expression, which inhibiting the transcription of CD122. In conclusion, our findings suggest that chronic circadian disruption attenuates NK cell cytolytic activity by decreasing the expression of CD122.
Massive impact of coronavirus disease 2019 pandemic on gastroenterology and hepatology departments and doctors in Spain
Authors: Crespo Javier , Fernández Carrillo Carlos , Iruzubieta Paula , Hernández‐Conde Marta , Rasines Laura , Jorquera Francisco , Albillos Agustín , Bañares Rafael , Mora Pedro , Fernández Vázquez Inmaculada , Hernández‐Guerra Manuel , Turnes Juan , Calleja José Luis ,   COVID‐19 SEPD/AEEH Group
Published: November 2020

Background and Aim

Significant human and material resources have been diverted to coronavirus disease 2019 (COVID‐19). Healthcare workers are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. We assess the impact of the COVID‐19 pandemic on gastroenterology and hepatology departments and specialists in Spain.

Methods

This study involves a nationwide survey addressing the impact of COVID‐19 on resources, procedures, and physicians of gastroenterology and hepatology departments in 81 hospitals representative of the Spanish National Health Service.

Results

Overall, 41.8% of hospital beds and 40.7% of gastroenterology and hepatology beds were allocated to COVID‐19 patient care, as well as 24.8% of gastroenterologists and 58.3% of residents. Outpatient visits, abdominal ultrasounds, and endoscopies were reduced by 81.8–91.9%. Nine large university hospitals had 75% and 89% reductions in therapeutic endoscopies and hepatocellular carcinoma surgery, respectively, with cancelation of elective liver transplant and transjugular intrahepatic portosystemic shunt. Prevalence of infected physicians was 10.6% and was dependent on regional population incidence (r = 0.74, P = 0.001), with 11% hospitalized and one physician dying. Up to 63.4% of physicians may have been infected before or shortly after Spain entered lockdown, 57% of them having recently performed endoscopies. Adequate protection was acknowledged in > 80% hospitals, but only 2.9% performed regular SARS‐CoV‐2 testing.

Conclusions

The impact of the COVID‐19 pandemic on healthcare delivery has been massive. A wave of gastroenterology‐related complications is expected because of resource diversion. Gastroenterologists have a high prevalence of infection, although they may have been infected during a first phase of lower awareness and protection. Regular SARS‐CoV‐2 screening, adequate protection, and quick reorganization of healthcare resources are still needed.
The end of the rural/urban divide? Migration, proletarianization, differentiation and peasant production in an ejido, Central Mexico
Authors: Hoogesteger Jaime , Rivara Federico
Published: November 2020

This article explores the relations between agricultural production, international migration, wage labour and processes of differentiation among peasant households. It does so based on the analysis of the ejido Jesús María in the northeast of the state of Guanajuato, Central Mexico. The history of this ejido and how Mexican neoliberal policies led to increased levels of migration and proletarianization since at least the early 1990s is presented. Then, it presents how in this context the production of asparagus for agro‐export developed on the irrigated lands of this ejido, showing that this process went hand in hand with social differentiation and important changes in the distribution of land and water. Then, it presents the results of a household and production survey that shows that most peasant households combine agricultural production with local urban and rural wage labour, migration, remittances and/or other economic activities. Households that can live from agriculture alone have had important capital investments in agricultural production coming from international migration and remittances. Based on these results, it argues that, as rural communities become increasingly dependent on external ‘urban/global’ capital, the rural/urban divide has become increasingly permeable with important consequences for peasant economies and related social differentiation processes.
Lichenoid morphology could be an early feature of oral proliferative verrucous leukoplakia
Authors: McParland Helen , Warnakulasuriya Saman
Published: November 2020

Background

Recognition and differentiation of early forms of proliferative verrucous leukoplakia (PVL) could be a challenge to both clinicians and pathologists.

Objective

To report on a retrospective study that was carried out on 51 cases of PVL that were initially diagnosed as frictional keratosis, oral leukoplakia or oral lichen planus. A secondary objective is to report on the outcome of malignant transformation during follow‐up.

Methods

Records of patients seen at an oral medicine clinic with the final clinical diagnosis of PVL were audited for early clinical and histopathologic features in their biopsy at first presentation, and for subsequent malignant transformation.

Results

Fifty‐one patients (25 men and 26 women) with a mean age 51 years (men) and 53 years (women) at initial presentation were studied. 28% men and 11.5% women were current smokers. Initial clinical diagnoses were frictional keratoses (n = 4), Leukoplakia (n = 17) and lichen planus (n = 30). Epithelial dysplasia was reported in the initial biopsy in 12 cases and lichen planus/lichenoid features in 22 cases (22/51; 43%). Malignant transformation occurred in 11/51 patients (21.5%).

Conclusion

Lichen planus or lichenoid lesions could be the initial presentation of many PVL cases that later develop multiple leukoplakic lesions with a final diagnosis of PVL.
The CXCL11‐CXCR3A axis influences the infiltration of CD274 and IDO1 in oral squamous cell carcinoma
Authors: Wang Xin , Zhang Jing , Zhou Gang
Published: November 2020

Background

The CXCL9/10/11‐CXCR3 axis plays pivotal roles in the recruitment of immune cells and the formation of cancer‐specific immunity in various cancers. High expression of immune checkpoints, which could be regulated by cytokines, is closely related to the establishment of immune escape in tumor microenvironment. Therefore, the study was tried to provide insights into the influence of the CXCL9/10/11‐CXCR3 axis on immune checkpoints in oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMDs), especially oral leukoplakia (OLK).

Methods

The mRNA levels of CXCL9/10/11 and CXCR3 were analyzed in TCGA, GEO and Oncomine and verified in OLK and OSCC. The specimens were used to analysis the relationship between CXCL9/10/11 and CXCR3 variants. The correlation between CXCL9/10/11 and immune checkpoint/ligand in head and neck squamous cell carcinoma was analyzed in TIMER and confirmed in samples. Small interference transfection of CXCL11 in SCC25 cells was used to evaluate the function of CXCL11 on CD274/IDO1 expression.

Results

CXCL9/10/11 had increase expression trends from normal tissues to OSCC. The proportion of CXCR3A (one variant of CXCR3) was significantly increased in OSCC comparing with normal tissues, while other variants—CXCR3B and CXCR3alt—did not. CXCL9/10/11 was positively correlated with CXCR3A and immune checkpoints/ligand (IDO1, LAG3, and CD274) in OLK and OSCC. CXCL11‐knockdown SCC25 cells could directly inhibit the intracellular expression of CD274 and IDO1.

Conclusion

The upregulated CXCL9/10/11‐CXCR3A axis may interact with immune checkpoints/their ligands in OLK and OSCC. Furthermore, CXCL11 may affect the expression of CD274 and IDO1 in an autocrine mode in OSCC.
Development of a Comprehensive Tool for School Health Policy Evaluation: The WellSAT WSCC
Authors: Koriakin Taylor A. , McKee Sarah L. , Schwartz Marlene B. , Chafouleas Sandra M.
Published: November 2020

BACKGROUND

Stakeholders increasingly recognize the role of policy in implementing Whole School, Whole Community, Whole Child (WSCC) frameworks in schools; however, few tools are currently available to assess alignment between district policies and WSCC concepts. The purpose of this study was to expand the Wellness School Assessment Tool (WellSAT) for evaluation of policies related to all 10 domains of the WSCC model.

METHODS

Developing the WellSAT WSCC was an iterative process that involved (1) identifying items for each domain based on key concepts and best practice recommendations; (2) expert review of the draft measure; (3) cognitive pre‐testing; (4) developing scoring criteria; and (5) pilot‐testing the measure.

RESULTS

Ratings from expert reviewers indicated that the tool included items that were both relevant and important to each of the 10 WSCC domains. Results of cognitive pre‐testing indicated that the items were understood as intended. Feedback from expert reviews, cognitive pre‐testing, and pilot‐testing was used to further revise and refine the measure and develop a final version of the tool. Acceptable interrater reliability was established for the final selection of items.

CONCLUSIONS

The WellSAT WSCC provides a reliable means for assessing integration and alignment between WSCC model concepts and district policies.