bluuebunny/crossref_metadata_2025 huggingface dataset:
Humeral air sac cystadenocarcinoma in a rainbow lorikeet (Trichoglossus moluccanus)
Authors: Baron HR , Foo TSY , Phalen DN
Published: February 2020

Background

A 17‐year‐old female rainbow lorikeet (Trichoglossus moluccanus) was presented for a swelling over the right proximal humerus and an inability to fly.

Case report

Radiographs revealed a markedly osteoproductive and moderately osteolytic lesion of the proximal left humerus with marked associated soft tissue swelling. Biopsy of the proximal humerus was consistent with an air sac cystadenocarcioma. The bird's condition deteriorated over 25 days after initial presentation and it developed a respiratory wheeze, tail bob, tachypnea and died. On postmortem examination, the bird was found to have an air sac cystadenocarcinoma associated with the proximal humerus, extending into the thoracic cavity through a network of fibrous sheets and displaying infiltration into the lung tissue bilaterally.

Conclusion

This is the first report of a humeral air sac cystadenocarcinoma in a lorikeet and it builds on our understanding of the species affected by avian neoplasia.
Legal regulations, ethical guidelines and recent policies to increase transparency of clinical trials
Authors: Borysowski Jan , Wnukiewicz‐Kozłowska Agata , Górski Andrzej
Published: February 2020

Timely and accurate dissemination of outcomes is essential to accomplish main benefits of scientific research including clinical trials. Clinical trial results can be disseminated in two main ways: by publication in a peer‐reviewed journal and by posting on a publicly available clinical trial register. The credibility of the literature on clinical trials is significantly diminished because a high percentage of trials is not published. While current legal regulations both in the European Union (EU) and the USA impose a duty to submit summary results of clinical trials to a respective register (EU Clinical Trial Register and ClinicalTrials.gov, respectively), the compliance with this requirement has been generally inadequate. Trial outcomes can be also made accessible by data sharing. However, in spite of the wide promotion of this idea, the access of investigators to participant‐level datasets remains limited. The main objective of this review is to discuss current legal regulations, international standards, ethical guidelines and recent policies pertaining to dissemination of clinical trial results.
Hypocalcaemia following denosumab in prostate cancer: A clinical review
Authors: Lau Lik‐Hui , Cliff Edward R.S. , Wong Vanessa , Wong Henry , Torkamani Niloufar , Eer Audrey , Weickhardt Andrew , Grossmann Mathis
Published: February 2020

Objectives

Denosumab is often used in men with advanced prostate cancer to prevent skeletal‐related events, but can be associated with severe hypocalcaemia. Our objective was to review the pathophysiology, identify risk factors and provide recommendations for prevention and management of denosumab‐associated hypocalcaemia.

Design

We reviewed the literature regarding denosumab‐associated severe hypocalcaemia, defined as necessitating hospitalization for intravenous calcium treatment, in the context of prostate cancer.

Patients

Men with prostate cancer with severe denosumab‐associated hypocalcemia.

Results

We identified 20 men with prostate cancer with severe denosumab‐associated hypocalcemia, including the present case. Median age (range) was 70 years (45‐86). All had skeletal metastases and presented with symptomatic hypocalcemia 16 days (4‐35) after the initial (n = 18) or second (n = 2) denosumab treatment, with a serum total calcium of 1.36 mmol/L (1.13‐1.91). The key risk factor was presence of active osteoblastic metastases, evidenced by elevated serum alkaline phosphatase, 838 U/L (58‐2620) and supportive imaging. Other risk factors reported in some men included vitamin D deficiency (<50 nmol/L), 25‐OH vitamin D 44 nmol/L (22‐81), renal impairment, serum creatinine 103 μmol/L (62‐1131) and hypomagnesaemia, 0.82 mmol/L (0.29‐1.20). Men received intravenous calcium infusions for 16 days (1‐90), and median total intravenous elemental calcium requirements were 3.17 g (0.47‐26.65).

Conclusions

Denosumab treatment in men with metastatic prostate cancer can be associated with life‐threatening hypocalcaemia requiring prolonged hospitalization for intravenous calcium treatment. Modifiable risk factors should be corrected before denosumab administration. In men with active osteoblastic metastases, consideration should be given to delay denosumab treatment until underlying disease activity is controlled, and/or be administered with close monitoring and proactive treatment with calcium and calcitriol.
Use of double flange voice prosthesis for periprosthetic leakage in laryngectomised patients: A prospective case‐crossover study
Authors: Mayo‐Yáñez Miguel , Cabo‐Varela Irma , Suanzes‐Hernández Jorge , Calvo‑Henríquez Christian , Chiesa‐Estomba Carlos , Herranz González‐Botas Jesús
Published: February 2020

Introduction

Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. One of the main problems of voice prosthesis is the periprosthesis leakage. Provox Vega XtraSeal incorporates a double flange on the pharyngeal side of the prosthesis in order to avoid these failures. The aim of the study is to compare the device lifetime between the Provox Vega and Provox Vega XtraSeal and to examine possible related factors that influence their duration.

Methods

Prospective case‐crossover study in 20 laryngectomised patients with Provox Vega and periprothesis leakage to whom a Provox Vega XtraSeal was placed. Survival and possible factors that affect voice prosthesis were studied using Kaplan‐Meier curves and Cox Proportional Hazards Regression with Schoenfeld residuals to test the possible assumptions.

Results

A total of 230 prostheses were evaluated. The most frequent reason for replacement was due to an endoprosthesis leakage (n = 146, 67%) in both models. Mean lifetime of Provox Vega was 104.474 ± 7.29 days (CI 95% 90.19‐118.76) and of Provox XtraSeal was 176.76 ± 26.46 days (CI 95% 124.9‐228.61) (P = .012). Complementary treatment with radiotherapy demonstrated a higher device survival (P = .007).

Discussion

Provox XtraSeal seems to be effective reducing the number of changes due to periprosthetic leakage, thus increasing the survival of voice prosthesis.
TRUMP, TWITTER, AND TREASURIES
Authors: Tillmann Peter
Published: February 2020

After appointing Federal Reserve Chairman Powell, President Trump put pressure on the Fed to cut interest rates. We show that, on average, a statement from Trump on the Fed led to lower long‐term interest rates, consistent with expectations of lower expected future short rates. However, the impact of Trump's statements declined over time. (JEL E52, E43, E32)
Fishing restrictions and remoteness deliver conservation outcomes for Indonesia's coral reef fisheries
Authors: Campbell Stuart J. , Darling Emily S. , Pardede Shinta , Ahmadia Gabby , Mangubhai Sangeeta , Amkieltiela  , Estradivari  , Maire Eva
Published: February 2020

Coral reef fisheries depend on reef fish biomass to support ecosystem functioning and sustainable fisheries. Here, we evaluated coral reefs across 4,000 km of the Indonesian archipelago to reveal a large gradient of biomass, from <100 kg/ha to >17,000 kg/ha. Trophic pyramids characterized by planktivore dominance emerged at high biomass, suggesting the importance of pelagic pathways for reef productivity. Total biomass and the biomass of most trophic groups were higher within gear restricted and no‐take management, but the greatest biomass was found on unmanaged remote reefs. Within marine protected areas (MPAs), 41.6% and 43.6% of gear restricted and no‐take zones, respectively, met a global biomass target of 500 kg/ha, compared with 71.8% of remote sites. To improve conservation outcomes for Indonesia's biodiverse and economically important coral reef fisheries, our results suggest to: (1) strengthen management within Indonesia's existing MPAs and (2) precautionarily manage remote reefs with high biomass.
Systemic redox imbalance in patients with nonalcoholic fatty liver disease
Authors: Asghari Somayyeh , Hamedi‐Shahraki Soudabeh , Amirkhizi Farshad
Published: February 2020

Background

Oxidative stress is one of the major pathologic mechanisms for the progression of nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the relationship between the extent of steatosis and oxidative stress parameters in patients with NAFLD.

Methods

The data obtained from 122 patients with NAFLD and 106 healthy controls aged 20‐60 years with body mass index (BMI) ranging from 25 to 35 kg/m2. Abdominal ultrasonography was performed in participants in order to the grading of hepatic steatosis. Fasting blood samples and anthropometric measurements were collected for all study subjects. Oxidative stress was evaluated by measurement of serum malondialdehyde (MDA), oxidized low‐density lipoprotein (ox‐LDL), total antioxidant capacity (TAC) and erythrocyte superoxide dismutase (SOD) as well as glutathione peroxidase (GPx) activities.

Results

Serum levels of liver enzymes (P < .0001) and MDA (P = .018), as well as erythrocyte SOD activity (P < .0001), were significantly higher in patients with NAFLD compared to healthy controls. Furthermore, patients with NAFLD had significantly lower serum TAC levels compared to healthy controls (P < .0001). No significant differences were observed in serum ox‐LDL level and erythrocyte GPx activity between the groups. The probability of being NAFLD increased with increasing serum levels of MDA (P = .020) and SOD activity (P < .0001). In contrast, decreased serum TAC levels predicted the probability of being NAFLD (P < .0001).

Conclusions

Increased extent of hepatic steatosis could be considered as a pathological mechanism for enhancing oxidative stress in patients with NAFLD, independent of obesity, and is exacerbated further in patients with more severe condition.
Intersectionality, identity work and migrant progression from low‐paid work: A critical realist approach
Authors: Netto Gina , Noon Mike , Hudson Maria , Kamenou‐Aigbekaen Nicolina , Sosenko Filip
Published: February 2020

This article contributes to developing intersectionality theory by deepening understanding of how patriarchy and racism interact with other structural factors to influence low‐paid migrants’ progression attempts. Using a critical realist approach and analysing interviews of 31 female and male migrants employed in five large organizations in Scotland and England, we reveal how major structural factors influence their main forms of identity work and the resources that they draw on in both the workplace and home. The feminist approach undertaken by this study makes significant advances to organizational intersectional theory in three ways. Firstly, it highlights the importance of examining the interaction of the influence of patriarchy within the home with racism and other structuring forces within the workplace. Secondly, it reveals how combinations of constraints and enablements that intersect with gendered and racialized identity work create formidable barriers to progression. Thirdly, it explores migrants’ differential access to diverse resources, including financial, social, discursive and psychological resources in both spheres over time. These findings reinforce the need for policy actions that recognize the interaction of structural factors which influence female and male migrant progression and the need for support within and beyond the workplace.
Awareness, Care and Treatment In Obesity maNagement to inform Haemophilia Obesity Patient Empowerment (ACTION‐TO‐HOPE): Results of a survey of US patients with haemophilia and obesity (PwHO) and their partners and caregivers
Authors: Croteau Stacy E. , Cutter Susan , Hernandez Grace , Wicklund Brian , Dreyer Gillette Meredith L. , Haugstad Kimberly , Cooper David L. , Ostrow Vlady , Nadglowski Joe
Published: February 2020

Background

The ACTION study identified barriers to initiating and maintaining weight loss in patients with obesity; however, joint‐related issues (pain, mobility and bleeding) may affect perceptions of patients with haemophilia and obesity (PwHO).

Aim

To identify patient and caregiver insights on the unique challenges of PwHO.

Methods

Following IRB approval, adults who self‐identified as PwHO, spouses/partners of adult PwHO, and caregivers of adolescent PwHO (aged 12‐17 years) completed an online survey between December 2017 and April 2018.

Results

Respondents included 124 adult PwHO, 45 spouses/partners and 42 caregivers. By calculated BMI, most adults were overweight (43%) or had obesity (51%); this differed from self‐reported weight category. PwHO goals were improving health conditions (60%), having more energy (54%), reducing risks of weight (46%), and losing any weight (44%). Issues related to joint health were secondary for PwHO but frequently reported by spouses/parents. Most perceived weight loss to be a high priority (66%) and their responsibility (64%) but required a complete lifestyle change (63%). Most anticipated that weight loss would reduce joint pain (62%), bleeding (58%) and factor use (52%) and increase mobility (62%). Weight discussions with healthcare providers (HCPs) were commonly reported (51%). HCP discussions targeted improving health conditions (46%), achieving any weight loss (44%), being more active (73%) and improving eating habits (72%). Most PwHO (65%) perceived obesity as a disease and believe that 10% weight loss would be extremely beneficial (78%). In the past 5 years, 80% discussed being overweight and 68% losing weight; a minority reported being successful (9%) or somewhat successful (38%) with weight loss. More realistic or specific (51%/47%) goals, resources (46%), referrals to weight‐loss programmes (41%) or dietitians (38%), meals or recipes (54%/50%), local or national (42%/41%) programmes for PwHO and success stories of PwHO (40%) are needed or would be helpful.

Conclusions

PwHO, spouse/partners and caregivers exhibited awareness of general and haemophilia‐specific consequences of excess body weight. Most have tried general approaches to improve eating and increase activity with little success and desire more education on weight management and more details on specific actionable recommendations distributed through existing haemophilia channels. These insights will better inform the creation of weight‐loss programmes for this community.
The basement geology of Japan from A to Z
Authors: Wallis Simon R. , Yamaoka Ken , Mori Hiroshi , Ishiwatari Akira , Miyazaki Kazuhiro , Ueda Hayato
Published: February 2020

The Precambrian and lower Paleozoic units of the Japanese basement such as the Hida Oki and South Kitakami terranes have geological affinities with the eastern Asia continent and particularly strong correlation with units of the South China block. There are also indications from units such as the Hitachi metamorphics of the Abukuma terrane and blocks in the Maizuru terrane that some material may have been derived from the North China block. In addition to magmatism, the Japanese region has seen substantial growth due to tectonic accretion. The accreted units dominantly consist of mudstone and sandstone derived from the continental margin with lesser amounts of basaltic rocks associated with siliceous deep ocean sediments and local limestone. Two main phases of accretionary activity and related metamorphism are recorded in the Jurassic Mino–Tanba–Ashio, Chichibu, and North Kitakami terranes and in the Cretaceous to Neogene Shimanto and Sanbagawa terranes. Other accreted material includes ophiolitic sequences, e.g. the Yakuno ophiolite of the Maizuru terrane, the Oeyama ophiolite of the Sangun terrane, and the Hayachine–Miyamori ophiolite of the South Kitakami terrane, and limestone‐capped ocean plateaus such as the Akiyoshi terrane. The ophiolitic units are likely derived from arc and back‐arc basin settings. There has been no continental collision in Japan, meaning the oceanic subduction record is more complete than in convergent orogens seen in intracontinental settings making this a good place to study the geological record of accretion. Hokkaido lacks most of the Paleozoic history recognized in Honshu, Shikoku, Kyushu, and the Ryukyu Islands to the south and its geology reflects the Cenozoic development of two convergent domains with volcanic arcs, their approach, and eventual collision. The Hidaka terrane reveals a cross section through a volcanic arc and the main accretionary complex of the convergent system is represented by the Sorachi–Yezo terrane.
Are Migrants Overrepresented Among Individual Welfare Beneficiaries?
Authors: Jakubiak Igor
Published: February 2020

The level of immigrant welfare dependency is the subject of heated debate in the majority of developed countries, which have experienced a significant increase in immigration in recent years. In both Europe and the US, the problem of potential excessive use of social transfers is beginning to bring real policy consequences. This article addresses this issue by presenting a quantitative assessment of welfare receipt in 17 European countries, as well as Yun decomposition of its differences between natives and immigrants. It adds to existing literature by comparing the levels of welfare dependence among EU and non‐EU migrants for individual benefits including and excluding pensions, using recent data from EU‐SILC. Results suggest that immigrants rely on welfare less often than natives, and receive lower benefits when they do. Those conclusions are reversed, however, when old‐age benefits are not considered – especially in the case of non‐EU migrants.
Clinical investigation of the durability of the lesions created by left atrial linear ablation with a cryoballoon
Authors: Shigeta Takatoshi , Okishige Kaoru , Nishimura Takuro , Aoyagi Hideshi , Yoshida Hiroshi , Nakamura Rena , Hirao Tatsuhiko , Sasano Tetsuo , Hirao Kenzo , Yamauchi Yasuteru
Published: February 2020

Introduction

Pulmonary vein isolation (PVI) and linear ablation with a roof line and bottom line on the left atrial (LA) posterior wall (LAPW) can be achieved with a cryoballoon (CB). This study sought to investigate the long‐term durability of these linear lesions.

Methods and results

Among 290 persistent patients with atrial fibrillation (AF) who had undergone linear ablation with a CB on the roof and bottom line of the LAPW in addition to the PVI, we analyzed those patients who underwent a re‐do AF ablation. Arrhythmia recurrence was confirmed in 70 (24%) out of 290 patients, and 47 (16%) patients underwent re‐do sessions. At the beginning of the re‐do ablation, we examined the reconnection sites of the linear lesions on the LAPW and PVI. Maintenance of the conduction block on the LAPW roof and bottom lines was observed in 35 out of 47 patients (74.5%), and 16 out of 35 patients (45.7%), respectively. The length of the roof line was significantly shorter in patients with preservation of the conduction block on the LAPW roof than in those without (36.2 ± 6.5 mm vs 41.6 ± 4.7 mm, P = .02).

Conclusion

Durable lesions could be obtained after linear ablation with the CB for the LAPW roof line, especially in those with a relatively short LAPW roof line. However, patients requiring touch‐up ablation with radiofrequency were included, and that was associated with a potential financial implication.
Claudins of sea lamprey (Petromyzon marinus) – organ‐specific expression and transcriptional responses to water of varying ion content
Authors: Kolosov Dennis , Bui Phuong , Wilkie Mike P. , Kelly Scott P.
Published: February 2020

The role of lamprey epithelium tight junctions (TJs) in the regulation of salt and water balance is poorly understood. This study reported on claudin (Cldn) TJ protein transcripts of pre‐metamorphic larval and post‐metamorphic juvenile sea lamprey (Petromyzon marinus) and the transcriptional response of genes encoding Cldns to changed environmental ion levels. Transcripts encoding Cldn‐3b, ‐4, ‐5, ‐10, ‐14, ‐18 and ‐19 were identified, and mRNA expression profiles revealed the organ‐specific presence of cldn‐5 and ‐14, broad expression of cldn‐3b,
‐4, ‐10, ‐18 and ‐19 and spatial differences in the mRNA abundance of cldn‐4, ‐3b and ‐14 along the ammocoete intestine. Expression profiles were qualitatively similar in ammocoetes and juvenile fishes. Transcript abundance of genes encoding Cldns in osmoregulatory organs (gill, kidney, intestine and skin) was subsequently investigated after exposure of ammocoetes to ion‐poor water (IPW) and juveniles to hyperosmotic conditions [60% sea water (SW)]. IPW‐acclimated ammocoetes increased mRNA abundance of nearly all cldns in the gill. Simultaneously, cldn‐10 abundance increased in the skin, whereas cldn‐4, ‐14 and ‐18 decreased in the kidney. Ammocoete cldn mRNA abundance in the intestine was altered in a region‐specific manner. In contrast, cldn transcript abundance was mostly downregulated in osmoregulatory organs of juvenile fish acclimated to SW – cldn‐3b, ‐10 and ‐19 in the gill; cldn‐3b, ‐4, ‐10 and ‐19 in the skin; cldn‐3b in the kidney; and cldn‐3b and ‐14 in the intestine. Data support the idea that Cldn TJ proteins play an important role in the osmoregulatory physiology of pre‐ and post‐metamorphic sea lamprey and that Cldn participation can occur across organs, in an organ‐specific manner, as well as differ spatially within organs, which contributes to the regulation of salt and water balance in these fishes.
A review of methods for characterizing the environmental consequences of actions in life cycle assessment
Authors: Palazzo Joseph , Geyer Roland , Suh Sangwon
Published: February 2020

Understanding the environmental consequences of actions is becoming increasingly important in the field of industrial ecology in general, and in life cycle assessment (LCA) more specifically. However, a consensus on how to operationalize this idea has not been reached. A variety of methods have been proposed and applied to case studies that cover various aspects of consequential life cycle assessment (CLCA). Previous reviews of the topic have focused on the broad agenda of CLCA and how different modeling frameworks fit into its goals. However, explicit examination of the spectrum of methods and their application to the different facets of CLCA are lacking. Here, we provide a detailed review of methods that have been used to construct models of the environmental consequences of actions in CLCA. First, we cover the following structural modeling approaches: (a) economic equilibrium models, (b) system dynamics models, (c) technology choice models, and (d) agent‐based models. We provide a detailed review of particular applications of each model in the CLCA domain. The advantages and disadvantages of each are discussed, and their relationships with CLCA are clarified. From this, we are able to map these models onto the established aspects of CLCA. We learn that structural models alone are not sufficient to quantify the uncertainty distributions of underlying parameters in CLCA, which are essential components of a robust analysis of consequences. To address this, we provide a brief introduction to a counterfactual‐based causal inference approach to parameter identification and uncertainty analysis that is emerging in the CLCA literature. We recommend that one potential research path forward is the establishment of feedback loops between empirical estimates and structural models.
New therapeutic approaches for the fertility‐sparing treatment of endometrial cancer
Authors: Mitsuhashi Akira , Shozu Makio
Published: February 2020

This review seeks to describe new fertility‐sparing endometrial cancer (EC) treatment strategies that take into consideration the medical and general health background of patients. We particularly focus on the application of metformin, which is a biguanide widely prescribed for treatment of type 2 diabetes mellitus. Fertility‐sparing treatment using progestin is considered a standard treatment option for patients with atypical endometrial hyperplasia (AEH) and EC who desire to conceive. A previous meta‐analysis of fertility‐sparing treatments revealed a high remission rate; however, high rates of relapse persisted. Most young patients with AEH and EC who are subjected to fertility‐sparing treatment have a background of obesity, insulin resistance and abnormal glucose tolerance complicated with polycystic ovary syndrome. Recently, metformin has been attracting more attention in the field of cancer research. Several in vitro and in vivo reports regarding the efficacy of metformin in EC management have accumulated. Thus far, the efficacy of combining metformin with progestin has been revealed in a single phase II study of medroxyprogesterone acetate in combination with metformin as a fertility‐sparing treatment for patients with AEH or EC. In addition to improving the metabolic profile of patients with EC having metabolic disorders, metformin supplementation may improve the long‐term oncological outcome of these patients. To date, many clinical trials employing progestin and metformin as a fertility‐sparing treatment of AEH and EC are ongoing. In the near future, it is expected that the clinical advantage of metformin progestin combination therapy will be clarified.
Diclofenac Mouthwash as a potential therapy for reducing pain and discomfort in chemo‐radiotherapy–induced oral mucositis
Authors: Brennan Peter A. , Lewthwaite Rowena , Sakthithasan Poornima , McGuigan Sharon , Donnelly Oliver , Alam Peyman , Gomez Ricardo S. , Fedele Stefano
Published: February 2020

Aims

Oral and/or oropharyngeal acute mucositis during and after chemo‐radiotherapy (chemo‐RT) for head and neck squamous cell carcinoma (HNSCC) can be extremely painful, sometimes requiring nasogastric feeding to enable adequate nutrition. The MASCC/ISOO evidence‐based guidelines recommend benzydamine mouthwash for mucositis prevention in RT (recently updated to include chemo‐RT), and a Cochrane systematic review found other agents to be effective in prophylaxis. Diclofenac mouthwash is licensed for painful oral mucosal inflammatory conditions but to our knowledge has not been assessed in chemo‐RT–associated oral mucositis.

Method

A clinical observation and service evaluation study in 10 patients undergoing chemo‐RT for HNSCC to assess the potential value of diclofenac mouthwash (0.74 mg/mL) in reducing symptoms. Patients used 20ml of mouthwash up to 4 times a day starting in week 3 (of a 6‐week course of treatment), recording pain and discomfort scores using a visual analogue scale on days 0, 1,7 and 14 (until the end of week 4). As per our current clinical practice, oral mucositis was not clinically scored as an outcome. Statistical analysis was performed using a one‐way ANOVA.

Results

Using diclofenac mouthwash, 9/10 patients experienced pain score reduction from day 0 (mean score 6.75 ± SD 1.83) to day 2 (5.05 ± SD 1.62) and day 14 (4.09 ± SD 1.96).

Conclusions

Diclofenac mouthwash may be beneficial for managing chemo‐RT–induced oral mucositis. While a prospective randomised clinical trial is needed, it can be prescribed for this condition within its current licence.
Medicaid and long‐term care: The effects of penalizing strategic asset transfers
Authors: Liu Junhao , Mukherjee Anita
Published: February 2020

Medicaid provides a critical source of insurance for long‐term care, and individuals may strategically offload assets (typically to children) to meet the means‐tested eligibility requirement. In this article, we quantify the extent of such behavior using variation in the penalty for improper parent‐to‐child transfers induced by the Deficit Reduction Act of 2005. We estimate difference‐in‐differences models based on the hypothesis that only individuals with high levels of nursing home risk (high risk) will alter transfers because of the Act. We find that over a 2‐year horizon, high‐risk individuals reduced transfers to children on the extensive margin by 11 percent and that the average total amount of transfers decreased by $4,860. The results hold only for coupled respondents. We also conduct a triple‐differences analysis to examine heterogeneity with financial literacy and find that even those with a low level of financial literacy responded to the penalty.
Evolution of reproductive traits in the mahagony family (Meliaceae)
Authors: Laino Gama Rebeca , Muellner‐Riehl Alexandra Nora , Demarco Diego , Pirani José Rubens
Published: February 2020

Meliaceae are a mostly pantropical family in the Sapindales, bearing flowers typically provided with a staminal tube, formed by filaments that are fused partially or totally. Nevertheless, several genera of subfamily Cedreloideae have free stamens, which may be adnate to an androgynophore in some taxa. The fact that the family exhibits a wide diversity of floral and fruit features, as well as of sexual systems and pollination syndromes, presents interesting questions on the evolutionary processes that might have taken place during its history. In this study, we analyzed the distribution of 20 reproductive morphological traits of Meliaceae, upon an available molecular phylogenetic framework, using 31 terminals from the family's two main clades (Cedreloideae and Melioideae), plus six Simaroubaceae taxa as outgroup. We aimed to identify and/or confirm synapomorphies for clades within the family and to develop hypotheses on floral evolution and sexual systems in the group. Our reconstruction suggests that the ancestor of Meliaceae was possibly provided with united stamens and unisexual flowers in dioecious individuals, with a subsequent change to free stamens and monoecy in the ancestor of Cedreloideae. Most characters studied show some degree of homoplasy, but some are unique synapomorphies of clades, such as the haplostemonous androecium. An androgynophore defines the Cedrela‐Toona clade. The comparative approach of our study and the evolutionary hypotheses generated herein reveal several aspects demanding further structural investigation, and possible evolutionary pathways of the reproductive structures along with the lineages' diversification, mostly related to the specialization of sexual systems, floral biology, and dispersal strategies.
Therapeutic effects of Choreito, a traditional Japanese (Kampo) medicine, on detrusor overactivity induced by acetic acid in rats
Authors: Ueno Manabu , Minagawa Tomonori , Saito Tetsuichi , Imamura Tetsuya , Nagai Takashi , Ogawa Teruyuki , Ishizuka Osamu
Published: February 2020

Choreito (CRT), a traditional Japanese (Kampo) medicine, is widely used for the treatment of overactive bladder (OAB) and other lower urinary tract symptoms in Japan. This study aimed to identify the effects and therapeutic mechanism of CRT on the improvement of detrusor overactivity (DO) using an experimental rat model. Forty‐five female Sprague‐Dawley rats were equally divided into three groups: intravesical saline instillation with normal food (normal group), intravesical acetic acid (AA) instillation with normal food (AA group), and intravesical AA instillation with CRT (AA with CRT group). To induce a decrease in bladder capacity, instillation of 0.2% AA was used based on prior studies. Cystometric investigation was employed to clarify the effects of AA and CRT. Microcirculation was performed using a laser blood flowmeter, and the localization of hypoxia‐inducible factor 1α (HIF1α) was assessed by immunohistochemistry. The bladder capacities of the normal, AA, and AA with CRT groups were 1.2 ± 0.3 mL, 0.4 ± 0.1 mL, and 0.8 ± 0.1 mL, respectively. CRT significantly attenuated AA irritation of the urinary bladder and exerted protective effects on basal pressure, micturition pressure, micturition interval, and micturition volume. Furthermore, CRT could prevent the excess blood flow and edematous change under the urothelium induced by intravesical AA instillation. No obvious changes in immunohistochemical HIF1α staining were observed among the groups. CRT attenuated DO induced by intravesical AA instillation in a rat experimental model. CRT might impart therapeutic effects on OAB via the mitigation of urothelial damage and regulation of excess blood flow.
Electrogastrographic and autonomic nervous system responses to solid and liquid meals in youth with functional dyspepsia
Authors: Vargas‐Luna Francisco Miguel , Huerta‐Franco María Raquel , Schurman Jennifer V. , Deacy Amanda D. , Bagherian Amber , Harvey Lisa , Friesen Craig A.
Published: February 2020

Background

Meal‐related symptoms are common in paediatric functional dyspepsia (FD). There are only a small number of paediatric studies assessing mechanisms for meal‐related symptoms, and these have not utilized Rome IV criteria. The aim of the current study was to assess gastric myoelectric and autonomic nervous system (ANS) responses to both liquid and solid meals in youth with Rome IV‐defined FD.

Methods

In healthy controls (N = 14) and youth with FD (N = 12), we recorded electrocardiograph (to assess heart rate variability; HRV) and electrogastrograph (EGG) signals before and after two test meals, one liquid and one solid. EGG parameters and HRV were assessed for the entire pre‐ and postprandial periods and in short time intervals. Additionally, liquid gastric emptying was assessed utilizing a 13C‐acetate breath test.

Key Results

During the EGG, the dominant power increased with both meals in controls but not patients with FD. During HRV assessment, the low frequency to high frequency ratio was higher after the liquid meal in controls, despite being similar preprandial, as compared to patients with FD. In controls, both standard deviation of normal to normal waves (SDNN) and root mean square of successive ECG R peaks (R‐R interval) differences (rMSSD) increased after the liquid meal (but not after the solid meal) in controls but not patients with FD.

Conclusions and Inferences

Youth with Rome IV‐defined FD lacks the normal postprandial EGG dominant power response or autonomic nervous system response following a liquid meal. The latter appears to indicate a lack of ANS flexibility.
Born to revive: molecular and physiological mechanisms of double tolerance in a paleotropical and resurrection plant
Authors: Fernández‐Marín Beatriz , Nadal Miquel , Gago Jorge , Fernie Alisdair R. , López‐Pozo Marina , Artetxe Unai , García‐Plazaola José Ignacio , Verhoeven Amy
Published: February 2020

Resurrection plants recover physiological functions after complete desiccation. Almost all of them are native to tropical warm environments. However, the Gesneriaceae include four genera, remnant of the past palaeotropical flora, which inhabit temperate mountains. One of these species is additionally freezing‐tolerant: Ramonda myconi. We hypothesise that this species has been able to persist in a colder climate thanks to some resurrection‐linked traits.

To disentangle the physiological mechanisms underpinning multistress tolerance to desiccation and freezing, we conducted an exhaustive seasonal assessment of photosynthesis (gas exchange, limitations to partitioning, photochemistry and galactolipids) and primary metabolism (through metabolomics) in two natural populations at different elevations.

R. myconi displayed low rates of photosynthesis, largely due to mesophyll limitation. However, plants were photosynthetically active throughout the year, excluding a reversible desiccation period. Common responses to desiccation and low temperature involved chloroplast protection: enhanced thermal energy dissipation, higher carotenoid to Chl ratio and de‐epoxidation of the xanthophyll cycle. As specific responses, antioxidants and secondary metabolic routes rose upon desiccation, while putrescine, proline and a variety of sugars rose in winter.

The data suggest conserved mechanisms to cope with photo‐oxidation during desiccation and cold events, while additional metabolic mechanisms may have evolved as specific adaptations to cold during recent glaciations.
Establishment and evolution of heterochromatin
Authors: Liu Jing , Ali Mujahid , Zhou Qi
Published: February 2020

The eukaryotic genome is packaged into transcriptionally active euchromatin and silent heterochromatin, with most studies focused on the former encompassing the majority of protein‐coding genes. The recent development of various sequencing techniques has refined this classic dichromatic partition and has better illuminated the composition, establishment, and evolution of this genomic and epigenomic “dark matter” in the context of topologically associated domains and phase‐separated droplets. Heterochromatin includes genomic regions that can be densely stained by chemical dyes, which have been shown to be enriched for repetitive elements and epigenetic marks, including H3K9me2/3 and H3K27me3. Heterochromatin is usually replicated late, concentrated at the nuclear periphery or around nucleoli, and usually lacks highly expressed genes; and now it is considered to be as neither genetically inert nor developmentally static. Heterochromatin guards genome integrity against transposon activities and exerts important regulatory functions by targeting beyond its contained genes. Both its nucleotide sequences and regulatory proteins exhibit rapid coevolution between species. In addition, there are dynamic transitions between euchromatin and heterochromatin during developmental and evolutionary processes. We summarize here the ever‐changing characteristics of heterochromatin and propose models and principles for the evolutionary transitions of heterochromatin that have been mainly learned from studies of Drosophila and yeast. Finally, we highlight the role of sex chromosomes in studying heterochromatin evolution.
Contribution of microglia and monocytes to the development and progression of age related macular degeneration
Authors: Fletcher Erica L
Published: February 2020

Purpose

Age related macular degeneration (AMD) is the leading cause of irreversible vision loss in industrialised nations. Based on genetics, as well as proteome analysis of drusen, the role the innate immune system in the development and/or progression of the disease is well established. Mononuclear phagocytes, such as microglia and monocytes, play critical roles in innate immunity. Here, the role of retinal microglia in mediating normal retinal function, and how these cells change with age is discussed, so as to understand their role in the development and progression of AMD.

Recent findings

It is now known that microglia dynamically survey the neural environment, responding rapidly to even the most subtle neural injury. The dynamic and phagocytic roles of microglia can change with age contributing to alteration in the response of these cells to damage with age. Accumulation of innate immune cells in the subretinal space is a hallmark feature of the development of AMD, reflecting either an increase in migration of monocytes into the retina, or a failure of immune cell elimination from the retina. Furthermore, changes in phagocytic ability of immune cells could contribute to the accumulation of drusen deposits in the posterior eye.

An overview of how retinal microglia maintain retinal homeostasis under normal conditions is provided, and then how they contribute to each stage of AMD. In addition, circulating monocytes are altered in those with AMD, contributing to the overall inflammatory state. Understanding the role of cells of the innate immune system in AMD may uncover novel therapeutic targets with which to reduce either the development or progression of disease.
Oral corticosteroids and asthma in children: Practical considerations
Authors: De Filippo Maria , Clark Evangéline , Fillard Anouchka , Diaferio Lucia , Caimmi Davide
Published: February 2020

Corticosteroids (CS) are among the most prescribed drugs in pediatrics. In allergy, CS are prescribed for several different conditions. If CS show clear benefits when adequately prescribed, CS are also associated with several side effects, well known by pediatricians. As for asthma exacerbations, the oral route is always the preferred one in pediatrics. Several authors debated if the use of a single dose of dexamethasone is better in terms of efficacy, compared with a 3‐ to 5‐day course of prednisone or prednisolone. Another interesting issue that has not been fully clarified concerns whether oral corticosteroids should be prescribed in preschoolers presenting with acute wheezing. The present review aims to review the most recent publications on this topic and to try to clarify which may be the best option in children suffering from asthma exacerbations.
What the paediatrician needs to know about HIV‐1 infection
Authors: Parigi Sara , Licari Amelia , Marseglia Gian Luigi , Galli Luisa , Chiappini Elena
Published: February 2020

Nowadays, it is spreading the false perception that pediatric HIV infection has been almost completely disappeared in Italy, as well as in other Western countries, and it does not deserve the attention of the primary care pediatrician anymore. Hereby, we report the important role still played by the primary care pediatrician in management and prevention of pediatric HIV infection in Western countries.
Allergen immunotherapy and asthma
Authors: Tosca Maria Angela , Olcese Roberta , Licari Amelia , Ciprandi Giorgio
Published: February 2020

Allergen immunotherapy (AIT) represents at present the unique disease‐modifying treatment strategy for IgE‐mediated allergic diseases. AIT can induce clinical improvement of allergic asthma, including reduced symptoms, medication use, and improvement of quality of life, with a long‐lasting effect after cessation of treatment. Notably, the current asthma guidelines are now recommending sublingual immunotherapy as an add‐on therapy for asthma in adults and adolescents with house dust mite allergy. Clinical indications of AIT, with particular reference to pediatric asthma, mechanisms of clinical and immunological tolerance to allergens, and the potential biomarkers predicting clinical response are discussed.
Digital allergology: Towards a clinical decision support system for allergen immunotherapy
Authors: Matricardi Paolo Maria , Potapova Ekaterina , Forchert Leandra , Dramburg Stephanie , Tripodi Salvatore
Published: February 2020

Mobile health is the “medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants, and other wireless devices.” For example, mobile apps (such as MASK‐Air, Allergy.Monitor, Pollen, and others) have proven useful in the management of patients with allergic rhinitis. These apps can be used in the context of broader clinical decision support systems (CDSS) for enhancing allergy‐related decisions and actions with pertinent, organized clinical knowledge and patient information to improve allergy care. A CDSS targeted to control rhinitis with drugs and other interventions guiding the patient in his/her self‐ and doctor‐driven management is currently being produced and investigated by the MACVIA network. Another one, called @IT‐2020, is targeted to support etiologic diagnostics and allergen immunotherapy (AIT) prescriptions for patients with seasonal allergic rhinitis. Intensive investigation is necessary to better define the advantages and limitations of mobile‐health technology in allergology and establish guidelines for their proper use in daily practice in the context of a rapidly evolving European regulatory environment.
Oral desensitization in IgE‐mediated food allergy: Effectiveness and safety
Authors: Calvani Mauro , Bianchi Annamaria , Imondi Chiara , Romeo Eleonora
Published: February 2020

The avoidance of allergenic foods and emergency medications on accidental exposure are the only currently approved treatments in food allergy. EAACI guideline on allergen immunotherapy recommends oral immunotherapy as a therapeutic option to increase the threshold of the reaction during treatment in children with persistent IgE‐mediated cow's milk, hen's egg, and peanut allergy from around 4‐5 years of age, but the same recommendation cannot currently be made to achieve post‐discontinuation effectiveness. Both systemic and local reactions during OIT have been frequently reported. For this reason, EAACI guideline suggests several recommendations on safety, including carefully monitoring patients for allergic reactions, especially during the up‐dosing phase of OIT, and monitoring for symptoms of new‐onset eosinophilic esophagitis. New approaches are certainly necessary to give priority not only to effectiveness but also to safety.
Thyroid tumor surveillance using ultrasound in childhood cancer survivors
Authors: Furui Yu , Morita Daisuke , Okura Eri , Komori Kazutoshi , Saito Shoji , Hirabayashi Kanae , Tanaka Miyuki , Nakazawa Yozo
Published: February 2020

Background

The optimal method for thyroid cancer screening in childhood cancer survivors (CCSs) who received radiation involving the thyroid gland is still debated. We describe a case series of ultrasound surveillance for thyroid tumor in CCSs in our institute.

Methods

We conducted thyroid tumor surveillance for CCSs with a history of radiation therapy involving the thyroid. The basic screening method was palpation. Thyroid ultrasound was also performed for patients who agreed after its benefits and risks were explained to them. We surveyed CCSs who visited the long‐term follow‐up outpatient clinic in our institution between October 2014 and September 2018.

Results

Of 82 CCSs who visited our institution during the study period, 44 were eligible for inclusion. None had a mass identified by palpation. Thyroid ultrasound was performed in 39 CCSs, and we identified thyroid nodules in 27. Four patients had a nodule with malignant echo features. Two of these cases received biopsies, and one patient was ultimately diagnosed with an early stage thyroid carcinoma.

Conclusions

Childhood cancer survivors irradiated in the thyroid had a higher prevalence of thyroid nodules than the general population. Ultrasound screening contributed to early detection of impalpable thyroid cancer and enabled us to perform minimal surgery. Thus, ultrasound appears to be a useful option for secondary thyroid cancer screening. The thyroid tumor surveillance modality should be considered according to the individual case, and the patient must receive a clear explanation of the benefits and risks. These results could help doctors consider how to screen for secondary thyroid cancer.
Effects of providing nursing care with web‐based program on maternal self‐efficacy and infant health
Authors: Sari Cigdem , Altay Naime
Published: February 2020

Objective

The study was conducted to examine the efficacy of a web‐based program, informed by Pender's Health Promotion Model, given to primiparous women on the growth and development of infant, infants’ health, and women's self‐efficacy level.

Methods

This randomized controlled study with a posttest design was conducted in three primary care clinics. The study group comprised 71 primiparous women and their infants (intervention group: N = 35; control group: N = 36). The women who are at the 33–37th gestational week in the intervention group participated in the web‐based program. They completed four education modules. Women in the control group received routine care in clinics. Data forms were completed in the first week and first, second, and third months postpartum. Breastfeeding status, weight, head circumference, development of infants and women's self‐efficacy were evaluated in the postnatal period up to 3 months.

Results

In the intervention group, the ratio of infants who were exclusively breastfed was higher compared to the control group. The mean scores for the LATCH instrument which measures breastfeeding status and Parental Self‐Efficacy Scale, were significantly higher in the intervention compared to the control group (p < .05).

Conclusion

The women who participated in the web‐based program demonstrated better self‐efficacy and their infants demonstrated better scores on measures of growth, development, and health than those in the control group.