bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of sodium humate and glutamine combined supplementation on growth performance, diarrhea incidence, blood parameters, and intestinal microflora of weaned calves
Authors: Wang Dong , Du Yuanyi , Wang Shuang , You Zhendong , Liu Yun
Published: July 2021

This experiment was conducted to investigate the effects of sodium humate (HNa) and glutamine (Gln) alone or combined supplementation on growth performance, diarrhea incidence, blood parameters, and intestinal microflora of weaned Holstein calves. In a 14‐day experiment, 40 calves at 51 ± 3 days of age were randomly allocated to four treatment groups: (1) NC (basal diet), (2) NC + 5% HNa, (3) NC + 1% Gln, and (4) NC + 5% HNa + 1% Gln. Calves combined supplementation with HNa and Gln had a higher (P < .05) ADG, serum concentration of glucose (GLU), IgA, and IgG but lower fecal scores, diarrhea incidence, serum concentration of TNF‐α, and IL‐10 compared with NC group (P < .05). Compared with NC group, HNa + Gln group showed higher (P < .05) serum GSH and T‐AOC activities but lower (P < .05) concentration of MDA and D‐lac. Furthermore, the abundances of Prevotella ruminicola, Bifidobacterium, and Lactobacillus in rectal digesta were increased (P < .05), but the Escherichia coli was significantly decreased. In conclusion, combined supplementation with HNa and Gln can effectively improve the immune status, antioxidant capacity, and intestinal microflora of the weaned calves while reducing diarrhea incidence.
Sensitivity to being betrayed and betraying others in obsessive compulsive disorder and depression
Authors: Howkins Sarah , Millar Josie F. A. , Salkovskis Paul M.
Published: July 2021

Objectives

Mental contamination (MC) describes subjective internal feelings of ‘dirtiness’, which are experienced in the absence of direct physical contact/contaminants. There is evidence of a link between MC in obsessive compulsive disorder (OCD) and the experience of past betrayals. However, it has also been noted that ‘perpetrators’ also experience MC. We aimed to replicate the previous finding of specificity of OCD for sensitivity to being betrayed by comparing with those suffering from depression, and to extend this by evaluating whether people with high MC OCD are also relatively more sensitive to the idea that they might betray others compared to those with low levels of MC OCD.

Design

A cross‐sectional, between‐groups design was used.

Method

Four groups, high MC OCD (N = 60), low MC OCD (N = 61), depression (N = 28), and non‐clinical controls (N = 46) completed online questionnaires. Participants were recruited through the National Health Service (NHS) and social media.

Results

Relative to all groups, the high MC OCD group had significantly higher scores both for betrayal sensitivity and sensitivity to betraying others. The depression group showed similar levels to low MC OCD in betrayal sensitivity but were significantly lower (and comparable to non‐clinical controls) in sensitivity to betraying others.

Conclusions

Betrayal sensitivity occurs trans‐diagnostically. There may be a specific link between the development of OCD and the perception of betraying others, perhaps linked to the trauma of being betrayed making those so affected more likely to worry about their own responsibility for betraying others.

Practitioner points

Clinicians should, across diagnoses, attend to sensitivity to being betrayed and the experiences which may have led to this.

Current treatments for MC OCD recommend working with historical experiences of ‘betrayal’. This study suggests that people with OCD also have an increased sensitivity to the idea of being a ‘perpetrator’ of betrayal linked to high responsibility beliefs.

Specifically for OCD, it is possible that the experience of previously being betrayed results in increased current sensitivity to being responsible for being a ‘betrayer’. It may, therefore, also be useful for therapists to consider if patients with MC OCD are concerned about potentially betraying others and to consider this within the formulation.

The focus of clinical work could be to redefine these difficulties by reappraising beliefs regarding experience of betrayal and the likelihood of betraying others.

Elevated levels of betrayal sensitivity were found in people with depression, and this may need to be considered in treatment approaches.
Racism and misrecognition
Authors: Xie Yarong , Kirkwood Steve , Laurier Eric , Widdicombe Sue
Published: July 2021

Recognition and misrecognition have been theorized as key concepts for social justice. Misrecognition involves being disrespected or labelled in ways which do not accord with a person’s self‐identify. Racism can be understood as a specific form of misrecognition but little research has explored this form or drawn on notions of misrecognition in the discursive psychological study of racism. Our study addresses this gap by drawing on discursive psychology and conversation analysis to examine reports of racial encounters in public spaces, where misrecognition of the targets’ nationality is invoked. We demonstrate that instances of misrecognition are judged as racism through the selection and use of categories and/or category‐sensitive predicates that exclude the target of them from (national) category membership to which they claim entitlement. People reporting racialized encounters and those responding to them treat the description and evaluation of such incidents sensitively, orienting to the delicacy of alleging racism. In this article, we enhance theoretical understandings of misrecognition by showing how it is constructed interactionally and demonstrate the value of notions of recognition and misrecognition for the study of racism.
Forebulge migration in the foreland basin system of the central‐southern Apennine fold‐thrust belt (Italy): New high‐resolution Sr‐isotope dating constraints
Authors: Sabbatino Monia , Tavani Stefano , Vitale Stefano , Ogata Kei , Corradetti Amerigo , Consorti Lorenzo , Arienzo Ilenia , Cipriani Anna , Parente Mariano
Published: July 2021

The Apennines are a retreating collisional belt where the foreland basin system, across large domains, is floored by a subaerial forebulge unconformity developed due to forebulge uplift and erosion. This unconformity is overlain by a diachronous sequence of three lithostratigraphic units made of (a) shallow‐water carbonates, (b) hemipelagic marls and shales and (c) siliciclastic turbidites. Typically, the latter two have been interpreted regionally as the onset of syn‐orogenic deposition in the foredeep depozone, whereas little attention has been given to the underlying unit. Accordingly, the rate of migration of the central‐southern Apennine fold‐thrust belt‐foreland basin system has been constrained, so far, exclusively considering the age of the hemipelagites and turbidites, which largely post‐date the onset of foredeep depozone. In this work, we provide new high‐resolution ages obtained by strontium isotope stratigraphy applied to calcitic bivalve shells sampled at the base of the first syn‐orogenic deposits overlying the Eocene‐Cretaceous pre‐orogenic substratum. Integration of our results with published data indicates progressive rejuvenation of the strata sealing the forebulge unconformity towards the outer portions of the fold‐thrust belt. In particular, the age of the forebulge unconformity linearly scales with the pre‐orogenic position of the analysed sites, pointing to an overall constant migration velocity of the forebulge wave in the last 25 Myr.
Postoperative changes in plasma miR21‐5p as a novel biomarker for colorectal cancer recurrence: A prospective study
Authors: Fukada Masahiro , Matsuhashi Nobuhisa , Takahashi Takao , Sugito Nobuhiko , Heishima Kazuki , Yoshida Kazuhiro , Akao Yukihiro
Published: July 2021

Cancer‐related microRNAs (miRNAs) are emerging as promising and noninvasive biomarkers for colorectal cancer (CRC). This study aimed to investigate the usefulness of postoperative changes in plasma miR21‐5p levels for recurrence and progressive disease (PD) after surgical resection. This study was a prospective study of 103 CRC patients who underwent surgical resection. Self‐paired plasma samples collected pre‐operation (Pre), 7 days post‐operation (POD7), 1 month post‐operation (POM1), and 6 months post‐operation (POM6) were analyzed. The miRNA levels were evaluated by quantitative reverse transcription PCR. Among the enrolled patients, ten cases (9.7%) of postoperative recurrence and six cases (5.8%) of postoperative PD occurred at POM6. In the recurrence and PD group, plasma miR21‐5p levels significantly increased (POM1: P < .01, POM6: P < .01, respectively). The area under the curve (AUC) value for postoperative changes in plasma miR21‐5p levels at POM1 and POM6 to discriminate recurrence and PD were 0.675 and 0.715, respectively. Combined analysis with postoperative carcinoembryonic antigen (CEA) level in discriminating recurrence and PD increased AUC values (POM1: 0.715 and POM6: 0.789). Furthermore, multivariate analysis for recurrence and PD after surgical resection showed that postoperative changes in the plasma miR21‐5p level at POM1 and POM6 were independent prognostic factors (POM1: P = .03, POM6: P < .01). The postoperative changes in plasma miR21‐5p level could be a useful noninvasive biomarker for monitoring and predicting recurrence and PD after surgical resection of CRC patients. Furthermore, plasma miR21‐5p can predict recurrence and PD after surgical resection.
What is the evidence on the added value of implant‐supported overdentures? A review
Authors: Van de Winkel Thomas , Heijens Laura , Listl Stefan , Meijer Gert
Published: July 2021

Background

Implant‐supported overdentures (IODs) have been reported to increase patients' oral health‐related quality of life (OHRQoL) in comparison with conventional dentures (CDs); however, the conclusiveness of evidence on the clinical effectiveness and value for money of IODs versus CDs remains unclear.

Purpose

To review how the added value of IODs is demonstrated in the literature.

Materials and methods

MEDLINE, EMBASE, and the Cochrane Database were searched for randomized control trials, controlled clinical trials, and prospective cohort studies containing evaluations of the economic and health benefits and costs of IODs. Information about the clinical effectiveness, such as magnitude of bite forces or chewing efficacy, OHRQoL, costs, and cost‐effectiveness of IODs, was extracted.

Results

A total of 17 articles were included, reporting 15 economic evaluations: 11 cost‐utility analyses (CUAs), 2 of which were combined with a cost‐effectiveness analysis (CEA), and 2 cost–benefit analyses (CBAs). Seven CUAs used the Oral Health Impact Profile (OHIP) questionnaire while four used satisfaction questionnaires to assess the OHRQoL. One study applied quality‐adjusted prosthesis years (QAPYs) for this purpose. The CBAs expressed both the beneficial outcome and the costs of the IOD in monetary terms. The included studies employed a large variety of economic evaluation methods, which limited cross‐study comparability.

Conclusions

On the basis of existing economic evaluations, IODs have frequently been suggested to be a cost‐efficient treatment alternative to CDs; however, the comparability between the various economic evaluation studies was limited due to the different outcome measures used. In addition, it remains unclear whether the additional health benefits of IODs outweigh the higher costs. This is largely dependent on the decision maker's valuation of oral health outcomes. Future research is encouraged to further elucidate patient willingness to pay for IODs and the societal return on investing in IODs more generally.
‘Oh, I’ve got an appointment’: A qualitative interview study exploring how to support attendance at diabetes screening after gestational diabetes
Authors: Dennison Rebecca A. , Meek Claire L. , Usher‐Smith Juliet A. , Fox Rachel A. , Aiken Catherine E. , Griffin Simon J.
Published: July 2021

Aims

To explore the views of women with a history of gestational diabetes mellitus (GDM) on suggested practical approaches to support diabetes screening attendance after GDM, which is recommended but poorly attended.

Methods

We conducted semi‐structured interviews with 20 participants in Cambridgeshire, UK who had been diagnosed with GDM and were 3–48 months postpartum. Interviews covered whether participants had been screened and why, plans for future screening and their views on potential interventions to facilitate attendance (at the first postpartum test and annual testing). Framework analysis was used to analyse the transcripts. The interview schedule, suggested interventions and thematic framework were based on a recent systematic review.

Results

Sixteen participants had undergone screening since pregnancy, explaining that they had an appointment arranged and wanted reassurance that they did not have diabetes. The participants who had not been tested were not aware that it was recommended. Only 13 had planned to attend subsequent tests at the start of the interview. Eight themes to support future attendance were discussed. The majority of the participants agreed that changing the processes for arranging tests, offering choice in test location and combining appointments would facilitate attendance. Child‐friendly clinics, more opportunities to understand GDM and the role of postpartum testing, stopping self‐testing and increasing their GP’s awareness of their pregnancy received inconsistent feedback. The nature of the test used did not appear to influence attendance.

Conclusions

The participants wanted to be screened for diabetes after GDM. We have identified interventions that could be relatively simply incorporated into routine practice to facilitate screening attendance, such as flexibility in the appointment location or time and sending invitations for tests.
Complete AV block in a neonatal foal suffering from nutritional myodegeneration
Authors: Conze T. M. , Falkenau A. , Goehring L. S. , May A.
Published: July 2021

This case report concerns a 1‐day‐old, full‐term Quarter Horse colt presented due to a progressive inability to rise and nurse. Besides the general weakness, a marked bradycardia was evident, which was caused by a third‐degree atrioventricular (AV) block. Subsequently, the diagnosis of acute nutritional myodegeneration (NMD) was made based on clinical signs, elevated muscle enzymes, ECG findings, as well as low serum selenium and vitamin E values. Despite intensive care and supportive therapy, the foal´s condition deteriorated, and euthanasia was elected. Necropsy confirmed the diagnosis of NMD and revealed diffuse necrosis and inflammatory infiltration of the skeletal and myocardial musculature, as well as the cardiac conduction system which might have resulted in complete AV block.
Comparative anti‐inflammatory effects of insulin and dexamethasone on cardiovascular biomarkers and antioxidants in miniature donkeys subjected to induced carbohydrate overload
Authors: Samimi A. S. , Poostfroush S. , Samimi K. , Tajik J.
Published: July 2021

Background

Inflammatory responses as a result of carbohydrate (CHO) engorgement have been associated with peripheral tissue insulin resistance.

Objectives

The aim of this study was to comparatively evaluate the anti‐inflammatory effects of intravenous (i.v.) administration of insulin and dexamethasone on clinical parameters, antioxidants and cardiovascular biomarkers in miniature donkeys subjected to induced CHO overload.

Study design

Prospective, experimental study.

Methods

Eighteen clinically healthy male miniature donkeys with the age of 5 ± 1 years, weight of 105 ± 6 kg, body condition score of 5 (moderate) and height at the withers of 0.9 ± 0.06 m were used for this study. The animals were randomly assigned into three experimental groups (2 treatments and 1 negative control). Oligofructose (OF) at 10 g/kg of bodyweight was administered via nasogastric tube to induce CHO overload. Six hours later, animals in the treatment groups received IV 3 IU/kg bwt of insulin and 2 mg/kg bwt dexamethasone, respectively.

Results

The results of this study revealed that heart rate (HR), respiratory rate (RR) and rectal temperature (RT), packed cell volume (PCV), white blood cell (WBC), glucose, homocysteine (Hcy) and cardiac troponin I (cTnI) increased, while the values of superoxide dismutase (SOD) and glutathione peroxidase (GPX) decreased in miniature donkeys subjected to CHO engorgement. All variables (except PCV) returned to normal values within 24 h in treatment groups. In treatment groups, HR and RR were significantly lower than the control group after 12 h. There were no significant differences between insulin and dexamethasone in levels of cTnI, Hcy, SOD, GPX, glucose, PCV and WBC after 24 h.

Main limitations

Recording of only antioxidants and cardiovascular biomarkers is insufficient to well define the anti‐inflammatory effects of insulin.

Conclusions

It could be suggested that insulin (3 IU/kg bwt) and dexamethasone (2 mg/kg bwt) may be useful during CHO overload in miniature donkeys.
In vitro inhibition and molecular docking of a new ciprofloxacin‐chalcone against SARS‐CoV‐2 main protease
Authors: Alaaeldin Rania , Mustafa Muhamad , Abuo‐Rahma Gamal El‐Din A. , Fathy Moustafa
Published: July 2021

Background/Aim

SARS‐CoV‐2 is one of the coronavirus families that emerged at the end of 2019. It infected the respiratory system and caused a pandemic worldwide. Fluoroquinolones (FQs) have been safely used as antibacterial agents for decades. The antiviral activity of FQs was observed. Moreover, substitution on the C‐7 position of ciprofloxacin enhanced its antiviral activity. Therefore, this study aims to investigate the antiviral activity of 7‐(4‐(N‐substituted‐carbamoyl‐methyl)piperazin‐1yl)‐chalcone in comparison with ciprofloxacin against SARS‐CoV‐2 main protease (Mpro).

Materials and methods

Vero cells were infected with SARS‐CoV‐2. After treatment with ciprofloxacin and the chalcone at the concentrations of 1.6, 16, 160 nmol/L for 48 h, SARS‐CoV‐2 viral load was detected using real‐time qPCR, SARS‐CoV‐2 infectivity was determined using plaque assay, and the main protease enzyme activity was detected using in vitro 3CL‐protease inhibition assay. The activity of the chalcone was justified through molecular docking within SARS‐CoV‐2 Mpro, in comparison with ciprofloxacin.

Results

The new chalcone significantly inhibited viral load replication where the EC50 was 3.93 nmol/L, the plaque formation ability of the virus was inhibited to 86.8% ± 2.47. The chalcone exhibited a significant inhibitory effect against SARS‐CoV‐2 Mpro in vitro in a dose‐dependent manner. The docking study into SARS‐CoV‐2 Mpro active site justified the importance of adding a substitution to the parent drug. Additionally, the assessment of the drug‐likeness properties indicated that the chalcone might have acceptable ADMET properties.

Conclusion

The new chalcone might be useful and has new insights for the inhibition of SARS‐CoV‐2 Mpro.
Turning the tide? Economic reforms and union revival in India
Authors: Badigannavar Vidu , Kelly John , Kumar Manik
Published: July 2021

Despite nearly three decades of ostensibly pro‐employer economic reforms in India, trade union membership and density in India appear to have risen. Although similar trends have been reported and investigated in other emerging economies such as China and South Africa, the union revival thesis in India is yet to be fully explored. Using large‐scale official survey data from 1993–1994 to 2011–2012 and primary data collected through 56 interviews with key stakeholders, this paper investigates the patterns of union membership growth in India. Findings indicate varying degrees of growth in union membership across all industrial sectors and employment types. We draw upon theoretical insights from economic theories of union growth, comparative politics and social movement unionism to explain union membership growth in India.
Sleeping is a nightmare: A qualitative study on the experience and management of poor sleep quality in women with fibromyalgia
Authors: Climent‐Sanz Carolina , Gea‐Sánchez Montserrat , Fernández‐Lago Helena , Mateos‐García José Tomás , Rubí‐Carnacea Francesc , Briones‐Vozmediano Erica
Published: July 2021

Aim

This study aimed to explore the experience and management of poor sleep quality in Spanish women with fibromyalgia (FM).

Design

This was a qualitative study based on one‐to‐one interviews.

Methods

Twenty‐one adult women diagnosed with FM were recruited from the community between January and March 2020. Data were collected through in‐depth semistructured one‐to‐one interviews, using an interview guide of open questions about the experience and management of poor sleep quality, and were analyzed with thematic qualitative analysis. The symptom management theory was used as a biopsychosocial conceptual framework.

Results

The results were organized into two themes: (a) experience of poor sleep quality and (b) management strategies for poor sleep quality. Poor sleep quality was found to be a severe symptom of FM that negatively impacts pain, fatigue, stiffness, mental health, and quality of life. The participants perceived pharmacological treatment to be the main approach of health care professionals for improving sleep, and most did not want this form of treatment. Self‐management strategies lack clear beneficial effects on sleep quality.

Conclusion

Women with FM recognize that they need to receive more information from nurses and allied professions about sleep in the context of FM and how to effectively manage poor sleep quality.

Impact

This study contributes to a better understanding of how women with FM experience and manage poor sleep quality. More information about management strategies for poor sleep quality from nurses and other health care professionals is needed in women with FM. The results of this study can be applied by nurses and health care professionals, including sleep educators, in the treatment of this patient group.
The incidence and location of epicardial connections in the era of contact force guided ablation for pulmonary vein isolation
Authors: Sun Xuerong , Niu Guodong , Lin Jinxuan , Suo Ni , Guo Tao , Lu Jiang , Feng Tianjie , Zheng Lihui , Yao Yan , Zhang Shu
Published: July 2021

Background

The effects of epicardial connections (ECs) involving pulmonary veins (PVs) in atrial fibrillation (AF) ablation have been revealed recently. However, no systematic approaches to identify and ablate the ECs were established.

Methods

Patients with AF undergoing radiofrequency (RF) catheter ablation were retrospectively analyzed. ECs were identified when (1) PV isolation (PVI) cannot be achieved after first‐pass isolation; (2) PVI was still absent although the conduction gap was detected and ablated; (3) the earliest activation area (EAA) was revealed located within the PV antrum distant from the initial ablation line using high‐density mapping (HDM) technique; (4) focal ablation at the EAA was effective to achieve PVI. Relevant pacing maneuvers were performed to elucidate ECs’ bidirectional conduction.

Results

Overall, 36 ECs were identified and ablated in 35/597 (5.86%) patients. Among the 35 patients with ECs, at least one PV insertion of ECs was located at the carina region. The most common pattern was a single breakthrough in 31 (88.6%) patients, followed by multiple breakthroughs in 3 and wide breakthroughs in 1. The median distance from EAA to the initial ablation line was 10.0 mm. The average number of RF energy delivery was 1.75 ± 1.00, and single RF delivery was adequate in 16/36 (44.4%) patients. Continuous potentials were present at the EAA in 9/34 (26.5%) patients.

Conclusion

ECs were confirmed and ablated successfully in 5.86% (35/597) AF patients using HDM. PV insertions of ECs were mainly located at the carina region. Continuous potentials might assist in the prediction of ECs.
Diagnosis, significance, and management of ventricular thrombi in patients referred for VT ablation
Authors: Beavers David L. , Ghannam Michael , Liang Jackson , Cochet Hubert , Attili Anil , Sharaf‐Dabbagh Ghaith , Latchamsetty Rakesh , Jongnarangsin Krit , Morady Fred , Bogun Frank
Published: July 2021

Introduction

In patients with structural heart disease presenting with ventricular tachycardia (VT), detection of ventricular thrombi and subsequent management can be challenging. This study aimed to assess the value of multimodality imaging with cardiac magnetic resonance imaging (CMR), contrast‐enhanced transthoracic echocardiography (TTE), and computed tomography (CT) for thrombus detection as well as a management algorithm geared towards anticoagulation and deferred ablation for patients referred for VT ablation.

Methods and results

A total of 154 consecutive patients referred for VT ablation underwent preprocedural multimodality imaging with CMR, CT, and TTE. In 9 patients (6%) a new ventricular thrombus was detected and anticoagulation was initiated. Thrombi were detected by CMR in nine patients, by CT in seven patients, and by TTE in two patients. Five patients eventually underwent endocardial VT ablation procedures 6.0 ± 2.0 months after initiation of anticoagulation with one patient also requiring an epicardial approach. Two patients died while on anticoagulation, unrelated to ventricular arrhythmia. Four of five patients were rendered non‐inducible and no testing was performed in 1/5 patients. Areas containing left ventricular thrombi were non‐excitable with pacing. Six of thirty‐two inducible VTs were mapped in close vicinity of ventricular thrombi. No clinical embolic events occurred during the ablation procedures.

Conclusions

Ventricular thrombus was detected in 6% of consecutive patients with structural heart disease undergoing VT ablation. CMR was the most sensitive modality, while contrast‐enhanced TTE failed to detect the majority of thrombi. Anticoagulation followed by ablation can be safely and successfully performed in patients with ventricular thrombi.
Residency and movement patterns of adult Port Jackson sharks (Heterodontus portusjacksoni) at a breeding aggregation site
Authors: Bass Nathan Charles , Day Joanna , Guttridge Tristan L. , Mourier Johann , Knott Nathan A. , Vila Pouca Catarina , Brown Culum
Published: July 2021

Examining the movement ecology of mesopredators is fundamental to developing an understanding of their biology, ecology and behaviour, as well as the communities and ecosystems they influence. The limited research on the residency and movements of benthic marine mesopredators has primarily used visual tags, which do not allow for the efficient and accurate monitoring of individual space use. In this study, the authors investigated the residency and movement patterns of Port Jackson sharks Heterodontus portusjacksoni (Meyer 1793) at a breeding aggregation site in Jervis Bay, south‐eastern Australia, using passive acoustic telemetry to further our understanding of the movement ecology of these important mesopredators. Between 2012 and 2014, individuals were tagged with acoustic transmitters, and their residency and movements within the bay were monitored for up to 4 years. H. portusjacksoni showed strong preferences for particular reefs within and between breeding seasons. Males had significantly higher residency indices at their favoured sites relative to females, suggesting that males may be engaging in territorial behaviour. Conversely, female H. portusjacksoni exhibited higher roaming indices relative to males indicating that females may move between sites to assess males. Finally, H. portusjacksoni showed temporal variation in movements between reefs with individuals typically visiting more reefs at night relative to the day, dusk and dawn corresponding with their nocturnal habits.
The identification of fish eggs of two species, the ovate soleSolea ovataand black porgyAcanthopagrus schlegelii
Authors: Zheng Yan‐jing , Li Xiu‐qin , Yang Zhen‐xiong , Cai Wei‐xu , Lou Quan‐sheng , Tao Wei
Published: July 2021

Fish eggs of the ovate soleSolea ovataand black porgyAcanthopagrus schlegeliiwere identified through DNA barcoding of cytochromecoxidase subunit I (COX1). Visual taxonomic features were achieved, and photographs of the eggs of both species at different developmental stages were reported for the first time. In addition, the dissolution of oil globules caused by ethanol as egg fixatives was observed. This result showed the importance of using formalin as egg fixatives in the case of morphometric analysis and the necessity of combining molecular and visual taxonomic method for morphological study.
Is intraoperative enteroscopy still relevant in small bowel disorders in the era of capsule endoscopy and device‐assisted enteroscopy? Real‐world experience from a tertiary care hospital
Authors: Pal Partha , Tandan Manu , Kulkarni Sujay , Reddy Palle Manohar , Ramchandani Mohan , Sekaran Anuradha , Shetty Mahesh G , Rebala Pradeep , Rao G V , Reddy D Nageshwar
Published: July 2021

Background and Aim

With the advent of video capsule endoscopy (VCE) and device‐assisted enteroscopy (DAE), the indication of intraoperative enteroscopy (IOE) has become limited due to reported high morbidity/mortality. Most of the earlier studies on IOE were small/from pre‐VCE/DAE era. We aimed to evaluate the impact of IOE in management of small bowel disorders (SBD) in post‐VCE/DAE era.

Methods

Patients with SBD undergoing IOE over last 15 years were evaluated retrospectively. Overall diagnostic/therapeutic yield, incremental diagnostic yield over preoperative investigations, and adverse events were noted. We also evaluated the number of cases in which IOE changed the management or guided surgical or endoscopic therapy. Rebleeding and recurrence were evaluated in patients with available follow‐up data.

Results

A total of 89 patients (59 male, 9–82 years) were included in the study. Overall diagnostic and therapeutic yield were 92.1% and 85.4%, respectively. Common findings of IOE were benign ulcers/strictures (30.1%), vascular lesions (26%), diverticula (15.1%), and tumors (13.7%). A total of 49.4% (44/89), 36% (32/89), and 20.2% (18/89) underwent VCE, DAE, or both, respectively, before IOE. Incremental diagnostic yield over preoperative work‐up was 31.5% (28/89), and IOE changed the management in 37.1% (33/89) patients. IOE was used to guide surgery/endotherapy in 39.3% (35/89) patients. Recurrent gastrointestinal bleed occurred in 21.2% (14/66) patients. Morbidity and mortality rates were 20.2% (18/89) and 3.4% (3/89), respectively.

Conclusions

Intraoperative enteroscopy remains an essential technique to evaluate SBD and can detect new and additional lesions even after extensive preoperative evaluation. IOE is useful in guiding therapy in preoperatively identified lesions and can change management in a substantial proportion of patients. Hence, IOE has a definitive role in post‐VCE/DAE era in carefully selected patients with SBD.
Osteological development of a small and fast metamorphic frog, Microhyla fissipes (Anura, Neobatrachia, Microhylidae)
Authors: Zhang Meihua , Zhu Wei , Wang Bin , Wang Shouhong , Chang Liming , Zhao Tian , Jiang Jianping
Published: July 2021

Describing osteological development is of great importance for understanding vertebrate phenotypic variations, form‐functional transitions and ecological adaptations. Anurans exhibit dramatic changes in their morphology, habitat preferences, diet and behaviour between the tadpole and frog stages. However, the anatomical details of their cranial and postcranial development have not been extensively studied, especially in Microhylidae. In this work, we studied the microhylid Microhyla fissipes, commonly known as the ornamented pygmy frog, a small‐sized frog with fast metamorphosis. Its osteological development was comprehensively described based on 120 cleared and stained specimens, including six tadpoles for each stage between 28 and 45, six juveniles and six adults. Additionally, 22 osteological traits of these specimens involved in food acquisition, respiration, audition and locomotion were selected and measured to reflect the changes in tadpole ecological functions during metamorphosis. Our study provides the first detailed qualitative and quantitative developmental information about these structures. Our results have confirmed that skeletal elements (viz., neopalatines, omosternum, clavicles and procoracoids) absent in adults are not detected during development. Our data reveal that morphologically, radical transformations of the cranial structures related to feeding and breathing are completed within stages 42–45 (72 h), but the relative length and width of these skeletons have changed in earlier stages. The postcranial skeletons correlated with locomotion are well developed before stage 42 and approach the adult morphology at stage 45. Indeed, the relative length of the pectoral girdle and forelimb reaches the adult level at stage 42 and stage 45, respectively, whereas that of the vertebral column, pelvic girdle and hind limbs increases from their appearance until reaching adulthood. Based on published accounts of 19 species from Neobatrachia, Mesobatrachia and Archaeobatrachia, cranial elements are among the first ossified skeletons in most studied species, whereas sphenethmoids, neopalatines, quadratojugals, mentomeckelians, carpals and tarsals tend to ossify after metamorphosis. These results will help us to better understand the ecomorphological transformations of anurans from aquatic to terrestrial life. Meanwhile, detailed morphological and quantitative accounts of the osteological development of Microhyla fissipes will provide a foundation for further study.
Association between the developing sphenoid and adult morphology: A study using sagittal sections of the skull base from human embryos and fetuses
Authors: Yamamoto Masahito , Jin Zhe‐Wu , Hayashi Shogo , Rodríguez‐Vázquez José Francisco , Murakami Gen , Abe Shinichi
Published: July 2021

The developing sphenoid is regarded as a median cartilage mass (basisphenoid [BS]) with three cartilaginous processes (orbitosphenoid [OS], ala temporalis [AT], and alar process [AP]). The relationships of this initial configuration with the adult morphology are difficult to determine because of extensive membranous ossification along the cartilaginous elements. The purpose of this study was therefore to evaluate the anatomical connections between each element of the fetal sphenoid and adult morphology. Sagittal sections from 25 embryos and fetuses of gestational age 6–34 weeks and crown‐rump length 12–295 mm were therefore examined and compared with horizontal and frontal sections from the other 25 late‐term fetuses (217–340 mm). The OS was identified as a set of three mutually attached cartilage bars in early fetuses. At all stages, the OS‐post was continuous with the anterolateral part of the BS. The BS included the notochord and Rathke's pouch remnant in embryos and early fetuses. The dorsum sellae was absent from embryos, but it protruded from the BS in early fetuses before a fossa for the hypophysis became evident. Although not higher than the hypophysis at midterm, the dorsum sellae elongated superiorly after gestational age 25 weeks. In early fetuses, the AP was located on the side immediately anterior to the otic capsule. The AT developed on the side immediately posterior to the extraocular rectus muscles. At late term, the greater wing was formed by membranous bones from the AT and AP. The AT and AP formed a complex bridge between the BS and the greater wing. A small cartilage, future medial pterygoid process (PTmed) was located inferior to the AT in early fetuses. At midterm, one endochondral bone and multiple membranous bones formed the PTmed. The lateral pterygoid process (PTlat) was formed by a single membranous bone plate. Therefore, we connected fetal elements and the adult morphology as follows. (1) Derivative of the OS makes not only the lesser wing but also the anterior margin of the body of the sphenoid. (2) Derivatives of the BS are the body of the sphenoid including the sella turcica and the dorsum sellae. (3) Most of the greater wing including the foramen rotundum and the foramen oval originate from the AT and AP and multiple membranous bones. (4) The PTmed originate from endochondral bones and multiple membranous bones, while the PTlat derive from a single membranous bone.
Rural/urban differences in the prevalence of stroke risk factors: A cross‐sectional analysis from the REGARDS study
Authors: Kamin Mukaz Debora , Dawson Erica , Howard Virginia J. , Cushman Mary , Higginbotham John C. , Judd Suzanne E. , Kissela Brett M. , Safford Monika M. , Soliman Elsayed Z. , Howard George
Published: July 2021

Purpose

We previously described the magnitude of rural‐urban differences in the prevalence of stroke risk factors and stroke mortality. In this report, we sought to extend the understanding of rural‐urban differences in the prevalence of stroke risk factors by using an enhanced definition of rural‐urban status and assessing the impact of neighborhood socioeconomic status (nSES) on risk factor differences.

Methods

This analysis included 28,242 participants without a history of stroke from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Participants were categorized into the 6‐level ordinal National Center for Health Statistics Urban‐Rural Classification Scheme. The prevalence of stroke risk factors (hypertension, diabetes, smoking, atrial fibrillation, left ventricular hypertrophy, and heart disease) was assessed across the rural‐urban scale with adjustment for demographic characteristics and further adjustment for nSES score.

Findings

Hypertension, diabetes, and heart disease were more prevalent in rural than urban regions. Higher odds were observed for these risk factors in the most rural compared to the most urban areas (odds ratios [95% CI]: 1.25 [1.11‐1.42] for hypertension, 1.15 [0.99‐1.33] for diabetes, and 1.19 [1.02‐1.39] for heart disease). Adjustment for nSES score partially attenuated the odds of hypertension and heart disease with rurality, completely attenuated the odds of diabetes, and unmasked an association of current smoking.

Conclusions

Some of the higher stroke mortality in rural areas may be due to the higher burden of stroke risk factors in rural areas. Lower nSES contributed most notably to rural‐urban differences for diabetes and smoking.
Complementary jobs and optimal matching
Authors: Gebauer Markus
Published: July 2021

This paper introduces strong complementarities in labour into an otherwise classical Diamond–Mortensen–Pissarides search model. Specifically, two workers are required to perform a task. The assumption of Nash bargaining is maintained to represent the Hosios condition transparently. We show that this setup leads to additional externalities that require more than a Hosios‐style condition to be met. The surplus must be shared between the workers so that the employer internalizes additional externalities. This makes implementing efficiency even more challenging.
COVID‐19 infection, progression, and vaccination: Focus on obesity and related metabolic disturbances
Authors: Westheim Annemarie J. F. , Bitorina Albert V. , Theys Jan , Shiri‐Sverdlov Ronit
Published: July 2021

Coronaviruses are constantly circulating in humans, causing common colds and mild respiratory infections. In contrast, infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), responsible for coronavirus disease‐2019 (COVID‐19), can cause additional severe complications, particularly in patients with obesity and associated metabolic disturbances. Obesity is a principal causative factor in the development of the metabolic syndrome; a series of physiological, biochemical, clinical, and metabolic factors that increase the risk of obesity‐associated diseases. “Metabolically unhealthy” obesity is, in addition to metabolic disturbances, also associated with immunological disturbances. As such, patients with obesity are more prone to develop serious complications from infections, including those from SARS‐CoV‐2. In this review, we first describe how obesity and related metabolic disturbances increase the risk of SARS‐CoV‐2 infection. Then, mechanisms contributing to COVID‐19 complications and poor prognosis in these patients are discussed. Finally, we discuss how obesity potentially reduces long‐term COVID‐19 vaccination efficacy. Despite encouraging COVID‐19 vaccination results in patients with obesity and related metabolic disturbances in the short‐term, it is becoming increasingly evident that long‐term COVID‐19 vaccination efficacy should be closely monitored in this vulnerable group.
When is enough, enough? Questions of sampling in vertebrate ichnology
Authors: Belvedere Matteo , Budka Marcin , Wiseman Ashleigh L. A. , Bennett Matthew R.
Published: July 2021

Sample size is a challenge for most field scientists determined not by the statistically ideal, but by the available. In vertebrate ichnology, track length is an important variable correlating well with the track‐maker’s biology. It is also key to estimating the minimum number of individuals (MNI) present on a trampled horizon. Broad assumptions on biometrics of the track‐makers are often made based on a few prints without consideration for intra‐trackway variability. In this study we use a simple bootstrapping algorithm to explore variance within sample size for a range of trackways with fossil and experimental examples to determine the minimum sample size required to extract linear measurements. Predictably, experimentation shows that inter‐step variability changes with track‐maker and substrate, but the degree of variance is not as marked as previously anticipated. Change‐point modelling suggests that a maximum sample size of 22–25 captures most of the variance present in track length at least; another threshold at 7–10 has been identified, which represents the reasonable sample size minimum. Samples of fewer than seven tracks are subject to large amounts of potential variance and are unlikely to provide reliable and consistent measurements. These sampling thresholds hold across a wide range of depositional environments and track‐makers. We calculate generic standard errors for human track‐makers which may assist the practitioner with small samples to estimate the likely errors, especially when making MNI estimates. The challenge is placed to the wider vertebrate ichnology to explore this issue for other track‐makers and develop similar guidance.
Elevating Social and Behavior Change as an Essential Component of Family Planning Programs
Authors: Skinner Joanna , Hempstone Hope , Raney Laura , Galavotti Christine , Light Benedict , Weinberger Michelle , Van Lith Lynn
Published: July 2021

The global family planning community has made significant progress towards enabling 120 million more women and girls to use contraceptives by 2020, though we enter the decade ahead with a long road yet to travel. While investment in strong health systems and supply chains is still needed, the supply‐driven approach dominant in family planning fails to address the individual, relational, and social barriers faced by women and couples in achieving their reproductive intentions and desired family size. Overcoming these barriers will require a better understanding of behavioral drivers and the social environment in which family planning decisions are made, and an increased investment in the proven, yet underutilized, approach of social and behavior change (SBC). We make the case that a more intentional focus on the science of human behavior in family planning can help advance the achievement of global, regional, and national goals while also calling for strategic and sustained investment that reflects the critical importance and proven impact of SBC approaches.
Perioperative anidulafungin combined with triazole prophylaxis for the prevention of early invasive candidiasis in lung transplant recipients
Authors: Sartain Emily , Schoeppler Kelly , Crowther Barrett , Smith Joshua B. , Abidi Maheen Z. , Grazia Todd J. , Steele Mark , Gleason Terri , Porter Krista , Gray Alice
Published: July 2021

Background

Invasive candidiasis (IC) is a substantial cause of morbidity and mortality among lung transplant recipients (LTRs). Postoperative factors include prolonged hospital stay, central lines, delayed chest closure, and dehiscence increase IC risk. Correspondingly, current guidelines propose targeted IC coverage early posttransplant with fluconazole or an echinocandin.

Methods

This retrospective analysis was performed on LTRs from January 2016 to January 2020 and evaluated effectiveness of a recent protocol utilizing perioperative anidulafungin for early IC prevention in addition to long‐term triazole antifungal prophylaxis. Prior to this protocol, patients were primarily established on itraconazole prophylaxis alone. The primary endpoint was proven or probable IC within 90 days after transplant. Multivariable logistic regression modeling was used to assess risk factors for invasive fungal infection (IFI).

Results

Among 144 LTRs, there was a numerically lower incidence of IC in the protocol group, although not statistically significant (6% vs. 13%, p = 0.16). Incidence of proven or probable IFI was 7.5% in the protocol cohort and 19.5% in the pre‐protocol cohort (p = 0.038). In multivariable analysis, when controlling for lung allocation score (OR 1.04, 95% CI 1.01–1.08), donor perioperative culture with fungal growth (OR 2.92, 95% CI 1.02‐8.92), and dehiscence (OR 3.54, 95% CI 1.14–10.85), protocol cohort was not significantly associated with IFI (OR 0.41, 95% CI 0.12–1.23).

Conclusions

To our knowledge, this is the first study investigating combination triazole/echinocandin use in the early post‐lung transplant period. These findings demonstrate that in‐hospital anidulafungin offers unclear benefit for early IC prevention when used in combination with triazole prophylaxis.
A whole blood based resuscitation strategy in civilian medical services: Experience from a Norwegian hospital in the period 2017–2020
Authors: Hagen Kristin Gjerde , Strandenes Geir , Kristoffersen Einar Klæboe , Braathen Hanne , Sivertsen Joar , Bjerkvig Christopher Kalhagen , Sommerfelt‐Pettersen Nina , Aasheim Irmelin Beathe , Lunde Turid Helen Felli , Hervig Tor , Apelseth Torunn Oveland
Published: July 2021

Background

Civilian and military guidelines recommend early balanced transfusion to patients with life‐threatening bleeding. Low titer group O whole blood was introduced as the primary blood product for resuscitation of massive hemorrhage at Haukeland University Hospital, Bergen, Norway, in December 2017. In this report, we describe the whole blood program and present results from the first years of routine use.

Study design and methods

Patients who received whole blood from December 2017 to April 2020 were included in our quality registry for massive transfusions. Post‐transfusion blood samples were collected to analyze isohemagglutinin (anti‐A/‐B) and hemolysis markers. Administration of other blood products, transfusion reactions, and patient survival (days 1 and 30) were recorded. User experiences were surveyed for both clinical and laboratory staff.

Results

Two hundred and five patients (64% male and 36% female) received 836 units in 226 transfusion episodes. Patients received a mean of 3.7 units (range 1–35) in each transfusion episode. The main indications for transfusion were trauma (26%), gastrointestinal (22%), cardiothoracic/vascular (18%), surgical (18%), obstetric (11%), and medical (5%) bleeding. There was no difference in survival between patients with blood type O when compared with non‐group O. Haptoglobin level was lower in the transfusion episodes for non‐O group patients, however no clinical hemolysis was reported. No patients had conclusive transfusion‐associated adverse events. Both clinical and laboratory staff preferred whole blood to component therapy for massive transfusion.

Discussion

The experience from Haukeland University Hospital indicates that whole blood is feasible, safe, and effective for in‐hospital treatment of bleeding.