bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum syndecan‐4 is associated with nonalcoholic fatty liver disease
Authors: Xia Shu Jing , Tang Li Zhong , Li Wen Hua , Xu Zhao Shan , Zhang Li Li , Cheng Feng Gan , Chen Hong Xia , Wang Zi Hua , Luo Yu Cheng , Dai An Na , Fan Jian Gao
Published: August 2021

Objectives

The accelerated shedding of extracellular domains of syndecan‐4 (SDC4) is associated with central obesity and insulin resistance, while the association between serum SDC4 and nonalcoholic fatty liver disease (NAFLD) is unknown. We aimed to examine the association between SDC4 and NAFLD.

Methods

Adults undergoing a health examination from 1 June 2019 to 31 December 2019 were enrolled. A diagnosis of NAFLD was made with an abdominal ultrasound. Logistic regression models and the receiver operating characteristic (ROC) curves were used to evaluate the role of SDC4 in predicting NAFLD.

Results

In total, 533 eligible participants were finally enrolled, among them 157 (29.46%) had NAFLD. The proportion of patients with NAFLD increased with the increasing quartiles of serum SDC4. With the increase of serum SDC4 levels, metabolic features including waist circumference, serum triglyceride, total cholesterol, fasting blood glucose, fasting insulin and homeostasis model assessment of insulin resistance were significantly increased. SDC4 was an independent factor for NAFLD (odds ratio 1.963, 95% confidence interval [CI] 1.628‐2.367, P < 0.001). The area under the ROC curve of SDC4 for predicting NAFLD was 0.934 (95% CI 0.910‐0.959). The optimal cut‐off value was 6.575 ng/mL at Youden's index of 0.767. SDC4 had the highest diagnostic sensitivity (84.1%), positive predictive value (82.5%), negative predictive value (93.3%) and positive likelihood ratio (11.356) among all the variables.

Conclusions

Elevated serum SDC4 level is associated with metabolic disorders and the prevalence of NAFLD among general population. Serum SDC4 may serve as a biomarker of NAFLD.
Behavioural Bias Benefits: Beating Benchmarks By Bundling Bouncy Baskets
Authors: Kashyap Ravi
Published: August 2021

We consider in detail an investment strategy, titled ‘the bounce basket’, designed for someone to express a bullish view on the market by allowing them to take long positions on securities that would benefit the most from a rally in the markets. We demonstrate the use of quantitative metrics and large amounts of historical data towards decision‐making goals. This investment concept combines macroeconomic views with characteristics of individual securities to beat the market returns. The central idea of this theme is to identity securities from a regional perspective that are heavily shorted and yet are fundamentally sound with at least a minimum buy rating from a consensus of stock analysts covering the securities. We discuss the components of creating such a strategy including the mechanics of constructing the portfolio. Using simulations, in which securities lending data is modelled as geometric Brownian motions, we provide a few flavors of creating a ranking of securities to identity the ones that are heavily shorted. An investment strategy of this kind will be ideal in market scenarios when a downturn happens due to unexpected extreme events and the markets are anticipated to bounce back thereafter. This situation is especially applicable to incidents being observed, and relevant proceedings, during the Coronavirus pandemic in 2020–2021. This strategy is one particular way to overcome a potential behavioural bias related to investing, which we term the ‘rebound effect’.
Preferences for tree fruit market attributes among smallholder farmers in Eastern Rwanda
Authors: Ihli Hanna , Seegers Ronja , Winter Etti , Chiputwa Brian , Gassner Anja
Published: August 2021

The increasing demand for high‐value agricultural products such as fresh fruit presents opportunities for farmers in developing countries due to their higher market value compared with traditional staple crops. This study uses data on trust, risk, and time preferences obtained through behavioral experiments, combined with a discrete choice experiment to understand their effect on farmers’ choices of marketing attributes, collecting data from 252 farmers from Eastern Rwanda. The results reveal that farmers, overall, have positive attitudes toward collective marketing channels with guaranteed immediate payments, written contracts, provision of inputs, credit, and training, a personal relationship with a buyer, and low investment costs. Additionally, farmers with lower levels of risk aversion were found to have a greater preference for immediate payment than farmers with higher levels of risk aversion. Farmers with higher future orientation are more likely to choose contracts that guarantee inputs and/or services and written contracts, and they attach lower relative importance to immediate payments than farmers with lower future orientation. Farmers with higher trust levels attach lower relative importance to immediate payments, written contracts, and a personal relationship with a buyer than farmers with lower trust levels.
Longitudinal vegetation turnover in an eastern Rift Valley riparian corridor
Authors: Giberti Giulia Silvia , Gumiero Bruna , Kiprotich Alfred Koech , Methu Stephen Wanjiku , Harper David Malcolm , Pacini Nic
Published: August 2021

East African riparian corridors are biodiversity hot spots that occur in catchments degrading under deforestation and overgrazing. Quadrats and belt transects were employed to investigate plant succession along the River Gilgil, in the Kenyan Rift Valley. The study found that most species (total 365) were broadly distributed across the tropics, but Rift Valley endemics were 12.5%, and 4%–18% were exotic. Plant composition varied with altitude, lithology, soils and rainfall. Agglomerative (Jaccard) hierarchical clustering and Non‐metric Dimensional Scaling identified two and three vegetation groups, for quadrats and transects, respectively, correlated with lithology and soils. Indicator species analysis highlighted that the upstream portion of the catchment was characterised by forest taxa with few exotics. The downstream included woodland species adapted to mesic/xeric conditions and to overgrazing. Longitudinal change in species composition (β diversity) between sites was assessed by taking into consideration the contribution of ‘spatial species turnover’ and ‘nestedness’, resulting from species replacement and species loss, respectively. The β diversity of the riparian corridor vegetation was 0.40 and spatial turnover accounted for 80%–85% of this, while the rest was attributed to the nestedness component. Riverine and native trees increased downstream but with low regeneration. Afromontane vegetation extended its distribution towards lower altitudes.
False acetabulum is preoperative guidance for Crowe type IV hips on hip reduction without femoral shortening during total hip arthroplasty
Authors: Sun Jing‐Yang , Zhang Bo‐Han , Shen Jun‐Min , Du Yin‐Qiao , Zhou Yong‐Gang
Published: August 2021

Background

We aimed to analyze if the false acetabulum is a good indicator for determining femoral shortening.

Methods

We retrospectively included 102 patients with unilateral Crowe type IV developmental dysplasia who underwent primary total hip arthroplasty from April 2008 to May 2019. Based on the presence of false acetabulum, the 102 hips were further classified Crowe IVA group and Crowe IVB group. Radiographic measurement included the height of greater trochanter (HGT) preoperatively and postoperatively, which reflected the distalisation of greater trochanter (DGT). Harris hip score (HHS), limb length discrepancy (LLD), and complications were collected as clinical evaluation.

Results

Sixty hips were classified into Crowe IVA group, and 42 hips were classified into Crowe IVB group. Within Crowe IVA group, the proportion of hips treated with subtrochanteric osteotomy was significantly higher than that in Crowe IVB group (97% vs. 12%) (P < 0.001). The DGT in Crowe IVA group was also greater (67 vs. 32 mm) (P < 0.001). At last follow‐up, both two groups obtained excellent clinical scores. There was no significant difference in postoperative LLD between the two groups (P = 0.001). Six dislocations occurred and three patients developed femoral nerve palsy, while all recovered in a year.

Conclusion

The false acetabulum is a promising and good indicator for determining femoral shortening.
A comparison of prostate cancer prediction models in men undergoing both magnetic resonance imaging and transperineal biopsy: Are the models still relevant?
Authors: Doan Paul , Graham Petra , Lahoud John , Remmers Sebastiaan , Roobol Monique J , Kim Lawrence , Patel Manish I.
Published: August 2021

Objective

To externally validate and compare the performance of the European Randomized Study of Screening for Prostate Cancer risk calculator 3/4 (ERSPC‐RC3/4), the Prostate Biopsy Collaborative Group risk calculator (PBCG‐RC) and the van Leeuwen model to determine which prediction model would perform the best in a contemporary Australian cohort undergoing transperineal (TP) biopsy.

Materials and Methods

A retrospective review identified all patients undergoing TP biopsy across two centres. Of the 797 patients identified, 373 had the data required to test all three risk calculators. The probability of high‐grade prostate cancer, defined as International Society of Urological Pathology Grade Group >1, was calculated for each patient. For each prediction model discrimination was assessed using area under the receiver‐operating characteristic curve (AUC), calibration using numerical and graphical summaries, and net benefit using decision curve analysis.

Results

Assessment of model discrimination for detecting high‐grade prostate cancer showed AUCs of 0.79 (95% confidence interval [CI] 0.74–0.84) for the ERSPC‐RC3/4, 0.81 (95% CI 0.77–0.86) for the van Leeuwen model, and 0.68 (95% CI 0.63–0.74) for the PBCG‐RC, compared to 0.58 (95% CI 0.52–0.65) for prostate‐specific antigen alone. The ERSPC‐RC3/4 was the best calibrated in the moderate‐risk range of 10–40%, whilst the van Leeuwen model was the best calibrated in the low‐risk range of 0–10%. The van Leeuwen model demonstrated the greatest net benefit from 10% risk onwards, followed closely by the ERSPC‐RC3/4 and then the PBCG‐RC.

Conclusion

The ERPSC‐RC3/4 demonstrated good performance and was comparable to the van Leeuwen model with regard to discrimination, calibration and net benefit for an Australian population undergoing TP prostate biopsy. It is one of the most accessible risk calculators with an easy‐to‐use online platform, therefore, we recommend that Australian urologists use the ERSPC‐RC3/4 to predict risk in the clinical setting.
Genomic profile – a possible diagnostic and prognostic marker in upper tract urothelial carcinoma
Authors: Grahn Alexandra , Eisfeldt Jesper , Malm Camilla , Foroughi Asl Hassan , Jaremko Georg , Tham Emma , Brehmer Marianne
Published: August 2021

Objectives

To investigate gene alterations as diagnostic and prognostic markers in upper tract urothelial carcinoma (UTUC).

Patients and Methods

Patients with UTUC who underwent nephroureterectomy between 2005 and 2012 were followed until November 2020. DNA was extracted from paraffin‐embedded tumour tissue. Next‐generation sequencing using a 388‐gene panel was performed. First a blinded analysis using principal component analysis and hierarchical clustering was used to search for patterns of mutations. Then a comparative analysis using analysis of variance (ANOVA) was used to search for mutations enriched in groups of various grades, stages, and survival. In addition, careful manual annotation was used to identify pathogenic mutations over‐represented in tumours of high grade/stage and/or poor survival.

Results

A total of 39 patients were included. All tumour stages and grades were represented in the cohort. The median follow‐up was 10.6 years. In all, 11 patients died from UTUC during the follow‐up. Tumour mutational burden showed a statistically significant correlation with stage, grade, and stage + grade. Grade 1, Grade 2, and Grade 3 tumours had different mutational patterns. Patients who died from UTUC had pathogenic mutations in specific genes e.g. tumour protein p53 (TP53) and HRas proto‐oncogene, GTPase (HRAS). Patients with Ta Grade 1 tumours with a known pathogenic fibroblast growth factor receptor 3 (FGFR3) mutation did not die from UTUC.

Conclusion

The genetic analysis was highly concordant with histopathological features and added prognostic information in some cases. Thus, results from genomic profiling may contribute to the choice of treatment and follow‐up regimens in the future.
Improving stochastic local search for uniform k‐SAT by generating appropriate initial assignment
Authors: Fu Huimin , Zhang Wuyang , Wu Guanfeng , Xu Yang , Liu Jun
Published: August 2021

Stochastic local search (SLS) algorithms are well known for their ability to efficiently find models of random instances of the SAT problem, especially for uniform random k‐SAT instances. Two processes affect most SLS solvers—the initial assignment of the variables and the heuristics that select which variable to flip. In the last few years, the work on generating the appropriate initial assignment has not been paid much attention or seen much progress, while most SLS solvers focused on the heuristic algorithm. The present work aims to improve SLS algorithms on uniform random k‐SAT instances by developing effective methods for generating the initial assignment of variables in a controlled way. First, the allocation strategy introduced recently for 3‐SAT instances is extended to initialize the initial assignment on random k‐SAT instances. Then a concept of an initial probability distribution of the clause‐to‐variable ratio of the instance is introduced to determine the parameters of the allocation strategy. This combined method is added to the beginning of six state‐of‐the‐art SLS algorithms in order to generate initial assignments of variables in a controlled way instead of generating them randomly, resulting in six extended SLS algorithms named WalkSATlm_E, DCCASat_E, Score2SAT_E, CSCCSat_E, Probsat_E, and Sparrow_E, respectively. They are then evaluated in terms of their capabilities and efficiency on uniform random k‐SAT instance from the random track of SAT Competitions in 2016, 2017, and 2018. Experimental results show that these improved SLS solvers outperform their original performance, especially WalkSAT_E, Score2SAT_E, and CSCCSat_E outperform the winner of the random track of SAT competition in 2017. In addition, based on the initial probability distribution method, the present work proposes a parameter tuning and analysis of random 3‐SAT instances and provides an additional comparative analysis with the state‐of‐the‐art random SLS solvers based on large‐scale experiments.
Perinatal arterial ischemic stroke and periventricular venous infarction in infants with unilateral cerebral palsy
Authors: Vitagliano Melissa , Dunbar Mary , Dyck Holzinger Sasha , Letourneau Nicole , Dewey Deborah , Oskoui Maryam , Shevell Michael , Kirton Adam
Published: August 2021

Aim

To explore clinical factors associated with perinatal arterial ischemic stroke (AIS) and periventricular venous infarction (PVI) in infants who develop unilateral cerebral palsy (CP).

Method

This was a case–control study. Data current to 2019 was extracted from the Canadian Cerebral Palsy Registry (CCPR). Cases were infants born at term with confirmed unilateral CP. Magnetic resonance images were stratified by expert review of reports as definitive perinatal stroke (AIS or PVI). Controls with common data elements were recruited from a population‐based study in Alberta. Multivariable regression analyses were performed to estimate associations expressed as odds ratios with 95% confidence intervals.

Results

Of 2093 cases from the CCPR, 662 had unilateral CP, of whom 299 (45%) had perinatal stroke: AIS 169 (57%) and PVI 130 (43%). Median age at diagnosis for AIS was 11.9 months (interquartile range: 6.2–25.7mo; range 0.17–104.1mo), and 58.6% were male. Median age at diagnosis for PVI was 25.3 months (interquartile range: 14.5–38mo, range 0.7–114.7mo) and 57.7% were male. Independent associations for both AIS and PVI on multivariable analysis were chorioamnionitis, illicit drug exposure, diabetes, gestational age, and maternal age. Variables associated with AIS alone were low Apgar score and prolonged rupture of membranes. Variables associated with PVI alone were small for gestational age and primigravida.

Interpretation

Controlled analysis of disease‐specific unilateral CP may offer unique perspectives on its pathophysiology. Acute intrapartum factors are mainly associated with AIS, while in utero factors are associated with PVI.
Does the value‐added tax Reform increase a firm’s collateral bank loans? Evidence from China
Authors: Zeng Jing , Wang Xiongyuan , Chan Kam C.
Published: August 2021

By leveraging the value‐added tax (VAT) Reform as an exogenous event in China, we examine the impact of the tax cut on bank collateral loan on firms. Our findings suggest that (1) The Reform allows firms to deduct the tax of purchasing fixed assets that leads to a significant increase in the firm's collateral loan amounts. (2) The transmission mechanism is due to the increased level of corporate transparency and a lowered financial risk after the Reform. (3) The impact of the Reform on collateral bank loans is more pronounced for state‐owned firms, large firms, firms far away from lenders and firms located in low financial development regions.
The missing N1 or jittered P2: Electrophysiological correlates of pattern glare in the time and frequency domain
Authors: Tempesta Austyn J. , Miller Claire E. , Litvak Vladimir , Bowman Howard , Schofield Andrew J.
Published: August 2021

Excessive sensitivity to certain visual stimuli (cortical hyperexcitability) is associated with a number of neurological disorders including migraine, epilepsy, multiple sclerosis, autism and possibly dyslexia. Others show disruptive sensitivity to visual stimuli with no other obvious pathology or symptom profile (visual stress) which can extend to discomfort and nausea. We used event‐related potentials (ERPs) to explore the neural correlates of visual stress and headache proneness. We analysed ERPs in response to thick (0.37 cycles per degree [c/deg]), medium (3 c/deg) and thin (12 c/deg) gratings, using mass univariate analysis, considering three factors in the general population: headache proneness, visual stress and discomfort. We found relationships between ERP features and the headache and discomfort factors. Stimulus main effects were driven by the medium stimulus regardless of participant characteristics. Participants with high discomfort ratings had larger P1 components for the initial presentation of medium stimuli, suggesting initial cortical hyperexcitability that is later suppressed. The participants with high headache ratings showed atypical N1‐P2 components for medium stripes relative to the other stimuli. This effect was present only after repeated stimulus presentation. These effects were also explored in the frequency domain, suggesting variations in intertrial theta band phase coherence. Our results suggest that discomfort and headache in response to striped stimuli are related to different neural processes; however, more exploration is needed to determine whether the results translate to a clinical migraine population.
Toxoplasma gondii and multiple sclerosis: A systematic review and meta‐analysis
Authors: Cicero Calogero Edoardo , Allibrio Francesca Elsa , Giuliano Loretta , Luna Jaime , Preux Pierre‐Marie , Nicoletti Alessandra
Published: August 2021

Background and purpose

According to the hygiene hypothesis, infections by agents such as parasites have a protective role against the risk of developing multiple sclerosis (MS). Among parasites, Toxoplasma gondii, an intracellular parasite, showed evidence of a protective effect. This study was undertaken to summarize the available evidence on the association between T. gondii infection and MS.

Methods

A systematic review of all the available articles published up to November 2020 has been conducted independently by two investigators in the following databases: PubMed, Scopus, Lissa, and SciELO. The association between T. gondii infection and MS has been pooled with a random effects model.

Results

From 562 articles, seven were included in the systematic review and meta‐analysis for a global population of 752 MS cases and 1282 controls. T. gondii infection was associated with MS with a pooled odds ratio of 0.68 (95% confidence interval = 0.50–0.93).

Conclusions

The available evidence supports the hypothesis that T. gondii infection represents a protective factor against the development of MS.
Small‐scale fisheries and local food systems: Transformations, threats and opportunities
Authors: Arthur Robert I , Skerritt Daniel J , Schuhbauer Anna , Ebrahim Naazia , Friend Richard M , Sumaila U Rashid
Published: August 2021

Fish from marine and inland capture fisheries is an important food that contributes significantly to diets and health, but their contribution is somewhat overlooked in food security and poverty‐related policies. Given the current numbers of malnourished people globally, there is a pressing need to consider how to better realize the potential of fish in food systems that can address malnourishment. To do so, we re‐examine the fisheries literature from the perspective of food systems. Starting with nutritional needs and considering how these may be met through local food systems reveals an ongoing transformation that has implications for small‐scale fisheries, as increasingly become part of globalized food systems. We describe the factors that can change the nature of production, mediate access to fish and the distribution of benefits that can lead to impoverishment. This emphasizes the governance challenges that lie at the heart of complex, contested and increasingly globalized food systems, in which actors interact to shape the systems, determining who benefits and how. We draw attention to critical issues of access, power and the values and norms that underpin efforts to manage and transform fisheries, exposing the unequal struggle to secure access that small‐scale fishers and poor people must endure. We suggest a vital challenge for fisheries management is to engage with this struggle and develop policies and management measures that would enable fisheries to make positive contributions to food systems and nutritional security, while meeting global sustainable development objectives.
Effect of treatment with resiniferatoxin in an experimental model of pulpal inflammatory in mice
Authors: Muñoz‐Carrillo José Luis , Vargas‐Barboza Jazmín Monserrat , Villalobos‐Gutiérrez Paola Trinidad , Flores‐De La Torre Juan Armando , Vazquez‐Alcaraz Silverio Jafet , Gutiérrez‐Coronado Oscar
Published: August 2021

Aim

To evaluate whether treatment with resiniferatoxin (RTX) is capable of lowering the plasma levels of PGE2 and TNF‐α, as well as histopathological parameters in inflammation of pulp tissue in a mouse experimental model.

Methodology

Ten groups of six BALB/c mice were formed as follows: healthy group (HC), healthy group treated with RTX (HRTX), two groups with pulp inflammation at 14 and 18 hours (PI14/PI18), six groups with pulpal inflammation plus treatment with Ibuprofen (IBU14/IBU18), dexamethasone (DEX14/DEX18) and resiniferatoxin (RTX14/RTX18) at 14 and 18 hours, respectively. Pulpal inflammation was induced through occlusal exposure of the pulp of the maxillary first molar. The plasma levels of PGE2 and TNF‐α and the histological parameters of the pulp tissue of the HC and HRTX groups were evaluated at the time of acquiring the animals. In the other groups, the plasma levels of PGE2 and TNF‐α and the histopathological parameters were evaluated at 14 and 18 hours after pulp damage. Plasma levels of PGE2 and TNF‐α were quantified by ELISA, and the histopathological parameters were evaluated by H/E staining. Statistical significance was determined by one‐way analysis of variance (ANOVA) to test for overall differences between group means.

Results

A significant increase (*p < .05) in plasma levels of PGE2 and TNF‐α occurred 14 and 18 hours after pulp damage. In addition, treatment with RTX significantly decreased (*p < .05) the plasma levels of PGE2 and TNF‐α at 14 and 18 hours after pulp damage, as well as the infiltrate of inflammatory cells at 18 hours after pulp damage, similarly to treatment with ibuprofen and dexamethasone.

Conclusion

It was possible to detect systemic levels of PGE2 and TNF‐α at 14 and 18 hours after pulp damage. Likewise, treatment with RTX was associated with an anti‐inflammatory effect similar to treatment with ibuprofen and dexamethasone. These findings place resiniferatoxin as a therapeutic alternative in the treatment of inflammatory diseases in Dentistry.
GATA2 rs2335052 and GATA2 rs78245253 single‐nucleotide polymorphisms in Chinese patients with acute myelocytic leukemia
Authors: Fang Fang , Xu Jing , Kang Yefang , Ren Huanying , Muyey Daniel Muteb , Chen Xiuhua , Tan Yanhong , Xu Zhifang , Wang Hongwei
Published: August 2021

Introduction

GATA binding protein 2 (GATA2) gene, involved in progression of hematologic malignancies and various solid tumors, is a susceptibility gene for inherited acute myeloid leukemia (AML). However, the influence of its single‐nucleotide polymorphisms (SNPs) on AML remains unknown.

Methods

We used allele‐specific PCR to genotype GATA2 rs2335052 and rs78245253 in 159 newly diagnosed AML (non‐M3) patients and 300 healthy volunteers, and all of participants came from China. And 34 common hematological tumor gene mutations in 159 AML patients were detected by next‐generation sequencing. Kaplan‐Meier survival analysis and Cox proportional hazard regression were used to analyze the association between the two SNPs and the prognosis of AML.

Results

We found GATA2 rs2335052 C/T genotype, rs2335052 T/T genotype and rs78245253 G/C genotype in 51.6%, 13.8% and 11.3% AML patients. Our results demonstrated that GATA2 rs2335052 and rs78245253 were associated with certain laboratory features in AML patients, which had no effect on the pathogeny, chemotherapy response and recurrence of patients. Nevertheless, Kaplan‐Meier survival analysis showed that, compared with rs78245253 G/G genotype, rs78245253 G/C genotype was significantly related to a decrease in overall survival (OS) (P = .020). Additionally, multivariate cox regression analysis showed that GATA2 rs78245253 was an independent risk factor for OS of AML patients in China.

Conclusion

GATA2 rs78245253 was an independent predictor for prognosis of AML patients in China and may be used as a potential indicator to predict the survival of AML patients in China. Further studies are needed to validate these findings and clarify the underlying mechanism.
Use of heuristics during the clinical decision process from family care physicians in real conditions
Authors: Fernández‐Aguilar Carmen , Martín‐Martín José Jesús , Minué Lorenzo Sergio , Fernández Ajuria Alberto
Published: August 2021

Rationale aims and objectives

The available evidence on the use of heuristics and their relationship with diagnostic error in primary care is very limited. The aim of the study is to identify the use of unknown thought and specifically the possible use of Representativeness, Availability and overconfidence heuristics in the clinical practice of primary care physicians in cases of dyspnoea and to analyse their possible relationship with diagnostic error.

Methods

A total of 371 patients consulting with new episodes of dyspnoea in Primary Care centres in Spain were registered. Based on specific operational definitions, the use of unconscious thinking and the use of heuristics during the diagnostic process were assessed. Subsequently, the association between their use and diagnostic error was analysed.

Results

In 49.6% of cases, the confirmatory diagnosis coincided with the first diagnostic impression, suggesting the use of the representativeness heuristic in the diagnostic decision process. In 82.3% of the cases, the confirmatory diagnosis was among the three diagnostic hypotheses that were first identified by the general physicians, suggesting a possible use of the availability heuristic. In more than 50% of the cases, the physicians were overconfident in the certainty of their own diagnosis. Finally, a diagnostic error was identified in 9.9% of the recorded cases and no statistically significant correlation was found between the use of some unconscious thinking tools (such as the use of heuristics) and the diagnostic error.

Conclusion

Unconscious thinking manifested through the acceptance of the first diagnostic impression and the use of heuristics is commonly used by primary care physicians in the clinical decision process in the face of new episodes of dyspnoea; however, its influence on diagnostic error is not significant. The proposed explicit and reproducible methodology may inspire further studies to confirm these results.
Application of artificial neural network‐genetic algorithm and response surface methodology for optimization of ultrasound‐assisted extraction of phenolic compounds from cashew apple bagasse
Authors: Patra Abhipriya , Abdullah S , Pradhan Rama Chandra
Published: August 2021

This study explores the effect of ultra‐sonication on the extraction of phenolic compounds of cashew apple bagasse (CAB). The extraction was conducted at different combinations of treatment time (5–15 min), ultrasound amplitude (30–60%), and bagasse to solvent ratio (30–50 g/ml) for maximum yield of total phenolic content (TPC), total tannin content (TTC), and β‐carotene content. Both response surface methodology (RSM) and artificial neural network (ANN) were used to model and optimize the process parameters. The optimum conditions achieved using RSM were: treatment time of 12 min, ultrasound amplitude of 55%, and bagasse to solvent ratio of 45 g/ml. In contrast, the optimum conditions proposed by ANN were: treatment time of 15 min, 60% amplitude, and 50 g/ml bagasse to solvent ratio. The TPC, TTC, and β‐carotene content was determined under RSM optimized conditions as 29.04 mg GAE/g, 26.70 μg tannic acid/g, and 18.12 μg/g, respectively and under ANN optimized conditions as 30.61 mg GAE/g, 30.80 μg tannic acid/g, and 19.50 μg/g, respectively. All the statistical parameters showed the lowest value in the ANN model than the RSM model with the highest coefficient of determination (R2). The measured value of the TPC, TTC, and β‐carotene content at optimized conditions were in agreement with the predicted value obtained from the above models. Besides these, the ultra‐sonication significantly increased the TPC, TTC, and β‐carotene content while comparing with conventional solvent extraction. Hence, this method could be an effective green method over conventional technologies to extract phenolic compounds from CAB.

Practical Applications

The by‐products of the cashew apple processing industries are generally discarded as waste even though it contains a significant amount of bioactive compounds including phenols. Due to this, the industries are facing issues related to waste disposal and environmental pollution. Extracting and utilizing beneficial phenolic compounds can solve these issues to an extend. However, the scientific research related to the process development for extracting phenolic compounds from cashew apple bagasse is very scarce. The developed green technology with optimum process conditions will be helpful for the industries, researchers, and food scientists to develop different value‐added products enriched with the extracted phenolic compounds.
Factors associated with the experience of patients presenting in pain to the emergency department
Authors: Hughes James A. , Alexander Kimberley E. , Spencer Lyndall , Yates Patsy
Published: August 2021

Aims and Objectives

This study aims to examine the association between person, environment, health and illness factors, pain care and the patient experience in the emergency department, guided by symptom management theory.

Background

Current outcome measures of pain care in the emergency department focus on process measures such as the time taken to deliver analgesic medication. Patient‐reported outcomes of pain care are rare in emergency department literature and predominantly focus on patient satisfaction. Measuring overall patient experience is common, with extensive surveys undertaken in the United Kingdom, United States of America and Australia; however, these are not used as an outcome of pain care.

Design

Prospective cohort study.

Methods

One hundred and ninety patients arriving at a large, inner‐city adults‐only emergency department in moderate to severe pain were recruited to answer a modified version of the emergency department patient experience of care survey.

Results

Fifteen factors were identified as influencing the patient experience of care when presenting in pain. These influences of patient experience included the emergency department environment, time to first analgesic medication and the provision of analgesic medication.

Conclusions

In addition to pain care factors, there is a significant association between the emergency department environment—especially workload, throughput and patient placement—and the experience of patients who present in pain to the emergency department.

Relevance to Clinical Practice

This study demonstrated an association between time to first analgesic medication and the patient experience of care. Providing timely care, including pain care, in emergency departments is difficult, but necessary to improve the patient experience of care.
Ineffectiveness of antenatal guidance intervention for vitamin D insufficiency and deficiency in pregnant women in Kyoto, Japan
Authors: Yamade Ichiro , Inoue Takuya , Hamada Hironori , Sudou Shinsuke , Otsubo Masahiro , Sawada Morio , Nakayama Takahiro , Hatayama Hiroshi
Published: August 2021

Aim

The aim of this study was to investigate the vitamin D status among healthy pregnant women in Japan, and to evaluate the effectiveness of the antenatal health guidance intervention for the pregnant women who were informed about their low vitamin D levels.

Methods

We measured the level of 25‐hydroxyvitamin D (25[OH]D) using chemiluminescent immunoassay among the singleton pregnant women who received at antenatal routine check‐up (8–24 weeks of gestation) with written consent during September 2017–September 2018. The measurement values were informed by the concerned physician and health guidance intervention was given to the pregnant women with inadequate Vitamin D status (25[OH]D < 30 ng/mL). At around 36 weeks of gestation, the measurement of 25(OH)D and a questionnaire regarding behavioral changes after the guidance was conducted.

Results

The average value of 25(OH)D of 1192 pregnant women before the guidance was 14.89 ± 4.85 ng/mL, and the prevalence of sufficient vitamin D status (25(OH)D ≥ 30 ng/mL) was 0.67% (8/1192). Nine hundred eighty‐two pregnant women who had inadequate vitamin D status were followed, thereafter‐guidance prevalence of sufficiency was 1.02% (10/982); insufficiency, 14.66% (144/982); and deficiency, 84.32% (828/982), respectively. Although the prevalence of deficiency was decreased after guidance intervention significantly, the prevalence was still high and the effect on behavioral changes was a little.

Conclusion

The prevalence of vitamin D sufficient status among pregnant women in Japan was extremely low, which is a serious condition. It was also revealed the effectiveness of the antenatal health guidance intervention for pregnant women was not enough.
Sexual dysfunction in Thai gynecologic malignancies survivors: A single‐institutional cross‐sectional observational survey
Authors: Dandamrongrak Poonsuk , Chaiwong Sirintip , Ekalaktam Pakwaran , Achariyapota Vuthinun
Published: August 2021

Objective

To examine the prevalence of female sexual dysfunction (FSD) in gynecologic cancer survivors.

Methods

A cross‐sectional observation survey recruited women aged 18–65 years old who were diagnosed with gynecologic cancers and underwent surgery, radiation, chemotherapy, or combined modalities. Data were collected from September 2019 to March 2020 by the Thai version of the female sexual function index questionnaire to define FSD. The survey contained six domains: desire, arousal, lubrication, orgasm, satisfaction, and pain.

Results

Of the 98 women included in the study, the mean age was 48.7 ± 10.6 years old. Two‐third (67.3%) of the participants was premenopausal, had been diagnosed with ovarian cancer, and had early‐stage gynecologic cancers. Fifty‐eight of 98 (59.2%) participants were sexually active in the past 4 weeks before the survey. Among those, 89.6% had FSD. The median scores in the FSD group were significantly lower than those in the non‐FSD group in all six domains, namely, desire, arousal, lubrication, orgasm, satisfaction, and pain (p < 0.05). There was no statistically significant difference observed between participants with and without FSD in terms of age group, cancer‐related data, or sexual behavior data, except participants who had good/excellent relationships with their partners, which impacted FSD (p = 0.01).

Conclusions

This study discovered the high prevalence (89.6%) of hidden issue of “female sexual dysfunction” in Thai gynecologic cancer survivors. The good/excellent relationships with their partners affected the FSD who were sexually active in the past 4 weeks before the survey.
A modified version of the sensory Pivot technique as a possible tool for the analysis of food adulteration: A case of coffee
Authors: Ameca‐Veneroso Carolina , Sánchez‐Arellano Lucia , Ramón‐Canul Lorena Guadalupe , Herrera‐Corredor José Andrés , Cuervo‐Osorio Víctor Daniel , Quetz‐Aguirre Elvira María , Rodríguez‐Miranda Jesús , Cabal‐Prieto Adán , Ramírez‐Rivera Emmanuel de Jesús
Published: August 2021

The objective of this study was to validate the Pivot sensory technique for sensory analysis of adulterated coffees. The Pivot technique was modified (instructions and determination of the values of the unadulterated sample considered Pivot). A total of 130 consumers evaluated five pairs of samples (Pivot vs. five coffee samples adulterated with black bean coffee). A sensory vocabulary was generated for the construction of confidence ellipses and the calculation of sample classification percentage between the Pivot sample and the adulterated samples. A total of 52 sensory attributes were generated (28 aromas, 5 basic tastes, and 19 flavors). As adulteration increased, a decrease in the number of aromas, high discrimination, and a classification percentage of 68% between the Pivot sample and the adulterated samples. The Pivot technique can be a tool to study the effect of adulteration in coffees.

Practical Applications

The use of the modified Pivot technique in combination with the determination of the values of the Pivot (unadulterated sample) sample can be very useful for the identification of the sensory effect caused by the adulteration of different foods, including those that are protected by some quality seal for quality or for quality control. The scope of this research may be of interest to the industry, producers, and academia.
Epidemiology of periodontal disease in dogs in theUKprimary‐care veterinary setting
Authors: O'Neill D. G. , Mitchell C. E. , Humphrey J. , Church D. B. , Brodbelt D. C. , Pegram C.
Published: August 2021

Objectives

Periodontal disease is a frequent diagnosis of dogs and can have severe negative impacts on welfare. It was hypothesised that breeds with skull shapes that differ most in conformation from the moderate mesocephalic skull shape have higher odds of periodontal disease.

Materials and Methods

The cohort study included a random sample of dogs under primary veterinary care in 2016 from the VetCompass Programme database. Risk factor analysis used random effects multivariable logistic regression modelling.

Results

The study included a random sample of 22,333 dogs. The 1‐year period prevalence for diagnosis with periodontal disease was 12.52% (95% CI: 12.09 to 12.97). Eighteen breeds showed increased odds compared with crossbred dogs. Breeds with the highest odds included Toy Poodle (odds ratio 3.97, 95% confidence intervals 2.21 to 7.13), King Charles Spaniel (odds ratio 2.63, 95% confidence interval 1.50 to 4.61), Greyhound (odds ratio 2.58, 95% confidence interval 1.75 to 3.80) and Cavalier King Charles Spaniel (odds ratio 2.39, 95% confidence interval 1.85 to 3.09). Four breeds showed reduced odds compared with crossbreds. Brachycephalic breeds had 1.25 times the odds (95% confidence interval 1.11 to 1.42) of periodontal disease compared with mesocephalic breeds. Spaniel types had 1.63 times the odds (95% confidence interval 1.42 to 1.87) compared with non‐spaniel types. Increasing adult bodyweight was associated with progressively decreasing odds of periodontal disease.

Clinical Significance

The high prevalence identified in this study highlights periodontal disease as a priority welfare concern for predisposed breeds. Veterinarians can use this information to promote improved dental care in predisposed dogs, especially as these dogs age.
Two dogmas of aesthetic empiricism
Authors: Lopes Dominic McIver
Published: August 2021

Aesthetic hedonism is the default theory of aesthetic value. Some of its critics share with it a pair of unquestioned assumptions, namely, that any theory of aesthetic value should make special appeal to its being the case that the canonical form of aesthetic evaluation is a state of pleasure and to its being the case that the canonical purpose of aesthetic acts is to access pleasure. This paper argues that there is reason to doubt both assumptions. Doubting both assumptions suggests a wider range of alternatives to aesthetic hedonism and primitivist inversions of aesthetic hedonism.
High Plains wheat mosaic virus: An enigmatic disease of wheat and corn causing the High Plains disease
Authors: Tatineni Satyanarayana , Hein Gary L.
Published: August 2021

Brief history

In 1993, severe mosaic and necrosis symptoms were observed on corn (maize) and wheat from several Great Plains states of the USA. Based on the geographical location of infections, the disease was named High Plains disease and the causal agent was tentatively named High Plains virus. Subsequently, researchers renamed this virus as maize red stripe virus and wheat mosaic virus to represent the host and symptom phenotype of the virus. After sequencing the genome of the pathogen, the causal agent of High Plains disease was officially named as High Plains wheat mosaic virus. Hence, High Plains virus, maize red stripe virus, wheat mosaic virus, and High Plains wheat mosaic virus (HPWMoV) are synonyms for the causal agent of High Plains disease.

Taxonomy

High Plains wheat mosaic virus is one of the 21 definitive species in the genus Emaravirus in the family Fimoviridae.

Virion

The genomic RNAs are encapsidated in thread‐like nucleocapsids in double‐membrane 80–200 nm spherical or ovoid virions.

Genome characterization

The HPWMoV genome consists of eight single‐stranded negative‐sense RNA segments encoding a single open reading frame (ORF) in each genomic RNA segment. RNA 1 is 6,981‐nucleotide (nt) long, coding for a 2,272 amino acid protein of RNA‐dependent RNA polymerase. RNA 2 is 2,211‐nt long and codes for a 667 amino acid glycoprotein precursor. RNA 3 has two variants of 1,439‐ and 1,441‐nt length that code for 286 and 289 amino acid nucleocapsid proteins, respectively. RNA 4 is 1,682‐nt long, coding for a 364 amino acid protein. RNA 5 and RNA 6 are 1,715‐ and 1,752‐nt long, respectively, and code for 478 and 492 amino acid proteins, respectively. RNA 7 and RNA 8 are 1,434‐ and 1,339‐nt long, code for 305 and 176 amino acid proteins, respectively.

Biological properties

HPWMoV can infect wheat, corn (maize), barley, rye brome, oat, rye, green foxtail, yellow foxtail, and foxtail barley. HPWMoV is transmitted by the wheat curl mite and through corn seed.

Disease management

Genetic resistance against HPWMoV in wheat is not available, but most commercial corn hybrids are resistant while sweet corn varieties remain susceptible. Even though corn hybrids are resistant to virus, it still serves as a green bridge host that enables mites to carry the virus from corn to new crop wheat in the autumn. The main management strategy for High Plains disease in wheat relies on the management of green bridge hosts. Cultural practices such as avoiding early planting can be used to avoid mite buildup and virus infections.
Social alienation and cultural distance in the context of secession in the South Caucasus
Authors: Dzutsati Valery
Published: August 2021

What explains the variation in individual support for the territorial integrity of the state that faces violent secession? While previous research has emphasised the role of state elites, institutions, and secessionist groups, this article elucidates the popular underpinnings of the state's response to secessionist claims. The proposed theory utilises in‐group and between‐group social distance to explain individual attitudes. Greater alienation from society leads people in the core state to reduce their support for the territorial integrity of the state. The perception of the cultural distinction of the secessionist group is associated with higher or lower support for the territorial integrity of the state, depending on the feasibility of reconquest of the secessionist territory. When reconquest is probable, support for the territorial integrity of the state will be positively associated with cultural distance. When it is improbable, support for the territorial integrity of the state will be negatively associated with cultural distance. The analysis of survey data from the South Caucasian countries that have struggled with secessionist movements for decades provides strong supportive evidence for these conjectures.
Pulmonary echinococcosis as a rare cause of Pancoast syndrome
Authors: Mathur Vaibhav , Gupta Ashish , Vyas Arvind
Published: August 2021

A peculiar brachial plexus syndrome was first described in 1924 by Pancoast,1 (N Engl J Med, 1997,337) wherein an apical pulmonary tumor invades the C8 and T1 extraspinal nerves, the sympathetic chain, stellate ganglion, and adjacent structures. Echinococcal cysts are slowly enlarging masses, generally remaining clinically silent until their expanding size or their space‐occupying effect in an involved organ elicits symptoms. These infections are prevalent in most areas where livestock is raised in association with dogs. Pulmonary hydatid cysts are also usually only evident when they are large enough to exert mechanical compression or are complicated due to their rupture. (Clin Chest Med, 2002,397) Pancoast syndrome due to infectious causes have been previously less described, (Am J Med Sci, 2011, 333) and hence, we report pulmonary hydatid cyst as a treatable cause of this syndrome.