bluuebunny/crossref_metadata_2025 huggingface dataset:
Taxonomic review of the Miltochrista pudibunda (Snellen) species-group (Lepidoptera: Erebidae: Arctiinae) with description of a new species
Authors: VOLYNKIN ANTON V. , SINGH NAVNEET , ČERNÝ KAREL , JOSHI RAHUL
Published: July 2021

The Miltochrista pudibunda (Snellen, 1880) species-group is reviewed. A new synonym is established: M. pudibunda = M. irregularis Rothschild, 1913, syn. nov. The species previously treated by authors (since Hampson (1900)) as M. pudibunda is described as new: M. berdepsebunda sp. nov. A lectotype female is designated for Miltochrista irregularis Rothschild, 1913. Adults together with male and female genitalia of all species of the group are illustrated, diagnoses are provided for each species.
A Nonlinear Multiscale Theory of Atmospheric Blocking: Structure and Evolution of Blocking Linked to Meridional and Vertical Structures of Storm Tracks
Authors: Luo Dehai , Zhang Wenqi
Published: June 2021

This paper examines the impact of the meridional and vertical structures of a preexisting upstream storm track (PUST) organized by preexisting synoptic-scale eddies on eddy-driven blocking in a nonlinear multiscale interaction model. In this model, the blocking is assumed, based on observations, to be comprised of barotropic and first baroclinic modes, whereas the PUST consists of barotropic, first baroclinic, and second baroclinic modes. It is found that the nonlinearity (dispersion) of blocking is intensified (weakened) with increasing amplitude of the first baroclinic mode of the blocking itself. The blocking tends to be long lived in this case. The lifetime and strength of blocking are significantly influenced by the amplitude of the first baroclinic mode of blocking for given basic westerly winds (BWWs), whereas its spatial pattern and evolution are also affected by the meridional and vertical structures of the PUST. It is shown that the blocking mainly results from the transient eddy forcing induced by the barotropic and first baroclinic modes of PUST, whereas its second baroclinic mode contributes little to the transient eddy forcing. When the PUST shifts northward, eddy-driven blocking shows an asymmetric dipole structure with a strong anticyclone–weak cyclone in a uniform BWW, which induces northward-intensified westerly jet and storm-track anomalies mainly on the north side of blocking. However, when the PUST has no meridional shift and is mainly located in the upper troposphere, a north–south antisymmetric dipole blocking and an intensified split jet with maximum amplitude in the upper troposphere form easily for vertically varying BWWs without meridional shear.
Invented Forces in Supercell Models
Authors: Davies-Jones Robert
Published: June 2021

This paper examines methods used in supercell models to maintain a steady, sheared, horizontally uniform environment with a three-force balance in the planetary boundary layer (PBL) and a two-force balance above it. Steady environments are maintained while ignoring the thermal-wind balance that permits large shear above the PBL. The Taylor-Proudman theorem indicates that wind profiles above the PBL must be unidirectional for balanced environments. In principle, supercell models that do not accommodate thermal advection should not support balanced steady environments with veering horizontally uniform winds.

Recent methods add a permanent, pervasive, horizontal external force that varies only with height. By adding two more degrees of freedom, this force circumvents the Taylor-Proudman theorem and enables a static, horizontally uniform environment for any wind profile. It succeeds by adding spurious energy in lieu of flow towards low pressure to offset frictional loss of kinetic energy. However, the artificial force has downsides. It decouples the environmental horizontal equation of motion from the hydrostatic equation and the thermodynamics from the dynamics. It cancels environmental friction and the part of the Coriolis force that acts on the environmental wind. Within the storm, its curl can speciously generate significant horizontal vorticity near the ground. Inaccuracies arise in circulations around material circuits because of modifications by the artificial force and resulting miscalculations of parcel trajectories. Doubt is cast on conclusions about tornadogenesis drawn from recent simulations that contain an invented force.
A New Framework for Identifying and Investigating Seasonal Climate Extremes
Authors: Röthlisberger Matthias , Hermann Mauro , Frei Christoph , Lehner Flavio , Fischer Erich M. , Knutti Reto , Wernli Heini
Published: June 2021

Previous studies have recognized the societal relevance of climatic extremes on the seasonal time scale and examined physical processes leading to individual high-impact extreme seasons (e.g., extremely wet or warm seasons). However, these findings have not yet been generalized beyond case studies since at any specific location only very few seasonal events of such rarity occurred in the observational record. In this concept paper, a pragmatic approach to pool seasonal extremes across space is developed and applied to investigate hot summers and cold winters in ERA-Interim and the Community Earth System Model Large Ensemble (CESM-LENS). We identify spatial extreme season objects as contiguous regions of extreme seasonal mean temperatures based on statistical modeling. Regional pooling of extreme season objects in CESM-LENS then yields considerable samples of analogs to even the most extreme ERA-Interim events. This approach offers numerous opportunities for systematically analyzing large samples of extreme seasons, and several such analyses are illustrated. We reveal a striking co-occurrence of El Niño to La Niña transitions and the largest ERA-Interim midlatitude extreme summer events. Moreover, we perform a climate model evaluation with regard to extreme season size and intensity measures and estimate how often an extreme winter like the cold North American 2013/14 winter is expected anywhere in midlatitude regions. Furthermore, we present a large set of simulated analogs to this event, which makes it possible to study commonalities and differences of their underlying physical processes. Finally, substantial but spatially varying climatological differences in the size of extreme summer and extreme winter objects are identified.
Are Immigrant-Origin Candidates Penalized Due to Ingroup Favoritism or Outgroup Hostility?
Authors: Portmann Lea , Stojanović Nenad
Published: June 2021

An influential explanation for the persistent political underrepresentation of minorities in elected office is that minority candidates are discriminated against by voters of the dominant ethnic group. We argue, however, for the need to distinguish between two forms of discrimination: ingroup favoritism and outgroup hostility. We measure the impact of each by using an extensive data set drawn from Swiss elections, where voters can cast both positive and negative preference votes for candidates. Our results show that immigrant-origin candidates with non-Swiss names incur an electoral disadvantage because they receive more negative preference votes than candidates with typically Swiss names. But we also find that minority candidates face a second disadvantage: voters discriminate in favor of majority candidates by allocating them more positive preference votes. These two forms of electoral discrimination are critically related to a candidate’s party, whereas the impact of the specific outgroup to which a minority candidate belongs is less pronounced than expected.
A novel test fixture for mode III fracture characterization of monolithic laminates and composite sandwich specimens
Authors: Sabbadin Pietro , Berggreen Christian , Legarth Brian Nyvang , Lin Lujin
Published: June 2021

This work presents a novel test fixture for mode III fracture characterization of delaminations in monolithic laminates and face-core debonds in foam core composite sandwich specimens. The test fixture is configured as an extension of the already existing shear-torsion-bending (STB) test designed for monolithic laminates. The specimen sizing, lay-up configuration and the manufacturing process are presented. Accordingly, an overview of the test fixture is provided along with the data reduction method employed to compute the energy release rate. The results from representable fracture characterization tests are presented as force vs. displacement curves, where different definitions of the critical load for crack propagation can be defined. Thus, the critical value of the energy release rate is computed using analytically based equations for the different definitions given for the critical loads. The results show a stable crack growth for monolithic laminate specimens. However, a highly non-linear response of the sandwich specimens, before the onset of crack propagation, is observed. A non-linear numerical analysis and destructive specimen inspections are carried out in order to identify the source of the non-linear behaviour observed in the experimental results.
Exploring the Relationship between Shared Decision-Making, Patient-Centered Medicine, and Evidence-Based Medicine
Authors: Páez Gustavo , Forte Daniel Neves , Gabeiras María del Pilar López
Published: June 2021

Shared decision-making is a possible link between the best of patient-centered medicine and evidence-based medicine. This article seeks to describe the link between them. It discusses to what extent the integration of such perspectives is successful in assuring respect for the patient’s autonomy. From the evidence herein, we conclude that if the doctor–patient relationship and communication are strengthened to cover all issues relevant to the patient’s health and values, is it possible for him or her to achieve more autonomous decisions by this linkage of shared decision-making and patient-centered medicine?

Shared decision-making is a possible link between the best of patient-centered medicine and evidence-based medicine. This article seeks to describe the link between them.
Health professional’s exposure, attitude, and acceptance of drug promotion by industry representatives: A cross-sectional study in Ethiopia
Authors: Yimenu Dawit Kumilachew , Demeke Chilot Abiyu , Kasahun Asmamaw Emagn , Siraj Ebrahim Abdela , Wendalem Adane Yehualaw , Bazezew Zegaye Agmassie , Atsbeha Berhanemeskel Weldegerima , Mekuria Abebe Basazn
Published: June 2021

Interactions between pharmaceutical companies and health care providers have long been an area of interest from ethical as well as scientific grounds. The information provided by those companies must be scientifically accurate and fair. The current study aimed to investigate the exposure, attitude, and training background of medical doctors and pharmacy professionals regarding drug promotional activities, and assess their acceptance of promotional gifts provided by pharmaceutical sales representatives. A cross-sectional study was conducted on medical doctors and pharmacy professionals working at Bahir Dar and Gondar cities, Amhara regional state, Ethiopia. Data were collected using a self-administered structured questionnaire and Statistical Package for Social Science (SPSS) version 26 was used for analysis. A Chi-square test was computed to investigate the presence of an association between the dependent and independent variables. A p-value of less than 0.05 was considered to declare significance at a 95% Confidence Interval (CI). A total of 105 health professionals, 81 pharmacy professionals, and 24 medical doctors have participated in the study. Above two-thirds of the respondents (69.5%) agreed that most talks sponsored by drug companies were helpful and educational. On the other hand, 39% of the respondents agreed and 47.6% disagreed that receiving gifts from pharmaceutical representatives will increase the chance that they will eventually sell or recommend the drug company’s products. The majority of the study participants (81%) preferred drug samples and stationery as appropriate gifts by pharmaceutical sales representatives. Significant gaps were found regarding the training of health professionals about the ethics of drug marketing and how to deal with pharmaceutical representatives. Policies aiming at restricting health care provider’s contacts with pharmaceutical companies during residency training along with incorporating gift restriction policies could bring significant improvements.
Fear of a School-to-Deportation Pipeline: How Teachers, Administrators, and Immigrant Students Respond to the Threat of Standardized Tests and Deportation
Authors: Maloney Patricia , Austin Duke W. , Verma SaunJuhi
Published: June 2021

Existing studies evaluate zero tolerance policies and the school-to-prison pipeline. Additional research identifies the role of criminal justice systems in deporting immigrants. Our work bridges these two literatures by discussing how immigrant students navigate the criminal justice system within schools. Using interviews with immigrant students, teachers, and administrators, we address the question: How is the school-to-deportation pipeline maneuvered by stakeholders? Our study identifies how school authority figures react to and even use the fear of the pipeline to (1) either protect students from becoming criminalized or (2) exclude students from standardized exam participation so as to maintain funding sources.
Immunohistochemical evaluation of suspected oral malignant melanoma in cats
Authors: Saverino Kelly M. , Durham Amy C. , Kiupel Matti , Reiter Alexander M.
Published: June 2021

Oral malignant melanoma (OMM) is considered the third most common oral malignant neoplasm in cats, but its variable morphology and frequent lack of melanin pigment make it a diagnostic challenge. Twenty-two cases of cats with malignant oral neoplasms that were diagnosed as OMM or listed OMM as a suspected differential diagnosis on the biopsy report were examined using an immunohistochemistry (IHC) panel for S100, melan-A, PNL2, laminin, CD34, and pan-cytokeratin. Although OMM was suspected ( n = 14) or previously diagnosed ( n = 8), only 2 cases were immunohistochemically confirmed as OMM. Seven cases were classified as soft tissue sarcoma based on positive expression of CD34 or laminin, and one was classified as carcinoma based on positive expression of pan-cytokeratin. The majority of cases ( n = 12) were categorized as unclassified malignant neoplasms because they did not express melan-A, PNL2, laminin, CD34, or pan-cytokeratin; however, a proportion of these did express S100 ( n = 7). Long-term prognosis of all 22 cats was poor, with a median survival time of 87 days (range = 2–249 days). Cases with longer survival times (>100 days) were treated with surgery, radiation therapy, or a combination. For feline oral malignant neoplasms thought to be OMM, routine use of IHC is required for an accurate diagnosis.
Career ambition and employee performance behaviour: The presence of ideological development
Authors: Bui Hong T. M. , Shoaib Shandana , Vu Viet Ha Tran , Nguyen Thanh Q. , Nhuận Mai Trọng
Published: June 2021

This study develops and tests a theoretical model that investigates how career ambition can have an impact on different types of academics’ performance behaviour and how ideological development at work can affect this model in a special context of a communist country. In a study of 991 employees in a large university in Vietnam, the model is largely supported. The findings suggest that in-role behaviour has a significant mediating role in the effect of career ambition on extra-role behaviour and that this mediating effect is stronger among the group of employees who have participated in advanced ideological development in the context of Vietnamese higher education. This study advances the understanding of an underdeveloped relationship between career ambition and employee performance behaviour and expands the knowledge of the impact of ideological development at work.
Taking social responsibilities overseas? The learning paths and performance consequences of Chinese multinationals
Authors: Wu Sihong , Fan Di
Published: June 2021

Corporate social responsibility (CSR) has been seen as an effective strategy that emerging market multinational enterprises increasingly adopt in order to cope with the liability of origin, yet much less attention has been paid to the micro-foundations of such a strategy. It remains less explored as to how CSR is leveraged by individuals—that is, expatriates. Addressing this research gap, a total of 150 valid survey responses from 38 Chinese multinationals were tested using the structural equation modeling technique. The results show that expatriates’ cross-cultural competence and engagement in CSR facilitate the learning efficiency of subsidiaries. The findings also suggest that expatriates’ effort positively mediates the relationship between CSR and performance outcomes (at both individual level and organizational level). Embracing the micro-foundations perspective in CSR research, this study offers both theoretical and practical implications for future international management research.
Book review: Cajetan Iheka and Jack Taylor (Eds.), African Migration Narratives: Politics, Race and Space
Authors: Verma Ruchi
Published: June 2021

Cajetan Iheka and Jack Taylor (Eds.), African Migration Narratives: Politics, Race and Space. University of Rochester Press, pp. 328. Year 2018, Price: $75 (paperback). ISBN 978-1580469340.
The Frontline Health Care Workers in Schools: Health Equity, the Distribution of School Nurses, and Student Access
Authors: Gratz Trevor , Goldhaber Dan , Willgerodt Mayumi , Brown Nate
Published: June 2021

The extent to which observed disparities in access to primary pediatric care are mirrored in student access to school nursing services is unknown. Using school employment records, we linked 1,346 nurses to school districts serving 1,141,495 students in Washington state. The percentage of students who are Black is negatively associated with the student-to-nurse ratio, while the percentage of students eligible for free-or-reduced-price lunch is positively associated, and relative to urban districts, rural districts have higher student-to-nurse ratios. Disparities in access to school nursing services mirror access gaps for pediatric care along socioeconomic status and geography. The increased number of nurses working in districts with more racial/ethnic minority students may play a protective role and ameliorate access gaps observed in pediatric primary care. States can likely use existing employment and licensing data to understand where school nurses work and therefore guide resource allocation decisions.
Periocular apocrine adenocarcinoma presenting as an orbital mass: clinicopathological features and management in four patients
Authors: Koç İrem , Kiratli Hayyam , Kapucu Yasemin , Söylemezoğlu Figen
Published: June 2021

Purpose:

Apocrine adenocarcinoma is a cutaneous adnexal malignancy which can rarely arise from ocular structures. In this retrospective study, we report our experience with four patients who had primary periocular apocrine adenocarcinoma initially presenting with an orbital tumor.

Methods:

Data extracted included demographics, clinical, imaging, and histopathological features, and treatment outcomes.

Results:

The definitive diagnosis was established after an incisional biopsy in all cases. Two patients were then managed with exenteration. The third patient underwent local resection followed by radiotherapy but had to be exenterated because of new tumor formation 7 years later. The fourth patient had to be managed with oral bicalutamide which kept the tumor stable for 3 years. Recurrence-free survival for the radical surgical treatment group was 10, 6, and 7 years respectively.

Conclusion:

Periocular apocrine adenocarcinoma may insidiously develop as an orbital mass without any clinically detectable primary eyelid skin or conjunctival lesions. This tumor must be in the differential diagnosis of medially located ill-defined orbital masses in patients over 50 years of age. Orbital exenteration appeared as an effective treatment of apocrine adenocarcinoma with orbital extension. Anti-androgenic treatment in an androgen receptor-positive tumor provided temporary local tumor control.
Gliotic tissue simulating a macular neovascularization in full-thickness macular hole
Authors: Vigano’ Chiara , Borrelli Enrico , Sacconi Riccardo , Brambati Maria , Bandello Francesco , Querques Giuseppe
Published: June 2021

The authors report a case of a male patient affected by macular hole. In particular, a hyperreflective tissue was found on optical coherence tomography (OCT) examination in macular region, just above the retinal pigment epithelium (RPE). OCT angiography (OCTA) did not show the presence of vascular tissue, thus the hyperreflective material was ascribed to primary gliotic tissue. This case highlights the ability for Müller cells placed near macular holes to migrate up to the RPE and to produce gliotic tissue.
Multicenter Experience With Large Diameter Balloon-Expandable Stent-Grafts for the Treatment of Infrarenal Penetrating Aortic Ulcers
Authors: Stana Jan , Fernandez Prendes Carlota , Kruszyna Lukasz , Passaloglou Ioannis Thomas , Ruffino Maria Antonella , Reyes Valdivia Andres , del Castro Madrazo Jose Antonio , Oikonomou Kyriakos , Chan Hon Lai , Makaloski Vladimir , Tsilimparis Nikolaos
Published: June 2021

Purpose

To describe the use of large-diameter balloon-expandable stent-grafts (BeGraft aortic stent-graft, Bentley InnoMed GmbH, Hechingen, Germany) in the treatment of infrarenal penetrating aortic ulcer (iPAU).

Materials and Methods

Retrospective analysis of patients undergoing endovascular treatment with the BeGraft aortic stent-graft in 8 European centers from January 2017 to October 2020. Demographics, perioperative data, and midterm outcomes were collected. Endpoints of the study were technical feasibility, early mortality, and morbidity.

Results

A total of 40 patients were included. The mean age was 73.9±7.05 years and 63.2% were male. Indications for treatment included size and morphology (65%), presence of symptoms (29.5%), and contained ruptures (5.5%). Urgent treatment was performed in 5% of cases. Technical success was 97.5%. Median operation time was 58 minutes (19–170 minutes), with 27.5% of patients having additional procedures during the main intervention (1 additional repair with a C-TAG (W.L. Gore & Associates, Inc, Flagstaff, AZ, USA) thoracic endoprosthesis, 5 covered endovascular reconstruction of aortic bifurcation procedures, 3 extensions with proximal cuffs, and 2 percutaneous angioplasties of the common iliac arteries). Percutaneous femoral access was used in 72.5%, while groin cut-down was performed in 27.5%. Repair was successful with only 1 stent in 45% of cases, while 37.5% required 2 stents and nearly 17.5% required 3/4 stent-grafts. The 30-day mortality was 0%, with a 2.5% reintervention rate (1 patient required evacuation of an intra-abdominal hematoma). Median follow-up was 13.9 months (2–39 months), during which no vascular-related reinterventions or deaths were reported. In 4 patients, a type II endoleak was observed. No cases of graft migration, thrombosis, or stent-fracture were observed.

Conclusions

The treatment of iPAU with the BeGraft aortic stent-graft in a selective patient group is feasible with low rate of perioperative morbidity and mortality. Balloon-expandable stent-grafts offer the option to repair iPAUs with a shorter coverage of the aorta using low-profile sheath, that enables treatment in the presence of calcified access vessels and small diameter aortic bifurcations.
Comparison of healthcare resource utilization and medical costs between patients with seropositive and seronegative rheumatoid arthritis
Authors: Kim Hyoungyoung , Cho Soo-Kyung , Choi Seongmi , Im Seul Gi , Jung Sun-Young , Jang Eun Jin , Sung Yoon-Kyoung
Published: June 2021

Objectives:

To compare healthcare utilization and medical costs between patients with seronegative (SN) and seropositive (SP) rheumatoid arthritis (RA).

Methods:

We conducted a nationwide population study using the Korean health insurance claims database in 2016. We divided patients with RA into SN and SP groups and compared healthcare utilization including medications, medical utilization, and direct medical costs for 1 year between the groups in a cross-sectional analysis. Differences in costs between patients with SPRA and SNRA were assessed using the quantile regression model. We performed longitudinal analysis using data from 2012 and 2016 to examine changes over time.

Results:

A total of 103,815 SPRA and 75,809 SNRA patients were included in the analyses. The SPRA group used significantly more methotrexate (73.2% versus 30.3%) and biologic agents (7.9% versus 2.9%) than the SNRA group. The number of RA-related outpatient visits [6.0 ± 3.7 versus 4.4 ± 4.0 times/year, standardized difference (SD) = 0.41] and annual medical costs per patient ($1027 versus $450/year, SD = 0.25) were higher in the SPRA group than the SNRA group. Quantile regression results indicated that the incremental cost of seropositivity on total medical costs of RA patients gradually increased as medical costs approached the upper quantile. The annual direct medical costs for each patient between 2012 and 2016 increased in both groups: by 25.1% in the SPRA group and 37.6% in the SNRA group.

Conclusion:

Annual RA-related direct medical costs and RA-related healthcare utilization per patient are higher in patients with SPRA than those with SNRA.
Against carceral data collection in response to anti-Asian violences
Authors: Kuo Rachel , Bui Matthew
Published: June 2021

This commentary reflects on recent instances of anti-Asian violence and state responses to redress violence through data-driven strategies. Data collection often presents itself as an appealing strategy, due to impacted communities’ desires for evidence and metrics to substantiate political claims. Yet, data collection can bolster the carceral state. This commentary takes an antagonistic approach to policing, including the ongoing creation of data infrastructures by—and for—law enforcement through hate crimes legislation. We critically discuss the challenges and possibilities in building towards anti-carceral responses amidst ongoing racial violence and crisis.
The Curvilinear Relationship Between Job Control and Voice: Role of Emotional Resistance to Change and Supervisor Developmental Feedback
Authors: Tiantian Xia , Zhenduo Zhang , Huan Xiao , Jing Xiu , Wentong Jia
Published: June 2021

The purpose of this study was to delve into the underlying mechanism and contextual boundary condition of the U-shaped relationship between job control and voice at the episode level within the framework of conservation of resources theory. Adopting a two-wave experience sampling method, this study collected 265 matched cases nested in 53 Chinese employees for 5 consecutive days. By hierarchical linear regression, the U-shaped effect of job control on voice at the episode level was replicated. Furthermore, the mediating role of emotional resistance (ER) to change and to the moderating role of supervisor developmental feedback (SDF) was examined. Job control has a U-shaped effect on day-level voice and an inverted U-shaped effect on trait ER, which mediates the curvilinear relationship between job control and day-level voice. Daily SDF moderates the curvilinear relationship between job control and day-level voice such that daily SDF buffers the negative relationship between low job control and day-level voice, as well as amplifies the positive relationship between high job control and day-level voice. The current study unveils the mediating states and contextual boundary conditions of the curvilinear relationship between job control and day-level voice by testing the mediating role of ER and moderating role of SDF at the episode level, thereby further contributing to the literature on voice.
Validation of reference genes for whole blood gene expression analysis in cord blood of preterm and full-term neonates and peripheral blood of healthy adults
Authors: Hieronymus Kristin , Dorschner Benjamin , Schulze Felix , Vora Neeta L. , Parker Joel S. , Winkler Jennifer Lucia , Rösen-Wolff Angela , Winkler Stefan
Published: June 2021

Background

Preterm birth is the leading cause of neonatal morbidity and mortality, but research efforts in neonatology are complicated due to the unavailability of large volume blood samples. Whole blood assays can be used to overcome this problem by performing both functional and gene expression studies using small amounts of blood. Gene expression studies using RT-qPCR estimate mRNA-levels of target genes normalized to reference genes. The goal of this study was to identify and validate stable reference genes applicable to cord blood samples obtained from developing neonates of different gestational age groups as well as to adult peripheral blood samples. Eight reference gene candidates (ACTB, B2M, GAPDH, GUSB, HPRT, PPIB, RPLP0, RPL13) were analyzed using the three published software algorithms Bestkeeper, GeNorm and NormFinder.

Results

A normalization factor consisting of ACTB and PPIB allows for comparative expression analyses of neonatal samples from different gestational age groups. Normalization factors consisting of GAPDH and PPIB or ACTB and GAPDH are suitable when samples from preterm and full-term neonates and adults are compared. However, all candidate reference genes except RPLP0 exhibited significant intergroup gene expression variance and a higher gene expression towards an older age which resulted in a small but statistically significant systematic bias. Systematic analysis of RNA-seq data revealed new reference gene candidates with potentially superior stability.

Conclusions

The current study identified suitable normalization factors and proposed the use of the additional single gene RPLP0 to avoid systematic bias. This combination will enable comparative analyses not only between neonates of different gestational ages, but also between neonates and adults, as it facilitates more detailed investigations of developmental gene expression changes. The use of software algorithms did not prevent unintended systematic bias. This generally highlights the need for careful validation of such results to prevent false interpretation of potential age-dependent changes in gene expression. To identify the most stable reference genes in the future, RNA-seq based global approaches are recommended.
Insertion of an endogenous Jaagsiekte sheep retrovirus element into the BCO2 - gene abolishes its function and leads to yellow discoloration of adipose tissue in Norwegian Spælsau (Ovis aries)
Authors: Kent Matthew , Moser Michel , Boman Inger Anne , Lindtveit Kristine , Árnyasi Mariann , Sundsaasen Kristil Kindem , Våge Dag Inge
Published: June 2021

Background

The accumulation of carotenoids in adipose tissue leading to yellow fat is, in sheep, a heritable recessive trait that can be attributed to a nonsense mutation in the beta-carotene oxygenase 2 (BCO2) gene. However, not all sheep breeds suffering from yellow fat have this nonsense mutation, meaning that other functional mechanisms must exist. We investigated one such breed, the Norwegian spælsau.

Results

In spælsau we detected an aberration in BCO2 mRNA. Nanopore sequencing of genomic DNA revealed the insertion of a 7.9 kb endogenous Jaagsiekte Sheep Retrovirus (enJSRV) sequence in the first intron of the BCO2 gene. Close examination of its cDNA revealed that the BCO2 genes first exon was spliced together with enJSRV-sequence immediately downstream of a potential -AG splice acceptor site at enJSRV position 415. The hybrid protein product consists of 29 amino acids coded by the BCO2 exon 1, one amino acid coded by the junction sequence, followed by 28 amino acids arbitrary coded for by the enJSRV-sequence, before a translation stop codon is reached.

Conclusions

Considering that the functional BCO2 protein consists of 575 amino acids, it is unlikely that the 58 amino acid BCO2/enJSRV hybrid protein can display any enzymatic function. The existence of this novel BCO2 allele represents an alternative functional mechanism accounting for BCO2 inactivation and is a perfect example of the potential benefits for searching for structural variants using long-read sequencing data.
Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)
Authors: Nkeh-Chungag Benedicta Ngwenchi , Engwa Godwill Azeh , Businge Charles , Mdondolo Mziwohlanga , Pajaro Medina Magdevy , Goswami Nandu
Published: June 2021

Background

The risk of cardiovascular diseases (CVDs) is becoming more prevalent in pregnant women though not much data is available for pregnant women with human immunodeficiency virus (HIV). Foetoplacental vascular endothelial dysfunction is thought to be at the origin of chronic diseases such as diabetes and obesity later on in life. Because HIV and anti-retroviral treatment (ARTs) are associated with endothelial dysfunction, children exposed in utero to these conditions may be at greater risk of developing CVDs. Despite the high prevalence of HIV in pregnant South African women, little is known about the effects of ART on the cardiovascular health of the mother and offspring. Hence, the proposed study intends to investigate how HIV/ARTs may affect the cardiovascular health of the mother and offspring at different time points during the pregnancy and up to 2 years after birth.

Methods

A longitudinal case–control study in HIV positive pregnant women on ART and HIV negative pregnant women will be conducted. All pregnant women will be assessed for cardio-metabolic risk factors and markers (lipids, anthropometric and glycaemic indies, oxidative stress), hemodynamic status (blood pressure parameters) and vascular function (arterial compliance, retinal microvasculature, uterine artery mean pulsatility index). Child health will be monitored in utero and postnatally via routine foetal health screening, placental integrity, anthropometry, blood pressure parameters, markers of oxidative stress and endothelial function in cord blood and cardiovascular epigenetic markers in urine.

Discussion

There is a paucity of studies in South Africa and sub-Sahara Africa as a whole that utilised a longitudinal study model to assess the effects of ARTs on vascular endothelial changes in pregnant women living with HIV and the cardiometabolic health of their offspring. This study will therefore help to monitor changes in cardiometabolic risk during pregnancy and in children exposed in utero to HIV-infection and ART use. Findings from this study will provide useful information for developing guidelines on the use of ARTs in pregnancy and management of cardiometabolic health of the offspring of HIV positive mothers.
Cardio-metabolic outcomes in South Asians compared to White Europeans in the United Kingdom: a matched controlled population-based cohort study
Authors: Almulhem Munerah , Chandan Joht Singh , Gokhale Krishna , Adderley Nicola J. , Thayakaran Rasiah , Khunti Kamlesh , Tahrani Abd A. , Hanif Wasim , Nirantharakumar Krishnarajah
Published: June 2021

Background

There appears to be an inequality in the risk of cardio-metabolic disease between those from a South Asian (SA) background when compared to those of White Europeans (WE) descendance, however, this association has not been explored in a large European cohort. This population-based open retrospective cohort explores the incidence of cardio-metabolic disease in those without pre-existing cardiometabolic disease taken from a large UK primary care database from 1st January 2007 to 31st December 2017.

Methods

A retrospective open cohort matched population-based study using The Health Improvement Network (THIN) database. The outcomes of this study were the incidences of cardio-metabolic events (type 2 diabetes mellitus, hypertension, ischemic heart disease, stroke, heart failure, and atrial fibrillation).

Results

A total of 94,870 SA patients were matched with 189,740 WE patients. SA were at an increased risk of developing: T2DM (adjusted hazard ratio (aHR) 3.1; 95% CI 2.97–3.23); HTN (1.34; 95% CI: 1.29–1.39); ischaemic heart disease (IHD) (1.81; 95% CI: 1.68–1.93) and heart failure (HF) (1.11; 95% CI: 1.003–1.24). However, they were at a lower risk of atrial fibrillation (AF) (0.53; 95% CI: 0.48–0.59) when compared to WE. Of those of SA origin, the Bangladeshi community were at the greatest risk of T2DM, HTN, IHD and HF, but were at the lowest risk of AF in when compared to Indians and Pakistanis.

Conclusion

Considering the high risk of cardio-metabolic diseases in the SA cohort, differential public health measures should be considered in these patients to reduce their risk of disease, which may be furthered tailored depending on their country of origin.
Primary care consultations on emotional distress – a part of the acculturation process in patients with refugee backgrounds: a grounded theory approach
Authors: Rothlind Erica , Fors Uno , Salminen Helena , Wändell Per , Ekblad Solvig
Published: June 2021

Background

Considering the global refugee crisis, there is an increasing demand on primary care physicians to be able to adequately assess and address the health care needs of individual refugees, including both the somatic and psychiatric spectra. Meanwhile, intercultural consultations are often described as challenging, and studies exploring physician–patient communication focusing on emotional distress are lacking. Therefore, the aim was to explore physician–patient communication, with focus on cultural aspects of emotional distress in intercultural primary care consultations, using a grounded theory approach, considering both the physician’s and the patient’s perspective.

Methods

The study was set in Region Stockholm, Sweden. In total, 23 individual interviews and 3 focus groups were conducted. Resident physicians in family medicine and patients with refugee backgrounds, originating from Somalia, Syria, Afghanistan and Iraq, were included. Data was analysed using a grounded theory approach.

Results

Over time, primary care patients with refugee backgrounds seemed to adopt a culturally congruent model of emotional distress. Gradual acceptance of psychiatric diagnoses as explanatory models for distress and suffering was noted, which is in line with current tendencies in Sweden. This acculturation might be influenced by the physician. Three possible approaches used by residents in intercultural consultations were identified: “biomedical”, “didactic” and “compensatory”. They all indicated that diagnoses are culturally valid models to explain various forms of distress and may thus contribute to shifting patient perceptions of psychiatric diagnoses.

Conclusions

Physicians working in Swedish primary care may influence patients’ acculturation process by inadvertently shifting their perceptions of psychiatric diagnoses. Residents expressed concerns, rather than confidence, in dealing with these issues. Focusing part of their training on how to address emotional distress in an intercultural context would likely be beneficial for all parties concerned.
Development of a multivariable prognostic PREdiction model for 1-year risk of FALLing in a cohort of community-dwelling older adults aged 75 years and above (PREFALL)
Authors: Gade Gustav Valentin , Jørgensen Martin G. , Ryg Jesper , Masud Tahir , Jakobsen Lasse Hjort , Andersen Stig
Published: June 2021

Background

Falls are the leading cause of fatal and non-fatal injuries in older adults, and attention to falls prevention is imperative. Prognostic models identifying high-risk individuals could guide fall-preventive interventions in the rapidly growing older population. We aimed to develop a prognostic prediction model on falls rate in community-dwelling older adults.

Methods

Design: prospective cohort study with 12 months follow-up and participants recruited from June 14, 2018, to July 18, 2019.

Setting: general population.

Subjects: community-dwelling older adults aged 75+ years, without dementia or acute illness, and able to stand unsupported for one minute.

Outcome: fall rate for 12 months.

Statistical methods: candidate predictors were physical and cognitive tests along with self-report questionnaires. We developed a Poisson model using least absolute shrinkage and selection operator penalization, leave-one-out cross-validation, and bootstrap resampling with 1000 iterations.

Results

Sample size at study start and end was 241 and 198 (82%), respectively. The number of fallers was 87 (36%), and the fall rate was 0.94 falls per person-year. Predictors included in the final model were educational level, dizziness, alcohol consumption, prior falls, self-perceived falls risk, disability, and depressive symptoms. Mean absolute error (95% CI) was 0.88 falls (0.71–1.16).

Conclusion

We developed a falls prediction model for community-dwelling older adults in a general population setting. The model was developed by selecting predictors from among physical and cognitive tests along with self-report questionnaires. The final model included only the questionnaire-based predictors, and its predictions had an average imprecision of less than one fall, thereby making it appropriate for clinical practice. Future external validation is needed.

Trial registration

Clinicaltrials.gov (NCT03608709).
Eosinophilic interstitial nephritis and cardiac insufficiency in Kimura’s disease: a case report
Authors: Xiang Li , Zhou Hua , Liu Hua , Zhang Dachuan , Li Min , Yang Min , Yang Yan
Published: June 2021

Background

Kimura’s disease (KD) is a rare chronic inflammatory disease and the etiology remains uncharacterized. The typical manifestations are painless lymph node or subcutaneous masses. There is currently no report of prominent renal interstitial injury and cardiac insufficiency in KD.

Case presentation

A 45-year-old man was referred to our hospital with dark urine, subcutaneous masses in forehead and right retroauricular, multiple lymphadenopathy and unexplained cardiac insufficiency. Renal biopsy demonstrated eosinophilic interstitial nephritis. Laboratory tests revealed eosinophilia and a high level of serum IgE. A biopsy of cervical lymph node was performed and KD was diagnosed. Treatment with oral prednisone resulted in a decrease of eosinophil, serum IgE, improvement of cardiac function, and regression of the subcutaneous mass.

Conclusions

We describe an extremely rare KD case presenting with eosinophilic interstitial nephritis, cardiac insufficiency and significant response to prednisone. The clinicians should improve the disease awareness and find optimal treatment.
Prevalence of iron and folic acid supplements consumption and associated factors among pregnant women in Eswatini: a multicenter cross-sectional study
Authors: Mabuza Gugulethu N. , Waits Alexander , Nkoka Owen , Chien Li-Yin
Published: June 2021

Background

During pregnancy, nutritional requirements increase and if not met, pregnancy-related complications may manifest. To prevent these undesirable outcomes, the World Health Organization recommends daily oral iron and folic acid (IFA) supplementation as part of antenatal care. Despite this recommendation, the use of IFA supplements is still very low in several developing countries. Additionally, no prior information exists regarding the level of consumption of IFA in Eswatini. Thus, this study aimed to determine the prevalence of consumption of IFA supplements and to identify factors associated with the consumption of IFA supplements among pregnant women in Eswatini.

Methods

A cross-sectional questionnaire survey was conducted among 330 pregnant women aged ≥ 18 years in their third trimester in Eswatini. Participants were recruited from eight purposively selected healthcare facilities from July 2019 to October 2019. Good consumption was defined as consuming all or almost all IFA supplements throughout pregnancy.

Results

During the first trimester, 10.3 % of the participants consumed all or almost all IFA supplements. In the second and third trimesters, those who consumed all or almost all supplements were 37 and 39.7 %, respectively, for iron and 37.6 and 40.9 %, respectively, for folic acid. Barriers, including side effects, forgetfulness, safe previous pregnancies without IFA, others’ advice against consumption, IFA stock-outs, inability to meet transport costs, and inadequate supply of IFA tablets, contribute to low consumption of IFA. Multivariate logistic regression models showed that the barriers were inversely associated with good consumption of IFA supplements. Better knowledge and attitude toward IFA and older maternal age were positively associated with good consumption of IFA supplements.

Conclusions

Low consumption of IFA supplements in overall pregnancy is mainly owing to the late antenatal care attendance. Strategies such as establishing a preconception care unit and school-based provision of IFA may be helpful. It is evident that most women still lack knowledge, and some have negative attitudes about IFA supplements. Health education to raise awareness and emphasize the importance of starting antenatal care early as well as consuming supplements on time should be revisited and intensified. Multiple strategies such as including community health care workers for distributing IFA supplements, discussing with clients about the measures to reduce forgetfulness, advising ways to prevent and manage the side effects, providing subsidies to cover transport costs, and ensuring adequate supply of IFA supplements in facilities may need to be employed to reduce the identified barriers.
Intralesional injection of rose bengal augments the efficacy of gemcitabine chemotherapy against pancreatic tumors
Authors: Innamarato Patrick , Morse Jennifer , Mackay Amy , Asby Sarah , Beatty Matthew , Blauvelt Jamie , Kidd Scott , Mullinax John E. , Sarnaik Amod A. , Pilon-Thomas Shari
Published: June 2021

Background

Chemotherapy regimens that include the utilization of gemcitabine are the standard of care in pancreatic cancer patients. However, most patients with advanced pancreatic cancer die within the first 2 years after diagnosis, even when treated with standard of care chemotherapy. This study aims to explore combination therapies that could boost the efficacy of standard of care regimens in pancreatic cancer patients.

Methods

In this study, we used PV-10, a 10% solution of rose bengal, to induce the death of human pancreatic tumor cells in vitro. Murine in vivo studies were carried out to examine the effectiveness of the direct injection of PV-10 into syngeneic pancreatic tumors in causing lesion-specific ablation. Intralesional PV-10 treatment was combined with systemic gemcitabine treatment in tumor-bearing mice to investigate the control of growth among treated tumors and distal uninjected tumors. The involvement of the immune-mediated clearance of tumors was examined in immunogenic tumor models that express ovalbumin (OVA).

Results

In this study, we demonstrate that the injection of PV-10 into mouse pancreatic tumors caused lesion-specific ablation. We show that the combination of intralesional PV-10 with the systemic administration of gemcitabine caused lesion-specific ablation and delayed the growth of distal uninjected tumors. We observed that this treatment strategy was markedly more successful in immunogenic tumors that express the neoantigen OVA, suggesting that the combination therapy enhanced the immune clearance of tumors. Moreover, the regression of tumors in mice that received PV-10 in combination with gemcitabine was associated with the depletion of splenic CD11b+Gr-1+ cells and increases in damage associated molecular patterns HMGB1, S100A8, and IL-1α.

Conclusions

These results demonstrate that intralesional therapy with PV-10 in combination with gemcitabine can enhance anti-tumor activity against pancreatic tumors and raises the potential for this strategy to be used for the treatment of patients with pancreatic cancer.