bluuebunny/crossref_metadata_2025 huggingface dataset:
Light‐sheet microscopy‐based 3D single‐cell tracking reveals a correlation between cell cycle and the start of endoderm cell internalization in early zebrafish development
Authors: Kondow Akiko , Ohnuma Kiyoshi , Kamei Yasuhiro , Taniguchi Atsushi , Bise Ryoma , Sato Yoichi , Yamaguchi Hisateru , Nonaka Shigenori , Hashimoto Keiichiro
Published: November 2020

Controlling the initiation of cell migration plays a fundamental role in shaping the tissue during embryonic development. During gastrulation in zebrafish, some mesendoderm cells migrate inward to form the endoderm as the innermost germ layer along the yolk syncytial layer. However, how the initiation of inward migration is regulated is poorly understood. In this study, we performed light‐sheet microscopy‐based 3D single‐cell tracking consisting of (a) whole‐embryo time‐lapse imaging with light‐sheet microscopy and (b) three‐dimensional single cell tracking in the zebrafish gastrula in which cells are marked with histone H2A‐mCherry (nuclei) and the sox17:EGFP transgene (expressed in endoderm cells). We analyzed the correlation between the timing of cell internalization and cell division. Most cells that differentiated into endoderm cells began to internalize during the first half of the cell cycle, where the length of a cell cycle was defined by the period between two successive cell divisions. By contrast, the timing of other internalized cells was not correlated with a certain phase of the cell cycle. These results suggest the possibility that cell differentiation is associated with the relationship between cell cycle progression and the start of internalization. Moreover, the 3D single‐cell tracking approach is useful for further investigating how cell migration is integrated with cell proliferation to shape tissues in zebrafish embryos.
Assessment of myocardial damage after acute myocardial infarction by diastolic deceleration time of coronary flow velocity using echocardiography and contrast‐enhanced magnetic resonance imaging
Authors: Imamura Sari , Hirata Kumiko , Takemoto Kazushi , Orii Makoto , Shimamura Kunihiro , Shiono Yasutsugu , Tanimoto Takashi , Matsuo Yoshiki , Ino Yasushi , Kitabata Hironori , Kubo Takashi , Tanaka Atsushi , Hozumi Takeshi , Akasaka Takashi
Published: November 2020

Background

There are limited data available regarding the use of diastolic deceleration time (DDT) of three major arteries measured by transthoracic echocardiography (TTE) for assessing coronary microvascular damage after acute myocardial infarction (AMI). Therefore, we aimed to compare the DDT of three major arteries using TTE with the transmural extent of infarction (TEI) and infarct size, which were classified using contrast‐enhanced magnetic resonance imaging (CE‐MRI), in patients with AMI.

Methods

The DDT of the culprit coronary artery was measured in 74 patients using TTE and CE‐MRI 1 week after the onset of AMI. The TEI was graded based on the transmural extent of the hyper‐enhanced tissue (grades 1–4).

Results

The assessable rate for the DDT was 95%; individual rates were 100% for the left anterior descending coronary artery, 90% for the left circumflex artery, and 93% for the right coronary artery. The DDT decreased gradually as the TEI grade progressed (P = .021). Infarct size was significantly correlated with the DDT (r = −0.51, P < .0001). Univariate analysis revealed that the left ventricular (LV) end‐systolic volume, LV ejection fraction, and DDT were significantly associated with TEI grade 4. After adjustment via multiple logistic regression analysis, the DDT was independently remained. With a cutoff value of 950ms, as determined by the ROC curve, DDT could detect TEI grade 4 with 81.1% sensitivity and 80.1% specificity.

Conclusion

The DDT of three major coronary arteries measured by TTE 1 week after the onset of AMI can assess the extent of myocardial damage, which is determined by CE‐MRI.
From trials to clinical practice: Temporal trends in the coverage of specialized allied health services for Parkinson's disease
Authors: Bloem Bastiaan R. , Eimers Marietta , van Galen Mirte S. , Munneke Marten , Darweesh Sirwan K. L.
Published: November 2020

Background and purpose

To determine how the coverage of specialized allied health services for patients with Parkinson's disease (PD) has developed in the Netherlands since the publication of trials that demonstrated cost‐effectiveness.

Methods

We used healthcare expenditure‐based data on all insured individuals in the Netherlands to determine the annual proportion of patients with PD who received either specialized or generic allied health services (physiotherapy, occupational therapy, speech–language therapy) in 2 calendar years separated by a 5‐year interval (2012 and 2017). Specialized allied health services were delivered through the ParkinsonNet approach, which encompassed professional training and concentration of care among specifically trained professionals.

Results

Between 2012 and 2017, there was an increase in the number of patients with any physiotherapy (from 17,843 [62% of all patients with PD that year] to 22,282 [68%]), speech–language therapy (from 2171 [8%] to 3378 [10%]), and occupational therapy (from 2813 [10%] to 5939 [18%]). Among therapy‐requiring patients, the percentage who were treated by a specialized therapist rose substantially for physiotherapy (from 36% in 2012 to 62% in 2017; χ2 = 2460.2; p < 0.001), speech–language therapy (from 59% to 85%; χ2 = 445.4; p < 0.001), and occupational therapy (from 61% to 77%; χ2 = 231.6; p < 0.001). By contrast, the number of patients with generic therapists did not change meaningfully. By 2017, specialized care delivery had extended to regions that had been poorly covered in 2012, essentially achieving nationwide coverage.

Conclusions

Following the publication of positive trials, specialized allied healthcare delivery was successfully scaled for patients with PD in the Netherlands, potentially serving as a template for other healthcare innovations for patients with PD elsewhere.
Outcomes and long‐term mortality after basilar artery occlusion—A cohort with up to 20 years’ follow‐up
Authors: Ritvonen Juhani , Sairanen Tiina , Silvennoinen Heli , Virtanen Pekka , Salonen Oili , Lindsberg Perttu J. , Strbian Daniel
Published: November 2020

Background

The data on long‐term outcome after basilar artery occlusion (BAO) are scarce. Little is known about BAO survivors´ outcome over decades.

Aim

We set out to investigate long‐term survival and causes of death in BAO patients with up to two decades of follow‐up. We also evaluated differences in outcome trends.

Methods

Two hundred and seven BAO patients treated with intravenous thrombolysis (IVT) at the Department of Neurology, Helsinki University Hospital, between 1995 and 2016, were analyzed. Short‐term outcome was assessed by modified Rankin Scale (mRS) at 3 months. Long‐term cumulative survival rate was analyzed using Kaplan−Meier analysis. Factors associated with mortality were analyzed with Cox regression.

Results

Moderate outcome (mRS 0–3) was achieved in 41.1% and good outcome (mRS 0–2) in 30.4% of patients at 3 months. Three‐month mortality was 39.6%, of which 89% died within the first month. The median follow‐up time in 3‐month survivors was 8.9 years (maximum 21.8 years). Total mortality during follow‐up was 52.2%. Cumulative mortality rate was 25.7%. Older age, coronary artery disease and more extensive ischemic changes on admission brain imaging were independently associated with long‐term mortality. After the acute phase, the rate of other vascular causes of death increased in relation to stroke.

Conclusions

The described evolution of a large, single‐center BAO cohort shows a trend towards a higher rate of good and/or moderate outcome during later years in IVT‐treated patients. Survivors showed relative longevity, and the rate of cardiac and other vascular causes of death increased in relation to stroke sequelae over the long term.
Safety and efficacy of midazolam nasal spray for the treatment of intermittent bouts of increased seizure activity in the epilepsy monitoring unit: A double‐blind, randomized, placebo‐controlled trial
Authors: Spencer David C. , Sinha Saurabh R. , Choi Eun Jung , Cleveland Jody M. , King Aliceson , Meng Tze‐Chiang , Pullman William E. , Sequeira David J. , Van Ess Peter J. , Wheless James W.
Published: November 2020

Objective

Midazolam nasal spray (MDZ‐NS) is indicated for acute treatment of intermittent, stereotypic episodes of frequent seizure activity (ie, seizure clusters, acute repetitive seizures) that are distinct from a patient's usual seizure pattern, in patients 12 years of age and older with epilepsy. This trial evaluated safety and efficacy of MDZ‐NS in patients with epilepsy who were admitted to the epilepsy monitoring unit for seizure characterization/presurgical evaluation.

Methods

In this randomized, double‐blind, placebo‐controlled phase 3 trial (P261‐301; NCT01999777), eligible patients with ≥2 seizures in the 6‐hour window preceding trial medication administration for whom treatment was appropriate based on investigator's judgment were randomized (1:1) to MDZ‐NS 5 mg or placebo. Efficacy outcomes were proportion of patients seizure‐free for 6 hours after treatment and time to first seizure within 6 hours. Safety and tolerability outcomes included treatment‐emergent adverse events (TEAEs).

Results

Sixty‐two patients were randomized (MDZ‐NS n = 31; placebo n = 31), received trial medication, and completed the trial. A higher proportion of patients on MDZ‐NS than placebo were seizure‐free for 6 hours following treatment (54.8% vs 38.7%); however, the 16.1% difference was not statistically significant (P = .1972). The Kaplan‐Meier curve of time to first seizure showed separation of both groups in favor of MDZ‐NS from ~1.5 hours post‐dose and throughout the 6‐hour Treatment phase. Median time to first seizure was not estimable for MDZ‐NS (>50% of patients had no seizure) and 3.9 hours for placebo (P = .1388). TEAEs with MDZ‐NS were generally comparable to those with placebo. There were no deaths, serious TEAEs, or discontinuations due to TEAEs.

Significance

Although the observed treatment difference may be clinically meaningful, statistical significance was not demonstrated. Results suggest that MDZ‐NS 5 mg may provide improvement over placebo, with efficacy maintained for ≥6 hours post‐dose. MDZ‐NS was well tolerated in this population.
Status epilepticus admissions during the COVID‐19 pandemic in Salzburg—A population‐based study
Authors: Leitinger Markus , Poppert Kai‐Nicolas , Mauritz Matthias , Rossini Fabio , Zimmermann Georg , Rohracher Alexandra , Kalss Gudrun , Kuchukhidze Giorgi , Höfler Julia , Bosque Varela Pilar , Kreidenhuber Rudolf , Volna Kamila , Neuray Caroline , Kobulashvili Teia , Granbichler Claudia A. , Siebert Uwe , Trinka Eugen
Published: November 2020

Several emergencies were admitted less frequently to the hospital during the coronavirus disease 2019 (COVID‐19) pandemic. To investigate whether this also occurred with status epilepticus (SE) we compared admissions due to first SE from March to April 2020 (“Time of COVID,” TOC) with January to February 2020 (“pre‐COVID,” preCOV). We also compared admission numbers in TOC and preCOV with the respective 2‐month periods in 2018 and 2019 in a retrospective cohort analysis. Two investigators independently searched the hospital patient database for various forms of SE. There was no significant change in the 2‐month incidences of first SE in the city of Salzburg from preCOV of 6.1 (95% confidence interval [CI] 2.9‐12.3) to TOC of 6.9/100 000 adults (95% CI 3.4‐13.3). Admission numbers did not differ significantly from previous years. Estimated adjusted incidence was in line with a recent 5‐year epidemiological study in Salzburg. However, a trend toward less‐frequent nonconvulsive SE (NCSE) and loss of female predominance were indirect hints of underdiagnosing SE. In contrast to other medical conditions, SE most often presents clinically with impaired consciousness, which may promote admission to emergency departments even in times of lock‐down. Further research of medical support of women and patients with NCSE during pandemic‐related restrictions is warranted.
Cross talk between drug‐resistant epilepsy and the gut microbiome
Authors: Holmes Manisha , Flaminio Zia , Vardhan Mridula , Xu Fangxi , Li Xin , Devinsky Orrin , Saxena Deepak
Published: November 2020

One‐third of epilepsy patients have drug‐resistant epilepsy (DRE), which is often complicated by polydrug toxicity and psychiatric and cognitive comorbidities. Advances in understanding the microbiome and gut‐brain‐axis are likely to shed light on epilepsy pathogenesis, anti‐seizure medication (ASM) resistance, and potential therapeutic targets. Gut dysbiosis is associated with inflammation, blood‐brain barrier disruption, and altered neuromodulators. High‐throughput and metagenomic sequencing has advanced the characterization of microbial species and functional pathways. DRE patients show altered gut microbiome composition compared to drug‐sensitive patients and healthy controls. The ketogenic and modified Atkins diets can reduce seizures in some patients with DRE. These low‐carbohydrate dietary therapies alter the taxonomic and functional composition of the gut microbiome, and composition varies between diet responders and nonresponders. Murine models suggest that specific phyla are necessary to confer efficacy from the diet, and antibiotic treatment may eliminate efficacy. The impact of diet might involve alterations in microbiota, promotion of select microbial interactions, and variance in brain neurotransmitter levels that then influence seizures. Understanding the mechanics of how diet manipulates seizures may suggest novel therapies. Most ASMs act on neuronal transmission via effects on ion channels and neurotransmitters. However, ASMs may also assert their effects via the gut microbiota. In animal models, the microbiota composition (eg, abundance of certain phyla) can vary with ASM active drug metabolites. Given the developing understanding of the gut microbiome in DRE, probiotics are another potential therapy. Probiotics alter the microbiota composition, and small studies suggest that these supplements can reduce seizures in some patients. DRE has enormous consequences to patients and society, and the gut microbiome holds promise as a potential therapeutic target. However, the exact mechanism and recognition of which patients are likely to be responders remain elusive. Further studies are warranted.
Paracrine roles of hormone receptors in Riehl’s melanosis: A quantitative analysis of oestrogen and progesterone receptor expression patterns
Authors: Woo Yu Ri , Jung Yujin , Jeong Seo Won , Park Hyun Jeong
Published: November 2020

The incidence of Riehl's melanosis (RM) is most common in the fifth or sixth decade of life with a female preponderance. As the skin is regarded a non‐reproductive organ on which sex steroid hormones act, a possible relationship between the pathogenesis of RM and sex steroid hormone receptors can be inferred. This study intended to evaluate the expression profile of oestrogen receptor (ER)β and progesterone receptor (PR) in RM. Twelve lesional and perilesional normal‐appearing skin samples of RM patients and the skin of 12 healthy controls were retrieved for the analysis. Real‐time PCR analysis and immunohistochemical studies were conducted for ERβ and PR, respectively. The lesional and perilesional normal‐appearing skin of 12 patients with RM and the skin of 12 healthy controls were retrieved for the analysis. Interestingly, the dermal ERβ immunostaining intensity was increased more in lesional skin than in perilesional skin. When compared to healthy controls, increased expression of ERβ and PR mRNAs was observed in the lesional skin of patients with RM. Of note, epidermal and dermal ERβ and dermal PR expressions showed increased staining intensities in the lesional skin of RM patients compared with healthy controls. The altered expression of ERβ and PR in RM supports the possible role of these hormone receptors in the pathogenesis of RM.
Parenting Among Rohingya and Afghan Refugee Parents Residing in Malaysia
Authors: Shaw Stacey A. , Pillai Veena , Yang Chongming , Saasa Sherinah
Published: November 2020

Objective

This study examined the measurement properties of parenting‐related measures among 140 Rohingya and Afghan refugee parents residing in Malaysia, then examined factors associated with these parenting outcomes.

Background

Unprecedented numbers of forced migrant families reside in countries of first asylum with temporary status and limited legal rights. Limited research examines parenting experiences among these communities.

Method

To examine construct validity and reliability of parenting‐related measures among this sample, we carried out confirmatory factor analysis to examine respectively the factor structure of scales measuring underlying latent constructs of Child Adjustment & Parent Efficacy, the Alabama Parenting Questionnaire, and the Family Functioning Scale. Their associations with individual (gender, age, ethnicity, education), social (marital status, number of children), and environmental factors (time in Malaysia, food insecurity, employment, and emotional distress) were examined using structural equation modeling.

Results

Residing in Malaysia for a longer period of time was associated with higher child behavioral intensity, lower parent self‐efficacy, and higher family conflict. Food insecurity was associated with lower parent self‐efficacy, and being employed was associated with positive parenting as well as poor supervision. Higher levels of emotional distress were associated with higher child behavioral intensity, lower parent self‐efficacy, and lower levels of poor supervision.

Conclusion

Displacement challenges negatively affect refugee parents and families.

Implications

Solutions are needed that bolster the abilities of forced migrants to establish permanence and provide for their families. Additionally, attention toward the unique challenges of refugee families can guide service provision within countries of first asylum.
Management guideline for Werner syndrome 2020. 7. Skin ulcer associated with Werner syndrome: Dermatological treatment
Authors: Motegi Sei‐ichiro , Takemoto Minoru , Taniguchi Toshibumi , Kubota Yoshitaka , Taniguchi Akira , Nakagami Hironori , Maezawa Yoshiro , Koshizaka Masaya , Kato Hisaya , Mori Seijiro , Tsukamoto Kazuhisa , Kuzuya Masafumi , Yokote Koutaro
Published: November 2020

Skin ulcers in Werner's syndrome often arise from hyperkeratotic lesions and trauma to pressure points such as the plantar region, and are more difficult to treat than wound healing in healthy individuals. Multiple factors contribute to the intractable skin ulcers in Werner's syndrome, including skin thinning, sclerosis, fatty tissue loss, impaired blood flow, calcification, and excessive pressure due to osteoarticular deformity. Treatment includes topical application of a keratolytic agent for keratosis around the ulcer. Treatment of ulcers is the same as for normal ulcers, and if the ulcer is associated with infection and necrotic tissue, surgical debridement with a scalpel or scissors should be performed as much as possible after washing with saline or mildly warm water or with an antibacterial agent. Topical medications that promote softening and debridement of the necrotic tissue are used with careful control of moisture in the wound. Topical agents that promote granulation should be used in wounds where necrotic tissue has been removed without infection. Dressings to maintain a moist environment in the wound may also be useful. If the wound does not improve with conservative treatment, surgical treatment should be considered. Geriatr Gerontol Int 2021; 21: 160–162.
Developing a patient safety guide for primary care: A co‐design approach involving patients, carers and clinicians
Authors: Morris Rebecca L. , Ruddock Angela , Gallacher Kay , Rolfe Carly , Giles Sally , Campbell Stephen
Published: November 2020

Background

Patients and carers should be actively involved in patient safety and empowered to use person‐centred approaches where they are asked to both identify safety concerns and partner in preventing them.

Objectives

The aim of this study was to co‐design a patient safety guide for primary care (PSG‐PC) to support patients and carers to address key patient safety questions and identify key points where they can make their care safer. The objectives were to i) identify when and how patients and carers can be involved in primary care patient safety, and ii) identify the relevant information to include in the PSG‐PC.

Design

An experience‐based co‐design approach.

Setting and Participants

We conducted three workshops with patients, carers, community pharmacists and general practitioners to develop and refine the PSG‐PC.

Results

Participants identified both explicit and implicit issues of primary care patient safety especially relating to technical and relational components of involving patients and carers. The importance of communication, understanding roles and responsibilities, and developing partnerships between patients and health‐care providers were considered essential for actively involving patients in patient safety. Co‐developing the PSG‐PC provided insight to improve care to develop the PSG‐PC.

Discussion

The PSG‐PC is the first guide to be developed for primary care, co‐designed with patients, carers, general practitioners and pharmacists. The PSG‐PC will support patients and carers to partner with health‐care professionals to improve patient safety addressing international and national priorities to continuously improve patient safety.
A review of reported cases of HIV pre‐exposure prophylaxis failure with resultant breakthrough HIV infections
Authors: To KW , Lee SS
Published: November 2020

Objectives

Early randomized controlled trials (RCTs) have confirmed high efficacy of pre‐exposure prophylaxis (PrEP) for preventing HIV infection in men who have sex with men (MSM) with high HIV exposure risk. Nevertheless, some PrEP failure cases have been reported despite adequate drug adherence. This review aims to summarize the common features of PrEP failure cases and discuss the implications of upscaling PrEP programmes.

Methods

A search based on articles and clinical trials was conducted through Medline and OVID, with keywords for accessing publications reporting ‘true’ PrEP failure in the presence of documented adherence to daily regimen of co‐formulated tenofovir disoproxil fumarate/emtricitabone.

Results

Ten cases of ‘true’ PrEP failure were identified, all of which were preceded by continued practice of condomless anal sex, despite documented adherence. Dried blood spot and/or hair analyses provided supporting evidence of adherence in eight cases. There was strong association of PrEP failure with recurrent or multiple sexually transmitted diseases and infection with resistant HIV viruses. Seroconversion was usually atypical or delayed because of significantly suppressed viral load, making diagnosis a clinical challenge.

Discussion

Although it is uncommon, ‘true’ PrEP failure can occur in a real‐world situation, contrary to the outcome of early RCTs. Failure to identify HIV infection while on PrEP can potentially lead to the emergence of drug‐resistant virus. To achieve effective HIV prevention, PrEP programmes should emphasize safer sexual practice in addition to drug adherence. Early identification of PrEP failure is crucial, which requires the development of highly sensitive assays and their clinical application.
Trichoscopic signs of tinea capitis: a guide for selection of appropriate antifungal
Authors: Genedy Rasha M. , Sorour Osama A. , Elokazy Miada A. W.
Published: November 2020

Background

Tinea capitis is the most common pediatric dermatophyte infection. Optimal treatment regimen differs according to the type of the dermatophyte involved.

Objectives

The aim of this work was to study the trichoscopic signs in relation to isolated organism in a sample of Egyptian patients with tinea capitis and the possibility of using them as a guide for selection of appropriate antifungal.

Methods

This study was carried out on 60 subjects with tinea capitis. Patients were mycologically examined, both direct microscopy with KOH preparation and culture of the scraped hair materials on Sabouraud dextrose agar. Culture mounts were used for identification of the organism. Trichoscopic examination of all patients was performed using the Dermlite DLIII dermoscope.

Results

There was significant higher prevalence of both comma and corkscrew hair in endothrix infection and T. violaceum‐infected cases. On the other hand, there was significant higher prevalence of zigzag, barcode hairs, and white sheaths in ectothrix infection and M. canis‐infected cases.

Conclusion

While some trichoscopic findings are nonspecific, others were found to be more specific. Finding zigzag hairs and barcode hairs points to ectothrix infection (M. canis), and it is recommended to start treatment with griseofulvin. On the other hand, finding comma hairs and corkscrew hairs without zigzag hairs and barcode hairs points to endothrix infection (T. violaceum), and it is recommended to start treatment with terbinafine in the usual dose.
Weight for length measures may not accurately reflect adiposity in preterm infants born appropriate for gestational age during hospitalisation or after discharge from the neonatal intensive care unit
Authors: Nagel Emily , Desjardins Christopher , Earthman Carrie , Ramel Sara , Demerath Ellen
Published: November 2020

Background

Weight/length (W/L) indices are poor surrogates for adiposity in preterm infants born appropriate for gestational age (AGA) at birth, but whether the association subsequently improves is unknown.

Objective

To determine if W/L indices accurately reflect adiposity in premature infants born AGA in later infancy.

Methods

Associations between W/L indices and fat mass, fat mass index and percent body fat (%BF) obtained via air displacement plethysmography (ADP) were examined in 260 preterm infants (majority born AGA) at 28 to 63 weeks' postmenstrual age (PMA). Accuracy of W/L indices as indicators of adiposity was assessed by proportion of variance explained (R2) and root mean square error from linear regression of adiposity on W/L indices and proportion of infants misclassified by W/L indices. Accuracy was further compared in term vs preterm infants at term‐equivalent age. The impact of early vs late preterm status on associations between W/L indices and %BF was also examined.

Results

BMI and W/L were most strongly associated with %BF but yielded poorly fitting models (maximum R2 = 0.35; 53% misclassification). A significant interaction of W/L indices and early vs late preterm status on %BF revealed that estimation of %BF differs by status. Accuracy of W/L indices was worse in preterm infants at term‐equivalent age.

Conclusions

W/L indices were not good indicators of adiposity in preterm infants from 28 to 63 weeks' PMA (born AGA) with all categories of W/L indices combined. Future research should examine whether results are similar in preterm infants born with disproportionate W/L or who experience disproportionate growth postnatally.
Attitudes towards multi‐organ donation among intensive care unit nurses in transplant hospitals
Authors: Fernández‐Alonso Víctor , Moro‐Tejedor María Nieves , Palacios‐Ceña Domingo , Paredes‐Garza Francisco , Gil‐Carrasco María Dolores , De La Matta Cantò Marina , López‐Parra Nuria , Espín‐Faba José Antonio , Torres‐González Juan Ignacio , García‐Pozo Ana
Published: November 2020

Aim

To evaluate the attitudes towards deceased multi‐organ donation and transplantation among nurses within the critical care units of the six public tertiary transplant hospitals in Madrid, Spain.

Background

Spain has a rate of 49 donations per million population, whereas Madrid has a lower donation rate of 34.2 per million population. Nurses generate social opinion, and their attitude can be one of the barriers against organ donation.

Method

An observational descriptive study was conducted among critical care units’ nurses. The measuring instrument was the Collaborative International Donor Project in Organ Donation and Transplantation. Data were collected from January to October 2019, and a statistical analysis was performed.

Results

A total of n = 313 questionnaires achieved a response rate of 51%. Of the intensive care unit nurses surveyed, 85% had a favourable opinion towards the donation of their organs being affected by psychosocial variables related to social variables with respect to family, religion and attitude towards the body.

Conclusion

The intensive care unit nurses of the Madrid transplant hospitals maintain a favourable attitude towards organ donation and transplantation. It is necessary to implement specialized training and periodically evaluate training in this sector. To maintain and improve the attitude towards organ donation, family discussion among health personnel should be encouraged. Religion influences the attitude of nurses and donation rates.

Implication for nursing and health policy

Intensive care nurses’ attitude towards organ donation is influenced by social variables. This study shows that the attitude is positive but improvable. These findings contribute to promote awareness of the lack of organs and the benefits of organ donation.
Song parameters, repertoire size and song sharing within and across age classes in the saffron finch
Authors: Benítez Saldívar María Juliana , Miño Carolina Isabel , Massoni Viviana
Published: November 2020

Birds sing mostly to attract partners or to defend territories or resources. In relation to the first function, song can vary with age if older experienced males signal their quality through their vocal output. Regarding the second function, song can also vary with age if singing behavior helps mediate social interactions through repertoire sharing with neighbors. Here, we investigate whether song parameters change with age, and in which direction, in saffron finches Sicalis flaveola pelzelni, obligate secondary cavity nesters which produce elaborate melodious songs and show delayed plumage maturation. Cross‐sectional comparisons revealed that second year (SY) males sing shorter syllables, and shorter and less versatile songs than older after second year males (ASY), as expected if the latter are more experienced singers. Longitudinal comparisons, which better depict age‐related changes, showed that as birds age one year, song length and repertoire size do not change significantly, syllable duration shortens and, as expected for experienced singers, song versatility increases. Correlations between repertoire distance and nesting distance suggest that both SY and ASY males might be adjusting their repertoires to those of ASY neighbors; the former pattern conforms to the expectations if young birds try to emulate the songs of more experienced birds, while the latter is expected if song sharing helps de‐escalating antagonistic social interactions amongst males. This research, which provides the first description of song parameters in young second year saffron finches, expands our knowledge of song variation across age classes in songbirds.
Metabolic reprogramming of glycolysis and glutamine metabolism are key events in myofibroblast transition in systemic sclerosis pathogenesis
Authors: Henderson John , Duffy Laura , Stratton Richard , Ford Dianne , O’Reilly Steven
Published: November 2020

Systemic Sclerosis (SSc) is a rare fibrotic autoimmune disorder for which no curative treatments currently exist. Metabolic remodelling has recently been implicated in other autoimmune diseases; however, its potential role in SSc has received little attention. Here, we aimed to determine whether changes to glycolysis and glutaminolysis are important features of skin fibrosis. TGF‐β1, the quintessential pro‐fibrotic stimulus, was used to activate fibrotic pathways in NHDFs in vitro. Dermal fibroblasts derived from lesions of SSc patients were also used for in vitro experiments. Parameters of glycolytic function were assessed using by measuring extracellular acidification in response to glycolytic activators/inhibitors, whilst markers of fibrosis were measured by Western blotting following the use of the glycolysis inhibitors 2‐dg and 3PO and the glutaminolysis inhibitor G968. Succinate was also measured after TGF‐β1 stimulation. Itaconate was added to SSc fibroblasts and collagen examined. TGF‐β1 up‐regulates glycolysis in dermal fibroblasts, and inhibition of glycolysis attenuates its pro‐fibrotic effects. Furthermore, inhibition of glutamine metabolism also reverses TGF‐β1‐induced fibrosis, whilst glutaminase expression is up‐regulated in dermal fibroblasts derived from SSc patient skin lesions, suggesting that enhanced glutamine metabolism is another aspect of the pro‐fibrotic metabolic phenotype in skin fibrosis. TGF‐β1 was also able to enhance succinate production, with increased succinate shown to be associated with increased collagen expression. Incubation of SSc cells with itaconate, an important metabolite, reduced collagen expression. TGF‐β1 activation of glycolysis is a key feature of the fibrotic phenotype induced by TGF‐B1 in skin cells, whilst increased glutaminolysis is also evident in SSc fibroblasts.
MAIR‐II deficiency ameliorates cardiac remodelling post‐myocardial infarction by suppressing TLR9‐mediated macrophage activation
Authors: Yonebayashi Saori , Tajiri Kazuko , Murakoshi Nobuyuki , Xu Dongzhu , Li Siqi , Feng Duo , Okabe Yuta , Yuan Zixun , Song Zonghu , Aonuma Kazuhiro , Shibuya Akira , Aonuma Kazutaka , Ieda Masaki
Published: November 2020

Macrophages are fundamental components of inflammation in post‐myocardial infarction (MI) and contribute to adverse cardiac remodelling and heart failure. However, the regulatory mechanisms in macrophage activation have not been fully elucidated. Previous studies showed that myeloid‐associated immunoglobulin–like receptor II (MAIR‐II) is involved in inflammatory responses in macrophages. However, its role in MI is unknown. Thus, this study aimed to determine a novel role and mechanism of MAIR‐II in MI. We first identified that MAIR‐II–positive myeloid cells were abundant from post‐MI days 3 to 5 in infarcted hearts of C57BL/6J (WT) mice induced by permanent left coronary artery ligation. Compared to WT, MAIR‐II–deficient (Cd300c2−/−) mice had longer survival, ameliorated cardiac remodelling, improved cardiac function and smaller infarct sizes. Moreover, we detected lower pro‐inflammatory cytokine and fibrotic gene expressions in Cd300c2−/−‐infarcted hearts. These mice also had less infiltrating pro‐inflammatory macrophages following MI. To elucidate a novel molecular mechanism of MAIR‐II, we considered macrophage activation by Toll‐like receptor (TLR) 9–mediated inflammation. In vitro, we observed that Cd300c2−/− bone marrow–derived macrophages stimulated by a TLR9 agonist expressed less pro‐inflammatory cytokines compared to WT. In conclusion, MAIR‐II may enhance inflammation via TLR9‐mediated macrophage activation in MI, leading to adverse cardiac remodelling and poor prognosis.
Speciation‐by‐depth on coral reefs: Sympatric divergence with gene flow or cryptic transient isolation?
Authors: Prada Carlos , Hellberg Michael E.
Published: November 2020

The distributions of many sister species in the sea overlap geographically but are partitioned along depth gradients. The genetic changes leading to depth segregation may evolve in geographic isolation as a prerequisite to coexistence or may emerge during primary divergence leading to new species. These alternatives can now be distinguished via the power endowed by the thousands of scorable loci provided by second‐generation sequence data. Here, we revisit the case of two depth‐segregated, genetically isolated ecotypes of the nominal Caribbean candelabrum coral Eunicea flexuosa. Previous analyses based on a handful of markers could not distinguish between models of genetic exchange after a period of isolation (consistent with secondary contact) and divergence with gene flow (consistent with primary divergence). Analyses of the history of isolation, genetic exchange and population size based on 15,640 new SNP markers derived from RNAseq data best support models where divergence began 800K BP and include epochs of divergence with gene flow, but with an intermediate period of transient isolation. Results also supported the previous conclusion that recent exchange between the ecotypes occurs asymmetrically from the Shallow lineage to the Deep. Parallel analyses of data from two other corals with depth‐segregated populations (Agaricia fragilis and Pocillopora damicornis) suggest divergence leading to depth‐segregated populations may begin with a period of symmetric exchange, but that an epoch of population isolation precedes more complete isolation marked by asymmetric introgression. Thus, while divergence‐with‐gene flow may account for much of the differentiation that separates closely related, depth‐segregated species, it remains to be seen whether any critical steps in the speciation process only occur when populations are isolated.
ALL‐CAPS
Authors: Arbel Yonathan A. , Toler Andrew
Published: November 2020

A hallmark of consumer contracts is their use of long blocks of capitalized text. These “all‐caps” clauses are meant to alert consumers to nonstandard, risky, or important aspects of the transaction that would otherwise be hidden in the fine print. Based on a belief in the power of all‐caps, courts will often deny enforcement of many key terms—such as warranty disclaimers, liability releases, arbitration clauses, and automatic billing—unless they are presented in all‐caps. This article is the first to empirically examine the effectiveness of all‐caps. Using an experimental methodology, the article finds that all‐caps fail to appreciably improve consent. Moreover, some evidence suggests that all‐caps are harmful to older consumers. We collect evidence from standard form agreements used by the largest companies in the United States and find that, despite its limitations, three‐quarters of consumer contracts contain at least one all‐caps paragraph. Based on these findings and other evidence reported here, this article lays out the dangers and risks of continued reliance on all‐caps and calls for abandoning all‐caps.
Prevalence and risk factors of metabolic associated fatty liver disease among people living with HIV in China
Authors: Liu Danping , Shen Yinzhong , Zhang Renfang , Xun Jingna , Wang Jiangrong , Liu Li , Steinhart Corklin , Chen Jun , Lu Hongzhou
Published: November 2020

Background and Aim

The new definition for metabolic associated fatty liver disease (MAFLD), formerly named non‐alcoholic fatty liver disease (NAFLD), would undoubtedly have significant influence on diagnosis, epidemiology, and new drug research. We investigated the prevalence and risk factors of MAFLD among people living with HIV (PLWH).

Methods

In this cross‐sectional study, transient elastography was performed in PLWH without significant alcohol intake and hepatitis B virus and hepatitis C virus infection. NAFLD was diagnosed as controlled attenuation parameter (CAP) ≥ 248 dB/m by transient elastography, and MAFLD was defined according to the 2020 international consensus. Advanced fibrosis was defined as liver stiffness measurement (LSM) ≥ 10 kPa.

Results

Among the 361 PLWH enrolled, the prevalence of NAFLD and MAFLD were 37.67% and 34.90%, respectively. Compared with the non‐MAFLD group, the prevalence of elevated alanine aminotransferase (ALT) level (44.44% vs 16.17%, P < 0.001) and advanced fibrosis (19.05% vs 2.55%, P < 0.001) were significantly higher in the MAFLD group. A positive correlation between LSM and CAP values was found in the MAFLD group (rs = 0.350, P < 0.001) but not in the non‐MAFLD group. In multivariate analysis, independent risk predictors for MAFLD were higher ALT level (odds ratio [OR] 1.015, 95% confidence interval [CI] 1.003–1.028, P = 0.018), higher uric acid (OR 1.005, 95% CI 1.002–1.009, P = 0.003), higher total cholesterol (OR 1.406, 95% CI 1.029–1.921, P = 0.032), and greater waist–height ratio (OR 1.291, 95% CI 1.196–1.393, P < 0.001).

Conclusions

A third of PLWH had MAFLD, which was highly accordant with the prevalence of NAFLD. Routine screening for MAFLD is necessary in PLWH.
Update to limits to growth: Comparing the World3 model with empirical data
Authors: Herrington Gaya
Published: November 2020

In the 1972 bestseller Limits to Growth (LtG), the authors concluded that, if global society kept pursuing economic growth, it would experience a decline in food production, industrial output, and ultimately population, within this century. The LtG authors used a system dynamics model to study interactions between global variables, varying model assumptions to generate different scenarios. Previous empirical‐data comparisons since then by Turner showed closest alignment with a scenario that ended in collapse. This research constitutes a data update to LtG, by examining to what extent empirical data aligned with four LtG scenarios spanning a range of technological, resource, and societal assumptions. The research benefited from improved data availability since the previous updates and included a scenario and two variables that had not been part of previous comparisons. The two scenarios aligning most closely with observed data indicate a halt in welfare, food, and industrial production over the next decade or so, which puts into question the suitability of continuous economic growth as humanity's goal in the twenty‐first century. Both scenarios also indicate subsequent declines in these variables, but only one—where declines are caused by pollution—depicts a collapse. The scenario that aligned most closely in earlier comparisons was not amongst the two closest aligning scenarios in this research. The scenario with the smallest declines aligned least with empirical data; however, absolute differences were often not yet large. The four scenarios diverge significantly more after 2020, suggesting that the window to align with this last scenario is closing.
Understanding relative metal prices and availability: Combining physical and economic perspectives
Authors: Watson Brett J. , Eggert Roderick G.
Published: November 2020

Scientists typically use physical indicators, such as average crustal abundance, and energy requirements in production, as measures of the availability of mineral resources. Economists, on the other hand, typically rely on measures such as prices, and extraction costs. This study investigates the role of crustal abundance, energy requirements, and other physical indicators in determining relative metal prices. The relationship between prices, and physical indicators is estimated statistically for a sample of 22 chemical elements over the period 1970–2013 using an economic market model. The results suggest that energy requirements in production explain 43% of observed variation in metal prices, crustal abundance 21%, and other physical indicators (toxicity, native metal status, and melting point) combine to explain 12% of the observed differences in metal prices.
Complex genomic alterations and intellectual disability: an interpretative challenge
Authors: Silipigni R. , Milani D. , Tolva G. , Monfrini E. , Giacobbe A. , Marchisio P. G. , Guerneri S.
Published: November 2020

Background

Complex chromosomal rearrangements (CCRs) are structural rearrangements involving more than three chromosomes or having more than two breaks; approximately 70% are not associated with any clinical phenotype. Here, we describe a CCR segregating in a two‐generation family.

Method

A 4‐year‐old male was evaluated for developmental delay, mild intellectual disability and epicanthus. Karyotype, fluorescence in situ hybridisation (FISH) analysis and array comparative genomic hybridisation (aCGH) analysis were performed on the patient and of all family members.

Result

Array CGH analysis of the proband detected two non‐contiguous genomic gains of chromosome 2 at bands q32.3q33.2 and bands q36.1q36.3. Both karyotype and FISH analysis revealed a recombinant chromosome 2 with a direct insertion of regions q32.3q33.2 and q36.1q36.3 into region q12. Both of these regions were also present in their original location. Karyotype and FISH analysis of the father revealed a de novo direct insertion of regions q32.3q33.2 and q36.1q36.3 into region q12. Moreover, a de novo balanced translocation involving the q arm of the same chromosome 2 and the p arm of chromosome 10 was observed in the father of the proband. The single nucleotide polymorphism (SNP) array analysis and haplotype reconstruction confirmed the paternal origin of the duplications. Karyotype, FISH analysis and array CGH analysis of other family members were all normal.

Conclusion

This report underlines the importance of using different methods to correctly evaluate the origin and the structure of CCRs in order to provide an appropriate management of the patients and a good estimation of the reproductive risk of the family.
Validation of a new hand function outcome measure in individuals with Charcot‐Marie‐Tooth disease
Authors: Prada Valeria , Robbiano Giulia , Mennella Giulia , Hamedani Mehrnaz , Bellone Emilia , Grandis Marina , Schenone Angelo , Zuccarino Riccardo
Published: November 2020

The symptomatology of Charcot‐Marie‐Tooth (CMT) disease mainly involves the feet and the hands. To date, there is no consensus on how to evaluate hand function in CMT. The aim of this study is to correlate the data of the engineered glove Hand Test System (HTS) with specific tests and the CMT examination score (CMTES). We analyzed 45 patients with the diagnosis of CMT using HTS, which measures the hand dexterity by specific sequences performed at maximum velocity. We completed the evaluation with the CMTES, tripod pinch and hand grip strength tested by a dynamometer, thumb opposition test (TOT), and Sollerman Hand function test (SHFT), and we conducted a test‐retest with 20 normal subjects. Finger tapping (FT) and index‐medium‐ring‐little (IMRL) sequence showed a significant correlation with CMTES (FT: dominant hand (DH): P = .036; non‐dominant hand (NDH): P = .033; IMRL: DH: P = .009; NDH: P = .046). TOT correlated with CMTES significantly in both hands (P < .0001). tripod pinch showed a statistically significant correlation with CMTES (DH: P = .002; NDH: P = .005). Correlation between the hand grip and CMTES was significant only in DH (DH: P = .002). SHFT had a significant correlation with the CMTES (DH: P = .002). Test‐retest showed a good reliability. HTS parameters correlate with CMTES confirming that this tool is sensitive to the hand deficits. In conclusion, we can state that HTS is a good, simple to use, and objective instrument to evaluate the hand function of CMT patients, but more studies on responsiveness and sensitivity are needed.
A simple nuclear contrast staining method for microCT‐based 3D histology using lead(II) acetate
Authors: Metscher Brian
Published: November 2020

X‐ray microtomography (microCT) enables histological‐scale 3D imaging of many types of biological samples, but it has yet to rival traditional histology for differentiation of tissue types and cell components. This report presents prima facie results indicating that a simple lead(II) acetate staining solution can impart preferential X‐ray contrast to cell nuclei. While not strictly selective for nuclei, the staining reflects local cell‐density differences. It can be applied in a single overnight treatment and does not require hematoxylin staining or drying of the sample. The stain is removable with EDTA, and it may enhance early calcifications. A basic protocol is given as a guide for further testing and optimization.