bluuebunny/crossref_metadata_2025 huggingface dataset:
A study of the diffusion behaviour of reactive dyes in cellulose fibres using confocal Raman microscopy
Authors: Yang Binfan , Dai Yamin , Zhong Yi , Zhang Linping , Xu Hong , Wang Bijia , Sui Xiaofeng , Feng Xueling , Chen Zhize , Mao Zhiping
Published: November 2020

Confocal Raman microscopy was used as a non‐destructive tool for in situ investigation of the diffusion of CI Reactive Blue 194 in viscose fibres. Dyed fibres were analysed by Raman depth imaging along the radius at different dyeing times (30, 60, 90, 120, 150, 180, 240, 300, 600, 900, 1200, 1500, 1800, 2100 and 2400 seconds) and temperatures (30, 40, 50, 60, 70 and 80°C). The dye concentration in the fibre was expressed by normalising the characteristic peak of dyes at 1577 cm−1 to eliminate the interference of the fibre. The Raman depth mapping images showed that dye molecules gradually diffused to the interior of the fibre with an increase in dyeing time, remaining ring‐shaped in the state of diffusion. In addition, the diffusion rate increased with increases in the dyeing temperature. This was understandable because dye molecules with a higher kinetic energy move faster. It was also found that the external structure of fibres played a significant role in the diffusion behaviour of CI Reactive Blue 194 during the initial stage of dyeing. The concentration gradient distribution of CI Reactive Blue 194 in the fibre was reflected by Raman depth mapping. The study demonstrates the potential of confocal Raman microscopy for monitoring the dynamic diffusion of dye molecules in fibres.
Optimizing Precision of Hypertension Care to Maximize Blood Pressure Control: A Pilot Study Utilizing a Smartphone App to Incorporate Plasma Renin Activity Testing
Authors: Mehanna Mai , Chen Yiqing E. , Gong Yan , Handberg Eileen , Roth Brittney , De Leon Jessica , Smith Steven M. , Harrell Jonathan G. , Cooper‐DeHoff Rhonda M.
Published: November 2020

Only half of patients with hypertension (HTN) respond to any given antihypertensive medication. Heterogeneity in pathophysiologic pathways underlying HTN is a major contributor. Personalizing antihypertensive therapy could improve blood pressure (BP) reduction. The objective of this study was to assess the effect of pragmatic implementation of a personalized plasma renin activity (PRA)‐based smartphone app on improving BP reduction. Patients with untreated or treated but uncontrolled HTN were recruited. BP and PRA were measured at baseline with final BP measured at 6 months. Patient’s information was entered into the app and treatment recommendations were returned. Clinicians were at liberty to follow or disregard the app’s recommendations. BP levels and percent BP control among patients whose clinicians did and did not follow the app’s recommendations were compared using independent t‐test and Fisher’s exact test, respectively. Twenty‐nine European American patients were included (38% women) with mean age of 52 ± 9 years and median PRA of 1.3 ng/mL/hr (interquartile range 0.5–3.1 ng/mL/hr). Participants whose clinicians followed the app’s recommendations (n = 16, 55%) as compared with those whose clinicians did not (n = 13, 45%), had a greater reduction in 6‐month systolic BP (−15 ± 21 vs. −3 ± 21 mm Hg; adjusted‐P = 0.1) and diastolic BP (−8 ± 8 vs. −1 ± 8 mm Hg; adjusted‐P = 0.04). BP control at 6 months tended to be greater among patients whose clinicians accepted the app’s recommendations vs. those whose clinicians did not (63% vs. 23%, P = 0.06). This pilot study demonstrates that acceptance of the app’s recommendations was associated with a greater BP reduction. Future studies to confirm these pilot findings are warranted.
Modeling neurodevelopment in a dish with pluripotent stem cells
Authors: Imaizumi Kent , Okano Hideyuki
Published: November 2020

Pluripotent stem cells (PSCs) can differentiate into all cell types in the body, and their differentiation procedures recapitulate the developmental processes of embryogenesis. Focusing on neurodevelopment, we describe here the application of knowledge gained from embryology to the neural induction of PSCs. Furthermore, PSC‐based neural modeling provides novel insights into neurodevelopmental processes. In particular, human PSC cultures are a powerful tool for the study of human‐specific neurodevelopmental processes and could even enable the elucidation of the mechanisms of human brain evolution. We also discuss challenges and potential future directions in further improving PSC‐based neural modeling.
Disordered eating in women with type 1 diabetes: Continuous glucose monitoring reveals the complex interactions of glycaemia, self‐care behaviour and emotion
Authors: Rama Chandran Suresh , Zaremba Natalie , Harrison Amy , Choudhary Pratik , Cheah Yee , Allan Jacqueline , Debong Fredrik , Reid Fiona , Treasure Janet , Hopkins David , Ismail Khalida , Stadler Marietta
Published: November 2020

Objectives

Glycaemia in people with type 1 diabetes and disordered eating is not well characterised. We explored the glycaemia, self‐care behaviour and emotional state of women with type 1 diabetes and disordered eating.

Research design and methods

In all, 13 women with and 10 without disordered eating and type 1 diabetes participated in this case–control study. We used a mixed‐methods approach with a 7‐day blinded continuous glucose monitoring and real‐time record of non‐prompted capillary glucose (CG), emotion, activity and physical symptoms on a diabetes diary using a smartphone application (mySugr®). We compared groups using Mann–Whitney U test or Fisher's exact test. We conducted thematic analyses of free‐text diary entries (NVivo®) and quantitative analysis of emotion/symptom tags.

Results

People with type 1 diabetes and disordered eating spent longer time above range in level 2 hyperglycaemia (>13.9 mmol/L, Median [interquartile range]: 21% [16,60] vs 5% [2,17], p = 0.015). They had lower time in range and similar time below range compared to those without disordered eating. The standard deviation of CG was significantly higher in the disordered eating group (4.7 mmol/L [4.5, 6.1] vs 3 [2.8, 3.2], p = 0.018). The median of the percentage of rising sensor glucose trends was three times higher in the disordered eating group. They also had higher negative emotional and physical symptoms associated with high blood glucose (>15 mmol/L).

Conclusions

Disordered eating has a significant impact on the glycaemia and emotion of a person with type 1 diabetes.
Risk of developing diabetes in patients with atrial fibrillation taking non‐vitamin K antagonist oral anticoagulants or warfarin: A nationwide cohort study
Authors: Huang Huei‐Kai , Liu Peter Pin‐Sung , Lin Shu‐Man , Hsu Jin‐Yi , Peng Carol Chiung‐Hui , Munir Kashif M. , Wu Ting‐Yu , Yeh Jih‐I , Loh Ching‐Hui , Tu Yu‐Kang
Published: November 2020

Aim

To compare the risk of diabetes development in patients with atrial fibrillation (AF) treated with non‐vitamin K antagonist oral anticoagulants (NOACs) and warfarin.

Materials and Methods

We conducted a nationwide retrospective cohort study using Taiwan's National Health Insurance Research Database. Adult patients with new onset of AF, treated with NOACs or warfarin between 2012 and 2016, were included. The NOAC cohort was further divided into dabigatran, rivaroxaban and apixaban groups. The primary outcome was incident diabetes requiring treatment with antidiabetic drugs. Fine and Gray subdistribution hazards models were used to estimate the adjusted hazard ratio (aHR). Propensity score matching was performed for each head‐to‐head comparison.

Results

A total of 10 746 new‐onset AF patients were included in our study. During the mean 2.4‐year follow‐up, NOACs were associated with a lower risk of developing diabetes than warfarin (aHR = 0.80, 95% confidence interval [CI]: 0.68‐0.94, P = .007). Subgroup analyses confirmed that dabigatran, rivaroxaban and apixaban each had a reduced diabetes risk. Stratified analyses showed that the lower risk of diabetes associated with NOAC treatment was specific to patients aged 65 years or older (aHR = 0.74, 95% CI: 0.62‐0.89, P = .002) and those with good medication adherence (aHR = 0.70, 95% CI: 0.58‐0.84, P < .001).

Conclusions

Taking an NOAC was associated with a lower risk of developing diabetes than taking warfarin in patients with AF.
Real‐world use of cardioprotective glucose‐lowering drugs in patients with type 2 diabetes and cardiovascular disease: A Danish nationwide cohort study, 2012 to 2019
Authors: Funck Kristian L. , Knudsen Jakob S. , Hansen Troels K. , Thomsen Reimar W. , Grove Erik L.
Published: November 2020

Aims

To investigate temporal trends in time to initiation of sodium‐glucose co‐transporter‐2 inhibitors and glucagon‐like peptide 1 analogues (cardioprotective glucose‐lowering drugs [GLDs]) in patients with a new dual diagnosis of type 2 diabetes (T2DM) and cardiovascular disease (CVD).

Materials and methods

In a cohort study, we identified patients with a new dual diagnosis of T2DM and CVD using linked healthcare data from nationwide registries on drug prescriptions and diagnosis codes. For each calendar year between 2012 and 2018, we examined time to initiation and cumulative user proportions (CUPs) for cardioprotective GLD use 1 and 2 years after the dual diagnosis.

Results

Among all individuals living in Denmark in the period 2012 to 2018, 41 733 patients with a new dual diagnosis of T2DM and CVD were identified (median [interquartile range] age 71 [64–79] years, 61% male, and 57% with CVD as the latest diagnosis). Incidence curve slopes and 1‐ and 2‐year CUPs for cardioprotective GLDs increased during the study period (1‐year CUP 4.0%, 95% confidence interval [CI] 3.6–4.5) in 2012 to 14.7, 95% CI 13.7–15.7, in 2018; 2‐year CUP 5.5, 95% CI 5.0–6.1, in 2012 to 16.7, 95% CI 15.8–17.7, in 2017). T2DM patients with CVD as the second (latest) diagnosis had higher 1‐year CUPs than CVD patients with T2DM as the latest diagnosis: 2012: 7.0 (95% CI 6.2–8.0) versus 1.4 (95% CI 1.0–1.8); 2018: 18.1 (95% CI 16.8–19.6) versus 10.0 (95% CI 8.8‐11.3).

Conclusions

In patients with T2DM and CVD, the incidence of cardioprotective GLD initiation increased between 2012 and 2018, however, within 2 years of dual diagnosis, it remained low.
Speckle tracking echocardiography in the indeterminate form of Chagas disease
Authors: Cianciulli Tomás Francisco , Albarracín Gerardo Ariel , Napoli Llobera Mariano , Prado Nilda Graciela , Saccheri María Cristina , Hernández Vásquez Yolanda María , Méndez Ricardo José , Beck Martín Alejandro , Baez Karina Giselle , Balletti Lorena Romina
Published: November 2020

Background

Chagas disease is one of the most common diseases in Latin‐America, and cardiac involvement is a significant cause of death. Assessment of myocardial strain may detect early myocardial damage.

Objectives

To determine differences in longitudinal strain using speckle tracking to assess regional and global left ventricular function in patients with the indeterminate form of Chagas disease, in comparison with a control group.

Methods

This is a retrospective matched case–control study, conducted in a single center. We evaluated 45 adult patients with Chagas disease, diagnosed with 2 serological methods, without evidence of cardiac involvement, who were compared with 45 healthy control subjects, who were sex‐ and age‐matched. All patients underwent Doppler echocardiography and longitudinal strain with speckle tracking.

Results

Median age was 59 years, and 60% were female. Echocardiographic parameters were similar in patients with Chagas and control subjects. In patients with Chagas, global strain differed significantly from that of control subjects (−17 vs −20.3, P < .001). Segmental strain showed 7 abnormal segments in patients with Chagas (P < .05).

Conclusions

In patients with the indeterminate form of Chagas disease, global and segmental longitudinal peak systolic strain is reduced compared with healthy subjects, thus suggesting that it could be a sensitive technique to detect early myocardial damage. These findings could provide useful information regarding the pathophysiology of cardiac involvement and understand whether they might have prognostic usefulness or help develop strategies to modify the course and prognosis of patients with Chagas disease. A longitudinal prospective study would be necessary to validate our findings.
Increased frequency of proinflammatory CD4 T cells and pathological levels of serum neurofilament light chain in adult drug‐resistant epilepsy
Authors: Ouédraogo Oumarou , Rébillard Rose‐Marie , Jamann Hélène , Mamane Victoria Hannah , Clénet Marie‐Laure , Daigneault Audrey , Lahav Boaz , Uphaus Timo , Steffen Falk , Bittner Stefan , Zipp Frauke , Bérubé Arline , Lapalme‐Remis Samuel , Cossette Patrick , Nguyen Dang Khoa , Arbour Nathalie , Keezer Mark R. , Larochelle Catherine
Published: November 2020

Objective

Adult drug‐resistant epilepsy (DRE) is associated with significant morbidity. Infiltration of immune cells is observed in DRE epileptic foci; however, the relation between DRE and the peripheral immune cell compartment remains only partially understood. We aimed to investigate differences in immune cell populations, cytokines, and neurodegenerative biomarkers in the peripheral blood of subjects with epilepsy versus healthy controls, and in DRE compared to well‐controlled epilepsy (WCE).

Methods

Peripheral blood mononuclear cells and serum from >120 age‐ and sex‐matched adults suffering from focal onset epilepsy and controls were analyzed by multipanel flow cytometry, multiplex immunoassays, and ultrasensitive single molecule array.

Results

Using a data‐driven analytical approach, we identified that CD4 T cells in the peripheral blood are present in a higher proportion in DRE patients. Moreover, we observed that the frequency of CD4 T cells expressing proinflammatory cytokines interleukin (IL)‐17A, IL‐22, tumor necrosis factor, interferon‐γ, and granulocyte‐macrophage colony–stimulating factor, but not anti‐inflammatory cytokines IL‐10 and IL‐4, is elevated in the peripheral blood of DRE subjects compared to WCE. In parallel, we found that Th17‐related circulating proinflammatory cytokines are elevated, but Th2‐related cytokine IL‐4 is reduced, in the serum of epilepsy and DRE subjects. As Th17 cells can exert neurotoxicity, we measured levels of serum neurofilament light chain (sNfL), a marker of neuronal injury. We found significantly elevated levels of sNfL in DRE compared to controls, especially among older individuals.

Significance

Our data support that DRE is associated with an expansion of the CD4 Tcell subset in the peripheral blood and with a shift toward a proinflammatory Th17/Th1 CD4 Tcell immune profile. Our results further show that pathological levels of sNfL are more frequent in DRE, supporting a potential neurodegenerative component in adult DRE. With this work, we provide evidence for novel potential inflammatory and degenerative biomarkers in DRE.
Effect of behavioral intervention on medication adherence among elderly with select non‐communicable diseases (ENDORSE): Pilot randomized controlled trial
Authors: Raj Jeffrey P , Mathews Betsy
Published: November 2020

Aim

Adherence to medication is important in older patients with non‐communicable diseases, and there is a need to investigate various interventions to enhance adherence in our Indian setting. This pilot randomized controlled trial aimed at testing the effectiveness of systematic education and behavioral intervention in enhancing medication adherence among older adults.

Methods

It was a single center, open label, parallel arm, randomized controlled trial carried out among older (age >60 years) inpatients of general medicine wards diagnosed with select non‐communicable diseases, such as diabetes, hypertension, dyslipidemia and coronary artery disease. Participants were randomized either to receive the usual standard of care or the intervention that comprises of systematic education, patient diary to mark daily medicine intake and periodic telephone reminders. Barriers to medication adherence were identified and interventions were tailored according to the identified barriers over a 6‐month follow‐up period. The primary end‐points were change in the reported pill count (RPC) within groups and between groups at the third and sixth month.

Results

The RPC in control and intervention arms at the thrid month were 78.20% and 91.88% (P = 0.007), whereas at 6 months they were 68.64% and 83.08% (P = 0.003), respectively. Similarly, change in RPC in intervention arm between baseline and the third month (mean difference 24.08%, P = 0.001), and between baseline and the sixth month (mean difference 15.280%, P = 0.006) were statistically significant. However, the RPC between the third and sixth month showed a significant decline (mean difference 8.8%, P = 0.016).

Conclusion

In this pilot study, we prove that behavioral interventions have improved medication adherence among older adults, and it is feasible to carry out such studies among older adults in India. Geriatr Gerontol Int 2020; 20: 1079–1084.
Dermatologic manifestations of COVID‐19: a comprehensive systematic review
Authors: Mirza Fatima N. , Malik Amyn A. , Omer Saad B. , Sethi Aisha
Published: November 2020

Recent reports have suggested that there may be dermatologic manifestations of COVID‐19. We searched 12 databases for peer‐reviewed or pre‐print published studies until July 15, 2020, for this PRISMA‐compliant review (CRD42020182050). We used the Oxford Center for Evidence‐Based Medicine Levels of Evidence to facilitate data synthesis. From 86 retrieved studies, we collated data on 2,560 patients with dermatologic manifestations of COVID‐19. The most common findings were chilblains/pernio‐like lesion (51.5%), erythematous maculopapular rashes (13.3%), and viral exanthem (7.7%). Average pediatric age was 12.9 years (SD 3.6) and adult was 34.2 years (SD 21.8). Average latency from time of upper respiratory illness symptoms to cutaneous findings was 1.5 days (SD 2.9) in children and 7.9 days (SD 10.7) in adults, ranging from −3 to 38 days. Roughly one‐tenth in both populations were otherwise asymptomatic or presented with only skin findings for the entirety of the disease course; 13.3% (pediatrics) and 5.3% (adults) presented with skin issues first. Dermatologic findings may play an important role in identifying cases early and serve as an important proxy to manage spread. Further prospective data collection with international prospective registries is needed.
Binturong Arctictis binturong conservation: the relationship between the zoo community and ABConservation for an integrated conservation programme in Palawan, Philippines
Authors: Bourgeois A. , Kayser P. , Debruille A. , Veron G.
Published: November 2020

Zoological institutions play an ever‐greater role in awareness of biodiversity and are increasingly involved in conservation initiatives. The Binturong Arctictis binturong is an elusive and poorly known carnivore of the family Viverridae, found in South East Asian ecosystems. This species, affected by diverse human‐related threat processes, is listed as Vulnerable on the International Union for Conservation of Nature Red List. This paper reports on the collaborative efforts involving the Binturong European Endangered Species Programme, the French non‐governmental organization ABConservation, the European Association of Zoos and Aquaria, the zoo community and researchers at the Museum National d'Histoire Naturelle, Paris (France), all aimed at the conservation of Binturongs. The resulting multidisciplinary initiatives allow the development of an integrated conservation programme for this species in Palawan (Philippines), including community awareness, education programmes, research projects and empowerment of range communities in nature conservancy. Zoos contributed significantly to the development of the field initiatives of ABConservation. Participation of zoos in field programmes for conservation is beneficial for both parties, because zoos support conservation through funding, raising awareness and expertise, and at the same time they acquire increased knowledge about the species they have in their care, and gain relevance in defining their role and missions.
Impact of EndoRings on colon adenoma detection rate: A meta‐analysis of randomized trials
Authors: Facciorusso Antonio , Mohan Babu P , Crinò Stefano Francesco , Muscatiello Nicola
Published: November 2020

Background and Aim

Evidence of a superior efficacy of EndoRings over standard colonoscopy in improving colon adenoma detection rate is lacking. We aimed to compare EndoRings and standard colonoscopy through a pairwise meta‐analysis of randomized trials.

Methods

We searched the PubMed/Medline and Embase database through July 2020 and identified five randomized controlled trials (recruiting 2751 patients). The primary outcome was adenoma detection rate; secondary outcomes included advanced and sessile serrated adenoma detection rate, mean adenoma per colonoscopy, cecal intubation rate, and time. We performed pairwise meta‐analysis through a random‐effects model and expressed data as risk ratio and 95% confidence interval.

Results

Overall, pooled adenoma detection rate was 53.9% (49–58.8%) with EndoRings and 49.1% (42–56.1%) with standard colonoscopy (risk ratio 1.05, 0.95–1.17). Advanced adenoma detection (risk ratio 0.91, 0.74–1.12), sessile serrated detection rate (risk ratio 1.10, 0.81–1.50), and polyp detection rate (risk ratio 1.06, 0.98–1.15) were similar between the two groups. Likewise, mean adenoma per colonoscopy (mean difference 0.17, −0.09 to 0.43), cecal intubation rate (risk ratio 1.00, 0.99–1.01), and cecal intubation time (mean difference 0.20 min, −0.34 to 0.74) did not differ between the two add‐on devices. No serious adverse event was observed.

Conclusion

EndoRings did not seem to significantly improve the diagnostic performance of colonoscopy. Further trials are needed to confirm these results.
Features associated with high‐risk sessile serrated polyps at index and follow‐up colonoscopy
Authors: Anwar Shahzaib , Cock Charles , Young Joanne , Young Graeme P , Meng Rosie , Simpson Kalindra , Coats Michelle , Huang Junming , Bampton Peter , Fraser Robert , Symonds Erin L
Published: November 2020

Background and Aim

Clinically significant serrated polyps are precursors of colorectal cancers, with features considered high risk including size ≥10 mm, dysplasia, and presence of synchronous conventional adenoma. While these features have been described in cohorts undergoing screening colonoscopy, there is little information regarding the prevalence and patient characteristics associated with high‐risk sessile serrated polyps (SSPs) in those undergoing surveillance colonoscopy.

Methods

Polyp pathology at the index and first follow‐up colonoscopy performed between 2004 and 2019 were examined in patients enrolled in a surveillance program because of an index finding of adenoma and/or SSP. Demographics and pathology features for SSP were compared between the colonoscopies.

Results

Of 6297 patients undergoing index colonoscopy, 2035 underwent follow‐up colonoscopy after 3.3 years (interquartile range 2.1–4.8 years). The proportion with SSP decreased from 7.6% at index to 5.0% at follow‐up (P < 0.001); however, the proportion of SSPs that were considered high risk was not different between the colonoscopies (62.8% vs 62.4%). Female gender was associated with the presence of high‐risk SSP at index colonoscopy (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.28–2.06), while age ≥75 years (OR 3.38, 95% CI 1.67–6.81) and previous high‐risk SSP (OR 9.40, 95% CI 4.23–20.88) were independently associated with high‐risk SSP at follow‐up.

Conclusions

The prevalence of SSP falls by one‐third at first follow‐up colonoscopy although the proportion of SSP with high‐risk features remains the same. While females were more likely to have a high‐risk SSP at the index colonoscopy, those at greatest risk for high‐risk SSP at follow‐up colonoscopy were age >75 years and an index high‐risk SSP.
Development and validation of the fall risk perception questionnaire for patients in acute care hospitals
Authors: Choi Jieun , Choi Se Min , Lee Jeong Sin , Seo Soon Seok , Kim Ja Yeon , Kim Hye Young , Kim Sung Reul
Published: November 2020

Aims and objectives

This study aimed to develop a fall risk perception questionnaire for patients admitted to acute care hospitals and to establish its reliability and validity.

Background

To prevent falls during patients’ hospitalisation, it is essential for them to accurately perceive their risk of falling.

Design

This methodological study was performed to develop a fall risk perception questionnaire.

Methods

After generating a preliminary questionnaire, two rounds of content validity testing were performed with nine experts. Following a pilot test, a convenience sample of 236 participants was recruited from an acute care hospital between 2 May 2018 and 15 December 2019. Construct, convergent and known‐group validity of the questionnaire was evaluated, and reliability was estimated by calculating the internal consistency reliability coefficients. The study adhered to STROBE guidelines.

Results

Exploratory factor analysis yielded a three‐factor solution with 27 items. The questionnaire showed statistically significant positive correlation with the Korean Falls Efficacy Scale‐International and the Morse Fall Scale, thus establishing convergent validity. For known‐group comparison, Morse Fall Scale scores were categorised into two groups by cut‐off score. The risk for falls group had a significantly higher perceived fall risk than the no risk for falls group, thus establishing known‐group validity. Cronbach's alpha values indicated good to excellent reliability for the overall questionnaire with 27 items and for each of the three subfactors.

Conclusions

The fall risk perception questionnaire demonstrated satisfactory reliability and validity in an acute care hospital setting.

Relevance to clinical practice

Because understanding patients’ perceptions of their fall risk is essential for preventing falls, it is necessary to regularly assess patients’ fall risk perception using tools with established reliability and validity.
Parental Responses to Coming out by Lesbian, Gay, Bisexual, Queer, Pansexual, or Two‐Spirited People across Three Age Cohorts
Authors: van Bergen Diana D. , Wilson Bianca D.M. , Russell Stephen T. , Gordon Allegra G. , Rothblum Esther D.
Published: November 2020

Objective

The study aimed to better understand the complexities of parental responses to coming out in the narratives from Lesbian, Gay, Bisexual, Queer, Pansexual, or Two‐Spirited (LGBQ+) individuals, and to examine whether those from recent cohorts experience a different parental response than those in older cohorts.

Background

Sexual minorities come out at younger ages today than in past decades, and coming out to parents is a major part of the identification process.

Method

Interview excerpts of 155 US lesbian, gay, bisexual, queer, pansexual, or two‐spirited (LGBQ+) respondents were analyzed with a qualitative thematic analysis and with basic quantitative methods. The sample consisted of 61 interviewees in a young cohort (ages 18–25), 65 in a middle cohort (ages 35–42), and 29 in an older cohort (ages 52–59), in six ethnic/racial groups.

Results

Themes based on LGBQ+ people's accounts indicated that parental responses varied with the degree of their a priori knowledge of respondents' sexual identities (ranging from suspicion or certainty to surprise). Parental appraisal was either lacking, negative, mixed, or positive with accompanying silent, invalidating, ambivalent, and validating responses, respectively. Validating responses from parents were more often found in the youngest cohort, but invalidating responses were frequent across all cohorts. LGBQ+ people in the oldest cohort were more inclined to accept their parents being noncommunicative about sexuality in general and also about sexual diversity.

Conclusion

It is too early to state that coming out to parents has become easier. Harmony in the parent–child relationship after coming out and open communication about sexual identities is regarded as desirable and yet it remains elusive for many LGBQ+ people.
Does the Marriage Tax Differential Influence Same‐Sex Couples' Marriage Decisions?
Authors: Cheng Christine , Crumbley D. Larry , Enis Charles , Yurko Amy J. N. , Yurko Joseph P.
Published: November 2020

Objective

This article evaluates whether the federal marriage tax penalty (penalty) or federal marriage bonus (bonus) affects the marriage decisions of same‐sex couples (SSCs).

Background

Extant studies provide limited, mixed evidence that the penalty has a nominal economic effect on different‐sex couples' marriage decisions. No evidence exists indicating that the marriage bonus impacts couples' marriage decisions. We use the 2013 federal recognition of same‐sex marriage (SSM) to explore whether the penalty or bonus influences SSCs' marriage decisions.

Method

To examine the penalty or bonus influence, a difference‐in‐differences regression compares how the 2013 federal recognition of SSM (which imposes the penalty on SSCs) influenced the marriage–penalty and marriage–bonus relation for SSCs. We obtain household level data for 2012–2016 from American Community Survey's Public Use Microdata Sample and use the National Bureau of Economic Research tax simulation model to estimate each household's penalty or bonus.

Results

Our evidence indicates that the penalty is negatively related to SSCs' marriage decisions only after 2013. Overall, a 1% increase in the penalty as a percentage of household income reduces the odds of marriage by up to 6.41%. In contrast, we do not find consistent evidence that the bonus effectively encourages marriage.

Conclusion

Our results indicate that only the marriage tax penalty has an economically significant effect on SSCs' marriage decisions.
Mechanical Thrombectomy using Distal Access Catheters: Current Status and Future Prospects
Authors: Nayak Sanjeev
Published: November 2020

BACKGROUND AND PURPOSE

Mechanical Thrombectomy (MT) using modern devices has proved to be efficacious in re‐establishing intracranial circulation and reduced procedural times. We outline a number of endovascular techniques utilizing the distal access catheter, the circumstances where they are applicable, and the outcomes achieved.

METHODS

In this review, we describe a variety of endovascular techniques with distal access catheter, deployed with and without the stent retriever device gained from our experience of performing over 700 procedures in 10 years of providing a 24/7 service within the national framework of a hyperacute stroke centre.

RESULTS

We used distal access catheter techniques for intracranial support during a stent‐retriever thrombectomy or thrombo‐suction on its own. When used as a sole suction device, or combined with a stent‐retriever, we have been able to provide a rapid route to successful reperfusion, with minimal complications related to our endovascular procedures. We can report distal access catheter techniques works well when access to thrombi involves navigation through tortuous vessel anatomy, notably when convoluted loops in the cervical internal carotid artery are encountered. We suggest use of the distal access catheter techniques in thrombectomy procedures for steep‐angle Middle Cerebral Artery occlusions, M2/M3 occlusion, and for basilar occlusion, where thrombectomy via suction alone proved to be adequate.

CONCLUSION

In this pictorial review, we have demonstrated techniques where distal access catheter when used as a sole suction device, or combined with a stent‐retriever, has been able to provide a rapid route to successful reperfusion, with minimal complications related to our endovascular procedures.
Incentive and welfare effects of correlated returns
Authors: Courbage Christophe , Peter Richard , Rey Béatrice
Published: November 2020

We provide a microeconomic analysis of the incentive and welfare effects of correlated returns. While most of the existing literature has focused on risky returns as an aggregate shock, we introduce a correlation between returns and the individual's nonfinancial endowment. Using a simple consumption‐saving model with two periods, time‐separable utility, and two states allow us to rewrite the correlated return in terms of a transfer rate that measures the spread between the return in the good and the bad state. We find that a critical level of the transfer rate separates savers from borrowers. We also identify restrictions on the individual's risk preferences for a larger transfer rate to raise optimal savings. We analyze the welfare effects of correlated returns by characterizing the transfer rate that maximizes intertemporal expected utility. The welfare benefits of correlated returns derive from their insurance effects.
Hepatitis C testing and treatment uptake among young people who use opioids in New York City: A cross‐sectional study
Authors: Kapadia Shashi N. , Katzman Caroline , Fong Chunki , Eckhardt Benjamin J. , Guarino Honoria , Mateu‐Gelabert Pedro
Published: November 2020

Young people who use drugs have a rising hepatitis C (HCV) incidence in the United States, but they may face barriers to testing and treatment adoption due to stigma. We conducted a cross‐sectional study of New York City residents aged 18‐29 years who reported non‐medical prescription opioid and/or heroin use in the past 30 days. Participants were recruited from the community between 2014‐2016 via respondent‐driven sampling. Participants completed an in‐person structured survey that included questions about HCV testing and treatment and received HCV antibody testing. There were 539 respondents: 353 people who inject drugs (PWID) and 186 non‐PWID. For PWID, median age was 25 years, 65% were male and 73% non‐Hispanic White. For non‐PWID, median age was 23 years, 73% were male and 39% non‐Hispanic White. 20% of PWID and 54% of non‐PWID had never been tested for HCV (P < .001). Years since first injection (aOR 1.16, CI: 1.02‐1.32, P = .02) and history of substance use treatment (aOR 3.17, CI: 1.53‐6.61, P = .02) were associated with prior testing among PWID. The seroprevalence of HCV among PWID was 25%, adjusted for sampling weights. Of the 75 who were aware of their HCV‐positive status, 53% had received HCV‐related medical care, and 28% had initiated treatment. HCV prevalence among young PWID is high, and many have never been tested. Injection experience and treatment engagement is associated with testing. Interventions to increase testing earlier in injection careers, and to improve linkage to HCV treatment, will be critical for young PWID.
Ecological level analysis of primary lung tumors in dogs and cats and environmental radon activity
Authors: Fowler Brittany L. , Johannes Chad M. , O'Connor Annette , Collins Deanna , Lustgarten Jonathan , Yuan Chaohui , Weishaar Kristen , Sullivan Kelly , Hume Kelly R. , Mahoney Jennifer , Vale Brittany , Schubert Alicia , Ball Valerie , Cooley‐Lock Katie , Curran Kaitlin M. , Nafe Laura , Gedney Allison , Weatherford Megan , LeVine Dana N.
Published: November 2020

Background

Epidemiologic studies suggest residential radon exposure might increase the risk of primary lung cancer in people, but these studies are limited by subject mobility. This limitation might be overcome by evaluating the association in pets.

Hypothesis

Primary pulmonary neoplasia (PPN) rate is higher in dogs and cats residing in counties with a high radon exposure risk (Environmental Protection Agency [EPA] zone 1) compared to zones 2 (moderate radon exposure risk) and 3 (low radon exposure risk).

Animals

Six hundred ninety client‐owned dogs and 205 client‐owned cats with PPN.

Methods

Retrospective review of medical records at 10 veterinary colleges identified dogs and cats diagnosed with PPN between 2010 and 2015. Each patient's radon exposure was determined by matching the patient's zip code with published county radon exposure risk. County level PPN rates were calculated using the average annual county cat and dog populations. The PPN counts per 100 000 dog/cat years at risk (PPN rates) were compared across radon zones for each species.

Results

The PPN rate ratio in counties in high radon zone (1) was approximately 2‐fold higher than in counties in lower radon zones for dogs (rate ratio zone 1 to 2, 2.49; 95% confidence interval [CI], 1.56‐4.00; rate ratio zone 1 to 3, 2.29; 95% CI, 1.46‐3.59) and cats (rate ratio zone 1 to 2, 2.13; 95% CI, 0.95‐4.79; zone 1 to 3, 1.81; 95% CI, 0.9‐3.61).

Conclusions and Clinical Importance

Exposure to household radon might play a role in development of PPN in dogs and cats.
The dog erythrocyte antigen 1 blood group in nondomesticated canids and compatibility testing between domestic dog and nondomesticated canid blood
Authors: Charpentier Thomas , Petit Thierry , Guidetti Maryline , Goy‐Thollot Isabelle
Published: November 2020

Background

The dog erythrocyte antigen (DEA) 1 blood group is considered as the most immunogenic and clinically important in dogs. Little is known in nondomesticated canids.

Objectives

To type DEA 1 in nondomesticated captive canids and to evaluate potential interspecific blood transfusions between domestic and nondomestic canids.

Animals

One hundred forty captive nondomesticated canids belonging to 13 species from 19 French zoos, and 63 domestic dogs.

Methods

Prospective study. Blood samples were typed for DEA 1 using immunochromatographic and flow cytometric techniques. A neutral gel column test was used for crossmatching.

Results

Of 140 nondomesticated canids, 72.9% were DEA 1+ and 27.1% were DEA 1− using immunochromatographic technique and 74.3% were DEA 1+ and 25.7% were DEA 1− by flow cytometric technique.

Crossmatch (XM) between 140 nondomesticated canid red blood cells (RBCs) and plasma from a previously DEA 1+ sensitized DEA 1− dog revealed 112 incompatibilities (80%). Crossmatches between 130 nondomesticated canid serum and 1 or up to 8 donor dogs' RBCs revealed 99 of 130 (76%) compatibilities. Crossmatches between 115 nondomesticated canid RBCs and donor dogs' serum revealed 59 of 115 (51%) compatibilities.

Conclusions and Clinical Importance

Dog erythrocyte antigen 1 blood type is present in nondomesticated canids with variable prevalence depending on species. The majority of tested nondomesticated canids appear to have no naturally occurring alloantibodies against domestic dogs' RBCs. Therefore xenotransfusion of blood from domestic dogs can be considered when species specific blood is not available. Cross matching is essential before xenotransfusion.
Acid‐base disorders in sick goats and their association with mortality: A simplified strong ion difference approach
Authors: Gomez Diego E. , Bedford Sofia , Darby Shannon , Palmisano Megan , MacKay Robert J. , Renaud David L.
Published: November 2020

Objectives

To investigate the acid‐base status of sick goats using the simplified strong ion difference (sSID) approach, to establish the quantitative contribution ofsSID variables to changes in blood pH and HCO3−and to determine whether clinical, acid‐base, and biochemical variables on admission are associated with the mortality of sick goats.

Animals

One hundred forty‐three sick goats.

Methods

Retrospective study. CalculatedsSID variables included SID using 6 electrolytes unmeasured strong ions (USI) and the total nonvolatile buffer ion concentration in plasma (Atot). The relationship between measured blood pH and HCO3−, and thesSID variables was examined using forward stepwise linear regression. Cox proportional hazard models were constructed to assess associations between potential predictor variables and mortality of goats during hospitalization.

Results

Hypocapnia, hypokalemia, hyperchloremia, hyperlactatemia, and hyperproteinemia were common abnormalities identified in sick goats. Respiratory alkalosis, strong ion acidosis, and Atotacidosis were acid‐base disorders frequently encountered in sick goats. In sick goats, thesSID variables explained 97% and 100% of the changes in blood pH and HCO3−, respectively. The results indicated that changes in the respiratory rate (<16 respirations per minute), USI, and pH at admission were associated with increased hazard of hospital mortality in sick goats.

Conclusions and Clinical Importance

ThesSID approach is a useful methodology to quantify acid‐base disorders in goats and to determine the mechanisms of their development. Clinicians should consider calculation of USI in sick goats as part of the battery of information required to establish prognosis.
Intention mutability and translation of rural intention into actual rural medical practice
Authors: Playford Denese , Ngo Hanh , Puddey Ian
Published: November 2020

Background

Rural intention and experience during medical school have been related to subsequent rural work. However, their relative contributions and the timing of their effects are not known. These data are critical to effective educational interventions able to improve rural medical workforce numbers, an international priority.

Methods

Participants were graduates of an Australian MBBS degree between 2006 and 2016, who completed both entry and exit surveys approved by the Medical Deans of Australia, including workplace intention data. Rural/urban workplace intention changes from entry to exit were analysed using multinomial logistic regression. Binary logistic regression was used to assess actual rural versus urban work, obtained from a public practitioner registration website.

Results

Of 547 eligible undergraduates, 169 completed a year‐long rural clinical school (RCS). A subset of 93 of the 547 graduates practiced rurally, of whom 42 had completed RCS. Both rural background and RCS predicted rural practice intention; both were also significantly related to actual rural work. Enduring rural intention was associated with nearly sevenfold odds of actually practicing rurally, compared with an enduring urban intention. Those who changed practice intention from entry to exit were more likely to practice in the region of their exit intention. Of special note: Rural Clinical School of Western Australia (RCSWA) exposure particularly affects urban origin students such that the odds of changing from an urban to a rural orientation immediately after their rural experience were more than fourfold higher than those not so participating.

Discussion

Both intention and RCSWA experience are associated with subsequent rural work. The impacts of RCSWA were able to be localised after the rural educational experience. Amongst those with mutable intention, exit intention was that most strongly related to actual work, suggesting this as the most reliable point to select for further rural training.
Hemeprotein Tpx1 interacts with cell‐surface heme transporter Str3 in Schizosaccharomyces pombe
Authors: Normant Vincent , Brault Ariane , Avino Mariano , Mourer Thierry , Vahsen Tobias , Beaudoin Jude , Labbé Simon
Published: November 2020

Str3 is a transmembrane protein that mediates low‐affinity heme uptake in Schizosaccharomyces pombe. Under iron‐limiting conditions, Str3 remains at the cell surface in the presence of increasing hemin concentrations. Using a proximity‐dependent biotinylation approach coupled to mass spectrometry and coimmunoprecipitation assays, we report that the peroxiredoxin Tpx1 is a binding partner of Str3. Under microaerobic conditions, cells deficient in heme biosynthesis and lacking the heme receptor Shu1 exhibit poor hemin‐dependent growth in the absence of Tpx1. Analysis of membrane protein preparations from iron‐starved hem1Δ shu1Δ str3Δ tpx1Δ cells coexpressing Str3‐GFP and TAP‐Tpx1 showed that TAP‐Tpx1 is enriched in membrane protein fractions in response to hemin. Bimolecular fluorescence complementation assays brought additional evidence that an interaction between Tpx1 and Str3 occurs at the plasma membrane. Results showed that Tpx1 exhibits an equilibrium constant value of 0.26 μM for hemin. The association of Tpx1 with hemin protects hemin from degradation by H2O2. The peroxidase activity of hemin is lowered when it is bound to Tpx1. Taken together, these results revealed that Tpx1 is a novel interacting partner of Str3. Our data are the first example of an interaction between a cytoplasmic heme‐binding protein and a cell‐surface heme transporter.
Epidemiology of invasive fungal disease in haematologic patients
Authors: Souza Luciana , Nouér Simone A. , Morales Hugo , Simões Belinda , Solza Cristiana , Queiroz‐Telles Flavio , Nucci Marcio
Published: November 2020

Invasive fungal disease (IFD) is frequent in patients with haematologic malignancies and in recipients of haematopoietic cell transplantation (HCT). An epidemiologic study conducted in Brazil reported a high incidence of IFD in haematologic patients, and invasive fusariosis was the leading IFD. A limitation of that study was that galactomannan was not available for at least half of the study period. In order to characterise the epidemiology and burden of IFD in three cohorts, HCT, acute myeloid leukaemia (AML) or myelodysplasia (MDS), and acute lymphoid leukaemia (ALL), we conducted a prospective multicentre cohort study in four haematologic Brazilian centres. From August 2015 to July 2016, all patients receiving induction chemotherapy for newly diagnosed or relapsed AML, MDS or ALL, and all HCT recipients receiving conditioning regimen were followed during the period of neutropenia following chemotherapy or the conditioning regimen. During a 1‐year period, 192 patients were enrolled: 122 HCT recipients (71 allogeneic, 51 autologous), 46 with AML, and 24 with ALL. The global incidence of IFD was 13.0% (25 cases, 11 proven and 14 probable). Invasive aspergillosis (14 cases) was the leading IFD, followed by candidemia (6 cases) and fusariosis (3 cases). The incidence of IFD was 26.1% in AML/MDS, 16.7% in ALL, 11.3% in allogeneic HCT, and 2.0% in autologous HCT. The burden of IFD in haematologic patients in Brazil is high, with a higher frequency in AML and ALL. Invasive aspergillosis is the leading IFD, followed by invasive candidiasis and fusariosis.
Multicentre derivation and validation of a prognostic scoring system for mortality assessment in HIV‐infected patients with talaromycosis
Authors: Qin Yuanyuan , Zhou Yihong , Lu Yanqiu , Chen Hui , Jiang Zhongsheng , He Kaiyin , Tian Qun , Qin Yingmei , Rao Man , Harypursat Vijay , Li Huan , Chen Yaokai
Published: November 2020

Background

Although the widespread use of modern antiretroviral therapy (ART) has reduced the incidence of talaromycosis in people living with HIV, mortality remains as high as 20% in this population, even after appropriate antifungal treatment.

Objectives

The objective of our study was to develop a risk assessment system for HIV‐infected patients with comorbid talaromycosis, in order to provide these patients with appropriate, effective and potentially life‐saving interventions at an early stage of their illness.

Patients/Methods

This was a multicentre, retrospective cohort study conducted in China. We built a predictive model based on data from 11 hospitals, and a validated model using the data of 1 hospital located in an endemic area.

Results

Forward stepwise multivariate statistical calculations indicated that age, aspartate aminotransferase/alanine transaminase ratio and albumin levels, and BUN levels were valid, independent predictors of the risk of death in HIV‐infected patients with talaromycosis. Our developed and validated risk scoring system is effective for the identification of HIV‐infected patients with talaromycosis at high risk of death at hospital admission (p < .001; AUC = 0.860). In our study, our risk prediction model provided functional and robust discrimination in the validation cohort (p < .001; AUC = 0.793).

Conclusion

The prognostic scoring system for mortality assessment developed in the present study is an easy‐to‐use clinical tool designed to accurately assist clinicians in identifying high‐risk patients with talaromycosis.