bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between mobile phone use in young children and caregiver-rated health
Authors: Kojimahara Noriko , Matsushita Mariko , Sato Yasuto
Published: March 2021

The association between mobile phone or tablet use and children’s health remains unclear. The main aim of this study was to examine whether caregiver-rated health and children’s mental disorders were related to their mobile phone use. We conducted a multistage sampling Internet survey of 1535 caregivers living with children aged 0–14 years in Japan. Using this cross-sectional data, multiple regression models were used to test for relationships among factors related to mobile phone use, caregiver-rated child health, and mental disorders. Total mobile phone use time was related to age, number of siblings, availability of Wi-Fi at home, and the child’s ownership of a mobile phone. Age and availability of Wi-Fi at home were positively related to tablet use, but neither the number of siblings nor the child’s ownership of a tablet were related to tablet use. In addition, we examined that tablet use (Odds ratio 0.62, 95% CI 0.39–1.00) and Wi-Fi use (Odds ratio 0.66, 95% CI 0.47–0.93) were related to low caregiver-rated child health among preschool students. It was newly pointed out that tablet and Wi-Fi use were related to low caregiver-rated child health among preschool students. As young children are likely to be exposed to internet for the purpose of babysitting, this study suggested that parents should be aware of mental influence for tablets and Wi-Fi use.
Hippocampal atrophy is associated with psychotic symptom severity following traumatic brain injury
Authors: Bray Michael J C , Sharma Bhanu , Cottrelle's Julia , Peters Matthew E , Bayley Mark , Green Robin E A
Published: March 2021

Psychosis is a rare, but particularly serious sequela of traumatic brain injury. However, little is known as to the neurobiological processes that may contribute to its onset. Early evidence suggests that psychotic symptom development after traumatic brain injury may co-occur with hippocampal degeneration, invoking the possibility of a relationship. Particularly regarding the hippocampal head, these degenerative changes may lead to dysregulation in dopaminergic circuits, as is reported in psychoses due to schizophrenia, resulting in the positive symptom profile typically seen in post-injury psychosis. The objective of this study was to examine change in hippocampal volume and psychotic symptoms across time in a sample of moderate-to-severe traumatic brain injury patients. We hypothesized that hippocampal volume loss would be associated with increased psychotic symptom severity. From a database of n = 137 adult patients with prospectively collected, longitudinal imaging and neuropsychiatric outcomes, n = 24 had complete data at time points of interest (5 and 12 months post-traumatic brain injury) and showed increasing psychotic symptom severity on the Personality Assessment Inventory psychotic experiences subscale of the schizophrenia clinical scale across time. Secondary analysis employing stepwise regression with hippocampal volume change (independent variable) and Personality Assessment Inventory psychotic symptom change (dependent variable) from 5 to 12 months post-injury was conducted including age, sex, marijuana use, family history of schizophrenia, years of education and injury severity as control variables. Total right hippocampal volume loss predicted an increase in the Personality Assessment Inventory psychotic experiences subscale (F(1, 22) = 5.396, adjusted R2 = 0.161, P = 0.030; β = −0.017, 95% confidence interval = −0.018, −0.016) as did volume of the right hippocampal head (F(1, 22) = 5.764, adjusted R2 = 0.172, P = 0.025; β = −0.019, 95% confidence interval = −0.021, −0.017). Final model goodness-of-fit was confirmed using k-fold (k = 5) cross-validation. Consistent with our hypotheses, the current findings suggest that hippocampal degeneration in the chronic stages of moderate-to-severe traumatic brain injury may play a role in the delayed onset of psychotic symptoms after traumatic brain injury. These findings localized to the right hippocampal head are supportive of a proposed aetiological mechanism whereby atrophy of the hippocampal head may lead to the dysregulation of dopaminergic networks following traumatic brain injury; possibly accounting for observed clinical features of psychotic disorder after traumatic brain injury (including prolonged latency period to symptom onset and predominance of positive symptoms). If further validated, these findings may bear important clinical implications for neurorehabilitative therapies following traumatic brain injury.
Randomized Trial of Ruxolitinib in Antiretroviral-Treated Adults With Human Immunodeficiency Virus
Authors: Marconi Vincent C , Moser Carlee , Gavegnano Christina , Deeks Steven G , Lederman Michael M , Overton Edgar T , Tsibris Athe , Hunt Peter W , Kantor Amy , Sekaly Rafick-Pierre , Tressler Randall , Flexner Charles , Hurwitz Selwyn J , Moisi Daniela , Clagett Brian , Hardin William R , del Rio Carlos , Schinazi Raymond F , Lennox Jeffrey J
Published: March 2021

Background

Inflammation is associated with end-organ disease and mortality for people with human immunodeficiency virus (PWH). Ruxolitinib, a Jak 1/2 inhibitor, reduces systemic inflammation for individuals without human immunodeficiency virus (HIV) and HIV reservoir markers ex vivo. The goal of this trial was to determine safety and efficacy of ruxolitinib for PWH on antiretroviral therapy (ART).

Methods

AIDS Clinical Trials Group (ACTG) A5336 was an open-label, multisite, randomized controlled trial (RCT). Participants were randomly assigned (2:1) using centralized software to ruxolitinib (10 mg twice daily) plus stable ART for 5 weeks vs ART alone, stratified by efavirenz use. Eligible participants were suppressed on ART for ≥2 years, without comorbidities, and had >350 CD4+ T cells/µL. Primary endpoints were premature discontinuation, safety events, and change in plasma interleukin 6 (IL-6). Secondary endpoints included other measures of inflammation/immune activation and HIV reservoir.

Results

Sixty participants were enrolled from 16 May 2016 to 10 January 2018. Primary safety events occurred in 2.5% (1 participant) for ruxolitinib and 0% for controls (P = .67). Three participants (7.5%) prematurely discontinued ruxolitinib. By week 5, differences in IL-6 (mean fold change [FC], 0.93 vs 1.10; P = .18) and soluble CD14 (mean FC, 0.96 vs 1.08; relative FC, 0.96 [90% confidence interval {CI}, .90–1.02]) levels for ruxolitinib vs controls was observed. Ruxolitinib reduced CD4+ T cells expressing HLA-DR/CD38 (mean difference, –0.34% [90% CI, –.66% to –.12%]) and Bcl-2 (mean difference, –3.30% [90% CI, –4.72% to –1.87%]).

Conclusions

In this RCT of healthy, virologically suppressed PWH on ART, ruxolitinib was well-tolerated. Baseline IL-6 levels were normal and showed no significant reduction. Ruxolitinib significantly decreased markers of immune activation and cell survival. Future studies of Jak inhibitors should target PWH with residual inflammation despite suppressive ART.

Clinical Trials Registration

NCT02475655.
Electrocardiogram screening for aortic valve stenosis using artificial intelligence
Authors: Cohen-Shelly Michal , Attia Zachi I , Friedman Paul A , Ito Saki , Essayagh Benjamin A , Ko Wei-Yin , Murphree Dennis H , Michelena Hector I , Enriquez-Sarano Maurice , Carter Rickey E , Johnson Patrick W , Noseworthy Peter A , Lopez-Jimenez Francisco , Oh Jae K
Published: March 2021

Aims 

Early detection of aortic stenosis (AS) is becoming increasingly important with a better outcome after aortic valve replacement in asymptomatic severe AS patients and a poor outcome in moderate AS. We aimed to develop artificial intelligence-enabled electrocardiogram (AI-ECG) using a convolutional neural network to identify patients with moderate to severe AS.

Methods and results 

Between 1989 and 2019, 258 607 adults [mean age 63 ± 16.3 years; women 122 790 (48%)] with an echocardiography and an ECG performed within 180 days were identified from the Mayo Clinic database. Moderate to severe AS by echocardiography was present in 9723 (3.7%) patients. Artificial intelligence training was performed in 129 788 (50%), validation in 25 893 (10%), and testing in 102 926 (40%) randomly selected subjects. In the test group, the AI-ECG labelled 3833 (3.7%) patients as positive with the area under the curve (AUC) of 0.85. The sensitivity, specificity, and accuracy were 78%, 74%, and 74%, respectively. The sensitivity increased and the specificity decreased as age increased. Women had lower sensitivity but higher specificity compared with men at any age groups. The model performance increased when age and sex were added to the model (AUC 0.87), which further increased to 0.90 in patients without hypertension. Patients with false-positive AI-ECGs had twice the risk for developing moderate or severe AS in 15 years compared with true negative AI-ECGs (hazard ratio 2.18, 95% confidence interval 1.90–2.50).

Conclusion 

An AI-ECG can identify patients with moderate or severe AS and may serve as a powerful screening tool for AS in the community.
Explaining socioeconomic disparities and gaps in the use of antenatal care services in 36 countries in sub-Saharan Africa
Authors: Obse Amarech G , Ataguba John E
Published: March 2021

Significant maternal and child deaths occur in sub-Saharan Africa (SSA) even with existing effective interventions. Antenatal care (ANC), for example, is an intervention that improves the health of pregnant women and their babies, but only 52% of pregnant women in SSA had the recommended minimum of four ANC visits between 2011 and 2016. While significant socioeconomic inequalities in ANC visits have been reported to the disadvantage of the poor, little is known about the depth of ANC coverage and associated inequalities. This paper introduces ‘deficits’ (i.e. the number of ANC visits that are needed to reach the recommended minimum of four ANC visits) and ‘surpluses’ (i.e. the number of ANC visits over and above the recommended minimum of four ANC visits) to assess socioeconomic inequalities in the indicator and depth of the ‘deficits’ and ‘surpluses’ in ANC visits. Using the latest available Demographic and Health Survey data for 36 SSA countries and concentration indices, the paper found that ‘deficits’ in ANC visits are more prevalent among poorer women compared to ‘surpluses’ that are concentrated among the rich. On average, women with ‘deficits’ in ANC visits require about two more ANC visits to reach the recommended four ANC visits, and women with ‘surpluses’ exceeded the recommended minimum by about two ANC visits. The factors that explain a substantial share of the socioeconomic inequalities in ANC ‘deficits’ and ‘surpluses’ in SSA include wealth, education and area of residency, which are essentially the social determinants of health inequalities. For policy response, it is suggested that education is a significant channel to affect the other social determinants of inequalities in ANC coverage reported in the paper. Thus, countries must prioritize quality education as addressing education, especially among women in SSA, will significantly reduce disparities in ANC service utilization and accelerate progress towards universal health coverage.
Auxin signaling and vascular cambium formation enable storage metabolism in cassava tuberous roots
Authors: Rüscher David , Corral José María , Carluccio Anna Vittoria , Klemens Patrick A W , Gisel Andreas , Stavolone Livia , Neuhaus H Ekkehard , Ludewig Frank , Sonnewald Uwe , Zierer Wolfgang
Published: March 2021

Cassava storage roots are among the most important root crops worldwide, and represent one of the most consumed staple foods in sub-Saharan Africa. The vegetatively propagated tropical shrub can form many starchy tuberous roots from its stem. These storage roots are formed through the activation of secondary root growth processes. However, the underlying genetic regulation of storage root development is largely unknown. Here we report distinct structural and transcriptional changes occurring during the early phases of storage root development. A pronounced increase in auxin-related transcripts and the transcriptional activation of secondary growth factors, as well as a decrease in gibberellin-related transcripts were observed during the early stages of secondary root growth. This was accompanied by increased cell wall biosynthesis, most notably increased during the initial xylem expansion within the root vasculature. Starch storage metabolism was activated only after the formation of the vascular cambium. The formation of non-lignified xylem parenchyma cells and the activation of starch storage metabolism coincided with increased expression of the KNOX/BEL genes KNAT1, PENNYWISE, and POUND-FOOLISH, indicating their importance for proper xylem parenchyma function.
Synergies between low- and intermediate-redshift galaxy populations revealed with unsupervised machine learning
Authors: Turner Sebastian , Siudek Malgorzata , Salim Samir , Baldry Ivan K , Pollo Agnieszka , Longmore Steven N , Malek Katarzyna , Collins Chris A , Lisboa Paulo J , Krywult Janusz , Moutard Thibaud , Vergani Daniela , Fritz Alexander
Published: March 2021

The colour bimodality of galaxies provides an empirical basis for theories of galaxy evolution. However, the balance of processes that begets this bimodality has not yet been constrained. A more detailed view of the galaxy population is needed, which we achieve in this paper by using unsupervised machine learning to combine multidimensional data at two different epochs. We aim to understand the cosmic evolution of galaxy subpopulations by uncovering substructures within the colour bimodality. We choose a clustering algorithm that models clusters using only the most discriminative data available, and apply it to two galaxy samples: one from the second edition of the GALEX-SDSS-WISE Legacy Catalogue (GSWLC-2; z ∼ 0.06), and the other from the VIMOS Public Extragalactic Redshift Survey (VIPERS; z ∼ 0.65). We cluster within a nine-dimensional feature space defined purely by rest-frame ultraviolet-through-near-infrared colours. Both samples are similarly partitioned into seven clusters, breaking down into four of mostly star-forming galaxies (including the vast majority of green valley galaxies) and three of mostly passive galaxies. The separation between these two families of clusters suggests differences in the evolution of their galaxies, and that these differences are strongly expressed in their colours alone. The samples are closely related, with star-forming/green-valley clusters at both epochs forming morphological sequences, capturing the gradual internally driven growth of galaxy bulges. At high stellar masses, this growth is linked with quenching. However, it is only in our low-redshift sample that additional, environmental processes appear to be involved in the evolution of low-mass passive galaxies.
MUSE analysis of gas around galaxies (MAGG) – III. The gas and galaxy environment of z = 3–4.5 quasars
Authors: Fossati M , Fumagalli M , Lofthouse E K , Dutta R , Cantalupo S , Arrigoni Battaia F , Fynbo J P U , Lusso E , Murphy M T , Prochaska J X , Theuns T , Cooke R J
Published: March 2021

We present a study of the environment of 27 z = 3–4.5 bright quasars from the MUSE Analysis of Gas around Galaxies (MAGG) survey. With medium-depth Multi Unit Spectroscopic Explorer (MUSE) observations (4 h on target per field), we characterize the effects of quasars on their surroundings by studying simultaneously the properties of extended gas nebulae and Ly α emitters (LAEs) in the quasar host haloes. We detect extended (up to ≈100 kpc) Ly α emission around all MAGG quasars, finding a very weak redshift evolution between z = 3 and z = 6. By stacking the MUSE datacubes, we confidently detect extended emission of C iv and only marginally detect extended He ii up to ≈40 kpc, implying that the gas is metal enriched. Moreover, our observations show a significant overdensity of LAEs within 300 $\rm km~s^{-1}$ from the quasar systemic redshifts estimated from the nebular emission. The luminosity functions and equivalent width distributions of these LAEs show similar shapes with respect to LAEs away from quasars suggesting that the Ly α emission of the majority of these sources is not significantly boosted by the quasar radiation or other processes related to the quasar environment. Within this framework, the observed LAE overdensities and our kinematic measurements imply that bright quasars at z = 3–4.5 are hosted by haloes in the mass range $\approx 10^{12.0}\small{--}10^{12.5}~\rm M_\odot$.
Untangling the crosstalk between BRCA1 and R-loops during DNA repair
Authors: San Martin Alonso Marta , Noordermeer Sylvie M
Published: March 2021

R-loops are RNA:DNA hybrids assembled during biological processes but are also linked to genetic instability when formed out of their natural context. Emerging evidence suggests that the repair of DNA double-strand breaks requires the formation of a transient R-loop, which eventually must be removed to guarantee a correct repair process. The multifaceted BRCA1 protein has been shown to be recruited at this specific break-induced R-loop, and it facilitates mechanisms in order to regulate R-loop removal. In this review, we discuss the different potential roles of BRCA1 in R-loop homeostasis during DNA repair and how these processes ensure faithful DSB repair.
MKK4-MPK3-WRKY17-mediated salicylic acid degradation increases susceptibility to Glomerella leaf spot in apple
Authors: Shan Dongqian , Wang Chanyu , Zheng Xiaodong , Hu Zehui , Zhu Yunpeng , Zhao Yu , Jiang Awei , Zhang Haixia , Shi Kun , Bai Yixue , Yan Tianci , Wang Lin , Sun Yanzhao , Li Jianfang , Zhou Zhaoyang , Guo Yan , Kong Jin
Published: March 2021

Glomerella leaf spot (GLS), a fungal disease caused by Colletotrichum fructicola, severely affects apple quality and yield, yet few resistance genes have been identified in apple (Malus domestica Borkh.). Here we found a transcription factor MdWRKY17 significantly induced by C. fructicola infection in the susceptible apple cultivar “Gala.” MdWRKY17 overexpressing transgenic “Gala” plants exhibited increased susceptibility to C. fructicola, whereas MdWRKY17 RNA-interference plants showed opposite phenotypes, indicating MdWRKY17 acts as a plant susceptibility factor during C. fructicola infection. Furthermore, MdWRKY17 directly bound to the promoter of the salicylic acid (SA) degradation gene Downy Mildew Resistant 6 (MdDMR6) and promoted its expression, resulting in reduced resistance to C. fructicola. Additionally, Mitogen-activated protein kinase (MAPK) 3 (MdMPK3) directly interacted with and phosphorylated MdWRKY17. Importantly, predicted phosphorylation residues in MdWRKY17 by MAPK kinase 4 (MdMEK4)-MdMPK3 were critical for the activity of MdWRKY17 to regulate MdDMR6 expression. In the six susceptible germplasms, MdWRKY17 levels were significantly higher than the six tolerant germplasms after infection, which corresponded with lower SA content, confirming the critical role of MdWRKY17-mediated SA degradation in GLS tolerance. Our study reveals a rapid regulatory mechanism of MdWRKY17, which is essential for SA degradation and GLS susceptibility, paving the way to generate GLS resistant apple.
“I Don’t Identify with It”: A Qualitative Analysis of People’s Experiences of Living with Complex Regional Pain Syndrome
Authors: Antunovich Dana , Tuck Natalie , Reynolds Lisa M , Bean Debbie
Published: March 2021

Objective

Complex regional pain syndrome (CRPS) is a painful limb condition known to cause significant disability and distress. However, little previous research has explored CRPS from a patient perspective. The present qualitative study aimed to describe the experiences of people living with CRPS.

Subjects

Forty-eight people with CRPS participated in this research.

Methods

Participants completed a face-to-face or telephone interview about their perceptions and experiences of CRPS and completed three drawings to illustrate their experiences. Data were analyzed through reflexive thematic analysis, and images in drawings were grouped and coded by theme.

Results

Three overarching themes encapsulated the data, including that 1) people experience CRPS as a source of severe symptoms and emotional difficulties, 2) CRPS undermines personal and social identity, and 3) this results in psychological responses that protect against the emotional and social impact of severe symptoms. Psychological responses include: a) searching for an explanation, b) “nothing is my fault,” emphasizing a lack of personal responsibility and personal control, and c) detaching the limb from the self.

Conclusions

CRPS is experienced as highly threatening to physical ability, psychological state, and identity. In response to these threats, people may develop their own explanations for CRPS and may mentally detach themselves from responsibility, control, and the painful limb itself. Future research could explore the impact of these factors on psychological well-being and CRPS symptoms and outcomes.
Evaluation of nutritional strategies to slow growth rate then induce compensatory growth in 90-kg finishing pigs
Authors: Rao Zhong-Xing , Tokach Mike D , Woodworth Jason C , DeRouchey Joel M , Goodband Robert D , Gebhardt Jordan T
Published: March 2021

Two 44-d experiments were conducted to evaluate nutritional strategies with different concentrations of dietary lysine (and other amino acids) on growth rate and subsequent compensatory gain of 90-kg finishing pigs. Three diets were formulated to contain 0.70 (control), 0.50% and 0.18% standardized ileal digestible (SID) Lys. In Exp. 1, 356 pigs (Line 241 × 600, DNA; initially 89.0 ± 1.10 kg) were used with four treatments. From d 0 to 28, pigs received either the control or the 0.50%-Lys diet. On d 28, pigs either remained on these diets or were switched the 0.18%-Lys diet until d 44. There were 18 pens per treatment from d 0 to 28 and 9 pens per treatment from d 28 to 44. From d 0 to 28, pigs fed the 0.50%-Lys diet had decreased (P < 0.001) ADG and G:F compared to those fed the control diet. From d 28 to 44, pigs switched to the 0.18%-Lys diet had decreased (P < 0.05) ADG and G:F compared to pigs that remained on the control or 0.50%-Lys diets. From d 0 to 44, pigs fed 0.50%-Lys diet for 44-d had decreased (P < 0.05) ADG, G:F, and percentage carcass lean compared to pigs fed the control diet. Pigs fed the 0.50%-Lys diet then the 0.18%-Lys diet had decreased (P < 0.05) ADG and G:F compared to other treatments. Pigs fed the 0.50%-Lys diet for 44-d and pigs fed the control diet then 0.18%-Lys diet had decreased (P < 0.05) ADG, G:F, and percentage carcass lean compared to control pigs. In Exp. 2, 346 pigs (Line 241 × 600, DNA; initially 88.6 ± 1.05 kg) were used to evaluate compensatory growth after varying durations of dietary lysine restriction. A total of four treatments were used including pigs fed the control diet for 44-d or fed the 0.18%-Lys diet for 14, 21, or 28-d and then fed the control diet until the conclusion of the experiment on d 44. There were nine pens per treatment. On average, pigs fed the 0.18%-Lys diet grew 49% slower than the control. Compared to the control, ADG of pigs previously fed the 0.18%-Lys diet increased (P < 0.05) 28% during the first week after switching to the control diet and 12% for the rest of the trial. Despite this improvement, overall ADG, G;F, final BW, and percentage carcass lean decreased (linear, P < 0.05) as the duration of Lys restriction increased. In summary, feeding Lys-restricted diets reduced the ADG and G:F of finishing pigs. Compensatory growth can be induced in Lys-restricted finishing pigs, but the duration of restriction and recovery influences the magnitude of compensatory growth.
Essential Amino Acid Density
Authors: Fussell Maya , Contillo Allison , Druehl Heidi , Rodriguez Nancy R.
Published: March 2021

The essential amino acid (EAA) content of animal-based proteins contributes to their superior quality compared with plant-based proteins. Recently, there has been a growing trend toward plant-based meal patterns. However, the impact of adapting a primarily plant-based meal pattern in the context of US Department of Agriculture’ Healthy Eating Patterns based on the Dietary Guidelines for Americans and healthy aging is not known. The EAA content, adequacy, and density (the amount of EAA relative to total calories or total protein) of animal- and plant-based protein equivalents in the context of 4 healthy eating patterns, omnivore, vegetarian, vegan energy matched, and vegan protein matched, were determined. The EAA content of all 4 meal patterns met established EAA Recommended Dietary Allowances. However, matching total protein to accommodate recommended protein intakes for healthy aging resulted in an additional 300 calories for the vegan protein matched eating pattern. The implications for this work for healthy aging with specific regard for protein adequacy, energy balance, EAA density, current dietary recommendations, and professional practice are considered. The surplus calories that accompany higher-protein, EAA adequate plant-based meal patterns require further consideration in the context of healthy aging. Essential amino acid density is a novel approach with potential for effective integration of protein quality and protein quantity in configuring healthy eating patterns for optimal health across the lifespan.
Incidental 18F-Florapronol Uptake in Meningioma
Authors: Lee Inki , Kong Joon Seog , Youn Sang Min , Lim Ilhan , Ha Jeong Ho
Published: March 2021

A 76-year-old woman underwent 18F-florapronol (18F-FC119S, an amyloid β imaging PET agent) PET, owing to cognitive impairment. 18F-florapronol PET images revealed an incidental 18F-florapronol uptake in the right frontal lobe. A well-enhancing extra-axial mass in the right frontal lobe was observed on MRI scans, suggesting a meningioma. After excision of the tumor, the biopsy results confirmed it as a meningothelial meningioma.
Quality of Life and Satisfaction in Transgender Men After Phalloplasty in a Retrospective Study
Authors: Papadopulos Nikolaos A. , Ehrenberger Benjamin , Zavlin Dmitry , Lellé Jean-Daniel , Henrich Gerhard , Kovacs Laszlo , Herschbach Peter , Machens Hans-Günther , Schaff Jürgen
Published: March 2021

Background

Partly as a result of the increasing attention directed toward transgender individuals and despite much research work on the topic of quality of life (QOL) of transgender, there is still a lack of studies using standardized questionnaires in their evaluation.

Aims

We designed a survey to evaluate the influence of surgery after phalloplasty (osteofasciocutaneous fibula free flap or osteofasciocutaneous radial free forearm flap) on QOL, emotional stability, self-esteem, and psyche of postoperated transgender men.

Methods

The present study included 32 transgender men who had undergone gender-affirming surgery (GAS) exclusively in our department between 2000 and 2012. Apart from our self-developed, indication-specific questionnaire with questions on socioeconomic and demographic data as well as postoperative satisfaction, the testing instrument included 4 frequently used, standardized testing instruments, which we compared with normative data. These included (a) a self-assessment test Fragebogen zur Lebenszufriedenheit with questions on QOL consisting of 3 modules (general satisfaction, satisfaction with health, and satisfaction with body image/outer appearance), (b) the Freiburg Personality Inventory, (c) the Rosenberg Self-Esteem Questionnaire, and (d) the Patient Health Questionnaire 4.

Findings

Our self-developed, indication-specific questionnaire showed that 88% of our patients were very satisfied with the aesthetic result, 75% have had sex after surgery, and 72% were very satisfied with sexual function after GAS. Eighty-one percent had a strong improvement of QOL, and 91% would undergo the same treatment again. Eighty-four percent would recommend GAS to others. All patients lived as men fulltime.

Discussion

Our study reveals that GAS plays an important part in the interdisciplinary treatment of transgender individuals as it improves the QOL in transgender men in most aspects of everyday life and has a positive influence on the patients' psyche and self-esteem in a retrospective study.
A putative WAVE regulatory complex (WRC) interacting receptor sequence (WIRS) in the cytoplasmic tail of HSV-1 gE does not function in WRC recruitment or neuronal transport
Authors: Denes Christopher E. , Newsome Timothy P. , Miranda-Saksena Monica , Cunningham Anthony L. , Diefenbach Russell J.
Published: March 2021

HSV-1 envelope glycoprotein E (gE) is important for viral egress and cell-to-cell spread but the host protein(s) involved in these functions have yet to be determined. We aimed to investigate a role for the Arp2/3 complex and actin regulation in viral egress based on the identification of a WAVE Regulatory Complex (WRC) Interacting Receptor Sequence (WIRS) in the cytoplasmic tail (CT) of gE. A WIRS-dependent interaction between the gE(CT) and subunits of the WRC was demonstrated by GST-pulldown assay and a role for the Arp2/3 complex in cell-to-cell spread was also observed by plaque assay. Subsequent study of a recombinant HSV-1 gE WIRS-mutant found no significant changes to viral production and release based on growth kinetics studies, or changes to plaque and comet size in various cell types, suggesting no function for the motif in cell-to-cell spread. GFP-Trap pulldown and proximity ligation assays were unable to confirm a WIRS-dependent interaction between gE and the WRC in human cell lines though the WIRS-independent interaction observed in situ warrants further study. Confocal microscopy of infected cells of neuronal origin identified no impairment of gE WIRS-mutant HSV-1 anterograde transport along axons. We propose that the identified gE WIRS motif does not function directly in recruitment of the WRC in human cells, in cell-to-cell spread of virus or in anterograde transport along axons. Further studies are needed to understand how HSV-1 manipulates and traverses the actin cytoskeleton and how gE may contribute to these processes in a WIRS-independent manner.
Fine-tuning p53 activity by modulating the interaction between eukaryotic translation initiation factor eIF4E and RNA-binding protein RBM38
Authors: Sun Wenqiang , Laubach Kyra , Lucchessi Christopher , Zhang Yanhong , Chen Mingyi , Zhang Jin , Chen Xinbin
Published: March 2021

p53 is critical for tumor suppression but also elicits detrimental effects when aberrantly overexpressed. Thus, multiple regulators, including RNA-binding protein RBM38, are found to tightly control p53 expression. Interestingly, RBM38 is unique in that it can either suppress or enhance p53 mRNA translation via altered interaction with eIF4E potentially mediated by serine-195 (S195) in RBM38. Thus, multiple RBM38/eIF4E knock-in (KI) cell lines were generated to investigate the significance of eIF4E-RBM38 interaction in controlling p53 activity. We showed that KI of RBM38-S195D or -Y192C enhances, whereas KI of RBM38-S195K/R/L weakens, the binding of eIF4E to p53 mRNA and subsequently p53 expression. We also showed that KI of eIF4E-D202K weakens the interaction of eIF4E with RBM38 and thereby enhances p53 expression, suggesting that D202 in eIF4E interacts with S195 in RBM38. Moreover, we generated an Rbm38 S193D KI mouse model in which human-equivalent serine-193 is substituted with aspartic acid. We showed that S193D KI enhances p53-dependent cellular senescence and that S193D KI mice have a shortened life span and are prone to spontaneous tumors, chronic inflammation, and liver steatosis. Together, we provide in vivo evidence that the RBM38-eIF4E loop can be explored to fine-tune p53 expression for therapeutic development.
Human nucleoli comprise multiple constrained territories, tethered to individual chromosomes
Authors: Mangan Hazel , McStay Brian
Published: March 2021

It is unknown how ribosomal gene (rDNA) arrays from multiple chromosomal nucleolar organizers (NORs) partition within human nucleoli. Exploration of this paradigm for chromosomal organization is complicated by the shared DNA sequence composition of five NOR-bearing acrocentric chromosome p-arms. Here, we devise a methodology for genetic manipulation of individual NORs. Efficient “scarless” genome editing of rDNA repeats is achieved on “poised” human NORs held within monochromosomal cell hybrids. Subsequent transfer to human cells introduces “active” NORs yielding readily discernible functional customized ribosomes. We reveal that ribosome biogenesis occurs entirely within constrained territories, tethered to individual NORs inside a larger nucleolus.
Effects of open innovation breadth on industrial innovation input–output relationships
Authors: Frank Alejandro Germán , Benitez Guilherme Brittes , Ferreira Lima Mateus , Bernardi João Augusto Bonzanini
Published: March 2021

Purpose

Open innovation breadth (OIB) considers the diversity of external collaboration partners for innovation. The authors investigate the moderating effect of OIB on the relationship between industrial innovation activities (innovation inputs) and industrial innovation results (innovation outputs).

Design/methodology/approach

This study is based on secondary data from the Brazilian innovation survey, representing more than 30,000 innovative companies across 55 industrial sectors.

Findings

This study’s results show that OIB has different moderating effects regarding the several innovation input–output relationships. While OIB benefits some relationships, others are hampered by the diversity of collaboration partners.

Originality/value

Few studies have addressed OIB at the macro level. Using the perspective of transaction cost economics (TCE), the authors discuss the contributions and limitations of OIB at the industry level.
Contribution of PCA/K-means methods to the mixed assessment of patient safety culture
Authors: Fourar Youcef Oussama , Djebabra Mebarek , Benhassine Wissal , Boubaker Leila
Published: March 2021

Purpose

The assessment of patient safety culture (PSC) is a major priority for healthcare providers. It is often realized using quantitative approaches (questionnaires) separately from qualitative ones (patient safety culture maturity model (PSCMM)). These approaches suffer from certain major limits. Therefore, the aim of the present study is to overcome these limits and to propose a novel approach to PSC assessment.

Design/methodology/approach

The proposed approach consists of evaluating PSC in a set of healthcare establishments (HEs) using the HSOPSC questionnaire. After that, principal component analysis (PCA) and K-means algorithm were applied on PSC dimensional scores in order to aggregate them into macro dimensions. The latter were used to overcome the limits of PSC dimensional assessment and to propose a quantitative PSCMM.

Findings

PSC dimensions are grouped into three macro dimensions. Their capitalization permits their association with safety actors related to PSC promotion. Consequently, a quantitative PSC maturity matrix was proposed. Problematic PSC dimensions for the studied HEs are “Non-punitive response to error”, “Staffing”, “Communication openness”. Their PSC maturity level was found underdeveloped due to a managerial style that favors a “blame culture”.

Originality/value

A combined quali-quantitative assessment framework for PSC was proposed in the present study as recommended by a number of researchers but, to the best of our knowledge, few or no studies were devoted to it. The results can be projected for improvement and accreditation purposes, where different PSC stakeholders can be implicated as suggested by international standards.
Challenges of being a digitally savvy principal
Authors: Richardson Jayson W. , Watts Jeremy Lucian Daniel , Sterrett William L.
Published: March 2021

Purpose

The purpose of this study was to better understand the challenges faced by leaders who have demonstrated excellence in integrating technology into teaching and learning in P-12 schools in the United States.

Design/methodology/approach

This case study of technology savvy P-12 school principals provides insights into how building leaders overcome digital technology innovation challenges. In the summer of 2017, the authors interviewed 12 of the 18 recipients of the NASSP Digital Principal Award. These principals serve as examples of how to lead schools in the digital age.

Findings

Using Bolman and Deal's (2013) conceptual framework, the authors analyzed the data around the four frames (i.e., political, structural, human resources, and symbolic) to understand the challenges of being a digital principal. Bolman and Deal posited leaders who function predominantly in a single frame may miss essential organizational change elements.

Research limitations/implications

The authors recognize several limitations in this study. First, the nominating process for the NASSP Digital Principals award involves an application process. Thus, while these principals were recognized for meeting these criteria, it is possible that these awardees were selected based on their nomination materials rather than on actual longitudinal evidence. Second, this study's data were gathered through interviews. The authors did not gather data through student work samples, teacher and staff interviews, or other data points, but rather the single data point of principal perspectives through interviews.

Originality/value

One silver lining from the pandemic is that leading schools cannot be detangled from the digital needs of diverse stakeholders. As such, digital principalship has become the new norm where the principal leads on a screen, teachers teach on a screen, and students learn on a screen. The award-winning digital principals in this study played an integral role in how they message their school's story, how they navigate and design structures, how they overcome political realities, and how they invest in addressing the needs of individuals.
Production of 11α‐hydroxysteroids from sterols in a single fermentation step by Mycolicibacterium smegmatis
Authors: Felpeto‐Santero Carmen , Galán Beatriz , García José Luis
Published: March 2021

11α‐hydroxylated steroid synthons are one of the most important commercially pharmaceutical intermediates used for the production of contraceptive drugs and glucocorticoids. These compounds are currently produced by biotransformation using fungal strains in two sequential fermentation steps. In this work, we have developed by a rational design new recombinant bacteria able to produce 11α‐hydroxylated synthons in a single fermentation step using cholesterol (CHO) or phytosterols (PHYTO) as feedstock. We have designed a synthetic operon expressing the 11α‐hydroxylating enzymes from the fungus Rhizopus oryzae that was cloned into engineered mutant strains of Mycolicibacterium smegmatis that were previously created to produce 4‐androstene‐3,17‐dione (AD), 1,4‐androstadiene‐3,17‐dione (ADD) from sterols. The introduction of the fungal synthetic operon in these modified bacterial chassis has allowed producing for the first time 11αOH‐AD and 11αOH‐ADD with high yields directly from sterols in a single fermentation step. Remarkably, the enzymes of sterol catabolic pathway from M. smegmatis recognized the 11α‐hydroxylated intermediates as alternative substrates and were able to efficiently funnel sterols to the desired hydroxylated end‐products.
Association between benzodiazepine outpatient treatment and risk of early seizure recurrence in emergency patients with seizure: A multicenter retrospective study
Authors: Roussel Melanie , Chauvin Anthony , Le Borgne Pierrick , Drogrey Marie , Eyer Xavier , Hatabian Ulysse , Choquet Christophe , Peyrony Olivier , Luhmann Laura , Kassasseya Christian , Belaud Valentin , Navarro Vincent , Bloom Ben , Montassier Emmanuel , Freund Yonathan
Published: March 2021

Introduction

Seizures are one of the most common neurological reasons for emergency department (ED) visits. The benefit of ED‐initiated, short‐course outpatient benzodiazepine (BZD) treatment to prevent early recurrent seizure is unknown. This study assesses the risk of early seizure recurrence in patients who were or were not started with outpatient BZD in the ED.

Methods

This was a multicenter retrospective study conducted in eight French EDs between January 1 and December 31, 2019. All patients admitted for seizure were retrospectively screened and those discharged home from the ED were included. Patients with a history of chronic alcohol intoxication or chronic BZD therapy were excluded. Baseline characteristics, type of seizure, and 30‐day outcome were retrospectively collected from the electronic health records. The primary endpoint was a return visit for seizure recurrence within 30 days. Independent factors associated with a seizure recurrence were identified using a multivariable binary logistic regression.

Results

A total of 2,218 patients were included and 1,820 were analyzed. The median age was 39 years and 60% were men. Among them 82% of patients had a generalized tonic–clonic seizure and 47% of seizures were idiopathic. BZD treatment was started in 773 (42%) patients. A total of 154 (8%) patients had an early recurrence at 30 days: 68 (9%) in patients who were treated with BZD versus 86 (8%) in patients who were not (odds ratio [OR] = 1.07, 95% confidence interval [CI] = 0.71 to 1.43). In multivariable analysis, two factors were independently associated with the primary endpoint: chronic epileptic treatment (adjusted OR = 2.58, 95% CI = 1.55 to 4.37) and having had a focal seizure (adjusted OR = 2.16, 95% CI = 1.56 to 4.37).

Conclusion

BZD therapy was started in 42% of patients who were discharged home after ED visit for a seizure. This treatment was not an independent factor associated with the risk of return visit for seizure recurrence at 30 days.
Guided endodontics: The impact of new technologies on complex case solution
Authors: Loureiro Marco Antônio Z. , Silva Julio A. , Chaves Gustavo S. , Capeletti Lucas R. , Estrela Carlos , Decurcio Daniel A.
Published: March 2021

Discuss the impact of new diagnostic and planning technologies on the resolution of a clinical case of an upper central incisor with lateral perforation, root canal calcification and apical periodontitis. A 44‐year‐old woman sought treatment because of a colour change in an anterior tooth. The tooth had already been endodontically accessed, and she reported that two different clinicians had failed to locate the root canal. A Cone Beam Computed Tomography scan showed excessive wear and root perforation in the middle third, as well as pulp canal obliteration in the apical third. The perforation was treated using a biomaterial, and the root canal was located using guided endodontics. This treatment protocol was used to access, prepare, medicate with calcium hydroxide for 21 days and fill the root canal. Treatment results were satisfactory at 6‐month follow‐up.
Swiss neonatal caregivers express diverging views on parental involvement in shared decision‐making for extremely premature infants
Authors: Fauchère Jean‐Claude , Klein Sabine D. , Hendriks Manya J. , Baumann‐Hölzle Ruth , Berger Thomas M.B. , Bucher Hans Ulrich ,   the Swiss Neonatal End‐of‐Life Study Group
Published: March 2021

Aim

Due to scarce available national data, this study assessed current attitudes of neonatal caregivers regarding decisions on life‐sustaining interventions, and their views on parents' aptitude to express their infant's best interest in shared decision‐making.

Methods

Self‐administered web‐based quantitative empirical survey. All 552 experienced neonatal physicians and nurses from all Swiss NICUs were eligible.

Results

There was a high degree of agreement between physicians and nurses (response rates 79% and 70%, respectively) that the ability for social interactions was a minimal criterion for an acceptable quality of life. A majority stated that the parents' interests are as important as the child's best interest in shared decision‐making. Only a minority considered the parents as the best judges of what is their child's best interest. Significant differences in attitudes and values emerged between neonatal physicians and nurses. The language area was very strongly associated with the attitudes of neonatal caregivers.

Conclusion

Despite clear legal requirements and societal expectations for shared decision‐making, survey respondents demonstrated a gap between their expressed commitment to shared decision‐making and their view on parental aptitude to formulate their infant's best interest. National guidelines need to address these barriers to shared decision‐making to promote a more uniform nationwide practice.
“Unlucky punch”: unexpected annular rupture during TAVR and successful treatment
Authors: Geyer Martin , Tamm Alexander , Dohle Daniel‐S. , Kornberger Angela , Schnorbus Boris , Beiras‐Fernandez Andres , Münzel Thomas , von Bardeleben Ralph Stephan
Published: March 2021

Although rare, annular rupture in TAVR is a feared and often unpredictable complication with relevant impact on in‐hospital prognosis. Severe annular calcification is a common risk factor for annular rupture. We report on a case of annular rupture during TAVR with a balloon‐expanded prosthesis in the absence of any annular calcification in the planning CT scan and illustrate the proposed pathomechanism as well as its successful immediate surgical management.
Monitoring the effects of COVID‐19 in emerging adults with pre‐existing mood and anxiety disorders
Authors: Osuch Elizabeth , Demy Jazzmin , Wammes Michael , Tremblay Paul , Vingilis Evelyn , Carter Chlöe
Published: March 2021

Aim

The COVID‐19 quarantine closed many mental health services. Emerging adults with pre‐existing mood or anxiety disorders were of concern for worsening symptoms. We sought to demonstrate a method for monitoring mental health status of a group of patients with reduced access to their usual mental health services during quarantine.

Methods

A total of 326 patients enrolled in the First‐Episode Mood and Anxiety Program in London, Ontario, Canada were invited to participate in online questionnaires regularly. Patients were flagged for high level of risk based on depression scores, suicidal ideation and worsening in anxiety, depression or quality of health. All patients were also asked if they wanted contact with a clinician.

Results

One hundred and fourteen (35%) patients completed at least one questionnaire. Thirty were flagged based on scores; 37 (32.5%) participating patients requested help. Participants who were flagged for concerning scores were younger, more likely to be on the wait list for treatment, to have been laid off from work and have more functional impairment. Participants requesting support had higher symptom scores for depression and lower scores on quality of health.

Conclusions

The process utilized here identified patients at risk and in need of clinical support in the context of pandemic quarantine. It provided an accessible avenue for invited patients to communicate both symptom status and need for contact. Such a process can provide valuable monitoring during times when the usual communications between patients and health care providers is compromised and clinician time is limited. It is easily implemented.