bluuebunny/crossref_metadata_2025 huggingface dataset:
High genetic drift in endangered northern peripheral populations of the Behr's hairstreak butterfly (Satyrium behrii)
Authors: Keyghobadi Nusha , Crawford Lindsay A. , Desjardins Sylvie
Published: December 2020

The persistence and adaptation of leading‐edge peripheral populations may be critical for allowing species to shift their range limits under climate change. However, peripheral populations are potentially vulnerable to genetic, demographic, and environmental stochasticity.

Here, we characterise genetic variation across space and among years in northern peripheral populations of the Behr's hairstreak butterfly in British Columbia, Canada. This butterfly is dependent on antelope‐brush ecosystems that are threatened in this part of the world and is federally listed as Endangered in Canada.

Using a large panel of amplified fragment length polymorphism (AFLP) genetic markers, we found low diversity in these populations. We also detected a high degree of year‐to‐year variation in allele frequencies, resulting in low effective population size estimates.

Our findings suggest that Canadian populations of the Behr's hairstreak experience high genetic drift and may be vulnerable to genetic stochasticity.

Unstable demography, low effective population size, and low genetic diversity in these populations could impede their adaptation to rapidly changing environmental conditions and contribute to a contraction of the species' range under climate change.
Potential misdiagnosis of von Willebrand disease caused by insufficient mixing after thawing frozen plasma
Authors: Jo Su‐Yeon , Kim In‐Suk , Kim Hyerim
Published: December 2020

Introduction

von Willebrand disease (vWD) is a common inherited bleeding disorder caused by a deficiency in von Willebrand factor (vWF), but many laboratories and clinicians continue to struggle with diagnosing or excluding vWD. Its diagnosis requires laboratory testing, which may be compromised by preanalytical events, including poor specimen quality. This study assessed 17 different preanalytical conditions as potential causes of vWD misdiagnosis.

Methods

Specimens from healthy controls (N = 21) were obtained. vWF antigen and vWF activity were analyzed using a newly developed automatic coagulation analyzer according to various preanalytic conditions such as centrifugation conditions, storage room temperature before centrifugation, cold storage temperature after centrifugation, thawing conditions, and inadequate mixing of thawed citrated plasma following the recommendations of the Clinical and Laboratory Standards Institute (CLSI) H21‐A5 guidelines.

Results

The only condition that was significantly different from the reference condition was lack of mixing after thawing frozen citrated plasma (vWF activity and antigen were reduced by 58.7% and 49.6%, respectively). Our study showed that mixing after thawing was more important than the chosen method of mixing.

Conclusion

Thawed plasma should be mixed because of the risk of misdiagnosing vWD. Further education regarding the importance of appropriate mixing is warranted to achieve results comparable to those of freshly centrifuged samples.
Robot‐assisted partial nephrectomy versus standard laparoscopic partial nephrectomy for renal hilar tumor: A prospective multi‐institutional study
Authors: Hinata Nobuyuki , Shiroki Ryoichi , Tanabe Kazunari , Eto Masatoshi , Takenaka Atsushi , Kawakita Mutsushi , Hara Isao , Hongo Fumiya , Ibuki Naokazu , Nasu Yasutomo , Teishima Jun , Kawai Noriyasu , Kawauchi Akihiro , Kondo Tsunenori , Kawamorita Naoki , Oyama Chikara , Horie Shigeo , Shimbo Masaki , Kato Masashi , Kanayama Hiroomi , Koito Yuya , Fujisawa Masato ,   the Japanese Society of Endourology
Published: December 2020

Objective

To investigate whether robot‐assisted partial nephrectomy compared with laparoscopic partial nephrectomy is effective for renal hilar tumor removal.

Methods

This was a prospective, multicenter, single‐arm, open‐label trial with a 2‐year enrollment period. A total of 22 academic hospitals in Japan participated in the present study. Comparison with historical control values from reported studies of laparoscopic partial nephrectomy was carried out. The warm ischemia time and positive surgical margin rate were set as primary perioperative and oncological outcomes. In the historical control group, these were 27.7 min and 13%, respectively.

Results

The analysis population included 105 participants. The mean warm ischemia time was 20.2 (95% confidence interval 16.7–21.8; P < 0.0001 vs 27.7). Two of 103 participants (1.9%) had a positive surgical margin (95% confidence interval 0.5–6.8%). Both results satisfy the prespecified decision criteria for the superiority of robot‐assisted partial nephrectomy over the historical control of laparoscopic partial nephrectomy. Resected weight and preoperative estimated glomerular filtration rate were predictive factors of functional loss of the partially nephrectomized kidney after robot‐assisted partial nephrectomy.

Conclusion

Robot‐assisted partial nephrectomy for clinical T1 renal hilar tumors results in shorter warm ischemia time than and comparable positive surgical margin rate to those reported for laparoscopic partial nephrectomy.
Molecular characterization of N‐methyl‐d‐aspartate receptor from Bemisia tabaci
Authors: Dixit S. , Thakur N. , Shukla A. , Upadhyay S. K. , C. Verma P.
Published: December 2020

The N‐methyl‐d‐aspartate receptors (NMDARs) are ionotropic ligand gated channels that are highly permeable to calcium ions. In insects, NMDARs are associated with glutamatergic neurotransmission governing diverse physiological and biological processes like vitellogenesis and ovarian development. Therefore, NMDAR may act as attractive target for insect pest control. In present study, we performed structural and functional characterization of NMDARs in Bemisia tabaci, a highly invasive crop pest and potent virus vector. We identified that NMDAR consists of three subunits each encoded by single gene in whiteflies which are highly conserved among different insect orders. Expression analysis suggests that subunit 1 (BtNR1) and subunit 2 (BtNR2) are the main functional units. External supplementation of NMDAR ligand or BtNRs silencing was lethal to insects, which suggested that NMDAR function is highly balanced in whiteflies.
Ecdysis triggering hormone is essential for larva–pupa–adult transformation in Leptinotarsa decemlineata
Authors: Shen C.‐H. , Xu Q.‐Y. , Fu K.‐Y. , Guo W.‐C. , Jin L. , Li G.‐Q.
Published: December 2020

In Drosophila melanogaster, ecdysis triggering hormone (ETH) is the key factor triggering ecdysis behaviour and promoting trachea clearance. However, whether ETH plays the dual roles in non‐dipteran insects is unknown. In this survey, we found that Ldeth mRNA levels were positively correlated with circulating 20‐hydroxyecdysone (20E) titers in Leptinotarsa decemlineata. Ingestion of an ecdysteroid agonist halofenozide or 20E stimulated the transcription of Ldeth, whereas RNA interference (RNAi) of ecdysteroidogenesis (LdPTTH or LdSHD) or 20E signalling (LdEcR, LdUSP or LdFTZ‐F1) genes inhibited the expression, indicating ETH acts downstream of 20E. RNAi of Ldeth at the final instar stage impaired pupation. More than 80% of the Ldeth‐depleted beetles remained as prepupae, completely wrapped in the old larval cuticles. These prepupae became withered, dried and darkened gradually, and finally died in soil. The remaining Ldeth hypomorphs pupated and emerged as abnormal adults, bearing smaller and wrinkle elytrum and hindwing. Moreover, the tracheae in the Ldeth hypomorphs were full of liquid. We accordingly proposed that the failure of trachea clearance disenabled air‐swallowing after pupa–adult ecdysis and impacted wing expansion. Our results suggest that ETH plays the dual roles, initiation of ecdysis and motivation of trachea clearance, in a coleopteran.
Ablation guided by STAR‐mapping in addition to pulmonary vein isolation is superior to pulmonary vein isolation alone or in combination with CFAE/linear ablation for persistent AF
Authors: Honarbakhsh Shohreh , Schilling Richard J. , Providencia Rui , Dhillon Gurpreet , Bajomo Omotomilola , Keating Emily , Finlay Malcolm , Hunter Ross J.
Published: December 2020

Introduction

The optimal ablation approach for persistent atrial fibrillation (AF) remains unclear.

Methods and Results

Objective was to compare the long‐term rates of freedom from AF/AT in patients that underwent STAR mapping guided ablation against outcomes of patients undergoing conventional ablation procedures.

Patients undergoing ablation for persistent AF as part of the Stochastic Trajectory Analysis of Ranked signals (STAR) mapping study were included. Outcomes following 'pulmonary vein isolation (PVI) plus STAR mapping guided ablation (STAR mapping cohort) were compared to patients undergoing PVI alone ablation during the same time period and also a propensity‐matched cohort undergoing PVI plus the addition of complex fractionated electrogram (CFAE) and/or linear ablation (“conventional ablation”). Rates of procedural AF termination and freedom from AF/AT during follow‐up were compared.

Sixty‐five patients were included in both the STAR cohort and propensity matched conventional ablation cohort. AF termination rates were significantly higher in the STAR cohort (51/65, 78.5%) than conventional ablation cohort (10/65, 15.4%) and PVI alone ablation cohort (13/50, 26.0%; STAR cohort vs. other 2 cohorts both p < .001). There was no significant difference in procedure time between the three cohorts. During ≥20 months follow‐up a lower proportion of patients had AF/AT recurrence in the STAR cohort (20.0%) compared with the conventional ablation cohort (50.8%) or the PVI alone ablation cohort (50.0%; both p < .05 compared to STAR cohort).

Conclusions

Outcomes of PVI plus STAR mapping guided ablation was superior to PVI alone or in combination with linear/CFAE ablation. A multicenter randomized controlled trial is planned to confirm these findings.
Surface unipolar electrogram characteristics to predict site of origin of outflow tract arrhythmias using noninvasive mapping
Authors: Coleman Kristie M. , Saleh Moussa , Makker Parth , Vaishnav Aditi S. , Atteya Gourg , Shein Jamie , Bhullar Amarbir , Skipitaris Nicholas T. , Mountantonakis Stavros E.
Published: December 2020

Background

Noninvasive electroanatomic mapping (NIEAM) demonstrate patterns of depolarization that are useful in identifying the chamber of origin (COO) in outflow tract ventricular arrhythmias (OTVA). However, its use in predicting exact site of origin (SOO) has not yet been validated.

Methods

NIEAMs (CardioInsight, Medtronic) from 40 patients (age 62.5 ± 2.6) undergoing ablation for OTVA were reviewed for diagnostic accuracy in predicting the SOO. Earliest arrhythmia breakout and directionality of earliest instantaneous unipolar electrograms (uEGMs) on NIEAMs were evaluated subjectively by two observers for quality and amplitude. Sites with most negative earliest uEGMs on right and left ventricular outflow tracts, as well as epicardial surface were manually identified. Using NIEAM‐based activation timing of the lateral mitral annulus and basal septum COO was identified for each OTVA. Predictions of SOO using NIEAMs was compared with true SOO from invasive study. NIEAMs SOO predictions were compared with subjective 12 lead electrocardiogram (ECG) review by two observers.

Results

Review of arrhythmia breakout and signal directionality had poor diagnostic value in predicting SOO in OTVA (50.6% and 49.4%, 56.6% and 43.4%, respectively) and underperformed compared with ECG interpretation (59.1% and 80.5%). After excluding uEGMs with poor characteristics, the uEGM with most negative amplitude at the COO was predictive of the true SOO with 96.4% sensitivity and specificity.

Conclusion

We propose a stepwise approach when interpreting NIEAMs for OTVA where patterns of activation are evaluated first to determine the COO, followed by identification of the site with most negative amplitude instantaneous uEGM to determine SOO.
Procedure characteristics and outcomes of atrial fibrillation ablation procedures using cryoballoon versus radiofrequency ablation: A report from the GWTG‐AFIB registry
Authors: Friedman Daniel J. , Holmes DaJuanicia , Curtis Anne B. , Ellenbogen Kenneth A. , Frankel David S. , Knight Bradley P. , Russo Andrea M. , Matsouaka Roland , Turakhia Mintu P. , Lewis William R. , Piccini Jonathan P.
Published: December 2020

Introduction

Cryoballoon ablation (CBA) is an alternative to radiofrequency ablation (RFA) for ablation of atrial fibrillation (AF) and real‐world comparisons of this strategy are lacking. As such, we sought to compare patient and periprocedural characteristics and outcomes of CBA versus RFA in the Get With the Guidelines AFIB Registry.

Methods

Categorical variables were compared via the χ2 test and continuous variables were compared via the Wilcoxon rank‐sum test. Adjusted analyses were performed using overlap weighting of propensity scores.

Results

A total of 5247 (1465 CBA, 3782 RFA) ablation procedures were reported from 33 sites. Those undergoing CBA more often had paroxysmal AF (60.0% vs. 48.8%) and no prior AF ablation (87.5% vs. 73.8%). CHA2DS2‐VASc scores were similar. Among de novo ablations, most ablations involved intracardiac echocardiography and electroanatomic mapping, but both were less common with CBA (87.3% vs. 93.9%, p < .0001, and 87.7% vs. 94.6%, p < .0001, respectively). CBA was associated with shorter procedures (129 vs. 179 min, p < .0001), increased fluoroscopy use (19 vs. 11 min, p < .0001), and similar ablation times (27 vs. 35 min, p = .15). Nonpulmonary vein ablation was common with CBA: roof line 38.6%, floor line 20.4%, cavotricuspid isthmus 27.7%. RFA was associated with more total complications compared to CBA (5.4% vs. 2.3%, p < .0001), due to more volume overload and “other” events, although phrenic nerve injury was more common with CBA (0.9% vs 0.1%, p = .0001). In the adjusted model, any complication was less common among CBA cases (odds ratio, 0.45; confidence interval, 0.25–0.79, p = .0056).

Conclusion

CBA was associated with fewer complications, and shorter procedure times, and greater fluoroscopy times, compared to RFA. Nonpulmonary vein ablation and electroanatomic mapping system use was common with CBA.
Confounders of the aldosterone‐to‐renin ratio when used as a screening test in hypertensive patients: A critical analysis of the literature
Authors: Veldhuizen Gregory P. , Alnazer Rawan M. , Kroon Abraham A. , de Leeuw Peter W.
Published: December 2020

The aldosterone‐to‐renin ratio (ARR) is a common screening test for primary aldosteronism in hypertensives. However, there are many factors which could confound the ARR test result and reduce the accuracy of this test. The present review's objective is to identify these factors and to describe to what extent they affect the ARR. Our analysis revealed that sex, age, posture, and sodium‐intake influence the ARR, whereas assay techniques do not. Race and body mass index have an uncertain effect on the ARR. We conclude that several factors can affect the ARR. Not taking these factors into account could lead to misinterpretation of the ARR.
Association of thyroid hormones with blood pressure and arterial stiffness in the general population: The Dali study
Authors: Jamal Md Tasneem , Li Qing‐Lu , Li Qi‐Yan , Liang Wan‐Ying , Wang Li‐Hong , Wei Jian‐Hang , Liang Quan , Hu Nai‐Qing , Li Li‐Hua
Published: December 2020

Thyroid dysfunction plays a role in blood pressure (BP) regulation. However, the associations between thyroid function and BP and arterial stiffness in the general Chinese population without thyroid disease are unknown. This population‐based cross‐sectional study aimed to investigate the association between thyroid function and peripheral and central BP and arterial stiffness in Chinese individuals. After excluding those who had thyroid diseases or incomplete clinical measurements, this study included 691 participants. Of the participants, 444 (64.2%) were women and 215 (31.1%) had hypertension. After adjustment for covariates, serum FT3 was significantly associated with a higher pulse rate in both sexes. In men, each 2.72‐fold increase in serum FT4 levels was associated with higher peripheral systolic BP (+10.82 mmHg, p = .005) and pulse pressure (+5.71 mmHg, p = .03). Each 2.72‐fold increase in serum FT4 levels was associated with higher central systolic BP (+8.03 mmHg, p = .03) and pulse pressure (+3.89 mmHg, p = .05). In women, serum FT4 was only associated with a higher central pulse pressure (+2.96 mmHg, p = .04). After adjustment for covariates, serum FT4 was significantly associated with a faster cfPWV exclusively in men. Our study showed that serum FT4 is associated with higher peripheral and central BP and faster cfPWV in men, whereas serum FT3 is positively associated with a higher pulse rate in both sexes, indicating that the effects of thyroid function on BP and arterial stiffness are more significant in men than in women.
The effect of chlorhexidine primer application on the clinical performance of composite restorations: a literature review
Authors: Josic Uros , Maravic Tatjana , Mazzitelli Claudia , Del Bianco Federico , Mazzoni Annalisa , Breschi Lorenzo
Published: December 2020

To discuss the effectiveness of chlorhexidine (CHX) used as therapeutic dentin primer in adhesively bonded composite restorations.

Overview

An electronic search in MEDLINE database, accessed through PubMed was conducted. No restrictions of languages and date of publication were made. The following key words were used: “chlorhexidine”, “composite” and “composite resins.” Clinical studies in which CHX was used during bonding procedures were included in this review. Six studies met the inclusion criteria. Of these, five studies were carried out on noncarious cervical lesions (NCCL). Only one study was carried out on class II preparation of permanent molars. In all studies, either etch‐and‐rinse and self‐etch adhesive systems were used during bonding procedures. On the basis of the reviewed clinical trials, it can be concluded that CHX primer application does not seem to influence clinical outcome of composite restorations.

Clinical significance

Current scientific evidence cannot neither strongly recommend nor discourage the application of CHX as therapeutic primer in composite restorations. Studies with longer follow‐up periods with adhesive restorations placed on dentin after caries removal, rather than only on NCCL, are desirable to further investigate the therapeutic effect of CHX during bonding procedures.
The Attitudes and Beliefs of Australian Midwives and Obstetricians About Birth Options and Labor Interventions
Authors: Coates Dominiek , Donnolley Natasha , Henry Amanda
Published: December 2020

Introduction

The global rise in the rate of induction of labor and cesarean birth shows considerable unexplained variation both within and between countries. Prior research suggests that the extent to which women are engaged in the decision‐making process about birth options, such as elective cesarean, induction of labor, or use of fetal monitoring, is heavily influenced by clinician beliefs and preferences. The aim of this study was to investigate the beliefs about labor interventions and birth options held by midwives and obstetric medical staff from 8 Sydney hospitals and assess how the health care providers’ beliefs were associated with discipline or years of experience.

Methods

This is a survey study of midwives and obstetric staff that was distributed between November 2018 and July 2019. Modified from the previously validatedbirth attitudes surveyfor the Australian context, survey domains include (1) maternal choice and woman's role in birth, (2) safety by mode or place of birth, (3) attitudes toward cesarean birth for preventing urinary incontinence, (4) approaches to decrease cesarean birth rates, and (5) fears of birth mode. Responses were compared between professions and within professions by years of experience using Mann‐WhitneyUtesting.

Results

A total of 217 midwives and 58 medical staff completed the survey (response rate, 30.5%). Midwifery staff responses generally favored a physiologic approach to birth, versus beliefs more in favor of intervention (particularly cesarean birth) among medical staff. There was interprofessional discrepancy on most items, particularly regarding safety of mode or place of birth and approaches to decrease cesarean birth rates. Within disciplines, there was more variation in medical staff attitudes than within the midwifery staff. No clinically important differences in beliefs by years of experience were noted.

Discussion

Clinicians need to be aware of their own beliefs and preferences about birth as a potential source of bias when counselling women, particularly when there are a range of treatment options and the evidence may not strongly favor one option over another. As both groups had similar perceptions about the importance of women's autonomy, shared decision‐making training could help bridge belief gaps and improve care around birth decisions.
Fasted and fed small bowel motility patterns at cine‐MRI in chronic intestinal pseudo‐obstruction
Authors: van Rijn Kyra L. , Bredenoord Albert J. , Smout André J. P. M. , Bouma Gerd , Tielbeek Jeroen A. W. , Horsthuis Karin , Stoker Jaap , de Jonge Catharina S.
Published: December 2020

Background

Chronic intestinal pseudo‐obstruction (CIPO) is a severe intestinal motility disorder of which the pathophysiology is largely unknown. This study aimed at gaining insight in fasted and fed small bowel motility in CIPO patients using cine‐MRI with caloric stimulation.

Methods

Eight adult patients with manometrically confirmed CIPO were prospectively included. Patients underwent a cine‐MRI protocol after an overnight fast, comprising fasting‐state scans and scans after ingestion of a meal (Nutridrink, 300 kcal). Small bowel motility was quantified resulting in a motility score in arbitrary units (AU) and visually assessed by three radiologists. Findings were compared with those in 16 healthy volunteers.

Key Results

Motility scores (median, IQR) in CIPO patients were 0.21 (0.15–0.30) in the fasting state and 0.23 (0.15–0.27) directly postprandially. In healthy volunteers, corresponding motility scores were 0.15 (0.13–0.18) and 0.22 (0.19–0.25), respectively. The postprandial change in motility score was +1% (−19 to +21%) in CIPO and +39% (+23 to +50%) in healthy volunteers (p = 0.001*). Visual analysis revealed increased small bowel contractility in four, normal in two, and decreased in two CIPO patients.

Conclusions & Inferences

Surprisingly, we found hyperactive small bowel motility in half of the CIPO patients, suggestive of uncoordinated motility. A wide variation in motility patterns was observed, both higher, lower, and comparable contractility compared with healthy subjects. No clear postprandial activation was seen in patients. Cine‐MRI helps to gain insight in this complex disease and can potentially impact treatment decisions in the future.
Genetic characterization of the red coloured corolla phenotype for Gossypium arboreum accession PI 529731
Authors: Erpelding John E.
Published: December 2020

Flower corolla colour is an important trait for the attraction of pollinators and for the horticultural industry. Gossypium arboreum (L.) accessions from the United States Department of Agriculture germplasm collection frequently show flowers with a yellow coloured corolla. Accession PI 529731 is unique in that the flowers have a red coloured corolla. Genetic characterization of corolla pigmentation was conducted by crossing PI 529731 with two white flower accessions. Flowers with a red corolla were observed in the F1 generations suggesting a dominant trait. Variation in corolla colour was observed for plants in the F2 populations including dark red, red, light red, white, yellow and white with petals having red coloured margins. These data support a single dominant gene conferring the four red corolla phenotypes. The yellow corolla phenotype also supported a single dominant gene model. Dominant alleles at both loci are required for expression of the PI 529731 phenotype and data support a two gene model with a 9:3:3:1 segregation ratio. These data are useful for the characterization of genetic mechanisms controlling tissue‐specific pigmentation.
Adverse cutaneous effects of mitogen‐activated protein kinase inhibitors in children
Authors: Dávila Osorio Victoria Lucia , Vicente María Asunción , Baselga Eulalia , Salvador Hector , Cruz Ofelia , Prat Carolina
Published: December 2020

Background

Mitogen‐activated protein kinase inhibitors (MEKi) are currently used for the treatment of central nervous system tumors in children and have shown promising results. Cutaneous adverse effects are among the most common toxicities described in adults, but few studies exist in pediatric patients.

Objective

We aimed to describe the cutaneous adverse effects associated with MEKi in pediatric patients.

Methods

A retrospective study was carried out at our pediatric hospital in Barcelona, Spain, in patients undergoing treatment with MEKi.

Results

Sixty‐one children between 1 and 18 years of age were included. All patients developed cutaneous toxicity. Eczema, hair abnormalities, oral aphthae, and paronychia were among the most common cutaneous side effects.

Conclusions

Recognizing skin toxicity in pediatric patients under treatment with MEKi is essential to establishing appropriate education and therapy, thereby improving treatment tolerability and minimizing avoidable interruptions in treatment.
Autoimmune progesterone dermatitis in the adolescent population
Authors: Aghazadeh Nessa , Chattha Asma J. , Hartz Martha F. , Davis Dawn Marie R.
Published: December 2020

Background/Objective

Autoimmune progesterone dermatitis (APD) is a rare autoimmune hypersensitivity reaction that occurs cyclically at the peak of endogenous progesterone production during the menstrual cycle in women. No study characterizing APD in the adolescent population is found; it appears likely to be underdiagnosed and undertreated.

Methods

A retrospective, single‐center, review of all adolescent and pediatric patients (<20 years old at onset) with documented diagnosis of APD.

Results

Seventeen adolescent APD patients were included (mean age at diagnosis: 14.4 ± 2 years, mean interval of 13.6 ± 11.1 months between symptom onset and diagnosis). Twelve patients presented with urticaria, two with fixed drug eruption. Erythema multiforme, eczema, and recurrent aphthous stomatitis were present in one patient each. Exposure to exogenous progestin was present in two patients prior to disease onset. Progesterone skin test was performed in six patients with positive results in two. Fourteen patients received antihistamines and/or a topical corticosteroid. Combined oral contraceptives (COCs) were given to eleven patients, in seven via continuous daily dosing. Gonadotropin‐releasing hormone agonist (GnRHa) was used in five, progesterone desensitization in four, omalizumab in two, and danazol in one patient.

Conclusions

Adolescent APD is associated with a significant delay in diagnosis. The most common manifestation is urticaria. Exogenous exposure to progestins is uncommon in adolescent APD. Continuous COC, GnRHa, and progesterone desensitization have been used to control symptoms. Large, multicenter studies are required to better define, diagnose, and treat this under recognized condition among adolescent patients.
The sources of international investment income in emerging market economies
Authors: Joyce Joseph P.
Published: December 2020

We investigate international investment income flows in 26 emerging market countries during the period of 1998–2015. Net investment income registered a deficit for this group of countries of between 2% and 3% of GDP during this period. This deficit has been dominated by payments on foreign direct investment liabilities, which is consistent with the change in the composition of the external liabilities of these countries. Our results indicate that both capital account and trade openness are associated with the deficits on direct investment income. In addition, there was a small deficit in portfolio investment income, which is affected by the development of domestic financial markets and investor protection. Other investments’ income and the income from foreign exchange reserves have a negligible role in total investment income.
The case for starting a new exchange rate after debt settlement: Reexamining alternatives to Argentina’s exchange rate policy in 2001–2002
Authors: Ho Tai‐kuang , Lin Ya‐chi , Yeh Kuo‐chun
Published: December 2020

This research explores the question of which exchange rate regime would bring about better output and price stability, given the initial conditions and the external shocks facing Argentina’s economy in 2001–2002. Our analytical model incorporates a transmission mechanism, the balance‐sheet effects, which formulates the possible interaction between foreign debt and exchange rate policy. We find that a floating exchange rate that depends on external finance outperforms dollarization, after supposing the amount of foreign debt payments is limited. As the relative performance of alternative exchange rate arrangements depends on the foreign debt payments, our empirical results imply that the restructuring of foreign debt should be an integral part of any negotiation concerning the postcrisis exchange rate regime. Our results also show that with the existence of foreign debt, the policy trade‐off implied by the Trilemma becomes much constrained.
Dental infection associated with exuberant gingival necrosis in a patient with paroxysmal nocturnal hemoglobinuria: A case report
Authors: Ximenes Iury da Silva , Filho Osias Vieira de Oliveira , Malta Cássia Emanuella Nóbrega , Dantas Thinalli Sousa , Alves Ana Paula Negreiros Nunes , Mota Mario Rogério Lima , Sousa Fabrício Bitu
Published: December 2020

Paroxysmal nocturnal hemoglobinuria (PNH) is a hematological disorder that affects hematopoietic stem cells. An association with other hematological diseases, such as hemolytic anemia and neutropenia, is observed with a high occurrence of aplastic anemia. The aim of the present study is to report a case of dental infection in a patient with PNH exhibiting exuberant gingival involvement. A 45‐year‐old male patient sought the Federal University of Ceara reporting severe toothache associated with tooth 24. Clinical examination revealed that the tooth was associated with an apparent fistula and a yellowish lesion with smooth surface located in the palate. The patient had interrupted the medication to control PNH. Blood transfusion was requested due to deficient hematological parameters. Tooth extraction and excisional biopsy were performed under antibiotic coverage. In the postoperative period, low‐level laser therapy (LLLT) was performed. Histopathological examination revealed connective tissue showing extensive necrotic areas, accumulation of basophilic material, numerous cyst‐like cavities, and degenerated cells. Histopathological findings were compatible with the initial clinical diagnosis of gingival necrosis. The patient evolved with febrile neutropenia, requiring hospitalization for 1 month. Improvement in the overall health was observed after the administration of antibiotics, eculizumab, and weekly LLLT at the biopsy site.
Dysphagia in a persistently vegetative patient improved by orthodontic treatment of severe dental misalignment
Authors: Tamura Atsuko , Yamaguchi Kohei , Ariya Chantaramanee , Totoki Hisako , Tohara Haruka
Published: December 2020

Introduction

We describe the treatment of severe dysphagia in a patient left in a persistent vegetative state after an episode of hypoxic‐ischemic encephalopathy following a traffic accident.

Case Report

A 38‐year‐old man was in a persistent vegetative state since a traffic accident in 2005, which resulted in cardiopulmonary arrest and hypoxic‐ischemic encephalopathy. His airway had been secured with a tracheostomy, and a gastric tube had been inserted; however, he continued to suffer from urinary tract infections, glossoptosis, and silent aspiration of saliva. Both the maxilla and mandible had very narrow dental arches, with the mandibular incisors exhibiting severe lingual inclination.

Course

We first corrected the dentition in the narrow maxillary arch, followed by the mandibular arch. As the dental alignment improved, tongue movements appeared during oral care, and endoscopy also revealed signs of an active saliva swallowing reflex.

Discussion

The “training approach” generally used to treat severe dysphagia is usually impossible in persistently vegetative patients. In our patient, the tongue movements and saliva swallowing reflex appeared after we expanded the narrow dental arches, suggesting that an orthodontic approach can be effective in such cases. Our findings can be applied to similar cases of vegetative patients to facilitate better oral care and outcomes.
Who Are the Liberal Gun Owners?
Authors: Yamane David , DeDeyne Jesse , Aravena Méndez Alonso Octavio
Published: December 2020

In the recent renaissance of interest in guns among sociologists, studies of the political conservatism of gun owners have proliferated, but we still know very little about politically liberal gun owners. This despite the fact that one in five U.S. gun owners (some 12 million adults) self‐identifies as liberal. This exploratory study, therefore, seeks to understand what seems on the surface to be an interesting and not rare category in American society: the liberal gun owner. In particular, we seek to answer two questions: Do liberal gun owners differ from other liberals who do not own guns and from other gun owners who are not liberal? We answer these questions using data from the General Social Survey, treating liberal gun owners as a category rather than a point on a continuum. Binary and multinomial logistic regressions suggest ways in which liberal gun owners are a distinct group, more resembling their fellow gun owners in their demographic and geographic backgrounds, but differing from moderate and/or conservative gun owners in important ways, including in their propensity to be hunters, religious affiliation, religiosity, and punitive attitudes.
Japanese experiment of a complete and objective automatic grading system of facial signs from selfie pictures: Validation with dermatologists and characterization of changes due to age and sun exposures
Authors: Flament Frederic , Velleman Damien , Yamashita Eri , Nicolas Alexandre , Yokoyama Emilie , Itaya Ayako , Zhang Yuze , Jiang Ruowei , Aarabi Pahram , Abric Aurelie , Nakada Aya , Sagawa Yoko , Nishihara Haruna , Morita Akimichi , Cassier Matthieu , Delaunay Caroline
Published: December 2020

Objective

To evaluate the capacity of the automatic detection system to accurately grade, from smartphones' selfie pictures, the severity of ten facial signs in Japanese women and their changes due to age and sun exposures.

Methods

A three‐step approach was conducted, based on self‐taken selfie images. At first, to check on 310 Japanese women (18‐69 years) enrolled in the northerner Hokkaido area (latitude 43.2°N), how, on ten facial signs, the A.I‐based automatic grading system may correlate with dermatological assessments, taken as reference. Second, to assess and compare age changes in 310 Japanese and 112 Korean women. Third, as these Japanese panelists were recruited according to their usual behavior toward sun exposure, that is, non‐sun‐phobic (NSP, N = 114) and sun‐phobic (SP, N = 196), and through their regular and early use of a photo‐protective product, to characterize the facial photo‐damages.

Results

(a) On the ten facial signs, detected automatically, nine were found significantly (P < .0001) highly correlated with the evaluations made by three Japanese dermatologists (Wrinkles: r = .75; Sagging: r = .80; Pigmentation: r = .75). (b) The automatic scores showed significant changes with age, by decade, of Wrinkles/Texture, Pigmentation, and Ptosis/Sagging (P < .05). (c) After 45 years, a significantly increased severity of Wrinkles/Texture and Pigmentation was observed in NSP vs. SP women (P < .05). A trend of an increased Ptosis/Sagging (P = .09) was observed.

Conclusion

This work illustrates, for the first time through investigations conducted at home, some impacts of aging and sun exposures on facial signs of Japanese women. Results significantly confirm the importance of sun avoidance coupled with photo‐protective measures. In epidemiological studies, the AI‐based system offers a fast, affordable, and confidential approach in detection and quantification of facial signs and their dependence with ages, environments and lifestyles.
Development of a clinical scale to assess the severity of striae distensae
Authors: de Freitas Verena Mony Paes , Miot Hélio Amante , Miot Luciane Donida Bartoli , Nogueira Marcelle Almeida de Sousa , Yarak Samira , Ranulfo Rogerio Tercio , Nunes Gisele Jacobino de Barros , Sanches Jose Antonio , Bagatin Edileia
Published: December 2020

Background and Objective

There is no validated instrument to assess the clinical severity of striae distensae. Here, we aimed to develop a striae distensae severity scale.

Material and Methods

After a Delphi‐based consensus, 15 items related to striae severity were assessed in 110 areas (breasts, abdomen, and buttocks) from 45 participants. The items were analyzed through a partial least squares model to select the most important variables. To assess the reliability of the scale, 43 areas were retested.

Results

Of the 110 areas evaluated, 34 were breasts, 24 abdomens, and 52 buttocks. Striae were considered mild in 30% of the evaluations, moderate in 33%, severe in 21%, and extremely severe in 16%. The final model was composed by: width of the widest striae, width of the striae with the most frequent pattern, atrophy, number of affected quadrants, distribution (multiple or isolated), hypo or hyperchromia and topography. The scores of the scale demonstrated a high correlation with the clinical classification (rho = 0.77). There was a high agreement in the scores from the reassessed areas (intraclass correlation coefficient = 0.90).

Conclusion

An objective and reliable scale to assess the clinical severity of striae distensae on the breasts, abdomen, and buttocks was developed.
Tracking Hispanic Political Emergence in Georgia: An Update
Authors: Hood M.V. , Bullock Charles S.
Published: December 2020

Objective

This short note traces the political presence of Hispanics in Georgia over the last decade and a half. Our analysis examines Hispanics as a group, as well as comparisons to whites and blacks.

Methods

We rely on official records from the Georgia Secretary of State to produce over time inferences concerning Hispanic voter registration and turnout.

Results

Our findings indicate that Hispanics in Georgia have registered steady gains in registration and turnout since the early 2000s. The share of Hispanics in the Georgia electorate, while just over 2 percent in 2018, is also slowly on the rise. Hispanic political influence is less than the group's share in the population due to the presence of non‐citizens, and registration and turnout rates that continue to lag those for whites and blacks.

Conclusion

In the long term, the Hispanic population has the ability to reshape politics in the Peach State. However, given our findings, this process could take years to play out fully.
Establishment of normal reference intervals in dogs using a viscoelastic point‐of‐care coagulation monitor and its comparison with thromboelastography
Authors: Buriko Yekaterina , Drobatz Kenneth , Silverstein Deborah C.
Published: December 2020

Background

Viscoelastic coagulation devices are a useful adjunct to the evaluation of hemostasis in veterinary patients. VCM Vet is a point‐of‐care device that is simple in operation and could be used to diagnose and trend hemostatic abnormalities in sick patients. VCM Vet does not use activators.

Objectives

We aimed to establish reference intervals (RIs) for VCM Vet in a healthy adult canine population and concurrently perform thromboelastographic (TEG) analysis on these samples with and without tissue factor (TF) activation for RI comparisons.

Methods

Duplicate VCM Vet tests were performed immediately upon sample collection. Two concurrent TEG tests were performed on the remaining blood, one citrated, untreated (CU), and one activated with TF at a 1:3600 dilution.

Results

Fifty‐two dogs were enrolled in the study. The following RIs were generated for VCM Vet machine 1 and 2, respectively: clot time (CT) (seconds) 163‐480 and 172‐457; clot formation time (CFT) (seconds) 104‐288 and 94‐252, α‐angle (degrees) 41‐65 and 44‐66, and maximum clot firmness (MCF) (no units) 27‐43 and 30‐46. Moderate to good correlations were observed between the two machines with Lin’s concordance correlation coefficients of 0.51‐0.9 and a P < 0.002. TEG RIs were similar to previously reported values.

Conclusions

VCM Vet RIs were generated. Each VCM Vet device should have a unique RI established due to inter‐device variability. Direct correlations of VCM Vet values with TEG parameters were not performed due to the narrow range of the normal values and the need to evaluate patients with a wide range of hemostatic abnormalities.
Presumed cancer‐associated retinopathy (CAR) mimicking Sudden Acquired Retinal Degeneration Syndrome (SARDS) in canines
Authors: Grozdanic Sinisa D. , Lazic Tatjana , Kecova Helga , Mohan Kabhilan , Adamus Grazyna , Kuehn Markus H.
Published: December 2020

Objective

To describe functional and structural features of presumed cancer‐associated retinopathy (CAR) mimicking sudden acquired retinal degeneration syndrome (SARDS) in dogs and describe treatment outcomes.

Animals

Subjects were 17 dogs from 8 eight US states and Canada diagnosed with SARDS or immune‐mediated retinitis (IMR) by 12 ophthalmologists. Nine eyes from seven deceased patients were used for microarray (MA), histology, or immunohistochemical (IHC) analysis.

Procedures

Dogs underwent complete ophthalmic examination, including retinal photography, optical coherence tomography (OCT), chromatic pupil light reflex testing (cPLR), and electroretinography (ERG), in addition to complete systemic examination. Histology, microarray, and IHC analysis were performed in CAR retinas to evaluate histological and molecular changes in retinal tissue.

Results

None of the patients evaluated satisfied previously established criteria for diagnosis of SARDS (flat ERG+ no red – good blue PLR), and all were diagnosed with IMR. All patients were diagnosed with a cancer: meningioma (24%), sarcoma (18%), pituitary tumor (12%), and squamous cell carcinoma (12%), other (34%). Median survival time was 6 months from diagnosis (range 1‐36 months). Most frequent systemic abnormalities were as follows: proteinuria (78%); elevated liver enzymes (47%); and metabolic changes (PU/PD, polyphagia – 24%). Immunosuppressive therapy resulted in the reversal of blindness in 44% of treated patients, with 61% of all treated patients recovering and/or maintaining vision. Median time for preservation of vision was 5 months (range 1‐35 months).

Conclusions

Observed changes are highly suggestive of immune‐mediated damage in IMR‐CAR eyes. A relatively high percentage of patients with CAR responded positively to immunosuppressive therapy.
Mitogenomic phylogeny of bee families confirms the basal position and monophyly of Melittidae
Authors: Husemann Martin , Neiber Marco Thomas , Nickel Jana , Reinbold Carla V. M. , Kuhlmann Michael , Cordellier Mathilde
Published: December 2020

Bees (Anthophila) represent a critical taxon for the ecosystem service of pollination and hence have received great scientific attention. The more than 20,000 known species of bees are grouped in seven families. Yet, the relationships between bee families are not entirely clear, and specifically, the position of Melittidae and their monophyly has been discussed in the past. Here, we present the most comprehensive mitogenomic phylogeny of bees including five members of Melittidae from two subfamilies and three tribes. Our results suggest monophyly of the family Melittidae and further support their basal position. The data also support the two subfamilies, but are not in line with current assignment of tribes. Our results show, despite advancement with transcriptomic and whole genomic data, the value of mitochondrial data for the reconstruction of phylogenies.
Physicians’ and Patients’ Perceptions of Physicians’ Social Competencies in Gynaecology and Obstetrics
Authors: Emrová Lenka
Published: December 2020

The quality and level of the Czech health-care system is a very current and often discussed topic. The Czech health-care system is considered to be the most advanced health system in the world, on the other hand, the Czech health-care system is often criticized for being more “technological” and “scientifical” and that the psychosocial aspects are neglected. The physicians are expected to have acquired social competencies, but not enough attention is paid to defining and developing them as well as creating conditions for their application. We need to change the curriculum for undergraduate and postgraduate physicians’ psychosocial preparation. Lifelong learning plays a significant role as doctors can get into contact with patients and develop their social competencies only in everyday practice. The research focuses on gynaecological and obstetric specialization where the need of psychosocial approach is considered essential. The purpose of this research was to determine if there exists an agreement between gynaecologists-obstetricians and patients‑women expectations on what behaviour make physicians’ social competent behaviour. The main methods used are three focus groups for six doctors and nine semi‑standardized interviews with expectant mothers. The obtained data were processed using the method of coding and creation of clusters. The results indicate that there is considerable agreement between physicians and patients on the categories of socially-competent behaviour. However, the differences are in the perceived importance of the competencies; the physicians consider intrapersonal competencies to be the most important, while mothers consider interpersonal and communication competencies to be the most important. These results are discussed with respect to the implications for future research of interventions in the field of physicians’ social skills training in formal and informal education. We consider knowledge based directly on the perception of physicians and patients to be valuable because it provides further insight into what is important to include in the education of social competencies.