bluuebunny/crossref_metadata_2025 huggingface dataset:
Between a rock and an egg‐crushing place: selection pressure from natural enemies and plant defences on eggs of the viburnum leaf beetle in its native range
Authors: Desurmont Gaylord A. , Kerdellant Elven , Lambin Nicolas
Published: October 2020

1. The viburnum leaf beetle (VLB) is native to Eurasia and invasive in North America. It lays eggs inside young Viburnum twigs; eggs can be crushed by plant defences (wounding response) and attacked by natural enemies (parasitoids).

2. We evaluated plant defences and parasitism rates in 42 field sites in 11 European countries, on three host plants (V. opulus, V. lantana, and V. tinus), and under two main climatic conditions (Mediterranean, oceanic/continental).

3. Plant defences killed six times more eggs than natural enemies overall (25.4% vs. 4.1%). This effect was consistent for all host plants and climatic conditions. Egg survivorship and parasitism were lower in Mediterranean sites.

4. Parasitism was positively density‐dependent, indicating a higher risk of parasitism on heavily infested twigs, but this effect was confounded with host plant species.

5. These results suggest that plant defences have been the dominant selection force driving the evolution of VLB oviposition behaviour.
The impact of technological endodontic resources on the training of the general dentist
Authors: Tavares Érika P. , Tavares André L. P. , Flório Flávia M.
Published: October 2020

Introduction

Technological resources are considered important for the practice and training in endodontics. It is not yet clear the extent of the insertion of these resources in predoctoral dental programmes and the effect of such resources to the general dentist training.

Aim

To evaluate the faculty perception regarding the insertion of technological resources, particularly rotary instruments, and the impact of such resources to the student's learning process graded at the end of predoctoral dental programmes in Brazil by the National Students Performance Exam (ENADE).

Methods

The endodontic department faculties in all 205 programmes that participated in the 2016 ENADE received a questionnaire by email. The institution, faculty credentials, and insertion of technologies in each programme were described, and an association between these data and the ENADE score was tested.

Results

149 educators (72.7%) answered the form. From this total, 73.2% of them were from private institutions and 26.8% from public ones. Educators mix manual and rotary instrumentation to treat selected patients in 47.7% of the programmes. Most educators (89.9%) consider the utilisation of technology in endodontics as positive. Whilst there was not a significant association between the use of rotary instrumentation and better performance in ENADE, there was a significant association between the performance and the supply of special instruments by the institutions.

Conclusion

These results show that even though most faculties consider the insertion of technologies as positive, the factor that caused a significant impact to the training of the general dentist is the general infrastructure of the institutions.
Ex vivo T‐cell depletion vs post‐transplant cyclophosphamide, sirolimus, and mycophenolate mofetil as graft‐vs‐host disease prophylaxis for allogeneic hematopoietic stem cell transplantation
Authors: Montoro Juan , Roldán Elisa , Piñana José Luis , Barba Pere , Chorão Pedro , Quintero Abdiel , Hernani Rafael , Ortí Guillermo , Lorenzo José Ignacio , Balaguer‐Roselló Aitana , Salamero Olga , Fox Laura , Solves Pilar , Gómez Inés , Guerreiro Manuel , Hernández Boluda Juan Carlos , Sanz Guillermo , Solano Carlos , Sanz Miguel Ángel , Valcárcel David , Sanz Jaime
Published: October 2020

Objective

To compare the efficacy and safety of CD34+ selected ex vivo T‐cell depletion (TCD) vs post‐transplant cyclophosphamide, sirolimus, and mycophenolate mofetil (PTCy‐Sir‐MMF) as graft‐vs‐host disease (GVHD) prophylaxis.

Methods

We retrospectively included patients who underwent allogeneic hematopoietic stem cell transplantation (allo‐HSCT) with either TCD (n = 38) or PTCy‐Sir‐MMF (n = 91).

Results

Cumulative incidence of neutrophil and platelet recovery was 92% vs 99% (P = .06) and 89% vs 97% (P = .3) in TCD and PTCy‐Sir‐MMF, respectively. Cumulative incidences of aGHVD grade II‐IV, III‐IV, and moderate to severe cGVHD were 11% vs 19% (P = .2), 3% vs 2% (P = .9), and 3% vs 36% (P < .001) in TCD and PTCy‐Sir‐MMF, respectively. The 2‐year non‐relapse mortality, relapse, disease‐free and overall survival were 25% vs 8% (P = .01), 20% vs 16% (P = .2), 55% vs 76% (P = .004), 57% vs 83% (P = .004) for TCD and PTCy‐Sir‐MMF, respectively. Cumulative incidence of cytomegalovirus and Epstein‐Barr infection requiring therapy was 76% vs 40% (P < .001) and 32% vs 0% (P < .001) in TCD and PTCy‐Sir‐MMF, respectively. PTCy‐Sir‐MMF platform showed faster T‐cell reconstitution.

Conclusions

PTCy‐Sir‐MMF provides better survival outcomes but is associated with higher risk of cGVHD compared to TCD.
Influence of cortisol awakening response on telomere length: Trends for males and females
Authors: Thomas Natalie , Hudaib Abdul‐Rahman , Romano‐Silva Marco , Bozaoglu Kiymet , H. X. Thomas Elizabeth , Rossell Susan , Kulkarni Jayashri , Gurvich Caroline
Published: October 2020

Although telomere attrition is associated with the process of normal ageing, shorter telomere length (TL) has been associated with acute and chronic stressors. A neurobiological factor hypothesised to be responsible for this accelerated attrition is the dysregulation of the cortisol stress response, which can induce DNA damage affecting DNA telomeric caps. Marked sex differences are reported in both the cortisol stress response and telomere dynamics, yet no explicit investigation of sex specificity on the relationship between cortisol and TL exists. This study used mathematical equation modelling to describe the relationship between diurnal cortisol levels and telomere length within the context of sex, in a healthy population. Cortisol awakening responses (CAR) were measured via ELISA methodology in fifty‐one healthy participants (28 males, 23 females). qPCRs determined TL from genomic DNA extracted from saliva. To assess the effect of free cortisol on relative TL ratio, a semi‐log regression plot of the two variables trended for sex were fitted using spline curves. Results demonstrated significant differences between males and females in the relationship defining CAR and TL association (p = 0.03). These results suggest the relationship is not linear and can be represented as a complex arcsin function, and that the patterns are opposite in males and females. Males demonstrate a positive correlation, with higher levels of CAR being associated with longer telomere sequences. Females demonstrated a negative correlation. Future studies must carefully take into consideration moderating factors such as sex, and sex hormones across the lifespan when investigating telomere length.
A place to land: spatiotemporal drivers of stopover habitat use by migrating birds
Authors: Cohen Emily B. , Horton Kyle G. , Marra Peter P. , Clipp Hannah L. , Farnsworth Andrew , Smolinsky Jaclyn A. , Sheldon Daniel , Buler Jeffrey J.
Published: October 2020

Migrating birds require en route habitats to rest and refuel. Yet, habitat use has never been integrated with passage to understand the factors that determine where and when birds stopover during spring and autumn migration. Here, we introduce the stopover‐to‐passage ratio (SPR), the percentage of passage migrants that stop in an area, and use 8 years of data from 12 weather surveillance radars to estimate over 50% SPR during spring and autumn through the Gulf of Mexico and Atlantic coasts of the south‐eastern US, the most prominent corridor for North America’s migratory birds. During stopovers, birds concentrated close to the coast during spring and inland in forested landscapes during autumn, suggesting seasonal differences in habitat function and highlighting the vital role of stopover habitats in sustaining migratory communities. Beyond advancing understanding of migration ecology, SPR will facilitate conservation through identification of sites that are disproportionally selected for stopover by migrating birds.
Sting morphology of the European hornet, Vespa crabro L., (Hymenoptera: Vespidae) re‐examined
Authors: Stetsun Halyna , Matushkina Natalia A.
Published: October 2020

The European hornet Vespa crabro L. (Hymenoptera: Aculeata: Vespidae) is considered the largest native vespid wasp in Europe. The females use their sting to defend themselves and the colony. Despite a long history of research, the morphology of the sting in V. crabro remains insufficiently studied. Here, we provide a detailed description of the sting of V. crabro revealed with light microscopy, scanning electron microscopy and confocal laser scanning microscopy. Shape and sculpture of sting sclerites, sensilla of different morphotypes and peculiarities of the cuticle autofluorescence are combined to discuss the functional and phylogenetic significance of the sting characters in Aculeata.
Song matching in a long‐lived, sedentary bird with a low song rate: The importance of song type, song duration and intrusion
Authors: Ansell Dean , Magrath Robert D. , Haff Tonya M.
Published: October 2020

Territorial songbirds often match the song features or singing patterns of rivals, commonly as an aggressive signal. Most studies of song matching have been on Northern Hemisphere species with short lifespans and high song rates, but vocal matching is predicted to be affected both by longevity and territorial stability. We studied song matching in males of the white‐browed scrubwren, Sericornis frontalis, a long‐lived, sedentary, territorial Australian songbird. We quantified natural song rate and diversity, and then conducted three playback experiments to test: (a) whether males match by song type; (b) how they respond physically and vocally to territorial intrusion; and (c) whether they match by song length, and use it as an agonistic signal. Males naturally had very low song rates, singing on average less than three times per hour, and moderate repertoires, with an estimated mean of 17.5 song types for individual males. Males did not engage in extended counter‐singing bouts. The first experiment showed that males matched the song type of immediate neighbours almost 90% of the time, if that type was in their repertoire. The remaining experiments revealed that song‐type matching was an aggressive signal; males responded more aggressively to, and were more likely to match, playback simulating a neighbour's territorial intrusion than song from their shared boundary. Males did not match songs by length, but they produced longer songs after simulated intrusion. Males also responded more aggressively to playback of longer songs that simulated intrusion, but less aggressively to longer songs from the territory boundary. Overall, we show that sedentary, long‐lived songbirds with low song rates, can use song‐type matching as an aggressive signal to communicate with neighbours and intruders. Song length had a different role in communication, possibly related to individual quality or territory ownership.
Antiviral therapies: advances and perspectives
Authors: Gonçalves Bruna Carolina , Lopes Barbosa Mário Gabriel , Silva Olak Anna Paula , Belebecha Terezo Natalia , Nishi Leticia , Watanabe Maria Angélica , Marinello Poliana , Zendrini Rechenchoski Daniele , Dejato Rocha Sergio Paulo , Faccin‐Galhardi Lígia Carla
Published: October 2020

Viral infections cause high morbidity and mortality, threaten public health, and impose a socioeconomic burden. We have seen the recent emergence of SARS‐CoV‐2 (Severe Acute Respiratory Syndrome Coronavirus 2), the causative agent of COVID‐19 that has already infected more than 29 million people, with more than 900 000 deaths since its identification in December 2019. Considering the significant impact of viral infections, research and development of new antivirals and control strategies are essential. In this paper, we summarize 96 antivirals approved by the Food and Drug Administration between 1987 and 2019. Of these, 49 (51%) are used in treatments against human immunodeficiency virus (HIV), four against human papillomavirus, six against cytomegalovirus, eight against hepatitis B virus, five against influenza, six against herpes simplex virus, 17 against hepatitis C virus and one against respiratory syncytial virus. This review also describes future perspectives for new antiviral therapies such as nanotechnologies, monoclonal antibodies and the CRISPR‐Cas system. These strategies are suggested as inhibitors of viral replication by various means, such as direct binding to the viral particle, blocking the infection, changes in intracellular mechanisms or viral genes, preventing replication and virion formation. We also observed that a large number of viral agents have no therapy available and the majority of those approved in the last 32 years are restricted to some groups, especially anti‐HIV. Additionally, the emergence of new viruses and strains resistant to available antivirals has necessitated the formulation of new antivirals.
In conversation with Janet Thornton
Authors: Dhillon Paraminder , Thornton Janet M.
Published: October 2020

Professor Dame Janet Thornton is a pioneer in structural bioinformatics who has developed an extensive computational toolkit for the analysis of protein structure and inference of function and evolution. She began her career in science as a physicist, following an undergraduate degree in physics from the University of Nottingham with a Master's and PhD in biophysics in London. After undertaking a postdoctoral position in the group of Sir David Phillips at the University of Oxford, Janet returned to London where she eventually held professorial appointments at both University College London and Birkbeck College. During this period, she formed a number of long‐standing and fruitful collaborations that, amongst other advances, led to the development of a software that revolutionised protein structure validation – PROCHECK – as well as a unique classification system for protein structures, CATH. Janet was Director of the European Bioinformatics Institute EMBL‐EBI between 2001 until 2015 and played a pivotal role in launching ELIXIR, a pan‐European infrastructure for biological data. She remains at EMBL‐EBI as a senior scientist, and her group primarily focuses on understanding protein structure and function and how these contribute to our understanding of diseases and ageing. Her contributions to the life sciences have been distinguished through numerous awards and honours, and in 2012, she was appointed a Dame Commander of the Order of the British Empire for services to bioinformatics.
Neurocognitive evaluation using the International HIV Dementia Scale (IHDS) and Montreal Cognitive Assessment Test (MoCA) in an HIV‐2 population
Authors: Almeida F , Macedo A , Trigo D , Abreu M , Guimarães M , Luís N , Pinho R , Tavares R
Published: October 2020

Objectives

We aimed to characterize neurocognitive impairment (NI) in an HIV‐2 population using an observational cross‐sectional study in four Portuguese hospitals.

Methods

Adult HIV‐2‐infected patients were included. Montreal Cognitive Assessment Test (MoCA) and International HIV Dementia Scale (IHDS) scales were applied for screening of NI. Patient Health Questionnaire‐9 (PHQ‐9) and Instrumental Activities of Daily Living (IADL) scales were used for assessment of depression and functionality. A multivariate analysis was performed to assess for risk factors for NI.

Results

Eighty‐one patients were included, 50.6% of African origin (n = 41) and 49.4% of Portuguese origin (n = 40). The MoCA scale showed alterations in 81.5% of patients (100% of migrants vs. 62.5% of non‐migrants, P < 0.001) and the IHDS scale showed alterations in 42%. Both scales were altered simultaneously in 35.8%. Variables independently associated with NI were age [odds ratio (OR) = 0.885] and migrant status (OR = 9.150).

Conclusions

Neurocognitive impairment (both scales altered) was present in 35.8%, which is comparable to what is described for HIV‐1. The MoCA performed worse in the migrant population and might not be applicable in this setting.
Palatal root surgery of a maxillary molar using a piezosurgery transantral approach with simultaneous sinus lift grafting: a case report
Authors: Silberman J. J. , Moldauer B. I. , Torres J. , Gallardo C. , Sanabria‐Liviac D.
Published: October 2020

Aim

To report a case involving transantral palatal root piezoelectric surgery followed by a sinus floor augmentation procedure with the purpose of minimizing and managing complications associated with sinus lining perforations and optimizing bone regeneration at the site of the surgical defect.

An asymptomatic 28‐year‐old male patient with the diagnosis of chronic apical periodontitis on a previously root filled right maxillary first molar (FDI tooth 16) and second premolar (No. 15) was managed by transantral apical surgery. Cone‐beam computerized tomography (CBCT) revealed the position of the palatal root of the first molar within the maxillary sinus. The case highlights the management of the palatal root and the handling of a perforation of the Schneiderian membrane through a combination of piezosurgery and a sinus lift grafting procedure involving a second‐generation of platelet concentrates. No postoperative complications were observed. Sinus bone augmentation after a 26‐month recall period was confirmed by CBCT in the clinically asymptomatic teeth.

Key learning points

The selective bone tissue cutting and enhanced visibility obtained by piezoelectric surgery in comparison with current rotary techniques make this technology the preferred tool for apical surgery when the mucosal lining of the maxillary sinus could be compromised.

The wound healing and physical properties of the platelet‐rich fibrin membranes in combination with an allograft material can be considered as sinus bone graft options when a transantral approach is performed on a palatal root of a maxillary molar.

A preoperative tomographic examination is essential for apical surgery using a transantral approach with sinus bone augmentation, because of the information obtained from the axial and coronal views on the CBCT scan.
Effect of hydroxyapatite and 45S5 bioactive glass addition on a dental adhesive resin cement
Authors: da Costa Lima Assad Julia Magalhães , Ferreti Bonan Dantas Batista Roberta , Anami Lilian Costa , Almeida Amanda , de Araújo Ferreira Muniz Isis , de Melo Marinho Renata Marques , Dantas Batista André Ulisses , Cançado Castellano Lúcio Roberto , Ferreti Bonan Paulo Rogério
Published: October 2020

Objective

This study evaluates the mechanical, physical, and biological properties of resin‐based dental cement (RelyX ARC, 3M ESPE) incorporated with hydroxyapatite and 45S5 bioactive glass.

Methods

Bioactive glass (45S5) and hydroxyapatite (HA) were added to cement in different proportions (10 wt% and 20 wt%). Three‐point flexural strength, microhardness, surface roughness, film thickness, contact angle, and color were evaluated. Cytotoxicity in human osteoblasts culture (MG63) was evaluated. Statistical analysis was performed using one‐way and two‐way ANOVA and Tukey tests (α < 0.05).

Results

The addition of HA and 45S5 bioactive glass reduced the flexural strength of the composite. However, the resistance value was greater than the minimum values of the ISO standard. Film thickness was below the maximum values, except for the 20% HA. The contact angle was constant at 24 hours and 14 days, except for 10% 45S5 group, which presented a significant decrease in mean contact angle. Cellular viability for all groups increased from the first to the 14th day. Additionally, the cellular viability was above 50%.

Conclusions

In vitro incorporation of 45S5 bioactive glass on resin cement resulted in a promising luting dental material with adequate mechanical properties, thin film thickness, improved wettability, and adequate biocompatibility.
Low‐dose rituximab induction therapy is effective in immunological high‐risk renal transplantation without increasing cytomegalovirus infection
Authors: Yoshinaga Kasumi , Araki Motoo , Wada Koichiro , Maruyama Yuki , Mitsui Yosuke , Sadahira Takuya , Kubota Risa , Nishimura Shingo , Kobayashi Yasuyuki , Takeuchi Hidemi , Tanabe Katsuyuki , Kitagawa Masashi , Morinaga Hiroshi , Uchida Haruhito Adam , Kitamura Shinji , Sugiyama Hitoshi , Wada Jun , Watanabe Masami , Watanabe Toyohiko , Nasu Yasutomo
Published: October 2020

Objectives

To analyze the effect and impact of low‐dose rituximab induction therapy on cytomegalovirus infection in living‐donor renal transplantation.

Methods

A total of 92 recipients undergoing living‐donor renal transplantation at Okayama University Hospital from May 2009 to August 2018 were evaluated retrospectively. Indications for preoperative rituximab (200 mg/body) were the following: (i) ABO major mismatch; (ii) ABO minor mismatch; (iii) donor‐specific anti‐human leukocyte antigen antibody‐positive; and (iv) focal segmental glomerulosclerosis. We excluded four recipients who were followed <3 months, five who received >200 mg/body rituximab and seven who received prophylactic therapy for cytomegalovirus.

Results

There were 59 patients in the rituximab group and 17 in the non‐rituximab group. Groups differed significantly in age (median age 53 vs 37 years, respectively; P = 0.04), but not in sex (male 64% vs 65%, P = 1.00), focal segmental glomerulosclerosis (3% vs 0%, P = 1.00) or percentage of cytomegalovirus‐seronegative recipients of renal allografts from cytomegalovirus‐seropositive donors (12% vs 18%, P = 0.68). The estimated glomerular filtration rate did not differ significantly between groups until 24 months after transplantation. Cytomegalovirus clinical symptoms (10% vs 24%, P = 0.22), including fever ≥38°C (5% vs 12%, P = 0.31) and gastrointestinal symptoms (5% vs 12%, P = 0.31), and the 5‐year survival rates of death‐censored graft loss (90% vs 83%, P = 0.43) did not differ significantly between groups.

Conclusions

Low‐dose rituximab induction therapy is effective in immunological high‐risk recipients without increasing cytomegalovirus infection in the absence of valganciclovir prophylaxis.
Risk factors for incident kidney disease in older adults: an Australian prospective population‐based study
Authors: Kang Amy , Sukkar Louisa , Hockham Carinna , Jun Min , Young Tamara , Scaria Anish , Foote Celine , Neuen Brendon L. , Cass Alan , Pollock Carol , Comino Elizabeth , Lung Thomas , Pecoits‐Filho Roberto , Rogers Kris , Jardine Meg J. ,   EXTEND45 Study Steering Committee
Published: October 2020

Background and Aim

To determine risk factors for incident chronic kidney disease (CKD) in a large population‐based cohort.

Methods

This prospective opt‐in population‐based cohort study is based on the 45 and Up Study, where New South Wales residents aged ≥45 years were randomly sampled from the Services Australia database and agreed to complete the 45 and Up Study baseline questionnaire and have their responses linked to their health data in routinely collected databases. The primary outcome was the development of incident CKD, defined as eGFR < 60 mL/min/1.73 m2. CKD incidence was calculated using Poisson regression. Risk factors for incident CKD were assessed using Cox regression in multivariable models.

Results

In 39 574 participants who did not have CKD at enrolment, independent factors associated with developing CKD included: older age, regional residence (HR 1.38 (1.27–1.50) for outer regional vs major city), smoking (1.13 (1.00–1.27) for current smoker vs non‐smoker), obesity (1.25 (1.16–1.35) for obese vs normal body mass index), diabetes mellitus (1.41 (1.33–1.50)), hypertension (1.53 (1.44–1.62)), coronary heart disease (1.13 (1.07–1.20)), depression/anxiety (1.16 (1.09–1.24)) and cancer (1.29 (1.20–1.39)). Migrants were less likely to develop CKD compared with people born in Australia (0.88 (0.83–0.94)). Gender, partner status and socioeconomic factors were not independently associated with developing CKD.

Conclusions

This large population‐based study found multiple modifiable and non‐modifiable factors were independently associated with developing CKD. In the Australian setting, the risk of CKD was higher with regional residence. Differences according to socioeconomic status were predominantly explained by age, comorbidities and harmful health‐related behaviours.
Mobile applications for the management of chronic physical conditions: a systematic review
Authors: Jiménez‐Muñoz Laura , Gutiérrez‐Rojas Luis , Porras‐Segovia Alejandro , Courtet Philippe , Baca‐García Enrique
Published: October 2020

Background

Chronic physical conditions (CPC) decrease the quality of life of millions of people. In the absence of curative treatments, maintaining healthy lifestyle habits is one of the main pillars in their clinical management. Mobile‐based interventions may help patients take care of their health and follow medical recommendations. The purpose of this review is to summarise the latest evidence about mobile telephone applications (apps) for the management of CPC.

Methods

We performed a systematic search of the PubMed and EMBASE databases to identify articles that explored apps for the management of CPC, testing the apps empirically and providing clear outputs on effectiveness and/or feasibility. A total of 3528 articles were identified in the initial search. Following screening and selection process, 20 articles were included in the final review.

Results

Mobile apps for CPC are very heterogeneous. The condition with the greater number of apps available was diabetes, followed by cardiovascular diseases. Results of feasibility were generally positive, with high rates of study completion and user engagement. Some studies used incentives, monetary of otherwise. Some of the apps have been tested in randomised controlled trials showing effectiveness in improving symptoms and/or controlling analytical parameters.

Conclusions

Mobile apps are promising tools for the management of CPC. Some apps have been sufficiently tested to propose their implementation in clinical practice. However, several barriers exist that can slow down the routine use of new technologies in healthcare settings.
Synergy between the pay‐for‐performance scheme and better physician–patient relationship might reduce the risk of retinopathy in patients with type 2 diabetes
Authors: Chiou Shang‐Jyh , Liao Kuomeng , Huang Yu‐Tung , Lin Wender , Hsieh Chi‐Jeng
Published: October 2020

Aims/Introduction

This study investigated whether participation by patients with type 2 diabetes in Taiwan’s pay‐for‐performance (P4P) program and maintaining good continuity of care (COC) with their healthcare provider reduced the likelihood of future complications, such as retinopathy.

Materials and Methods

The analysis used longitudinal panel data for newly diagnosed type 2 diabetes from the National Health Insurance claims database in Taiwan. COC was measured annually from 2003 to 2013, and was used to allocate the patients to low, medium and high groups. Cox regression analysis was used with time‐dependent (time‐varying) covariates in a reduced model (with only P4P or COC), and the full model was adjusted with other covariates.

Results

Despite the same significant effects of treatment at primary care, the Diabetes Complications Severity Index scores were significantly associated with the development of retinopathy. After adjusting for these, the hazard ratios for developing retinopathy among P4P participants in the low, medium and high COC groups were 0.594 (95% confidence interval [CI] 0.398–0.898, P = 0.012), 0.676 (95% CI 0.520–0.867, P = 0.0026) and 0.802 (95% CI 0.603–1.030, P = 0.1062), respectively. Thus, patients with low or median COC who participated in the P4P program had a significantly lower risk of retinopathy than those who did not.

Conclusions

Diabetes care requires a long‐term relationship between patients and their care providers. Besides encouraging patients to participate in P4P programs, health authorities should provide more incentives for providers or patients to regularly survey patients’ lipid profiles and glucose levels, and reward the better interpersonal relationship to prevent retinopathy.
Accountable Care Hospitals and Preventable Emergency Department Visits for Rural Dementia Patients
Authors: Wang Nianyang , Amaize Aitalohi , Chen Jie
Published: October 2020

BACKGROUND/OBJECTIVES

This study examined urban/rural differences in the frequency of preventable emergency department (ED) visits among patients with Alzheimer's disease and related dementias (ADRD), with a focus on the variation of accountable care organization (ACO) participation status for hospitals in urban and rural areas.

DESIGN

We performed a cross‐sectional study using the 2015 State Emergency Department Databases, the American Hospital Association Annual Survey of Hospitals, and the Area Health Resource File. Individual‐, county‐, and hospital‐level characteristics and state fixed effects were used for model specification.

SETTING

Patients with ADRD from seven states who visited the ED and had routine discharges.

PARTICIPANTS

Our sample consisted of 117,196 patients with ADRD.

MEASUREMENTS

The outcome was preventable ED visits classified using the New York University Emergency Department visit algorithm. We performed a multivariable logistic regression to estimate the variation of preventable ED visits by urban and rural areas.

RESULTS

Rural patients with ADRD had 1.13 higher adjusted odds (P = .007) of going to the ED for a preventable visit compared with their urban counterparts. In addition, ACO‐affiliated hospitals had .91 lower adjusted odds (P = .005) of preventable ED visits for ADRD patients compared with hospitals not affiliated with an ACO. Whole‐county Mental Health Care Health Professional Shortage Area (HPSA) (odds ratio = 1.14; P = .002) designation was also an indicator of higher preventable ED rates.

CONCLUSION

ACO delivery systems have the potential to decrease rural preventable ED visits among ADRD patients.
Influences of lower limb edema on daily lives of elderly individuals in an elderly day care center
Authors: Tsuchiya Sayumi , Sawazaki Takuto , Osawa Shuji , Fujiu Makoto , Okuwa Mayumi , Sugama Junko
Published: October 2020

Aim

The purpose of this study is to describe the influences of lower limb edema on the daily lives of elderly individuals in elderly day care to describe the necessity of care for lower limb edema.

Methods

Semi‐structured interviews based on a quality of life questionnaire for limb lymphedema were conducted. Two types of text mining analysis methods were used: a frequent word analysis and a content analysis. The edema severity was graded on a scale of 0 to 3, and the sum of the numerical values of the grades for each person was defined as the pitting score.

Results

The seven participants had a mean age of 83.4 ± 4.6 years (mean ± SD). The pitting scores ranged from 1 to 25 in the participants. The words “think” (389 times), “walk” (136 times), and “put on” (135 times) were extracted frequently. The content analysis focused on the words “walk” and “put on.” The participants complained of difficulty walking, pain, and numbness when walking, weakness of their lower limbs, difficulty putting on shoes, restrictions on shoe types, and difficulty finding shoes.

Conclusions

These results demonstrate that elderly individuals experienced troubles during their daily lives caused by lower limb edema, which highlights the necessity of symptom management. Active interventions for edema by nurses are necessary to improve quality of life in elderly individuals.
Mothers' experiences of parenting a child with chromosomal structural abnormalities: The journey to acceptance
Authors: Kutsunugi Saeko , Tsujino Kumiko , Murakami Kyoko , Iida Kazuko , Gima Tsugiko , Endoh Yumiko , Tamashiro Yoko , Stone Teresa E. , Kobayashi Jun
Published: October 2020

Purpose

This study aimed to investigate the process mothers go through in coming to terms with raising a child with chromosomal structural abnormalities.

Methods

Sixteen mothers living in Japan were interviewed and a modified grounded theory approach was used for the analysis.

Results

A total of 35 concepts, nine subcategories, and six categories were extracted. The six categories were: (a) Concern about abnormalities; (b) A healthy child is considered as a standard; (c) Deepening attachment to the child; (d) Acceptance of the child as s/he is; (e) Changing attitude toward disabilities; (f) Creating a frontier for other mothers. The parenting journey meant that parents did not move in a straightforward way from the beginning of the process to the endpoint but instead moved between “Deepening attachment to the child” and “Acceptance of the child as s/he is” before they moved ahead.

Conclusion

Having support and meeting peers of mothers with similar issues is essential for mothers to review their perspectives that healthy children are the standard against which to measure their child and to motivate them to raise their children, but it was extremely difficult to have such opportunities due to rarity of the disorder. It is crucial to accumulate more practical information so that mothers can access and use it. Mothers also need support to enhance their self‐worth while giving due consideration to the possibility that they may be conscious of being stigmatized. Nurses need to advocate for these children and families to get the appropriate help, understanding and support.
Heterotrimeric G‐protein, Gi1, is involved in the regulation of proliferation, neuronal migration, and dendrite morphology during cortical development in vivo
Authors: Hamada Nanako , Iwamoto Ikuko , Kawamura Noriko , Nagata Koh‐ichi
Published: October 2020

Heterotrimeric G‐proteins are composed of α, β, and γ subunits, and function as signal transducers. Critical roles of the α‐subunits of Gi/o family heterotrimeric G‐proteins, Gαi2, and Gαo1, have so far been reported in brain development and neurodevelopmental disorders. In this study, we tried to clarify the role of Gαi1, α‐subunit of another Gi/o family member Gi1, during corticogenesis, based on the recent identification of its gene abnormalities in neurodevelopmental disorders. In western blot analyses, Gαi1 was found to be expressed in mouse brain in a developmental stage‐dependent manner. Morphological analyses revealed that Gαi1 was broadly distributed in cerebral cortex with relatively high expression in the ventricular zone (VZ) at embryonic day (E) 14. Meanwhile, Gαi1 was enriched in membrane area of yet unidentified early mitotic cells in the VZ and the marginal zone at E14. Acute knockdown of Gαi1 with in utero electroporation in cerebral cortex caused cell cycle elongation of the neural progenitor cells and promoted their cell cycle exit. Gαi1‐deficient cortical neurons also exhibited delayed radial migration during corticogenesis, with abnormally elongated leading processes and hampered nucleokinesis. In addition, silencing of Gαi1 prevented basal dendrite development. The migration and dendritic phenotypes were at least partially rescued by an RNAi‐resistant version of Gαi1. Collectively, these results strongly suggest a crucial role of Gi1 in cortical development, and disturbance of its function may cause deficits in synaptic network formation, leading to neurodevelopmental disorders.

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Metabolic needs of brain‐infiltrating leukocytes and microglia in multiple sclerosis
Authors: Kaushik Deepak Kumar , Yong Voon Wee
Published: October 2020

Metabolism, the umbrella term for complex biochemical pathways that sustain the basic functions of life, has garnered attention in recent years for its role in immune activation. Indeed, metabolic pathways and their intricate and complex connections with immune mechanisms constitute a new area of immunology termed ‘immunometabolism’. One highlight is the existence of a switch in the key metabolic programs in immune cells, which executes their effector functions. ‘Metabolic reprogramming’ is observed in conditions of both peripheral diseases as well as in neurodegenerative conditions associated with inflammation such as multiple sclerosis. Moreover metabolic reprogramming occurs for almost every immune cell type. Whether metabolic changes are cause or effect of immune activation, however, remains to be fully understood. Being central to cellular activation, metabolism has become very topical in terms of exploring therapeutic targets. This review covers the major metabolic programs in immune cells, discuss metabolites as regulators of immune cell functions, and consider metabolic enzymes or pathways as therapeutic targets using examples from multiple sclerosis and its animal models.

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Morphometry of the kangaroo spine and its comparison with human spinal data
Authors: Wilke Hans‐Joachim , Betz Volker Michael , Kienle Annette
Published: October 2020

The upright posture of the kangaroo suggests that the spine of the kangaroo could be a possible substitute model for biomechanical studies of the human spine. A prerequisite for this should be the agreement of anatomy in humans and kangaroos. The purpose of this study was to investigate the anatomical parameters of the kangaroo spine from C4 to S4 and compare them with existing anatomical data of the human spine. Eight complete spines of the red giant kangaroo were obtained and 21 anatomical parameters were measured from the vertebral bodies, spinal canal, endplate, pedicles, intervertebral discs, transverse, and spinous processes. Most similarities between kangaroo and human spines were found for the vertebral bodies in the cervical and the lumbar spine. The largest differences were evident for the spinous processes. Although both species are somehow upright, these differences may be explained by the way how they move. Jumping probably requires more muscle strength than walking on two legs.
MicroRNAs regulate distal region of mandibular development through Hh signaling
Authors: Trakanant Supaluk , Nihara Jun , Nagai Takahiro , Kawasaki Maiko , Kawasaki Katsushige , Ishida Yoko , Meguro Fumiya , Kudo Takehisa , Yamada Akane , Maeda Takeyasu , Saito Isao , Ohazama Atsushi
Published: October 2020

Mandibular anomalies are often seen in various congenital diseases, indicating that mandibular development is under strict molecular control. Therefore, it is crucial to understand the molecular mechanisms involved in mandibular development. MicroRNAs (miRNAs) are noncoding small single‐stranded RNAs that play a critical role in regulating the level of gene expression. We found that the mesenchymal conditional deletion of miRNAs arising from a lack of Dicer (an essential molecule for miRNA processing, Dicerfl/fl;Wnt1Cre), led to an abnormal groove formation at the distal end of developing mandibles. At E10.5, when the region forms, inhibitors of Hh signaling, Ptch1 and Hhip1 showed increased expression at the region in Dicer mutant mandibles, while Gli1 (a major mediator of Hh signaling) was significantly downregulated in mutant mandibles. These suggest that Hh signaling was downregulated at the distal end of Dicer mutant mandibles by increased inhibitors. To understand whether the abnormal groove formation inDicer mutant mandibles was caused by the downregulation of Hh signaling, mice with a mesenchymal deletion of Hh signaling activity arising from a lack of Smo (an essential molecule for Hh signaling activation, Smofl/fl;Wnt1Cre) were examined. Smofl/fl;Wnt1Cre mice showed a similar phenotype in the distal region of their mandibles to those in Dicerfl/fl;Wnt1Cre mice. We also found that approximately 400 miRNAs were expressed in wild‐type mandibular mesenchymes at E10.5, and six microRNAs were identified as miRNAs with binding potential against both Ptch1 and Hhip1. Their expressions at the distal end of the mandible were confirmed by in situ hybridization. This indicates that microRNAs regulate the distal part of mandibular formation at an early stage of development by involving Hh signaling activity through controlling its inhibitor expression level.
A Unified Model of Firm Dynamics with Limited Commitment and Assortative Matching
Authors: AI HENGJIE , KIKU DANA , LI RUI , TONG JINCHENG
Published: October 2020

We develop a unified theory of dynamic contracting and assortative matching to explain firm dynamics. In our model, neither firms nor managers can commit to arrangements that yield lower payoffs than their outside options, which are microfounded by the equilibrium conditions in a matching market. The model endogenously generates power laws in firm size and CEO compensation, and explains differences in their right tails. We also show that our model quantitatively accounts for many salient features of the time‐series dynamics and the cross‐sectional distribution of firm investment, dividend payout, and CEO compensation.
The effects of eggshell calcium (Biomin H®) and its combinations with alfacalcidol (1α‐hydroxyvitamin D3) and menaquinone‐7 (vitamin K2) on ovariectomy‐induced bone loss in a rat model of osteoporosis
Authors: Omelka Radoslav , Martiniakova Monika , Svik Karol , Slovak Lukas , Payer Juraj , Oppenbergerova Ingrid , Kovacova Veronika , Babikova Martina , Soltesova‐Prnova Marta
Published: October 2020

The purpose of this study was to investigate the impact of eggshell calcium (Biomin H® dietary supplement) and its combinations with alfacalcidol (1α‐hydroxyvitamin D3) and menaquinone‐7 (vitamin K2) on ovariectomy‐induced bone loss in rats. Adult female rats (n = 48) were divided into 6 groups of 8 individuals each: sham‐operated rats (SHAM); ovariectomized (OVX) rats untreated; OVX rats treated with Biomin H® (BIO); OVX rats simultaneously receiving Biomin H®, vitamin D3 (BIO + D3); OVX rats simultaneously treated with Biomin H®, vitamin K2 (BIO + K2) and OVX rats treated with Biomin H®, vitamin D3, vitamin K2 (BIO + D3 + K2) during 8 weeks. Biochemical parameters, bone mineral density (BMD), bone mineral content (BMC) and femoral bone microstructure were determined. Plasma calcium and phosphate were increased in BIO + D3 and BIO + D3 + K2 groups as compared to OVX. Alkaline phosphatase was elevated in OVX, BIO versus SHAM, BIO + D3 + K2 groups. When compared to OVX group, decreased urine deoxypyridinoline was observed in all treated groups and femoral BMD, BMC were higher in BIO, BIO + D3, BIO + D3 + K2 groups. The BIO + K2 rats had similar densitometrical values than OVX individuals. Microcomputed tomography revealed increased trabecular relative bone volume (due to an increase in trabecular number) in BIO + D3, BIO + D3 + K2 as compared to OVX. The higher relative bone volume in BIO + D3, BIO + D3 + K2 groups was also accompanied by an increase in bone surface. In the cortical bone, an enhanced periosteal bone apposition was identified in BIO, BIO + D3, BIO + K2, BIO + D3 + K2 groups. The rats from BIO + D3 + K2 group had a higher area of primary osteon's vascular canals. In BIO + D3, BIO + K2, BIO + D3 + K2 groups, an increased area of secondary osteons was determined in comparison with OVX. Our results indicate the beneficial effect of triple application of Biomin H®, vitamin D3, vitamin K2, as well as simultaneous administration of Biomin H®, vitamin D3 on the inhibition of ovariectomy‐induced bone loss in a rat model of osteoporosis.
Development of High‐Level Omega‐3 Eicosapentaenoic Acid (EPA) Production from Phaeodactylum tricornutum
Authors: Cui Yi , Thomas‐Hall Skye R. , Chua Elvis T. , Schenk Peer M.
Published: October 2020

Phaeodactylum tricornutum is a lipid‐rich marine diatom that contains a high level of omega‐3 polyunsaturated fatty acids, especially eicosapentaenoic acid (EPA). In an effort to reduce costs for large‐scale cultivation of this microalga, this study first established a New BBM medium (0.3 x strength BBM with only 3% of the initial phosphate level) to replace the traditional F/2 medium. Phaeodactylum tricornutum could grow in extremely low phosphate concentrations (25 µM), without compromising the EPA content. In the presence of sea salts, silicate addition was not necessary for high rate growth, high EPA content, or lipid accumulation in this species. Using urea as the sole nitrogen source tended to increase EPA contents per dry biomass (by 24.7%) while not affecting growth performance. The use of sea salts, rather than just sodium chloride, led to significantly improved biomass yields (20% increase) and EPA contents of total fatty acid (46–52% increase), most likely because it supplied sufficient essential elements such as magnesium. A salinity level of 35 led to significantly higher biomass yields compared with 20, but salinity had no significant influence on EPA content. EPA became the dominant fatty acid with average levels of 51.8% of total fatty acids during the exponential growth phase at 20 ppt in New BBM medium with sea salts.
A Multilevel Approach to Understand the Context and Potential Solutions for Low Colorectal Cancer (CRC) Screening Rates in Rural Appalachia Clinics
Authors: Zoellner Jamie , Porter Kathleen , Thatcher Esther , Kennedy Erin , Werth James L. , Grossman Betsy , Roatsey Tomas , Hamilton Heather , Anderson Roger , Cohn Wendy
Published: October 2020

Purpose

To explore system/staff‐ and patient‐level opportunities to improve colorectal cancer (CRC) screening within an 11‐clinic Federally Qualified Health Center (FQHC) in rural Appalachia with CRC screening rates around 22%‐30%.

Methods

Using a convergent parallel mixed‐methods design, staff (n = 26) and patients (n = 60, age 50‐75, 67% female, 83% <college, 47% Medicare, 23% Medicaid) were interviewed about CRC‐related screening practices. Staff and patient interviews were guided by the Consolidated Framework for Implementation Research and Health Belief Model, respectively, and analyzed using a hybrid inductive‐deductive approach.

Results

Among staff, inner setting factors that could promote CRC screening included high workplace satisfaction, experiences tracking other cancer screenings, and a highly active Performance Improvement Committee. Inner setting hindering factors included electronic medical record inefficiencies and requiring patients to physically return fecal tests to the clinic. Outer setting CRC screening promoting factors included increased Medicaid access, support from outside organizations, and reporting requirements to external regulators, while hindering factors included poor social determinants of health, inadequate colonoscopy access, and lack of patient compliance. Among patients, perceived screening benefits were rated relatively higher than barriers. Top barriers included cost, no symptoms, fear, and transportation. Patients reported high likelihood of getting a stool‐based test and colonoscopy if recommended, yet self‐efficacy to prevent CRC was considerably lower.

Conclusions

Contextualized perceptions of barriers and practical opportunities to improve CRC screening rates were identified among staff and patients. To optimize multilevel CRC screening interventions in rural Appalachia clinics, future quality improvement, research, and policy efforts are needed to address identified challenges.
Type IV dermoid sinus, intramedullary dermoid cyst and spina bifida in a Cane Corso
Authors: Blondel M. , Deprey J. , Moissonnier P.
Published: October 2020

A 1‐year‐old male Cane Corso was presented for progressive hindlimb neurologic deficits, with a history of suspected recurrent meningitis. Physical examination and advanced diagnostic imaging findings were suggestive of a thoracic dermoid sinus extending into the dura mater, and spina bifida. After initial medical treatment, the lesion was surgically excised, and the presence of an intramedullary cyst in continuation with the dermoid sinus was confirmed, requiring partial durectomy and myelotomy for removal. Histopathological examination of the excised tissue confirmed the diagnosis of a dermoid sinus associated with an intramedullary dermoid cyst. After surgery, the dog temporarily declined neurologically but then showed progressive neurological improvement. This report describes presentation and successful surgical treatment of a type IVa dermoid sinus associated with an intramedullary dermoid cyst and spina bifida in a dog.