bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of post‐operative serum albumin level on anastomotic leakage after transthoracic oesophagectomy for oesophageal squamous cell carcinoma
Authors: Zhuge Lingdun , Zheng Difan , Mao Hengyu , Xiang Jiaqing , Chen Haiquan
Published: November 2020

Background

The correlation of post‐operative serum albumin level with the occurrence of anastomotic leakage (AL) in oesophageal squamous cell carcinoma (ESCC) remains unclear. The aim of this study was to evaluate the impact of post‐operative serum albumin level on AL after transthoracic oesophagectomy.

Methods

Patients with ESCC who underwent transthoracic oesophagectomy between 2013 and 2017 in Fudan University Shanghai Cancer Center were included. The correlation of post‐operative serum albumin level with the occurrence and short‐term outcomes of AL was analysed.

Results

Patients with serum albumin level of <35 g/L on the first post‐operative day were identified with higher frequency of AL in the whole study population (10.3% versus 6.1%; P < 0.001), intrathoracic anastomosis subgroup (7.1% versus 3.9%; P = 0.002) and cervical anastomosis subgroup (24.1% versus 16.0%; P = 0.042). Multivariate analysis showed that low albumin level was an independent risk factor of AL in the overall population (odds ratio (OR) 1.842; P < 0.001), intrathoracic anastomosis subgroup (OR 1.815; P = 0.006) and cervical anastomosis subgroup (OR 1.946; P = 0.013). In patients with AL, low albumin level was associated with poorer short‐term outcomes. For patients with low albumin level on the first post‐operative day, the probability of AL was significantly reduced if the level in the first post‐operative week was improved to the normal range (5.9% versus 14.9%; P < 0.001).

Conclusion

Serum albumin level on the first post‐operative day was an independent predictor of AL in patients with ESCC receiving transthoracic oesophagectomy. Increase of albumin level to the normal range post‐operatively could reduce the risk of AL.
Family therapy interventions in India for persons with gambling disorder
Authors: George Sanju , Kallivayalil Roy Abraham
Published: November 2020

Gambling is a popular pastime in India and the number of problem gamblers is on the rise. Although the impact of gambling disorder on families is grossly under‐researched in India, drawing on international evidence it is only reasonable to assume that this is an important area deserving further clinical and research attention. Of the several types of interventions possible with families of persons with gambling disorder, in our clinical experience, the 5‐step intervention is a feasible and culturally adaptable psychotherapeutic intervention. In this paper we have looked at the theoretical aspects of this intervention and also raise some of the practical challenges of offering psychological interventions to families of persons with gambling disorder in India. Albeit limited, we discuss the evidence base to have emerged from India in this field. Finally, we suggest some intervention measures as the way forward.
Alcohol control policies in Former Soviet Union countries: A narrative review of three decades of policy changes and their apparent effects
Authors: Neufeld Maria , Bobrova Anastacia , Davletov Kairat , Štelemėkas Mindaugas , Stoppel Relika , Ferreira‐Borges Carina , Breda João , Rehm Jürgen
Published: November 2020

Issues

The last Soviet anti‐alcohol campaign of 1985 resulted in considerably reduced alcohol consumption and saved thousands of lives. But once the campaign's policies were abandoned and the Soviet alcohol monopoly broken up, a steep rise in mortality was observed in many of the newly formed successor countries, although some kept their monopolies. Almost 30 years after the campaign's end, the region faces diverse challenges in relation to alcohol.

Approach

The present narrative review sheds light on recent drinking trends and alcohol policy developments in the 15 Former Soviet Union (FSU) countries, highlighting the most important setbacks, achievements and best practices. Vignettes of alcohol control policies in Belarus, Estonia, Kazakhstan, Lithuania and Uzbekistan are presented to illustrate the recent developments.

Key Findings

Over the past decade, drinking levels have declined in almost all FSU countries, paralleled by the introduction of various alcohol‐control measures. The so‐called three ‘best buys’ put forward by the World Health Organization to reduce alcohol‐attributable burden (taxation and other measures to increase price, restrictions on alcohol availability and marketing) are relatively well implemented across the countries.

Implications

In recent years, evidence‐based alcohol policies have been actively implemented as a response to the enormous alcohol‐attributable burden in many of the countries, although there is big variance across and within different jurisdictions.

Conclusion

Strong declines in alcohol consumption were observed in the 15 FSU countries, which have introduced various alcohol control measures in recent years, resulting in a reduction of alcohol consumption in the World Health Organization European region overall.
Alcohol industry, corporate social responsibility and country features in Latin America
Authors: Conde Karina , Peltzer Raquel Inés , Pantani Daniela , Pinsky Ilana , Cremonte Mariana
Published: November 2020

Introduction and Aims

Research on corporate behaviour can contribute to the understanding of the possible adverse impacts of alcohol‐industry corporate social responsibility (CSR) initiatives and their potential influence on policymaking. This study explores the association between alcohol‐industry CSR activities and selected country features in Latin America and the Caribbean.

Design and Methods

Nine health experts evaluated 148 CSR activities using a standardised protocol; activities were classified into the categories risk management CSR (rmCSR), that is, to avoid/rectify externalities (n = 67), and strategic CSR, that is, to fulfill philanthropic responsibilities (n = 81). We evaluated the associations, separately, between the number of rmCSR and of strategic CSR actions in each country with threats from public health measures (specifically, the level of research into alcohol consumption and harms, the existence of an alcohol surveillance system and the number of governmental alcohol policy actions) and per capita alcohol consumption; we adjusted by economic indices (country income level and the gross domestic product) and population size.

Results

Multivariate analyses showed that the higher the level of alcohol research within a country and its per capita consumption, the more likely rmSCR activities were to occur, independently of the country's economic development or population.

Discussion and Conclusions

Results suggest rmSCR actions could be implemented as a way to preserve markets by counteracting scientific evidence about alcohol related harms. This evidence could serve as a starting point to future research, contributing to the understanding of alcohol industry behaviour and the advancement of effective public policies.
Left ventricular intra‐myocardial dissection after myocardial infarction
Authors: Rezaei‐Kalantari Kiara , Saedi Sedigheh , Alizadeasl Azin , Naghshbandi Mona
Published: November 2020

Left ventricular (LV) intra‐myocardial dissection or dissecting hematoma is a rare complication of myocardial infarction that could occur in the acute phase, during remodeling process and even after coronary revascularization. LV intra‐myocardial dissection has a high mortality, and the best management strategy remains controversial. Here, we present a case of dissection of left ventricle late after anterior myocardial infarction diagnosed by multimodality imaging.
Mechanisms to reduce the cytotoxicity of pharmacological nicotinamide concentrations in the pathogenic fungus Candida albicans
Authors: Ghugari Rahul , Tsao Sarah , Schmidt Mark , Bonneil Éric , Brenner Charles , Verreault Alain
Published: November 2020

Candida albicans is a pathogenic fungus that causes systemic infections and mortality in immunosuppressed individuals. We previously showed that deacetylation of histone H3 lysine 56 by Hst3 is essential for C. albicans viability. Hst3 is a fungal‐specific NAD+‐dependent protein deacetylase of the sirtuin family. In vivo, supraphysiological concentrations of nicotinamide (NAM) are required for Hst3 inhibition and cytotoxicity. This underscores the importance of identifying mechanisms by which C. albicans can modulate intracellular NAM concentrations. For the first time in a pathogenic fungus, we combine genetics, heavy isotope labeling, and targeted quantitative metabolomics to identify genes, pathways, and mechanisms by which C. albicans can reduce the cytotoxicity of high NAM concentrations. We discovered three distinct fates for supraphysiological NAM concentrations. First, upon transient exposure to NAM, high intracellular NAM concentrations rapidly return near the physiological levels observed in cells that are not exposed to NAM. Second, during the first step of a fungal‐specific NAM salvage pathway, NAM is converted into nicotinic acid, a metabolite that cannot inhibit the sirtuin Hst3. Third, we provide evidence that NAM enters the NAD+ metabolome through a NAM exchange reaction that contributes to NAM‐mediated inhibition of sirtuins. However, in contrast to the other fates of NAM, the NAM exchange reaction cannot cause a net decrease in the intracellular concentration of NAM. Therefore, this reaction cannot enhance resistance to NAM. In summary, we demonstrate that C. albicans possesses at least two mechanisms to attenuate the cytotoxicity of pharmacological NAM concentrations. It seems likely that those two mechanisms of resistance to cytotoxic NAM concentrations are conserved in many other pathogenic fungi.
Role of developing language attitudes in a study abroad context on adoption of dialectal pronunciations
Authors: Schmidt Lauren B.
Published: November 2020

This study examines how language attitudes play a role in the adoption of dialectal variants in second language (L2) pronunciation in a study abroad context. Twenty‐four North American university students participating in a 6‐week program in Buenos Aires, Argentina, were administered pre and posttest questionnaires and a posttest oral production task to determine how different background and attitudinal variables relate to production of two Argentine dialectal sounds, lenited‐/s/ and assibilated pre‐palatal /ʃ ʒ/. Results show that though students did not produce lenited‐/s/ forms, use of dialectal /ʃ ʒ/ phones by the end of the program was high—but variable—across individuals. Dialect preference, feelings toward Spanish, and desire to sound native‐like were identified as predictors of use of dialectal /ʃ ʒ/. These findings illustrate how social variables play a role in target model accent preferences and adoption of dialectal sounds in L2 pronunciation in a study abroad context.
Preconditioning of Caenorhabditis elegans to anoxic insult by inactivation of cholinergic, GABAergic and muscle activity
Authors: Bennett Heather L. , McClanahan Patrick D. , Fang‐Yen Christopher , Kalb Robert G.
Published: November 2020

For most metazoans, oxygen deprivation leads to cell dysfunction and if severe, death. Sublethal stress prior to a hypoxic or anoxic insult (“preconditioning”) can protect cells from subsequent oxygen deprivation. The molecular mechanisms by which sublethal stress can buffer against a subsequent toxic insult and the role of the nervous system in the response are not well understood. We studied the role of neuronal activity preconditioning to oxygen deprivation in Caenorhabditis elegans. Animals expressing the histamine gated chloride channels (HisCl1) in select cell populations were used to temporally and spatially inactivate the nervous system or tissue prior to an anoxic insult. We find that inactivation of the nervous system for 3 h prior to the insult confers resistance to a 48‐h anoxic insult in 4th‐stage larval animals. Experiments show that this resistance can be attributed to loss of activity in cholinergic and GABAergic neurons as well as in body wall muscles. These observations indicate that the nervous system activity can mediate the organism's response to anoxia.
Altered microbial structure and function after thermokarst formation
Authors: Liu Futing , Kou Dan , Chen Yongliang , Xue Kai , Ernakovich Jessica G. , Chen Leiyi , Yang Guibiao , Yang Yuanhe
Published: November 2020

Permafrost thaw could induce substantial carbon (C) emissions to the atmosphere, and thus trigger a positive feedback to climate warming. As the engine of biogeochemical cycling, soil microorganisms exert a critical role in mediating the direction and strength of permafrost C‐climate feedback. However, our understanding about the impacts of thermokarst (abrupt permafrost thaw) on microbial structure and function remains limited. Here we employed metagenomic sequencing to analyze changes in topsoil (0–15 cm) microbial communities and functional genes along a permafrost thaw sequence (1, 10, and 16 years since permafrost collapse) on the Tibetan Plateau. By combining laboratory incubation and a two‐pool model, we then explored changes in soil labile and stable C decomposition along the thaw sequence. Our results showed that topsoil microbial α‐diversity decreased, while the community structure and functional gene abundance did not exhibit any significant change at the early stage of collapse (1 year since collapse) relative to non‐collapsed control. However, as the time since the collapse increased, both the topsoil microbial community structure and functional genes differed from the control. Abundances of functional genes involved in labile C degradation decreased while those for stable C degradation increased at the late stage of collapse (16 years since collapse), largely driven by changes in substrate properties along the thaw sequence. Accordingly, faster stable C decomposition occurred at the late stage of collapse compared to the control, which was associated with the increase in relative abundance of functional genes for stable C degradation. These results suggest that upland thermokarst alters microbial structure and function, particularly enhances soil stable C decomposition by modulating microbial functional genes, which could reinforce a warmer climate over the decadal timescale.
Soluble vascular endothelial growth factor receptor‐1 as a novel marker of arteriovenous fistula stenosis in hemodialysis patients
Authors: Eroglu Eray , Kocyigit Ismail , Kahriman Guven , Karakukcu Cigdem , Tuncay Aydin , Zararsiz Gozde Erturk , Eren Davut , Kalay Nihat , Sipahioglu Murat Hayri , Oymak Oktay , Tokgoz Bulent
Published: November 2020

Introduction

Arteriovenous fistula (AVF) stenosis is one of the most important clinical problems in hemodialysis patients. The histopathological findings of neointimal hyperplasia and impaired angiogenesis have been well established in stenotic AVFs. Soluble vascular endothelial growth factor receptor‐1 (sVEGFR‐1) has been implicated in pathological angiogenesis. Thus, we aimed to investigate the association between sVEGFR‐1 and AVF stenosis in hemodialysis patients.

Methods

This prospective cohort study included 70 patients with end‐stage renal disease. Forty‐five patients were included in the final analysis, and the median follow‐up period was 36 months. Venous stenosis was detected by physical examination and documented by fistulography. Blood samples were analyzed a day before the fistula operation, and serum levels of sVEGFR‐1 were measured.

Findings

The median sVEGFR‐1 level was higher in the stenosis group than in the nonstenosis group (17 pg/mL [89.5%] vs. 5 pg/mL [19.2%], respectively; P < 0.001]. According to body mass index (BMI) categories, obese patients (BMI > 30 kg/m2) had the shortest stenosis‐free survival (20 months [9.35–30.65]). Multivariate Cox analysis showed that sVEGFR‐1, serum creatinine, and parathyroid hormone levels were associated with AVF stenosis risk. Kaplan‐Meier survival curves showed that patients with less than the median value of sVEGFR‐1 (<6093.07 pg/mL) had longer cumulative stenosis‐free survival than patients with sVEGFR‐1 levels above the median value (P < 0.001).

Discussion

Increased levels of sVEGFR‐1 and obesity were found to be associated with AVF stenosis in hemodialysis patients.
Assemblages of fruit flies (Diptera: Tephritidae) along an elevational gradient in the rainforests of Papua New Guinea
Authors: Finnie Sam , Sam Katerina , Leponce Maurice , Basset Yves , Drew Dick , Schutze Mark K. , Dahl Chris , Damag Micah , Dilu Mary , Gewa Bradley , Kaupa Borenke , Keltim Martin , Koane Bonny , Kua Joseph , Lilip Roll , Mogia Martin , Philip Frank , Ray Bryan , Sam Legi , Tulai Salape , Uma Collin , Umari Ruma , Valeba Joseph , Yalang Joachim , Novotny Vojtech
Published: November 2020

Papua New Guinea (PNG) has the greatest diversity of dacine fruit fly species (Diptera: Tephritidae: Dacinae) in the world, many of which are significant agricultural pests.

Although their taxonomy is relatively well known, there is limited research on their geographical and elevational distribution.

We undertook a survey of PNG's fruit fly fauna along a complete elevational gradient on Mt Wilhelm (175–3700 m a.s.l.) to determine the elevational species distribution and turnover of fruit fly communities. Fruit flies were sampled using a selection of male parapheromone lures, including Zingerone, a new and promising male attractant.

In total, we collected 10 700 fruit flies representing 77 species. The total abundance and species richness of fruit flies decreased with increasing elevation. Species richness was similarly high at 175 and 200 m a.s.l. (30 and 27 species) and at 700 and 1200 m a.s.l. (16 and 20 species, respectively) but dropped suddenly to only two species at 1700 m a.s.l. and to zero at all four sites above this elevation. There were no flies attracted exclusively to Zingerone. One species (Bactrocera recurrens) exhibited dramatic, temporal changes in abundance during the study period. Fruit fly assemblages were significantly influenced by both the lure type and elevation. Similarity of fruit fly communities decayed linearly with increasing elevational distance.

We concluded that the upper limit of fruit fly distribution in PNG occurs between 1700 and 2200 m a.s.l. and the centre of diversity occurs between 0 and 700 m a.s.l.
Specialist haematology consultation services in regional Western Australia: evaluating a model combining telehealth and onsite clinics
Authors: Auret Kirsten , Pikora Terri , Pola Melissa
Published: November 2020

Background

Models of care that increase specialist medical services to regional or remote patients are being explored worldwide. Many of the models include telehealth (also called telemedicine or video‐conferencing consultations) alone or in combination with traditional face‐to‐face clinic visits.

Aim

To report the experience of patients using telehealth consultation and costs associated with delivering the service in a Regional Cancer Centre over a 12‐month period.

Methods

Patients attending a Great Southern haematology clinic between September 2018 and July 2019 were invited to complete a brief questionnaire about their demographic and diagnosis details. Those attending a telehealth clinic were invited to complete a Tele‐Haematology Satisfaction Questionnaire and invited to participate in a face‐to‐face interview regarding their general experiences and thoughts related to telehealth and face‐to‐face consultations. Occasions of service costs and direct hospital expenses were provided by the central health service's telehealth office.

Results

The use of telehealth alone or as part of a mixed model was acceptable and convenient for most patients. In addition, high levels of satisfaction were reported including improved access to specialist services, reduced travel time and an ease of use of the telehealth system. The total cost saving was A$308 per occasion of service.

Conclusions

The present study demonstrated that the model was effective in providing outpatient services and cost effective to the health service, while being experienced as a satisfactory model by patients.
Touchy feely vectors: A compensatory design approach to support model‐based reasoning in developing country classrooms
Authors: Karnam DurgaPrasad , Agrawal Harshit , Parte Pranay , Ranjan Saurabh , Borar Priyanka , Kurup Prasanna Prakash , Joel Amose Jebin , Srinivasan Pattamadai Sankaran , Suryawanshi Uddhav , Sule Aniket , Chandrasekharan Sanjay
Published: November 2020

Educational technology designs in developing countries mostly focus on making knowledge resources widely available, through MOOCs, repositories and computer‐based tutoring. The use of digital media for cognitive augmentation, particularly interactive designs that help learners understand modelling topics in STEM, is underexplored. We report a 3‐year design study examining this potential in the Indian context, testing two iterations of an interactive system, Touchy‐Feely Vectors (TFV). The design supports learning vectors, a modelling topic pre‐university students struggle with. Virtual lesson‐plans were co‐designed with teachers to augment — but not replace — their existing practices, and to address classroom and resource constraints. Pre‐post testing of TFV‐1 (a computer‐based prototype) showed that it helped students develop a more integrated vector concept, and improved their reasoning. Field‐implementation of TFV‐2 (a textbook‐linked touch‐screen based design) in 6‐classrooms (3‐Control, N=135; 3‐Experimental, N=131) showed that it fostered cognitive engagement in average‐students and geometry‐algebra integration (model‐based reasoning) in good‐students. These results, along with a requirements analysis based on textbooks, indicate that the interaction possibilities supported by different representational media critically shape student reasoning. The study also illustrates a systematic approach to design and test digital media systems that support cognitive augmentation in developing countries.
Contemporary procedural trends of Watchman percutaneous left atrial appendage occlusion in the United States
Authors: Munir Muhammad Bilal , Khan Muhammad Zia , Darden Douglas , Pasupula Deepak K. , Balla Sudarshan , Han Frederick T. , Reeves Ryan , Hsu Jonathan C.
Published: November 2020

Objective

To determine trends in real‐world utilization and in‐hospital adverse events from Watchman implantation since its approval by the Food and Drug Administration in 2015.

Background

The risk of embolic stroke caused by atrial fibrillation is reduced by oral anticoagulants, but not all patients can tolerate long‐term anticoagulation. Left atrial appendage occlusion with the Watchman device has emerged as an alternative therapy.

Methods

This was a retrospective cohort study utilizing data from National Inpatient Sample for calendar years 2015–2017. The outcomes assessed in this study were associated complications, in‐hospital mortality, and resource utilization trends after Watchman implantation. Trends analysis were performed using analysis of variance. Multivariable adjusted logistic regression analysis was performed to determine predictors of mortality.

Results

A total of 17 700 patients underwent Watchman implantation during the study period. There was a significantly increased trend in the number of Watchman procedures performed over the study years (from 1195 in 2015 to 11 165 devices in 2017, p < .01). A significant decline in the rate of complications (from 26.4% in 2015% to 7.9% in 2017, p < .01) and inpatient mortality (from 1.3% in 2015% to 0.1% in 2017, p < .01) were noted. Predictors of in‐hospital mortality included a higher CHA2DS2‐VASc score (odds ratio [OR]: 2.61 per 1‐point increase, 95% confidence interval [CI]: 1.91–3.57), chronic blood loss anemia (OR: 3.63, 95% CI: 1.37–9.61) and coagulopathy (OR: 4.90, 95% CI: 2.32–10.35).

Conclusion

In contemporary United States clinical practice, Watchman utilization has increased significantly since approval in 2015, while complications and in‐patient mortality have declined.
Identification of mini‐chromosome maintenance 8 as a potential prognostic marker and its effects on proliferation and apoptosis in gastric cancer
Authors: Huang Bin , Lin Minghe , Lu Lisha , Chen Wujin , Tan Jingzhuang , Zhao Jinyan , Cao Zhiyun , Zhu Xiaoqin , Lin Jiumao
Published: November 2020

Mini‐chromosome maintenance (MCM) proteins play important roles in initiating eukaryotic genome replication. The MCM family of proteins includes several members associated with the development and progression of certain cancers. We performed online data mining to assess the expression of MCMs in gastric cancer (GC) and the correlation between their expression and survival in patients with GC. Notably, MCM8 expression was undoubtedly up‐regulated in GC, and higher expression correlated with shorter overall survival (OS) and progression‐free survival (PFS) in patients with GC. However, the role of MCM8 in GC has not been previously explored. Our in vitro experiments revealed that MCM8 knockdown inhibited cell growth and metastasis. Moreover, MCM8 knockdown induced apoptosis. Mechanistically, the expression levels of Bax and cleaved caspase‐3 were increased, whereas Bcl‐2 expression decreased. Additionally, we demonstrated that MCM8 knockdown suppressed tumorigenesis in vivo. Overall, these results suggest that MCM8 plays a significant role in GC progression.
gB co‐immunization with GP96 enhances pulmonary‐resident CD8 T cells and exerts a long‐term defence against MCMV pneumonitis
Authors: Guo Bingnan , Xu Peifeng , Chai Dafei , Cao Lei , Liu Lin , Song Tengfei , Hu Shuqun , Chen Yuling , Yan Xianliang , Xu Tie
Published: November 2020

Human cytomegalovirus (HCMV) infection in the respiratory tract leads to pneumonitis in immunocompromised hosts without available vaccine. Considering cytomegalovirus (CMV) mainly invades through the respiratory tract, CMV‐specific pulmonary mucosal vaccine development that provides a long‐lasting protection against CMV challenge gains our attention. In this study, N‐terminal domain of GP96 (GP96‐NT) was used as a mucosal adjuvant to enhance the induction of pulmonary‐resident CD8 T cells elicited by MCMV glycoprotein B (gB) vaccine. Mice were intranasally co‐immunized with 50 μg pgB and equal amount of pGP96‐NT vaccine 4 times at 2‐week intervals, and then i.n. challenged with MCMV at 16 weeks after the last immunization. Compared with pgB immunization alone, co‐immunization with pgB/pGP96‐NT enhanced a long‐lasting protection against MCMV pneumonitis by significantly improved pneumonitis pathology, enhanced bodyweight, reduced viral burdens and increased survival rate. Moreover, the increased CD8 T cells were observed in lung but not spleen from pgB/pGP96‐NT co‐immunized mice. The increments of pulmonary CD8 T cells might be mainly due to non‐circulating pulmonary‐resident CD8 T‐cell subset expansion but not circulating CD8 T‐cell populations that home to inflammation site upon MCMV challenge. Finally, the deterioration of MCMV pneumonitis by depletion of pulmonary site‐specific CD8 T cells in mice that were pgB/pGP96‐NT co‐immunization might be a clue to interpret the non‐circulating pulmonary‐resident CD8 T subset expansion. These data might uncover a promising long‐lasting prophylactic vaccine strategy against MCMV‐induced pneumonitis.
Bad Times, Good Credit
Authors: BECKER BO , BOS MARIEKE , ROSZBACH KASPER
Published: November 2020

Banks’ limited knowledge about borrowers’ creditworthiness constitutes an important friction in credit markets. Is this friction deeper in recessions, thereby contributing to cyclical swings in credit, or is the friction reduced, as bad times reveal information about firm quality? We test these alternative hypotheses using internal ratings data from a large Swedish cross‐border bank and credit scores from a credit bureau. The ability to classify corporate borrowers by credit quality is greater during bad times and worse during good times. Soft and hard information measures both display countercyclical patterns. Our results suggest that information frictions in corporate credit markets are intrinsically countercyclical and not due to cyclical variation in monitoring effort. The presence of countercyclical information frictions provides a rationale for countercyclical provisions or capital in banks to smooth credit cycles.
Evaluation of the Choose Health: Food, Fun, and Fitness 3rd‐ to 6th‐Grade Curriculum: Changes in Obesity‐Related Behaviors
Authors: Wolfe Wendy S. , Dollahite Jamie
Published: November 2020

BACKGROUND

Choose Health: Food, Fun, and Fitness (CHFFF) is aimed at 3rd to 6th graders, and uses experiential learning, food preparation, active games, goal setting, and a family newsletter to target behaviors shown to decrease childhood obesity and chronic disease risk. This study aimed to evaluate CHFFF as intended in low‐income settings.

METHODS

A quasi‐experimental design with delayed intervention was used. CHFFF participants in 27 after‐school and 28 in‐school groups in 5 New York counties in 2014 to 2015 completed a self‐report survey at initial enrollment, after a no‐intervention control period, and after receiving CHFFF. Statistical analyses were based on 561 3rd to 6th graders who completed all 3 surveys and participated in at least 4 of the 6 lessons.

RESULTS

Compared to their control period, after receiving CHFFF, youth significantly improved in the following multi‐item dietary scores: overall dietary intake (p < .001), vegetable intake (p < .001), fruit intake (p < .01), soda/fast food intake (p < .05) and intent to consume soda/fast food (p < .001). Youth also reported reading Nutrition Facts labels and sharing about healthy eating with their family more often (both p < .001), and greater likelihood of having tried a new food (p < .001).

CONCLUSIONS

Results provide evidence for the effectiveness of this curriculum in improving self‐reported child diet and related behaviors.
School as a Protective Setting for Excess Weight Gain and Child Obesity: A Meta‐Analysis
Authors: Nicholson Laura M. , McLeod Loren Dorothy , Reifenberg Alexandra , Beets Michael W. , Bohnert Amy M.
Published: November 2020

BACKGROUND

The structure provided by school settings even with no specific obesity‐intervention may prevent weight gain. This meta‐analytic study considered this premise by examining weight outcomes from control groups in published randomized controlled trials of school‐year obesity‐related interventions conducted in‐school and out‐of‐school.

METHODS

A systematic review and random‐effects meta‐analysis were conducted in accordance with Preferred Reporting Items of Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Databases were systematically searched and resulted in 1976 unique citations, with 14 retained for analysis. Analyses examined the change in weight outcomes among control group participants.

RESULTS

For studies (N = 6) reporting body mass index (BMI) (kg/m2) the overall standardized mean difference (SMD) from pre‐ to post‐intervention was 0.085 (raw units 0.278 kg/m2); for studies (N = 9) reporting zBMI, the SMD was 0.022 (0.020 z‐scores), for studies (N = 2) reporting waist circumference (cm), the SMD was 0.149 (1.609 cm); for studies (N = 2) reporting BMI percentile, the SMD was 0.064 (0.985 percentiles); and for studies (N = 1) reporting percent body fat, the SMD was 0.031 (0.30 percentage).

CONCLUSIONS

Children assigned to control conditions (as part of school‐based obesity‐related interventions) experience, on average, minimal changes in weight outcomes during the school year. Therefore, routine practices of schools may protect against unhealthy weight gains.
Model School‐District Wellness Policies Warrant Improvements in Comprehensiveness and Strength
Authors: Meendering Jessica R. , Skinner Maty M. , McCormack Lacey A.
Published: November 2020

BACKGROUND

School districts participating in the US Child Nutrition program are required to have a wellness policy. Many state agencies provide model policies to aid districts in policy creation. However, use of model wellness policies has not been associated with higher quality policies. Therefore, the purpose of the present study was to assess the quality of model wellness policies and to determine if federal regulations are more likely to be included than evidence‐based best practices.

METHODS

Model wellness polices available through state agency websites were analyzed for comprehensiveness and strength using the WellSAT 3.0 and item status as a federal regulation or best practice was assigned. We used linear regression to determine if federal regulation status was associated with inclusion in model wellness policies.

RESULTS

Overall, 34 states had model wellness policies available online. The total comprehensiveness and strength of model wellness policies was 59.3 ± 17.5 and 21.4 ± 17.6, respectively, out of 100 possible points. Among policy sections, comprehensiveness was highest within Nutrition Education (73.2 ± 31.6) and lowest in Wellness Promotion and Marketing (49.8 ± 27.2). On average, WellSAT items that were federal regulations were covered in 71% of model policies, while best practices were only covered in 54% of model policies (p = .008).

CONCLUSIONS

There is a need to improve the quality of model wellness policies. The development of a uniform model policy may be warranted to provide a comprehensive list of federal regulations and best practices, written with strong language, for inclusion within school wellness policies.
Salty taste threshold among children of different ethnicities
Authors: Dora Rosmawati , Lim Sim Yee , Haron Hasnah , Wong Jyh Eiin , Yatiman Noor Hafizah , Poh Bee Koon
Published: November 2020

Taste perception is an important determinant of food preference and consumption. Salty taste sensitivity among children can be influenced by ethnicity. This study determined the salty taste threshold among children of different ethnicities in Malaysia. Forty‐two children aged 9–11 years from the three main ethnic groups (14 Malays, 15 Chinese, 13 Indians) in Malaysia were recruited for this cross‐sectional study. The salty taste threshold was determined using two‐alternative forced‐choice staircase with 18 different concentrations of sodium chloride solutions (0.056 to 1,000 mM). Overall, the mean salty taste threshold among children was 1.01 ± 0.71 mM. No significant difference was noted in the salty taste threshold between boys and girls (p = .830). Chinese children had a significantly higher salty taste threshold (1.21 ± 0.53 mM) compared with Malay (1.13 ± 1.13 mM) and Indian children (0.67 ± 0.72 mM, p < .05). In conclusion, further studies are warranted to better understand how taste sensitivity may influence salt preference and food intake among children of different ethnicities in Malaysia.

Practical applications

Salty taste sensitivity developed during childhood is one of the factors that influence preference towards salty taste and intake of salty food in later life. A variety of cuisines in different ethnic cultures is related to different preferences in taste and food. The difference of salty taste threshold among children in this study may provide valuable insights and data for future intervention programme among children of different ethnicities. Besides, this study may also provide the foundation and references in the formulation of low salt food.
A research approach for co‐designing education with healthcare consumers
Authors: Brand Gabrielle , Sheers Carli , Wise Steve , Seubert Liza , Clifford Rhonda , Griffiths Pamela , Etherton‐Beer Christopher
Published: November 2020

Context

Community and consumer involvement in health professions education (HPE) is of growing interest among researchers and educators, particularly in preparing health care graduates to effectively learn from, and collaborate with, people with lived experience of health issues. However, to date there has been limited direction on methodological approaches to engage health care consumers in the research and co‐design of HPE.

Approach

In this paper, we describe the background to our work with health care consumers including the five core principles for successful co‐design (inclusive; respectful; participative; iterative; outcomes focused) and how they can be applied as a research approach in HPE. We introduce the use of arts and humanities‐based teaching methodologies including engagement, meaning‐making and translational education strategies to illustrate how this research approach has been applied to reframe mental health education and practice in Australia. Furthermore, we share some reflective insights on the opportunities and challenges inherent in using a co‐design research approach in HPE.

Conclusions

For the consumer voice to be embedded across HPE, there needs to be a collective commitment to curriculum redesign. This paper advances our understandings of the educational research potential of working with health care consumers to co‐design rich and authentic learning experiences in HPE. Co‐design research approaches that partner with and legitimise health care consumers as experts by experience may better align education and health professional practice with consumers’ actual needs, an important first step in transforming hierarchical health care relationships towards more humanistic models of care.
Novel Fus3‐ and Ste12‐interacting protein FsiA activates cell fusion‐related genes in both Ste12‐dependent and ‐independent manners in Ascomycete filamentous fungi
Authors: Katayama Takuya , Bayram Özgür , Mo Taoning , Karahoda Betim , Valerius Oliver , Takemoto Daigo , Braus Gerhard H. , Kitamoto Katsuhiko , Maruyama Jun‐ichi
Published: November 2020

Filamentous fungal cells, unlike yeasts, fuse during vegetative growth. The orthologs of mitogen‐activated protein (MAP) kinase Fus3 and transcription factor Ste12 are commonly involved in the regulation of cell fusion. However, the specific regulatory mechanisms underlying cell fusion in filamentous fungi have not been revealed. In the present study, we identified the novel protein FsiA as an AoFus3‐ and AoSte12‐interacting protein in the filamentous fungus Aspergillus oryzae. The expression of AonosA and cell fusion‐related genes decreased upon fsiA deletion and increased with fsiA overexpression, indicating that FsiA is a positive regulator of cell fusion. In addition, the induction of cell fusion‐related genes by fsiA overexpression was also observed in the Aoste12 deletion mutant, indicating that FsiA can induce the cell fusion‐related genes in an AoSte12‐independent manner. Surprisingly, the fsiA and Aoste12 double deletion mutant exhibited higher cell fusion efficiency and increased mRNA levels of the cell fusion‐related genes as compared to the fsiA single deletion mutant, which revealed that AoSte12 represses the cell fusion‐related genes in the fsiA deletion mutant. Taken together, our data demonstrate that FsiA activates the cell fusion‐related genes by suppressing the negative function of AoSte12 as well as by an AoSte12‐independent mechanism.
Clinical evaluation of two different (1,3)‐ß‐d‐glucan assays for diagnosis of invasive fungal diseases: A retrospective cohort study
Authors: Zubkowicz Marta , Held Jürgen , Baier Michael , Pletz Mathias W. , Kesselmeier Miriam , Hagel Stefan , Bahrs Christina
Published: November 2020

Background

Early diagnosis of invasive fungal diseases (IFDs) remains a major challenge in routine clinical practice.

Objectives

The aim of this retrospective cohort study was to evaluate the diagnostic performance of the fungal biomarker (1,3)‐ß‐d‐glucan (BDG) using the β‐Glucan test (GT) and the well‐established Fungitell assay® (FA) in real‐life clinical practice.

Patients/Methods

We included 109 patients with clinical suspicion of IFD who were treated at Jena University Hospital, Germany, between November 2018 and March 2019. The patients were classified according to the latest update of the EORTC/MSG consensus definitions of IFD. The first serum sample of every patient was analysed for BDG using the FA and the GT, respectively.

Results

Fifty‐six patients (51.4%) had at least one host factor for IFD. In patients with proven (n = 11) or probable IFDs (n = 20), median BDG concentrations were 145.0 pg/ml for the FA and 5.1 pg/ml for the GT, respectively. A positive test result of both BDG assays at manufacturer's cut‐offs predicted 89.5%‐98.3% of proven or probable IFD, but the sensitivity of both assays was limited: The FA identified 60.7% of IFDs (cut‐off: 80 pg/ml). Reducing the GT cut‐off value from 11.0 to 4.1 pg/ml increased the detection rate of IFDs from 35.5% to 54.8%.

Conclusions

A positive test result of both BDG assays at manufacturer's cut‐off was highly predictive for IFD, but except for Pneumocystis jirovecii pneumonia sensitivities were limited. Adjustment of the GT cut‐off value equalised sensitivities of GT and FA.
Hepatitis B related dilemmas in the renal unit
Authors: Holt Stephen G. , Locarnini Stephen , Sasadeusz Joe
Published: November 2020

Testing for hepatitis B in dialysis patients is routine, but newer and more sensitive detection methods mean that there is sometimes confusion around viral loads and occult infection. There are frequently difficult choices surrounding isolation and treatment. Here we describe the use of HBV serology and DNA testing in decisions around patients with end‐stage renal disease. We also suggest isolation decisions based on our current understanding of the virus and its infectivity.
SCFSNIPER7 controls protein turnover of unfoldase CDC48A to promote plant immunity
Authors: Ao Kevin , Tong Meixuezi , Li Lin , Lüdke Daniel , Lipka Volker , Chen She , Wiermer Marcel , Li Xin
Published: November 2020

The unfoldase CDC48 (Cell Division Cycle 48) is highly conserved in eukaryotes, serving as an AAA + ATPase to extract ubiquitinated proteins from large protein complexes and membranes. Although its biochemical properties have been studied extensively in yeast and animal systems, the biological roles and regulations of the plant CDC48s have been explored only recently.

Here we describe the identification of a novel E3 ligase from the SNIPER (snc1‐influencing plant E3 ligase reverse genetic) screen, which contributes to plant defense regulation by targeting CDC48A for degradation. SNIPER7 encodes an F‐box protein and its overexpression leads to autoimmunity.

We identified CDC48s as interactors of SNIPER7 through immunoprecipitation followed by mass spectrometry proteomic analysis. SNIPER7 overexpression lines phenocopy the autoimmune mutant Atcdc48a‐4. Furthermore, CDC48A protein levels are reduced or stabilized when SNIPER7 is overexpressed or inhibited, respectively, suggesting that CDC48A is the ubiquitination substrate of SCFSNIPER7.

Taken together, this study reveals a new mechanism where a SCFSNIPER7 complex regulates CDC48 unfoldase levels and modulates immune output.
Head and neck dermatitis, a subtype of atopic dermatitis induced by Malassezia spp: Clinical aspects and treatment outcomes in adolescent and adult patients
Authors: Guglielmo Alba , Sechi Andrea , Patrizi Annalisa , Gurioli Carlotta , Neri Iria
Published: November 2020

Background and objectives

Head and neck dermatitis (HND) is a clinical variant of atopic dermatitis (AD), presenting in adolescence or adulthood and characterized by involvement of the head, neck, and superior part of the trunk. The role of Malassezia spp has been advocated in the pathogenesis of HND, and antifungal agents represent the treatment of choice.

Methods

A retrospective single‐center study was performed to define the clinical features and treatment response of HND among adolescent and adult patients.

Results

Thirty‐one patients were identified, 17 with "adolescent‐onset" and 14 with "adult‐onset" HND. Adolescent‐onset HND positively correlated with a past history of AD and presented with exclusive head and neck involvement (P < .05). Adult‐onset HND was associated with concomitant widespread atopic eczema, involving the flexural areas of the upper and lower limbs, trunk, nipples, or hands (P < .05). A positive response to itraconazole in combination with topical treatments was observed in both groups.

Conclusions

This study delineates two HND clinical phenotypes: adolescent vs adult onset. Different characteristics were observed in terms of relationship to AD and eczema localization. A history of AD in childhood and presentation with exclusive involvement of head and neck regions was observed predominantly in the adolescent‐onset form, while adult‐onset HND often occurred in association with diffuse dermatitis and a past history of AD was less frequent than in the adolescent group. The study is limited by the single‐center retrospective nature, which may lead to diagnostic and selection biases, and the small cohort of patients.
Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature, with a focus on relapsing cases
Authors: Afiouni Rym , Zeinaty Perla , Kechichian Elio , Zoghaib Samer , Matar Stephanie , Helou‐Mallat Josiane , Tomb Roland
Published: November 2020

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe cutaneous adverse drug reaction with systemic symptoms. This study aims to investigate clinical features, causative drugs, and available treatments for pediatric DRESS, particularly for relapsing cases.

Methods

A systematic search of the English and French literature on pediatric DRESS was conducted using the Medline, Embase, and Cochrane collaboration databases. Confirmed cases of pediatric DRESS fulfilling the RegiSCAR diagnostic criteria with a probable or a definite diagnosis were included.

Results

After full‐text article review, 144 articles were included, representing a total of 354 pediatric patients with a mean age of 8.8 years. The mean time from the drug intake until the onset of the first symptom was 18.9 days. Antiepileptic drugs were the main trigger, followed by anti‐infectious agents. Relapsing DRESS was reported in 17 children. In comparison to non‐relapsing cases, relapsing patients had more comorbidities. The initial clinical presentation was more commonly erythroderma. Facial edema, fever, and enlarged lymph nodes in more than two sites were more commonly found in relapsing cases. Systemic steroids were more frequently administered.

Conclusion

Pediatric DRESS is a potentially severe adverse drug reaction. Antiepileptic agents are the most common causative agents. Fever, facial edema, lymph node enlargement, and pharyngeal and visceral involvement predicted DRESS reactivation in children. Corticosteroids were the mainstay of treatment.
INSM1 immunostaining in solid papillary carcinoma of the breast
Authors: Kudo Noritaka , Takano Jun , Kudoh Shinji , Arima Nobuyuki , Ito Takaaki
Published: November 2020

Solid papillary carcinoma (SPC) is a histological subtype of breast carcinomas. At least 50% of SPC show neuroendocrine differentiation. Insulinoma‐associated protein 1 (INSM1) is a transcription factor now employed as a useful neuroendocrine marker. It is suppressed by the Notch signaling pathway in other neuroendocrine tumors. However, the usefulness of INSM1 as a neuroendocrine marker and the relationships between INSM1 and NOTCH receptors in SPC of the breast currently remain unclear. To clarify the usefulness of INSM1 as a neuroendocrine marker and the relationships between INSM1 and NOTCH receptors in SPC, we performed immunohistochemistry using 19 tissue specimens of SPC of the breast. We complementarily analyzed public RNA sequencing data on breast carcinomas. Immunohistochemical examinations revealed that the staining intensity of INSM1 was significantly higher in the neuroendocrine group than in the non‐neuroendocrine group. Positive correlations were observed between INSM1 and synaptophysin (SYP), or chromogranin‐A (CHGA). In all cases, NOTCH 2 and 3 were positive, while NOTCH 1 and 4 were negative. According to public RNA data analyses, there were positive correlations between INSM1 and SYP, or CHGA, and negative correlations between INSM1 and NOTCH1–3. INSM1 is useful as a diagnostic marker for SPC with neuroendocrine differentiation in the breast.