bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of and risk factors for sexual dysfunctions in adults with type 1 or type 2 diabetes: Results from Diabetes MILES ‐ Flanders
Authors: Van Cauwenberghe Jolijn , Enzlin Paul , Nefs Giesje , Ruige Johannes , Hendrieckx Christel , De Block Christophe , Pouwer Frans
Published: August 2021

Background and aims

The prevalence of sexual dysfunctions in people with diabetes is still debated and understudied in women. This study examines the prevalence of sexual dysfunction in men and women with type 1 or type 2 diabetes (T1D or T2D) and the associations with clinical and psychological variables.

Methods

Adults with diabetes (n = 756) completed an online survey including questions on sexual functioning (adapted Short Sexual Functional Scale), general emotional well‐being (WHO‐5), symptoms of anxiety (GAD‐7) and diabetes distress (PAID‐20).

Results

One third of participants reported a sexual dysfunction. Men reported erectile dysfunction (T1D: 20%; T2D: 33%), and orgasmic dysfunction (T1D: 22%; T2D: 27%). In men, sexual dysfunction was independently associated with, older age (OR = 1.05, p = 0.022), higher waist circumference (OR = 1.04; p < 0.001) and longer duration of diabetes (OR = 1.04; p = 0.007). More men with sexual dysfunction reported diabetes distress (20% vs. 12%, p = 0.026). Women reported decreased desire (T1D: 22%; T2D: 15%) and decreased arousal (T1D: 9%; T2D: 11%). More women with sexual dysfunction reported diabetes distress (36% vs. 21%, p = 0.003), impaired emotional well‐being (36% vs. 25%, p = 0.036) and anxiety symptoms (20% vs. 11%, p = 0.026).

Conclusion

Sexual dysfunctions are common in both men and women with diabetes. In men, sexual dysfunctions were associated with clinical factors. More women with sexual dysfunction reported low emotional well‐being and anxiety symptoms compared to women without sexual dysfunction. For both men and women, sexual dysfunctions were associated with diabetes distress.
Individual, healthcare professional and system‐level barriers and facilitators to initiation and adherence to injectable therapies for type 2 diabetes: A systematic review and meta‐ethnography
Authors: Byrne Jo , Willis Andrew , Dunkley Alison , Fitzpatrick Claire , Campbell Sandra , Sidhu Manbinder S. , Choudhary Pratik , Davies Melanie J. , Khunti Kamlesh
Published: August 2021

Aims

To review and synthesise the contemporary qualitative evidence, relating to the individual, healthcare professional and system‐level barriers and facilitators to injectable therapies in people with type 2 diabetes, and evaluate (using an intersectional approach to explore the diverse perspectives of different identities) whether views have changed with treatment and guideline advancements.

Methods

A meta‐ethnography approach used. Eight databases searched from the years 2006 (GLP‐1 analogues introduced) to February 2021. Study selection (using a pre‐defined inclusion criteria), quality appraisal and data extraction, conducted independently by two reviewers.

Results

Screened 7143 abstracts, assessed 93 full‐text papers for eligibility and included 42 studies—using data from 818 individuals with type 2 diabetes and 160 healthcare professionals. Studies covered a diverse range of views from healthcare professionals and individuals, including those relating to older adults and people from ethnic migrant backgrounds, and 10 studies rated moderate to strong research value. Key themes abstracted: barriers (physical/psychological/social) and facilitators (motivation/capability/opportunity).

Conclusions

The first synthesis of contemporary qualitative data to adopt an intersectionality approach and explore diverse views relating to barriers and facilitators that influence engagement with injectable treatments for type 2 diabetes. A model is presented to help patients, health practitioners and policy makers identify barriers and facilitators and understand the complex interplay of physical, psychological and social factors involved when prescribing injectable therapies. Despite advances in injectable treatments and guidelines, findings highlight the many barriers that still exist and show how strongly held culturally‐specific health beliefs of people from diverse socio‐economic and ethnic backgrounds can become substantial obstacles to treatment.
Transitioning tacrolimus to sirolimus in allogeneic hematopoietic cell transplantation
Authors: Arrabi Linda , Jan Anna , Hosing Chitra , Milton Denái R. , Yeh Jason
Published: August 2021

Objectives

Calcineurin inhibitor (CNI) use for acute graft‐versus‐host disease (aGVHD) prophylaxis in allogeneic hematopoietic cell transplantation (allo‐HCT) recipients has been associated with toxicities. Toxicities may be managed by converting CNI to sirolimus as often done in solid organ transplantation. This study aimed to characterize allo‐HCT patients who completely transitioned from tacrolimus to sirolimus and evaluate the incidence of aGVHD within 100 days post‐transition, overall survival (OS), and incidence of relapse.

Methods

Safety and efficacy data were collected at baseline and at day 30 and 90 post‐transition from tacrolimus to sirolimus and at one‐year post‐HCT.

Results

Most patients who transitioned had acute leukemia, received a matched unrelated donor allo‐HCT, and transitioned due to nephrotoxicity or neurotoxicity. The resolution rate was 83% and 48% in the nephrotoxicity group, 78% and 61% in the neurotoxicity group, 33% and 33% in the group that developed both nephrotoxicity and transplant‐associated thrombotic microangiopathy at 30 and 90 days of assessments, respectively. Patients who transitioned before day 55 post‐allo‐HCT were more likely to develop new or worsening aGVHD. The one‐year OS and relapse rates were 37% and 20%, respectively.

Conclusions

The conversion from tacrolimus to sirolimus demonstrates promising resolution of acute toxicities; however, overall mortality remains high.
Social sensitivity and the ethics of attention
Authors: Magrì Elisa
Published: August 2021

Social sensitivity is a crucial aspect of interpersonal relationships, as it is intrinsic to the understanding of other selves as subjects situated in a social world. In revitalizing such a concept in the philosophical literature, this article examines the relation between habit, attention, and critical self‐awareness that lies at the core of social sensitivity. On the one hand, I reconsider the so‐called “passivity” of habit and tackle the role of attention as the power of varying point of view. On the other hand, I contrast Husserl's view of attentiveness with Murdoch's account of loving attention, arguing that social sensitivity centers on a type of striving that is closer to Husserl's methodology than Murdoch's approach to moral perfectionism.
Baseline characteristics and effects of fingolimod on cognitive performance in patients with relapsing‐remitting multiple sclerosis
Authors: Langdon Dawn W. , Tomic Davorka , Penner Iris‐Katharina , Calabrese Pasquale , Cutter Gary , Häring Dieter A. , Dahlke Frank , Kappos Ludwig
Published: August 2021

Background and purpose

Studies reporting the baseline determinants of cognitive performance and treatment effect on cognition in patients with multiple sclerosis (MS) are limited. We investigated the baseline correlates of cognition and the long‐term treatment effects of fingolimod 0.5 mg once daily on cognitive processing speed and attention in patients with relapsing‐remitting MS.

Methods

This post hoc analysis pooled data from the phase 3 FREEDOMS and FREEDOMS II trials (N = 1556). We assessed the correlation between baseline patient demographic and disease characteristics and baseline 3‐second Paced Auditory Serial Addition Test (PASAT‐3) scores (Spearman's rank test) and the changes from baseline in PASAT‐3 (mixed model repeated measures model) in the fingolimod and placebo (up to 24 months) or placebo‐fingolimod switched (from Month 24 up to 120 months) groups. Additionally, the predictive value of PASAT‐3 score for future disease outcomes was assessed (Cox or logistic regression models).

Results

Among the variables assessed, lower PASAT‐3 score at baseline correlated with higher disease burden (total brain volume, T2 lesion volume, and Expanded Disability Status Scale score), longer disease duration and older age (p < 0.0001 for all). Fingolimod significantly improved PASAT‐3 scores from baseline versus placebo at 6 (1.3; p = 0.0007), 12 (1.1; p = 0.0044) and 24 months (1.1; p = 0.0028), with a sustained effect (overall treatment effect p = 0.0012) up to 120 months. Improvements were seen regardless of baseline cognitive status (PASAT quartile). Baseline PASAT‐3 score was predictive of both clinical and magnetic resonance imaging measures of disease activity at Month 24 (p < 0.001 for all).

Conclusion

Early fingolimod treatment may offer long‐term cognitive benefit in patients with relapsing‐remitting MS.
Using remote seminars to teach animal behavior
Authors: Hayes Loren D. , Aviles Leticia , Fernandez‐Duque Eduardo , Huck Maren , Lacey Eileen A. , Maldonado‐Chaparro Adriana , Matchinske Miles , Pillay Neville , Solomon Nancy G. , Schradin Carsten
Published: August 2021

In response to the COVID‐19 crisis, numerous academic conferences and seminars were moved online. Some remote (online) seminars have the aim to be maintained permanently after the pandemic, offering weekly opportunities for scientists, postdocs, and students to learn about research and to improve global networking. Remote seminars are a good option to promote inclusion and diversity, allowing students worldwide to participate and to interact with researchers from a broad cultural and ethnic background. Capitalizing on our experience with the ongoing International Remote Seminar on Frontiers in Social Evolution (FINE), we propose four teaching tools that can be integrated into undergraduate and graduate courses and that can be adapted for use with most remote seminar series. We make recommendations for the use of: (i) Certified remote seminar attendance. (ii) Relevant articles from the primary literature. (iii) Teaching slides, and (iv) Recorded seminars. Our aims are to promote and facilitate the use of the proposed teaching tools in Animal Behavior and related courses, and to encourage other remote seminar organizers to make teaching tools available.
Role of antimicrobial peptides in atopic dermatitis
Authors: Suwanchote Supaporn , Waitayangkoon Palapun , Chancheewa Bussabong , Inthanachai Thananya , Niwetbowornchai Nattarika , Edwards Steven W. , Virakul Sita , Thammahong Arsa , Kiatsurayanon Chanisa , Rerknimitr Pawinee , Chiewchengchol Direkrit
Published: August 2021

Host defense peptides (HDPs) or antimicrobial peptides (AMPs) are short cationic amphipathic peptides of divergent sequences, which are part of the innate immune system and produced by various types of cells and tissues. The predominant role of HDPs is to respond to and protect humans against infection and inflammation. Common human HDPs include defensins, cathelicidin, psoriasin, dermcidin, and ribonucleases, but these peptides may be dysregulated in the skin of patients with atopic dermatitis (AD). Current evidence suggests that the antimicrobial properties and immunomodulatory effects of HDPs are involved in AD pathogenesis, making HDPs research a promising area for predicting disease severity and developing novel treatments for AD. In this review, we describe a potential role for human HDPs in the development, exacerbation, and progression of AD and propose their potential therapeutic benefits.
Transcriptomic landscape of skin lesions in cutaneous leishmaniasis reveals a strong CD8+ T cell immunosenescence signature linked to immunopathology
Authors: Fantecelle Carlos Henrique , Covre Luciana Polaco , Garcia de Moura Renan , Guedes Herbert Leonel de Matos , Amorim Camila Farias , Scott Phillip , Mosser David , Falqueto Aloisio , Akbar Arne N. , Gomes Daniel Claudio Oliveira
Published: August 2021

The severity of lesions that develop in patients infected by Leishmania braziliensis is mainly associated with a highly cytotoxic and inflammatory cutaneous environment. Recently, we demonstrated that senescent T and NK cells play a role in the establishment and maintenance of this tissue inflammation. Here, we extended those findings using transcriptomic analyses that demonstrate a strong co‐induction of senescence and pro‐inflammatory gene signatures in cutaneous leishmaniasis (CL) lesions. The senescence‐associated signature was characterized by marked expression of key genes such as ATM, Sestrin 2, p16, p21 and p38. The cell type identification from deconvolution of bulk sequencing data showed that the senescence signature was linked with CD8+ effector memory and TEMRA subsets and also senescent NK cells. A key observation was that the senescence markers in the skin lesions are age‐independent of patients and were correlated with lesion size. Moreover, a striking expression of the senescence‐associated secretory phenotype (SASP), pro‐inflammatory cytokine and chemokines genes was found within lesions that were most strongly associated with the senescent CD8 TEMRA subset. Collectively, our results confirm that there is a senescence transcriptomic signature in CL lesions and supports the hypothesis that lesional senescent cells have a major role in mediating immunopathology of the disease.
Manifesting hope in despair: Exploring prosocial behavioural outcomes of COVID‐19
Authors: Singla Himanshu , Mehta Minakshi Duggal , Mehta Pooja
Published: August 2021

The novel coronavirus (COVID‐19) outbreak has resulted into global devastation. This study attempts to explore the positive phenomenal impact of perceived pandemic anxiety resulting in prosocial behaviour (PB) through the mechanisms of self‐awareness and spiritual transformation using terror management theory (TMT). The study also examines the moderating impact of conscious state expansion (CSE) on the self‐awareness and spiritual transformation relationship, and the impact of this moderation effect is further tested separately on two gender groups. The data (N = 573) for the study were collected from the Punjab state of India during the ascending phase of outbreak. The results of PLS‐SEM analysis reveal the significant influence of variables under study on prosocial behavioural outcomes. Taking insights from the findings of the study it becomes clear that during dreadful situations, when people experience the possibility of loss of life, their self‐awareness level increases, which in turn results in their spiritual transformation. Such mechanism is observed more in the people possessing higher spiritual consciousness. The study concludes by recognising the positive role played by spiritual transformation (ST) in the evolution of the attributes of care and compassion for others, resulting in positive social consequences. The discussion, implications, limitations, and future directions are presented and discussed.
Investigating the redundancy principle in immersive virtual reality environments: An eye‐tracking and EEG study
Authors: Baceviciute Sarune , Lucas Gordon , Terkildsen Thomas , Makransky Guido
Published: August 2021

Background

The increased availability of immersive virtual reality (IVR) has led to a surge of immersive technology applications in education. Nevertheless, very little is known about how to effectively design instruction for this new media, so that it would benefit learning and associated cognitive processing.

Objectives

This experiment explores if and how traditional instructional design principles from 2D media translate to IVR. Specifically, it focuses on studying the underlying mechanisms of the redundancy‐principle, which states that presenting the same information concurrently in two different sensory channels can cause cognitive overload and might impede learning.

Methods

A total of 73 participants learned through a specifically‐designed educational IVR application in three versions: (1) auditory representation format, (2) written representation format, and (3) a redundancy format (i.e. both written and auditory formats). The study utilized advanced psychophysiological methods of Electroencephalography (EEG) and eye‐tracking (ET), learning measures and self‐report scales.

Results and Conclusions

Results show that participants in the redundancy condition performed equally well on retention and transfer post‐tests. Similarly, results from the subjective measures, EEG and ET suggest that redundant content was not found to be more cognitively demanding than written content alone.

Implications

Findings suggest that the redundancy effect might not generalize to VR as originally anticipated in 2D media research, providing direct implications to the design of IVR tools for education.
Differential effects of eplerenone versus amlodipine on muscle metaboreflex function in hypertensive humans
Authors: Peri‐Okonny Poghni A. , Velasco Alejandro , Lodhi Hamza , Wang Zhongyun , Arbique Debbie , Adams‐Huet Beverley , Iwamoto Gary , Mitchell Jere H. , Mizuno Masaki , Smith Scott , Vongpatanasin Wanpen
Published: August 2021

Numerous studies have demonstrated that sympathetic nervous system overactivation during exercise in hypertensive rodents and humans is due, in part, to an exaggerated reflex response known as the exercise pressor reflex. Our prior studies have implicated a key role of mineralocorticoid receptor activation in mediating an augmented exercise pressor reflex in spontaneously hypertensive rats, which is mitigated by blockade with eplerenone. However, the effect of eplerenone on exercise pressor reflex has not been assessed in human hypertension. Accordingly, the authors performed a randomized crossover study to compare the effects of eplerenone to another antihypertensive drug from a different class amlodipine on sympathetic nerve activity (SNA) in 14 patients with uncomplicated hypertension. The authors found that amlodipine unexpectedly augmented the increase in SNA during the second minute of isometric handgrip, which persisted into the post‐exercise circulatory arrest period (∆ SNA, from rest of 15 ± 2 vs. 9 ± 2 vs. 10 ± 2 bursts/min, amlodipine vs. baseline vs. eplerenone, respectively, p < .01), suggesting an exaggerated muscle metaboreflex function. Eplerenone did not alter sympathetic responses to exercise or post‐exercise circulatory arrest in the same hypertensive individuals. In conclusions, our studies provide the first direct evidence for a potentially unfavorable potentiation of muscle metaboreflex by amlodipine during isometric handgrip exercise in hypertensive patients whereas eplerenone has no significant effect. Our study may have clinical implications in terms of selection of antihypertensive agents that have the least detrimental effects on sympathetic neural responses to isometric exercise.
Behavioural responses of fathead minnows to carbohydrates found in aquatic environments
Authors: Fischer Abraham J. , Dew William A.
Published: August 2021

Carbohydrates make up a significant portion of dissolved organic carbon in waterways. Apart from studies demonstrating that chondroitin causes avoidance behaviours in some fish species, no work has been done to determine how fish respond to carbohydrates commonly found in their environment. In this study fathead minnows (Pimephales promelas) were attracted to N‐acetyl‐d‐glucosamine, avoided d‐arabinose and had no response to either d‐xylose or d‐glucose using a behavioural assay. This study provides further evidence that carbohydrates may be important chemosensory cues for fish.
Preliminary studies on the different roles of T6SSs in pathogenicity of Pseudomonas plecoglossicida NB2011
Authors: Jin Jiamin , Li Yiying , Huang Mengxia , Li Shanshan , Mao Zhijuan
Published: August 2021

Pseudomonas plecoglossicida, the causative agent of visceral granulomas in the large yellow croaker (Larimichthys crocea) in China, encodes three sets of type Ⅵ secretion systems (T6SS1‐3). The purpose of this study was to characterize the different roles of T6SSs involved in infection. In‐frame deletion of T6SSs was constructed, which resulted in 8 mutants. Competition against E. coli DH5α, virulence against the croaker and in vivo survival ability of the mutants were tested. The expression and secretion of Hcp by P. plecoglossicida NB2011 were investigated. The results showed T6SS2 mutant failed to inhibit the growth of E. coli, which is an indication of T6SS2 acting against environmental bacteria. The LD50 value of T6SS1 mutant strongly increased; T6SS2 and T6SS3 mutants were similar to that of the wild type; and the virulence of double deletion or triple deletion mutant was drastically alleviated, indicating that T6SS1 being one of the major virulence factors, and T6SS2 and T6SS3 directly or indirectly being involved in the pathogenicity. T6SS1 mutant disappeared in the fish spleen in 3 days, while other strains kept increasing, indicating the T6SS1 stimulation bacteria replication in vivo. Hcp1 secreted at 12–28°C and Hcp2 secreted at 12–35°C, while Hcp3 secretion not detected in vitro. This study has thrown some insights on the understanding of pathogenicity mechanisms of this pathogen.
People, not just places: Expanding physical and social vulnerability indices by psychological indicators
Authors: Babcicky Philipp , Seebauer Sebastian
Published: August 2021

Damage and disruption caused by floods do not just arise from the characteristics of physical structures, but also from the characteristics of residents inhabiting these structures. Social vulnerability analyses typically employ socio‐demographic proxy indicators that do not address the risk attitudes, beliefs and agency of those living in areas at risk. To close this gap, this article introduces a range of indicators from psychological risk research. Physical, social and psychological indicators are compared for their influence on vulnerability outcomes such as building damage or emotional distress. Based on survey data of 456 Austrian at‐risk households, hierarchical regression models confirm the added value of psychological indicators for measuring vulnerability above and beyond traditional physical and social indicators. Our findings show that psychological indicators are particularly important for explaining health impacts and distress. General intentions for flood preparedness, fear of flooding and self‐efficacy are most relevant. For a more holistic view of vulnerability, measurement instruments should incorporate psychological indicators. Disaggregated household‐level data is necessary to fully capture the variability between households living in the same flood‐prone area. Indicators perform differently depending on the other indicators included, and the considered outcome; therefore, we caution against pooling indicators to composite indices of overall vulnerability.
Metformin suppresses interleukin‐22 induced hepatocellular carcinoma by upregulating Hippo signaling pathway
Authors: Zhao Dong , Xia Lei , Geng Wei , Xu Dongwei , Zhong Chengpeng , Zhang Jianjun , Xia Qiang
Published: August 2021

Background and Aims

Epidemiological studies have shown direct associations between type 2 diabetes and the risk of cancers. Accumulating evidence indicates that metformin is profoundly implicated in preventing tumor development. However, the exact mechanism underlying the antitumor effects of metformin in hepatocellular carcinoma (HCC) is still not clear.

Methods

In this study, we investigated the effects of metformin on a mouse HCC model and interleukin‐22 (IL‐22)‐associated carcinogenesis in vitro.

Results

We found that metformin significantly suppressed the incidence and tumor burden of HCC in the diethyl‐nitrosamine‐induced HCC mouse model. As expected, the expression of IL‐22, an important factor involved in HCC progression, was markedly reduced by metformin. Treatment of HCC cells with metformin inhibited IL‐22 induced cell proliferation, migration, and invasion, and promoted cell apoptosis. Furthermore, ectopic expression of IL‐22 makes HCC more aggressive, whereas metformin largely compromised it in vitro and in vivo. Mechanistically, the whole transcriptome analysis and functional analysis revealed that Hippo signaling pathway was involved in the antitumor ability of metformin. Consistent with this, metformin directly inhibited LATS1/2 and activated Mst1/2, phosphorylated YAP1 in vitro. After blocking the Hippo pathway by XMU‐MP‐1, the inhibitor of MST1/2, the inhibitory effects by metformin were dramatically attenuated as shown by in vitro study.

Conclusions

Collectively, our findings illuminate a new regulatory mechanism, metformin activates Hippo signaling pathway to regulate IL‐22 mediated HCC progression and provide new insights into its tumor‐suppressive roles.
Exploring machine learning techniques to predict deforestation to enhance the decision‐making of road construction projects
Authors: Larrea‐Gallegos Gustavo , Vázquez‐Rowe Ian
Published: August 2021

Land use changes (LUCs), which are defined as the modification in the use of land due to anthropogenic activities, are important sources of GHG emissions. In this context, understanding future trends of LUCs, such as deforestation, in a spatial manner is relevant. The main objective of this study is to generate a deforestation prediction model for a given period of time (i.e., 2002–2017 and 2010–2017) to estimate the potential carbon emissions associated with different anthropogenic variables in the Peruvian Amazon using machine learning (ML) algorithms. This study was motivated in the analysis of a road project previously studied using life cycle assessment (LCA). Models using neural networks and random forest algorithms were trained and evaluated in a fully cloud‐based environment using Google Earth Engine. ML‐related results demonstrated that random forest is a quicker and straightforward response to model the system under study, especially considering that data do not require additional processing during the modeling and prediction stages. Predicted results suggest that expected road expansion may be related to considerable carbon emissions in the future. Calculated values are relevant especially if the mitigation efforts that Peru has complied with in the Paris Agreement are considered. The increased complexity of the framework is justified since it allows identifying the location of hotspots and may potentially complement the utility of LCA in policy support in the areas of territorial planning and tropical road expansion.
Opportunities and limitations for the introduction of circular economy principles in EU aquaculture based on the regulatory framework
Authors: Regueiro Leticia , Newton Richard , Soula Mohamed , Méndez Diego , Kok Björn , Little David C. , Pastres Roberto , Johansen Johan , Ferreira Martiña
Published: August 2021

EU aquaculture produces only a small fraction of the internal demand of aquatic foods, but boosting this activity must be done in compliance with high standards of environmental protection and social benefits, as fostered by the policies on circular economy recently launched by the EU. Nevertheless, the assessment of the environmental sustainability of aquaculture and other food production systems is complex, due to the different tools and approaches available. Moreover, the current EU regulatory framework may be restricting the options to implement some circular solutions. This paper examines the controversies related to the assessment of environmental impacts of aquaculture processes and the different available circular solutions, with a focus on the best options to valorize aquaculture side streams and how current regulatory burdens and gaps should be solved.
Health History Skills for Interprofessional Learners in Transgender and Nonbinary Populations
Authors: Ruud Maria N. , Demma Jennifer M. , Woll Anne , Miller Joseph M. , Hoffman Samantha , Avery Melissa D.
Published: August 2021

Introduction

Transgender and nonbinary peoplehave been identified as vulnerable and clinically underserved and experience health disparities. Lack of health care provider knowledge about transgender and gender diverse populations is a barrier to care, impacting health outcomes. The aim of this project was to develop, implement, and evaluate a simulation learning activity for midwifery and women's health nurse practitioner students and obstetrics and gynecology residents to interact with transgender and nonbinary individuals, with the goal of enhancing health history taking comfort and skills.

Methods

A partnership was formed among University faculty and simulation educators, a community clinic providing gender‐affirming care, and members of transgender and gender diverse populations who served as patient‐teachers. Two cases frequently encountered in clinics providing care to transgender individuals were developed for the simulation. Learners were divided into interprofessional groups of 3 and completed one of 2 case scenarios with a patient‐teacher. Learners and patient‐teachers debriefed after the simulation to discuss and reflect on the experience.

Results

Thirty‐three learners participated in the simulation, 12 midwifery students, 16 women's health nurse practitioner students and 5 obstetrics and gynecology residents. Significant differences were observed for all comfort and skills questions, showing increased perceived comfort and skills from pre‐ to postsimulation. There were no significant differences in attitude responses.

Discussion

We successfully created and implemented a new sexual and reproductive history taking skills simulation in partnership with community clinic staff and transgender and nonbinary persons. The session was well received by learners and patient‐teachers. Learners demonstrated significant improvements in comfort and skills in history taking in this setting and provided favorable feedback about the experience. This simulation can serve as a guide to others providing education to future midwives, women's health nurse practitioners, and obstetrician‐gynecologists.
Gall bladder ejection fractions in dogs investigated for chronic altered appetite: 14 cases (2015–2017)
Authors: Viljoen A. D. , Tamborini A. , Bexfield N. H.
Published: August 2021

Objectives

To determine if gall bladder dysmotility occurs in dogs investigated for chronic altered appetite and to determine if gall bladder dysmotility warrants further investigation as a contributing factor to altered appetite.

Materials and Methods

Case series of dogs investigated for chronic gastrointestinal disease. Gastrointestinal clinical signs were assessed before and after a 6‐week hydrolysed protein diet. Gall bladder ejection fractions were determined at the end of the 6‐week hydrolysed protein diet as part of an investigation that included a full blood cell count, biochemistry, abdominal X‐rays and ultrasound. The gall bladder ejections fraction results of dogs with normal appetite were compared to dogs with general inappetence and dogs with diurnal inappetence in the morning.

Results

In this retrospective case series of 14 dogs, altered appetite was the most frequent and persistent clinical sign associated with chronic gastrointestinal disease. Nine dogs had suboptimal gall bladder function and this occurred in dogs with, and without, gravity‐dependent biliary sludge. Gall bladder function and volumes of dogs in this study were comparable to those of dogs with nongravity‐dependent gall bladder sludge or gall bladder mucoceles in other studies. There was an observable difference in gall bladder ejection fractions between groups defined by appetite but no statistically significant difference was present. Small sample sizes meant the effect size was large.

Clinical Significance

Gall bladder dysmotility and distension can occur in the absence of gall bladder sludge and mucocoeles in younger dogs. Gall bladder dysmotility requires further investigation as a potential contributing factor to altered appetite in dogs.
Pharmacokinetic Profiles of Metamizole Metabolites after Intramuscular and Intravenous Administration in Healthy Arabian Horses
Authors: Yılmaz İsmet , Maraş Zeynep , Uğur Yılmaz , Erkan Özgür Mustafa , Durmaz Murat , İbrahim Ulusoy Halil , Erdoğan Selim
Published: August 2021

Metamizole sodium (MT) is an analgesic and antipyretic drug molecule used in humans, horses, cattle, swine, and dogs. Metamizole rapidly hydrolyzes and turns into methylamino antipyrine (MAA), an active primary metabolite of MT. The present study aims to determine the pharmacokinetic (PK) profiles of MT metabolites after intravenous (IV) and intramuscular (IM) administration into sex of Arabian horses (Equus ferus caballus) using a cross‐over study design. The plasma samples were extracted by solid‐phase extraction (SPE) method, and plasma concentrations of MT metabolites were analyzed by high‐performance liquid chromatography (HPLC). After administrations of MT, plasma concentrations of methylamino antipyrine (MAA), amino antipyrone (AA), and acetylamino antipyrone (AAA) were determined within range of 15 min‐12 h. Plasma concentrations of AA and AAA were lower than the plasma concentrations of major metabolite MAA at each sampling point. The PK parameters were statistically evaluated for MT’s metabolites between male and female horses and also between IM and IV administrations of PK parameters such as Cmax, tmax, t1/2λz, AUC0‐t, AUC0‐∞, λz, Cl and Vss (p < .05). The AUCIM/AUCIV ratio in female and male horses for MAA was 1.19 and 1.13, respectively. The AUCIM/AUCIV ratio for AA was lower than those found for MAA. AUCIM/AUCIV ratio was statistically significantly different between male and female horses for AA (p < .05). According to these results, some PK parameters such as Cmax, AUC, and MRT, MAA and AA concentrations have shown statistically significant differences by MT administrations.
A case of pubic osteomyelitis after implantation of an artificial urinary sphincter: A case report
Authors: Kusakabe Naohisa , Kitta Takeya , Chiba Hiroki , Higuchi Madoka , Shinohara Nobuo
Published: August 2021

Case

We describe a rare case of pubic osteomyelitis secondary to implantation of an artificial urinary sphincter (AUS). A 49‐year‐old man developed total urinary incontinence due to spinal cord injury 23 years earlier. After AUS implantation, he became continent. Fourteen years later, incontinence suddenly recurred.

Outcome

We planned to replace the dysfunctional AUS with a new one. We removed only the implanted control pump, leaving the urethral cuff at the bladder neck and pressure‐regulating balloon to reduce surgical invasiveness, and performed AUS reimplantation. A new urethral cuff was placed around the bulbar urethra. Postoperatively, antibiotics, placement of a drainage catheter, and removal of the new AUS were required due to device infection. However, the infection persisted and magnetic resonance imaging showed inflammatory changes at the symphysis pubis, so osteotomy was performed to control infection. One year postoperatively, no gait disturbance or recurrence of pubic osteomyelitis was identified. AUS reimplantation was again performed and the patient is now socially continent.

Conclusions

We have reported a rare case of pubic osteomyelitis secondary to AUS implantation. Clinicians should suspect pubic osteomyelitis if infection persists.
The autophagy‐enhancing drug carbamazepine improves neuropathology and motor impairment in mouse models of Machado–Joseph disease
Authors: Vasconcelos‐Ferreira Ana , Carmo‐Silva Sara , Codêsso José Miguel , Silva Patrick , Martinez Alberto Rolim Muro , França Jr Marcondes Cavalcante , Nóbrega Clévio , Pereira de Almeida Luís
Published: August 2021

Aims

Machado–Joseph disease (MJD), or spinocerebellar ataxia type 3 (SCA3), is the most common autosomal dominantly‐inherited ataxia worldwide and is characterised by the accumulation of mutant ataxin‐3 (mutATXN3) in different brain regions, leading to neurodegeneration. Currently, there are no available treatments able to block disease progression. In this study, we investigated whether carbamazepine (CBZ) would activate autophagy and mitigate MJD pathology.

Methods

The autophagy‐enhancing activity of CBZ and its effects on clearance of mutATXN3 were evaluated using in vitro and in vivo models of MJD. To investigate the optimal treatment regimen, a daily or intermittent CBZ administration was applied to MJD transgenic mice expressing a truncated human ATXN3 with 69 glutamine repeats. Motor behaviour tests and immunohistology was performed to access the alleviation of MJD‐associated motor deficits and neuropathology. A retrospective study was conducted to evaluate the CBZ effect in MJD patients.

Results

We found that CBZ promoted the activation of autophagy and the degradation of mutATXN3 in MJD models upon short or intermittent, but not daily prolonged, treatment regimens. CBZ up‐regulated autophagy through activation of AMPK, which was dependent on the myo‐inositol levels. In addition, intermittent CBZ treatment improved motor performance, as well as prevented neuropathology in MJD transgenic mice. However, in patients, no evident differences in SARA scale were found, which was not unexpected given the small number of patients included in the study.

Conclusions

Our data support the autophagy‐enhancing activity of CBZ in the brain and suggest this pharmacological approach as a promising therapy for MJD and other polyglutamine disorders.
Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease
Authors: Cai Ruyi , Shao Lina , Zhu Yifan , Liu Yueming , Zhang Jinshi , He Qiang
Published: August 2021

Aims

In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy (LVH) than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease (CKD).

Methods

In this retrospective study, we reviewed the medical records of 289 adult patients with CKD from the Zhejiang Provincial People's Hospital in Zhejiang, China. Demographic, echocardiographic and brachial and central blood pressure parameters were retrieved from medical records. Central blood pressure was measured using the SphygmoCor® CvMS (AtCor, Australia) device and its corresponding software. Multivariate logistic regression analyses were performed to identify independent predictors of LVH. Receiver operating characteristic curves were used to determine the ability of central and brachial blood pressure to predict LVH.

Results

The left ventricular mass index was positively associated with both central and brachial blood pressures. However, multiple logistic regression analysis demonstrated that a central pulse pressure (CPP) ≥ 58 mm Hg was an independent risk factor for LVH (OR = 5.597, 95%CI 2.363–13.259, p < .001). Brachial pulse pressure is not superior to CPP in predicting LVH (area under the curve [AUC] = 0.695, 95%CI 0.634–0.756, p < .001 vs. AUC = 0.687, 95%CI: 0.626–0.748, p < .001, respectively; p = .4824).

Conclusion

Our results suggested that, similarly to the general population, CPP is a better parameter for predicting the occurrence of LVH in patients with CKD.
Teacher‐as‐actor: Investigating the barriers and facilitators of patient education among hospitalized patients in a cardiology clinical unit
Authors: Boyde Mary , Tuckett Anthony , Ty Jerry
Published: August 2021

Patient education enables people with cardiovascular disease to develop self‐management behaviors. This study aimed to explore facilitators and barriers to teaching patients in a clinical cardiology unit with a single site qualitative investigation involving 21 registered nurses attending four focus groups. This study identified barriers related to patient factors including individual characteristics and responses to education, comorbidities, acuity, and evolving diagnosis, while for nurses the barriers were lack of knowledge and expertise. Barriers associated with the physical environment included nursing workload issues and lack of resources. Facilitators included patients being engaged in the process of education, prepared, and ready to be educated, while a conducive physical environment was also seen as a facilitator. This study exposed inhibiting and enabling variables associated with the exchange between patients and nurses by viewing the nurse and the patient as actors and audience in a theatrical model where communicating to teach patients is seen as a collaborative art. The nurse who understands the barriers and facilitators to teaching will more likely engage the patient in successful learning and development of self‐care behaviors.
Development of the Clinical Interpersonal Reactivity Index to evaluate nurses’ empathy
Authors: Aoki Yoshimi , Katayama Harumi
Published: August 2021

We determined the validity and reliability of the Clinical Interpersonal Reactivity Index in a sample of Japanese nurses. Participants were registered nurses at national university hospitals and nursing researchers in Japan. A postal questionnaire was conducted. Construct validity was analyzed by exploratory and confirmatory factor analysis, and convergent validity demonstrated using the Interpersonal Reactivity Index. The Clinical Interpersonal Reactivity Index has an 18‐item, two‐factor structure with Cronbach's alpha values of 0.87 and 0.73. Confirmatory factor analysis showed a goodness‐of‐fit index of 0.917, an adjusted goodness‐of‐fit of 0.894, a root mean square error of approximation of 0.60, and a comparative fit index of 0.911. Correlation analysis between the Clinical Interpersonal Reactivity Index and Interpersonal Reactivity Index indicated the factors were significantly correlated for empathic concern and perspective taking (r = 0.439–0.401). Test–retest assessment showed reliability coefficients for the first factor as r = 0.859 and the second factor as r = 0.709. The Clinical Interpersonal Reactivity Index demonstrated validity and reliability for Japanese nurses. The two factors evaluated perspective taking and unconditional positive regard.
Transfer of Torenia gracilis Benth. to Bonnaya as Bonnaya gracilis sp. nov. (Linderniaceae)
Authors: Pal Aaratrik , Sardesai Milind M. , Chowdhury Monoranjan
Published: August 2021

Torenia gracilis, a species closely similar to Bonnaya antipoda, was published by Bentham in Wallich's Numerical List without description and was later synonymised under B. verbenifolia, now a synonym of B. antipoda. In this paper, the nomenclature of T. gracilis Benth. (nom. inval.) is discussed and this taxon is treated within Bonnaya as B. gracilis sp. nov. with a detailed description and comments on its taxonomic identity.
Clinical features and long‐term outcomes in pediatric cyclic vomiting syndrome: A 9‐year experience at three tertiary academic centers
Authors: Dipasquale Valeria , Falsaperla Raffaele , Bongiovanni Annarita , Ruggieri Martino , Romano Claudio
Published: August 2021

Background

Pediatric cyclic vomiting syndrome (CVS) is a little‐known clinical condition, frequently diagnosed with delay. This study aims to describe the clinical presentation and management and to define possible predictive factors of the disease outcome.

Methods

In this retrospective study, all children who were diagnosed with CVS during the period 2010–2019 in three tertiary academic centers were included. The association between clinical variables and outcomes was investigated.

Key Results

Fifty‐seven children were included (male/female ratio 1.3:1; mean age at diagnosis 8.2 years). At the time of diagnosis, 63% of children had at least one episode every month. One or more prodromes were reported by 75% of patients. Family history of migraine was reported for 47% of children. Nearly, all of the children were started on prophylactic treatment. The median follow‐up period was 29 months ± 15. Overall, 56% of children had resolution of vomiting. Twenty‐six percent of children developed migraine. There were no differences in gender, age at onset, duration of follow‐up, severity, medication, family history, or trigger factors between children who underwent resolution of vomiting and those who did not, or between children who suffered from migraine or not at follow‐up. Four types of disease outcome were recognized, that is, resolution of vomiting with or without associated symptoms; persistence of vomiting with or without associated symptoms.

Conclusions and Inferences

Cyclic vomiting syndrome clinical presentation has inter‐individual variability. Most children recover at follow‐up, but often develop further somatic symptoms. In this study, no clinical variable clearly predicted the evolution of the syndrome toward one or the other outcome.
Symptom severity and clinical characteristics of patients with bloating
Authors: Gardiner Catherine P. , Singh Prashant , Ballou Sarah , Hassan Rifu , Yu Vanessa , Lembo Anthony , Nee Judy , Iturrino Johanna
Published: August 2021

Background

Abdominal bloating is common in functional gastrointestinal disorders (FGID). To better characterize this patient population, we evaluated clinical and psychological characteristics of bloating and analyzed their differences by bloating severity.

Methods

Patients with FGIDs evaluated at a single academic outpatient referral gastroenterology clinic were surveyed. Bloating severity was classified as minimal, moderate or severe. Symptom‐specific questionnaires were used to evaluate bowel habits, abdominal bloating, depression, anxiety, somatization and sleep disturbance. Associations between bloating severity, clinical characteristics and FGID subtypes were analyzed in univariate and multivariate modeling.

Key Results

Of 612 FGID patients included (78% female, mean age of 44 ± 16.5 years), bloating was reported as minimal in 231(37.8%), moderate in 217(35.4%), or severe in 164(26.8%). Patients with severe bloating were more likely to be female, younger, and have co‐existing functional dyspepsia than those with minimal bloating (p < 0.05). Bloating severity and severity of abdominal distension were significantly correlated (p < 0.05). On multivariable regression, patients who met criteria for functional constipation and functional dyspepsia had 80% and 125% higher odds, respectively, of severe bloating compared to minimal to moderate bloating. Younger age, abdominal pain and constipation severity, and somatization scores were also independently associated with severity of bloating.

Conclusions & Inferences

Severe bloating is associated with younger age, and with more severe abdominal pain, constipation, and somatization. Patients who met criteria for functional constipation and functional dyspepsia are more likely to experience severe bloating.
Microbiome‐mediated response to pulse fire disturbance outweighs the effects of fire legacy on plant performance
Authors: Revillini Daniel , David Aaron S. , Menges Eric S. , Main Kevin N. , Afkhami Michelle E. , Searcy Christopher A.
Published: August 2021

Fire plays a major role in structuring plant communities across the globe. Interactions with soil microbes impact plant fitness, scaling up to influence plant populations and distributions. Here we present the first factorial manipulation of both fire and soil microbiome presence to investigate their interactive effects on plant performance across a suite of plant species with varying life history traits.

We conducted fully factorial experiments on 11 species from the Florida scrub ecosystem to test plant performance responses to soils with varying fire histories (36 soil sources), the presence/absence of a microbiome, and exposure to an experimental burn.

Results revealed interactive ‘pulse’ effects between fire and the soil microbiome on plant performance. On average, post‐fire soil microbiomes strongly reduced plant productivity compared to unburned or sterilized soils. Interestingly, longer‐term fire ‘legacy’ effects had minor impacts on plant performance and were unrelated to soil microbiomes.

While pulse fire effects on plant–microbiome interactions are short‐term, they could have long‐term consequences for plant communities by establishing differential microbiome‐mediated priority effects during post‐disturbance succession. The prominence of pulse fire effects on plant–microbe interactions has even greater import due to expected increases in fire disturbances resulting from anthropogenic climate change.