bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex- and Developmental Stage–Related Differences in the Hepatic Transcriptome of Japanese Quail (Coturnix japonica) Exposed to 17β-Trenbolone
Authors: Mittal Krittika , Henry Paula F.P. , Cornman Robert S. , Maddox Catherine , Basu Niladri , Karouna-Renier Natalie K.
Published: June 2021

Endocrine-disrupting chemicals can cause transcriptomic changes that may disrupt biological processes associated with reproductive function including metabolism, transport, and cell growth. We investigated effects from in ovo and dietary exposure to 17β-trenbolone (at 0, 1, and 10 ppm) on the Japanese quail (Coturnix japonica) hepatic transcriptome. Our objectives were to identify differentially expressed hepatic genes, assess perturbations of biological pathways, and examine sex- and developmental stage–related differences. The number of significantly differentially expressed genes was higher in embryos than in adults. Male embryos exhibited greater differential gene expression than female embryos, whereas in adults, males and females exhibited similar numbers of differentially expressed genes (>2-fold). Vitellogenin and apovitellenin-1 were up-regulated in male adults exposed to 10 ppm 17β-trenbolone, and these birds also exhibited indications of immunomodulation. Functional grouping of differentially expressed genes identified processes including metabolism and transport of biomolecules, enzyme activity, and extracellular matrix interactions. Pathway enrichment analyses identified as perturbed peroxisome proliferator–activated receptor pathway, cardiac muscle contraction, gluconeogenesis, growth factor signaling, focal adhesion, and bile acid biosynthesis. One of the primary uses of 17β-trenbolone is that of a growth promoter, and these results identify effects on mechanistic pathways related to steroidogenesis, cell proliferation, differentiation, growth, and metabolism of lipids and proteins. Environ Toxicol Chem 2021;40:2559–2570. © 2021 SETAC. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Abstract

Investigations of toxicity from endocrine-disruptive chemicals must consider variations in responses between developmental stages and sexes. Stark differences were observed in the numbers of significantly differentially expressed genes (red dots) between Japanese quail (Coturnix japonica) males and females and adults and embryos exposed to 17β-trenbolone.
Dietary association of iron deficiency anemia and related pregnancy outcomes
Authors: Zulfiqar Hina , Shah Imran Ullah , Sheas Muhammad Naveed , Ahmed Zahoor , Ejaz Umaira , Ullah Irfan , Saleem Saad , Imran Muhammad , Hameed Muhammad , Akbar Banaras
Published: June 2021

Iron deficiency anemia (IDA) is a common public health occurrence of pregnancy which is particularly prevalent in developing countries like Pakistan. During this critical period, the deficiency of iron is very common as the iron requirements are greatly enhanced. IDA during pregnancy is associated with intrauterine growth retardation, premature birth, low birthweight, increased labor time, higher risk of infection, elevated maternal and prenatal mortality, muscle dysfunction, and low physical capacity. The present study was aimed to check the prevalence, effect of diet on IDA and its association with the pregnancy outcome, that is, birthweight. Five different public sector hospitals of Rawalpindi and Islamabad were analyzed. A sample size of 500 pregnant females of third trimester was observed which were then followed after delivery from September 2020 to January 2021. A well‐designed questionnaire was developed where different demographic factors, dietary recalls, biomarkers, and other determinants were obtained. The data from the questionnaires were later coded for the purpose of analysis in the statistical package (SPSS) using chi‐square test. Our study indicated that IDA is a moderate public health problem among pregnant women in twin cities and more than half of study subjects have depleted iron stores. Approximately 63% of the subjects were having iron deficiency and 24.8% were facing severe iron deficiency anemia. Only 12% of the subjects were considered as normal. The high prevalence of anemia in our subjects was probably due to low iron intake and poor dietary habits. The results of the study may not be generalizable due to time constraints and other factors. Maternal anemia still remains a major public health concern that requires more attention especially in developing and underdeveloping countries.
Visual experience modulates whole‐brain connectivity dynamics: A resting‐statefMRIstudy using the model of radiologists
Authors: Wang Yue , Jin Chenwang , Yin Zhongliang , Wang Hongmei , Ji Ming , Dong Minghao , Liang Jimin
Published: June 2021

Visual expertise refers to proficiency in visual recognition. It is attributed to accumulated visual experience in a specific domain and manifests in widespread neural activities that extend well beyond the visual cortex to multiple high‐level brain areas. An extensive body of studies has centered on the neural mechanisms underlying a distinctive domain of visual expertise, while few studies elucidated how visual experience modulates resting‐state whole‐brain connectivity dynamics. The current study bridged this gap by modeling the subtle alterations in interregional spontaneous connectivity patterns with a group of superior radiological interns. Functional connectivity analysis was based on functional brain segmentation, which was derived from a data‐driven clustering approach to discriminate subtle changes in connectivity dynamics. Our results showed there was radiographic visual experience accompanied with integration within brain circuits supporting visual processing and decision making, integration across brain circuits supporting high‐order functions, and segregation between high‐order and low‐order brain functions. Also, most of these alterations were significantly correlated with individual nodule identification performance. Our results implied that visual expertise is a controlled, interactive process that develops from reciprocal interactions between the visual system and multiple top‐down factors, including semantic knowledge, top‐down attentional control, and task relevance, which may enhance participants' local brain functional integration to promote their acquisition of specific visual information and modulate the activity of some regions for lower‐order visual feature processing to filter out nonrelevant visual details. The current findings may provide new ideas for understanding the central mechanism underlying the formation of visual expertise.
Single‐port transoral robotic surgery hypopharyngectomy
Authors: Mendelsohn Abie H. , Lawson Georges
Published: June 2021

Transoral robotic surgery (TORS) is an established treatment for many subsites of Head and Neck cancer. With the improved flexibility and access of the single‐port (SP) robotic system, tumors within the distal upper aerodigestive tract can now be reached and successfully treated with all the published advantages of transoral endoscopic surgery. Here in we offer the first published surgical technique for SP TORS for resectable hypopharyngeal carcinoma. The video presented demonstrates many important aspects utilizing the enhanced robotic system, including adjustments of the semi‐flexible endoscope and use of the third transoral surgical instrumentation. As previously reported, TORS hypopharyngectomy should be considered for resectable tumors to improve upon the deleterious effects of open surgical resection or chemoradiation therapy.
Beyond bias to Western participants, authors, and editors in developmental science
Authors: Moriguchi Yusuke
Published: June 2021

In this commentary, I argue that study participants, authors, and editorial members in developmental science are biased toward Western populations. First, I analysed the study participants and first authors of articles in Infant and Child Development between 2006 and 2010 and between 2016 and 2020. The results suggested that most study participants and first authors were from the Western population. However, since 2010, the number of study participants and first authors from non‐Western populations has gradually increased. Second, I analysed editorial members from journals in developmental science. The results indicated that most editorial members were Western researchers. Given these analyses, I discuss what we can do to increase diversity in developmental science.
Stochastic analysis of the relationship between atmospheric variables and coronavirus disease (COVID-19) in a hot, arid climate
Authors: Yassin Mohamed F. , Aldashti Hassan A.
Published: June 2021

The rapid outbreak of the coronavirus disease (COVID-19) has affected millions of people all over the world and killed hundreds of thousands. Atmospheric conditions can play a fundamental role in the transmission of a virus. The relationship between several atmospheric variables and the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are therefore investigated in this study, in which the State of Kuwait, which has a hot, arid climate, is considered during free movement (without restriction), partial lockdown (partial restrictions), and full lockdown (full restriction). The relationship between the infection rate, growth rate, and doubling time for SARS-CoV-2 and atmospheric variables are also investigated in this study. Daily data describing the number of COVID-19 cases and atmospheric variables, such as temperature, relative humidity, wind speed, visibility, and solar radiation, were collected for the period February 24 to May 30, 2020. Stochastic models were employed to analyze how atmospheric variables can affect the transmission of SARS-CoV-2. The normal and lognormal probability and cumulative density functions (PDF and CDF) were applied to analyze the relationship between atmospheric variables and COVID-19 cases. The Spearman's rank correlation test and multiple regression model were used to investigate the correlation of the studied variables with the transmission of SARS-CoV-2 and to confirm the findings obtained from the stochastic models. The results indicate that relative humidity had a significant negative correlation with the number of COVID-19 cases, whereas positive correlations were observed for cases of infection and temperature, wind speed, and visibility. The infection rate for SARS-CoV-2 is directly proportional to the air temperature, wind speed, and visibility, whereas inversely related to the humidity. The lowest growth rate and longest doubling time of the COVID-19 infection occurred during the full lockdown period. The results in this study may help the World Health Organization (WHO) make specific recommendations about the outbreak of COVID-19 for decision-makers around the world. Integr Environ Assess Manag 2022;18:500–516. © 2021 SETAC

KEY POINTS

We investigated the association between atmospheric variables and the transmission of the COVID-19 virus during the free movement (without restriction), partial lockdown (partial restrictions), and full lockdown (full restriction) periods. Relative humidity had a significant negative association with the number of COVID-19 infected cases. The COVID-19 infected cases were positively associated with the increase in temperature, wind speed, and visibility. The lowest growth rate and highest doubling time of the COVID-19 infection occurred in the full lockdown period.
A novel anti‐inflammatory treatment for bradykinin‐induced sore throat or pharyngitis
Authors: Leyva‐Grado Victor , Pugach Pavel , Sadeghi‐Latefi Nazlie
Published: June 2021

Background

Often thought of as a minor health concern, sore throat or pharyngitis is an important public health issue. It is one of the most common symptoms of upper respiratory diseases including COVID‐19 and is a leading cause of physician visits and antibiotic prescriptions. However, few over‐the‐counter medications are proven to heal sore throat inflammation.

Methods

Adenocarcinomic human alveolar basal epithelial cells (A549 cells) and three dimensional organotypic human respiratory tissues were used to study inflammation and various treatment effects on respiratory epithelia. The cells and tissues were studied both in the presence and absence of bradykinin, one of the first inflammatory mediators of pharyngitis. Inflammation was measured by analyzing the levels of prostaglandin E2 (PGE2), interleukin 8 (IL‐8), and leukotriene B4 (LTB4), transepithelial electrical resistance (TEER), and lactate dehydrogenase (LDH) release. Tissue morphology was analyzed by immunohistochemistry.

Results

In studying pharyngitis using organotypic human respiratory tissue stimulated with bradykinin, we saw an increase in PGE2 and interleukin‐8 (IL‐8) in response to bradykinin. Acetyl salicylic acid (ASA), a nonspecific COX inhibitor, was able to mitigate a bradykinin‐induced increase in PGE2 in our studies. However, ASA was inflammatory above its therapeutic window, increasing the levels of PGE2 and IL‐8 above those seen with bradykinin stimulation alone. We describe a novel, scientifically validated treatment for sore throat, that contains a low dose of ASA and other anti‐inflammatory ingredients.

Conclusion

This study elucidates the complex mechanisms involved in healing pharyngitis, an inflammatory condition of the upper respiratory epithelia. An ASA‐based formula (Biovanta) mitigated bradykinin‐induced inflammation more strongly than ASA alone in organotypic human respiratory tissues. Surprisingly, we found that many of the most common over the counter sore throat therapies exacerbate inflammation and IL‐8 in organotypic human respiratory tissues, suggesting these common treatments may increase the likelihood of further respiratory complications.
Efficacy and tolerability of a modified pediatric‐inspired intensive regimen for acute lymphoblastic leukemia in older adults
Authors: Patel Anand Ashwin , Heng Joseph , Dworkin Emily , Monick Sarah , Derman Benjamin A. , DuVall Adam S. , Gurbuxani Sandeep , Kosuri Satyajit , Liu Hongtao , Thirman Michael , Godley Lucy A. , Odenike Olatoyosi , Larson Richard A. , Stock Wendy
Published: June 2021

Although acute lymphoblastic leukemia (ALL) is most common in pediatric and adolescent and young adult (AYA) patients, 20% of cases are diagnosed in patients ≥ 55 years old. Use of intensive pediatric regimens in AYA populations has demonstrated excellent tolerability and significant improvements in event‐free survival (EFS) and overall survival (OS). The backbone of pediatric regimens includes asparaginase and corticosteroids, both of which are associated with more toxicity in older patients and those with body mass index (BMI) ≥ 30 kg/m which leads to poor tolerance of these regimens. We tested the safety and efficacy of a dose‐modified The Cancer and Leukemia Group B 10403 regimen using reduced doses of pegylated (PEG)‐asparaginase (ASP) and corticosteroids (RD‐10403) in 30 patients with Philadelphia‐chromosome negative ALL who were ≥50‐year‐old and younger adults with significant metabolic or hepatic co‐morbidities. The complete remission rate on day 28 was 77%, 3‐year EFS was 54%, and estimated 3‐year OS was 55%. Grade 3+ toxicity was noted in 40% of patients during induction, and induction‐related mortality was 3%. Additional prospective evaluation of RD‐10403 is merited to determine efficacy and safety of this regimen and to serve as a framework for chemoimmunotherapy combination therapy.
Whole‐Heart High‐Resolution Late Gadolinium Enhancement: Techniques and Clinical Applications
Authors: Toupin Solenn , Pezel Théo , Bustin Aurélien , Cochet Hubert
Published: June 2021

In cardiovascular magnetic resonance, late gadolinium enhancement (LGE) has become the cornerstone of myocardial tissue characterization. It is widely used in clinical routine to diagnose and characterize the myocardial tissue in a wide range of ischemic and nonischemic cardiomyopathies. The recent growing interest in imaging left atrial fibrosis has led to the development of novel whole‐heart high‐resolution late gadolinium enhancement (HR‐LGE) techniques. Indeed, conventional LGE is acquired in multiple breath‐holds with limited spatial resolution: ~1.4–1.8 mm in plane and 6–8 mm slice thickness, according to the Society for Cardiovascular Magnetic Resonance standardized guidelines. Such large voxel size prevents its use in thin structures such as the atrial or right ventricular walls. Whole‐heart 3D HR‐LGE images are acquired in free breathing to increase the spatial resolution (up to 1.3 × 1.3 × 1.3 mm3) and offer a better detection and depiction of focal atrial fibrosis. The downside of this increased resolution is the extended scan time of around 10 min, which hampers the spread of HR‐LGE in clinical practice. Initially introduced for atrial fibrosis imaging, HR‐LGE interest has evolved to be a tool to detect small scars in the ventricles and guide ablation procedures. Indeed, the detection of scars, nonvisible with conventional LGE, can be crucial in the diagnosis of myocardial infarction with nonobstructed coronary arteries, in the detection of the arrhythmogenic substrate triggering ventricular arrhythmia, and improve the confidence of clinicians in the challenging diagnoses such as the arrhythmogenic right ventricular cardiomyopathy. HR‐LGE also offers a precise visualization of left ventricular scar morphology that is particularly useful in planning ablation procedures and guiding them through the fusion of HR‐LGE images with electroanatomical mapping systems. In this narrative review, we attempt to summarize the technical particularities of whole‐heart HR‐LGE acquisition and provide an overview of its clinical applications with a particular focus on the ventricles.

Evidence Level

2

Technical Efficacy Stage

2
Measurement of the Brain Volume/Liver Volume Ratio by Three‐Dimensional MRI in Appropriate‐for‐Gestational Age Fetuses and Those With Fetal Growth Restriction
Authors: Li Kui , Yan Guohui , Zheng Weizeng , Sun Jin , Zou Yu
Published: June 2021

Background

Fetal growth restriction (FGR) is associated with a high fetal brain volume/liver volume (FBV/FLV) ratio. Ultrasound may not always be reliable, which has prompted further investigation of MRI techniques.

Purpose

To determine the relationship between FBV/FLV ratio, as measured by MRI, and gestational age (GA) in normal fetuses and those with FGR.

Study Type

Retrospective.

Population

One hundred and forty seven singleton pregnancies including 105 appropriate‐for‐gestational age (AGA) fetuses and 42 FGR fetuses.

Field Strength/Sequence

Three‐dimensional fast imaging employing steady‐state acquisition at 1.5 T.

Assessment

The FBV and FLV were measured by three radiologists. The inter‐ and intraobserver agreements, the correlation between FBV/FLV ratio, and advancing GA were evaluated; the diagnostic value of FBV/FLV ratio was evaluated and compared with head circumference/abdominal circumference (HC/AC) ratio measured by ultrasound.

Statistical Tests

Intraclass correlation coefficient (ICC) was used to determine inter‐ and intraobserver agreements. Regression analysis was used to assess the correlation between FBV/FLV ratio and advancing GA. The diagnostic value of the FBV/FLV ratio was examined by the area under the receiver operating characteristic (ROC) curve.

Results

The inter‐ and intraobserver agreements were excellent with an interobserver ICC of 0.984 and intra‐observer ICCs of 0.989, 0.994, and 0.995. The FBV/FLV ratio in AGA fetuses decreased significantly with advancing GA (Pearson correlation coefficient = −0.844). The FBV/FLV ratio in FGR fetuses was significantly higher than that in AGA fetuses. To identify fetuses at high risk for FGR using the FBV/FLV ratio, the area under the ROC curve was 0.978, with an optimal cut‐off value of 4.10. The sensitivity of FBV/FLV ratio in identifying FGR was significantly higher than that of HC/AC ratio (0.929 vs. 0.529).

Data Conclusion

An inverse correlation exists between FBV/FLV ratio and advancing GA in normal fetuses. A high FBV/FLV ratio may be used to ascertain fetuses at high risk for FGR.

Level of Evidence: 3

Technical Efficacy Stage: 3
Spatio‐temporal variability of dryness and wetness based on standardized precipitation evapotranspiration index and standardized wetness index and its relation to the normalized difference vegetation index
Authors: Lv Wenhan , Wu Chuanhao , Yeh Pat J.‐F. , Hu Bill X.
Published: June 2021

Land surface change (LSC) due to human‐caused global environmental changes has considerably affected the development of regional droughts. The standardized wetness index (SWI) developed recently by combining the standardized precipitation evapotranspiration index (SPEI) with the evapotranspiration (ET) estimated from the Budyko framework considers the joint effects of climate variability and LSC on the land dryness/wetness conditions. Here, using a 25‐year (1984–2008) monthly gridded terrestrial water budget dataset, a comparative global analysis of the spatio‐temporal variability of drought characteristics (duration D, severity S, peak K, frequency, and drought area) estimated based on SWI and SPEI is presented. The relationship between dryness/wetness (as indicated by SWI and SPEI) and LSC (as indicated by the Normalized Difference Vegetation Index, NDVI) is explored by correlation analysis and the dynamic time warping algorithm (DTW). The results show that SWI is strongly correlated with SPEI for most global regions (except for the extremely arid and extremely humid regions). Both SWI and SPEI show similar directions and magnitudes in the trends of drought characteristics during 1984–2008. However, the drying trends in SPEI are stronger than that of SWI particularly in arid regions, accompanied with larger global drought areas and higher frequencies of extreme drought. Furthermore, the correlation between SWI and LSC is larger than that between SPEI and LSC particularly in arid regions (e.g., northern Africa, Indus, and southern Australia). As SWI accounts for the effects of LSC, it can be inferred that the underestimation of drying trend indicated by SWI relative to SPEI is partially caused by LSC.
Evidence of Tinnitus Development Due to Stress: An Experimental Study in Rats
Authors: Kim Min Jung , Park So Young , Park Jung Mee , Yu Hyo Jeong , Park Ilyong , Park Shi Nae
Published: June 2021

Objectives/Hypothesis

Tinnitus can develop due to, or be aggravated by, stress in a rat model. To investigate stress as a possible causal factor in the development of tinnitus, we designed an animal study that included tinnitus behavior and excitatory/inhibitory neurotransmitter expression after noise exposure as well as restraint stress.

Study Design

An experimental animal study.

Methods

Wistar rats were grouped according to single or double exposure to noise and restraint stress. The noise exposure (NE) group was subjected to 110 dB sound pressure level (SPL) of 16 kHz narrow‐band noise (NBN) for 1 hour, and the restraint stress (RS) group was restrained for 1 hour with or without noise exposure. Gap prepulse inhibition of the acoustic startle (GPIAS) reflex was measured at an NBN of 16 kHz to investigate tinnitus development. Various immunohistopathologic and molecular biologic studies were undertaken to evaluate possible mechanisms of tinnitus development after noise and/or restraint stress.

Results

The RS‐only group showed a reduced GPIAS response, which is a reliable sign of tinnitus development. In the double‐stimulus groups, more tinnitus‐development signs of reduced GPIAS responses were observed. The expression of γ‐aminobutyric acid A receptor α1 (GABAAR α1) in the hippocampus decreased in the NE│RS group. Increased N‐methyl‐d‐aspartate receptor1 intensities in the NE│RS group and decreased GABAAR α1 intensities in the RS and NE│RS groups were observed in the CA3 region of the hippocampus.

Conclusions

Tinnitus appeared to develop after stress alone in this animal study. An imbalance in excitatory and inhibitory neurotransmitters in the hippocampus may be related to the development of tinnitus after acute NE and/or stress.

Level of Evidence

NA Laryngoscope, 131:2332–2340, 2021
The finite element method: A high‐performing approach for computing the probability of ruin and solving other ruin‐related problems
Authors: Ahmadian Davood , Ballestra Luca Vincenzo
Published: June 2021

The finite element method (FEM), despite being a very powerful tool for solving partial differential equations, has never been used to compute the probability of ruin, nor it has been applied to other kinds of ruin‐related problems, at least to the best of our knowledge. In this paper, in order to explore possible applications of the FEM in insurance mathematics, a high‐order FEM is proposed to solve problems related to ruin. Specifically, a FEM based on either quadratic, cubic, or quartic polynomials is developed to compute the probability of ruin and the (discounted) expected value of the assets of a firm in two previously published ruin models. Moreover, when dealing with the calculation of the probability of ruin, a suitable operator splitting technique is employed, such that the FEM variational formulation is used to approximate only spatial derivatives. Numerical experiments are presented showing that the FEM performs extraordinarily well. In fact, the solutions of the two problems considered can be obtained with an error (in the maximum norm) of order 10−5 or even smaller in a time smaller than a second. Finally, in accordance with already established theoretical results, the FEM reveals to be superconvergent at the boundaries of the finite elements.
On new generalized inequalities with some parameters for coordinated convex functions via generalized fractional integrals
Authors: Budak Hüseyin , Yildirim Seda Kilinç , Kara Hasan , Yildirim Hüseyin
Published: June 2021

In this work, firstly, we obtain a new identity with some parameters for generalized fractional integrals. Then by utilizing this obtained equality, we establish some new parameterized inequalities for coordinated convex functions via generalized fractional integrals. In addition, in a separate section, we show that the results given in the main section reduce to several trapezoid, midpoint, and Simpson type inequalities for various values of parameters.
Do we need more patient‐friendly treatment options for overactive bladder (OAB)?
Authors: Gerig Nel , Cameron Tracy , Arora Samir , Spear Jessica , Lescozec Laura , Zhang Mingming
Published: June 2021

Aims

To collect feedback from subjects diagnosed with overactive bladder (OAB) on its impact on their quality of life, their satisfaction with current treatment options, and to assess nonsurgical, tibial nerve stimulation as a treatment option.

Methods

Subjects were asked a variety of questions about the impact of OAB on their lives, their satisfaction with current and previous treatment approaches. Subjects evaluated the comfort of a nonworking prototype garment and were given electrical stimulation over their posterior tibial nerve to assess comfort and tolerability. Electromyographic (EMG) signals were recorded.

Results

A total of 40 subjects with OAB symptoms were evaluated in the study. Urgency (55%), frequency (47.5%), nocturia (40%), and incontinence (30%) were the most bothersome symptoms. At the time of the study only 32.5% of the subjects were treating their OAB symptoms. Of those that had tried and discontinued treatments, most had failed medications (n = 14) due to no improvements or side effects. Only 2 subjects found stimulation to be uncomfortable before an EMG signal could be detected. The most common word used to describe the feeling of stimulation was “constant,” followed by “tingling,” “vibrating,” and “comfortable.”

Conclusions

Most subjects who had tried OAB treatments were dissatisfied and discontinued their use. A new patient‐friendly approach to OAB therapy that delivers efficacy but overcomes drawbacks associated with currently available treatments is needed. Subjects found electrical stimulation over the tibial nerve to be comfortable and tolerable and this should be considered as an alternative treatment approach for OAB.
Trends in cardiovascular disease risk factors by BMI category among adults in England, 2003‐2018
Authors: Scholes Shaun , Fat Linda Ng , Mindell Jennifer S.
Published: June 2021

Objective

This study aimed to estimate trends in cardiovascular disease risk factors by BMI category among adults in England (n = 115,860).

Methods

Risk factors included cigarette smoking, hypertension, total diabetes, and raised total cholesterol. Risk factor prevalence was computed in the following four 4‐year time periods: 2003‐2006; 2007‐2010; 2011‐2014; and 2015‐2018. Change was computed as the difference between the first and last time periods, expressed in percentage points (PP).

Results

Hypertension remained at a stable level among men with normal weight but decreased among men with obesity (−4.1 PP; 95% CI: −7.1 to −1.0). Total diabetes remained at a stable level among adults with normal weight but increased among adults with obesity (men: 3.5 PP, 95% CI: 1.2 to 5.7; women: 3.6 PP, 95% CI: 1.8 to 5.4). Raised total cholesterol decreased in all BMI groups but fell more sharply among women with obesity (−21 PP; 95% CI: −25 to −17) versus their counterparts with normal weight (−16 PP; 95% CI: −18 to −14).

Conclusions

Greater reductions in hypertension and raised total cholesterol among adults with overweight and obesity partially reflect improvements in screening, treatment, and control among those at highest cardiovascular risk. Higher levels of risk factor prevalence among adults with overweight and obesity, in parallel with rising diabetes, highlight the importance of national prevention efforts to combat the public health impact of excess adiposity.
Can exercise promote additional benefits on body composition in patients with obesity after bariatric surgery? A systematic review and meta‐analysis of randomized controlled trials
Authors: Boppre Giorjines , Diniz‐Sousa Florêncio , Veras Lucas , Oliveira José , Fonseca Hélder
Published: June 2021

Background

Bariatric surgery is the most effective treatment for patients with severe obesity, but success rates vary substantially. Exercise is recommended after bariatric surgery to reduce weight regain but the effectiveness remains undetermined on weight loss due to conflicting results. It is also unclear what should be the optimal exercise prescription for these patients. A systematic review and meta‐analysis of randomized controlled trials on the effects of exercise on body weight (BW), anthropometric measures, and body composition after bariatric surgery was performed.

Methods

PubMed/MEDLINE®, EBSCO®, Web of Science® and Scopus® databases were searched to identify studies evaluating exercise effectiveness.

Results

The analysis comprised 10 studies (n = 487 participants). Exercise favored BW (−2.51kg; p = 0.02), waist circumference (−4.14cm; p = 0.04) and body mass index (−0.84kg·m−2; p = 0.02) reduction but no improvements in body composition. Combined exercise interventions were the most effective in reducing BW (−5.50kg; p < 0.01) and body mass index (−1.86kg·m−2; p < 0.01). Interventions starting >6‐months after bariatric surgery were more successful in reducing BW (−5.02kg; p < 0.01) and body mass index (−1.62kg·m−2; p < 0.01).

Conclusion

Exercise, combined exercise regimens and interventions starting >6‐months after bariatric surgery were effective in promoting BW, waist circumference and body mass index reduction. Exercise following bariatric surgery does not seem to favor body composition improvements.
Exploring shared public perspectives on biodiversity attributes
Authors: Austen Gail E. , Dallimer Martin , Irvine Katherine N. , Maund Phoebe R. , Fish Robert D. , Davies Zoe G.
Published: June 2021

Researchers, practitioners and policymakers have widely documented the multifarious ways that nature influences human well‐being. However, we still have only a limited understanding of how the public interact with, respond to and talk about attributes of biodiversity.

We used image‐based Q methodology to explore the shared and contrasting perspectives people hold for biodiversity. This approach is a powerful way of allowing people to articulate what is, or is not, important to them, free from constraints associated with statement‐based stimuli.

We used British woodlands as a study system, as they are accessible and well‐visited by the public. The elements of biodiversity incorporated in the Q methodology represented vertebrates, invertebrates, trees and understorey plants and fungi.

The shared public perspectives varied, and the reasons underpinning those perspectives were rich and diverse. People articulated reasons related to an array of biodiversity attributes (e.g. functions, behaviours, colours, smells, shapes). Many of the perspectives transcended specific species or taxonomic groups.

Although woodlands were used as a study system, people referenced perceptions and experiences external to this habitat (e.g. within their gardens) and associated with their everyday lives. Cultural influences and memories linked to particular people and places were also prominent.

Few of the shared perspectives map onto the objective measures and dimensions that researchers use to describe and categorise biodiversity (e.g. rarity, ecosystem service provision).

A free Plain Language Summary can be found within the Supporting Information of this article.
Cutin extraction and composition determined under differing depolymerisation conditions in cork oak leaves
Authors: Simões Rita , Miranda Isabel , Pereira Helena
Published: June 2021

Introduction

Cutin is a biopolyester involved in waterproofing aerial plant organs, including leaves. Cutin quantification and compositional profiling require depolymerisation, namely by methanolysis, but specific protocols are not available.

Objectives

Investigate how different methanolysis conditions regarding catalyst concentration effect cutin depolymerisation and monomer release, to better define protocols for cutin content determination and composition profiling.

Material and Methods

Cork oak (Quercus suber) dewaxed leaves were reacted with five sodium methoxide (NaOMe) concentrations. Extracts were analysed: glycerol by high‐performance liquid chromatography (HPLC) and long‐chain lipids by gas chromatography–mass spectrometry (GC–MS).

Results

Cutin was completely removed by 3% NaOMe (8.4% of dewaxed leaves), while mild 0.1% and 0.01% NaOMe methanolysis only depolymerised 14% of total cutin. Reactivity of cutin ester bonds is not homogeneous and glyceridic ester bonds are more easily cleaved, releasing the existing glycerol already under the mildest conditions (0.53% with 0.01% NaOMe and 0.41% with 3% NaOMe). The composition of cutin extracts varies with depolymerisation extent, with easier release of alkanoic acids and alkanols, respectively, 34.9% and 8.8% of total monomers at 0.1% NaOMe, while ω‐hydroxyacids (49.3% of total monomers) and α,ω‐diacids (9.0% of the monomers) are solubilised under more intensive reactive conditions.

Conclusion

Cutin of Quercus suber leaves is confirmed as a glyceridic polyester of ω‐hydroxyacids and alkanoic acids, with minor content of α,ω‐diacids, and including coumarate moieties. The protocol for the determination of cutin content and compositional profiling was established regarding catalyst concentration. The molar composition of cutin suggests a macromolecular assembly based on glycerol linked to lipid oligomeric chains with moderate cross‐linking.
Evaluation of more than one billion outpatient prescriptions and eight‐year trend showing a remarkable reduction in antibiotic prescription in Turkey: A success model of governmental interventions at national level
Authors: Aksoy Mesil , Isli Fatma , Kadi Esma , Varimli Didem , Gursoz Hakki , Tolunay Tolga , Kara Ates , Unal Serhat , Alp Mese Emine
Published: June 2021

Purpose

To present the antibiotic prescription trend between 2011–2018 at primary healthcare in Turkey in order to evaluate the effects of interventions at national level for providing rational prescription of antibiotics.

Methods

Electronic prescription data of the family physicians collected from January 1, 2011 to December 31, 2018 in 81 provinces of Turkey were recorded through the Prescription Information System and screened for the antimicrobial drugs. The interventions to promote rational antibiotic use during 2011–2018 in Turkey includes reminding the legislation to stop access of antibiotics without prescription, monitoring of antibiotic prescription behaviors of primary healthcare physicians, and education of healthcare workers and the public on the appropriate use of antibiotics.

Results

A total of 1 054 261 396 prescriptions for outpatients of all age groups were recorded during this period. Of the prescriptions written by family physcians, 34.94% were containing at least one antibiotic in 2011, which declined to 24.55% in 2018. Antibiotics constituted 13.99% of all the items in prescriptions in 2011 and 10.47% in 2018. Percentage of total antibiotic expenditure to the total drug expanditure decreased from 14.14% to 4.12% during 2011–2018. The most commonly prescribed antibiotics were amoxicillin and enzyme inhibitor combination, cefdinir, and cefuroxime during 2011–2018, with an increasing trend for prescription of first‐line antibiotic, amoxicillin, in recent years.

Conclusions

Governmental interventions at national level have contributed to reducing antibiotic prescription and increasing preference of first‐line antibiotics at primary healthcare level in Turkey over a course of 8 years. Turkey's model of governmental interventions may set an example for other countries with high consumption of antibiotics, and contribute to the actions against antimicrobial resistance worldwide.
Analysis of the interaction between personality dysfunction and traits in the statistical prediction of physical aggression: Results from outpatient and community samples
Authors: Leclerc Philippe , Savard Claudia , Vachon David D. , Faucher Jonathan , Payant Maude , Lampron Mireille , Tremblay Marc , Gamache Dominick
Published: June 2021

The Alternative Model for Personality Disorders (AMPD), included in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) and the World Health Organization's International Classification of Diseases (11th ed.; ICD‐11) are, respectively, hybrid categorical‐dimensional and dimensional frameworks for personality disorders (PDs). Both models emphasize personality dysfunction and personality traits. Previous studies investigating the links between the AMPD and ICD‐11, and self‐reported physical aggression have mostly focused on traits and did not take into account the potential interaction between personality dysfunction and traits. Thus, the aim of this study is to identify dysfunction*trait interactions using regression‐based analysis. Outpatients with personality disorder from a specialized public clinic (N = 285) and community participants (N = 995) were recruited to complete self‐report questionnaires. Some small‐size, albeit significant and clinically/conceptually meaningful personality dysfunction*trait interactions were found to predict physical aggression in both samples. Interaction analyses might further inform, to some degree, about the current discussion pertaining to the potential redundancy between dysfunction and traits, the optimal personality dysfunction structure (in the case of the AMPD), as well as clinical assessment based on AMPD/ICD‐11 PD frameworks.
Prevalence of depression and anxiety disorders following mild traumatic brain injury
Authors: Delmonico Richard L. , Theodore Brian R. , Sandel M. Elizabeth , Armstrong Mary Anne , Camicia Michelle
Published: June 2021

Background

Previous studies have identified an association between traumatic brain injuries and the development of psychiatric disorders in general. However, these studies were subject to limitations that demonstrate the need for a study of a large, clearly defined mild traumatic brain injury (mTBI) population within an integrated healthcare system.

Objective

To determine the prevalence and relative risk of postinjury affective disorders over 4 years following mTBI.

Design

Cohort study of mTBI cases and matched controls, over a 4‐year period.

Setting

An integrated healthcare delivery system in California.

Patients

A total of 9428 adult health plan members diagnosed with mTBI from 2000–2007 and enrolled in the year before injury, during which no TBI was ascertained. Control participants included 18,856 individuals selected based on the following criteria: Two unexposed health plan members per each mTBI‐exposed patient were randomly selected and individually matched for age, gender, race/ethnicity, and medical comorbidities.

Interventions

Not applicable.

Main Outcome Measures

A diagnosis of affective disorder (depressive, anxiety, and adjustment disorders) in the 4 years after mTBI or the reference date, determined according to the International Classification of Diseases, Ninth Revision, Clinical Modification as well as the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision.

Results

Affective disorders were most prominent during the first 12 months with 23% following mTBI and 14% in the control group. Four‐year aggregate adjusted odds ratios for having an affective disorder following mTBI were 1.2 (95% CI: 1.1, 1.2; p < .001) and 1.5 (95% CI: 1.5, 1.6; p < .001) for patients with and without prior affective disorders, respectively.

Conclusion

mTBI was associated with a significantly increased risk of having subsequent affective disorders. Screening for and addressing affective disorders at earlier stages following the injury is an important step to avoid persisting conditions that may pose a barrier to full recovery.
Hyperbolic‐Like Structure with Negative Poisson's Ratio: Deformation Mechanism and Structural Design
Authors: Wang Quan , Yin WuJun , Yu Hao , Zhu YinBo , Wu HengAn
Published: June 2021

Mechanical metamaterials with negative Poisson's ratio (NPR) effect possess important practical applications in aerospace, nanotechnology, and other fields. The microstructure and its deformation mode directly determine the NPR ability and mechanical performance of auxetic metamaterials. Herein, inspired by the double‐negative‐index ceramic aerogels, a novel NPR structural model is proposed in which symmetric reentrant oblique ligaments and short transversal ligaments constitute the main framework inside a square, which is different from the traditional reentrant structure due to the hyperbolic‐like skeleton and deformation modes. The influence of structural parameters on the NPR effect is investigated using the Timoshenko beam model and finite element simulations. The structural model is then extended to design multiple reentrant structures and assembled structures, respectively. The multiple reentrant structures include multiple pairs of symmetrically hyperbolic‐like skeletons, and the distribution of horizontal ligaments can be regulated to achieve a better NPR effect. For assembled structures under compression, the local rotational deformation and buckling result in structural instability, demonstrated by inflection points in the NPR curves. Moreover, one special assembled structure is found for which there is a linear relationship between the compressive strain and NPR value. The insights should be significant for designing mechanical metamaterials with the NPR effect.
Do collective bargaining rights save lives? A rare event analysis of firefighter fatalities in the United States
Authors: Wells Dominic D.
Published: June 2021

Risk analysis research often focuses on regulation, assessment, and management rather than risk governance. This study contributes to the risk governance literature by analyzing the relationship between collective bargaining rights for firefighters and firefighter fatalities in the United States. Using state‐level data from 2009 through 2018, this analysis shows that states with duty‐to‐bargain rights for firefighters have fewer firefighter fatalities than those without duty‐to‐bargain rights. Further, this analysis shows that the benefit of duty‐to‐bargain rights dissipates in states with a high percentage of fully volunteer fire departments. This study concludes with a discussion of the implications for fire departments and public policy.
Subgroup discovery in non‐inferiority trials
Authors: Fazzari Melissa J. , Kim Mimi Y.
Published: June 2021

Approaches and guidelines for performing subgroup analysis to assess heterogeneity of treatment effect in clinical trials have been the topic of numerous papers in the statistical and clinical literature, but have been discussed predominantly in the context of conventional superiority trials. Concerns about treatment heterogeneity are the same if not greater in non‐inferiority (NI) trials, especially since overall similarity between two treatment arms in a successful NI trial could be due to the existence of qualitative interactions that are more likely when comparing two active therapies. Even in unsuccessful NI trials, subgroup analyses can yield important insights about the potential reasons for failure to demonstrate non‐inferiority of the experimental therapy. Recent NI trials have performed a priori subgroup analyses using standard statistical tests for interaction, but there is increasing interest in more flexible machine learning approaches for post‐hoc subgroup discovery. The performance and practical application of such methods in NI trials have not been systematically explored, however. We considered the Virtual Twin method for the NI setting, an algorithm for subgroup identification that combines random forest with classification and regression trees, and conducted extensive simulation studies to examine its performance under different NI trial conditions and to devise decision rules for selecting the final subgroups. We illustrate the utility of the method with data from a NI trial that was conducted to compare two acupuncture treatments for chronic musculoskeletal pain.
Preparation of Ni2P Decorated Black Phosphorus Nanosheets Supported on Two‐Dimensional α‐Zirconium Phosphate and Its Catalysis for Hydrodesulfurization of Dibenzothiophene
Authors: Li Jia , Ma Hongqin , Wang Jie , Luo Xinyue , Yu Luqi , Gao Junyu
Published: June 2021

In this paper, a novel Ni2P/black phosphorus (Ni2P/BP) supported on two‐dimensional α‐zirconium phosphate (α‐ZrP) hybrid material was prepared, and its catalytic activity for hydrodesulfurization (HDS) was investigated. Through the reaction of nickel salt with BP nanosheets obtained by freeze‐assisted exfoliation method, Ni2P nanoparticles can be formed and firmly anchored on the surface of BP, effectively preventing themselves from aggregating. BP is not only used as the phosphorus source for the synthesis of Ni2P, but its superior electron mobility can significantly promote the catalytic HDS activity of Ni2P species. Moreover, the support of two‐dimensional α‐ZrP nanosheets with a large specific surface area has a strong structure, which greatly improves the stability of catalyst. The Ni2P/BP@ZrP catalyst could reach a dibenzothiophene (DBT) conversion of 87.4 % within 6 h at 260 °C, much higher than the traditional NiMo/Al2O3catalyst (65.6 %), showing a promising application for industrial catalytic desulfurization.