bluuebunny/crossref_metadata_2025 huggingface dataset:
Pesticide use, health impairments and economic losses under rational farmers behavior
Authors: Chatzimichael Konstantinos , Genius Margarita , Tzouvelekas Vangelis
Published: July 2021

This paper develops a novel methodology for measuring the economic losses resulting from the negative health impacts of pesticides while taking into account their role as a damage control agent. To this effect a production model is presented that takes into account both the effect of the health impairment caused by pesticides on labor units and the pest control and crop enhancing properties of pesticides. The supply responses and optimal cost adjustments made by rational farmers in the absence of health effects are examined, which facilitates the proper measurement of the private economic losses associated with the health effects of pesticides. The biases in previous pest‐damage measures that ignore the presence of health effects are also examined. The model is empirically applied to a unique panel dataset of organic and conventional Greek greenhouse vegetable producers where the use of health‐hazardous pesticides is particularly prominent. Moreover, the estimation of health impairment indices takes into account the observational nature of the data collected, applying recently developed treatment effects methods. The results show that farmers suffer considerable quasi‐rent losses due to the negative effect of pesticides on health.
Differences in ultrasonographic features between males and females with breast cancer of the luminal A and luminal B molecular subtypes
Authors: Li Bo , Zhao Xin , Zhang Lei , Cheng Wen
Published: July 2021

Aim

To analyze the relationships between the ultrasonographic features and the molecular subtypes of breast cancer in men and women.

Methods

Data were collected from 43 males and 80 females with breast cancer who were treated at our hospital. The following ultrasonographic characteristics of the tumors were evaluated: shape, orientation, margin, echo pattern, posterior features, calcifications, Color Doppler Flow Imaging, and Breast Imaging Reporting and Data System (BI‐RADS) category.

Results

On ultrasound, a nonparallel orientation, noncircumscribed margin, and attenuating posterior features were associated with luminal A lesions. A parallel orientation (P = 0.002), circumscribed margin (P = 0.04), no change in posterior features (P < 0.001), and the BI‐RADS 4 category (P = 0.001) were significantly associated with luminal B lesions. In the group with luminal A lesions, male patients were older (P = 0.001) and a greater number of the tumors exhibited a regular shape (P = 0.009), circumscribed margin (P < 0.001), no change in posterior features (P < 0.001), and the BI‐RADS 4 category (P < 0.001) than those in female patients. Male patients were older (P < 0.001) and a greater number showed a no change in posterior features (P < 0.001), spotty blood flow (P = 0.002), and the BI‐RADS 4 category (P < 0.001) than female patients with masses of the luminal B subtype.

Conclusion

Obvious differences in the ultrasonographic and pathological features were noted between breast cancer in males and females, which provided the theoretical basis for the individualized treatment of breast cancer, particularly breast cancer in males.
Treatment outcomes of patients with involved resection margin after rectal cancer surgery: A nationwide population‐based cohort study in South Korea
Authors: Bong Jun Woo , Lee Jung Ae , Ju Yeonuk , Seo Jihyun , Kang Sang Hee , Lee Sun Il , Min Byung Wook
Published: July 2021

Background

The involvement of resection margins after rectal cancer surgery by malignant tumors is a negative prognostic factor. Therefore, it is important to analyze treatment outcomes and establish adjuvant therapy.

Methods

The Health Insurance Review and Assessment Service collects data from medical institutions in South Korea. We reviewed the database of this prospectively collected cohort for patients who underwent curative resection for rectal cancer.

Results

Of the 5,620 patients, 113 (2.0%) were diagnosed with resection margin involvement after surgery. The resection margins of patients with mid‐rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and undergoing emergency surgery were more frequently involved. Neoadjuvant chemoradiotherapy was a significant preventive factor for resection margin involvement (odds ratio = 0.53; 95% confidence interval [CI], 0.32–0.87; p = 0.012). The OS of patients with adjuvant treatment was better than that of patients without adjuvant treatment (5‐year overall survival [OS]: 62.8% vs. 46.3%, p = 0.02). The administration of chemoradiotherapy was also significantly associated with better OS (hazard ratio = 0.36; 95% CI, 0.17–0.77; p = 0.009).

Conclusion

Efforts to acquire wider resection margins are necessary for patients with mid‐rectal cancer, pathologic stage III, mucinous/signet ring cell carcinoma, and emergency surgery. Neoadjuvant chemoradiotherapy was a significant preventive factor for involved resection margin. Patients with resection margin involvement showed better OS after adjuvant treatment than those without adjuvant treatment. The adjuvant chemoradiotherapy was helpful to prevent the worse prognosis of these patients.
The association between ECG criteria and Echo criteria for left ventricular hypertrophy in a general Chinese population
Authors: Lv Tingting , Yuan Yifang , Yang Jing , Wang Guijin , Kong Lingyun , Li Huijuan , Li Xingjie , Sun Yingxian , Li Xuewen , Zhang Zheng , Cheng Xiaoshu , Wu Lirong , Tan Xuerui , Han Bing , Li Hua , Zhang Zhaoguo , Wang Jiayu , Wu Yangfeng , Wang Yanfang , Guo Jihong , Zhang Ping
Published: July 2021

Background

Several ECG criteria have been widely used for diagnosis of left ventricular hypertrophy (LVH) in clinical practice. However, their performance in a general Chinese population is limited.

Methods and results

A multi‐stage, stratified cluster sampling across China was performed and 7415 representative Chinese adults aged 18–85 years were analyzed. ECG was collected by using GE MAC 5500 machine. The association between five ECG‐LVH criteria (i.e., Peguero–Lo Presti, Cornell, Cornell product, Sokolow–Lyon and Sokolow–Lyon product) and echocardiographic LVH (Echo‐LVH) was assessed by Pearson's correlation, diagnostic statistics like predictive values, and receiver operating characteristics (ROC) curve. We found that the prevalence of the Echo‐LVH was 11% while ECG‐LVH ranged from 3% to 27%. All ECG‐LVH criteria had high negative predictive value (NPV) (89%) and specificity (73–96%) but low positive predictive value (PPV) (12–24%) and sensitivity (4–29%). The newly Peguero–Lo Presti criteria had higher sensitivity (29%) but lower specificity (73%) and accuracy (68%) compared with other criteria. Cornell product had the best diagnostic performance (AUC: 0.59), as well as the highest specificity (96%) and accuracy (86%) but lowest sensitivity (4%). Among single‐lead components of ECG criteria, RaVL voltage and QRS duration performed relatively better than others. Hypertensive and older individuals had higher sensitivity but lower specificity and accuracy than their counterparts.

Conclusion

ECG‐LVH criteria had high NPV to detect Echo‐LVH. Though with higher sensitivity, Peguero–Lo Presti criteria did not have better diagnostic performance to detect Echo‐LVH. RaVL and QRS duration had stronger association with Echo‐LVH among all single‐lead components.
Risk factors for surgical site infection following cesarean delivery: A hospital‐based case–control study
Authors: Kvalvik Sedina Atic , Rasmussen Svein , Thornhill Heidi Frances , Baghestan Elham
Published: July 2021

Introduction

Cesarean section is the single most important risk factor for postpartum infection. Where the rest of the world shows increasing trends, the cesarean section rates are low in Norway and risk factors for infection after cesarean section may differ in high and low cesarean section settings. The goal of this study was to examine independent risk factors for surgical site infection after cesarean delivery in a setting of low cesarean section rates.

Material and methods

We conducted a hospital‐based case‐control study at Haukeland University Hospital. We included women who presented to our hospital with surgical site infection after cesarean section during the years 2014–2016 (n = 75). Controls were selected at a ratio of 2:1 (n = 148). Cases and controls were compared with respect to maternal and pregnancy characteristics using uni‐ and multivariable logistic regression models. Main outcome measures were anticipated risk factors for surgical site infection.

Results

The occurrence of surgical site infection was 0.4% and 5.4% after elective and emergency cesarean section, respectively. Compared to women without surgical site infection, women with surgical site infection were almost thrice more obese before pregnancy (OR 2.8, 95% CI 1.2–7.0), four times more likely to have preexisting psychiatric conditions (OR 4.4, 95% CI 1.1–17.6), and five times more likely to receive blood transfusion (OR 5.1, 95% CI 1.4–18.8). Signs of infection during labor was a marginally significant risk factor for surgical site infection (OR 2.0, 95% CI 1.0–5.4).

Conclusions

Emergency cesarean section was a significant risk factor for surgical site infection. Pregestational obesity, preexisting psychiatric conditions, and blood transfusion during or following delivery, were independent risk factors for surgical site infection. Signs of infection during labor was a marginally significant risk factor. Women with either of these risk factors should be carefully monitored and evaluated for signs of infection in the postpartum period.
Optimizing porcine donor kidney preservation with normothermic or hypothermic machine perfusion: A systematic review
Authors: Bouari Sarah , Eryigit Özgür , de Bruin Ron W. F. , IJzermans Jan N. M. , Minnee Robert C.
Published: July 2021

We present an updated overview of the literature comparing normothermic with hypothermic machine perfusion in porcine kidneys. We conducted a systematic literature review in Embase, Medline Epub (Ovid), Cochrane Central, Web of Science, and Google Scholar on studies comparing normothermic (NMP) to hypothermic machine perfusion (HMP) in porcine kidneys. A meta‐analysis was judged inappropriate because of heterogeneity in study design and perfusion methods. The quality of evidence of each included study was assessed. We included 8 studies. One out of 5 studies reported a significant difference in peak renal blood flow in favor of NMP. Oxygen consumption was significantly higher in NMP kidneys in 2 out of 5 studies. Peak creatinine clearance in NMP was significantly higher than that in HMP in 1 out of 6 studies. Two out of 4 studies reported a higher degree of epithelial vacuolation in kidneys receiving NMP over HMP. None of the studies found a significant difference between NMP and HMP in peak serum creatinine or graft survival after autotransplantation. The results need to be interpreted with caution in view of the diversity in perfusion protocols, the low quality of evidence, and the limited sample sizes.
Bone tissue engineering potentials of 3D printed magnesium‐hydroxyapatite in polylactic acid composite scaffolds
Authors: Anita Lett Jayasingh , Sagadevan Suresh , Léonard Estelle , Fatimah Is , Motalib Hossain M. A. , Mohammad Faruq , Al‐Lohedan Hamad A. , Paiman Suriati , Alshahateet Solhe F. , Abd Razak Saiful Izwan , Johan Mohd Rafie
Published: July 2021

The primary role of bone tissue engineering is to reconcile the damaged bones and facilitate the speedy recovery of the injured bones. However, some of the investigated metallic implants suffer from stress‐shielding, palpability, biocompatibility, etc. Consequently, the biodegradable scaffolds fabricated from polymers have gathered much attention from researchers and thus helped the tissue engineering sector by providing many alternative materials whose functionality is similar to that of natural bones. Herein, we present the fabrication and testing of a novel composite, magnesium (Mg)‐doped hydroxyapatite (HAp) glazed onto polylactic acid (PLA) scaffolds where polyvinyl alcohol (PVA) used as a binder. For the composite formation, Creality Ender‐3 pro High Precision 3D Printer with Shape tool 3D Technology on an FSD machine operated by Catia design software was employed. The composite has been characterized for the crystallinity (XRD), surface functionality (FTIR), morphology (FESEM), biocompatibility (hemolytic and protein absorption), and mechanical properties (stress‐strain and maximum compressive strength). The powder XRD analysis confirmed the semicrystalline nature and intact structure of HAp even after doping with Mg, while FTIR studies for the successful formation of Mg‐HAp/PVA@PLA composite. The FESEM provided analysis indicated for the 3D porous architecture and well‐defined morphology to efficiently transport the nutrients, and the biocompatibility studies are supporting that the composite for blood compatible with the surface being suitable enough for the protein absorption. Finally, the composite's antibacterial activity (against Staphylococcus aureus and Escherichia coli) and the test of mechanical properties supported for the enhanced inhibition of active growth of microorganisms and maximum compressive strength, respectively. Based on the research outcomes of biocompatibility, antibacterial activity, and mechanical resistance, the fabricated Mg‐HAp/PVA@PLA composite suits well as a promising biomaterial platform for orthopedic applications by functioning towards the open reduction internal fixation of bone fractures and internal repairs.
Myogenetic oligodeoxynucleotide complexed with berberine promotes differentiation of chicken myoblasts
Authors: Nihashi Yuma , Shinji Sayaka , Umezawa Koji , Shimosato Takeshi , Ono Tamao , Kagami Hiroshi , Takaya Tomohide
Published: July 2021

Myoblasts are myogenic precursors that develop into myotubes during muscle formation. Improving efficiency of myoblast differentiation is important for advancing meat production by domestic animals. We recently identified novel oligodeoxynucleotides (ODNs) termed myogenetic ODNs (myoDNs) that promote the differentiation of mammalian myoblasts. An isoquinoline alkaloid, berberine, forms a complex with one of the myoDNs, iSN04, and enhances its activities. This study investigated the effects of myoDNs on chicken myoblasts to elucidate their species‐specific actions. Seven myoDNs (iSN01–iSN07) were found to facilitate the differentiation of chicken myoblasts into myosin heavy chain (MHC)‐positive myotubes. The iSN04–berberine complex exhibited a higher myogenetic activity than iSN04 alone, which was shown to enhance the differentiation of myoblasts into myotubes and the upregulation of myogenic gene expression (MyoD, myogenin, MHC, and myomaker). These data indicate that myoDNs promoting chicken myoblast differentiation may be used as potential feed additives in broiler diets.
Genetic analysis for sow stayability at different parities in purebred Landrace and Large White pigs
Authors: Ogawa Shinichiro , Kimata Makoto , Ishii Kazuo , Uemoto Yoshinobu , Satoh Masahiro
Published: July 2021

Genetic parameters for sow stayability were estimated from farrowing records of 10,295 Landrace sows and 8192 Large White sows. The record for sow stayability from paritykto parityk + 1 (k = 1, …, 6) was 0 when a sow had a farrowing record at paritykbut not at parityk + 1, and 1 when a sow had both records. Heritability was estimated by using single‐trait linear and threshold animal models. Genetic correlations among parities were estimated by using two‐trait linear–linear and single‐trait random regression linear animal models. Genetic correlations with litter traits at birth were estimated by using a two‐trait linear–linear animal model. Heritability estimates by linear model analysis were low (0.065–0.119 in Landrace & 0.061–0.157 in Large White); those by threshold model analysis were higher (0.136–0.200 & 0.110–0.283). Genetic correlations among parities differed between breeds and models. Genetic correlation between sow stayability and number born alive was positive in many cases, implying that selection for number born alive does not reduce sow stayability. The results seem to be affected by decisions on culling made by farmers.
Do neighbours matter? The effect of single‐ and mixed‐species sowing density on seed germination of annual wetland plants
Authors: Bao Francielli , Rossatto Davi Rodrigo , Pott Arnildo , Elsey‐Quirk Tracy , de Assis Marco Antonio , Arruda Rafael , Ramos Desirée Marques
Published: July 2021

Question

Germination is one of the decisive processes influencing species presence and plant community structure. Here, we investigated the influence of seed density and single and mixed species on germination percentage and timing using annual wetland plants of the Pantanal in Brazil.

Location

Seeds were collected from annual species occupying a seasonally flooded grassland, at Fazenda São Bento (19°29′27,3″ S; 57°01′55,9″ W), in the Abobral sub‐region, Pantanal, Mato Grosso do Sul (Central‐West Brazil).

Methods

Experiments on the effects of seed density dependence on the germination time in intraspecific (single‐species) and interspecific (mixed‐species) treatments were conducted with ten annual species at three levels: for intraspecific — scarce (one seed), moderate (10 seeds), and high (20 seeds); and for interspecific — low (one each), medium (10) and abundant (20).

Results

The germination percentage was independent of density and species mixtures. Germination time was density‐dependent for the mixed‐species treatment, but not the single‐species treatments. Six species had a shorter germination time, suggesting a group priority effect. Other species delayed or did not alter their germination time, indicating that the response to intraspecific seed densities is species‐specific.

Conclusion

These findings illustrate that even though species have a history of coexistence and characteristics of rapid germination, seeds can alter germination time if they perceive neighbouring seeds of other species. Species that respond with a faster germination time may have a competitive advantage for recruitment and growth. These terrestrial species show high initial colonization power, which is essential in the regeneration of wetlands after flood disturbance.
Unicorn “holotype” skeleton from the Late Pleistocene spotted hyena den site Sewecken‐Berge (Germany)
Authors: Diedrich Cajus G.
Published: July 2021

Late Pleistocene Ice Age spotted hyena remains are described from the “Unicorn holotype skeleton” gypsum karst site Quedlinburg‐Sewecken‐Berge, Germany (Central Europe). The hyena population consists of adolescent to late adult individuals (96% of hyena NISP; 15% of megafauna NISP) indicating a commuting den site type. The comparisons to other European bone assemblages support hunting specialization on woolly rhinoceros (19% of NISP) and horses (27% of NISP). Specialization on bovids (Bison/Bos) can be added for this site. The megafauna contain few Eemian warm period remains of a large horseEquus ferus fossilis. Most (95%) of the megafauna is attributed to the Late Pleistocene glacial (Weichselian/Wuermian). Horse bones are dominated by distal leg elements from the smaller Przewalski horsesEquus ferus przewalskii(26% of NISP). The Unicorn “holotype” skeleton originates from a composed horse skull, vertebrae and front legs, whereas the elephant remains added to this biologically not valid species must have been a straight‐tusked elephant tusk.
Neuronal regeneration: Vertebrates comparative overview and new perspectives for neurodegenerative diseases
Authors: Alesci Alessio , Pergolizzi Simona , Lo Cascio Patrizia , Fumia Angelo , Lauriano Eugenia Rita
Published: July 2021

Neurodegenerative diseases afflict a significant percentage of the world's population. The human nervous system is unable to regenerate after an insult, or due to senility, while low vertebrates still exhibit this ability. Comparative neurobiology can increase knowledge about neuronal degeneration and regeneration. Anamni vertebrates retain the ability to regenerate up to large areas of the nervous system. The regenerative ability of central nervous system components depends on the phylogenetic distance between classes of vertebrates. It decreases during evolution. Teleosts can skilfully regenerate brain, spinal cord and retina. Amphibians and reptiles can only regenerate certain areas; spinal cord regeneration in reptiles is limited to axonal regrowth. Retina regeneration is possible in bird embryo but not in the adult. In this review, we analyse how the regeneration of neurons occurs in different classes of vertebrates, and how the study of these mechanisms could be applied to the search for new therapies for neurodegenerative disorders.
On the move: sloths and their epibionts as model mobile ecosystems
Authors: Kaup Maya , Trull Sam , Hom Erik F. Y.
Published: July 2021

Sloths are unusual mobile ecosystems, containing a high diversity of epibionts living and growing in their fur as they climb slowly through the canopies of tropical forests. These epibionts include poorly studied algae, arthropods, fungi, and bacteria, making sloths likely reservoirs of unexplored biodiversity. This review aims to identify gaps and eliminate misconceptions in our knowledge of sloths and their epibionts, and to identify key questions to stimulate future research into the functions and roles of sloths within a broader ecological and evolutionary context. This review also seeks to position the sloth fur ecosystem as a model for addressing fundamental questions in metacommunity and movement ecology. The conceptual and evidence‐based foundation of this review aims to serve as a guide for future hypothesis‐driven research into sloths, their microbiota, sloth health and conservation, and the coevolution of symbioses in general.
Tayra (Eira barbara) landscape use as a function of cover types, forest protection, and the presence of puma and free‐ranging dogs
Authors: Bianchi Rita , Jenkins Julianna M. A. , Lesmeister Damon B. , Gouvea Jéssica Abonízio , Cesário Clarice Silva , Fornitano Larissa , de Oliveira Mateus Yan , de Morais Kimberly Danielle Rodrigues , Ribeiro Renan Lieto Alves , Gompper Matthew E.
Published: July 2021

The tayra (Eira barbara) is a common and broadly distributed Neotropical carnivore, yet is not well‐studied. While this species is apparently associated with forested habitats, it also appears tolerant of some anthropogenic disturbance. We deployed 57 unbaited camera traps (n = 4923 trap‐days) in and around a protected area (Furnas do Bom Jesus State Park, São Paulo, Brazil) to survey for tayra and two potentially interactive species: puma (Puma concolor) and free‐ranging dogs (Canis familiaris). We used encounter histories generated from photographs and occupancy models to quantify tayra landscape use in the human‐dominated landscape composed of the protected area that was near a city and surrounded by agricultural lands dominated by small farms. We fit co‐occurrence models to understand whether puma and free‐ranging dogs affected landscape use by tayra. We detected tayra at 44% of sites and found that tayra landscape use increased with the proportion of forest cover within 500 m of the sampling site. Other factors predicting tayra landscape use included whether the sampling site was within the protected area, its distance to water, and slope. Dogs, which are common on the periphery of the protected area, seem to have a weak negative effect on tayra landscape use. Because of the concentration of forest within the park, this is an important protected area for the carnivore population within this human‐modified landscape. Thus, environmental variables, such as forest cover, distance to water, as well as administrative protection status, are important for understanding local‐scale tayra distribution.

Abstract in Portuguese is available with online material.
Administrative tribunals and equity: Military sexual assault survivors at the Veterans Review and Appeal Board
Authors: Eichler Maya
Published: July 2021

This article examines Veterans Review and Appeal Board (VRAB) decisions on military sexual assault related claims for disability entitlements since fiscal year 2009‐2010. These decisions have had significantly lower favourability rates than the average, despite recent improvements. As the case of VRAB shows, administrative tribunals may not be well equipped to ensure equitable outcomes for all users, calling into question their effectiveness as instruments of justice. Equity needs to become an explicit objective in the work of administrative tribunals, while external scrutiny may be necessary to ensure it is achieved.
Le droit de contracter avec l'État : Le principe d'égalité devant le service public en droit des marchés publics québécois
Authors: Jobidon Nicholas
Published: July 2021

Sommaire

Pour favoriser la concurrence entre les entreprises qui participent aux appels d’offres des organismes publics, une certaine jurisprudence reconnaît historiquement un droit égal à toutes les entreprises de conclure un contrat avec l'État : il s'agirait d’une expression du principe d'égalité devant le service public. Or, en parallèle avec les travaux de la Commission d'enquête sur l'industrie de la construction, le législateur québécois a adopté diverses normes visant à restreindre les entreprises pouvant déposer une soumission en réponse à un appel d'offres d'un organisme public ou municipal québécois. Ce principe est‐il toujours applicable au Québec, et si oui, quelle est sa portée au vu des modifications législatives récentes? Contracter avec l'État québécois est‐il toujours un droit, ou s'agit‐il maintenant plutôt d'un privilège?
Recent research on public procurement: Should it become a subfield of public administration?
Authors: Hudon Pierre‐André , Dumas Philippe , Garzón César
Published: July 2021

This article presents a descriptive review of public procurement research conducted between 2010 and 2018 based on the coding of a sample of 743 relevant articles. We use the results to build a case for making public procurement a subfield of public administration research. We first present a systematic framework for studying public procurement that lays the ground for the coding strategy. Second, we outline the scope and method of the research, and then describe our findings regarding the most important topics, journals and authors in the recent literature on public procurement. Finally, we suggest how to improve the visibility and relevance of public procurement research in public administration journals.
Improving function of cytotoxic T‐lymphocytes by transforming growth factor‐β inhibitor in oral squamous cell carcinoma
Authors: Kondo Yutaro , Suzuki Susumu , Takahara Taishi , Ono Shoya , Goto Mitsuo , Miyabe Satoru , Sugita Yoshihiko , Ogawa Tetsuya , Ito Hideaki , Satou Akira , Tsuzuki Toyonori , Yoshikawa Kazuhiro , Ueda Ryuzo , Nagao Toru
Published: July 2021

Immunotherapy with immune‐checkpoint therapy has recently been used to treat oral squamous cell carcinomas (OSCCs). However, improvements in current immunotherapy are expected because response rates are limited. Transforming growth factor‐β (TGF‐β) creates an immunosuppressive tumor microenvironment (TME) by inducing the production of regulatory T‐cells (Tregs) and cancer‐associated fibroblasts and inhibiting the function of cytotoxic T‐lymphocytes (CTLs) and natural killer cells. TGF‐β may be an important target in the development of novel cancer immunotherapies. In this study, we investigated the suppressive effect of TGF‐β on CTL function in vitro using OSCC cell lines and their specific CTLs. Moreover, TGFB1 mRNA expression and T‐cell infiltration in 25 OSCC tissues were examined by in situ hybridization and multifluorescence immunohistochemistry. We found that TGF‐β suppressed the function of antigen‐specific CTLs in the priming and effector phases in vitro. Additionally, TGF‐β inhibitor effectively restored the CTL function, and TGFB1 mRNA was primarily expressed in the tumor invasive front. Interestingly, we found a significant negative correlation between TGFB1 mRNA expression and the CD8+ T‐cell/Treg ratio and between TGFB1 mRNA expression and the Ki‐67 expression in CD8+ T‐cells, indicating that TGF‐β also suppressed the function of CTLs in situ. Our findings suggest that the regulation of TGF‐β function restores the immunosuppressive TME to active status and is important for developing new immunotherapeutic strategies, such as a combination of immune‐checkpoint inhibitors and TGF‐β inhibitors, for OSCCs.
Clinical and laboratory findings in patients with leukocyte adhesion deficiency type I: A multicenter study in Turkey
Authors: Yaz Ismail , Ozbek Begum , Bildik Hacer Neslihan , Tan Cagman , Oskay Halacli Sevil , Soyak Aytekin Elif , Esenboga Saliha , Cekic Sukru , Kilic Sara Sebnem , Keskin Ozlem , van Leeuwen Karin , Roos Dirk , Cagdas Deniz , Tezcan Ilhan
Published: July 2021

Leukocyte adhesion deficiency type I is a rare primary immunodeficiency disorder characterized by mutations in the ITGB2 gene encoding CD18. We present clinical and immunological features of 15 patients with leukocyte adhesion deficiency type 1 (LAD-1). Targeted next-generation sequencing was performed with either a primary immunodeficiency gene panel comprising 266 genes or a small LAD-panel consisting of five genes for genetic analysis. To measure the expression level of integrins on the leukocyte surface, flow cytometry analysis was performed. The median age of the patients at diagnosis was 3 (1–48) months. Eleven (73%) of the 15 patients had a LAD-1 diagnosis in their first 6 months and 14 (93%) patients had consanguineous parents. Delayed separation of the umbilical cord was present in 80% (n = 12) of the patients in our cohort, whereas omphalitis was observed in 53% (n = 8) of the patients. Leukocytosis with neutrophil predominance was observed in 73% (n = 11) patients. Nine distinct variants in the ITGB2 gene in 13 of the 15 patients with LAD-1 were characterized, two of which (c.305_306delAA and c.779_786dup) are novel homozygous mutations of ITGB2. Four unrelated patients from Syria had a novel c.305_306delAA mutation that might be a founder effect for patients of Syrian origin. Four (27%) patients underwent hematopoietic stem cell transplantation. Two patients died because of HSCT complications and the other two are alive and well. Early differential diagnosis of the patients is critical in the management of the disease and genetic evaluation provides a basis for family studies and genetic counseling.
Elective minimally invasive surgery for sigmoid diverticulitis: operative outcomes of patients with complicated versus uncomplicated disease
Authors: Mizrahi Ido , Abu‐Gazala Mahmoud , Fernandez Laura M. , Krizzuk Dimitri , Ioannidis Argyrios , Wexner Steven D.
Published: July 2021

Aim

The aim of this work was to compare the results of elective minimally invasive surgery between patients with complicated sigmoid diverticulitis and those with uncomplicated disease.

Method

An institutional review board‐approved database was searched for all consecutive patients who underwent elective minimally invasive surgery, including laparoscopic, hand‐assisted and robotic sigmoidectomy, for diverticulitis between 2010 and 2017; they were classified according to the modified Hinchey classification as having complicated (abscess, fistula, stricture, obstruction, bleeding or previous perforation) versus uncomplicated disease. Data recorded included baseline demographics, indications for surgery, operative details and complications.

Results

Three hundred and twenty‐five patients underwent elective sigmoidectomy for complicated (n = 105) and uncomplicated (n = 220) diverticulitis. Surgical indications for complicated disease were abscess (n = 74), stricture (n = 14), fistula (n = 28) and bleeding (n = 7). The two groups were statistically comparable for age, gender, body mass index and American Society of Anesthesiologists score. Patients with complicated disease had higher rates of concomitant loop ileostomy creation (9.5% vs. 0.9%, p < 0.001) and synchronous resections (9.5% vs. 2.7%, p = 0.01), higher volumes of blood loss (177 ± 140 vs. 125 ± 92 ml, p < 0.001), longer length of stay (5.6 ± 3 vs. 4.8 ± 2 days, p = 0.04) and longer operating time (218.2 ± 59 vs. 185.8 ± 63 min, p < 0.001). There were no significant differences in anastomotic leakage (3% vs. 1%, p = 0.3), conversion to laparotomy (4.8% vs. 2.3%, p = 0.3) or overall complications (36% vs. 25.9%, p = 0.06) for complicated versus uncomplicated disease, respectively.

Conclusion

Minimally invasive surgery for complicated diverticulitis resulted in higher rates of construction of proximal ileostomy and synchronous resections and longer operating times and length of hospital stay. Otherwise, it has outcomes that are not significantly different from the results recorded in patients with uncomplicated disease.
Ileorectal anastomosis in patients with Crohn’s disease. Postoperative complications and functional outcome—a systematic review
Authors: Bælum Jens Kristian , Qvist Niels , Ellebæk Mark Bremholm
Published: July 2021

Aim

The objective of this systematic review was to investigate the outcomes of ileorectal anastomosis (IRA) in Crohn’s disease and to clarify whether there are any time‐related trends in outcome measures. The primary outcomes are risk of anastomotic leakage, death, clinical recurrence and subsequent diverting or permanent stoma and/or proctectomy. Secondary end‐points are quality of life and functional outcome.

Methods

Systematic searches were conducted using the Cochrane Library, Embase and MEDLINE. The complete search strategy is uploaded online at http://www.crd.york.ac.uk/prospero/. Human studies in English with over five subjects were included and no limit was set regarding the date of publication. All relevant studies were screened by two reviewers. The web‐based software platform www.covidence.org was used for primary screening of the title, abstract, full‐text review and data extraction.

Results

The search identified 2231 unique articles. After the screening process, 37 remained.

Key results were an overall anastomotic leak rate of 6.4%; cumulative rates of clinical recurrence of 43% and 67% at 5 and 10 years, respectively; an overall rate of proctectomy of 18.9%; and subsequent ileostomy required in 18.8%. Only one study presented useful data on quality of life. Recurrence rates remained stable over time. A small decline in the anastomotic leak rate was found.

Conclusions

Only minor improvements in the outcomes of IRA in patients with Crohn´s disease have occurred during the past 50 years regarding anastomotic leakage and recurrence, except for a slight increase in the rate of a functioning IRA. These results call for implementation guidelines in patient selection for IRA and postoperative medical treatment and follow‐up.
The association between sleep quality, health status and disability due to breathlessness in chronic obstructive pulmonary disease patients
Authors: Ghalehbandi Mirfarhad , Khosravifar Shahrzad , Aloosh Oldooz , Rahimi‐Golkhandan Ania , Abounoori Mahdi , Aloosh Amirmohammad , Afshar Hale , Khosravifar Shaghayegh
Published: July 2021

Background

Chronic obstructive pulmonary disease (COPD) increases susceptibility to sleep disturbances. This study aimed to evaluate the association between COPD severity criteria with sleep quality.

Methods

One hundred fifty‐eight patients in Rasul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran, from April 2019 to March 2021 diagnosed with COPD were examined using the Pittsburgh Sleep Quality Index (PSQI), COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, spirometry and pulse oximetry.

Results

Of 158 subjects, 125 patients were male (79%), and 33 were female (21%). The mean subject's age and FEV1/FVC ratio were 62.6 ± 11.5 and 65.6 ± 14.9%, respectively. The mean CAT scoring and Spo2 saturation reported 16.2 ± 7 and 91.5 ± 10.8%, respectively. The mean PSQI score was 8.2 ± 3.8. The association between PSQI score with FEV1 and FEV1/FVC ratio was not statistically significant (p = 0.64 and 0.58, respectively), whereas the association between PSQI scores with CAT score (p ˂ 0.0001, r2 = 0.51) and dyspnoea severity (p ˂ 0.0001, r2 = 0.29) were statistically significant. The patients with higher CAT score demonstrated poor sleep quality, particularly in longer sleep latency (p = 0.001, r2 = 0.056), bad subjective sleep quality (p ˂ 0.0001, r2 = 0.286), lower sleep efficiency (p = 0.002, r2 = 0.077), higher sleep disturbance (p ˂ 0.0001, r2 = 0.225), daytime dysfunction (p ˂ 0.0001, r2 = 0.259) and sleep medication intake times a week (p = 0.01, r2 = 0.069). Dyspnoea severity was attributed to bad subjective sleep quality (p ˂ 0.0001, r2 = 0.069), higher sleep disturbances (p = 0.005, r2 = 0.08), and daytime dysfunction (p ˂ 0.0001, r2 = 0.108).

Conclusion

The PSQI has a significant association with the CAT and mMRC for COPD patients and is linked to the disease's severity.
Invasion disharmony in the global biogeography of native and non‐native beetle species
Authors: Liebhold Andrew M. , Turner Rebecca M. , Blake Rachael E. , Bertelsmeier Cleo , Brockerhoff Eckehard G. , Nahrung Helen F. , Pureswaran Deepa S. , Roques Alain , Seebens Hanno , Yamanaka Takehiko
Published: July 2021

Aim

The concept of “island disharmony” has been widely applied to describe the systematic over‐ and under‐representation of taxa on islands compared to mainland regions. Here, we explore an extension of that concept to biological invasions. We compare biogeographical patterns in native and non‐native beetle (Coleoptera) assemblages from around the world to test whether beetle invasions represent a random sample of species or whether some families are more prone to invade than others.

Location

Global.

Methods

Numbers of non‐native beetle species established in ten regions worldwide were compared with the land area of each region. The distribution of species among families was compared with the distribution among families for all species native to the same region and with the distribution among families for the global pool of all known beetle species. Ordination analysis was used to characterize differences among native and non‐native assemblages based upon the distribution of species among families.

Results

We report a total of 1,967 non‐native beetle species across all ten regions, and a classic log–log relationship between numbers of species per region and land area though relationships are generally stronger for native assemblages. Some families (e.g., Dermestidae and Bostrichidae) are over‐represented and others (e.g., Carabidae, Scarabaeidae and Buprestidae) are under‐represented in non‐native assemblages. The distribution of species among families is generally similar among native assemblages with greatest similarities among nearby regions. In contrast, non‐native species assemblages are more similar to each other than to native species assemblages.

Main conclusions

Certain families are over‐represented, and others are under‐represented in non‐native beetle assemblages compared to native assemblages, indicating “invasion disharmony” in the global representation of beetle families. Similarities in composition among non‐native assemblages may reflect unobserved associations with invasion pathways and life‐history traits that shape invasion success of different insect groups.
‘Building back better’ is neoliberal post‐disaster reconstruction
Authors: Cheek Wesley , Chmutina Ksenia
Published: July 2021

‘Building back better’ (BBB) has become one of the most common expressions in disaster risk reduction. Disasters offer an opportunity to encourage improvements not only in the structural safety of buildings and infrastructure, but also in addressing structural inequalities and injustice. Consequently, they are an opportunity to make things ‘better’. However, in the context of neoliberalism, the definition of ‘better’ does not always mean ‘good for all’. We argue here that BBB allows for widely varied definitions of what is and what is not a risk, who is and is not responsible, and what forms of action are to be taken in response to these dangers. This serves as a designation for capacity to make ‘better’, but not actively change, social and political systems that initially create risk. Disasters and its terminology, therefore, are not ideologically neutral and should thus be deliberately unpacked and critically evaluated rather than accepted unquestioned.
Physical rehabilitation interventions in children with acquired brain injury: a scoping review
Authors: Gmelig Meyling Christiaan , Verschuren Olaf , Rentinck Ingrid R , Engelbert Raoul H H , Gorter Jan Willem
Published: July 2021

Aim

To synthesize the evidence about the characteristics (frequency, intensity, time, type) and effects of physical rehabilitation interventions on functional recovery and performance in daily functioning in children and young people with acquired brain injury (ABI), including traumatic brain injuries (TBI) and non‐TBI, during the subacute rehabilitation phase.

Method

Using scoping review methodology, a systematic literature search was performed using four databases. Articles were screened by title and abstract and data from eligible studies were extracted for synthesis.

Results

Nine of 3009 studies were included. The results demonstrated a variety of intervention characteristics: frequency varied between 1 and 7 days per week; time of intervention varied between 25 minutes and 6 hours a day; intervention types were specified in seven studies; and none of the included studies reported details of intensity of intervention. All studies reported positive results on the International Classification of Functioning, Disability and Health: Children and Youth (ICF‐CY) levels of body function and activities after the intervention period, with study designs of included studies being cohort studies without concurrent controls (n=7) or case reports (n=2).

Interpretation

Inconsistency in results hampers generalizability to guide clinical practice. Physical interventions during subacute rehabilitation have potential to improve functional recovery with intervention characteristics as an important factor influencing its effectiveness. Future well‐designed studies are indicated to gain knowledge and optimize rehabilitation practice in paediatric ABI and high‐quality research including outcomes across all ICF‐CY domains is needed.
The evolving story of incretins (GIP and GLP‐1) in metabolic and cardiovascular disease: A pathophysiological update
Authors: Nauck Michael A. , Quast Daniel R. , Wefers Jakob , Pfeiffer Andreas F. H.
Published: July 2021

The incretin hormones glucose‐dependent insulinotropic polypeptide (GIP) and glucagon‐like peptide‐1 (GLP‐1) have their main physiological role in augmenting insulin secretion after their nutrient‐induced secretion from the gut. A functioning entero‐insular (gut‐endocrine pancreas) axis is essential for the maintenance of a normal glucose tolerance. This is exemplified by the incretin effect (greater insulin secretory response to oral as compared to “isoglycaemic” intravenous glucose administration due to the secretion and action of incretin hormones). GIP and GLP‐1 have additive effects on insulin secretion. Local production of GIP and/or GLP‐1 in islet α‐cells (instead of enteroendocrine K and L cells) has been observed, and its significance is still unclear. GLP‐1 suppresses, and GIP increases glucagon secretion, both in a glucose‐dependent manner. GIP plays a greater physiological role as an incretin. In type 2‐diabetic patients, the incretin effect is reduced despite more or less normal secretion of GIP and GLP‐1. While insulinotropic effects of GLP‐1 are only slightly impaired in type 2 diabetes, GIP has lost much of its acute insulinotropic activity in type 2 diabetes, for largely unknown reasons. Besides their role in glucose homoeostasis, the incretin hormones GIP and GLP‐1 have additional biological functions: GLP‐1 at pharmacological concentrations reduces appetite, food intake, and—in the long run—body weight, and a similar role is evolving for GIP, at least in animal studies. Human studies, however, do not confirm these findings. GIP, but not GLP‐1 increases triglyceride storage in white adipose tissue not only through stimulating insulin secretion, but also by interacting with regional blood vessels and GIP receptors. GIP, and to a lesser degree GLP‐1, play a role in bone remodelling. GLP‐1, but not GIP slows gastric emptying, which reduces post‐meal glycaemic increments. For both GIP and GLP‐1, beneficial effects on cardiovascular complications and neurodegenerative central nervous system (CNS) disorders have been observed, pointing to therapeutic potential over and above improving diabetes complications. The recent finding that GIP/GLP‐1 receptor co‐agonists like tirzepatide have superior efficacy compared to selective GLP‐1 receptor agonists with respect to glycaemic control as well as body weight has renewed interest in GIP, which previously was thought to be without any therapeutic potential. One focus of this research is into the long‐term interaction of GIP and GLP‐1 receptor signalling. A GLP‐1 receptor antagonist (exendin [9‐39]) and, more recently, a GIP receptor agonist (GIP [3‐30] NH2) and, hopefully, longer‐acting GIP receptor agonists for human use will be helpful tools to shed light on the open questions. A detailed knowledge of incretin physiology and pathophysiology will be a prerequisite for designing more effective incretin‐based diabetes drugs.
Chest pain and dyspnea in a young man
Authors: Ramakumar Venkatakrishnan , Farooqui Faraz Ahmed
Published: July 2021

A 27‐year‐old man presented with sudden onset chest pain associated with dyspnea for the preceding 1 week. He also reported typical angina for the past 3 months. Clinical examination revealed a continuous murmur in the upper left parasternal region. Echocardiography revealed a ruptured left sinus of Valsalva aneurysm communicating with the left atrium. CT angiogram confirmed a ruptured large aneurysm of the left sinus of Valsalva freely communicating with the left atrium via a long fistulous tract. Additionally, the tract resulted in partial compression of the left main coronary artery. A ruptured sinus of Valsalva aneurysm represents an important differential in young adults presenting with acute onset chest pain and heart failure. Fistulous tracts arising from the left sinus may result in compression of the left coronary system and sudden cardiac death making this a unique entity to recognize.
Is there an ‘ideal’ diet for patients with NAFLD?
Authors: Pugliese Nicola , Plaz Torres Maria Corina , Petta Salvatore , Valenti Luca , Giannini Edoardo G. , Aghemo Alessio
Published: July 2021

Nonalcoholic fatty liver disease (NAFLD) is a growing epidemic that encompasses three distinct clinical phenotypes: uncomplicated fatty liver, nonalcoholic steatohepatitis (NASH) and NASH‐related cirrhosis with its complications, including hepatocellular carcinoma. To date, no pharmacological treatments have been approved and lifestyle modifications including reduced caloric intake targeting a 7%‐10% weight loss from baseline assessment represent the standard approach. Mediterranean diet has been recommended as the best dietary pattern since it is easy to follow and, independently of caloric intake its nutritional components have beneficial metabolic effects that not only improve steatosis but also risk factors for cardiovascular events, the leading cause of morbidity/mortality in individuals with NAFLD. Other dietary patterns such as ketogenic diet and Dietary Approach to Stop Hypertension (DASH) diet can be used in patients with NAFLD. Recently, intermittent fasting diets have gained popularity among healthy individuals and have been proposed as a safe and effective treatment for the metabolic syndrome in experimental and in a few human studies. In this narrative review, we aim to summarize the evidence for the available dietary approaches for patients with NAFLD.