bluuebunny/crossref_metadata_2025 huggingface dataset:
Stillbirth and fetal anomalies: secondary analysis of a case–control study
Authors: Son SL , Allshouse AA , Page JM , Debbink MP , Pinar H , Reddy U , Gibbins KJ , Stoll BJ , Parker CB , Dudley DJ , Varner MW , Silver RM
Published: September 2020

Objective

Approximately 10% of stillbirths are attributed to fetal anomalies, but anomalies are also common in live births. We aimed to assess the relationship between anomalies, by system and stillbirth.

Design

Secondary analysis of a prospective, case–control study.

Setting

Multicentre, 59 hospitals in five regional catchment areas in the USA.

Population or sample

All stillbirths and representative live birth controls.

Methods

Standardised postmortem examinations performed in stillbirths, medical record abstraction for stillbirths and live births.

Main outcome measures

Incidence of major anomalies, by type, compared between stillbirths and live births with univariable and multivariable analyses using weighted analysis to account for study design and differential consent.

Results

Of 465 singleton stillbirths included, 23.4% had one or more major anomalies compared with 4.3% of 1871 live births. Having an anomaly increased the odds of stillbirth; an increasing number of anomalies was more highly associated with stillbirth. Regardless of organ system affected, the presence of an anomaly increased the odds of stillbirth. These relationships remained significant if stillbirths with known genetic abnormalities were excluded. After multivariable analyses, the adjusted odds ratio (aOR) of stillbirth for any anomaly was 4.33 (95% CI 2.80–6.70) and the systems most strongly associated with stillbirth were cystic hygroma (aOR 29.97, 95% CI 5.85–153.57), and thoracic (aOR16.18, 95% CI 4.30–60.94) and craniofacial (aOR 35.25, 95% CI 9.22–134.68) systems.

Conclusions

In pregnancies affected by anomalies, the odds of stillbirth are higher with increasing numbers of anomalies. Anomalies of nearly any organ system increased the odds of stillbirth even when adjusting for gestational age and maternal race.

Tweetable abstract

Stillbirth risk increases with anomalies of nearly any organ system and with number of anomalies seen.
Intravenous Alcohol Administration Selectively Decreases Rate of Change in Elasticity of Demand in Individuals With Alcohol Use Disorder
Authors: Nieto Steven J. , Green ReJoyce , MacKillop James , Ray Lara A.
Published: September 2020

Background

Alcohol demand is a key behavioral economic concept that provides an index of alcohol’s relative reinforcing value. Initial studies have reported that alcohol demand increases during alcohol administration and in response to alcohol cues. However, the extent to which these effects are observed explicitly in samples composed of individuals with alcohol use disorder (AUD) and are operative in conjunction with each other has not been studied.

Methods

To address this gap in the literature, we assessed alcohol demand during an alcohol challenge and subsequent alcohol cue‐exposure paradigm in non–treatment‐seeking, alcohol‐dependent (i.e., DSM‐IV criteria) participants (N = 27). Specifically, participants completed 2 counterbalanced intravenous, placebo‐controlled, alcohol administration sessions followed by a controlled cue‐exposure paradigm. At baseline and at breath alcohol concentration of 0.06 g/dl, participants completed the alcohol purchase task, assessing estimated alcohol consumption at escalating prices. Participants were also assessed for alcohol demand following each cue exposure.

Results

During alcohol administration, there was a significant decrease in the rate of change in elasticity compared with placebo, and during the cue‐reactivity paradigm, there was a significant main effect such that alcohol cues decreased the rate of change in elasticity relative to water cues. There were no statistically significant differences in other demand indices.

Conclusions

These findings provide further evidence that alcohol administration increases price insensitivity and extends the literature on alcohol’s effects on demand by using a clinical sample with AUD and by adding a placebo‐alcohol condition.
‘I Didn’t Know How to Be with My Husband’: State‐Religion Struggles over Sex Education in Israel and England
Authors: Taragin‐Zeller Lea , Kasstan Ben
Published: September 2020

Sex education presents a major dilemma for state‐minority relations, reflecting a conflict between basic rights to education and religious freedom. In this comparative ethnography of informal sex education among ultra‐Orthodox Jews (Haredim) in Israel and England, we frame the critical difference between “age‐appropriate” and “life‐stage” (marriage and childbirth) models of sex education. Conceptualizing these competing approaches as disputes over “knowledge responsibility,” we call for more context‐specific understandings of how educational responsibilities are envisioned in increasingly diverse populations.
Are muscle fibres of body builders intrinsically weaker? A comparison with single fibres of aged‐matched controls
Authors: Monti Elena , Toniolo Luana , Marcucci Lorenzo , Bondì Michela , Martellato Ivan , Šimunič Bostjan , Toninello Paolo , Franchi Martino V. , Narici Marco V. , Reggiani Carlo
Published: September 2020

Aim

Skeletal muscles of Body Builders (BB) represent an interesting model to study muscle mass gains in response to high volume resistance training. It is debated whether muscle contractile performance improves in proportion to mass. Here, we aim to assess whether muscle hypertrophy does not occur at the expense of performance.

Methods

Six BB and Six untrained controls (CTRL) were recruited. Cross‐sectional area (CSA) and maximum voluntary contraction (MVC) of quadriceps femoris muscle (QF) and CSA and architecture of vastus lateralis (VL) were determined. Moreover, a biopsy was taken from VL mid‐portion and single fibres were analysed.

Results

QF CSA and MVC were 32% (n.s., P = .052) and 58% (P = .009) higher in BB than in CTRL, respectively. VL CSA was 37% higher in BB (P = .030). Fast 2A fibres CSA was 24% (P = .048) greater in BB than in CTRL, when determined in immunostained sections of biopsy samples. Single permeabilized fast fibres CSA was 37% (n.s., P = .052) higher in BB than in CTRL, and their force was slightly higher in BB (n.s.), while specific tension (P0) was 19% (P = .024) lower. The lower P0 was not explained either by lower myosin content or by impaired calcium diffusion. Conversely, the swelling caused by skinning‐induced permeabilization was different and, when used to correct P0, differences between populations disappeared.

Conclusions

The results show that high degree of muscle hypertrophy is not detrimental for force generation capacity, as increases in fibre size and force are strictly proportional once the differential swelling response is accounted for.
The Arctic as a food producing region: Consumer perceptions and market segments
Authors: Yang Yang , Hobbs Jill E. , Natcher David C.
Published: September 2020

The Canadian Arctic is a unique food producing region. Much of the food produced in the Canadian Arctic has a strong tie with Indigenous cultures and communities, is produced or harvested in a pristine environment, and features species not commonly consumed in other parts of Canada. Building upon previous work and using data from a survey of Canadian consumers featuring a discrete choice experiment positioned around a seafood purchasing decision (Arctic Char), we use a latent class model to examine heterogeneity in consumer responses to Arctic food. We identify three groups (classes) of consumers who differ in the relative importance placed on geographic origin, Indigenous origin, wild harvested (vs. farmed), and certification for sustainability and authenticity. A class membership model explores the sociodemographic and psychographic characteristics differentiating consumers across these three groups, including food neophobia and consumers’ prior perceptions of the Arctic as a food producing region with respect to quality expectations, environmental and social impacts, Indigenous cultural origins, health, moral and price concerns. Our analysis sheds light onto Indigenous cultural origin as a novel type of credence attribute. We discuss implications for the Arctic food sector and for regional certification initiatives.
Factors associated with healing, reoperation and continence disturbance in patients following surgery for fistula‐in‐ano
Authors: Ng K.‐S. , Kwok A. M. F. , Young C. J.
Published: September 2020

Aim

Fistula‐in‐ano (FIA) is associated with high treatment costs and has a deleterious impact on quality of life. A wide range of healing, incontinence and recurrence rates have been reported. This study aimed to identify operative, patient and disease factors that influence these outcomes after surgery for FIA.

Method

An observational cohort study of consecutive patients who were managed for FIA at a tertiary colorectal practice (1999–2019) was performed. Outcome measures included healing, impaired continence and the need to reoperate. Clinico‐pathological variables, including patient comorbidities, fistula anatomy and operative approach, were assessed for their association with these outcomes.

Results

Some 411 procedures were performed on 263 patients [median age 41.8 years (range 17.8–79.7 years), 184 men (70.0%)]. Some 77.9% of patients achieved complete healing, 9.5% experienced some deterioration in continence postoperatively and 37.6% required reoperation at a median time of 19.0 weeks. Poorer healing was associated with Crohn’s disease, high trans‐sphincteric fistulas, extrasphincteric fistulas and steroid usage. Poorer continence was associated with female sex, age > 40 years, posterior location, suprasphincteric fistulas, seton insertion and having more than three subsequent procedures. The need to reoperate was associated with female sex, high trans‐sphincteric fistulas, suprasphincteric fistulas, inflammatory bowel disease and previous operations for FIA.

Conclusion

Minimizing recurrence of FIA and preservation of continence can be competing management goals. More than one in three patients require reoperation, one in five fails to heal completely and one in ten suffers worsened continence following surgery. Awareness of the factors that contribute to these outcomes is important to the process of informed consent and managing patient expectations before surgery.
Treatment with convalescent plasma in solid organ transplant recipients with COVID‐19: Experience at large transplant center in New York City
Authors: Rahman Farah , Liu Sean T. H. , Taimur Sarah , Jacobs Samantha , Sullivan Timothy , Dunn Dallas , Baneman Emily , Fuller Risa , Aberg Judith A. , Bouvier Nicole , Rana Meenakshi M.
Published: September 2020

Solid organ transplant (SOT) recipients may be at higher risk for poor outcomes with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Convalescent plasma is an investigational therapy that may benefit immunosuppressed patients by providing passive immunity. Convalescent plasma was administered to hospitalized patients with coronavirus disease‐2019 (COVID‐19) at an academic transplant center in New York City. Eligible patients were hospitalized and required to have positive nasopharyngeal polymerase chain reaction (PCR) diagnosis of SARS‐CoV‐2 infection, be at least 18 years old, and have either dyspnea, blood oxygen saturation ≤ 93% on ambient air, respiratory frequency ≥ 30 breaths/min, partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 300, or lung infiltrates > 50%. Thirteen SOT recipients received convalescent plasma from April 9, 2020, to May 17, 2020. The median time from symptom onset to plasma infusion was 8 days. Eight of 13 patients (62%) had de‐escalating oxygenation support by day 7 post‐convalescent plasma. Nine (69%) patients were discharged, 1 (7%) patients remain hospitalized, and 3 (23%) patients died. This series supports the need for additional studies on convalescent plasma use in SOT recipients with COVID‐19 to better determine efficacy and identify patients who are likely to benefit.
DNA Methylation‐Based Epigenetic Repression of SLC22A4 Promotes Resistance to Cytarabine in Acute Myeloid Leukemia
Authors: Buelow Daelynn R. , Anderson Jason T. , Pounds Stanley B. , Shi Lei , Lamba Jatinder K. , Hu Shuiying , Gibson Alice A. , Goodwin Emily A. , Sparreboom Alex , Baker Sharyn D.
Published: September 2020

Reduced expression of the uptake transporter, OCTN1 (SLC22A4), has been reported as a strong predictor of poor event‐free and overall survival in multiple cohorts of patients with acute myeloid leukemia (AML) receiving the cytidine nucleoside analog, cytarabine (Ara‐C). To further understand the mechanistic basis of interindividual variability in the functional expression of OCTN1 in AML, we hypothesized a mechanistic connection to DNA methylation‐based epigenetic repression of SLC22A4. We found increased basal SLC22A4 methylation was associated with decreased Ara‐C uptake in AML cell lines. Pre‐treatment with hypomethylating agents, 5‐azacytidine, or decitabine, restored SLC22A4 mRNA expression, increased cellular uptake of Ara‐C, and was associated with increased cellular sensitivity to Ara‐C compared with vehicle‐treated cells. Additionally, lower SLC22A4 methylation status was associated with distinct clinical advantages in both adult and pediatric patients with AML. These findings suggest a regulatory mechanism is involved in the interindividual variability in response to Ara‐C, and provides a basis for the integration of hypomethylating agents into Ara‐C‐based treatment regimens.
Unicuspid aortic valve in Turner syndrome, detected by 3D transoesophageal echocardiography: The usefulness of 3D echo in challenge diagnosis
Authors: D’Alfonso Maria Grazia , Oddo Andrea , Stefano Pieluigi , Mori Fabio
Published: September 2020

Turner syndrome is a genetic disorder associated with a variable range of cardiac congenital diseases. Out of these, unicuspid aortic valve is a rare malformation, related to premature aortic stenosis and its diagnosis represents a challenge with transthoracic echocardiography. The application of 3D echocardiography could facilitate the diagnosis, especially with transoesophageal approach. Moreover, cardiac computed tomography and cardiac magnetic resonance have demonstrated their usefulness for detection of aortic morphology. We report a case of young patient affected by Turner syndrome, with unicuspid aortic valve, identified by 3D transoesophageal echocardiography and confirmed by cardiac computed tomography. The patient was submitted to aortic valve replacement.
Fulminant vigabatrin toxicity during combination therapy with adrenocorticotropic hormone for infantile spasms: Three cases and review of the literature
Authors: Bhalla Sonam , Skjei Karen
Published: September 2020

Vigabatrin (VGB), adrenocorticotropic hormone (ACTH), and prednisone are first‐line treatments for infantile spasms (IS). A recent study reported benefits from the use of combination VGB and hormonal therapy over hormonal treatment alone in IS. We describe three patients with IS who developed acute encephalopathy with extrapyramidal symptoms, vigabatrin‐associated brain abnormalities on magnetic resonance imaging (VABAM), and death in one patient shortly after initiation of therapy with VGB and ACTH. A literature review supports increased risk of fulminant, symptomatic VABAM in patients receiving VGB in association with hormonal therapy, raising concerns regarding its safety in IS.
Effects of zonisamide monotherapy on bone health in drug‐naive epileptic patients
Authors: Koo Dae Lim , Nam Hyunwoo
Published: September 2020

Objective

Alteration of bone strength is an adverse effect of antiepileptic drug treatment. We investigated the effects of zonisamide (ZNS) monotherapy on bone mineral density (BMD) and biomarkers of bone metabolism after 13 months of treatment in drug‐naive epileptic patients.

Methods

Fifty‐nine patients with new onset drug‐naive epilepsy were enrolled (29 women, 30 men; mean age = 31.5 ± 11.5 years). The BMD and T scores were measured at the lumbar spine and femoral neck by using dual‐energy X‐ray absorptiometry. Biomarkers specific for bone metabolism (bone‐specific alkaline phosphatase, parathyroid hormone, osteocalcin, insulinlike growth factor‐1, C‐telopeptide, and vitamin D3 levels) were measured before and after long‐term ZNS monotherapy. Analysis of covariance (ANCOVA) was used to estimate BMD and biomarkers of bone metabolism before and after ZNS therapy. Age, sex, treatment duration, and ZNS dosage were included as covariates for adjustment in the ANCOVA model. Furthermore, subgroup analyses were performed for each sex, and the effect size was calculated.

Results

After 13 months of ZNS treatment, the BMD and T scores at the lumbar spine (L1‐L4 level) and femoral neck were not significantly different. Moreover, the biochemical markers showed no significant differences after ZNS monotherapy. Women showed significantly decreased baseline BMD at the femoral neck compared to men (P = .026), although the mean age and body mass index were not significantly different between the sexes. No significant changes in BMD or biomarkers of bone metabolism were seen in either sex after 13 months of ZNS treatment.

Significance

The results suggest that long‐term ZNS monotherapy does not affect bone health in drug‐naive patients with epilepsy negatively.
Geographies of care work: The commodification of care, digital care futures and alternative caring visions
Authors: Schwiter Karin , Steiner Jennifer
Published: September 2020

This article explores the growing interest in care within geography. Focusing on care as waged work, we trace current transformations through commodification and digitalisation. We discuss how the private household is turning into a precarious and feminised workplace for a growing number of workers, and we show how this development is promoted by the rise of labour agencies that facilitate the transnational recruitment of care workers. The literature on global care chains illustrates how the recruitment of migrant workers fills care deficits in destination countries while opening up care gaps in sending countries. We review this literature from economic geography and beyond and reflect on the continuing feminisation and devaluation of care labour. Based on these critical insights, we examine how processes of digitalisation contribute to reshaping care work. We discuss the ambivalent effects of digital technologies on care and argue that there is an urgent need to intensify our engagement with the processes and effects of digital transformations. In our conclusions, we call for strengthening the budding debate on alternative visions of caring within geography and point to avenues for future engagement.
Manuscripts are like vampires: Libraries and their uncertain histories on the island of Jerba, Tunisia
Authors: Love Paul M.
Published: September 2020

This article explores the methodological possibilities for using unverifiable, contradictory, or demonstrably false accounts of the past for historical research. Drawing from the methodological example of historical studies on accusations of vampirism in colonial East Africa, it presents histories of three Ibadi Muslim manuscript libraries on the island of Jerba, Tunisia. These stories contain contradictory or otherwise unverifiable elements, each of which raises methodological questions for its use as a historical source. The article argues that by drawing upon the methodological premise of these studies of vampires, historians can approach far more basic questions of historical research regarding chronology, contradictory evidence, and veracity.
Coordination challenges in implementing the three lines of defense model
Authors: Bantleon Ulrich , d'Arcy Anne , Eulerich Marc , Hucke Anja , Pedell Burkhard , Ratzinger‐Sakel Nicole V.S.
Published: September 2020

The three lines of defense model (TLoD) aims to provide a simple and effective way to improve coordination and enhance communications on risk management and control by clarifying the essential roles and duties of different governance functions. Without effective coordination of these governance functions, work can be duplicated or key risks may be missed or misjudged. To address these challenges, professional standards recommend that the chief audit executive (CAE) coordinates activities with other internal and external governance stakeholders (assurance providers). We consider survey responses from 415 CAEs from Austria, Germany, and Switzerland to analyze determinants that help to implement the TLoD without any challenges and to explore the extent of (coordination) challenges between the internal audit function and the respective governance stakeholders. Our results show a great variance in the extent of coordination challenges dependent on different determinants and the respective governance stakeholder.
Ocular manifestations of dermatological diseases part II: genodermatoses
Authors: Al Akrash Lamia S. , Al Semari Mohammad A. , Al Harithy Ruaa
Published: September 2020

Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations in dermatological diseases are common and have diagnostic value. At present, there are a limited number of comprehensive reviews emphasizing the ocular manifestations of dermatological diseases. More than 40 published articles about ocular findings in dermatology were reviewed. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including: I. infectious and inflammatory disorders; II. genodermatoses; III. connective tissue, autoimmune, neoplasms, and drug‐related disorders. We excluded metabolic, endocrine, and nutrition‐related dermatological diseases. In this part, we summarized the most common and important ocular findings in dermatology‐related genetic disorders with appropriate referral recommendations to ophthalmology.
Wolbachia affects reproduction in the spider mite Tetranychus truncatus (Acari: Tetranychidae) by regulating chorion protein S38‐like and Rop
Authors: Xia X. , Peng C.‐W. , Cui J.‐R. , Jin P.‐Y. , Yang K. , Hong X.‐Y.
Published: September 2020

Wolbachia‐induced reproductive regulation in hosts has been used to control pest populations, but little is known about the molecular mechanism underlying Wolbachia regulation of host genes. Here, reproductive regulation by Wolbachia in the spider mite Tetranychus truncatus was studied at the molecular level. Infection with Wolbachia resulted in decreasing oviposition and cytoplasmic incompatibility in T. truncatus. Further RNA‐seq revealed genes regulated by Wolbachia in T. truncatus. Real‐time quantitative polymerase chain reaction (qPCR) showed that genes, including chorion protein S38‐like and Rop were down‐regulated by Wolbachia. RNA interference (RNAi) of chorion protein S38‐like and Rop in Wolbachia‐uninfected T. truncatus decreased oviposition, which was consistent with Wolbachia‐induced oviposition decrease. Interestingly, suppressing Rop in Wolbachia‐infected T. truncatus led to increased Wolbachia titres in eggs; however, this did not occur after RNAi of chorion protein S38‐like. This is the first study to show that chorion protein S38‐like and Rop facilitate Wolbachia‐mediated changes in T. truncatus fertility. In addition, RNAi of Rop turned the body colour of Wolbachia‐uninfected T. truncatus black, which indicates that the role of Rop is not limited to the reproductive regulation of T. truncatus.
The practice doctorate approach to assessing advanced nursing practice in Ireland
Authors: Conrad Dianne , Burson Rosanne , Moran Katherine , Kesten Karen , Corrigan Catherine , Hussey Pamela , Pohl Elizabeth
Published: September 2020

Aim

To describe the practice doctorate scholarly approach to assess advanced nursing practice in Ireland to address healthcare and nursing policy initiatives.

Background

A global team from Ireland and the United States collaborated with stakeholders, using a practice doctorate approach to identify geographic healthcare needs, the current state of the education and the evolving roles of advanced nursing practice. In Ireland, current policy initiatives call for expanding the capacity for advanced nurse practitioners to meet healthcare needs in community settings.

Sources of Evidence

Further assessment data were required from stakeholders to inform graduate nursing education to prepare advanced practice nurses to fulfil increasingly complex healthcare needs. The practice doctorate approach included review of literature, current policy and assessment with interviews, dialogue and the development of working relationships with policymakers, academics and practitioners.

Discussion

The current state and future vision of graduate nursing education are evolving. A force field analysis identified promoting and restraining factors to the desired state of development of the primary care advanced practice role. Relationship building with stakeholders and sharing of expertise was key to engage academia and policymakers to address identified restraining forces. Short‐term outcomes included development of collaborative relationships between practice, academia and policymakers, curricular development for the primary care nurse practitioner and intentionally shared dissemination to promote community graduate nursing education.

Implications for Nursing Practice

This innovative practice scholarship approach was used to assess and promote advanced nursing practice impact and promote the nursing profession globally.

Implications for Policy

Successful collaboration between two global partners was achieved to promote policy objectives for both nursing and health care, with the ultimate goal of improving health outcomes and population health.
Multiple criteria assessment of sustainability programs in the textile industry
Authors: Lombardi Netto Antonio , Salomon Valerio A.P. , Ortiz‐Barrios Miguel A. , Florek‐Paszkowska Anna K. , Petrillo Antonella , De Oliveira Otavio J.
Published: September 2020

To survive in the long term, business needs to profit, controlling environmental impacts with social responsibility. Sustainability programs involve the integration of social and environmental issues in business models and organizational processes. The assessment of sustainability programs is a problem of multiple criteria decision analysis (MCDA). This work presents applications of MCDA for the assessment of sustainability programs in the textile industry. Applied methods for MCDA are analytic hierarchy process (AHP) and the technique for the order of preference by similarity to ideal solution (TOPSIS). The reasons to apply AHP and TOPSIS include providing an assessment index, ranging from 0 to 1, and that the MCDA model is expected to have more criteria than alternatives. Therefore, an application of other methods, such as data envelopment analysis, could be prejudiced. Concepts from the triple bottom line, economic, social as well as environmental criteria were inserted in the proposed model. Sustainability programs of six leading companies from the Brazilian textile industry were evaluated. The main finding of the research is that AHP and TOPSIS resulted in similar evaluations for sustainability programs. Both methods resulted in the same rank of alternatives. However, with TOPSIS, companies' sustainability indices were more disperse, varying from 0.10 to 0.92 against a range from 0.23 to 0.69 with AHP.
The Trust‐Based Communicative Obligations of Expert Authorities
Authors: Kelsall Joshua
Published: September 2020

This article analyses the extent to which expert authorities have basic communicative obligations to be open, honest, and transparent, with a view to shaping strategies of public engagement with such authorities. This article is in part a response to epistemic paternalists such as Stephen John, who argue that the communicative obligations of expert authorities, such as scientists, permit the use of lying, or lack of openness and transparency, as a means of sustaining public trust in scientific authority. In this article, I elucidate John’s position and reject it. I argue that expert authorities have strong communicative obligations to be open, honest, and transparent, which are grounded in the insight that such authorities hold positions of public trust. After demonstrating how this insight undermines John’s position, I conclude the article by considering the implications regarding public engagement with expert authorities.
Risk factors for falls among adults with intellectual disabilities: A narrative review
Authors: Pope John , Truesdale Maria , Brown Michael
Published: September 2020

Background

The prevalence of falls involving people with intellectual disabilities (ID) is high in comparison with the general population. There has been little evidence to date on the contributing risk factors. The objective of this review was to identify risk factors for people with intellectual disabilities.

Method

Literature searches were conducted using electronic databases to explore evidence on the subject, and narrative synthesis was employed to analyse the results.

Results

Seven risk factors were identified: decreasing physical ability, epilepsy, paretic conditions, impulsiveness, previous falls, incontinence and non‐use of assistive equipment. Thematic analysis identified factors across the four concepts: the person, the situation, ongoing and protective factors.

Conclusion

Factors for falls involving people with intellectual disabilities are dynamic and multifactorial. Some are specific to the population; however, further research is required to develop the understanding of the possible reasons. The findings have implications across policy, education, practice and research.
Regional drivers of diversification in the late Quaternary in a widely distributed generalist species, the common pheasant Phasianus colchicus
Authors: Liu Simin , Liu Yang , Jelen Edouard , Alibadian Mansour , Yao Cheng‐Te , Li Xintong , Kayvanfar Nasrin , Wang Yutao , Vahidi Farhad S. M. , Han Jian‐Lin , Sundev Gombobaatar , Zhang Zhengwang , Schweizer Manuel
Published: September 2020

Aim

Pleistocene climate and associated environmental changes have influenced phylogeographic patterns of many species. These not only depend on a species’ life history but also vary regionally. Consequently, populations of widespread species that occur in several biomes might display different evolutionary trajectories. We aimed to identify regional drivers of diversification in the common pheasant, a widely distributed ecological generalist.

Location

Asia.

Taxon

Common pheasant Phasianus colchicus.

Methods

Using a comprehensive geographical sampling of 204 individuals from the species’ entire range genotyped at seven nuclear and two mitochondrial loci, we reconstructed spatio‐temporal diversification and demographic history of the common pheasant. We applied Bayesian phylogenetic inference to describe phylogeographic structure, generated a species tree and inferred demographic history within and migration between lineages. Moreover, to establish a taxonomic framework, we conducted a species delimitation analysis.

Results

The common pheasant diversified during the Late Pleistocene into eight distinct lineages. It originated at the edge of the Qinghai–Tibetan plateau and spread to East and Central Asia. Only the widely distributed lowland lineage of East Asia displayed recent range expansion. Greater phylogeographic structure was identified elsewhere, with lineages showing no sign of recent demographic changes. One lineage in south‐central China is the result of long‐term isolation within a climatically stable but topographically complex region. In lineages from arid Central Asia and China, range expansions were impeded by repeated population fragmentation during dry glacial periods and by recent aridification.

Main conclusions

Spatio‐temporal phylogeographic frameworks of widespread taxa such as the common pheasant provide valuable opportunities to identify divergent drivers of regional diversification. Our results suggest that diversification and population histories in the eight distinct evolutionary lineages were shaped by regionally variable effects of past climate and associated environmental changes. The evolutionary history of the common pheasant is best reflected by its being split into three species.
Modified snare technique improves left ventricular lead implant success for cardiac resynchronization therapy
Authors: Marques Pedro , Nunes‐Ferreira Afonso , António Pedro S. , Aguiar‐Ricardo Inês , Lima da Silva Gustavo , Guimarães Tatiana , Bernardes Ana , Santos Igor , Pinto Fausto J. , de Sousa João
Published: September 2020

Background

Left ventricular (LV) lead placement is the most challenging aspect of cardiac resynchronization therapy (CRT) device implantation, with a failure rate of up to 10% due to complex coronary anatomies. We describe a modified snare technique for LV lead placement and evaluate its safety and efficacy in cases when standard methods fail.

Methods and Results

A prospective study was conducted of patients indicated for a CRT implant. When LV lead delivery to the target vessel failed using standard techniques, a modified snare technique was employed. Patients were evaluated every 6 months. From 2015 to 2019, 566 CRTs were implanted (26.1% female, 72 ± 10.2 years old, follow‐up duration 18.9 ± 15.8 months). The standard LV implant technique failed in 94 cases (16.6%), of which the modified snare technique was successful in 92 (97.9%). There were no differences between the modified snare and standard techniques in the rates of 30‐day postimplant CRT all‐cause mortality (3.2% vs. 1.7%, p = .33), 4‐year all‐cause mortality (15.9% vs. 15.5%, p = .49), or major acute complications (7.4% vs. 3.8%, p = .12). However, the 4‐year procedural reintervention rate was lower with the modified snare technique (3.2% vs. 10.2%, p < .05), specifically LV implant failure or dislodgement rates (0% vs. 5.3%, p < .05), improving the response rate (71.8% vs. 55.1%, p < .05).

Conclusions

For challenging coronary sinus anatomies that preclude LV lead placement by standard methods, this modified snare alternative was safe and effective, with comparable mortality and complications, but significantly lower procedural reintervention and higher response rates.
Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials
Authors: Bieber T. , Thyssen J.P. , Reich K. , Simpson E.L. , Katoh N. , Torrelo A. , De Bruin‐Weller M. , Thaci D. , Bissonnette R. , Gooderham M. , Weisman J. , Nunes F. , Brinker D. , Issa M. , Holzwarth K. , Gamalo M. , Riedl E. , Janes J.
Published: September 2020

Background

Janus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late‐stage development for adult patients with moderate‐to‐severe AD.

Objective

To report pooled safety data for baricitinib in patients with moderate‐to‐severe AD in the clinical development program including long‐term extension (LTE) studies.

Methods

This analysis included patient‐level safety data from six double‐blinded, randomized, placebo‐controlled studies (one phase 2 and five phase 3), one double‐blinded, randomized, LTE study and one open‐label LTE study, reported in three data sets: placebo‐controlled, 2‐mg – 4‐mg extended and All‐bari AD. Safety outcomes include treatment‐emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated.

Results

Data were collected for 2531 patients who were given baricitinib for 2247 patient‐years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo‐controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo‐controlled period in baricitinib‐treated patients. Frequency of herpes simplex was higher in the 4‐mg group (6.1%) vs. the 2‐mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2‐mg IR = 9.6; 4‐mg IR = 14.5) were lower vs. the placebo‐controlled data set (2‐mg IR = 12.4; 4‐mg IR = 21.3). In the All‐bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2‐mg group): two venous thrombosis events (4‐mg group) and one death.

Conclusion

This integrated safety analysis in patients with moderate‐to‐severe AD confirms the established safety profile of baricitinib.
Secure and precise insertion of minimally invasive resin‐bonded fixed dental prostheses after ridge augmentation by means of a positioning splint
Authors: Yazigi Christine , Elsayed Adham , Kern Matthias
Published: September 2020

Objective

Single‐retainer resin‐bonded fixed dental prostheses (RBFDPs) are described as an excellent minimally invasive treatment modality for the replacement of a single missing incisor even in cases of congenitally missing teeth that are often associated with hard and soft tissue defects that need to be properly managed to optimize the esthetic outcome. The lack of a retentive form due to the minimally invasive preparation form makes the adhesive bonding procedure for RBFDPs relatively technique‐sensitive and might discourage practitioners from offering this treatment modality.

Clinical considerations

A patient with both maxillary lateral incisors congenitally missing was assessed for eligibility for treatment with RBFDPs. Bilateral horizontal ridge defects were present and treated through ridge augmentation to ensure an ovate pontic design and enhance the esthetic outcome. A minimally invasive preparation within enamel was conducted; the restorations were digitally designed and milled out of (3Y‐TZP) zirconia ceramic with labial veneering with feldspathic ceramic for enhanced esthetics. An improved design of positioning splints was used for the adhesive bonding procedure to ensure exact, secure, and flawless insertion of the restorations.

Conclusions

RBFDPs offer a highly esthetic treatment modality for missing teeth in the anterior area. Tissue defects could be overcome be means of a minor oral surgery, while using improved positioning splints might ensure flawless adhesive bonding and promote the usage of RBFDPs.

Clinical Significance

Hard and soft tissue defects can be remarkably optimized through a minor ridge augmentation. Improved positioning splints allow an easy and secure positioning as well as visual inspection of the seating in end‐position and complete removal of resin cement excess. Implementing the concept of insertion splints might promote RBFDPs for anterior tooth replacement as it helps preventing bonding errors.
Nurse's difficulty and their educational needs regarding pediatric cancer care in Japan
Authors: Yoshitsugu Mayu , Sobue Ikuko
Published: September 2020

Aim

Aiming at environmental arrangements for pediatric cancer patients and their families to receive appropriate medical care and support with a sense of security, the Japanese Ministry of Health, Labour, and Welfare designated 15 hub hospitals for childhood cancer. These hub hospitals have established networks with approximately 200 centers/hospitals treating pediatric cancer. In order to promote equal access to nursing, we investigated nurses' difficulties and needs at these treatment hospitals with limited experience in pediatric cancer nursing.

Methods

In order to examine education on pediatric cancer nursing, we investigated difficulties felt by treatment hospital nurses, their educational experience and their educational needs. A total of 584 nurses (66.51%) from 52 hospitals from which written consent was received completed the questionnaires.

Results

Nurses had difficulties regarding nursing care for patients with critical conditions, such as terminal care, and actions to be taken when a patient's physical condition rapidly changes. Nurses most strongly desired education on nursing care for patients with serious problems, such as terminal care, and follow‐up provided in the form of in‐ and hub‐hospital lectures.

Conclusion

Our study suggested that in order to provide nurses in treatment hospitals with education focusing on nursing care for patients with serious problems, education systems based on cooperation between hub and treatment hospitals are needed.
Exploring the factors underlying remyelination arrest by studying the post‐transcriptional regulatory mechanisms of cystatin F gene
Authors: Li Jiayi , Durose Wilaiwan Wisessmith , Ito Junko , Kakita Akiyoshi , Iguchi Yohei , Katsuno Masahisa , Kunisawa Kazuo , Shimizu Takeshi , Ikenaka Kazuhiro
Published: September 2020

Remyelination plays an important role in determining the fate of demyelinating disorders. However, it is arrested during chronic disease states. Cystatin F, a papain‐like lysosomal cysteine proteinase inhibitor, is a crucial regulator of demyelination and remyelination. Using hemizygous proteolipid protein transgenic 4e (PLP4e/‐) mice, an animal model of chronic demyelination, we found that cystatin F mRNA expression was induced at 2.5 months of age and up‐regulated in the early phase of demyelination, but significantly decreased in the chronic phase. We next investigated cystatin F regulatory factors as potential mechanisms of remyelination arrest in chronic demyelinating disorders. We used the CysF‐STOP‐tetO::Iba‐mtTA mouse model, in which cystatin F gene expression is driven by the tetracycline operator. Interestingly, we found that forced cystatin F mRNA over‐expression was eventually decreased. Our findings show that cystatin F expression is modulated post‐transcriptionally. We next identified embryonic lethal, abnormal vision, drosophila like RNA‐binding protein 1 (ELAVL‐1), and miR29a as cystatin F mRNA stabilizing and destabilizing factors, respectively. These roles were confirmed in vitro in NIH3T3 cells. Using postmortem plaque samples from human multiple sclerosis patients, we also confirmed that ELAVL‐1 expression was highly correlated with the previously reported expression pattern of cystatin F. These data indicate the important roles of ELAVL‐1 and miR29a in regulating cystatin F expression. Furthermore, they provide new insights into potential therapeutic targets for demyelinating disorders.

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Italian Nurses’ Attitudes Towards Neonatal Palliative Care: A Cross‐Sectional Survey
Authors: Cerratti Francesca , Tomietto Marco , Della Pelle Carlo , Kain Victoria , Di Giovanni Pamela , Rasero Laura , Cicolini Giancarlo
Published: September 2020

Purpose

Neonatal palliative care becomes an option for critically ill neonates when death is inevitable. Assessing nurses’ attitudes towards, barriers to, and facilitators of neonatal palliative care is essential to delivering effective nursing care.

Methods

This study was conducted from January to September 2015 and involved Italian nurses employed in Level III neonatal intensive care units in 14 hospitals in northern, central, and southern Italy. A modified version of the Neonatal Palliative Care Attitudes Scale (NiPCAS) was adopted to assess nurses’ attitudes.

Findings

A total of 347 neonatal nurses filled out the questionnaire. The majority were female (87.6%), with a mean age of 40.38 (±8.3) years. The mean score in the “organization” factor was 2.71 (±0.96). The “resources” factor had a mean score of 2.44 (±1.00), while the “clinician” factor had a mean score of 3.36 (±0.90), indicating the main barriers to and facilitators of implementing palliative nursing care.

Conclusions

Italian neonatal nurses may face different obstacles to delivering neonatal palliative care and to improve their attitudes in this field. In the Italian context, no facilitators of, only barriers to, palliative care delivery were identified.

Clinical Relevance

Nurses’ attitudes towards neonatal palliative care are essential to supporting nurses, who are constantly exposed to the emotional and moral distress connected with this field of end‐of‐life nursing care.
Exosomal microRNA‐139‐5p from mesenchymal stem cells accelerates trophoblast cell invasion and migration by motivation of the ERK/MMP‐2 pathway via downregulation of protein tyrosine phosphatase
Authors: Liu Huijie , Wang Fang , Zhang Ying , Xing Yanling , Wang Qian
Published: September 2020

Aim

Exosomes present essential roles for intercellular interaction via extracellular pathways during systemic dysfunctions, including preeclampsia (PE). Here, we assessed the specific mechanism of mesenchymal stem cells (MSC)‐originated exosomes in PE.

Methods

The effects of exosomes on trophoblasts were studied by EdU, wound healing, Transwell and TUNEL assays. By microarray analysis, we found that exosomes enhanced the microRNA‐139‐5p (miR‐139‐5p) in trophoblasts, and confirmed the target gene of miR‐139‐5p by bioinformatics prediction and dual‐luciferase reporter gene assay. At the same time, ERK/MMP‐2 pathway‐related biomolecules were assessed through Western blot analysis. The pathway inhibitor was used for rescue experiments. Finally, the effect of exosomes on the pathology of PE rats was verified by in vivo experiments.

Results

The exosomes originated from hucMSC fostered the trophoblast cell migration, invasion and proliferation and obstructed apoptosis. Moreover, miR‐139‐5p could be transmitted to trophoblasts through hucMSC‐secreted exosomes. miR‐139‐5p targeted protein tyrosine phosphatase (PTEN), which regulated the ERK/MMP‐2 pathway. Inhibition of the ERK/MMP‐2 pathway significantly reduced the promoting effect of exosomes on trophoblasts. Treatment with exosomes significantly lowered blood pressure values and reduced 24‐h proteinuria in PE rats.

Conclusion

hucMSC‐originated exosomes overexpressing miR‐139‐5p activated the ERK/MMP‐2 pathway via PTEN downregulation, thus accelerating trophoblast cell invasion and migration, and blocking apoptosis. These results demonstrated that hucMSC‐derived exosomes overexpressing miR‐139‐5p might be an innovative direction for therapeutic approaches against PE.
Systemic amyloidosis from A (AA) to T (ATTR): a review
Authors: Muchtar E. , Dispenzieri A. , Magen H. , Grogan M. , Mauermann M. , McPhail E. D. , Kurtin P. J. , Leung N. , Buadi F. K. , Dingli D. , Kumar S. K. , Gertz M. A.
Published: September 2020

Systemic amyloidosis is a rare protein misfolding and deposition disorder leading to progressive organ failure. There are over 15 types of systemic amyloidosis, each caused by a different precursor protein which promotes amyloid formation and tissue deposition. Amyloidosis can be acquired or hereditary and can affect various organs, including the heart, kidneys, liver, nerves, gastrointestinal tract, lungs, muscles, skin and soft tissues. Symptoms are usually insidious and nonspecific resulting in diagnostic delay. The field of amyloidosis has seen significant improvements over the past decade in diagnostic accuracy, prognosis prediction and management. The advent of mass spectrometry‐based shotgun proteomics has revolutionized amyloid typing and has led to the discovery of new amyloid types. Accurate typing of the precursor protein is of paramount importance as the type dictates a specific management approach. In this article, we review each type of systemic amyloidosis to provide the practitioner with practical tools to improve diagnosis and management of these rare disorders.