bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey on the Analysis of User Interactions and Visualization Provenance
Authors: Xu Kai , Ottley Alvitta , Walchshofer Conny , Streit Marc , Chang Remco , Wenskovitch John
Published: July 2020

There is fast‐growing literature on provenance‐related research, covering aspects such as its theoretical framework, use cases, and techniques for capturing, visualizing, and analyzing provenance data. As a result, there is an increasing need to identify and taxonomize the existing scholarship. Such an organization of the research landscape will provide a complete picture of the current state of inquiry and identify knowledge gaps or possible avenues for further investigation. In this STAR, we aim to produce a comprehensive survey of work in the data visualization and visual analytics field that focus on the analysis of user interaction and provenance data. We structure our survey around three primary questions: (1) WHY analyze provenance data, (2) WHAT provenance data to encode and how to encode it, and (3) HOW to analyze provenance data. A concluding discussion provides evidence‐based guidelines and highlights concrete opportunities for future development in this emerging area. The survey and papers discussed can be explored online interactively at https://provenance-survey.caleydo.org.
State of the Art in Time‐Dependent Flow Topology: Interpreting Physical Meaningfulness Through Mathematical Properties
Authors: Bujack Roxana , Yan Lin , Hotz Ingrid , Garth Christoph , Wang Bei
Published: July 2020

We present a state‐of‐the‐art report on time‐dependent flow topology. We survey representative papers in visualization and provide a taxonomy of existing approaches that generalize flow topology from time‐independent to time‐dependent settings. The approaches are classified based upon four categories: tracking of steady topology, reference frame adaption, pathline classification or clustering, and generalization of critical points. Our unique contributions include introducing a set of desirable mathematical properties to interpret physical meaningfulness for time‐dependent flow visualization, inferring mathematical properties associated with selective research papers, and utilizing such properties for classification. The five most important properties identified in the existing literature include coincidence with the steady case, induction of a partition within the domain, Lagrangian invariance, objectivity, and Galilean invariance.
Practical Product Sampling by Fitting and Composing Warps
Authors: Hart D. , Pharr M. , Müller T. , Lopes W. , McGuire M. , Shirley P.
Published: July 2020

We introduce a Monte Carlo importance sampling method for integrands composed of products and show its application to rendering where direct sampling of the product is often difficult. Our method is based on warp functions that operate on the primary samples in [0,1)n, where each warp approximates sampling a single factor of the product distribution. Our key insight is that individual factors are often well‐behaved and inexpensive to fit and sample in primary sample space, which leads to a practical, efficient sampling algorithm. Our sampling approach is unbiased, easy to implement, and compatible with multiple importance sampling. We show the results of applying our warps to projected solid angle sampling of spherical triangles, to sampling bilinear patch light sources, and to sampling glossy BSDFs and area light sources, with efficiency improvements of over 1.6× on real‐world scenes.
A randomized controlled study comparing guided bone regeneration with connective tissue graft to reestablish buccal convexity at implant sites: A 1‐year volumetric analysis
Authors: De Bruyckere Thomas , Cabeza Ricardo Garcia , Eghbali Aryan , Younes Faris , Cleymaet Roberto , Cosyn Jan
Published: July 2020

Objectives

To volumetrically compare guided bone regeneration (GBR) with connective tissue graft (CTG) to reestablish convexity at the buccal aspect of single implants.

Materials and methods

Patients with a single tooth gap in the anterior maxilla and horizontal alveolar defect were enrolled in a single‐blind randomized clinical trial (RCT). All sites had a buccopalatal bone dimension of at least 6 mm, received a single implant, and were randomly allocated to the control (GBR) or test group (CTG) to reestablish buccal soft tissue convexity. Patients received a provisional crown at 3 months and a permanent crown at 6 months. Primary outcomes were volumetric increase (mm3) and linear increase (mm) in buccal soft tissue profile (BSP) within a well‐defined area of interest at fixed time points. Alveolar process deficiency was a secondary outcome.

Results

Twenty‐one patients were included per group (control: 11 females, mean age 51; test: 9 females, mean age 48). After 1 year, GBR resulted in a significant volumetric increase of 20.74 mm3(P< .001) corresponding to linear increase in BSP of 1.30 mm (P< .001). For CTG, this was 15.86 (P< .001) and 1.19 mm (P< .001), respectively. The changes over time in volume (P= .173) and BSP (P= .241) were not significantly different between the groups. Twenty‐nine percentage and 26% of the final volumetric increase was the result of installing and altering prosthetic components in the control and test groups, respectively. Alveolar process deficiency significantly reduced from pre‐op to 1 year following GBR (P< .001) and CTG (P< .001). The difference between the groups was not significant (P= .342). However, 58% of the patients treated with GBR and 38% treated with CTG failed to show perfect soft tissue convexity at the buccal aspect.

Conclusion

GBR as well as CTG are effective in reducing horizontal alveolar defects for aesthetic purposes. However, in about half of the cases, either strategy failed to optimally reestablish buccal convexity.
Convergence of stakeholders’ environmental threat perceptions following mass coral bleaching of the Great Barrier Reef
Authors: Thiault Lauric , Curnock Matthew I. , Gurney Georgina G. , Heron Scott F. , Marshall Nadine A. , Bohensky Erin , Nakamura Nao , Pert Petina L. , Claudet Joachim
Published: July 2020

Managing human use of ecosystems in an era of rapid environmental change requires an understanding of diverse stakeholders’ behaviors and perceptions to enable effective prioritization of actions to mitigate multiple threats. Specifically, research examining how threat perceptions are shared or diverge among stakeholder groups and how these can evolve through time is increasingly important. We investigated environmental threat perceptions related to Australia's Great Barrier Reef and explored their associations before and after consecutive years of mass coral bleaching. We used data from surveys of commercial fishers, tourism operators, and coastal residents (n = 5254) conducted in 2013 and 2017. Threats perceived as most serious differed substantially among groups before bleaching but were strongly aligned after bleaching. Climate change became the most frequently reported threat by all stakeholder groups following the coral bleaching events, and perceptions of fishing and poor water quality as threats also ranked high. Within each of the 3 stakeholder groups, fishers, tourism operators, and coastal residents, the prioritization of these 3 threats tended to diverge in 2013, but convergence occurred after bleaching. These results indicate an emergence of areas of agreement both within and across stakeholder groups. Changes in perceptions were likely influenced by high‐profile environmental‐disturbance events and media representations of threats. Our results provide insights into the plasticity of environmental‐threat perceptions and highlight how their convergence in response to major events may create new opportunities for strategic public engagement and increasing support for management.
An audit of cytopathology in the oral and maxillofacial region: 18 years of experience
Authors: Pérez‐de‐Oliveira Maria Eduarda , Petersen Wagner Vivian , do Amaral‐Silva Gleyson Kleber , Almeida Leite Amanda , Ajudarte Lopes Márcio , Santos‐Silva Alan Roger , Jorge Júnior Jacks , de Almeida Oslei Paes , Agustin Vargas Pablo
Published: July 2020

Introduction

The aim of this study was to perform an audit of oral and maxillofacial specimens submitted for cytological diagnosis to verify the importance of this complementary examination.

Methods

A retrospective analysis of our institutional cytopathology database was performed over an 18‐year period. Clinical information and cytological data were collected. Associations between independent variables and outcomes were assessed using the Pearson χ2 test or Fisher's test, with a 5% significance level. When available, the histological diagnosis was compared with cytological diagnosis to identify the percentage of agreement and the specificity, sensitivity and accuracy of cytology in identifying malignant neoplasms.

Results

A total of 1082 cases were identified, which included 65 different cytological diagnoses. Exfoliative cytology (EC) was performed in 312 cases (29.1%) and fine needle aspiration cytology (FNAC) in 770 cases (70.9%). EC was mainly employed to diagnose oral infectious diseases (P < 0.001) and FNAC to diagnose neoplasms, cystic, reactive and miscellaneous lesions (P < 0.001). Cell‐block was performed in 555 FNAC cases (51.3%). Panoptic, Papanicolaou and haematoxylin‐eosin staining were performed in FNAC and periodic acid‐Schiff in EC (P < 0.001). In 211 cases (19.5%), the histological diagnosis was available and the percentage agreement with the cytological diagnosis was 41.2%. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to identify malignant neoplasms were 84.6%, 100%, 100%, 77.8% and 90.0%, respectively.

Conclusions

EC was mainly performed for diagnosis of infectious diseases and FNAC for diagnosis of salivary gland tumours, odontogenic lesions, reactive lesions and cervical metastasis.
Noxa upregulation and 5‐gene apoptotic biomarker panel in colorectal cancer
Authors: Kosmidou Vivian , Vlassi Margarita , Anagiotos Kyriakos , Raftopoulou Sofia , Kalogerakou Eirini , Skarmalioraki Salomi , Aggeli Chrysanthi , Choreftaki Theodosia , Zografos George , Pintzas Alexander
Published: July 2020

Background

NOXA and MCL1 are involved in the intrinsic pathway of apoptosis, where Noxa selectively binds to MCL1 and prevents it from inhibiting apoptosis. Both factors are considered as potential tumour biomarkers, while MCL1 has attracted interest as target in cancer. The purpose of this study was to investigate the expression of NOXA and MCL1 in 160 CRC tumour samples, to investigate their significance, also in combination with IAPs, DR5 expression and KRAS gene mutations in CRC.

Materials and methods

Fresh frozen colorectal tissue was obtained from patients undergoing surgery for CRC. Real‐time quantitative PCR was performed for the determination of mRNA expression levels. Protein expression was determined immunohistochemically. Differences in the mRNA expression profile were evaluated with the nonparametric Wilcoxon signed ranks test. Statistical analysis was performed with the use of Mann‐Whitney U test and receiver‐operating characteristic (ROC) curve.

Results

NOXA was found to be overexpressed in CRC tumours (P < .0001), even from early stage. Moreover, NOXA/MCL1 mRNA expression was significantly elevated in tumour samples compared to normal pairs (P < .0001). ROC curve analysis showed that both NOXA expression and its combination with Mcl1 expression have fair discriminatory value between CRC and normal colorectal tissue. Combinatorial ROC analysis revealed the most significant discriminatory value of NOXA, MCL1 with cIAP1 and cIAP2 (AUC = 0.834, P < .0001) as a 5‐gene panel of markers.

Conclusion

Noxa, Mcl1, DR5, cIAP1 and cIAP2 mRNA expressions are significantly deregulated in CRC and could provide a panel of markers with significant discriminatory value between CRC and normal colorectal tissue.
Community clinic and emergency department physicians' adherence to acute pharyngitis antibiotic treatment guidelines
Authors: Levi Esther , Ronen Ohad
Published: July 2020

Background

Antibiotic treatment guidelines for common infectious diseases enable proper diagnosis and treatment and avoid unnecessary antibiotic treatment, preventing both financial expenditure and antimicrobial resistance to antibiotics.

Methods

The aim of our study was to investigate whether community physicians referring patients to the medical centre and whether emergency department (ED) physicians diagnose and treat acute pharyngitis according to these guidelines. We conducted a retrospective study. Data were collected on 99 patients admitted with the diagnosis of acute pharyngitis. The patients were admitted to the medical centre between 2015 and 2014. The physicians' adherence to antibiotic guidelines for indication, type and duration of treatment for acute pharyngitis was examined.

Results

The adherence of community physicians regarding the indication for antibiotic treatment was low (16%). The adherence of community and ED physicians regarding the type of treatment was high (96% and 99%, respectively). The adherence of ED physicians regarding the duration of treatment was higher than the adherence among community physicians (58% and 13.3%, respectively, Wilcoxon signed‐rank test, P < .001). Interns tended to adhere to the guidelines more than seniors (36.4% versus 12.0%, respectively, Fisher's exact test, P = .07).

Conclusions

There is a lack of compliance with the guidelines among community physicians regarding the diagnosis and antibiotic treatment of acute pharyngitis, which is characterized by excessive antibiotic treatment. Therefore, ways to increase awareness and adherence to clinical guidelines, and to allow the conditions in the clinics to fulfil the guidelines should be investigated.
Extent of polymorphism and selection pressure on the Trypanosoma cruzi vaccine candidate antigen Tc24
Authors: Arnal Audrey , Villanueva‐Lizama Liliana , Teh‐Poot Christian , Herrera Claudia , Dumonteil Eric
Published: July 2020

Introduction

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major public health problem in the Americas, and existing drugs have severe limitations. In this context, a vaccine would be an attractive alternative for disease control. One of the difficulties in developing an effective vaccine lies in the high genetic diversity of T. cruzi. In this study, we evaluated the level of sequence diversity of the leading vaccine candidate Tc24 in multiple parasite strains.

Methods and Results

We quantified its level of polymorphism within and between T. cruzi discrete typing units (DTUs) and how this potential polymorphism is structured by different selective pressures. We observed a low level of polymorphism of Tc24 protein, weakly associated with parasite DTUs, but not with the geographic origin of the strains. In particular, Tc24 was under strong purifying selection pressure and predicted CD8+ T‐cell epitopes were mostly conserved. Tc24 strong conservation may be associated with structural/functional constrains to preserve EF hand domains and their calcium‐binding loops, and Tc24 is likely important for the parasite fitness.

Discussion

Together, these results show that a vaccine based on Tc24 is likely to be effective against a wide diversity of parasite strains across the American continent, and further development of this vaccine candidate should be a high priority.
Treatment options and long‐term outcomes of horses with subchondral lucencies of the medial femoral condyle
Authors: Santschi E. M.
Published: July 2020

Subchondral lucencies (SCL) occur in the equine medial femoral condyle (MFC) and can cause lameness and impair performance. Treatment of MFC SCL has evolved over the last 40 years from rest alone to cyst injection to several surgical procedures. Horses most commonly develop MFC SCL in the first 18 months of life, and expectations for performance and sales can impact therapeutic decisions. These complications mean that a single treatment plan cannot be applied to every SCL. An additional issue is accurate long‐term performance data. Long‐term follow‐up can also be difficult to obtain due to horse movement, confidentiality issues after sales, and the complexities of finding new owners and getting their cooperation. This short communication reviews available racing information from publications reporting treatment of MFC SCL and provides long‐term follow‐up racing data on 13 horses treated with a transcondylar screw. Horses receiving a transcondylar screw raced as well as horses treated with other procedures and had longer careers, further supporting the use of this technique in the treatment of MFC SCL.
Hair follicle immune privilege and its collapse in alopecia areata
Authors: Bertolini Marta , McElwee Kevin , Gilhar Amos , Bulfone‐Paus Silvia , Paus Ralf
Published: July 2020

Anagen stage hair follicles (HFs) exhibit “immune privilege (IP)” from the level of the bulge downwards to the bulb. Both passive and active IP mechanisms protect HFs from physiologically undesired immune responses and limit immune surveillance. IP is relative, not absolute, and is primarily based on absent, or greatly reduced, intra‐follicular antigen presentation via MHC class I and II molecules, along with prominent expression of “no danger” signals like CD200 and the creation of an immunoinhibitory signalling milieu generated by the secretory activities of HFs. Perifollicular mast cells, Tregs and other immunocytes may also contribute to HF IP maintenance in healthy human skin. Collapse of anagen hair bulb IP is an essential prerequisite for the development of alopecia areata (AA). In AA, lesional HFs are rapidly infiltrated by NKG2D + T cells and natural killer (NK) cells, while perifollicular mast cells acquire a profoundly pro‐inflammatory phenotype and interact with autoreactive CD8+ T cells. Using animal models, significant functional evidence has accumulated that demonstrates the dominance of the immune system in AA pathogenesis. Purified CD8+T‐cell and NK cell populations alone, which secrete fγ, suffice to induce the AA phenotype, while CD4+T‐cells aggravate it, and Tregs and iNKT cells may provide relative protection against AA development. While IP collapse may be induced by exogenous agents, inherent IP deficiencies might confer increased susceptibility to AA for some individuals. Thus, a key goal for effective AA management is the re‐establishment of a functional HF IP, which will also provide superior protection from disease relapse.
Topical L‐thyroxine: The Cinderella among hormones waiting to dance on the floor of dermatological therapy?
Authors: Paus Ralf , Ramot Yuval , Kirsner Robert S. , Tomic‐Canic Marjana
Published: July 2020

Topical hormone therapy with natural or synthetic ligands of nuclear hormone receptors such as glucocorticoids, vitamin D analogues and retinoids has a long and highly successful tradition in dermatology. Yet the dermatological potential of thyroid hormone receptor (TR) agonists has been widely ignored, despite abundant clinical, cell and molecular biology, mouse in vivo, and human skin and hair follicle organ culture data documenting a role of TR‐mediated signalling in skin physiology and pathology. Here, we review this evidence, with emphasis on wound healing and hair growth, and specifically highlight the therapeutic potential of repurposing topical L‐thyroxine (T4) for selected applications in future dermatological therapy. We underscore the known systemic safety and efficacy profile of T4 in clinical medicine, and the well‐documented impact of thyroid hormones on, for example, human epidermal and hair follicle physiology, hair follicle epithelial stem cells and pigmentation, keratin expression, mitochondrial energy metabolism and wound healing. On this background, we argue that short‐term topical T4 treatment deserves careful further preclinical and clinical exploration for repurposing as a low‐cost, effective and widely available dermatotherapeutic, namely in the management of skin ulcers and telogen effluvium, and that its predictable adverse effects are well‐manageable.
Decreased suppression of CD8+ and CD4+ T cells by peripheral regulatory T cells in generalized vitiligo due to reduced NFATC1 and FOXP3 proteins
Authors: Giri Prashant S. , Dwivedi Mitesh , Begum Rasheedunnisa
Published: July 2020

Regulatory T cells (Tregs) are involved in the suppression of activated T cells in generalized vitiligo (GV).
The study was aimed to investigate Tregs functional defects in Treg:CD8+ and Treg:CD4+ T cells' co‐culture systems of 55 GV patients and 45 controls. CD8+ and CD4+ T‐cell proliferation was assessed by BrdU assay; production of IL‐10, TGF‐β and IFN‐γ cytokines was assessed by ELISA; and FOXP3, CD25, NFATC1 and CD44 proteins were measured by flow cytometry. Generalized vitiligo patients showed reduced suppression of CD8+ and CD4+ T cells (P = .0384, P = .0084), increased IFN‐γ (P < .0001, P = .0019), decreased IL‐10 and TGF‐β (P < .0001) and decreased FOXP3, CD25 and NFATC1 proteins (P < .0001). Active vitiligo (AV) patients showed reduced suppression of CD8+ & CD4+ T cells (P = .006, P = .015), increased IFN‐γ (P = .036, P = .045), decreased IL‐10 (P = .009, P = .021), FOXP3 (P = .0244) and NFATC1 (P = .019). Severe GV (50%‐75% VASI) patients showed reduced suppression of CD8+ and CD4+ T cells (P = .0003, P = .001), increased IFN‐γ (P = .0029, P < .0001), decreased IL‐10 (P = .0057, P = .0017), FOXP3 (P = .002) and NFATC1 (P = .0347). VASI score was positively correlated with the suppression of CD8+ and CD4+ T cells (P = .0006, P < .0001), IL‐10 (P = .0096, P = .029), FOXP3 (P = .0008) and NFATC1 (P = .043), whereas it was negatively correlated with IFN‐γ (P = .0029, P = .0017). Early age of onset patients' Tregs demonstrated decreased suppression of CD8+ and CD4+ T cells (P = .0156, P = .0074), decreased TGF‐β (P = .0212, P = .0083) and NFATC1 (P = .0103). NFATC1 was positively correlated with FOXP3 in Tregs (P < .0001). Our results suggest impaired Tregs suppressive function in GV patients due to decreased NFATC1, FOXP3, CD25, IL‐10 and TGF‐β resulting into increased CD8+ and CD4+ T‐cell proliferation and IFN‐γ production. For the first time, decreased NFATC1 levels were correlated with decreased FOXP3, thereby altering Treg cell function in GV patients. Additionally, decreased Treg cell function also affected onset, activity and severity of GV.
A synthesis of (non‐)compliance theories with applications to small‐scale fisheries research and practice
Authors: Oyanedel Rodrigo , Gelcich Stefan , Milner‐Gulland E. J.
Published: July 2020

Non‐compliance in fisheries is a persistent challenge for the conservation and sustainable management of the oceans and has particularly acute impacts in small‐scale fisheries contexts. Small‐scale fisheries often suffer from chronic overexploitation, poor management, lack of enforcement and non‐compliance, but small‐scale fishers are highly dependent on the ocean as a source of employment and food. Improving our understanding of the determinants of non‐compliant behaviours in small‐scale fisheries can help develop strategies to prevent and reduce its consequences. Here, we review two main approaches for the study of non‐compliant behaviours and crimes more broadly, spanning criminology, economics and psychology. On the one hand, actor‐based approaches address the underlying motivations for people to comply or not with regulations. Opportunity‐based approaches, on the other hand, assume that non‐compliance is not distributed randomly across space and time and focuses on the role that the immediate environment plays in the performance of non‐compliant behaviours. We discuss potential applications of actor‐based and opportunity‐based approaches in guiding small‐scale fisheries non‐compliance research. Moreover, we provide guiding principles for integrating these approaches in a complementary way, highlighting opportunities and challenges for building a better non‐compliance research agenda for fisheries and beyond. Addressing non‐compliance is a common challenge for natural resource management in multiple ecosystems. Integrating these two perspectives has the potential to improve both research and practice.
Mechanisms of vascular damage by systemic dissemination of the oral pathogen Porphyromonas gingivalis
Authors: Farrugia Cher , Stafford Graham P. , Potempa Jan , Wilkinson Robert N. , Chen Yan , Murdoch Craig , Widziolek Magdalena
Published: July 2020

Several studies have shown a clear association between periodontal disease and increased risk of cardiovascular disease. Porphyromonas gingivalis (Pg), a key oral pathogen, and its cell surface‐expressed gingipains, induce oedema in a zebrafish larvae infection model although the mechanism of these vascular effects is unknown. Here, we aimed to determine whether Pg‐induced vascular damage is mediated by gingipains. In vitro, human endothelial cells from different vascular beds were invaded by wild‐type (W83) but not gingipain‐deficient (ΔK/R‐ab) Pg. W83 infection resulted in increased endothelial permeability as well as decreased cell surface abundance of endothelial adhesion molecules PECAM‐1 and VE‐cadherin compared to infection with ΔK/R‐ab. In agreement, when transgenic zebrafish larvae expressing fluorescently labelled PECAM‐1 or VE‐cadherin were systemically infected with W83 or ΔK/R‐ab, a significant reduction in adhesion molecule fluorescence was observed specifically in endothelium proximal to W83 bacteria through a gingipain‐dependent mechanism. Furthermore, this was associated with increased vascular permeability in vivo when assessed by dextran leakage microangiography. These data are the first to show that Pg directly mediates vascular damage in vivo by degrading PECAM‐1 and VE‐cadherin. Our data provide a molecular mechanism by which Pg might contribute to cardiovascular disease.
Time trends and other sources of variation in Helicobacter pylori infection in mainland China: A systematic review and meta‐analysis
Authors: Li Mengmeng , Sun Yuanyuan , Yang Jun , de Martel Catherine , Charvat Hadrien , Clifford Gary M , Vaccarella Salvatore , Wang Li
Published: July 2020

Background

Helicobacter pylori (H pylori) is a carcinogen that causes a huge burden of gastric cancer in China. We aimed to evaluate the temporal trends and other sources of variation of H pylori infection in adults from mainland China.

Materials and methods

For this systematic review and meta‐analysis, we searched PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases for articles published from January 1983 to June 2020. We included studies reporting H pylori prevalence in adults and then applied random effect meta‐analyses to obtain pooled prevalence estimates for all studies and subgroups. Sources of heterogeneity were investigated by moderator analysis, and time trends were assessed through random effect meta‐regression.

Results

Of the 2121 studies identified, 98 were eligible for inclusion. The pooled estimate of 670 572 participants from 26 provinces during 1983‐2018 was 49.6% (95% CI: 46.9%, 52.4%). H pylori prevalence varied considerably, ranging from 20.6% to 81.8%. Periods, urban/rural status, detection method, and study design explained 18.8%, 24.0%, 17.8%, and 30.4% of the heterogeneity, respectively. Overall, H pylori prevalence declined by −0.9% (95% CI: −1.1%, −0.6%) annually. Consistent declines in prevalence were observed by sex, age, and study characteristics.

Conclusions

Helicobacter pylori prevalence is slowly decreasing over time in mainland China, but the low declining speed is not enough to have a major impact on gastric cancer incidence for many years. The time trends and the large heterogeneity should be taken into account when conducting regional comparisons, disease burden estimations, and customized strategy making.
Health literacy experiences of multi‐ethnic patients and their health‐care providers in the management of type 2 diabetes in Malaysia: A qualitative study
Authors: Abdullah Adina , Liew Su May , Ng Chirk Jenn , Ambigapathy Subashini , V. Paranthaman P. Vengadasalam
Published: July 2020

Background

Patients with type 2 diabetes mellitus (T2DM) require adequate health literacy to understand the disease and learn self‐management skills to optimize their health. However, the prevalence of limited health literacy is high in patients with T2DM, especially in Asian countries.

Objective

This study aimed to explore experiences related to health literacy in Asian patients with T2DM.

Design

This is a qualitative study using in‐depth interviews and focus group discussions. A framework analysis was used to analyse the data.

Setting and participants

articipants (n = 24) were multi‐ethnic patients with T2DM (n = 18) and their primary health‐care providers (n = 6). This study was conducted in four primary health‐care clinics in Malaysia.

Results

Nine subthemes were identified within the four dimensions of health literacy: accessing, understanding, appraising and applying information.

Discussion

Motivated patients actively sought information, while others passively received information shared by family members, friends or even strangers. Language and communication skills played important roles in helping patients understand this information. Information appraisal was lacking, with patients just proceeding to apply the information obtained. Patients' use of information was influenced by their self‐efficacy, and internal and external barriers.

Conclusion

In conclusion, the experiences of multi‐ethnic patients with T2DM regarding health literacy were varied and heavily influenced by their cultures.
Thug life: bramble (Rubus fruticosus L. agg.) is a valuable foraging resource for honeybees and diverse flower‐visiting insects
Authors: Wignall Veronica R. , Arscott Natalie A. , Nudds Hayley E. , Squire Annabel , Green Thomas O. , Ratnieks Francis L. W.
Published: July 2020

Bramble (Rubus fruticosus L. agg.) is a common summer‐flowering plant native to the United Kingdom. Multiple complementary approaches were used to evaluate its ecological value to the honeybee (Apis mellifera), bumblebees (Bombus spp.) and other flower‐visiting insects in Sussex, England.

Regional surveys of insect groups at seven sites across 2 years showed that foraging activity on bramble was dominated by honeybees (60.2%; n = 28 surveys) and bumblebees (17.4%), compared to non‐Apis/Bombus bees (2.8%), hoverflies (Syrphidae, 7.9%), non‐syrphid flies (0.6%), butterflies (6.4%), wasps (0.4%) and beetles (4.4%). Foraging insect community structure was highly similar spatially, but varied significantly between survey months (June and July).

In detailed local surveys at one rural and one urban location, there was a diverse range of insect taxa foraging on the bramble flowers, including species of conservation concern (Bombus humilis, Coenonympha pamphilus and Limenitis camilla).

Pollen trapping at 12 honeybee hives in four locations showed that an average of 31% of pollen pellets collected by honeybees from late May to early August were bramble, with a peak of 66–86% per location.

Bramble was present in 54 out of 60 200 × 200 m randomly selected grid squares surveyed over a large area across Sussex. Plants were recorded in multiple habitat types in both urban and rural areas.

Bramble is sometimes considered an undesirable plant or a “thug” that outcompetes other wild flowers; however, these findings confirm that it is highly valuable for flower‐visiting insects. Wherever conflicts of interest and management strategies allow, bramble should be maintained and promoted for wildlife and insect conservation.
Effect of a high protein/low glycaemic index diet on insulin resistance in adolescents with overweight/obesity—A PREVIEW randomized clinical trial
Authors: Dorenbos Elke , Drummen Mathijs , Adam Tanja , Rijks Jesse , Winkens Bjorn , Martínez J. Alfredo , Navas‐Carretero Santiago , Stratton Gareth , Swindell Nils , Stouthart Pauline , Mackintosh Kelly , Mcnarry Melitta , Tremblay Angelo , Fogelholm Mikael , Raben Anne , Westerterp‐Plantenga Margriet , Vreugdenhil Anita
Published: July 2020

Background

Pubertal insulin resistance (IR) is associated with increased risk of type 2 diabetes mellitus development in adolescents with overweight/obesity.

Objectives

The PREVIEW study was a randomized parallel trial assessing the change in IR, analyzed by Homeostatic Model Assessment of IR (HOMA‐IR), at 2 years after randomization to a high protein vs a moderate protein diet in adolescents with overweight/obesity. It was hypothesized that a high protein/low glycaemic index diet would be superior in reducing IR compared to a medium protein/medium GI diet, in insulin resistant adolescents with overweight or obesity.

Methods

Adolescents with overweight/obesity and IR from the Netherlands, United Kingdom and Spain were randomized into a moderate protein/moderate GI (15/55/30En% protein/carbohydrate/fat, GI ≥ 56) or high protein/low GI (25/45/30En% protein/carbohydrate/fat, GI < 50) diet. Anthropometric and cardiometabolic parameters, puberty, dietary intake and physical activity (PA) were measured and effects on HOMA‐IR were analyzed.

Results

126 adolescents were included in this study (13.6 ± 2.2 years, BMI z‐score 3.04 ± 0.66, HOMA‐IR 3.48 ± 2.28, HP n = 68, MP n = 58). At 2 years, changes in protein intake were not significantly different between timepoints or intervention groups and no effects of the intervention on IR were observed. The retention rate was 39%, while no compliance to the diets was observed.

Conclusions

The PREVIEW study observed no effect of a high protein/low GI diet on IR in adolescents with overweight/obesity and IR because of lack of feasibility, due to insufficient retention and dietary compliance after 2 years.
Statins significantly alter urinary stone‐related urine biochemistry in calcium kidney stone patients with dyslipidemia
Authors: Liu Chan Jung , Huang Ho Shiang
Published: July 2020

Objective

To investigate whether the use of statins would alter 24‐h urine biochemistry in male patients with calcium kidney stones.

Methods

We prospectively recruited 78 male patients with calcium kidney stones between May 2017 and December 2017, and 30 male controls with matching sex and age, but without kidney stones. All patients were classified into higher‐ and lower‐risk groups of atherosclerotic cardiovascular disease according to the American College of Cardiology/American Heart Association guidelines. Atorvastatin 20 mg per day was prescribed for 12 weeks to the higher risk patients. For kidney stone group, 24‐h urine collections were carried out before and after statin therapy.

Results

A total of 78 patients and 30 controls were included. Higher‐risk patients had significantly higher urine uric acid and calcium levels than lower‐risk patients. After atorvastatin treatment for 12 weeks, urine citrate significantly increased (P < 0.001) accompanied with increased urine pH (P < 0.001), whereas urine uric acid significantly decreased after treatment. Although urine oxalate significantly increased after treatment (P = 0.037), we did not find any significant difference in urine calcium, ion activity product of calcium oxalate and ion activity product of calcium phosphate.

Conclusion

These findings suggest that atorvastatin administration might increase urinary citrate and decrease urinary uric acid in patients with calcium kidney stones and dyslipidemia.
Annexin A3 in sepsis: novel perspectives from an exploration of public transcriptome data
Authors: Toufiq Mohammed , Roelands Jessica , Alfaki Mohamed , Syed Ahamed Kabeer Basirudeen , Saadaoui Marwa , Lakshmanan Arun Prasath , Bangarusamy Dhinoth Kumar , Murugesan Selvasankar , Bedognetti Davide , Hendrickx Wouter , Al Khodor Souhaila , Terranegra Annalisa , Rinchai Darawan , Chaussabel Damien , Garand Mathieu
Published: July 2020

According to publicly available transcriptome datasets, the abundance of Annexin A3 (ANXA3) is robustly increased during the course of sepsis; however, no studies have examined the biological significance or clinical relevance of ANXA3 in this pathology. Here we explored this interpretation gap and identified possible directions for future research. Based on reference transcriptome datasets, we found that ANXA3 expression is restricted to neutrophils, is upregulatedin vitroafter exposure to plasma obtained from septic patients, and is associated with adverse clinical outcomes. Secondly, an increase in ANXA3 transcript abundance was also observedin vivo, in the blood of septic patients in multiple independent studies. ANXA3 is known to mediate calcium‐dependent granules–phagosome fusion in support of microbicidal activity in neutrophils. More recent work has also shown that ANXA3 enhances proliferation and survival of tumour cells via a Caspase‐3‐dependent mechanism. And this same molecule is also known to play a critical role in regulation of apoptotic events in neutrophils. Thus, we posit that during sepsis ANXA3 might either play a beneficial role, by facilitating microbial clearance and resolution of the infection; or a detrimental role, by prolonging neutrophil survival, which is known to contribute to sepsis‐mediated organ damage.
Obesity and triple‐negative‐breast‐cancer: Is apelin a new key target?
Authors: Gourgue Florian , Mignion Lionel , Van Hul Matthias , Dehaen Natacha , Bastien Estelle , Payen Valery , Leroy Baptiste , Joudiou Nicolas , Vertommen Didier , Bouzin Caroline , Delzenne Nathalie , Gallez Bernard , Feron Olivier , Jordan Bénédicte F. , Cani Patrice D.
Published: July 2020

Epidemiological studies have shown that obese subjects have an increased risk of developing triple‐negative breast cancer (TNBC) and an overall reduced survival. However, the relation between obesity and TNBC remains difficult to understand. We hypothesize that apelin, an adipokine whose levels are increased in obesity, could be a major factor contributing to both tumour growth and metastatization in TNBC obese patients. We observed that development of obesity under high‐fat diet in TNBC tumour‐bearing mice significantly increased tumour growth. By showing no effect of high‐fat diet in obesity‐resistant mice, we demonstrated the necessity to develop obesity‐related disorders to increase tumour growth. Apelin mRNA expression was also increased in the subcutaneous adipose tissue and tumours of obese mice. We further highlighted that the reproduction of obesity‐related levels of apelin in lean mice led to an increased TNBC growth and brain metastases formation. Finally, injections of the apelinergic antagonist F13A to obese mice significantly reduced TNBC growth, suggesting that apelinergic system interference could be an interesting therapeutic strategy in the context of obesity and TNBC.
Significance of body mass index for diagnosing sarcopenia is equivalent to slow gait speed in Japanese individuals with type 2 diabetes: Cross‐sectional study using outpatient clinical data
Authors: Nakanishi Shuhei , Iwamoto Masahiro , Shinohara Hisanori , Iwamoto Hideyuki , Kaneto Hideaki
Published: July 2020

Aims/Introduction

This study examined the association between body mass index (BMI) and the risk of sarcopenia in Japanese type 2 diabetes patients.

Materials and Methods

Patients with type 2 diabetes who visited an outpatient clinic comprised the study’s participants. Sarcopenia was defined using the definition of the Asian Working Group for Sarcopenia 2014. The area under the curve was examined for the presence of sarcopenia based on the receiver operating characteristic curve of BMI.

Results

Among 1,137 patients, 210 were diagnosed with low grip strength, 78 with slow gait speed, 444 with low muscle mass and 142 with sarcopenia. The optimal cut‐off point of BMI level for risk of sarcopenia was 24.4 kg/m2 (area under the curve 0.729, 95% confidence interval 0.688–0.770, sensitivity 0.587, specificity 0.789). Furthermore, the receiver operating characteristic curve of BMI for sarcopenia did not significantly differ (P = 0.09) from that of gait speed, an established marker of sarcopenia. In both the male and female groups, there was no difference between the receiver operating characteristic curves of BMI and gait speed for sarcopenia. (P = 0.23 and P = 0.40, respectively).

Conclusions

These results suggest that a BMI <24 kg/m2 among Japanese patients with type 2 diabetes could increase their risk of sarcopenia, the extent of which is equivalent to the risk for sarcopenia from slow gait speed in this study. Further prospective investigation, however, is required.
Insights into effectiveness of tight ultrafiltration and frozen storage in bioactive compound retention in watermelon juice concentrate
Authors: Bhattacharjee Chiranjit , Saxena Vinod K. , Dutta Suman
Published: July 2020

The aim of this study is to evaluate the potential of tight ultrafiltration for the concentration of bioactive compounds in watermelon juice and also analyze the effectiveness of frozen storage for storing the juice concentrate. The concentration of the juice was performed at two different temperatures of 30 ± 2°C and 23 ± 2°C and at pressures of 2 and 3 bar for concentration factors of 1.5, 2, and 3. Total phenolic content in the concentrate was determined in terms of gallic acid and flavonoid concentration was analyzed in terms of rutin equivalent. Lycopene was determined spectrophotometrically using the hexane extraction method. The ultrafiltration (UF) process was successful in retaining a high percentage of bioactive compounds in the watermelon juice concentrate. Flavonoids showed the highest levels of concentration among the four important bioactive compounds. The ultrafiltration experimental set of T = 23 ± 2°C, P = 3 bar and volumetric concentration factor = 1.5 was found to be most feasible. Frozen storage at −18°C was successful in retaining a high percentage of bioactives in the concentrate after 1 month although vitamin C loss was on the higher side. Lycopene was highly preserved in the concentrate juice after frozen storage with retention of 93%.

Practical Applications

One of the major ways to reduce the amount of postharvest losses in watermelon is to convert it to juice by postharvest value addition. To make it available all through the year, the juice has to be processed in order to store it for longer periods. Membrane technology provides the best option to treat the juice in a nonthermal manner to retain its nutritional and sensorial characteristics after processing. Tight ultrafiltration can be a great tool for obtaining a juice concentrate that is rich in bioactive compounds. Watermelon has a significant amount of vitamin C, polyphenols, and also contains lycopene, a carotenoid with potential cancer preventive properties. Tight ultrafiltration can be useful in retaining these important components in the concentrated juice simultaneously reducing the water content, thereby increasing its shelf life. By optimizing different parameters associated with ultrafiltration, it can be possible to industrially scale up this process to make the juice available throughout the year.
Application of artificial intelligence using a convolutional neural network for diagnosis of early gastric cancer based on magnifying endoscopy with narrow‐band imaging
Authors: Ueyama Hiroya , Kato Yusuke , Akazawa Yoichi , Yatagai Noboru , Komori Hiroyuki , Takeda Tsutomu , Matsumoto Kohei , Ueda Kumiko , Matsumoto Kenshi , Hojo Mariko , Yao Takashi , Nagahara Akihito , Tada Tomohiro
Published: July 2020

Background and Aim

Magnifying endoscopy with narrow‐band imaging (ME‐NBI) has made a huge contribution to clinical practice. However, acquiring skill at ME‐NBI diagnosis of early gastric cancer (EGC) requires considerable expertise and experience. Recently, artificial intelligence (AI), using deep learning and a convolutional neural network (CNN), has made remarkable progress in various medical fields. Here, we constructed an AI‐assisted CNN computer‐aided diagnosis (CAD) system, based on ME‐NBI images, to diagnose EGC and evaluated the diagnostic accuracy of the AI‐assisted CNN‐CAD system.

Methods

The AI‐assisted CNN‐CAD system (ResNet50) was trained and validated on a dataset of 5574 ME‐NBI images (3797 EGCs, 1777 non‐cancerous mucosa and lesions). To evaluate the diagnostic accuracy, a separate test dataset of 2300 ME‐NBI images (1430 EGCs, 870 non‐cancerous mucosa and lesions) was assessed using the AI‐assisted CNN‐CAD system.

Results

The AI‐assisted CNN‐CAD system required 60 s to analyze 2300 test images. The overall accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the CNN were 98.7%, 98%, 100%, 100%, and 96.8%, respectively. All misdiagnosed images of EGCs were of low‐quality or of superficially depressed and intestinal‐type intramucosal cancers that were difficult to distinguish from gastritis, even by experienced endoscopists.

Conclusions

The AI‐assisted CNN‐CAD system for ME‐NBI diagnosis of EGC could process many stored ME‐NBI images in a short period of time and had a high diagnostic ability. This system may have great potential for future application to real clinical settings, which could facilitate ME‐NBI diagnosis of EGC in practice.
Betula platyphylla BpHOX2 transcription factor binds to different cis‐acting elements and confers osmotic tolerance
Authors: Tan Zilong , Wen Xuejing , Wang Yucheng
Published: July 2020

The homeodomain‐leucine zipper (HD‐Zip) proteins play crucial roles in plant developmental and environmental responses. However, how they mediate gene expression to facilitate abiotic stress tolerance remains unknown. In the present study, we characterized BpHOX2 (encoding a HD‐Zip I family protein) from birch (Betula platyphylla). BpHOX2 is predominately expressed in mature stems and leaves, but expressed at a low level in apical buds and roots, suggesting that it has tissue‐specific characteristics. BpHOX2 expression was highly induced by osmotic and salt, but only slightly induced by abscisic acid. Overexpression of BpHOX2 markedly improved osmotic tolerance, while knockdown of BpHOX2 increased sensitivity to osmotic stress. BpHOX2 could induce the expression of pyrroline‐5‐carboxylate synthase, peroxidase, and superoxide dismutase genes to improve proline levels and the reactive oxygen species scavenging capability. Chromatin immunoprecipitation sequencing combined with RNA sequencing showed that BpHOX2 could bind to at least four cis‐acting elements, including dehydration‐responsive element “RCCGAC”, Myb‐p binding box “CCWACC,” and two novel cis‐acting elements with the sequences of “AAGAAG” and “TACGTG” (termed HBS1 and HBS2, respectively) to regulate gene expression. Our results suggested that BpHOX2 is a transcription factor that binds to different cis‐acting elements to regulate gene expression, ultimately improving osmotic tolerance in birch.