bluuebunny/crossref_metadata_2025 huggingface dataset:
The histone deacetylaseclr3regulates secondary metabolite production and growth under oxidative stress conditions inPenicillium brasilianum
Authors: Akiyama Daniel Yuri , Rocha Marina Campos , Costa Jonas Henrique , Malavazi Iran , Fill Taícia Pacheco
Published: May 2020

Most of the biosynthetic gene clusters (BGCs) found in filamentous fungi are silent under standard laboratory cultivation conditions due to the lack of expression triggering stimuli, representing a considerable drawback in drug discovery. To access the full biosynthetic potential of these microbes, studies towards the activation of cryptic BGCs are essential. Histone acetylation status is an important regulator of chromatin structure which impacts in cell physiology and, therefore, expression of biosynthetic gene clusters in filamentous fungi. Histone deacetylases (HDACs) and histone acetyl-transferases (HATs) are responsible for maintaining and controlling this process under different cell conditions. In this study,clr3, a gene encoding a histone deacetylase inPenicillium brasilianumwas deleted and associated phenotypic and metabolic changes evaluated. Results indicate reduced growth under oxidative stress conditions in the Δclr3knockout strain. Also, the production of several secondary metabolites including austin-related meroterpenoids, brasiliamides, mycotoxins such as verruculogen and penicillic acid, as well as cyclodepsipeptides was reduced in the Δclr3strain when compared to wild-type strain. Accordingly, addition of epigenetic modulators responsible for HDAC inhibition such as suberoylanilide hydroxamic acid (SAHA) and nicotinamide (NAA) toP. brasilianumgrowth media also culminated in reduction of secondary metabolite production. Mass Spectrometry Imaging (MSI) was applied to compare metabolite production and spatial distribution on the colony. Results suggest that Clr3 plays an important role in secondary metabolite biosynthesis inP. brasilianum, thus offering new strategies for regulation of natural product synthesis by assessing chromatin modification inP. brasilianum.
Neurodevelopmental deficits and cell-type-specific transcriptomic perturbations in a mouse model ofHNRNPUhaploinsufficiency
Authors: Dugger Sarah A. , Dhindsa Ryan S. , De Almeida Sampaio Gabriela , Ressler Andrew K. , Rafikian Elizabeth E. , Petri Sabrina , Letts Verity A. , Teoh JiaJie , Ye Junqiang , Colombo Sophie , Yang Mu , Boland Michael J. , Frankel Wayne N. , Goldstein David B.
Published: May 2020

Heterozygousde novoloss-of-function mutations in the gene expression regulatorHNRNPUcause an early-onset developmental and epileptic encephalopathy. To gain insight into pathological mechanisms and lay the potential groundwork for developing targeted therapies, we characterized the neurophysiologic and cell-type-specific transcriptomic consequences of a mouse model ofHNRNPUhaploinsufficiency. Heterozygous mutants demonstrated neuroanatomical abnormalities, global developmental delay, impaired ultrasonic vocalizations and increased seizure susceptibility, thus modeling aspects of the human disease. Single-cell RNA-sequencing of hippocampal and neocortical cells revealed widespread, yet modest, dysregulation of gene expression across mutant neuronal subtypes. We observed an increased burden of differentially-expressed genes in mutant excitatory neurons of the subiculum—a region of the hippocampus implicated in temporal lobe epilepsy. Evaluation of transcriptomic signature reversal as a therapeutic strategy highlights the potential importance of generating cell-type-specific signatures. Overall, this work provides insight intoHNRNPU-mediated disease mechanisms, and provides a framework for using single-cell RNA-sequencing to study transcriptional regulators implicated in disease.
Molecular Architecture of Early Dissemination and Evolution of the SARS-CoV-2 Virus in Metropolitan Houston, Texas
Authors: Long S. Wesley , Olsen Randall J. , Christensen Paul A. , Bernard David W. , Davis James R. , Shukla Maulik , Nguyen Marcus , Ojeda Saavedra Matthew , Cantu Concepcion C. , Yerramilli Prasanti , Pruitt Layne , Subedi Sishir , Hendrickson Heather , Eskandari Ghazaleh , Kumaraswami Muthiah , McLellan Jason S. , Musser James M.
Published: May 2020

We sequenced the genomes of 320 SARS-CoV-2 strains from COVID-19 patients in metropolitan Houston, Texas, an ethnically diverse region with seven million residents. These genomes were from the viruses causing infections in the earliest recognized phase of the pandemic affecting Houston. Substantial viral genomic diversity was identified, which we interpret to mean that the virus was introduced into Houston many times independently by individuals who had traveled from different parts of the country and the world. The majority of viruses are apparent progeny of strains derived from Europe and Asia. We found no significant evidence of more virulent viral types, stressing the linkage between severe disease, underlying medical conditions, and perhaps host genetics. We discovered a signal of selection acting on the spike protein, the primary target of massive vaccine efforts worldwide. The data provide a critical resource for assessing virus evolution, the origin of new outbreaks, and the effect of host immune response.

Significance

COVID-19, the disease caused by the SARS-CoV-2 virus, is a global pandemic. To better understand the first phase of virus spread in metropolitan Houston, Texas, we sequenced the genomes of 320 SARS-CoV-2 strains recovered from COVID-19 patients early in the Houston viral arc. We identified no evidence that a particular strain or its progeny causes more severe disease, underscoring the connection between severe disease, underlying health conditions, and host genetics. Some amino acid replacements in the spike protein suggest positive immune selection is at work in shaping variation in this protein. Our analysis traces the early molecular architecture of SARS-CoV-2 in Houston, and will help us to understand the origin and trajectory of future infection spikes.
Getting started: altering promoter choice as a mechanism for cell type differentiation
Authors: Ray Mukulika , Larschan Erica
Published: May 2020

In this issue of Genes & Development, Lu and colleagues (pp. 663–677) have discovered a key new mechanism of alternative promoter choice that is involved in differentiation of spermatocytes. Promoter choice has strong potential as mechanism for differentiation of many different cell types.
Contract complexity and trust in construction project subcontracting
Authors: Zhang Shui Bo , Chen Junying , Fu Yafan
Published: May 2020

Purpose

The purpose of this paper is to unpack the “black box” of the relationship between contract and inter-organizational trust, both theoretically and empirically. Two mediators, namely perceived safeguard and restriction, are identified to build up two seemingly contrary possible paths between contract and trust from current literature. Both paths are tested in the context of Chinese construction industry due to our access to sample.

Design/methodology/approach

A survey of 295 contractor-subcontractor relationships from Chinese construction industry was conducted. A three-step multiple regression model was employed to test the mediating effect of perceived safeguard and restriction. Then, a hierarchical regression model was used to test the possible moderating effect of bilateral transaction-specific investment.

Findings

The empirical results support the mediating effect of perceived safeguard between contract and trust in the construction subcontracting industry. Bilateral transaction-specific investments enhance the positive effect of contract on safeguard perception.

Originality/value

Theoretically, this study contributes to governance literature by opening up the “black box” of the relationship between contract and trust. It provides a better understanding of how and when contract complexity impacts trust, instead of simply focusing on whether contract and trust act as complements or substitutes. Practically, this study provides guidelines for construction firms to decide the degree of contract complexity under various degrees of bilateral transaction-specific investments to enhance the other party’s trust, so as to improve performance outcomes.
Musculoskeletal disorders within the carpentry trade: analysis of timber flooring subtasks
Authors: Akanmu Abiola , Olayiwola Johnson , Olatunji Oluwole Alfred
Published: May 2020

Purpose

Carpenters are constantly vulnerable to musculoskeletal disorders. Their work consists of subtasks that promote nonfatal injuries and pains that affect different body segments. The purpose of this study is to examine ergonomic exposures of carpentry subtasks involved in floor framing, how they lead to musculoskeletal injuries, and how preventive and protective interventions around them can be effective.

Design/methodology/approach

Using wearable sensors, this study characterizes ergonomic exposures of carpenters by measuring and analyzing body movement data relating to major subtasks in carpentry flooring work. The exposures are assessed using Postural Ergonomic Risk Assessment classification, which is based on tasks involving repetitive subtasks and nonstatic postures.

Findings

The findings of this paper suggest severe risk impositions on the trunk, shoulder and elbow as a result of the measuring and marking and cutting out vent locations, as well as in placing and nailing boards into place.

Research limitations/implications

Because of the type and size of wearable sensor used, only results of risk exposures of four body-parts are presented.

Practical implications

This study draws insights on how to benchmark trade-specific measurement of work-related musculoskeletal disorders. Safety efforts can be targeted toward these risk areas and subtasks. Specifically, results from these will assist designers and innovators in designing effective and adaptable protective interventions and safety trainings.

Originality/value

Extant studies have failed to provide adequate evidence regarding the relationships between subtasks and musculoskeletal disorders; they have only mimicked construction tasks through laboratory experimental scenarios. This study adds value to the existing literature, in particular by providing insights into hazards associated with floor carpentry subtasks.
Assessment of the effect of external risk factors on the success of an oil and gas construction project
Authors: A Kassem Mukhtar , Khoiry Muhamad Azry , Hamzah Noraini
Published: May 2020

Purpose

Construction projects in the oil and gas sector are greatly affected by external risk factors, especially those related to the economy, politics, security and stability factors. Hence, this research aimed to investigate the fundamental relationship between the external risk factors and their effects on the construction project success using Structural Equation Modeling method and PLS-SEM approach.

Design/methodology/approach

Data collected through a structured survey distributed to projects teams in the oil and gas sectors in Yemeni companies involved in mega construction projects. A hierarchical model for assessing causative external risk factors and their effects on project success was developed and analyzed using Smart PLS 3 software of SEM.

Findings

The findings showed that economic, political, force majeure and security-related risk factors had a strong effect on project success. Besides, the Coefficient of Determination (R-squared value) equals 0.743, represented the proportion of variation in the dependent variable(s), which can be explained by one or more predictor variable. Moreover, the predictive relevance value Q2 is 0.375 above zero, which indicates that the conceptual model can predict the endogenous latent constructs. The calculated Goodness of Fit (GoF) Index of the model was 0.699, which shows that the developed model had substantial explanatory power to represent the relationship between the cause of external risk factors to and the effect on construction project success.

Research limitations/implications

This research was limited to the oil and gas construction projects in Yemen as case study.

Practical implications

Practically, this study highlights the external risk factors that cause a negative effect on the success of oil and gas construction projects in Yemen. The research model of these factors is the first step in the risk management process to develop strategic responses for risks and explain the relationship between cause and effect on project success.

Social implications

The model of external risks factors that cause the failure of construction projects helps develop response strategies for these risks, thereby increasing the chances of project success reflected in the oil and gas sector, which is a main tributary of the national economy in developing countries.

Originality/value

There is a need to improve the planning of economic and security performance as well as to mitigate political risk factors effects on project success and other risk factors discussed in this study, which effect on construction project success according to their priorities.
Ferrari five: How to recover control of the traditional channel in Colombia?
Authors: Borda Armando , Guerra García Gonzalo , Cordova Carlos , Cordova Miguel
Published: May 2020

Learning outcomes

The learning outcomes are as follows: to analyze host market characteristics and consumer behavior to develop sound value propositions; to distinguish the characteristics of traditional retail as opposed to the ones of modern retail; to identify the potential benefits and challenges of working with traditional retail; to discuss how informality may affect business relations; and to identify potential avenues to align divergent interests between the focal firm and traditional retailers.

Case overview/synopsis

The case described the situation faced by French International Company (FICO), a leading manufacturer of cigarettes, after the acquisition of Fosforera Colombiana (FOCOSA) in Colombia. FICO aimed to leverage the leadership position of FOCOSA and of its flagship brand Ferrari Lights that possess a 60% market share. However, after just a few months, it was clear that the acquired subsidiary was not performing adequately. The financial results obtained were disastrous. To face this situation, FICO appointed as the new marketing director to Waldo Tarantini who has experienced dealing with informal markets. To be aligned to the Colombian consumption pattern of five cigarettes daily, Waldo decided to launch a new presentation of the leading brand denominated Ferrari five, a package of 5 cigarettes at COP 1000. Considering that more than 60% of the sale can be explained by traditional retail, it was mandatory to secure its participation. Nevertheless, traditional retailers obtained up to 56% margin by selling single sticks. Waldo and his team rapidly needed to craft a commercial strategy to secure the participation of traditional retailers in a market plagued by informality, smuggling products and lack of control from national authorities.

Complexity academic level

The case is intended to be used at the early stages of post-graduate studies and in executive education programs addressing issues such as emerging markets, informality, the base of the pyramid, trade marketing and product launches. In particular, the case can be used in MSc in Marketing’s students, first-year MBA students or executives following short courses. The field of studies in which the case should be taught is marketing or trade marketing in particular when analyzing emerging economies.

Supplementary materials

Teaching notes are available for educators only.

Subject code

CSS 8: Marketing.
Optimization of hierarchical reinforcement learning relationship extraction model
Authors: Wu Qihang , Li Daifeng , Huang Lu , Ye Biyun
Published: May 2020

Purpose

Entity relation extraction is an important research direction to obtain structured information. However, most of the current methods are to determine the relations between entities in a given sentence based on a stepwise method, seldom considering entities and relations into a unified framework. The joint learning method is an optimal solution that combines relations and entities. This paper aims to optimize hierarchical reinforcement learning framework and provide an efficient model to extract entity relation.

Design/methodology/approach

This paper is based on the hierarchical reinforcement learning framework of joint learning and combines the model with BERT, the best language representation model, to optimize the word embedding and encoding process. Besides, this paper adjusts some punctuation marks to make the data set more standardized, and introduces positional information to improve the performance of the model.

Findings

Experiments show that the model proposed in this paper outperforms the baseline model with a 13% improvement, and achieve 0.742 in F1 score in NYT10 data set. This model can effectively extract entities and relations in large-scale unstructured text and can be applied to the fields of multi-domain information retrieval, intelligent understanding and intelligent interaction.

Originality/value

The research provides an efficient solution for researchers in a different domain to make use of artificial intelligence (AI) technologies to process their unstructured text more accurately.
Silicone use among Nepali transgender women: the hazards of beauty
Authors: Regmi Pramod Raj , van Teijlingen Edwin , Neupane Sanjeev Raj
Published: May 2020

Purpose

It is widely believed that transgender individuals in Nepal inject silicone for face and body manipulation, a phenomenon thought to be common among transgender individuals globally. Therefore, this qualitative study conducted in Nepal explored: (1) awareness of silicone use and sources of information; (2) reasons for using silicone; (3) notion of cost and quality of these procedures; (4) reported negative aspects, including side effects and (5) health seeking behaviors of Nepali transgender women.

Design/methodology/approach

The authors carried out eight focus group discussions (FGDs) with transgender women at four different districts of Nepal, five in the capital Kathmandu and three in different rural areas. We also interviewed three transgender women who preferred not to participate in the FGD but were happy to be interviewed separately. Similarly, six interviews with stakeholders working for sexual and gender minority populations were also conducted.

Findings

Most FGD participants were young (mean age 23.06 ± 3.9 years) and the majority (55%; n = 34) completed grade six to high school level. Peer networks of transgender people and the Internet were the more popular sources of information about silicone. The decision to use silicone was largely influenced by the desire to look beautiful and more feminine. Often they appear not to follow the recommended procedures for silicone use. Their health seeking behavior regarding side effects or complications of these procedures was very poor.

Originality/value

Findings reflect that targeted interventions aimed at transgender individuals should educate them on the use of silicone, as well as explore safe and affordable approaches to meet gender-related appearance needs of Nepali transgender people.
Mental health crisis training for non-mental health professionals
Authors: Maindonald Rebecca , Attoe Chris , Gasston-Hales Melanie , Memon Perah , Barley Elizabeth
Published: May 2020

Purpose

This study aims to evaluate a training in mental health crisis support for non-mental health professionals who work in urgent care settings. The training consists of an e-learning module, a one-day face-to-face (F2F) interactive study day and simulation training.

Design/methodology/approach

This multi-methods study collected data pre and post training and at three to six months post training. Validated questionnaires, rating scales and open-ended questions were used to measure self-efficacy in health-care skills, attitudes towards mental illness and knowledge and confidence in working in mental health. A subsample of participants was interviewed post training about how they had used the knowledge and skills learned.

Findings

A total of 706 staff completed the e-learning, 88 attended the F2F training and 203 attended simulation training. Overall satisfaction with the training was high, with F2F and simulation training preferred. Statistically significant improvements in self-efficacy for health-care skills, positive attitudes towards mental illness, and mental health-related knowledge and confidence were found post training. Qualitative analyses of interview and survey data indicated that participants had translated learning to practice through improved attitudes and behavioural changes when working with patients experiencing a mental health crisis.

Originality/value

This training improved mental health-related knowledge, confidence and self-efficacy and reduced mental health-related stigma in professionals who provide urgent care to people in mental health crisis. Participants reported changes to their practice following training; this is important as care has been inadequate for this group. Workforce planners and leaders should consider implementing this or similar training widely.
Interaction diagrams and failure criteria for RC columns subjected to high temperature
Authors: Mahmoud Khaled Ahmed
Published: May 2020

Purpose

Previous works in constructing interaction diagrams have only focused on incorporating transient creep strain implicitly in the ultimate limit strain. The present paper aims to use different approaches to define concrete ultimate limit strain (failure strain) envelops at high temperatures for preloaded and unloaded, confined and unconfined, columns during heating are proposed. These approaches are chosen to understand the effect of using different techniques to determine transient creep strain on the resulted Nu–Mu diagrams.

Design/methodology/approach

Transient creep strain is included within the concrete ultimate limit strain relationships, implicitly and explicitly, by four different ways, and accordingly, four different failure criteria are suggested. To define the concrete ultimate limit strain, studies are conducted to evaluate the compression strain corresponding to the maximal flexural capacity at elevated temperatures. In the analysis, the thermal and structural analyses are decoupled and, based on the resulted ultimate limit strain, the Nu – Mu diagrams are constructed at different fire exposures.

Findings

The validity of the proposed model is established by comparing its predictions with experimental results found in the literature. Finally, comparative calculations regarding interaction diagrams obtained by the proposed model and by other methods found in the literature are performed. It was found that the proposed model predictions agree well with experimental results. It was also found that the suggested approaches, which include simplifications, reasonably predicted the exact column capacity.

Originality/value

The model.
Response of ramp-type heating in a monoclinic generalized thermoelastic material
Authors: Rani Leena , Shekhar Sushant
Published: May 2020

Purpose

The two-dimensional deformation of a homogeneous, thermally conducting, monoclinic material has been studied by using Laplace and Fourier transforms technique. A linear temperature ramping function is used to more realistically model: thermal loading of the half-space surface. The general solution obtained is applied to a specific problem of a half-space subjected to ramp-type heating and loading. The displacements, stresses and temperature distribution so obtained in the physical domain are computed numerically and illustrated graphically. The comparison for Lord-Shulman (L-S), Green and Lindsay (G–L), Green and Naghdi (G–N) and Chandrasekharaiah and Tzou (CTU) theories have been shown graphically to estimate the effect of ramping parameter of heating for an insulated and temperature gradient boundaries.

Design/methodology/approach

The design of the study is eigenvalue approach

Findings

Homogeneous, thermally conducting monoclinic material has been taken under consideration to study the effect of linear temperature ramping parameter on temperature and normal displacement field. It is observed that magnitude of field quantities is large near the point of application of source for the non-dimensional values of time in all the four models. The numerical values for the field quantities are computed graphically for a wide range of values of finite pulse rise-time in the two situations t0 < t, t0 > t for generalized thermoelasticity theories.

Originality/value

(1) Governing equations for homogeneous, t0 thermally conducting, monoclinic material are described and solved. (2) Eigen value approach is used to solve the problem. (3) The effect of ramping parameter of heating has been studied for various models of the thermoelasticity to show the comparision between them.
Multidimensional performance evaluation styles: budget rigidity and discretionary adjustments
Authors: Masuya Keita , Yoshida Eisuke
Published: May 2020

Purpose

This study aims to reconceptualize performance evaluation styles and reveal their performance effects.

Design/methodology/approach

Based on a literature review, this study conceptualizes performance evaluation styles on two dimensions: priority of budgetary targets when setting performance criteria and use of accounting information for ex-post performance evaluation. This study discusses two concepts – budget rigidity and discretionary adjustments – to explain these two dimensions, and their optimal combination is then investigated by considering environmental uncertainty. The empirical analysis uses survey data from Japanese firms.

Findings

The results indicate that suitable combinations of budget rigidity and discretionary adjustments differ depending on environmental uncertainty. As expected, a combination of lower budget rigidity and higher discretionary adjustments is optimal in an uncertain environment. Contrary to expectations, a combination of higher budget rigidity and higher discretionary adjustments is optimal in a stable environment. Moreover, higher discretionary adjustments complement budgetary targets’ motivational effects, regardless of environmental uncertainty.

Originality/value

This study’s theoretical and empirical analysis suggests that it is difficult to understand the performance implications of performance evaluation styles without recognizing their multidimensionality and interdependencies. Moreover, the results demonstrate that discretionary adjustments in budget-based performance evaluations seem to act rationally in practice.
Never too old to work: managing an age diverse workforce
Authors: Butler Steve
Published: May 2020

Purpose

Setting the scene of a workforce that is living and working longer. Changing demographics are going to have a huge impact on the workplace and businesses need to get ahead of the curve.

Design/methodology/approach

Age stereotyping is one of the biggest issues faced by companies today. Companies need to focus on recruiting and retaining people based on their ability and capabilities, not their age.

Findings

In an intergenerational team, the team members are not artificially defined or divided by age; it is their talent that is important. Employers must recognize the unique skills and experiences each team member brings.

Originality/value

The expectation of flexibility among younger employees is now ingrained. If businesses want to recruit and retain younger workers, they must embrace this way of working. Flexibility is just as important for older workers, especially those with caring responsibilities (children or elderly parents.) Employers need to adapt their benefits package to appeal to all.
Wildfire reveals transient changes to individual traits and population responses of a native bumble bee Bombus vosnesenskii
Authors: Mola John M. , Miller Michael R. , O'Rourke Sean M. , Williams Neal M.
Published: May 2020

Fire‐induced changes in the abundance and distribution of organisms, especially plants, can alter resource landscapes for mobile consumers driving bottom‐up effects on their population sizes, morphologies and reproductive potential. We expect these impacts to be most striking for obligate visitors of plants, like bees and other pollinators, but these impacts can be difficult to interpret due to the limited information provided by forager counts in the absence of survival or fitness proxies.

Increased bumble bee worker abundance is often coincident with the pulses of flowers that follow recent fire. However, it is unknown if observed postfire activity is due to underlying population growth or a stable pool of colonies recruiting more foragers to abundant resource patches. This distinction is necessary for determining the net impact of disturbance on bumble bees: are there population‐wide responses or do just a few colonies reap the rewards?

We estimated colony abundance before and after fire in burned and unburned areas using a genetic mark–recapture framework. We paired colony abundance estimates with measures of body size, counts of queens, and estimates of foraging and dispersal to assess changes in worker size, reproductive output, and landscape‐scale movements.

Higher floral abundance following fire not only increased forager abundance but also the number of colonies from which those foragers came. Importantly, despite a larger population size, we also observed increased mean worker size. Two years following fire, queen abundance was higher in both burned and unburned sites, potentially due to the dispersal of queens from burned into unburned areas. The effects of fire were transient; within two growing seasons, worker abundance was substantially reduced across the entire sampling area and body sizes were similar between burned and unburned sites.

Our results reveal how disturbance can temporarily release populations from resource limitation, boosting the genetic diversity, body size, and reproductive output of populations. Given that the effects of fire on bumble bees acted indirectly through pulsed resource availability, it is likely our results are generalizable to other situations, such as habitat restorations, where resource density is enhanced within the landscape.
Twelve‐hour fasting compared with expedited oral intake in the initial inpatient management of hyperemesis gravidarum: a randomised trial
Authors: Tan PC , Abdussyukur SA , Lim BK , Win ST , Omar SZ
Published: May 2020

Objective

To evaluate fasting for 12 hours compared with expedited oral feeding in hospitalised women with hyperemesis gravidarum (HG).

Design

Randomised trial.

Setting

University Hospital, Malaysia: April 2016–April 2017.

Population

One hundred and sixty women hospitalised for HG.

Method

Women were randomised upon admission to fasting for 12 hours or expedited oral feeding. Standard HG care was instituted.

Main outcome measure

Primary outcome was satisfaction score with overall treatment at 24 hours (0–10 Visual Numerical Rating Scale VNRS), vomiting episodes within 24 hours and nausea VNRS score at enrolment, and at 8, 16 and 24 hours.

Results

Satisfaction score, median (interquartile range) 8 (5–9) versus 8 (7–9) (P = 0.08) and 24‐hour vomiting episodes were 1 (0–4) versus 1 (0–5) (P = 0.24) for 12‐hour fasting versus expedited feeding, respectively. Repeated measures analysis of variance of nausea scores over 24 hours showed no difference (P = 0.11) between trial arms. Participants randomised to 12‐hour fasting compared with expedited feeding were less likely to prefer their feeding regimen in future hospitalisation (41% versus 65%, P = 0.001), to recommend to a friend (65% versus 84%, P = 0.01; RR 0.8, 95% CI 0.6–0.9) and to adhere to protocol (85% versus 95%, P = 0.04; RR 0.9, 95% CI 0.8–1.0). Symptoms profile, ketonuria status at 24 hours and length of hospital stay were not different.

Conclusion

Advisory of 12‐hour fasting compared with immediate oral feeding resulted in a non‐significant difference in satisfaction score but adherence to protocol and fidelity to and recommendation of immediate oral feeding to a friend were lower. The 24‐hour nausea scores and vomiting episodes were similar.

Tweetable abstract

Women hospitalised for hyperemesis gravidarum could feed as soon, as much and as often as can be tolerated compared with initial fasting.
SARS‐CoV‐2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services
Authors: Esteves Sandro C. , Lombardo Francesco , Garrido Nicolás , Alvarez Juan , Zini Armand , Colpi Giovanni M. , Kirkman‐Brown Jackson , Lewis Sheena E. M. , Björndahl Lars , Majzoub Ahmad , Cho Chak‐Lam , Vendeira Pedro , Hallak Jorge , Amar Edouard , Cocuzza Marcello , Bento Fabiola C. , Figueira Rita C. , Sciorio Romualdo , Laursen Rita J. , Metwalley Ahmad M. , Jindal Sunil K. , Parekattil Sijo , Ramasamy Ranjith , Alviggi Carlo , Humaidan Peter , Yovich John L. , Agarwal Ashok
Published: May 2020

The prolonged lockdown of health facilities providing non‐urgent gamete cryopreservation—as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS‐CoV‐2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto‐immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the “fertility window” may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.
Epidemiological analysis of peripartum hysterectomy across nine European countries
Authors: Kallianidis Athanasios F. , Maraschini Alice , Danis Jakub , Colmorn Lotte B. , Deneux‐Tharaux Catherine , Donati Serena , Gissler Mika , Jakobsson Maija , Knight Marian , Kristufkova Alexandra , Lindqvist Pelle G. , Vandenberghe Griet , Van Den Akker Thomas ,   INOSS (the International Network of Obstetric Survey Systems)
Published: May 2020

Introduction

Peripartum hysterectomy is a surgical procedure performed for severe obstetric complications such as major obstetric hemorrhage. The prevalence of peripartum hysterectomy in high‐resource settings is relatively low. Hence, international comparisons and studying indications and associations with mode of birth rely on the use of national obstetric survey data. Objectives were to calculate the prevalence and indications of peripartum hysterectomy and its association with national cesarean section rates and mode of birth in nine European countries.

Material and methods

We performed a descriptive, multinational, population‐based study among women who underwent peripartum hysterectomy. Data were collected from national or multiregional databases from nine countries participating in the International Network of Obstetric Survey Systems. We included hysterectomies performed from 22 gestational weeks up to 48 hours postpartum for obstetric hemorrhage, as this was the most restrictive, overlapping case definition between all countries. Main outcomes were prevalence and indications of peripartum hysterectomy. Additionally, we compared prevalence of peripartum hysterectomy between women giving birth vaginally and by cesarean section, and between women giving birth with and without previous cesarean section. Finally, we calculated correlation between prevalence of peripartum hysterectomy and national cesarean section rates, as well as national rates of women giving birth after a previous cesarean section.

Results

A total of 1302 peripartum hysterectomies were performed in 2 498 013 births, leading to a prevalence of 5.2 per 10 000 births ranging from 2.6 in Denmark to 10.7 in Italy. Main indications were uterine atony (35.3%) and abnormally invasive placenta (34.8%). Relative risk of hysterectomy after cesarean section compared with vaginal birth was 9.1 (95% CI 8.0‐10.4). Relative risk for hysterectomy for birth after previous cesarean section compared with birth without previous cesarean section was 10.6 (95% CI 9.4‐12.1). A strong correlation was observed between national cesarean section rate and prevalence of peripartum hysterectomy (ρ = 0.67, P < .05).

Conclusions

Prevalence of peripartum hysterectomy may vary considerably between high‐income countries. Uterine atony and abnormally invasive placenta are the commonest indications for hysterectomy. Birth by cesarean section and birth after previous cesarean section are associated with nine‐fold increased risk of peripartum hysterectomy.
Epidemiology of bacteria and viruses in the respiratory tract of humans and domestic pigs
Authors: Bunke Jennifer , Receveur Kerstin , Oeser Ann Christin , Gutsmann Imke , Schubert Sabine , Podschun Rainer , Zell Roland , Fickenscher Helmut , Krumbholz Andi
Published: May 2020

Bacteria and viruses were analysed in the upper respiratory tract of symptomatic pig farmers and their domestic pigs. Eighty six human nasal and 495 (50 pools) porcine snout swabs were collected in Schleswig‐Holstein, Germany. Staphylococcus (S.) aureus (62.8%, 54/86), human rhino‐ and coronaviruses (HRV, 29.1%, 25/86; HCoV, 16.3%, 14/86) were frequently detected in humans, while Haemophilus parasuis (90.0%, 45/50), Mycoplasma hyorhinis (78.6%, 11/14), Enterovirus G (EV‐G, 56.0%, 28/50) and S. aureus (36.0%, 18/50), respectively, were highly prevalent in pigs. The detection of S. aureus in human follow‐up samples indicates a carrier status. The methicillin‐resistant phenotype (MRSA) was identified in 33.3% (18/54) of nasal swabs and in one of 18 (5.6%) pooled snout swabs that were tested positive for S. aureus. Strains were indicative of the livestock‐associated clonal complex CC398, with t011 being the most common staphylococcal protein A type. Enterobacterales and non‐fermenters were frequently isolated from swabs. Their detection in follow‐up samples suggests a carrier status. All were classified as being non‐multiresistant. There was no example for cross‐species transmission of viruses. In contrast, transmission of S. aureus through occupational contact to pigs seems possible. The study contributes to the ‘One Health’ approach.
The relationship between sunitinib exposure and both efficacy and toxicity in real‐world patients with renal cell carcinoma and gastrointestinal stromal tumour
Authors: Westerdijk Kim , Krens Stefanie D. , van der Graaf Winette T.A. , Mulder Sasja F. , van Herpen Carla M.L. , Smilde Tineke , van Erp Nielka P. , Desar Ingrid M.E.
Published: May 2020

Aim

Sunitinib is an oral tyrosine kinase inhibitor approved for the treatment of renal cell carcinoma (RCC) and gastrointestinal stromal tumor (GIST). Because of the large interpatient pharmacokinetic variability and established exposure‐response and exposure‐toxicity relationships in clinical trial patients, therapeutic drug monitoring (TDM) seems promising for optimizing sunitinib exposure. We aimed to investigate the relationship between sunitinib exposure and treatment outcome in a real‐world patient cohort.

Methods

We performed a retrospective observational cohort study in 53 patients with metastatic RCC and 18 patients with metastatic GIST treated with sunitinib and receiving TDM‐guided dosing. Time on treatment – as a surrogate for progression‐free survival – in patients who achieved adequate sunitinib exposure was compared with patients who did not. Additionaly, the median sunitinib exposure was compared in patients with or without sunitinib‐induced toxicity leading to dose reduction.

Results

The median time on treatment in patients with RCC who achieved adequate sunitinib exposure (n = 39) was 32 weeks, compared to 15 weeks in patients who did not achieve adequate sunitinib exposure (n = 12) (P = 0.244). In 29 patients (41%) with toxicity leading to dose reduction, sunitinib sum plasma trough concentration (Ctrough) until dose reduction was significantly higher compared to patients without toxicity leading to dose reduction (median 60 ng/mL vs 44 ng/mL; P < 0.001) and reduced to comparable levels after dose reduction (44 ng/mL; P = 0.488).

Conclusion

In our real‐world patient cohort, patients with sunitinib‐induced toxicity requiring dose reduction had significantly higher sunitinib exposure compared to patients without toxicity. The threshold for toxicity, however, was lower compared to that previously described in clinical trials.
Fruit preferences by fishes in a Neotropical floodplain
Authors: Araujo Joisiane Mendes , Correa Sandra Bibiana , Anderson Jill , Penha Jerry
Published: May 2020

The diets of frugivorous animals result from the interaction between feeding preference and ecological factors such as availability of alternative resources and interactions with other frugivores. A better understanding of frugivore diets will enable predictions about the vulnerability of plant populations to anthropogenic or natural environmental changes. In addition, frugivores with greater variation in diet (generalists) are potentially more resilient to habitat changes than specialists. Here, we combined data on diets of frugivorous fishes with visual censuses on fruit availability to evaluate if fishes are selective or opportunistic in their use of fruits in floodplain habitats. We found a high diversity of fruit species (74 species) frequently consumed by four common species of frugivorous fishes during the flooding season. The identity of preferred fruits, rather than their availability, had a stronger effect on the patterns of fruit consumed by fishes in this system. Fruit preferences by fish may influence the long‐term persistence and the maintenance of plant diversity in floodplain habitats. Possible disturbances of fish populations with selective consumption and the plant populations on which they depend could increase the vulnerability of both populations involved. Thus, selectivity may affect ecological and evolutionary processes associated with frugivory by fish.

Abstract in Portuguese is available with online material.
Diabetic retinopathy progression 6 months post‐cataract surgery with intravitreous bevacizumab vs triamcinolone: A secondary analysis of the DiMECAT trial
Authors: Sasongko Muhammad B. , Rogers Sophie , Constantinou Marios , Sandhu Sukhpal S. , Wickremasinghe Sanjeewa S. , Al‐Qureshi Salmaan , Lim Lyndell L.
Published: May 2020

Importance

Diabetic retinopathy (DR) may progress following cataract surgery due to surgery‐induced inflammation. The effect of intravitreal bevacizumab (BVB) and triamcinolone acetonide (TCA), which have differing anti‐inflammatory properties, on DR progression following cataract surgery has not been reported.

Background

To report the progression of DR in diabetic patients undergoing cataract extraction treated with intravitreal BVB or TCA during the surgery.

Design

Post hoc analysis of 6‐month data from a prospective, randomized, double‐masked clinical trial.

Participants

Diabetic patients with clinically significant cataract and fovea involving diabetic macular oedema (DME), or a recent history of DME.

Methods

Participants were randomly allocated 1:1 to receive intravitreal BVB 1.25 mg or TCA 4 mg during and post‐cataract surgery as needed. The rate of DR progression between groups was compared.

Main Outcome Measures

DR progression.

Results

There were 61 eyes included. Patients receiving BVB were older than those receiving TCA (70.2 vs 64.3 years; P < .05). Three participants (10.7%) in the BVB and three (9.09%) in the TCA group had a one‐step progression, while none in BVB and only one (3%) in the TCA group demonstrated two‐step DR progression. In the majority of these patients, DR progression was from mild to moderate non‐proliferative diabetic retinopathy.

Conclusion and Relevance

In this study, BVB and TCA groups had a similar, and lower rate of DR progression compared to previous studies where no adjunctive treatment was administered, suggesting that patients with DME may benefit from either intraoperative intravitreous BVB or TCA injection to reduce the risk of DR progression following cataract surgery.
Life below water: Fish spawning aggregations as bright spots for a sustainable ocean
Authors: Pittman Simon J. , Heyman William D.
Published: May 2020

Transient fish spawning aggregations (FSAs) are critical life‐cycle events for many commercially important species, in which fish congregate in huge numbers to spawn at predictable times and places. This behavior makes them exceptionally vulnerable to fishing. The “illusion of plenty” and poor access to monitoring tools and techniques has resulted in some FSAs being overfished or unwittingly eliminated. We present a co‐conservation network, formally linking site‐focused partners who cooperatively monitor and actively manage multispecies FSAs. FSA sites and networks offer great potential as conservation bright spots to replenish fished populations, rehabilitate marine ecosystems, and ensure the flow of ecosystem services to the millions of people that rely upon them for their wellbeing. We call for urgent global recognition of FSAs as effective spatial nexus for addressing multiple interconnected global policy targets for a sustainable ocean.
Acute purpura fulminans—a rare cause of skin necrosis: A single‐institution clinicopathological experience
Authors: Brozyna Jeremy R. , Sardiña Luis A. , Sharma Anurag , Theil Karl S. , Bergfeld Wilma F.
Published: May 2020

Background

Purpura fulminans, an uncommon syndrome of intravascular thrombosis with hemorrhagic infarction of the skin, is often accompanied by disseminated intravascular coagulation (DIC) and multi‐organ failure, and may ultimately lead to death.

Methods

Herein, we document 13 skin biopsies from 11 adult patients with the clinical diagnosis of sepsis and confirmed histopathologic diagnosis of intravascular thrombosis and/or DIC, compatible with acute infectious purpura fulminans (AIPF). Detailed history and clinical examination were performed, and the lesions were correlated with histopathologic findings. Any underlying medical disease was taken into consideration.

Results

There were 5 males and 6 females with lower extremity or peri‐incisional purpuric skin lesions. The most important comorbidities identified were a history of surgical procedure or neoplasm, although 4 patients had no relevant underlying history. Most skin biopsies revealed focal epidermal ischemia or necrosis and 3 showed full‐thickness epidermal necrosis. In the underlying dermis, there were fibrin thrombi in superficial and deep blood vessels with acute inflammation. Changes of an inflammatory destructive vasculitis were identified in 5 cases. No bacteria or fungi were identified on histopathology.

Conclusions

AIPF is a rapidly‐progressing medical emergency which may be identified by histopathology in culture‐negative cases. Biopsies may show neutrophilic infiltrate without infective organisms.