bluuebunny/crossref_metadata_2025 huggingface dataset:
Botulinum toxin injection for chronic pelvic pain: A systematic review
Authors: Luo Fang Yuan , Nasr‐Esfahani Maryam , Jarrell John , Robert Magali
Published: June 2020

Introduction

Botulinum toxin has proven therapeutic effects in alleviating pain in several myofascial disorders, with an expanding potential in chronic pelvic pain. The objective of this systematic review is to evaluate the efficacy and safety of botulinum toxin injection as an off‐label treatment for female chronic pelvic pain.

Material and methods

Using PRISMA guidelines, MEDLINE, EBM Reviews, PubMed, CINAHL, TRIP Database, EMBASE, Web of Science and gray literature were searched. Studies assessing the efficacy of botulinum toxin for chronic pelvic pain in adult females, with 10 or more women, published in English up to 13 January 2020, were included. All eligible studies were reviewed and data were extracted by two independent reviewers using a standardized form. Quality of evidence was graded using the Cochrane Risk of Bias 2 tool for randomized controlled trials and the Ottawa‐Newcastle scale for observational studies.

Results

In all, 491 records were screened. Seventeen articles were included in the final review: 5 randomized controlled trials and 12 observational studies. The quality of evidence ranged from low to high. There was a large degree of heterogeneity in study designs, and thus a meta‐analysis was not feasible. All observational studies concluded that botulinum toxin was an effective treatment for chronic pelvic pain, with the greatest change in visual analog scale from 8.69 at baseline to 3.07 at 24 months post‐injection. However, only one of the five randomized controlled trials found statistical significant differences favoring botulinum toxin in the reporting of the EQ‐5D (botulinum 0.78 [0.69‐1.00], control 0.69 [0.25‐0.81], P = .03) and frequency of intercourse (botulinum 1 [1‐1.75], placebo 1 [0‐1], P = .025). The most common adverse effect was transient localized pain at injection site (6%‐88%). No serious adverse events were reported.

Conclusions

Although observational studies were encouraging, there is insufficient high quality evidence to recommend botulinum toxin injection for chronic pelvic pain. However, it appears to be safe to use. Future studies of higher quality in its treatment efficacy are indicated.
Regular use of proton pump inhibitor and risk of rheumatoid arthritis in women: a prospective cohort study
Authors: Yuan Jinqiu , Zhang Changhua , Sparks Jeffrey A. , Malspeis Susan , Tsoi Kelvin Kam‐Fai , Kim Jean H. , Fisher Benjamin A. , Gao Fang , Sumerlin Tim , Liu Yan , Liu Yuxing , Pan Yihang , He Yulong , Sung Joseph J.Y.
Published: June 2020

Background

Proton pump inhibitors (PPIs) have a significant impact on the gut microbiome, which in turn, might increase the risk of rheumatoid arthritis (RA).

Aim

To evaluate regular use of PPIs and risk of RA.

Methods

This is a prospective analysis of the US nurses who reported PPI use data, and were free of RA from the Nurses’ Health Study (NHS 2002‐2014) and NHS II (2003‐2015). The exposure was regular use of PPI in the past 2 years, which was repeatedly evaluated in biennial surveys. RA was confirmed by the 1987 or 2010 American College of Rheumatology criteria. We estimated the hazard ratios (HRs) and confidence interval (CIs) with time‐dependent Cox regression adjusting for potential confounders.

Results

We documented 421 cases of RA over 1 753 879 person‐years of follow‐up. Regular PPI users had a 44% higher risk of RA as compared with non‐regular users (adjusted HR = 1.44; 95%CI, 1.10‐1.89). The risk of RA increased with the total duration of PPI use (P‐trend = 0.008). Compared with non‐regular users, the adjusted HRs were 1.22 (95%CI, 0.93‐1.62) for women with >0 to 4 years’ use and 1.73 (95% CI, 1.14 to 2.61) for >4 years’ use.

Conclusions

Regular use of PPI was associated with increased risk of RA in women, with a higher risk observed in individuals with a longer duration of PPI use. Due to the observational study design, large prospective trials are still required to confirm our finding.
Review article: chronic liver disease and pregnancy
Authors: Faulkes Rosemary E. , Chauhan Abhishek , Knox Ellen , Johnston Tracey , Thompson Fiona , Ferguson James
Published: June 2020

Background

The prevalence of chronic liver disease in women of child bearing age is increasing, leading to a higher incidence of pregnancy in this cohort. Chronic medical conditions have a significant adverse effect on maternal morbidity and mortality. To date, reviews on this topic have been written either from a hepatology or obstetrics viewpoint, and no specific guidelines are available solely for the management of chronic liver disease in pregnancy.

Aims

To produce a comprehensive review on the clinical management of women with chronic liver disease during pregnancy, addressing the risks of pregnancy to mother and child, how these risks can be ameliorated, and what additional considerations are required for management of chronic liver disease in pregnancy.

Methods

Data were collected up to May 2020 from the biomedical database PubMed, national and international guidelines in gastroenterology and hepatology.

Results

During pregnancy, women with cirrhosis are more likely to develop decompensated disease, worsening of portal hypertension, and to deliver premature infants.

Conclusions

The risks associated with pregnancy can be ameliorated by advanced planning, assessing risk using the model for end stage liver disease score and risk reduction through varices screening. A multidisciplinary approach is paramount in order to minimise complications and maximise the chance of a safe pregnancy and birth for mother and baby.
Association between diabetes mellitus and hepatic encephalopathy in patients with cirrhosis
Authors: Labenz Christian , Nagel Michael , Kremer Wolfgang M. , Hilscher Max , Schilling Caroline A. , Toenges Gerrit , Kuchen Robert , Schattenberg Jörn M. , Galle Peter R. , Wörns Marcus‐Alexander
Published: June 2020

Background

Diabetes mellitus may lead to increased serum ammonia and systemic inflammation thereby promoting hepatic encephalopathy (HE).

Aim

To investigate the potential association between diabetes mellitus/glycaemic control and the presence of covert HE as well as the development of overt HE in a prospective setting.

Methods

A total of 240 patients with liver cirrhosis were included into this prospective cohort study and followed for a median of 17 months. Covert HE was diagnosed by pathological results in the Portosystemic Hepatic Encephalopathy Score. Predictors for the presence of covert HE or the development of overt HE were analysed using logistic regression or Cox‐regression models.

Results

At study inclusion, 65 patients (27.1%) presented with diabetes mellitus and covert HE was detected in 33.3%. Patients with diabetes mellitus had a more preserved liver function as compared to patients without diabetes mellitus (MELD 9 vs 10; P = 0.043). In regression analyses after adjustment for confounders, diabetes mellitus was independently associated with the presence of covert HE at study inclusion and the development of overt HE during follow‐up. These associations were confirmed in separate propensity‐score‐weighted regression models. In subgroup analyses, patients with worse glycaemic control (HbA1c >= 6.5%) had a pronounced risk for covert HE (OR 2.264, 95% CI 1.002‐5.118) and overt HE (HR 4.116, 95% CI 1.791‐9.459).

Conclusions

Diabetes mellitus may associate with higher risk for the presence of covert HE and the development of overt HE in patients with liver cirrhosis. Adequate glycaemic control may be a potential target to attenuate this important complication.
Bromine, a possible marine diet indicator? A hypothesis revisited
Authors: Kozachuk M. S. , Sham T. K. , Martin R. R. , Nelson A. J.
Published: June 2020

This study examines the hypothesis that bromine in human skeletal tissue serves as an indicator of marine diet. Synchrotron‐based X‐ray fluorescence microscopy of samples from archaeological sites on the Peruvian North Coast showed relative enrichment of bromine in the cementum and osteons. X‐ray absorption spectroscopy determined organobromine to be present, suggesting an exclusive association with the organic component. We used skeletal tissue from marine mammals as a proxy for the marine diet. Bromine, when observed in these specimens, was recorded close to the detection limits; therefore, bromine in archaeological skeletal material does not appear to be an indicator of marine diet.
Archaeometrical characterization of pigments and paintings on Pre‐Hispanic pottery from the regions of Fiambalá and Chaschuil (Catamarca, Argentina)*
Authors: Ratto N. , Reinoso M. , Basile M. , Freire E. , Halac E. B.
Published: June 2020

The results of an analysis of pigments used in slips and designs deployed in ceramic assemblages recovered from archaeological sites located in different environments, expressing the socio‐historical process developed in the regions of Fiambalá and Chaschuil (Catamarca, Argentina) during the last 1500 years are presented. The sample, formed by fragments of different ceramic styles and natural pigments, was analysed via Raman spectroscopy and X‐ray diffraction. Results indicate the continuity in use of certain pigments (mainly hematite for red hues and Mn oxides in combination with magnetite for black paints) within the different socio‐political organizations that inhabited the region from the first to the 14th centuries ce, in spite of the diverse shades of colour, which suggests an intentional search linked with their cultural conventions. For the Inca Period, this scenery of continuities in minerals employed for reds and blacks is complemented by the use of new compounds (Ti oxide, apatite and gypsum) in order to generate the ‘cream’ tones applied as slips, all of which have not been identified for previous moments.
Effects of statins and exercise on postprandial lipoproteins in metabolic syndrome vs metabolically healthy individuals
Authors: Alvarez‐Jimenez Laura , Moreno‐Cabañas Alfonso , Ramirez‐Jimenez Miguel , Morales‐Palomo Felix , Ortega Juan F. , Mora‐Rodriguez Ricardo
Published: June 2020

Aims

To determine if the combination of exercise and statin could normalize postprandial triglyceridaemia (PPTG) in hypercholesteraemic individuals.

Methods

Eight hypercholesteraemic (blood cholesterol 182 ± 38 mg dL−1; low‐density lipoprotein–cholesterol [LDL‐c] 102 ± 32 mg dL−1) overweight (body mass index 30 ± 4 kg m−2) individuals with metabolic syndrome (MetS) were compared to a group of 8 metabolically healthy (MetH) controls (blood cholesterol 149 ± 23 mg dL−1; LDL‐c 77 ± 23 mg dL−1, and body mass index 23 ± 2 kg m−2). Each group underwent 2 PPTG tests, either 14 hours after a bout of intense exercise or without previous exercise. Additionally, MetS individuals were tested 96 hours after withdrawal of their habitual statin medication to study medication effects.

Results

A bout of exercise before the test meal did not reduce PPTG in MetS (P = .347), but reduced PPTG by 46% in MetH (413 ± 267 to 224 ± 142 mg dL−1 for 5 h incremental area under the curve; P = .02). In both trials (i.e., either after a bout of intense exercise or without previous exercise), statin withdrawal in MetS greatly increased PPTG (average 65%; P < .01), mean LDL‐c (average 25%; P < .01), total cholesterol (average 16%; P < .01) and apolipoprotein (Apo) B48 (24%; P < .01), without interference from exercise. However, Apo B100 was not affected by statin withdrawal.

Conclusion

Hypercholesteraemic MetS individuals (compared to MetH controls) fail to show an effect of exercise on reducing PPTG. However, chronic statin medication blunts the elevations in triglyceride after a fat meal (i.e., incremental area under the curve of PPTG) reducing their cardiovascular risk associated with their atherogenic dyslipidaemia. Statin decreases PPTG by reducing the secretion or accelerating the catabolism of intestinal Apo B48.
What does physiological synchrony reveal about metacognitive experiences and group performance?
Authors: Dindar Muhterem , Järvelä Sanna , Haataja Eetu
Published: June 2020

There is a growing body of research on physiological synchrony (PS) in Collaborative Problem Solving (CPS). However, the current literature presents inconclusive findings about the way in which PS is reflected in cognitive and affective group processes and performance. In light of this, this study investigates the relationship between PS and metacognitive experiences (ie, judgement of confidence, task interest, task difficulty, mental effort and emotional valence) that are manifested during CPS. In addition, the study explores the association between PS and group performance. The participants were 77 university students who worked together on a computer‐based CPS simulation in groups of three. Participants’ electrodermal activity (EDA) was recorded as they worked on the simulation and metacognitive experiences were measured with situated self‐reports. A Multidimensional Recurrence Quantification Analysis was used to calculate the PS among the collaborators. The results show a positive relationship between continuous PS episodes and groups’ collective mental effort. No relationship was found between PS and judgement of confidence, task interest, task difficulty or emotional valence. The relationship between PS and group performance was also non‐significant. The current work addresses several challenges in utilising multimodal data analytics in CPS research and discusses future research directions.
Enhancing students’ choreography and reflection in university dance courses: A mobile technology‐assisted peer assessment approach
Authors: Hsia Lu‐Ho , Hwang Gwo‐Jen
Published: June 2020

Choreography is an important and challenging educational objective in dance courses. However, most previous technology‐enhanced learning studies for dance education mainly focused on students’ dance skills, while the issue concerning the approaches to promoting students’ choreographic performance has generally been ignored. To address this issue, the present study developed a mobile technology‐assisted peer assessment approach based on social constructivism for use in a university general education dance routine choreography class. A total of 266 university students were divided into an experimental group and a control group. The experiment lasted for 15 weeks and involved two rounds of peer assessment. The results showed that mobile peer assessment could significantly enhance the innovative competence of dance routines and dance skills. In addition, according to the students’ feedback, the dance routine choreography class was conducive to improving social skills, innovative competence, and intrinsic motivation, while mobile peer assessment could assist students in understanding accurate evaluation criteria, reflecting on their own in a more objective way, and broadening the aspects of appreciating the work.
Revision of the occurrence of muskox (Ovibos moschatus Zimmermann 1780) from the Gravettian of Arbreda Cave (Serinyà, northeastern Iberian Peninsula): new insights for the study of Iberian cold‐adapted faunas
Authors: Rufí Isaac , Drucker Dorothée G. , Bocherens Hervé , Lloveras Lluís , Madurell‐Malapeira Joan , Maroto Julià , Soler Joaquim , Soler Narcís
Published: June 2020

During the Last Glacial cycle (MIS 4 to MIS 2), the isthmic Pyrenees mountain range acted as a biogeographical barrier, effectively restricting faunal exchanges to its western and eastern terminations. The study of the composition of megaherbivore communities has revealed the transitional character of the Cantabrian region (northwest Iberian Peninsula) during the MIS 3, between western European cold faunas and southern Iberian temperate faunas. In the Catalan area (northeastern Iberian Peninsula), cold‐adapted faunas are frequently recorded during the cold pulses of MIS 3 and MIS 2, albeit to a lesser extent. In the present paper, we provide the first direct evidence of a muskox record in the Iberian Peninsula, together with a morphometric study and the results of collagen δ13C and δ15N analysis. The results reveal that the Arbreda specimen fits biometrically within the Late Holocene Umingmak specimens (Banks Island, Canada). Moreover, its isotopic values fall into the range of Late Pleistocene Mammoth steppe muskoxen, which indicates a typical ecological behaviour for muskox. Indeed, it suggests a niche partitioning of this cold‐adapted specimen in relation to other Gravettian Iberian fauna. Chronologically, this occurrence is interpreted as an isolated southward expansion of the biogeographical limits of muskox during the Greenland Stadial 4, in the latest MIS 3.
Effects of propofol on the development of cancer in humans
Authors: Xu Yichi , Pan Shuya , Jiang Wenxiao , Xue Fang , Zhu Xueqiong
Published: June 2020

Cancer is one of most the significant threats to human health worldwide, and the primary method of treating solid tumours is surgery. Propofol, one of the most widely used intravenous anaesthetics in surgery, was found to be involved in many cancer‐related pathophysiology processes, mainly including anti‐tumour and minor cancer‐promoting effects in various types of cancer. An increasing number of studies have identified that propofol plays a role in cancer by regulating the expression of multiple signalling pathways, downstream molecules, microRNAs and long non‐coding RNAs. Emerging evidence has indicated that propofol can enhance the anti‐tumour effect of chemotherapeutic drugs or some small molecular compounds. Additionally, in vivo animal models have shown that propofol inhibits tumour growth and metastasis. Furthermore, most clinical trials indicate that propofol is associated with better survival outcomes in cancer patients after surgery. Propofol use is encouraged in cancers that appear to have a better prognosis after its use during surgery. We hope that future large and prospective multicenter studies will provide more precise answers to guide the choice of anaesthetics during cancer surgery.
Identifying cerebral palsy phenotypes objectively
Authors: Leviton Alan
Published: June 2020

This commentary is on the systematic review by Pham et al. on pages 1024–1030 of this issue.
Assessment of left ventricular diastolic function by three‐dimensional transthoracic echocardiography
Authors: Badano Luigi P. , Muraru Denisa , Ciambellotti Francesca , Caravita Sergio , Guida Valentina , Tomaselli Michele , Parati Gianfranco
Published: June 2020

Doppler echocardiography assessment of left ventricular (LV) filling pressures at rest and during exercise is the most widely used imaging technique to assess LV diastolic function in clinical practice. However, a sizable number of patients evaluated for suspected LV diastolic function show an inconsistency between the various parameters included in the flowchart recommended by current Doppler echocardiography guidelines and results in an undetermined LV diastolic function. Current three‐dimensional echocardiography technology allows obtaining accurate measurements of the left atrial volumes and functions that have been shown to improve the diagnostic accuracy and prognostic value of the algorithms recommended for assessing both LV diastolic dysfunction and heart failure with preserved ejection fraction. Moreover, current software packages used to quantify LV size and function provide also volume‐time curves showing the dynamic LV volume change throughout the cardiac cycle. Examining the diastolic part of these curves allows the measurement of several indices of LV filling that have been reported to be useful to differentiate patients with normal LV diastolic function from patients with different degrees of diastolic dysfunction. Finally, several software packages allow to obtain also myocardial deformation parameters from the three‐dimensional datasets of both the left atrium and the LV providing additional functional parameters that may be useful to improve the diagnostic yield of three‐dimensional echocardiography for the LV diastolic dysfunction. This review summarizes the current applications of three‐dimensional echocardiography to assess LV diastolic function.
Dopamine depletion induces neuron‐specific alterations of GABAergic transmission in the mouse striatum
Authors: Boccalaro Ida Luisa , Schwerdel Cornelia , Cristiá‐Lara Leonardo , Fritschy Jean‐Marc , Rubi Lena
Published: June 2020

Lack of dopamine (DA) in the striatum and the consequential dysregulation of thalamocortical circuits are major causes of motor impairments in Parkinson's disease. The striatum receives multiple cortical and subcortical afferents. Its role in movement control and motor skills learning is regulated by DA from the nigrostriatal pathway. In Parkinson's disease, DA loss affects striatal network activity and induces a functional imbalance of its output pathways, impairing thalamocortical function. Striatal projection neurons are GABAergic and form two functionally antagonistic pathways: the direct pathway, originating from DA receptor type 1‐expressing medium spiny neurons (D1R‐MSN), and the indirect pathway, from D2R‐MSN. Here, we investigated whether DA depletion in mouse striatum also affects GABAergic function. We recorded GABAergic miniature IPSCs (mIPSC) and tonic inhibition from D1R‐ and D2R‐MSN and used immunohistochemical labeling to study GABAAR function and subcellular distribution in DA‐depleted and control mice. We observed slower decay kinetics and increased tonic inhibition in D1R‐MSN, while D2R‐MSN had increased mIPSC frequency after DA depletion. Perisomatic synapses containing the GABAAR subunits α1 or α2 were not affected, but there was a strong decrease in non‐synaptic GABAARs containing these subunits, suggesting altered receptor trafficking. To broaden these findings, we also investigated GABAARs in GABAergic and cholinergic interneurons and found cell type‐specific alterations in receptor distribution, likely reflecting changes in connectivity. Our results reveal that chronic DA depletion alters striatal GABAergic transmission, thereby affecting cellular and circuit activity. These alterations either result from pathological changes or represent a compensatory mechanism to counteract imbalance of output pathways.
Satisfaction in the Soul: Common Factors Theory Applied to Traditional Healers in Rural Nepal
Authors: Pham Tony V. , Koirala Rishav , Kohrt Brandon A.
Published: June 2020

To explore the relationship between traditional healers and conventional psychotherapy, we conducted a combined ethnographic study and structured observational rating of healers in the middle hill region of central Nepal. We conducted in‐depth interviews and ethnographic observations of healing with 84 participants comprising 29 traditional healers and 55 other community members.  Overall, our observations and participant responses yielded a range of interventions that improved health through belief, satisfaction in the soul, social support, transference, and symbolic narration.  The findings from our overall ethnography suggest that healers offer a platform for their patients to accept a disease state, cope with it, and to experience palliation of distress.  We additionally focused on one participant who saw multiple healers for a case study, during which we rated healing behavior using an observational measure of empathy, emotional validation, and therapeutic alliance. Using this measure, healers who were perceived as successful, scored high on alliance, empathy, promoting expectations of recovery, and use of cultural models of distress. The results of our structured observation suggest healers draw upon processes also observed in psychotherapy. Further research is needed to explore if these practices can be generalized to healers in other parts of Nepal and other settings.
Out but in. The reconfiguration of American health policy expertise and the advent of a “peri‐administration” (1970–2010)
Authors: Lepont Ulrike
Published: June 2020

This article shows that, in the health policy sector, an infrastructure of expertise external to the state has developed in the United States from the 1970s on, representing a reserve of health‐care specialists in many ways comparable to a specialized, high‐level civil service. Decision makers can delve into that pool of experts when looking for advice, or to find loyal and competent managers to fill administrative positions. By identifying this infrastructure as a “peri‐administration,” this article links up with a recent line of thinking on the American State that reconsiders the classical interpretative frames proposed by the Weberian model. The article examines the contribution of this category of policy experts to the evolution of the policy framework and shows how they were instrumental in narrowing the alternatives available in U.S. health‐care policy from the 1970s to the Affordable Care Act of 2010.
Securement to prevent device‐related pressure injuries in the intensive care unit: A randomised controlled feasibility study
Authors: Coyer Fiona , Cook Jane‐Louise , Brown Wendy , Vann Amanda , Doubrovsky Anna
Published: June 2020

Medical device‐related pressure injuries are the most common cause of pressure injuries within the intensive care unit, in particular those caused by nasogastric tubes and endotracheal tubes. There are several known methods, which can alleviate the pressure of these devices on the skin surface to reduce the rate of these injuries. To determine the feasibility of conducting a larger, adequately powered trial testing, several clinically effective interventions to reduce the incidence of medical device‐related pressure injuries caused by these devices. Patients were recruited into both study arms and received one of three different methods of skin protection for both arms. Outcome measures included fidelity to the processes of care protocol, recruitment potential, and the number of medical device‐related pressure injuries. Recruitment (n = 87) was slower than expected with less than 10% of screened potential patients available for enrolment. Fidelity to the process of care for each subgroup was variable with better adherence in the nasogastric tube arm compared to the endotracheal tube arm. This feasibility study has revealed concerns about the intervention designs and effectiveness as well as challenges for the adherence of the nursing staff to the protocol.
Using molecular and crowd‐sourcing methods to assess breeding ground diet of a migratory brood parasite of conservation concern
Authors: Mills Lowell J. , Wilson Jeremy D. , Lange Anke , Moore Karen , Henwood Barry , Knipe Hazel , Chaput Dominique L. , Tyler Charles R.
Published: June 2020

Breeding ground food availability is critical to the survival and productivity of adult birds. The common cuckoo Cuculus canorus is a brood‐parasitic Afro‐Palearctic migrant bird exhibiting long‐term (breeding) population declines in many European countries. Variation in population trend between regions and habitats suggests breeding ground drivers such as adult food supply. However, cuckoo diet has not been studied in detail since before the most significant population declines in Europe began in the mid‐1980s. 20th century studies of cuckoo diet largely comprised field observations likely to carry bias towards larger prey taxa. Here we demonstrate the potential value of 1) using high‐throughput DNA sequencing of invertebrate prey in faeces to determine cuckoo diet with minimal bias towards large prey taxa, and 2) using crowd‐sourced digital photographs from across Britain to identify lepidopteran cuckoo prey taxa during recent years post‐decline (2005–2016). DNA analysis found a high frequency of Lepidoptera, including moths of family Lasiocampidae, prominent within the past literature, but also grasshoppers (Orthoptera) and flies (Diptera) that may be overlooked by field observation methodologies. The range of larval lepidopteran prey identified from photographs largely agreed with those previously documented, with potential signs of reduced diversity, and identities of key adult prey taxa were supported by molecular results. Notably, many identified cuckoo prey taxa have shown severe declines due to agricultural intensification, suggesting this has driven spatial patterns of cuckoo loss. Landscape‐scale, lowland rewilding interventions provide opportunities to understand the scale of reversal of previous agricultural intensification that may be necessary to restore prey populations sufficiently to permit recolonization by cuckoos.
Hypoxia‐induced miR‐3677‐3p promotes the proliferation, migration and invasion of hepatocellular carcinoma cells by suppressing SIRT5
Authors: Yao Bowen , Li Yazhao , Niu Yongshen , Wang Liang , Chen Tianxiang , Guo Cheng , Liu Qingguang
Published: June 2020

Hepatocellular carcinoma (HCC), with life‐threatening malignant behaviours, often develops distant metastases and is the fourth most common primary cancer in the world, having taken millions of lives in Asian countries such as China. The novel miR‐3677‐3p is involved in a high‐expression‐related poor prognosis in HCC tissues and cell lines, indicating oncogenesis functions in vitro and in vivo. Initially, we confirmed the inhibition of proliferation, migration and invasion in miR‐3677‐3p knock‐down MHCC‐97H and SMMC‐7721 cell lines, which are well known for their high degree of invasiveness. Then, we reversed the functional experiments in the low‐miR‐3677‐3p‐expression Hep3B cell line via overexpressing miR‐3677‐3p. In nude mice xenograft and lung metastasis assays, we found suppressor behaviours, smaller nodules and low density of organ spread, after injection of cells transfected with shRNA‐miR‐3677‐3p. A combination of databases (Starbase, TargetScan and MiRgator) illustrated miR‐3677‐3p targets, and it was shown to suppress the expression of SIRT5 in a dual‐luciferase reporter system. To clarify the conclusions of previous ambiguous research, we up‐regulated SIRT5 in Hep3B cells, and rescue tests were established for confirmation that miR‐3677‐3p suppresses SIRT5 to enhance the migration and invasion of HCC. Interestingly, we discovered hypoxia‐induced miR‐3677‐3p up‐regulation benefited HCC malignancy and invasiveness. In conclusion, the overexpression of miR‐3677‐3p mediated SIRT5 inhibition, which could increase proliferation, migration and invasion of HCC in hypoxic microenvironments.
IGFBP‐4 enhances VEGF‐induced angiogenesis in a mouse model of myocardial infarction
Authors: Wo Da , Chen Jinxiao , Li Qiongyu , Ma En , Yan Hongwei , Peng Jun , Zhu Weidong , Fang Yong , Ren Dan‐ni
Published: June 2020

Vascular endothelial growth factor (VEGF) is a well‐known angiogenic factor, however its ability in promoting therapeutic angiogenesis following myocardial infarction (MI) is limited. Here, we aimed to investigate whether dual treatment with insulin‐like growth factor binding protein‐4 (IGFBP‐4), an agent that protects against early oxidative damage, can be effective in enhancing the therapeutic effect of VEGF following MI. Combined treatment with IGFBP‐4 enhanced VEGF‐induced angiogenesis and prevented cell damage via enhancing the expression of a key angiogenic factor angiopoietin‐1. Dual treatment with the two agents synergistically decreased cardiac fibrosis markers collagen‐I and collagen‐III following MI. Importantly, while the protective action of IGFBP‐4 occurs at an early stage of ischemic injury, the action of VEGF occurs at a later stage, at the onset angiogenesis. Our findings demonstrate that VEGF treatment alone is often not enough to protect against oxidative stress and promote post‐ischemic angiogenesis, whereas the combined treatment with IGFBP4 and VEGF can utilize the dual roles of these agents to effectively protect against ischemic and oxidative injury, and promote angiogenesis. These findings provide important insights into the roles of these agents in the clinical setting, and suggest new strategies in the treatment of ischemic heart disease.
Homocysteine concentration and adenosine A2A receptor production by peripheral blood mononuclear cells in coronary artery disease patients
Authors: Deharo Pierre , Marlinge Marion , Guiol Clair , Vairo Donato , Fromonot Julien , Mace Patrick , Chefrour Mohamed , Gastaldi Marguerite , Bruzzese Laurie , Gaubert Melanie , Gaudry Marine , Kipson Nathalie , Criado Christine , Cuisset Thomas , Paganelli Franck , Ruf Jean , Guieu Regis , Fenouillet Emmanuel , Mottola Giovanna
Published: June 2020

Hyperhomocysteinemia is associated with coronary artery disease (CAD). The mechanistic aspects of this relationship are unclear. In CAD patients, homocysteine (HCy) concentration correlates with plasma level of adenosine that controls the coronary circulation via the activation of adenosine A2A receptors (A2AR). We addressed in CAD patients the relationship between HCy and A2AR production, and in cellulo the effect of HCy on A2AR function. 46 patients with CAD and 20 control healthy subjects were included. We evaluated A2AR production by peripheral blood mononuclear cells using Western blotting. We studied in cellulo (CEM human T cells) the effect of HCy on A2A R production as well as on basal and stimulated cAMP production following A2A R activation by an agonist‐like monoclonal antibody. HCy concentration was higher in CAD patients vs controls (median, range: 16.6 [7‐45] vs 8 [5‐12] µM, P < 0.001). A2A R production was lower in patients vs controls (1.1[0.62‐1.6] vs 1.53[0.7‐1.9] arbitrary units, P < 0.001). We observed a negative correlation between HCy concentration and A2A R production (r = −0.43; P < 0.0001), with decreased A2A R production above 25 µM HCy. In cellulo, HCy inhibited A2AR production, as well as basal and stimulated cAMP production. In conclusion, HCy is negatively associated with A2A R production in CAD patients, as well as with A2A R and cAMP production in cellulo. The decrease in A2A R production and function, which is known to hamper coronary blood flow and promote inflammation, may support CAD pathogenesis.
Improving quality in a complex primary care system—An example of refugee care and literature review
Authors: Young Richard A. , Nelson Mark J. , Castellon Ricardo E. , Martin Carmel M.
Published: June 2020

Rationale, aims and objectives

Applying traditional industrial quality improvement (QI) methodologies to primary care is often inappropriate because primary care and its relationship to the healthcare macrosystem has many features of a complex adaptive system (CAS) that is particularly responsive to bottom‐up rather than top‐down management approaches. We report on a demonstration case study of improvements made in the Family Health Center (FHC) of the JPS Health Network in a refugee patient population that illustrate features of QI in a CAS framework as opposed to a traditional QI approach.

Methods

We report on changes in health system utilization by new refugee patients of the FHC from 2016 to 2017. We review the literature and summarize relevant theoretical understandings of quality management in complex adaptive systems as it applies to this case example.

Results

Applying CAS principles in the FHC, utilization of the Emergency Department and Urgent Care Center by newly arrived refugee patients before their first clinic visit was reduced by more than half (total visits decreased from 31%‐14% of the refugee patients). Our review of the literature demonstrates that traditional algorithmic top‐down QI processes are most often unsuccessful in improving even a few single‐disease metrics, and increases clinician burnout and penalizes clinicians who care for vulnerable patients. Improvement in a CAS occurs when front‐line clinicians identify care gaps and are given the flexibility to learn and self‐organize to enable new care processes to emerge, which are created from bottom‐up leadership that utilize existing interdependencies and interact with the top levels of the organization through intelligent top‐down causation. We give examples of early adapters who are better applying the principles of CAS change to their QI efforts.

Conclusions

Meaningful improvement in primary care is more likely achieved when the impetus to implement change shifts from top‐down to bottom‐up.
Influence of various antioxidants on micro‐shear bond strength of resin composite to bleached enamel
Authors: Elawsya Mohamed Elshirbeny , El‐shehawy Tamer Mohamed , Zaghloul Nadia Mohamed
Published: June 2020

Objective

Teeth bleaching causes an immediate decrease in resin composite bonding ability. This study aimed to investigate the influence of various antioxidants on resin composite bond strength to bleached enamel.

Materials and methods

One hundred and ten human maxillary incisors were used. A negative control (group A) (n = 10) was assigned (no bleaching‐no antioxidant). The remaining teeth were divided into two groups (n = 50) according to the bleaching agent used: group B (40% hydrogen peroxide) and group C (35% carbamide peroxide). Both groups were subdivided into five subgroups (n = 10). A positive control subgroup (no antioxidant) and other four subgroups according to the antioxidant solution used (10% sodium ascorbate, 10% grape seed extract, 10% green tea extract, and 5% alpha‐lipoic acid). After resin composite building, the micro‐shear bond strength test was performed. Fracture analysis was examined using a stereomicroscope. Statistical analysis was performed using a two‐way analysis of variance and Tukey's HSD post hoc test.

Results

Bond strength significantly decreased after bleaching and there was no significant difference between bleaching agents (P < .0848). Except for alpha‐lipoic acid subgroups, the other antioxidants subgroups revealed significantly higher bond strengths than bleached control subgroups (P < .0001).

Conclusion

All antioxidants used except alpha‐lipoic acid were effective in the reversal of compromised bonding after bleaching.

Clinical significance

Immediate bonding procedures after bleaching are requisite when bleaching fails to treat teeth discoloration and the direct composite veneer is considered, also when shades of old composite restorations become mismatched after bleaching and should be replaced. Immediate reestablishment of resin bond strengths after bleaching can be achieved by using several antioxidants without the need for delay.
How Does the Stock Market View Bank Regulatory Capital Forbearance Policies?
Authors: LAI VAN SON , YE XIAOXIA
Published: June 2020

During the subprime crisis, the Federal Deposit Insurance Corporation (FDIC) has shown, once again, laxity in resolving and closing insolvent institutions. Ronn and Verma (1986) call the tolerance level below which a bank closure is triggered the regulatory policy parameter. We derive a model in which we make this parameter stochastic and bank specific to infer the stock market view of the regulatory capital forbearance value. For 565 U.S. listed banks during 1990 to 2012, the countercyclical forbearance fraction in capital, most substantial in recessions, could represent 17%, on average, of the market valuation of bank equity and could go as high as 100%.
Money, Bonds, and the Liquidity Trap
Authors: ARAUJO LUIS , FERRARIS LEO
Published: June 2020

This paper examines a search model of money and public bonds in which coordination frictions lead to multiple, Pareto ranked equilibria. Whether money and bonds are substitutes or complements, is not a primitive of the economy, but an equilibrium outcome. There exists an equilibrium resembling a liquidity trap, in which money and bonds are perfect substitutes, interest rates are zero, and monetary policy is ineffective; and a superior equilibrium in which money and bonds are complements, interest rates are positive and monetary policy has a liquidity effect. On this view, the liquidity trap is a belief‐driven phenomenon.
The tripartite model of intrinsic motivation in education: A 30‐year retrospective and meta‐analysis
Authors: Howard Joshua L. , Chong Jane X. Y. , Bureau Julien S.
Published: June 2020

Introduction

Intrinsic motivation is a well‐established concept in psychology, yet, different types of intrinsic motivation have not been thoroughly investigated. We examined covariates associated with three types of intrinsic motivation from self‐determination theory (SDT) within the education context: IM to know, IM to accomplish, and IM to experience stimulation.

Methods

A meta‐analysis was conducted on samples examining the tripartite model of intrinsic motivation between 1989 and 2019. In total, 78 samples met the inclusion criteria, representing 41,633 participants across multiple nationalities. The average age of participants across samples was 19 years, and 58.2% of participants were female. Path analysis and relative weight analysis were applied to meta‐analytically derived correlations.

Discussion

Results indicated that IM to know and IM to accomplish were moderately strong predictors of adaptive student outcomes. However, results also indicated a large degree of redundancy including indistinguishable antecedent pathways. IM to experience stimulation was positively, yet, less strongly associated with adaptive outcomes. However, it did appear to be empirically distinct from the remaining intrinsic motivation types in respect to its outcomes and antecedents.

Conclusion

Intrinsic motivation appears to be a relatively homogeneous construct within educational psychology. Specification of different types of intrinsic motivation is likely to provide only marginal benefit.
Alterations in fermentation parameters during and after induction of a subacute rumen acidosis in the rumen simulation technique
Authors: Orton Theresa , Rohn Karl , Breves Gerhard , Brede Melanie
Published: June 2020

Subacute rumen acidosis (SARA) is a common problem in dairy cattle. High‐concentrate rations lead to an accumulation of short‐chain fatty acids (SCFA) in the rumen and a subsequent decrease in ruminal pH. As SARA impairs animal welfare and productivity, numerous in vivo studies are focusing on evaluation of prevention strategies. In vitro models can support this research and reduce animal numbers and experimental costs. We used different diets and buffer compositions to induce SARA in the rumen simulation technique (Rusitec) and investigated the recovery process. The experiment consisted of an equilibration period (7 days), a first control period, a SARA period and a second control period (5 days each). During the SARA period, SARA was induced by infusing SARA1 or SARA2 buffer with reduced bicarbonate (20 mmol/L and 25 mmol/L) and phosphate (both 10 mmol/L) contents compared to a modified McDougall's buffer (bicarbonate 97.9 mmol/L, phosphates 20 mmol/L). Additionally, we compared three feeding strategies, which differed in the concentrate‐to‐roughage ratio (30:70, 70:30, changing ratio: 30% concentrate in control periods and 70% concentrate in SARA period). During the SARA period, the pH decreased to a constant value below the SARA thresholds of pH 5.8 and 5.6, whereas lactate concentrations remained low. The total SCFA production rate declined 3 days after SARA induction, and the molar proportion of acetate decreased. The decrease in pH and SCFA production was more pronounced for SARA1 buffer. The high‐concentrate diet reduced the molar proportion of acetate and increased NH3‐N concentrations. During the second control period, most parameters recovered. In conclusion, SARA conditions were successfully induced in the Rusitec. However, we observed a higher influence of buffer composition than of concentrate proportions on most biochemical parameters. Nearly all changes were reversible. This model can be applied to test acidosis prevention strategies prior to animal experiments.
Drastic changes in acute stroke treatment
Authors: Kimura Kazumi , Nito Chikako , Nishiyama Yasuhiro , Suda Satoshi , Aoki Junya , Saito Tomonari , Suzuki Kentaro , Sakamoto Yuki , Katano Takehiro
Published: June 2020

t‐PA therapy has been able to be performed based on RCT study results in the world from 25 years ago. However, the Japan government approved the use of t‐PA 15 years ago. In the last 15 years, diagnostic imaging and treatment for acute stroke have been changed remarkably. The appearance of diffusion‐weighted images as diagnostic imaging for acute stroke and mechanical thrombectomy as treatment for acute stroke can markedly improve patient outcome. We experienced many severe patients treated with such therapies discharged by walk. Therefore, we would like to emphasize that stoke treatment has been changed drastically. Unfortunately, at present, stroke patients who do not have benefit from t‐PA therapy and mechanical thrombectomy therapies are not so many. In order to solve those problems, we should need to establish a stroke medical care system in Japan as soon as possible. In this presentation, we will outline the image of acute stroke, acute treatment, and stroke medical care system.
Evaluating mandibular symphysis bone density according to various skeletal patterns with CBCT
Authors: Gousman Jay , Park Jae Hyun , Chae Jong‐Moon
Published: June 2020

Objective

The aim of this retrospective study was to evaluate the bone density (BD) at the mandibular symphysis according to horizontal and vertical patterns using cone‐beam computed tomography (CBCT).

Setting and Sampling

Three hundred nineteen untreated adults with a mean age of 24 years.

Materials and Methods

CBCT images were converted into the lateral cephalometric images, and tracings were performed for categorizing the patients based on skeletal features. Cortical BDs at B point, pogonion (Pog), genion (Ge) and menton (Me), and cancellous BDs of the mandibular symphysis were measured using CBCT images. Statistical analyses were performed to evaluate the effects of horizontal and vertical skeletal patterns on BDs.

Results

Females exhibited higher BD than males at the Me, Pog, Ge (P < .001). Hyperdivergent skeletal pattern showed significantly higher cortical BD than normovergent and hypodivergent skeletal patterns at Me (P < .001). Normovergent skeletal pattern showed significantly higher cortical BD than hypodivergent skeletal patterns at Me (P = .001). Class II skeletal pattern showed significantly higher cortical BD than Class I and III skeletal patterns at Me (P < .001) and Ge (P < .05). Class I skeletal pattern showed significantly higher mean cortical BD than Class III skeletal pattern at B point (P = .025). Cancellous BD was higher in Class III and hypodivergent skeletal patterns than others but showed no statistical significance.

Conclusions

Significant differences were identified across various skeletal patterns. Several mandibular symphyseal landmarks showed statistically significant differences in BD at Me, B point and Ge, with Me having the most statistically significant findings.
Double chamber cross‐talk, the ultimate double‐cross
Authors: Almehmadi Fahad , Duffett Stephen , Khan Habib R. , Klein George , Yee Raymond
Published: June 2020

Cross‐talk is a well‐described phenomenon in a dual‐chamber cardiovascular implantable electronic device. Far‐field ventricular events are more commonly sensed in the atrial channel, the reverse is uncommon, and seeing both at the same time has never been reported. We present a case of double cross‐talk in a dual‐chamber Medtronic ® implantable cardioverter‐defibrillator. In this report, we decipher an unusual device response to the cross‐talk and describe the programming changes required to resolve it.