bluuebunny/crossref_metadata_2025 huggingface dataset:
Cannabis: are there any benefits?
Authors: Vickery Alistair W. , Finch Phillip M.
Published: November 2020

Cannabis has been used as a medicine for millennia. Prohibition in the mid‐20th century precluded early scientific investigation. ‘Cannabis’ describes three separate forms – herbal cannabis, ‘hemp’ products, pharmaceutical‐grade regulated cannabinoid‐based medical products (CBMP). In Australia, CBMP became available for prescription in November 2016. Herbal cannabis with Δ9‐tetrahydrocannabinol (THC), which is illegal, and cannabidiol (CBD) in herbal extracts, are both unregulated and unreliable sources of cannabinoids. The endocannabinoid system (ECS), delineated in the late 1990s, has increased the understanding and interest in research for appropriate clinical indications. The ubiquitous ECS has homeostatic and anti‐inflammatory effects and comprises cannabinoid receptors, endocannabinoids and degrading enzymes. Phytocannabinoids are partial agonists of the ECS. In pre‐clinical studies, THC and CBD produce beneficial effects in chronic pain, anxiety, sleep and inflammation. Systematic reviews often conflate herbal cannabis and CBMP, confusing the evidence. Currently large randomised controlled trials are unlikely to be achieved. Other methodologies with quality end‐points are required. Rich, valuable high‐quality real‐world evidence for the safe and effective use of CBMP provides an opportunity to examine benefits and potential harms. Evidence demonstrates benefit of CBMP in multiple sclerosis, chronic neuropathic pain, chemotherapy induced nausea and vomiting, resistant paediatric epilepsy, anxiety and insomnia. CBMP are well tolerated with few serious adverse events. Additional clinical benefits are promising in many other resistant chronic conditions. Pharmaceutical grade prescribed CBMP has proven clinical benefits and provides another clinical option in the physician's pharmacopeia.
Priorities and practicalities of prescribing diabetes medicines with cardiovascular and renal protective effects: an Australian perspective
Authors: Hitchen Sarah A. , Lan Nick S. R. , Fegan P. Gerry , Yeap Bu B.
Published: November 2020

Recent cardiovascular safety trials on sodium‐glucose co‐transporter 2 inhibitors and glucagon‐like peptide‐1 receptor agonists have demonstrated the significant cardiovascular and renal benefits of these medications. Diabetes organisations have revised their medication guidelines to include a focus on disease outcomes for cardiovascular disease, heart failure and renal disease. This article summarises latest evidence, guideline recommendations and current Australian Pharmaceutical Benefits Scheme requirements.
Role of digital technology in delivering ‘healthy futures’ and ‘healthy cities’
Authors: Makeham Meredith
Published: November 2020

Digital health technologies and services play a critical role in the delivery of safe and efficient healthcare and better health outcomes. Interoperability of these technologies and services, as well as digital inclusion for communities are important enablers of a modern, connected health system. The ongoing development of these factors is an aspiration of Australia's National Digital Health Strategy (NDHS). The Australian Digital Health Agency co‐designed the NDHS with input from healthcare consumers and providers, digital health industry, academic and policy experts and organisations. Approved by all Australian governments in 2017, it provides a forward vision to 2022, with seven pillars that include: Access to health information through My Health record; Secure Messaging; Medicines Safety; Interoperability; Enhanced models of care; Workforce and Education and Driving Innovation. All of these pillars have interdependent features, and many play a role in enabling communities to live healthier and happier lives supported by better connected healthcare services as well as access to information in a timely and efficient manner at the point of care. A ‘Communities of Excellence’ programme has supported regional communities to connect health services to My Health Record, increase digital health tools use and provide digital health literacy support to consumers. The aims of this programme are to allow the benefits of improved interoperability and better connected care to flow to people and their clinicians, test innovation that could go on to be scaled nationally, and close the health inequity gap experienced by people in rural and remote communities.
Facilitators for improvement of psychiatric services and barriers in implementing changes: From the perspective of Finnish patients and family members
Authors: Lantta Tella , Anttila Minna , Varpula Jaakko , Välimäki Maritta
Published: November 2020

The need for psychiatric patients and their family members to have access to quality user‐friendly services has been studied for decades, yet few improvements have been made in treatment services. This study aims to explain how patients and family members have experienced facilitators of improvements, and their thoughts about barriers in the implementation of changes. An explanatory qualitative design was adopted. Data were collected using semi‐structured interviews with eight focus groups made up of a total of 35 participants from mental health associations in Finland. The Theoretical Domains Framework guided the deductive data analysis. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) was followed in the study. Participants in patient and family member associations had similar experiences and thoughts about facilitators of improvements in psychiatric services and barriers in the implementation of changes. For example, both participant groups experienced that promoting more positive roles of professionals could facilitate improvements in psychiatric care. On the other hand, a lack of theoretical competence and interpersonal skills of professionals could hinder change. We conclude that many of the facilitators that patients and families suggested could be addressed by enhancing collaboration and communication, having a more person‐centred approach, focusing on recovery throughout the course of care, and acknowledging staff’s well‐being at work. Second, the barriers to implementing changes centre around the limited knowledge and skills of staff, and a paternalistic system that focuses on managing risk and administering treatment.
Cardiac fibroblast miR‐27a may function as an endogenous anti‐fibrotic by negatively regulating Early Growth Response Protein 3 (EGR3)
Authors: Teng Lifeng , Huang Yubing , Guo Jun , Li Bin , Lin Jin , Ma Lining , Wang Yudai , Ye Cong , Chen Qianqian
Published: November 2020

Pathological myocardial fibrosis and hypertrophy occur due to chronic cardiac stress. The microRNA‐27a (miR‐27a) regulates collagen production across diverse cell types and organs to inhibit fibrosis and could constitute an important therapeutic avenue. However, its impact on hypertrophy and cardiac remodelling is less well‐known. We employed a transverse aortic constriction (TAC) murine model of left ventricular pressure overload to investigate the in vivo effects of genetic miR‐27a knockout, antisense inhibition of miR‐27a‐5p and fibroblast‐specific miR‐27a knockdown or overexpression. In silico Venn analysis and reporter assays were used to identify miR‐27a‐5p's targeting of Early Growth Response Protein 3 (Egr3). We evaluated the effects of miR‐27a‐5p and Egr3 upon transforming growth factor‐beta (Tgf‐β) signalling and secretome of cardiac fibroblasts in vitro. miR‐27a‐5p attenuated TAC‐induced cardiac fibrosis and myofibroblast activation in vivo, without a discernible effect on cardiac myocytes. Molecularly, miR‐27a‐5p inhibited transforming growth factor‐beta (Tgf‐β) signalling and pro‐fibrotic protein secretion in cardiac fibroblasts in vitro through suppressing the pro‐fibrotic transcription factor Early Growth Response Protein 3 (Egr3). This body of work suggests that cardiac fibroblast miR‐27a may function as an endogenous anti‐fibrotic by negatively regulating Egr3 expression.
Herbal formula LLKL ameliorates hyperglycaemia, modulates the gut microbiota and regulates the gut‐liver axis in Zucker diabetic fatty rats
Authors: Li Mei , Ding Lei , Hu Yu‐Li , Qin Ling‐Ling , Wu You , Liu Wei , Wu Li‐Li , Liu Tong‐Hua
Published: November 2020

LLKL, a new traditional Chinese medicine formula containing Edgeworthia gardneri (Wall.) Meisn., Sibiraea angustata and Crocus sativus L. (saffron), was designed to ameliorate type 2 diabetes mellitus. Despite the therapeutic benefits of LLKL, its underlying mechanisms remain elusive. This study evaluated the LLKL anti‐diabetic efficacy and its effect on gut microbiota to elucidate its mechanism of action in Zucker diabetic fatty rats. We found that administration of different LLKL concentrations (4.68, 2.34 and 1.17 g/kg/d) improved several diabetic parameters after a 6‐week treatment. Moreover, LLKL modulated gut microbiota dysbiosis, increased the expression of occluding and maintained intestinal epithelial homeostasis, leading to a reduction in LPS, TNF‐α and IL‐6 levels. Hepatic transcriptomic analysis showed that the Toll‐like receptor signalling pathway was markedly enriched by LLKL treatment. RT‐qPCR results validated that LLKL treatment decreased the expressions of TLR4, MyD88 and CTSK. Furthermore, a gene set enrichment analysis indicated that LLKL enhanced the insulin signalling pathway and inhibited glycerolipid metabolism and fatty acid metabolism, which were verified by the liver biochemical analysis. These findings demonstrate that LLKL ameliorates hyperglycaemia, modulates the gut microbiota and regulates the gut‐liver axis, which might contribute to its anti‐diabetic effect.
Impact of chronic intermittent hypoxia on the long non‐coding RNA and mRNA expression profiles in myocardial infarction
Authors: Hu Chaowei , Li Jing , Du Yunhui , Li Juan , Yang Yunyun , Jia Yifan , Peng Lu , Qin Yanwen , Wei Yongxiang
Published: November 2020

Chronic intermittent hypoxia (CIH) is the primary feature of obstructive sleep apnoea (OSA), a crucial risk factor for cardiovascular diseases. Long non‐coding RNAs (lncRNAs) in myocardial infarction (MI) pathogenesis have drawn considerable attention. However, whether CIH participates in the modulation of lncRNA profiles during MI is yet unclear. To investigate the influence of CIH on MI, cardiac damage was assessed by histology and echocardiography, and lncRNA and mRNA integrated microarrays were screened. MI mouse model showed myocardial hypertrophy, aggravated inflammation and fibrosis, and compromised left ventricle function under CIH. Compared with normoxia, 644 lncRNAs and 1084 differentially expressed mRNAs were identified following CIH for 4 weeks, whereas 1482 lncRNAs and 990 mRNAs were altered at 8 weeks. Strikingly, reoxygenation after CIH markedly affected 1759 lncRNAs and 778 mRNAs. Of these, 11 lncRNAs modulated by CIH were restored after reoxygenation and were validated by qPCR. The GO terms and KEGG pathways of genes varied significantly by CIH. lncRNA‐mRNA correlation further showed that lncRNAs, NONMMUT032513 and NONMMUT074571 were positively correlated with ZEB1 and negatively correlated with Cmbl. The current results demonstrated a causal correlation between CIH and lncRNA alternations during MI, suggesting that lncRNAs might be responsible for MI aggravation under CIH.
The immuno‐reactivity of polypseudorotaxane functionalized magnetic CDMNP‐PEG‐CD nanoparticles
Authors: Lan Haiqiang , Huang Tao , Xiao Jiangwei , Liao Zhaohong , Ouyang Jun , Dong Jianghui , Xian Cory J. , Hu Jijie , Wang Liping , Ke Yu , Liao Hua
Published: November 2020

pH‐magnetic dual‐responsive nanocomposites have been widely used in drug delivery and gene therapy. Recently, a polypseudorotaxane functionalized magnetic nanoparticle (MNP) was developed by synthesizing the magnetic nanoparticles with cyclodextrin (CD) molecules (CDMNP) via polyethylene glycol (PEG) (CDMNP‐PEG‐CD). The purpose of this study was to explore the antigenicity and immunogenicity of the nanoparticles in vivo prior to their further application explorations. Here, nanoparticles were assessed in vivo for retention, bio‐distribution and immuno‐reactivity. The results showed that, once administered intravenously, CDMNP‐PEG‐CD induced a temporary blood monocyte response and was cleared effectively from the body through the urine system in mice. The introduction of β‐CD and PEG/β‐CD polypseudorotaxane on SiO2 magnetic nanoparticles (SOMNP) limited particle intramuscular dispersion after being injected into mouse gastrocnemius muscle (GN), which led to the prolonged local inflammation and muscle toxicity by CDMNP and CDMNP‐PEG‐CD. In addition, T cells were found to be more susceptible for β‐CD–modified CDMNP; however, polypseudorotaxane modification partially attenuated β‐CD–induced T cell response in the implanted muscle. Our results suggested that CDMNP‐PEG‐CD nanoparticles or the decomposition components have potential to prime antigen‐presenting cells and to break the muscle autoimmune tolerance.
Neuroretinal dysfunction revealed by a flicker electroretinogram correlated with peripheral nerve dysfunction and parameters of atherosclerosis in patients with diabetes
Authors: Kawai Miyuka , Himeno Tatsuhito , Shibata Yuka , Hirai Nobuhiro , Asada‐Yamada Yuriko , Asano‐Hayami Emi , Ejima Yohei , Kasagi Rina , Nagao Eriko , Sugiura‐Roth Yukako , Nakai‐Shimoda Hiromi , Nakayama Takayuki , Yamada Yuichiro , Ishikawa Takahiro , Morishita Yoshiaki , Kondo Masaki , Tsunekawa Shin , Kato Yoshiro , Nakamura Jiro , Kamiya Hideki
Published: November 2020

Aims/Introduction

Diabetic polyneuropathy (DPN) develops in the early stage of diabetes. However, no common diagnostic protocol has yet been established. Here, to verify that the flicker electroretinogram using a hand‐held device can detect the early dysfunction of the peripheral nervous system in patients with diabetes, we investigated the correlation between the progression of DPN and neuroretinal dysfunction.

Materials and Methods

In total, 184 participants with type 1 or 2 diabetes underwent a flicker electroretinogram (ERG) using a hand‐held device RETeval™ and nerve conduction study. Participants were also evaluated for intima‐media thickness, ankle‐brachial index, toe brachial index and brachial‐ankle pulse wave velocity. Parameters of the nerve conduction study were used to diagnose the severity according to Baba’s classification. A multiple regression analysis was used to examine the associations of ERG parameters with the severity of DPN categorized by Baba’s classification. Diagnostic properties of the device in DPN were evaluated using a receiver operating characteristic curve.

Results

A multiple regression model to predict the severity of DPN was generated using ERG. In the model, moderate‐to‐severe DPN was effectively diagnosed (area under the receiver operating characteristic curve 0.692, sensitivity 56.5%, specificity 78.3%, positive predictive value 70.6%, negative predictive value 66.1%, positive likelihood ratio 2.60, negative likelihood ratio 0.56). In the patients without diabetic retinopathy, the implicit time and amplitude in ERG significantly correlated with the parameters of the nerve conduction study, brachial‐ankle pulse wave velocity and intima‐media thickness.

Conclusions

Electroretinogram parameters obtained by the hand‐held device successfully predict the severity of DPN. The device might be useful to evaluate DPN.
Oxygen uptake, heart rate and activities of locomotor muscles during a critical swimming speed protocol in the gilthead sea bream Sparus aurata
Authors: Hachim Mouniboudine , Rouyer Tristan , Dutto Gilbert , Kerzerho Vincent , Bernard Serge , Bourjea Jérôme , McKenzie David J.
Published: November 2020

Oxygen uptake, heart rate and contraction frequencies of slow oxidative (SO) and fast glycolytic (FG) muscle were measured simultaneously in gilthead seabream Sparus aurata submitted to stepwise increases in current speed in a swimming respirometer. Variation in oxygen uptake was closely related to variation in heart rate, over initial steps these rose in concert with an increase in contraction frequency of SO muscle. There was an asymptote in oxygen uptake and heart rate at high speeds that reflected a transition from exclusive use of aerobic SO muscle to a combination of SO and anaerobic FG muscle, and which preceded fatigue.
A Context‐Informed Perspective of Child Risk and Protection: Deconstructing Myths in the Risk Discourse
Authors: Nadan Yochay , Roer‐Strier Dorit
Published: November 2020

This article discusses context‐informed conceptualization in the study of children's risk and protection. It begins by defining this perspective, challenging the universalistic approach and the view of cultures as uniform, monolithic and static and acknowledging hybridity, complexity, and the dynamics of change and power relations. In the second part of the article, we exemplify three contexts (religion and spirituality, racism and exclusion, political conflict and violence) that emerged from our large‐scale qualitative research project in Israel exploring perceptions of child risk and protection in different contexts. In the third part of the article, we rethink the ontological nature of the categories of child “risk” and “protection.” We outline and deconstruct three prevalent myths identified in the risk discourse, discuss the stance of the observer and the issue of power, the discrepancies and value mismatch between parents and professionals, and the concept of complexity in the risk discourse.
A follow‐up survey of patients with acquired angioedema due to C1‐inhibitor deficiency
Authors: Pólai Zs. , Balla Zs. , Andrási N. , Kőhalmi K. V. , Temesszentandrási Gy. , Benedek Sz. , Varga L. , Farkas H.
Published: November 2020

Background

Acquired angioedema due to C1‐inhibitor deficiency (C1‐INH‐AAE) is a rare form of bradykinin‐mediated angioedema. It is diagnosed by complement testing; its treatment consists of the management of angioedema (AE) attacks and of underlying disease.

Objective

Evaluate the results of the clinical follow‐up of patients with C1‐INH‐AAE.

Methods

Between 1999 and 2020, 3938 patients with angioedema were evaluated, and 17 diagnosed with acquired C1‐INH deficiency were followed‐up.

Results

Mean age of the 17 patients was 61 years at diagnosis. In 33%, ACE inhibitors provoked AE attacks. Autoantibodies against C1‐INH were detected in 10 patients at diagnosis and in a further patient during follow‐up. The AE attacks involved the skin in 70.6%, the upper airways in 41.2% and the tongue/lip in 52.9% of patients. Twelve of the 17 patients had an underlying condition, mainly (n = 11) lymphoproliferative disease. In 10 patients diagnosed with a haematological disorder, AAE symptoms preceded the onset of the latter. One patient has not experienced an AE attack since diagnosis. Twelve patients were treated for angioedema attacks, and 32% of the attacks required acute treatment. PdC1‐INH was used to relieve AE attacks, and rituximab for the treatment of underlying disease (in six patients). Six patients had multiple AE attacks before any treatment. The symptom‐free period increased in five patients after the on‐demand administration of pdC1‐INH concentrate and following treatment of the underlying disease in two patients.

Conclusion

Early diagnosis of C1‐INH‐AAE and underlying disease is indispensable to reduce disease burden by introducing appropriate, individualized treatment and regular follow‐up.
The role of sleep dysfunction in temporomandibular onset and progression: A systematic review and meta‐analyses
Authors: Burr Meghan R. , Naze Garrett S. , Shaffer Stephen M. , Emerson Alicia J.
Published: November 2020

Background

Painful temporomandibular (TM) disorders result in 4.3 billion dollars spent annually in the United States. The complex interplay of physiological processes in persistent pain and dysfunctional sleep has been established. Recently, dysfunctional sleep has been identified as a potential pathway to the onset of painful TM disorder.

Objectives

The aims were to (1) identify self‐report outcome measures (SROMs) of sleep quality that are clinimetrically sound in patients with painful TM disorders and (2) determine whether sleep dysfunction has any diagnostic or prognostic value for this population.

Methods

A systematic search following PRISMA guidelines was run in six databases: CINAHL, Dental, PsychALL, PubMed, Scopus and Web of Science. Any study involving minors was excluded. Risks of biases were examined in all studies. Diagnostic pooled findings were reported.

Results

Of the identified articles (n = 681), 18 were included in this systematic review (n = 1 clinimetric studies, n = 11 diagnostic studies, n = 6 prognostic studies). Nine different assessment tools were used; only the Pittsburg Sleep Quality Index (PSQI) has been validated in patients with painful TM disorders. Overall, sleep dysfunction was diagnostic for painful TM disorders. The pooled relative risk of sleep dysfunction was 1.71 (95% CI 1.30. 2.26). When PSQI scores were greater than 5/21, the unadjusted hazard ratio for development of painful TM disorders was reported to be 2.1.

Conclusion

At present, the only SROM that has diagnostic and prognostic value in evaluating and managing patients with painful TM disorders is the PSQI.
The geography of COVID‐19 and the structure of local economies: The case of Italy
Authors: Ascani Andrea , Faggian Alessandra , Montresor Sandro
Published: November 2020

The aim of this article is to analyze the subnational spread of COVID‐19 in Italy using an economic geography perspective. The striking spatial unevenness of COVID‐19 suggests that the infection has hit economic core locations harder, and this raises questions about whether, and how, the subnational geography of the disease is connected to the economic base of localities. We provide some first evidence consistent with the possibility that the local specialization in geographically concentrated economic activities acts as a vehicle of disease transmission. This could generate a core‐periphery pattern in the spatiality of COVID‐19, which might follow the lines of the local economic landscape and the tradability of its outputs.
Attitudes, Subjective Norms, and Perceived Behavioral Control Associated with Age of First Use of Cannabis among Adolescents
Authors: Korn Liat , Haynie Denise L. , Luk Jeremy W. , Sita Kellienne , Simons‐Morton Bruce G.
Published: November 2020

BACKGROUND

Prevention of early age initiation of cannabis use is a national priority, highlighting the importance of identifying cannabis‐specific attitudes, norms, and perceived behavioral control in relation to initiation age.

METHODS

Data were from the NEXT Generation Health Study, a national longitudinal sample of US adolescents followed from 10th grade (N = 1850). Cannabis‐specific attitudes, norms, and perceived behavioral control were assessed at 10th grade. Age of first use was reported retrospectively 2‐3 years after high‐school and participants were categorized as early initiators (<14 years; 3.8%), high‐school (HS) initiators (14‐18 years; 35.6%), post‐HS initiators (>18 years; 8.3%), or never users (52.3%).

RESULTS

Relative to never users, early initiators were more likely to endorse pro‐use attitudes (AOR [adjusted odds ratio] = 2.39, 95% confidence interval [CI] = 1.27‐4.50), less disapproving parental attitudes toward use (AOR = 2.50, 95% CI = 1.45‐4.28), higher cannabis use among friends (AOR = 3.81, 95% CI = 2.21‐6.60), and higher ease of access (AOR = 2.10, 95% CI = 1.14‐3.87); HS initiators were similarly more likely to report less disapproving attitudes toward use (AOR = 1.55, 95% CI = 1.25‐1.91), higher cannabis use among friends (AOR = 2.81, 95% CI = 2.18‐3.65), and higher ease of access (AOR = 1.66, 95% CI = 1.21‐2.28).

CONCLUSIONS

Earlier cannabis initiation was associated with more favorable cannabis attitudes, subjective norms, and perceived behavioral control, highlight these variables as potential intervention targets.
Monilinema gen. nov., a homocytous genus (Cyanobacteria, Leptolyngbyaceae) from saline–alkaline lakes of Pantanal wetlands, Brazil
Authors: Malone Camila Francieli da Silva , Genuário Diego Bonaldo , Vaz Marcelo Gomes Marçal Vieira , Fiore Marli Fátima , Sant’Anna Célia Leite
Published: November 2020

Cyanobacteria morphotypes with simple morphology, mainly thin filamentous homocytous strains, comprise a taxonomically complex group and represent a challenge in systematic studies. However, the polyphasic approach applied nowadays to investigate the cyanobacterial diversity has emerged as a powerful tool to undercover cryptic taxa and to set up a more natural classification system. Yet, studies exploring the cultured diversity of cyanobacteria from extreme tropical environments have paved the way to the discovery of new cyanobacteria taxa, enabling the description of Pantanalinema, Alkalinema, and Cephalothrix as novel genera from saline–alkaline lakes in Pantanal wetlands (Brazil). The present study investigated a set of cyanobacterial strains resembling Leptolyngbya morphotypes by means of its morphology, 16S ribosomal RNA (16S rRNA) phylogeny, and ITS secondary structures. Based on the shape and structure of their trichomes, the low levels of 16S rRNA identity coupled with the distinct phylogenetic position with regard to well establish genera, and their divergent ecological feature, these strains must be accommodated into a novel genus, named as Monilinema gen. nov., described under the provisions of the International Code of Nomenclature for algae, fungi, and plants. Accordingly, based on the singularity of the D1–D1′ and V3 helixes, these strains should be considered as a single species, Monilinema alkalinum.
Mitochondrial genes from 18 angiosperms fill sampling gaps for phylogenomic inferences of the early diversification of flowering plants
Authors: Xue Jia‐Yu , Dong Shan‐Shan , Wang Ming‐Qiang , Song Tian‐Qiang , Zhou Guang‐Can , Li Zhen , Van de Peer Yves , Shao Zhu‐Qing , Wang Wei , Chen Min , Zhang Yan‐Mei , Sun Xiao‐Qin , Chen Hong‐Feng , Zhang Yong‐Xia , Zhang Shou‐Zhou , Chen Fei , Zhang Liang‐Sheng , Cox Cymon , Liu Yang , Wang Qiang , Hang Yue‐Yu
Published: November 2020

The early diversification of angiosperms is thought to have been a rapid process, which may complicate phylogenetic analyses of early angiosperm relationships. Plastid and nuclear phylogenomic studies have raised several conflicting hypotheses regarding overall angiosperm phylogeny, but mitochondrial genomes have been largely ignored as a relevant source of information. Here we sequenced mitochondrial genomes from 18 angiosperms to fill taxon‐sampling gaps in Austrobaileyales, magnoliids, Chloranthales, Ceratophyllales, and major lineages of eudicots and monocots. We assembled a data matrix of 38 mitochondrial genes from 107 taxa to assess how well mitochondrial genomic data address current uncertainties in angiosperm relationships. Although we recovered conflicting phylogenies based on different data sets and analytical methods, we also observed congruence regarding deep relationships of several major angiosperm lineages: Chloranthales were always inferred to be the sister group of Ceratophyllales, Austrobaileyales to mesangiosperms, and the unplaced Dilleniales was consistently resolved as the sister to superasterids. Substitutional saturation, GC compositional heterogeneity, and codon‐usage bias are possible reasons for the noise/conflict that may impact phylogenetic reconstruction; and angiosperm mitochondrial genes may not be substantially affected by these factors. The third codon positions of the mitochondrial genes appear to contain more parsimony‐informative sites than the first and second codon positions, and therefore produced better resolved phylogenetic relationships with generally strong support. The relationships among these major lineages remain incompletely resolved, perhaps as a result of the rapidity of early radiations. Nevertheless, data from mitochondrial genomes provide additional evidence and alternative hypotheses for exploring the early evolution and diversification of the angiosperms.
Provider‐related barriers and enablers to the provision of hepatitis C treatment by general practitioners in Scotland: A behaviour change analysis
Authors: Whiteley David , Speakman Elizabeth , Elliott Lawrie , Davidson Katherine , Hamilton Emma , Jarvis Helen , Quinn Michael , Flowers Paul
Published: November 2020

The ease of direct‐acting antiviral (DAA) medications for hepatitis C virus (HCV) has provided an opportunity to decentralize HCV treatment into community settings. However, the role of non‐specialist clinicians in community‐based pathways has received scant attention to date. This study examined barriers and enablers to expanding the role of general practitioners (GPs) in HCV treatment provision, using simple behaviour change theory as a conceptual framework. A maximum variation sample of 22 HCV treatment providers, GPs and HCV support workers participated in semi‐structured interviews. Data were inductively coded, and the resulting codes deductively mapped into three principal components of behaviour change: capability, opportunity and motivation (COM‐B). By this process, a number of provider‐ and systemic‐level barriers and enablers were identified. Key barriers included the pre‐treatment assessment of liver fibrosis, GP capacity and the ‘speciality’ of HCV care. Enablers included the simplicity of the drugs, existing GP/patient relationships and the provision of holistic care. In addition to these specific factors, the data also exposed an overarching provider understanding of ‘HCV treatment’ as triumvirate in nature, incorporating the assessment of liver fibrosis, the provision of holistic support and the treatment of disease. This understanding imposes a further fundamental barrier to GP‐led treatment as each of these three components needs to be individually addressed. To enable sustainable models of HCV treatment provision by GPs, a pragmatic re‐examination of the ‘HCV treatment triumvirate’ is required, and a paradigm shift from the ‘refer and treat’ status quo.
Aerator energy use in shrimp farming and means for improvement
Authors: Boyd Claude E. , McNevin Aaron A.
Published: November 2020

Estimates of aeration energy use in shrimp farming varied from 11.4 to 41.6 GJ/t shrimp (average = 19.8 GJ/t). Several opportunities for reducing energy use in aeration are available. Many farms adopt an excessive yield to installed aeration capacity ratio. Moreover, the proportion of installed aerator capacity in use and duration of aerator operation per day are often more than necessary during the initial two‐thirds of grow‐out, because adjustment is not made for the quantity of shrimp biomass. Farm‐made, long‐arm aerators used in Asia have several features leading to energy inefficiency and could be replaced by more efficient factory‐made, long‐arm aerators. Asian aquaculture aerator manufacturers should redesign aerators to include design features shown in research to improve efficiency. Dissolved oxygen concentration monitoring essential for verification of aeration performance is seldom performed by shrimp farmers. With good aeration technique, energy use for aeration should not exceed 10–15 GJ/t shrimp.
Probing the Exegetical Foundations of Consubstantiality: Worship, Mediatorial Figures, and the Homoousion
Authors: Butner D. Glenn
Published: November 2020

This article explores the question of whether modern theologians can adopt pro‐Nicene theology on the basis of modern biblical studies. It argues that under two hermeneutic assumptions (identified as the canon principle and inspiration principle), key data assessed in the Christological monotheism debates provides warrant for pro‐Nicene defenses of consubstantiality. Three features of Athanasius’s Contra Arianos are explored in dialogue with modern biblical scholarship to defend this claim: Athanasius’s variegated mediatorial Christology, his emphasis on Christ as preeminent mediator, and his appeals to cultic worship of Christ in the New Testament.
Epidemiology of diabetes among South Asians in the United States: lessons from the MASALA study
Authors: Gujral Unjali P. , Kanaya Alka M.
Published: November 2020

South Asian individuals in the United States are at an increased risk of type 2 diabetes (T2DM); however, the mechanisms behind this are not well understood. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study is the only longitudinal cohort of South Asians in the United States and provides key insights as to the epidemiology of T2DM in South Asians. Evidence from the MASALA study suggests that South Asians experience a disproportionately high burden of prevalent and incident T2DM compared with members of other race/ethnic groups. Higher insulin resistance in South Asians, even with low body mass index (BMI), more impairment in insulin secretion, and greater deposition of ectopic fat likely play a role in T2DM etiology. Furthermore, South Asian migrants to the United States experience a range of factors related to acculturation, social networks, and religious beliefs, which may impact physical activity and dietary practices. Interventions to prevent T2DM in South Asians should include a focus on cultural factors related to health and should consider the complete mechanistic pathway and the relative contributions of insulin resistance, β cell dysfunction, and ectopic fat deposition on T2DM development in South Asians, particularly in those with lower BMI.
Oral health education and promotion in special needs children: Systematic review and meta‐analysis
Authors: Lai Yvonne Yee Lok , Zafar Sobia , Leonard Helen Margaret , Walsh Laurence James , Downs Jennepher Anne
Published: November 2020

Objective

To review the effectiveness of oral health education and oral health promotion interventions for children and adolescents with intellectual and developmental disabilities (IDD), in ensuring optimal gingival health, caries experience and oral health‐related quality of life, compared to no interventions or alternative interventions.

Methods

A systematic review was conducted to identify published studies from four databases (Medline, PsycINFO, CINAHL and ERIC). Randomised or quasi‐randomised controlled trials were included. Two independent reviewers performed risk of bias and qualitative analysis. Meta‐analysis was performed as appropriate.

Results

Eight treatment comparisons were identified. There was low certainty evidence that fluoride interventions provided long‐term reductions in caries in those with IDD; and there was some evidence that chlorhexidine albeit with low certainty provided short‐term and long‐term reductions in plaque and gingivitis. There was moderate certainty evidence for short‐term reductions in dental plaque from the use of modified toothbrushes, but not compelling evidence for powered toothbrushes.

Conclusions

Most studies provided a low quality of evidence, and so any adaptations made to oral health practices of individuals with IDD need to consider their individual needs.

PROSPERO registration: CRD42019145784.
Ethylene is a local modulator of jasmonate‐dependent phenolamide accumulation during Manduca sexta herbivory in Nicotiana attenuata
Authors: Figon Florent , Baldwin Ian T. , Gaquerel Emmanuel
Published: November 2020

Rapid reconfigurations of interconnected phytohormone signalling networks allow plants to tune their physiology to constantly varying ecological conditions. During insect herbivory, most of the induced changes in defence‐related leaf metabolites are controlled by jasmonate (JA) signalling, which, in the wild tobacco Nicotiana attenuata, recruits MYB8, a transcription factor controlling the accumulation of phenolic‐polyamine conjugates (phenolamides). In this and other plant species, herbivory also locally triggers ethylene (ET) production but the outcome of the JA‐ET cross‐talk at the level of secondary metabolism regulation has remained only superficially investigated. Here, we analysed local and systemic herbivory‐induced changes by mass spectrometry‐based metabolomics in leaves of transgenic plants impaired in JA, ET and MYB8 signalling. Parsing deregulations in this factorial data‐set identified a network of JA/MYB8‐dependent phenolamides for which impairment of ET signalling attenuated their accumulation only in locally damaged leaves. Further experiments revealed that ET, albeit biochemically interrelated to polyamine metabolism via the intermediate S‐adenosylmethionine, does not alter the free polyamine levels, but instead significantly modulates phenolamide levels with marginal modulations of transcript levels. The work identifies ET as a local modulator of phenolamide accumulations and provides a metabolomics data‐platform with which to mine associations among herbivory‐induced signalling and specialized metabolites in N. attenuata.
Up‐regulated 2‐alkenal reductase expression improves low‐nitrogen tolerance in maize by alleviating oxidative stress
Authors: Wang Yi , Zhao Yanxiang , Wang Shanshan , Liu Junfeng , Wang Xiqing , Han Yanlai , Liu Fang
Published: November 2020

In plants, cellular lipid peroxidation is enhanced under low nitrogen (LN) stress; this increases the lipid‐derived reactive carbonyl species (RCS) levels. The cellular toxicity of RCS can be reduced by various RCS‐scavenging enzymes. However, the roles of these enzymes in alleviating oxidative stress and improving nutrient use efficiency (NUE) under nutrient stress remain unknown. Here, we overexpressed maize endogenous NADPH‐dependent 2‐alkenal reductase (ZmAER) in maize; it significantly increased the tolerance of transgenic plants (OX‐AER) to LN stress. Under LN condition, the biomass, nitrogen accumulation, NUE, and leaf photosynthesis of the OX‐AER plants were significantly higher than those of the wild‐type (WT) plants. The leaf and root malondialdehyde and H2O2 levels in the transgenic plants were significantly lower than those in WT. The expression of antioxidant enzyme‐related genes ZmCAT3, ZmPOD5 and ZmPOD13 was significantly higher in the transgenic lines than in WT. Under LN stress, the nitrate reductase activity in the OX‐AER leaves was significantly increased compared with that in the WT leaves. Furthermore, under LN stress, ZmNRT1.1 and ZmNRT2.5 expression was upregulated in the OX‐AER plants compared with that in WT. Overall, up‐regulated ZmAER expression could enhance maize's tolerance to LN stress by alleviating oxidative stress and improve NUE.
Associations between oil development and sexually transmitted infections: Public health nurse perspectives
Authors: Huseth‐Zosel Andrea L. , Secor‐Turner Molly , Wen Qian , Liu Xiyuan , Jansen Rick J.
Published: November 2020

Background

Oil development (OD) has been associated with increased sexually transmitted infection (STI) rates, with limited focus on the North Dakota (ND) oil boom. Public health (PH) nurse experiences can provide context related to health challenges during OD‐related population booms.

Objective

To compare reported STI rates in ND oil‐producing (OP) and non‐oil‐producing (NOP) counties before, during, and after the oil boom and describe PH nurse experiences during this time.

Design

We conducted secondary data analysis of oil production data and reported rates for chlamydia and gonorrhea, and conducted interviews with ND PH nurses.

Sample

PH nurses within ND counties geographically located in or near OD in the state.

Measurements

ND county‐level OD data trends were compared to similarly timed reported rates of chlamydia and gonorrhea in OP and NOP counties. PH nurse interviews were conducted addressing their STI‐related experiences working in PH during the oil boom.

Results

Significant findings include a correlation between OD and gonorrhea rates. PH nurses described a limited PH infrastructure to meet the health needs of a transient, increasing population.

Conclusions

Expanding the role of PH nurses in ND to implement STI screening and treatment would improve access to STI testing allowing for comprehensive reporting of STIs.
Quantifying the Trendiness of Trends
Authors: Jensen Andreas Kryger , Ekstrøm Claus Thorn
Published: November 2020

News media often report that the trend of some public health outcome has changed. These statements are frequently based on longitudinal data, and the change in trend is typically found to have occurred at the most recent data collection time point—if no change had occurred the story is less likely to be reported. Such claims may potentially influence public health decisions on a national level.

We propose two measures for quantifying the trendiness of trends. Assuming that reality evolves in continuous time, we define what constitutes a trend and a change in trend, and introduce a probabilistic Trend Direction Index. This index has the interpretation of the probability that a latent characteristic has changed monotonicity at any given time conditional on observed data. We also define an index of Expected Trend Instability quantifying the expected number of changes in trend on an interval.

Using a latent Gaussian process model, we show how the Trend Direction Index and the Expected Trend Instability can be estimated in a Bayesian framework, and use the methods to analyse the proportion of smokers in Denmark during the last 20 years and the development of new COVID-19 cases in Italy from 24 February onwards.
Is there evidence that periodontal diseases are risk factors for coronary arterial disease?—Scoping review
Authors: Silva Nicholas Newton Queiroz , Albuquerque e Aguiar Igor Hudson , Gomes Marcus Vinícius Silva Weigel , Neto Olavo Barbosa de Oliveira , Penteado Luiz Alexandre de Moura , de Lima Fernando José Camello
Published: November 2020

Aim

To determine the scientific evidence regarding the condition of periodontal diseases (PDs) as risk factors of coronary artery diseases.

Materials and methods

A scoping review was performed through the selection of articles from online databases (Medline via PubMed, LILACS, and Cochrane CENTRAL), using a search algorithm and eligibility criteria for data extraction and data synthesis of included papers. Four hundred forty‐one studies from online databases and 1364 from reference lists were initially identified, and 34 articles were selected for inclusion. Articles had to be published between 2015 and 2020 and had to associate PDs to coronary arterial diseases. All studies comprised a sample of 446443 participants. Favorable opinions totaled 70.59%, and the cross‐sectional observational study design was more frequently found (32.35%). Biochemical outcomes were showed more frequently, such as inflammatory biomarkers (58.82%). Despite a large advantage for favorable opinions, a statistically significant result was not found when extracted data were combined with studies opinions.

Conclusion

The evidence was classified as level II‐3, hence, still distant from the best ranks and can therefore be considered as unclear. Moreover, studies with the higher potential to generate evidence showed a high risk of bias.
The Political and Civic Lives of Public Sector Workers: Unions and “Public Service Motivation”*
Authors: Kerrissey Jasmine , Wilkerson Tiamba , Meyers Nathan
Published: November 2020

Public sector employees are highly engaged in civic and political life, from voting to volunteering. Scholars have theorized that this political activity stems from “public service motivation,” or the selection of publicly oriented individuals into public work. We build on this work by analyzing the role of public sector unions in shaping participation. Unions are central mobilizing organizations in political life, and one in three public sector workers are unionized. Special supplements of the Current Population Survey provide data on various forms of participation, sector, union membership, and union coverage. Logistic regressions find that unionized public sector workers have much higher odds of engaging in a range of activities compared to non‐union public workers, including protest, electoral politics, and political communication. Union membership impacts service work to a lesser extent, suggesting that unions are more central to political lives. These findings have implications for the consequences of union decline, including the class, race, and gender composition of who participates in democratic life.
Visible characteristics and structural modifications relating to enlarged facial pores
Authors: Nkengne Alex , Pellacani Giovanni , Ciardo Silvana , De Carvalho Nathalie , Vié Katell
Published: November 2020

Background

Many factors relate to enlargement and visibility of facial pores. However, how enlargement relates to modification of the skin structure is still poorly analysed. Therefore, our aim was to characterise the visible features and the micro‐environment of facial pores.

Materials and Methods

We recruited 160 women, half of them with normal‐size facial pores, the other half presenting enlarged pores. We analysed their right cheek using standardised photography, in vivo reflectance microscopy and optical coherence tomography.

Results

If the area of pores is indeed the most differentiating visible characteristic, enlarged facial pores are also denser and more contrasted. At the structural level, enlarged facial pores present a more regular organisation of keratinocytes, an irregular dermo‐epidermal junction and a higher attenuation of collagen between the surface and deeper layers. Still, the most relevant alterations of enlarged facial pores are the presence of bright tubular structures surrounding hair follicles and enlarged hair shafts.

Conclusion

These observations suggest that alterations of the stroma could result in altered skin tensions, leading to the dilation of the infundibulum and enlarged hair shaft. The modified tension would also explain the more regular organisation of the keratinocytes and the irregular dermo‐epidermal junction.
A Rationalist Defence of Determinism
Authors: Istvan Michael A.
Published: November 2020

Largely due to the popular allegation that contemporary science has uncovered indeterminism in the deepest known levels of physical reality, the debate as to whether humans have moral freedom, the sort of freedom on which moral responsibility depends, has put aside to some extent the traditional worry over whether determinism is true. As I argue in this article, however, there are powerful proofs for both chronological determinism and necessitarianism, forms of determinism that pose the most penetrative threat to human moral freedom. My ultimate hope is to show that, despite the robust case against human moral freedom that can be made without even relying on them, chronological determinism and necessitarianism should be regarded with renewed urgency.
Hormone receptor expression, clinical and histopathological analysis in feline injection site sarcomas
Authors: Zanuncio Virgínia V. , Conceição Lissandro G. , Loures Fabrícia H. , Cassali Geovanni D. , Rocha Kelvin , Lima Bruna M.
Published: November 2020

Feline injection site sarcomas (FISS) are aggressive, with high recurrence and rarely metastasising. The objective of this study was to evaluate, by immunohistochemistry, the expression of oestrogen (ER) and progesterone (PR) receptors in FISS and correlate them with clinical and histopathological aspects. This was a retrospective study with 51 cases of FISS. Immunohistochemistry was performed to detect vimentin, ER, PR and Ki67 expression. Clinical, histopathological and immunohistochemical characteristics were predictor variables and the expression of ER and PR were the dependent ones. Twenty‐eight (55%) of the 51 FISS cases were female and 23 (45%) male with 10.7 ± 4.2 years and median tumour size of 3 cm (2.0‐5.4). The trunk was the most affected site, with 38 cases (84%). Histological grade III was observed in 57% of the cases, considering differentiation score, necrosis and mitotic index. ER expression, positive in 64% of cases, was associated with the mitotic index (P = .05) and degree of pleomorphism (P = .04). PR was not associated with the variables and 63% of cases were negative for this receptor. Thus, ER expression can affect tumour growth. The knowledge on the FISS hormonal expression is important to clarify the pathophysiological mechanisms. Further studies are needed to predict the value of ER expression in the prognosis of FISS.