bluuebunny/crossref_metadata_2025 huggingface dataset:
Diverse phylogeny and morphology of magnetite biomineralized by magnetotactic cocci
Authors: Liu Peiyu , Liu Yan , Zhao Xiang , Roberts Andrew P. , Zhang Heng , Zheng Yue , Wang Fuxian , Wang Lushan , Menguy Nicolas , Pan Yongxin , Li Jinhua
Published: September 2020

Magnetotactic bacteria (MTB) are diverse prokaryotes that produce magnetic nanocrystals within intracellular membranes (magnetosomes). Here, we present a large‐scale analysis of diversity and magnetosome biomineralization in modern magnetotactic cocci, which are the most abundant MTB morphotypes in nature. Nineteen novel magnetotactic cocci species are identified phylogenetically and structurally at the single‐cell level. Phylogenetic analysis demonstrates that the cocci cluster into an independent branch from other Alphaproteobacteria MTB, that is, within the Etaproteobacteria class in the Proteobacteria phylum. Statistical analysis reveals species‐specific biomineralization of magnetosomal magnetite morphologies. This further confirms that magnetosome biomineralization is controlled strictly by the MTB cell and differs among species or strains. The post‐mortem remains of MTB are often preserved as magnetofossils within sediments or sedimentary rocks, yet paleobiological and geological interpretation of their fossil record remains challenging. Our results indicate that magnetofossil morphology could be a promising proxy for retrieving paleobiological information about ancient MTB.
Buttermilk as milk powder and whey substitute in compound milk chocolate: Comparative study and optimisation
Authors: Rasouli Pirouzian Haniyeh , Alakas Elif , Cayir Merve , Yakisik Elif , Toker Omer Said , Kaya Şevin , Tanyeri Ozan
Published: September 2020

The aim of this study was to investigate the optimal concentration of milk, whey and buttermilk powder by using mixture design for the formulation of compound milk chocolate. The influence of buttermilk as a milk and whey substitute on the main physicochemical parameters of compound milk chocolate was investigated. The optimisation of the variables indicated that using 35.660% milk powder, 27.957% whey powder and 36.383% buttermilk produced the optimum milk chocolate with the highest desirability without undesirable changes in the quality properties. Chocolates containing equal amounts of buttermilk and milk powder and also equal amounts of whey powder and buttermilk powder demonstrated high consumer acceptability.
Parity‐related variation in cortisol concentrations in hair during pregnancy
Authors: Marteinsdottir I , Sydsjö G , Faresjö Å , Theodorsson E , Josefsson A
Published: September 2020

Objective

To investigate hair cortisol concentrations (HCC) monthly in pregnant women and to explore the effect of parity.

Design

Prospective cohort study from gestational week (GW) 26, at childbirth and postpartum.

Setting

An antenatal care clinic in southeast Sweden.

Sample

390 pregnant women.

Methods

Cortisol was measured using radioimmunoassay in methanol extracts of ground hair samples.

Main outcome measures

Hair cortisol concentrations.

Results

Both primi‐ and multiparae exhibited an increase in HCC throughout pregnancy. Primiparae had significantly higher HCC in the latter part of the last trimester compared with multiparae (1 month P = 0.003, 2 months P = 0.038). The use of psychotropic medication in the first trimester correlated to HCC postpartum (P < 0.001). HCC in GW 14–17 was associated with HCC in GW 18–21 (primiparae and multiparae, P < 0.001), GW 22–25 (primiparae P = 0.036, multiparae P = 0.033), and 2 months postpartum (primiparae P = 0.049). HCC in GW 18–21 was associated with GW 22–25 in both primiparae (P < 0.001) and multiparae (P < 0.001) as well as 2 months prior to childbirth among primiparae (<0.037). In general, all estimates of HCC in pregnancy and postpartum showed a significant association between HCC for a specific month and the HCC in the previous month (all P < 0.001), except for the association of HCC among primiparae in GW 22–25 and 3 months prior to childbirth.

Conclusions

Increased cortisol concentrations in hair were observed during pregnancy, which decreased 3 months prior to childbirth in multiparae. The results indicate a quicker suppression of the hypothalamic CRH (corticotropin‐releasing hormone) production by placenta CRH in multiparous women.

Tweetable abstract

Multiparae have a quicker suppression of hypothalamic CRH production by placenta CRH during pregnancy compared to primiparae.
From Farm to Kitchen: How Gender Affects Production Diversity and the Dietary Intake of Farm Households in Ethiopia
Authors: Argaw Thomas Lemma , Phimister Euan , Roberts Deborah
Published: September 2020

Malnutrition in farm households remains a significant problem in many developing countries and is linked to a lack of diversity in diets. We explore how gender differences might affect household dietary diversity using the LSMS‐ISA Ethiopia panel dataset. Drawing on a farm household framework, nonlinear panel models are estimated allowing for unobserved heterogeneity and production endogeneity using a control function. We use decomposition techniques to identify the impact of different potential sources of gender difference in dietary diversity. Our results provide evidence of significant gender effects in production diversity and in dietary diversity using the food variety score (FVS). For other indicators of dietary diversity, the evidence of gender effects is weaker. The decomposition results suggest that, after controlling for differences in characteristics, female‐headed households are at a dietary diversity disadvantage. Gender differences in the relationship between production diversity, price and income and dietary diversity and the production diversity decisions appear to be the main drivers. The results also suggest that female preferences are more orientated towards ensuring greater dietary diversity in the household. Our evidence also suggests that a key driver of gender disadvantage in dietary diversity is related to whether food is sourced from the household’s own production or the market. This implies that part of the observed negative gender impact on dietary diversity may stem from differences in marketing and storage of own production through the year.
Forensic determination of hair deposition time in crime scenes using electron paramagnetic resonance
Authors: Shankar Nikhita , Guimarães André O. , Napoli Eleonora , Giulivi Cecilia
Published: September 2020

Several types of biological samples, including hair strands, are found at crime scenes. Apart from the identification of the value and the contributor of the probative evidence, it is important to prove that the time of shedding of hair belonging to a suspect or victim matches the crime window. To this end, to estimate the ex vivo aging of hair, we evaluated time‐dependent changes in melanin‐derived free radicals in blond, brown, and black hairs by using electron paramagnetic resonance spectroscopy (EPR). Hair strands aged under controlled conditions (humidity 40%, temperature 20–22°C, indirect light, with 12/12 hour of light/darkness cycles) showed a time‐dependent decay of melanin‐derived radicals. The half‐life of eumelanin‐derived radicals in hair under our experimental settings was estimated at 22 ± 2 days whereas that of pheomelanin was about 2 days suggesting better stabilization of unpaired electrons by eumelanin. Taken together, this study provides a reference for future forensic studies on determination of degradation of shed hair in a crime scene by following eumelanin radicals by utilizing the non‐invasive, non‐destructive, and highly specific EPR technique.
A forensic examination of four popular cross‐platform file‐sharing apps with Wi‐Fi P2P
Authors: Teng Szu‐Yuan , Wen Che‐Yen
Published: September 2020

File‐sharing apps with Wi‐Fi hotspot or Wi‐Fi Direct functions become more popular. They can work on multiple platforms and allow users to transfer files in a concealed manner. However, when criminals use these apps in illegal activities, it becomes an important issue for investigators to find digital evidence on multiple platforms. At present, there are few studies on this topic, and most of them are limited to the single platform problem. In this paper, we propose a forensic examination method for four popular cross‐platform file‐sharing apps with Wi‐Fi hotspot and Wi‐Fi Direct functions: Zapya, SHAREit, Xender, and Feem. We use 22 static and live forensic tools for 11 platforms to acquire, analyze, and classify the forensic artifacts. In our experiments, we find many useful forensic artifacts and classify them into six categories. The experimental results can support law enforcement investigations of digital evidence and provide information for future studies on other cross‐platform file‐sharing apps.
Graphical Interpretations of Data: Be Alert!
Authors: Reese R. Allan
Published: September 2020

R. Allan Reese offers advice for TV producers as he proofreads some Peston graphs
What's The Big Idea? Bayes' Rule
Authors: Hoang Lê Nguyên
Published: September 2020

In the second of our new series of columns on influential and inspiring ideas in statistics, Lê Nguyên Hoang explains a theorem that helps us to update our beliefs as new information arises
When Academia Meets Industry Meets Government
Authors: Kolassa John
Published: September 2020

John Kolassa interviews Ridha Ben Mrad, Nancy Reid and Dave Campbell about the Canadian experience of building statistical partnerships between academia, industry and government
Displaying emergency patient estimated wait times: A multi‐centre, qualitative study of patient, community, paramedic and health administrator perspectives
Authors: Walker Katie , Stephenson Melanie , Loupis Anne , Ben‐Meir Michael , Joe Keith , Stephenson Michael , Lowthian Judy , Yip Beatrice , Wu Elena , Hansen Kim , Rosler Rachel , Buntine Paul , Hutton Jennie
Published: September 2020

Objective

EDs have the potential ability to predict patient wait times and to display this to patients and other stakeholders. Little is known about whether consumers and stakeholders would want this information and how wait time predictions might be used. The aim of the present study was to gain perspectives from consumers and health services personnel regarding the concept of emergency wait time visibility.

Methods

We conducted a qualitative interview and focus group study in 2019. Participants included emergency medicine patients, families, paramedics, well community members, and hospital/paramedic administrators from multiple EDs and organisations in Victoria, Australia. Transcripts were coded and themes presented.

Results

One focus group and 103 semi‐structured interviews were conducted in 2019 including 32 patients, 22 carers/advocates and 21 paramedics in the ED; 20 health service administrators (paramedic and hospital) and 15 community members. Consumers and paramedics face physical and psychological difficulties when wait times are not visible. Consumers believe about a 2‐h wait is tolerable, beyond this most begin to consider alternative strategies for seeking care. Consumers want to see triage to doctor times; paramedics want door‐to‐off stretcher times (for all possible transport destinations); with 47 of 50 consumers and 30 of 31 paramedics potentially using this information. About 28 of 50 consumers would use times to inform facility or provider choice, another 19 of 50 want information once in the waiting room. During prolonged waits, 51 of 52 consumers would continue to seek care.

Conclusions

Consumers and paramedics want wait time information visibility. They would use the information in a variety of ways, both pre‐hospital and while waiting for care.
Effect of processing conditions as high‐intensity ultrasound, agitation, and cooling temperature on the physical properties of a low saturated fat
Authors: da Silva Thais Lomonaco Teodoro , Danthine Sabine , Martini Silvana
Published: September 2020

The objective of this work was to evaluate the effect that agitation rate, crystallization temperature, and sonication have on the physical properties of a soybean‐based fat with low levels of saturated fatty acids crystallized in a scraped surface heat exchanger (SSHE). The sample was crystallized at two temperatures (20 and 25 °C) and agitation rates (344/208 rpm in the barrels/pin worker‐high agitation HA and 185/71 rpm barrels/pin worker‐low agitation LA), and a constant flow of 11 L/hr. High‐intensity ultrasound (HIU – 12.7 mm‐diameter tip, 50% amplitude, 5 s pulses) was coupled to a water jacketed flow‐cell and placed at three different positions within the SSHE. The combination of all those parameters affected samples’ physical properties. Higher oil binding capacity (OBC) and elasticity (G’) were obtained at 20 °C compared to 25 °C (77% vs. 63.78% for OBC and 30.4 kPa vs. 6 kPa for G’, respectively) due to the smaller crystals formed at 20 °C. Fewer or no differences were observed due to agitation alone, but LA conditions allowed for more secondary nucleation to form due to sonication and resulted in a higher improvement on the properties of the fat.

Practical Application

Fat crystallization in a scrapped surface heat exchanger (SSHE) combined with a high‐intensity ultrasound (HIU) gives a realistic idea of how the HIU would work in an industrial line under continuous flow, shaved shear, and different supercooling. Results from this research will provide industry with tools on how and where to incorporate HIU in their processing line. Moreover, will give information on how to combined crystallization conditions and sonocrystallization in order to obtain improved physical properties.
Determination of the main naphthoquinones in Onosma hookeri Clarke. var. longiforum Duthie and its optimization of the ultrasound‐assisted extraction using response surface methodology
Authors: Wu Qiang , Er‐bu Aga , Liang Xiaoxia , Luan Shangxian , He Changliang , Yin Lizi , Yin Zhongqiong , Zou Yuanfeng , Li Lixia , Song Xu
Published: September 2020

In this study, besides isovaleryl shikonin, another shikonin derivative, tigloylshikonin, was also isolated from the roots of Onosma hookeri Clarke. var. longiforum Duthie as a main naphthoquinone constituent for the first time. Then optimization of the ultrasonic‐assisted extraction was done by Box–Behnken design–response surface methodology on the basis of single‐factor experiments. The optimized conditions were 72% (v/v) ethanol and the material to solution ratio was 1:37(g/mL) at 52 °C for 77 min. Under these conditions, the extraction yield of ethanol extract was 36.74 ± 0.32%, the contents of isovaleryl shikonin and tigloylshikonin reached 0.094 ± 0.003% and 0.223 ± 0.006%, respectively. Notably, in that optimized condition, the yield of isovaleryl shikonin increased by approximately 7.64‐fold than the previous report. In the in vitro antioxidant activity assay, the optimal ethanol extract exhibited similar 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) scavenging activity as butylated hydroxy toluene (BHT), but slightly weaker 2,2'‐azino‐bis‐3‐ethylbenzthiazoline‐6‐sulphonic acid (ABTS) scavenging activity and total antioxidant capacity than that of BHT. However, the active polar fraction, the ethyl acetate fraction, which is enriched with naphthoquinone constituents, performs as a better antioxidant agent than BHT. Therefore, both of them could be considered as a naturally sourced antioxidants compared to commercially available synthetic drugs.

Practical Application

Onosma hookeri Clarke. var. longiforum Duthie, a traditional Chinese medicine and food item, has been in use since a long time. A systematic determination of the main naphthoquinones, and antioxidant capacity of the naphthoquinones‐enriched ethanol extract and different polar fractions, was carried out in the present study. The results may provide theoretical basis for the claim that naphthoquinones‐enriched ethanol extract and ethyl acetate fraction from the roots of Onosma hookeri Clarke. var. longiforum Duthie could be used as potential natural antioxidants in the pharmaceutical, food, and cosmetic industries.
Refined Shortest Paths (RSP): Incorporation of topography in space use estimation from node‐based telemetry data
Authors: Niella Yuri , Flávio Hugo , Smoothey Amy F. , Aarestrup Kim , Taylor Matthew D. , Peddemors Victor M. , Harcourt Robert
Published: September 2020

Acoustic telemetry enables spatial ecologists to collect movement data from a variety of aquatic species. In estuaries and rivers, accounting for the complex shape of water bodies is challenging. Current methods for analysing utilization distributions (UDs) are restricted to using the locations of receivers where animals have been detected, which limits the information available to estimate movement paths.

We present a new r package (RSP—Refined Shortest Paths) for analysing the movements of animals tracked with acoustic transmitters in environments constrained by landmasses. The method estimates the shortest in water locations of monitored animals between pairs of detections using least‐cost path analysis. It then applies dynamic Brownian Bridge Movement Models to calculate UD areas. Intra‐ and interspecific overlaps in space and time are calculated and can be used, for example, to investigate potential influencing environmental factors.

Tracks refined with RSP follow the estuary shape, yielding substantially longer, but more realistic travel distances. Showcased examples demonstrate how RSP can be used to analyse intra‐ and interspecific movement patterns; determine similarities in habitat use; identify the environmental conditions responsible for influencing the size of the space use areas; and assess levels of spatial overlap between different species.

The RSP toolkit generates more realistic movements of tracked animals than those derived using receiver locations alone. An incidental benefit is its ability to deal with receiver loss, a common problem in acoustic telemetry studies. The analysis can be readily customized to suit different study species, array configurations and habitat shapes.
Physiological mechanism and spatial distribution of increased alveolar dead‐space in early ARDS: An experimental study
Authors: Beda Alessandro , Winkler Tilo , Wellman Tyler J. , De Prost Nicolas , Tucci Mauro , Vidal Melo Marcos F.
Published: September 2020

Background

We aimed to investigate the physiological mechanism and spatial distribution of increased physiological dead‐space, an early marker of ARDS mortality, in the initial stages of ARDS. We hypothesized that: increased dead‐space results from the spatial redistribution of pulmonary perfusion, not ventilation; such redistribution is not related to thromboembolism (ie, areas with perfusion = 0 and infinite ventilation‐perfusion ratio, ), but rather to moderate shifts of perfusion increasing in non‐dependent regions.

Methods

Five healthy anesthetized sheep received protective ventilation for 20 hours, while endotoxin was continuously infused. Maps of voxel‐level lung ventilation, perfusion, , CO2 partial pressures, and alveolar dead‐space fraction were estimated from positron emission tomography at baseline and 20 hours.

Results

Alveolar dead‐space fraction increased during the 20 hours (+0.05, P = .031), mainly in non‐dependent regions (+0.03, P = .031). This was mediated by perfusion redistribution away from non‐dependent regions (−5.9%, P = .031), while the spatial distribution of ventilation did not change, resulting in increased in non‐dependent regions. The increased alveolar dead‐space derived mostly from areas with intermediate (0.5≤≤10), not areas of nearly “complete” dead‐space (>10).

Conclusions

In this early ARDS model, increases in alveolar dead‐space occur within 20 hours due to the regional redistribution of perfusion and not ventilation. This moderate redistribution suggests changes in the interplay between active and passive perfusion redistribution mechanisms (including hypoxic vasoconstriction and gravitational effects), not the appearance of thromboembolism. Hence, the association between mortality and increased dead‐space possibly arises from the former, reflecting gas‐exchange inefficiency due to perfusion heterogeneity. Such heterogeneity results from the injury and exhaustion of compensatory mechanisms for perfusion redistribution.
Identification of the Physiologically Difficult Airway in the Pediatric Emergency Department
Authors: Dean Preston N. , Hoehn Erin F. , Geis Gary L. , Frey Mary E. , Cabrera‐Thurman Mary K. , Kerrey Benjamin T. , Zhang Yin , Stalets Erika L. , Zackoff Matthew W. , Maxwell Andrea R. , Pham Tena M. , Lautz Andrew J.
Published: September 2020

Background

The risk factors for peri‐intubation cardiac arrest in critically ill children are incompletely understood. The study objective was to derive physiologic risk factors for deterioration during tracheal intubation in a pediatric emergency department (PED).

Methods

This was a retrospective cohort study of patients undergoing emergency tracheal intubation in a PED. Using the published literature and expert opinion, a multidisciplinary team developed high‐risk criteria for peri‐intubation arrest: 1) hypotension, 2) concern for cardiac dysfunction, 3) persistent hypoxemia, 4) severe metabolic acidosis (pH < 7.1), 5) post–return of spontaneous circulation (ROSC), and 6) status asthmaticus. We completed a structured review of the electronic health record for a historical cohort of patients intubated in the PED. The primary outcome was peri‐intubation arrest. Secondary outcomes included tracheal intubation success rate, extracorporeal membrane oxygenation (ECMO) activation, and in‐hospital mortality. We compared outcomes between patients meeting one or more versus no high‐risk criteria.

Results

Peri‐intubation cardiac arrest occurred in 5.6% of patients who met at least one high‐risk criterion compared to 0% in patients meeting none (5.6% difference, 95% confidence interval [CI] = 1.0 to 18.1, p = 0.028). Patients meeting at least one criterion had higher rates of any postintubation cardiac arrest in the PED (11.1% vs. 0%, 11.1% difference, 95% CI = 4.1 to 25.3, p = 0.0007), in‐hospital mortality (25% vs. 2.3%, 22.7% difference, 95% CI = 11.0 to 38.9, p < 0.0001), ECMO activation (8.3% vs. 0%, 8.3% difference, 95% CI = 2.5 to 21.8, p = 0.004), and lower likelihood of first‐pass intubation success (47.2% vs. 66.1%, −18.9% difference, 95% CI = −35.5 to −1.5, p = 0.038), respectively.

Conclusions

We have developed criteria that successfully identify physiologically difficult airways in the PED. Children with hypotension, persistent hypoxemia, concern for cardiac dysfunction, severe metabolic acidosis, status asthmaticus or who are post‐ROSC are at higher risk for peri‐intubation cardiac arrest and in‐hospital mortality. Further multicenter investigation is needed to validate our findings.
Combined approaches to reveal genes associated with litter size in Yunshang black goats
Authors: Tao L. , He X. Y. , Jiang Y. T. , Lan R. , Li M. , Li Z. M. , Yang W. F. , Hong Q. H. , Chu M. X.
Published: September 2020

Intensive artificial selection has been imposed in Yunshang black goats, the first black specialist mutton goat breed in China, with a breeding object of improving reproductive performance, which has contributed to reshaping of the genome including the characterization of SNP, ROH and haplotype. However, variation in reproductive ability exists in the present population. A WGS was implemented in two subpopulations (polytocous group, PG, and monotocous group, MG) with evident differences of litter size. Following the mapping to reference genome, and SNP calling and pruning, three approaches – GWAS, ROH analysis and detection of signatures of selection – were employed to unveil candidate genes responsible for litter size. Consequently, 12 candidate genes containing OSBPL8 with the minimum P‐value were uncovered by GWAS. Differences were observed in the pattern of ROH between two subpopulations that shared similar low inbreeding coefficients. Two ROH hotspots and 12 corresponding genes emerged from ROH pool association analysis. Based on the nSL statistic, 15 and 61 promising genes were disclosed under selection for MG and PG respectively. Of them, some promising genes participate in ovarian function (PPP2R5C, CDC25A, ESR1, RPS26 and SERPINBs), seasonal reproduction (DIO3, BTG1 and CRYM) and metabolism (OSBPL8, SLC39A5 and SERPINBs). Our study pinpointed some novel promising genes influencing litter size, provided a comprehensive insight into genetic makeup of litter size and might facilitate selective breeding in goats.
ARSB gene variants causing Mucopolysaccharidosis VI in Miniature Pinscher and Miniature Schnauzer dogs
Authors: Raj K. , Berman‐Booty L. , Foureman P. , Giger U.
Published: September 2020

Mucopolysaccharidosis (MPS) VI is a lysosomal storage disease caused by a deficiency of N‐acetylgalactosamine‐4‐sulfatase, also called arylsulfatase B (ARSB, EC 3.1.6.12). Dogs with MPS VI show progressive predominantly oculoskeletal signs homologous to those in human and feline patients. We report herein two pathogenic ARSB gene variants in Miniature Pinscher and Miniature Schnauzer dogs with MPS VI and a genotyping survey in these breeds. All exons and adjacent regions of the ARSB gene were sequenced from three affected Miniature Pinschers and three affected Miniature Schnauzers. Allelic discrimination assays were used for genotyping. A missense variant (NM_001048133.1:c.910G>A) was found in exon 5 of MPS VI‐affected Miniature Pinschers that is predicted to result in a deleterious amino acid substitution of a highly conserved glycine to arginine (NP_001041598.1:p.Gly304Arg). In MPS VI‐affected Miniature Schnauzers, a 56 bp deletion (NM_001048133.1:c.‐24_32del) was found at the junction of exon 1 and its upstream region, predicting no enzyme synthesis. All clinically affected Miniature Pinschers and Miniature Schnauzers were homozygous for the respective variants, and screened healthy dogs in each breed were either heterozygous or homozygous for the wt allele. Whereas the Miniature Pinscher variant seemed to occur commonly (0.133 allele frequency), the Miniature Schnauzer variant was presumed to be rare. In conclusion, two breed‐specific pathogenic ARSB gene variants were identified in Miniature Pinscher and Miniature Schnauzer dogs with MPS VI, allowing for genotyping and informed breeding to prevent the production of affected offspring.
Interpretative characteristics and case features associated with the performances of radiologists in reading mammograms: A study from a non‐screening population in Asia
Authors: Trieu Phuong Dung (Yun) , Puslednik Louise , Colley Brooke , Brennan Anna , Rodriguez Veruska Cediel , Cook Nicholas , Dean Kaitlin , Dryburgh Sarah , Lowe Hayden , Mahon Charlotte , McGowan Saxon , O'Brien Joshua , Moog William , Whale Jorja , Wong Dennis , Li Tong , Brennan Patrick C.
Published: September 2020

Aims

To explore radiologist characteristics and case features associated with diagnostic performances in cancer detection on mammograms in a South East Asian population.

Methods

Fifty‐three radiologists reported 60 mammographic examinations which consisted of 40 normal and 20 cancer‐containing cases at the BREAST workshops. Radiologists were asked to examine each mammogram using the BIRADS on diagnostic monitors. Differences in reader characteristics and case features between correct and incorrect decisions were assessed separately for cancer and normal cases. Univariate and multivariate logistic regressions were applied to generate odds ratios (OR) for significant factors related to correct decisions.

Results

Radiologists who spent ≥10 hours/week reporting mammograms had a higher possibility of detecting cancer lesions (OR = 1.6; P = 0.01). A higher rate of accuracy in reporting negative cases was associated with female radiologists (OR = 1.4; P = 0.002), radiologists who read ≤20 mammograms per week (OR = 1.5; P < 0.0001), had completed training course (OR = 1.7; P < 0.0001) or wore eyeglasses (OR = 1.4; P = 0.01).

Cancer cases with breast density >50% (OR = 2.1; P < 0.0001), having abnormal lesions ≥9 mm (OR = 1.8; P < 0.0001), or displaying calcifications, a discrete mass or nonspecific density (OR = 1.6; P < 0.0001) were recorded with a higher detection rate by radiologists than other cases.

Lesions located on the right breasts (OR = 1.8; P < 0.0001) or found in the lower inner, upper outer or mixed locations (OR = 2.7; P < 0.0001) were also recorded with a better diagnostic possibility compared with other lesions.

Conclusion

This work identified key features related to diagnostic accuracy of breast cancer on mammograms in a nonscreening population, which is helpful for developing appropriate strategies to improve breast cancer detectability of radiologists.
New‐graduate physiotherapists' perceptions of their preparedness for rural practice
Authors: Martin Romany , Mandrusiak Allison , Lu Andric , Forbes Roma
Published: September 2020

Objective

Providing health care in a rural or remote setting requires physiotherapists to adapt to a number of unique challenges. New‐graduates working in rural or remote settings must respond to these challenges in addition to those of being a novice practitioner. This study investigated the perceived preparedness of new‐graduate physiotherapists for work in rural or remote settings.

Design

A qualitative general inductive approach.

Setting

Rural and remote Queensland.

Participants

New‐graduate physiotherapists   working in rural or remote locations were contacted via a snowballing recruitment strategy.

Main outcome measure

Semi‐structured interviews.

Results

Four key themes emerged from the data: (a) adjusting to rural life, (b) embracing opportunities, (c) stepping up to the plate and (d) preparing through authentic experiences.

Conclusion

New‐graduate physiotherapists perceived rural and remote practice to be a challenging but valuable opportunity with many social and professional rewards. The complex clinical demands and unique cultural factors inherent in rural and remote locations were experienced as additional obstacles to the transition from student to clinician. New‐graduate physiotherapists were satisfied that their entry‐level training provided the necessary skills required to practise rurally and remotely; however, they expressed ‘shock’ at the rapid adaptations needed to provide effective service in these settings. New‐graduates are confident that exposure to authentic rural and remote clinical practice during their training was integral to their preparedness.
Review article: how the intestinal microbiota may reflect disease activity and influence therapeutic outcome in inflammatory bowel disease
Authors: Caenepeel Clara , Sadat Seyed Tabib Nasim , Vieira‐Silva Sara , Vermeire Séverine
Published: September 2020

Background

Intestinal bacteria produce metabolites and by‐products necessary for homeostasis. Imbalance in this equilibrium is linked to multiple pathologies including inflammatory bowel disease (IBD). The role of the gut microbiota in determining treatment response is becoming apparent, and may act as biomarker for efficacy.

Aim

To describe knowledge about the intestinal microbiota on disease severity and treatment outcomes in IBD

Methods

Descriptive review using PubMed to identify literature on the intestinal microbiota in IBD

Results

Severe IBD has a less diverse microbiota with fewer commensal microbiota communities and more opportunistic pathogenic bacteria originating from the oral cavity or respiratory tract. IBD treatments can alter gut microbiota composition, but in vitro/in vivo studies are needed to prove causation. A diversification of the microbiota is observed during remission. Patients with a more diverse baseline microbiome and higher microbial diversity show better response to anti‐tumour necrosis factor‐α, vedolizumab and ustekinumab therapy. Higher abundance of short chain fatty acid‐producing bacteria, fewer mucus‐colonising bacteria and lower abundance of pro‐inflammatory bacteria have also been associated with a favourable outcome. Predictive models, based on a combination of microbiota, clinical data and serological markers, have good accuracy for treatment outcome and disease severity.

Conclusion

The intestinal microbiota in IBD carries a set of promising biomarkers of disease activity and prediction of therapeutic outcome. Current insights may also help in designing microbiota modulation strategies to improve outcomes in IBD.
Intra‐thoracic gossypiboma (textiloma) in a 6‐year‐old cocker spaniel
Authors: Reed N , Gosling M
Published: September 2020

This report documents the first case of gossypiboma (textiloma) identified within the thorax of a dog. CT findings, surgical removal and histopathology are described. Intra‐thoracic gossypiboma has not previously been reported in dogs and is rarely reported in the human medical literature, where it is most commonly associated with previous cardiac or pulmonary surgery. This dog had previously had a thoracotomy for attempted surgical correction of a persistent right aortic arch and left ligamentum arteriosum 6 years prior to presentation. A brief review of the previous literature and recommendations for prevention of this condition are provided.
Patterns of variation in tree composition and richness in Neotropical Non‐Flooded Evergreen Forests
Authors: Cupertino‐Eisenlohr Mônica A , Oliveira‐Filho Ary T , Simon Marcelo F
Published: September 2020

Questions

We investigated tree floristic variation among the Neotropical Non‐Flooded Evergreen Forests (NEF). We addressed the following questions: (a) which are the floristic groups among NEF and how are they correlated with environmental variables; (b) how many species, genera and families are shared between these floristic groups and which species are unique and indicative of each one; and (c) how does species richness vary between NEF groups?

Location

Neotropical region.

Methods

We used cluster and ordination analyses based on 518,004 tree occurrence data available in the NeoTropTree database to identify floristic groups throughout NEF. From the floristic groups identified here, we (a) verified correlations between floristic composition and precipitation, temperature, altitude, and latitude; (b) calculated the number of shared species, genera and families, and identified taxa unique to each group; and (c) obtained indicator species and estimated species richness for these floristic groups.

Results

We recorded 172 families, 1,276 genera and 15,134 species in 1,885 sites of NEF. The families most rich in species were Fabaceae, Rubiaceae and Myrtaceae. We identified nine groups among the NEF, which broadly correspond to floristic provinces reported in the literature. Altitude and annual mean temperature were associated with a species turnover gradient from Amazon to Andean Cloud Forest. Atlantic Forest (south) and Mesoamerica plus Caribbean (north) represented the extremes of a latitudinal gradient. The Atlantic Forest presented the largest number of exclusive and indicator species (2,477 and 265, respectively), while the Amazon showed the highest species richness (6,167 species).

Conclusions

Although it was possible to separate NEF into distinct floristic groups, this floristic dissociation seems to be recent, since it found support only in species data. The floristic groups identified in this study are largely congruent with their geographic distribution and spatial/ecological isolation, and seem to reflect historical, geological and climatic events that occurred in the Neotropics.
Impact of 68Gallium prostate‐specific membrane antigen tracers on the management of patients with prostate cancer who experience biochemical recurrence
Authors: Diao Wei , Cao Yuan , Su Dunyan , Jia Zhiyun
Published: September 2020

Objective

To investigate the impact of 68Gallium prostate‐specific membrane antigen (68Ga‐PSMA) tracers on the management of prostate cancer (PCa) patients with biochemical recurrence (BCR) by conducting a systematical review and meta‐analysis.

Materials and Methods

We performed a literature search of the PubMed, Embase and Web of Science databases up to 29 October 2019. We included studies that reported the proportion of patients whose management changed after 68Ga‐PSMA tracers were used in patients with BCR. We used the Quality Assessment of Diagnostic Accuracy Studies‐2 tool to evaluate the quality of the included studies. The proportion of patients with management changes were pooled using a random‐effects model. Subgroup analyses and meta‐regression analyses were performed to explore the source of heterogeneity. A Sankey diagram was used to show treatment change from before to after the use of 68Ga‐PSMA tracers.

Results

We included 20 eligible studies (2026 patients). The pooled proportion of patients with management change was 53% (95% confidence interval [CI] 46–60) in patients with BCR and 51% (95% CI, 34–67) in patients with early BCR (prostate‐specific antigen [PSA] <0.5 ng/mL). The pooled positron‐emission tomography‐positive rate in patients with BCR was 68% (95% CI 59–78). Fourteen studies reported management change, with most changes being intermodal in nature (42%, vs 17% intramodal change).

Conclusions

The use of 68Ga‐PSMA tracers altered the management of more than half of PCa patients with BCR, including those with early BCR. 68Ga‐PSMA tracers might be used to guide individualized treatment in patients with BCR, particularly those with early BCR.
Arctigenin protects against depression by inhibiting microglial activation and neuroinflammation via HMGB1/TLR4/NF‐κB and TNF‐α/TNFR1/NF‐κB pathways
Authors: Xu Xiang , Piao Hu‐Nan , Aosai Fumie , Zeng Xiao‐Yu , Cheng Jia‐Hui , Cui Yue‐Xian , Li Jing , Ma Juan , Piao Hu‐Ri , Jin Xuejun , Piao Lian‐Xun
Published: September 2020

Background and Purpose

Arctigenin, a major bioactive component of Fructus arctii, has been reported to have antidepressant‐like effects. However, the mechanisms underlying these effects are still unclear. Neuroinflammation can be caused by excessive production of proinflammatory cytokines in microglia via high‐mobility group box 1 (HMGB1)/TLR4/NF‐κB and TNF‐α/TNFR1/NF‐κB signalling pathways, leading to depression. In this study, we have investigated the antidepressant mechanism of arctigenin by conducting in vitro and in vivo studies.

Experimental Approach

The effects of chronic unpredictable mild stress (CUMS) on wild‐type (WT) and TLR4−/− mice were examined. Antidepressant‐like effects of arctigenin were tested using the CUMS‐induced model of depression in WT mice. The effects of arctigenin were assessed on the HMGB1/TLR4/NF‐κB and TNF‐α/TNFR1/NF‐κB signalling pathways in the prefrontal cortex (PFC) of mouse brain and HMGB1‐ or TNF‐α‐stimulated primary cultured microglia. The interaction between HMGB1 and TLR4 or TNF‐α and TNFR1 with or without arctigenin was examined by localized surface plasmon resonance (LSPR) and co‐immunoprecipitation assays.

Key Results

The immobility times in the tail suspension test (TST) and forced swimming test (FST) were reduced in TLR4−/− mice, compared with WT mice. Arctigenin exhibited antidepressant‐like effects. Arctigenin also inhibited microglia activation and inflammatory responses in the PFC of mouse brain. Arctigenin inhibited HMGB1 and TLR4 or TNF‐α and TNFR1 interactions, and suppressed both HMGB1/TLR4/NF‐κB and TNF‐α/TNFR1/NF‐κB signalling pathways.

Conclusions and Implications

Arctigenin has antidepressant‐like effects by attenuating excessive microglial activation and neuroinflammation through the HMGB1/TLR4/NF‐κB and TNF‐α/TNFR1/NF‐κB signalling pathways. This suggests that arctigenin has potential as a new drug candidate suitable for clinical trials to treat depression.
Dental caries, periodontal disease and restorative dental care among Indigenous and non‐Indigenous groups in Brazil: A descriptive study
Authors: Arantes Rui , Jamieson Lisa M. , Frazão Paulo
Published: September 2020

Objective

To compare patterns of dental caries, periodontal disease and dental care among Indigenous and non‐Indigenous Central‐West Brazilian subpopulations.

Methods

Data were from two population‐based cross‐sectional studies involving 5‐, 12‐, 15‐19‐ and 35‐44‐year‐olds. The first examined were the Guarani, Kaiowá, Terena and Kadiwéu Indigenous groups from Mato Grosso do Sul Brazilian state and the second comprised a non‐Indigenous population. Mean numbers of sound teeth, decayed, missing and filled teeth (dmft/DMFT), prevalence of poor oral hygiene for adults (35‐44 years) and of periodontal disease were estimated. Restorative dental service utilization was measured using the Care Index.

Results

The study populations comprised of 1830 Indigenous and 29 395 non‐Indigenous people. The Kaiwoá ethnic group had the lowest DMFT among Indigenous groups for ages 12, 15‐19 years; 0.9 (95% CI 0.7‐1.1) and 2.4 (95% CI 1.9‐2.9), respectively. The highest values were observed among the 12‐year‐old Terena ethnic group and 15‐ to 19‐year‐old Kadiwéo groups; 2.2 (95% CI 1.8‐2.5) and 3.7 (95% CI 3.1‐4.4), respectively. The mean DMFT values were significantly lower among Indigenous than non‐Indigenous people for all age groups. The prevalence of bleeding and calculus was 70.3% (95% CI 64.5%‐75.5%) and 80.1% (95% CI 74.8%‐84.5%), respectively, for Indigenous people and 43.9% (95% CI 34.4%‐50.7%) and 61.5% (95% CI 55.4%‐67.2%), respectively, for the non‐Indigenous population. Restorative services were higher among 5‐year‐old non‐Indigenous children and adults than for Indigenous groups. Among Indigenous groups, the Terena had the highest level of restored teeth (38.0% at 12 years) and Kadiwéu the lowest level (8.8% at 12 years).

Conclusion

In our study, Indigenous people had a lower caries burden, but less access to restorative services than their non‐Indigenous counterparts. These disparities likely reflect differences in historical, socioeconomic, cultural, environmental and political determinants that both groups have experienced differently over time.
Long‐term cognitive outcomes after cerebral sinovenous thrombosis in childhood
Authors: Slim Mahmoud , Aziz Aly Shah , Westmacott Robyn , Dlamini Nomazulu , Deveber Gabrielle , MacGregor Daune , Yau Ivanna , Andres Kathleen , Moharir Mahendranath
Published: September 2020

Aim

To assess long‐term cognitive function in children after cerebral sinovenous thrombosis (CSVT).

Method

Children with CSVT, who had neuropsychological testing for intellectual ability, executive function, attention, language, or behavior, were included in a prospective observational study. Outcomes were compared with normative means using one‐sample t‐tests. Predictors of abnormal function were examined using logistic regression.

Results

Fifty children with CSVT were included (median age at diagnosis 2y 10mo, interquartile range 7d–6y 10mo; 35 males, 15 females). The median follow‐up time was 4 years 2 months (interquartile range 2y 8mo–6y 4mo). Compared with normative means, children with CSVT had lower mean (± standard deviation) full‐scale IQ, working memory, and processing speed scores (93.3±16, p=0.01; 93.6±16, p=0.04; 93.7±15.3, p=0.02 respectively). They also had lower scores in executive function, attention, and language domains. Refractory seizure at presentation was associated with a trend in behavioral problems (odds ratio [OR] 6.3, 95% confidence interval [CI] 0.9–46, p=0.07). Females were less likely to experience processing speed difficulties (OR 0.22, 95% CI 0.04–1.3, p=0.09). Incomplete recanalization was associated with a greater risk of abnormal verbal comprehension (OR 5.3, 95% CI 0.93–30.5, p=0.059).

Interpretation

Children with CSVT as a group performed below age expectations on standardized neuropsychological tests, although there was variability across individuals and cognitive domains. Larger studies are needed to evaluate predictors of cognitive deficits in children with CSVT.
Descending aortic strain quantification by intra‐operative transesophageal echocardiography: Multimodality validation via cardiovascular magnetic resonance
Authors: Rong Lisa Q. , Palumbo Maria C. , Rahouma Mohammed , Lopes Alexandra J. , Devereux Richard B. , Kim Jiwon , Girardi Leonard N. , Gaudino Mario , Weinsaft Jonathan W.
Published: September 2020

Background

Whereas cardiac magnetic resonance (CMR) imaging provides high temporal resolution imaging of aortic distensibility (strain), transesophageal echocardiography (TEE) is widely used for intra‐operative aortic imaging and provides a clinical alternative for aortic assessment. We tested intra‐operative global circumferential aortic strain (GCS) measured on TEE in relation to the reference of CMR‐derived strain among patients undergoing surgical graft repair of ascending aortic aneurysms.

Methods

CMR (3T) was prospectively performed in patients scheduled for aortic repair. TEE was performed intra‐operatively; images were co‐localized with MRI. GCS on CMR and TEE was quantified independently, blinded to results of the other modality.

Results

25 patients (54 ± 10 year‐old, 88% male) were studied, inclusive of 13 genetically mediated and 12 degenerative aneurysms: CMR and TEE were performed within 12 ± 9 days. Pulse pressure (PP)–adjusted descending aortic TEE‐derived GCS strongly correlated with cine‐CMR‐derived GCS (r = .75, P = .002) though absolute GCS and PP‐adjusted values were slightly lower (5.40 ± 1.11 vs 6.49 ± 1.43% and 11.55 ± 3.04 vs 13.99 ± 4.53%, respectively). Similarly, TEE yielded slightly lower end‐diastolic area (EDA [5.1 ± 1.7 cm2 vs 5.8 ± 1.3 cm2, P = .004]) and end‐systolic area (ESA [6.1 ± 1.9 cm2 vs 6.5 ± 1.7 cm2, P = .10]), with significant correlations between the two modalities (r = .73, .76, P < .05 for all).

Conclusions

This exploratory study supports feasibility of TEE for assessing aortic GCS in a surgical at‐risk population, as well as magnitude of agreement between intra‐operative TEE and preoperative CMR. We found that there is a significant correlation between GCS and EDA and ESA aortic areas, but that TEE‐derived parameters underestimated CMR values by a small but significant amount.
Chronic aorto‐right ventricular fistula following penetrating cardiac injury: A case report
Authors: Hou Xiaojie , Wan Juyi , Liao Bin
Published: September 2020

Aorto‐cardiac fistula is a rare but potentially life‐threatening condition. We herein report a rare case of chronic aorto‐right ventricular fistula formation secondary to a stab penetrating injury to the heart and aorta occurred 15 years ago. The aorto‐right ventricular fistula was not found until 15 years after the incident. The fistula had been repaired successfully to prevent further deterioration of cardiac function. Here, we report the clinical presentation, diagnosis and treatment strategies of the aorto‐right ventricular fistula, and discuss the possible etiology of the development of the fistula after the penetrating injury.