bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions, needs and preferences of chronic disease self‐management support among men experiencing homelessness in Montreal
Authors: Merdsoy Laura , Lambert Sylvie , Sherman Jessica
Published: September 2020

Objective

This study explored the perceptions, needs and preferences for chronic disease self‐ management (SM) and SM support among men experiencing homelessness.

Design

A qualitative interpretive approach was used. Eighteen semi‐structured interviews were conducted with 18 homeless men with a chronic disease at an emergency overnight shelter of Welcome Hall Mission (WHM) in Montreal, Quebec. Interviews were audio‐recorded, transcribed verbatim and thematically analysed.

Results

The majority of participants perceived SM as important, described confidence to perform medical SM behaviours, and creatively adapted their SM behaviours to homelessness. Emotional SM was described as most challenging, as it was intertwined with the experience of homelessness. Three vulnerable groups were identified: (a) those with no social networks, (b) severe physical symptoms and/or (c) co‐morbid mental illness. The preferred mode of delivery for SM support was through consistent contacts with health‐care providers (HCPs) and peer‐support initiatives.

Discussion and Conclusions

Despite competing demands to fulfill basic needs, participants valued chronic disease SM and SM support. However, SM support must address complex challenges relating to homelessness including emotional SM, multiple vulnerabilities and barriers to forming relationships with HCPs.
Justice and legal practice in early medieval Italy, ca. 700–900
Authors: Heil Michael W.
Published: September 2020

This essay surveys the principle features of justice and legal practice in early medieval Italy as revealed in recent scholarship. It focuses on the Lombard (568–774) and Carolingian (774–888) periods, as well as the immediate post‐Carolingian period down to the year 900. It deals primarily with the justice of theplacita, or public court hearings, that have been the focus of most scholarship to date. It concludes with a brief consideration of other forms of justice and dispute settlement beyond theplacita.
Introduction: Transnational futures of international labour law
Authors: BLACKETT Adelle
Published: September 2020

This Special Issue on transnational labour law is placed in the context of the ILO centenary and the challenge of achieving the objective of decent work in a new century, under distinct transnational pressures. The author argues that international labour law, as the normative core of transnational labour law, can play a crucial role – in conjunction with a wide range of actors and the ILO in its standard‐setting and convenor capacities – in addressing this challenge and in reshaping the transnational legal architecture.
Beyond CAR T cells: Engineered Vγ9Vδ2 T cells to fight solid tumors
Authors: Rafia Chirine , Harly Christelle , Scotet Emmanuel
Published: September 2020

Despite recent significant progress in cancer immunotherapies based on adoptive cell transfer(s)(ACT), the eradication of cancers still represents a major clinical challenge. In particular, the efficacy of current ACT‐based therapies against solid tumors is dramatically reduced by physical barriers that prevent tumor infiltration of adoptively transferred effectors, and the tumor environment that suppress their anti‐tumor functions. Novel immunotherapeutic strategies are thus needed to circumvent these issues. Human peripheral blood Vγ9Vδ2 T cells, a non‐alloreactive innate‐like T lymphocyte subset, recently proved to be a promising anti‐tumor effector subset for ACT‐based immunotherapies. Furthermore, new cell engineering tools that leverage the potential of CRISPR/Cas technology open astounding opportunities to optimize their anti‐tumor effector functions. In this review, we present the current ACT strategies based on engineered T cells and their limitations. We then discuss the potential of engineered Vγ9Vδ2 T cell to overcome these limitations and improve ACT‐based cancer immunotherapies.
Molar‐incisor hypomineralization (MIH), dental fluorosis, and caries in rural areas with different fluoride levels in the drinking water
Authors: Fernandes Igor Cartaxo , Forte Franklin Delano Soares , Sampaio Fábio Correia
Published: September 2020

Aim

This study determined the prevalence of molar‐incisor hypomineralization (MIH) and its association with dental fluorosis and caries in children living in rural areas in north‐eastern Brazil who are exposed to residual fluoride (F) levels in the drinking water.

Design

A census was carried out with 610 schoolchildren aged 6 to 12 years. The European Academy of Paediatric Dentistry criteria, Thysltrup and Fejerskov index, and World Health Organization index were used for diagnosis of MIH, dental fluorosis, and caries detection, respectively. The association between the outcome and exposure variables was determined by robust Poisson regression (P < .05).

Results

Water F‐levels varied from 0.06 to 1.98 ppm. MIH was not related to fluoride levels in the drinking water, but it showed an inverse and direct correlation with dental caries and fluorosis, respectively. Children with MIH had a higher DMFT, and severe MIH cases were most frequent in children with dental fluorosis.

Conclusion

Drinking water F‐levels were not directly related to the occurrence of MIH in schoolchildren. The severity of MIH, however, was likely to be associated with dental fluorosis in areas with moderate to high fluoride levels in the drinking water.
STEM learning attitude predicts computational thinking skills among primary school students
Authors: Sun Lihui , Hu Linlin , Yang Weipeng , Zhou Danhua , Wang Xiaoqian
Published: September 2020

Computational thinking (CT) plays a vital role in the fields of science, technology, engineering and mathematics (STEM). However, whether students' learning attitude towards STEM is related to their CT skills remains unknown. Two studies were conducted to address this knowledge gap. In Study 1, we validated a newly developed STEM learning attitude scale among a sample of Chinese primary school students (N = 489). Exploratory and confirmatory factor analysis results revealed that the scale which consisted of three factors (mathematics, science and information technology) could sufficiently measure primary school students' STEM learning attitude in the current sample. In Study 2, we explored the association between students' STEM learning attitude and their CT skills. Evidence revealed that learning attitude towards STEM significantly predicted CT skills. We also found that girls had a more positive learning attitude towards STEM than boys, and the fourth grade might be the key period for the development of CT skills. Implications for promoting primary school students' STEM learning and CT skills were also discussed.
Sex‐based differences in procedural complications associated with atrial fibrillation catheter ablation: A systematic review and meta‐analysis
Authors: Campbell Martin L. , Larson John , Farid Talha , Westerman Stacy , Lloyd Michael S. , Shah Anand D. , Leon Angel R. , El‐Chami Mikhael F. , Merchant Faisal M.
Published: September 2020

Background

Women undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, most studies have been underpowered to detect differences in rarer complications such as stroke/transient ischemic attack (TIA) and procedural mortality.

Methods

We performed a systematic review of databases (PubMed, World of Science, and Embase) to identify studies published since 2010 reporting AFCA complications by sex. Six complications of interest were (1) vascular/groin complications; (2) pericardial effusion/tamponade; (3) stroke/TIA; (4) permanent phrenic nerve injury; (5) major bleeding; and (6) procedural mortality. For meta‐analysis, random effects models were used when heterogeneity between studies was ≥50% (vascular complications and major bleeding) and fixed effects models for other endpoints.

Results

Of 5716 citations, 19 studies met inclusion criteria, comprising 244,353 patients undergoing AFCA, of whom 33% were women. Women were older (65.3 ± 11.2 vs. 60.4 ± 13.2 years), more likely hypertensive (60.6% vs. 55.5%) and diabetic (18.3% vs. 16.5%), and had higher CHA2DS2‐VASc scores (3.0 ± 1.8 vs. 1.4 ± 1.4) (p < .0001 for all comparisons). The rates of all six complications were significantly higher in women. However, despite statistically significant differences, the overall incidences of major complications were very low in both sexes: stroke/TIA (women 0.51% vs. men 0.39%) and procedural mortality (women 0.25% vs. men 0.19%).

Conclusion

Women experience significantly higher rates of AFCA complications. However, the incidence of major procedural complications is very low in both sexes. The higher rate of complications in women may be partially attributable to older age and a higher prevalence of comorbidities at the time of ablation. More detailed studies are needed to better define the mechanisms of increased risk in women and to identify strategies for closing the sex gap.
Injectable conductive hydrogel restores conduction through ablated myocardium
Authors: van Zyl Martin , Pedrotty Dawn M. , Karabulut Erdem , Kuzmenko Volodymyr , Sämfors Sanna , Livia Christopher , Vaidya Vaibhav , Sugrue Alan , McLeod Christopher J. , Behfar Atta , Asirvatham Samuel J. , Gatenholm Paul , Kapa Suraj
Published: September 2020

Introduction

Therapies for substrate‐related arrhythmias include ablation or drugs targeted at altering conductive properties or disruption of slow zones in heterogeneous myocardium. Conductive compounds such as carbon nanotubes may provide a novel personalizable therapy for arrhythmia treatment by allowing tissue homogenization.

Methods

A nanocellulose carbon nanotube‐conductive hydrogel was developed to have conduction properties similar to normal myocardium. Ex vivo perfused canine hearts were studied. Electroanatomic activation mapping of the epicardial surface was performed at baseline, after radiofrequency ablation, and after uniform needle injections of the conductive hydrogel through the injured tissue. Gross histology was used to assess distribution of conductive hydrogel in the tissue.

Results

The conductive hydrogel viscosity was optimized to decrease with increasing shear rate to allow expression through a syringe. The direct current conductivity under aqueous conduction was 4.3 × 10−1 S/cm. In four canine hearts, when compared with the homogeneous baseline conduction, isochronal maps demonstrated sequential myocardial activation with a shift in direction of activation to surround the edges of the ablated region. After injection of the conductive hydrogel, isochrones demonstrated conduction through the ablated tissue with activation restored through the ablated tissue. Gross specimen examination demonstrated retention of the hydrogel within the tissue.

Conclusions

This proof‐of‐concept study demonstrates that conductive hydrogel can be injected into acutely disrupted myocardium to restore conduction. Future experiments should focus on evaluating long‐term retention and biocompatibility of the hydrogel through in vivo experimentation.
The effectiveness, feasibility, and acceptability of low‐sodium salts worldwide: An environmental scan protocol
Authors: Yin Xuejun , Liu Hueiming , Trieu Kathy , Webster Jacqui , Farrand Clare , Li Ka‐Chun , Pearson Sallie , Tian Maoyi
Published: September 2020

Excess sodium intake elevates blood pressure and risk for cardiovascular diseases. The use of low‐sodium salts is a potentially cost‐effective strategy to counter the rising global burden of cardiovascular diseases. This research aimed to understand the potential scale‐up of low‐sodium salt interventions by examining the availability of low‐sodium salts globally, synthesizing evidence about the effectiveness of low‐sodium salt interventions, and identifying the challenges and opportunities associated with implementing low‐sodium salt interventions. This study consists of three parts. The first part is a systematic online search of low‐sodium salts. The authors will use the advanced search functions of search engines and online shopping sites to execute the search. The second part is a systematic review of academic literature on the use of low‐sodium salts. A meta‐analysis will be performed to quantify the effectiveness of low‐sodium salt interventions. The third part is key informant interviews to understand the challenges of implementing low‐sodium salt interventions. Key informants will include policymakers, academic researchers, and salt industry representatives. The list of key informants will be generated through purposive sampling and snowball sampling based on the completed online search and the systematic review. The interview guides will be developed based on the RE‐AIM (Reach, Effective, Adoption, Implementation, and Maintenance) framework. The study received ethics approval from the University of New South Wales Human Research Ethics Advisory Panel (HC190921). Findings will be disseminated with academics and policymakers through a peer‐reviewed journal and conference presentations.
Home blood pressure monitoring in France: Device possession rate and associated determinants, the Esteban study
Authors: Vallée Alexandre , Gabet Amélie , Grave Clémence , Lelong Hélène , Blacher Jacques , Olié Valérie
Published: September 2020

Home blood pressure monitoring (HBPM) is increasingly being promoted in hypertension guidelines to improve hypertension management. Possessing a HBPM device could improve blood pressure (BP) control and prognostic impact. The aims of this study were to estimate the possession rate of HBPM devices in the French population and in hypertensive adults, and to investigate the determinants of possessing such devices at home. Cross‐sectional analyses were performed using data from the Esteban survey, which comprised a representative sample of the French population. Among the 2,054 study participants, 673 had hypertension. Of these, 385 were aware they had it. Weighted logistic regressions were performed to investigate the factors (socioeconomic, clinical, drug treatment, and healthcare visits) associated with possessing a HBPM device. 20.9% of the study sample, 42.1% of those with hypertension, and 54% of those aware of their hypertension, possessed a HBPM device. Female gender (OR = 2.03, 95%CI [1.46; 2.60]), smoking (OR = 2.33, 95%CI [1.51; 3.15]), antihypertensive drugs (OR = 1.75, 95%CI [1.06; 2.44]), general practitioner (GP) visits (OR = 3.28, 95%CI [1.84; 4.68]), and diabetes (OR = 0.41 95% CI [0.14; 0.68]) were associated with possessing a HBPM device among those aware of their hypertension. Over 20% of the study population possessed a HBPM device at home. This proportion rose to one in two in those aware or their hypertension. Among the latter, possessing a device was positively associated with female gender, GP visits, and antihypertensive drug use. Increasing possession of HBPM devices in the hypertensive population could foster better management of the condition.
Prevalence of non‐alcoholic fatty liver disease and factors associated with it in Indian women with a history of gestational diabetes mellitus
Authors: Kubihal Suraj , Gupta Yashdeep , Shalimar  , Kandasamy Devasenathipathy , Goyal Alpesh , Kalaivani Mani , Goyal Ankur , Kedia Saurabh , Kachhawa Garima , Ambekar Samita , Bhatia Divya , Garg Vineeta , Gupta Nandita , Tandon Nikhil
Published: September 2020

Aims/Introduction

This study aims to evaluate the prevalence of and factors associated with non‐alcoholic fatty liver disease (NAFLD) in Indian women with prior gestational diabetes mellitus (GDM) diagnosed using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria.

Materials and Methods

This cross‐sectional study (2018–2019) enrolled women with and without prior GDM. Study participants underwent detailed assessments, including relevant medical, obstetric and demographic details; 75‐g oral glucose tolerance test with glucose and insulin estimation at 0, 30 and 120 min; and other relevant biochemical and anthropometric measurements. NAFLD status was defined by ultrasonography.

Results

We evaluated a total of 309 women (201 and 108 with and without prior GDM, respectively) at a mean age of 31.9 ± 5.0 years and median of 16 months (interquartile range 9–38 months) following the index delivery. The prevalence of NAFLD was significantly higher in women with prior GDM (62.7% vs 50.0%, P = 0.038; grade 2 and 3 disease, 13.9% vs 6.5%). On logistic regression analysis (fully adjusted model), the odds of NAFLD were 2.11‐fold higher in women with prior GDM (95% confidence interval 1.16–3.85, P = 0.014). Overweight/obesity, metabolic syndrome, prediabetes and homeostasis model of assessment of insulin resistance (a measure of insulin resistance) were positively associated with NAFLD, whereas the Matsuda index (a measure of insulin sensitivity) showed a negative association with NAFLD.

Conclusions

The prevalence of NAFLD is high in women with prior GDM. Such women also have a high burden of cardiometabolic risk factors. Future studies should evaluate the intermediate and long‐term hepatic and cardiovascular risk, and the impact of lifestyle interventions in reducing morbidity in such women.
Non‐Esterified Fatty Acids and Risks of Frailty, Disability, and Mobility Limitation in Older Adults: The Cardiovascular Health Study
Authors: Ahiawodzi Peter , Djousse Luc , Ix Joachim H. , Kizer Jorge R. , Tracy Russell P. , Arnold Alice , Newman Anne , Mukamal Kenneth J.
Published: September 2020

BACKGROUND/OBJECTIVES

Non‐esterified fatty acids (NEFAs) play central roles in the relationship between adiposity and glucose metabolism, and they have been implicated in the pathogenesis of cardiovascular disease, but few studies have assessed their effects on complex geriatric syndromes like frailty that cross multiple organ systems. We sought to determine the relationships between NEFAs and incident frailty, disability, and mobility limitation in a population‐based cohort of older persons.

METHODS

We analyzed 4,710 Cardiovascular Health Study (CHS) participants who underwent measurement of circulating total fasting NEFAs in 1992–1993 and were assessed for frailty in 1996–1997 and for disability and mobility limitation annually. We used ordinal logistic regression to model incident frailty, linear regression to model components of frailty, and Cox regression to model disability and mobility limitation in relation to baseline NEFAs. To ensure proportional hazards, we truncated follow‐up at 9 years for disability and 6.5 years for mobility limitation.

RESULTS

A total of 42 participants became frail and 510 became pre‐frail over a 4‐year period, and we documented 1,720 cases of disability and 1,225 cases of mobility limitation during follow‐up. NEFAs were positively associated in a dose‐dependent manner with higher risks of incident frailty, disability, and mobility limitation. The adjusted odds ratios for frailty were 1.37 (95% confidence interval [CI] = 1.01–1.86; P = .04) across extreme tertiles and 1.17 (95% CI = 1.03–1.33; P = .01) per standard deviation increment. The corresponding hazard ratios for incident disability were 1.14 (95% CI = 1.01–1.30; P = .04) and 1.11 (95% CI = 1.06–1.17; P < .0001); those for incident mobility limitation were 1.23 (95% CI = 1.06–1.43; P = .006) and 1.15 (95% CI = 1.08–1.22; P < .0001). Results were largely consistent among both men and women. Among individual components of frailty, NEFAs were significantly associated with self‐reported exhaustion (β = .07; standard error = .03; P = .02).

CONCLUSION

Circulating NEFAs are significantly associated with frailty, disability, and mobility limitation among older adults. These results highlight the broad spectrum of adverse health issues associated with NEFA in older adults.
Social Isolation and Loneliness Among San Francisco Bay Area Older Adults During the COVID‐19 Shelter‐in‐Place Orders
Authors: Kotwal Ashwin A. , Holt‐Lunstad Julianne , Newmark Rebecca L. , Cenzer Irena , Smith Alexander K. , Covinsky Kenneth E. , Escueta Danielle P. , Lee Jina M. , Perissinotto Carla M.
Published: September 2020

BACKGROUND/OBJECTIVES

Physical distancing during the COVID‐19 pandemic may have unintended, detrimental effects on social isolation and loneliness among older adults. Our objectives were to investigate (1) experiences of social isolation and loneliness during shelter‐in‐place orders, and (2) unmet health needs related to changes in social interactions.

DESIGN

Mixed‐methods longitudinal phone‐based survey administered every 2 weeks.

SETTING

Two community sites and an academic geriatrics outpatient clinical practice.

PARTICIPANTS

A total of 151 community‐dwelling older adults.

MEASUREMENTS

We measured social isolation using a six‐item modified Duke Social Support Index, social interaction subscale, that included assessments of video‐based and Internet‐based socializing. Measures of loneliness included self‐reported worsened loneliness due to the COVID‐19 pandemic and loneliness severity based on the three‐item University of California, Los Angeles (UCLA) Loneliness Scale. Participants were invited to share open‐ended comments about their social experiences.

RESULTS

Participants were on average aged 75 years (standard deviation = 10), 50% had hearing or vision impairment, 64% lived alone, and 26% had difficulty bathing. Participants reported social isolation in 40% of interviews, 76% reported minimal video‐based socializing, and 42% minimal Internet‐based socializing. Socially isolated participants reported difficulty finding help with functional needs including bathing (20% vs 55%; P = .04). More than half (54%) of the participants reported worsened loneliness due to COVID‐19 that was associated with worsened depression (62% vs 9%; P < .001) and anxiety (57% vs 9%; P < .001). Rates of loneliness improved on average by time since shelter‐in‐place orders (4–6 weeks: 46% vs 13–15 weeks: 27%; P = .009), however, loneliness persisted or worsened for a subgroup of participants. Open‐ended responses revealed challenges faced by the subgroup experiencing persistent loneliness including poor emotional coping and discomfort with new technologies.

CONCLUSION

Many older adults are adjusting to COVID‐19 restrictions since the start of shelter‐in‐place orders. Additional steps are critically needed to address the psychological suffering and unmet medical needs of those with persistent loneliness or barriers to technology‐based social interaction.
Relationship between stressors, stress reactions and hardiness in Japanese mothers of early neonatal babies: A cross‐sectional study
Authors: Konno Kazuho
Published: September 2020

Aim

Mothers of early neonatal babies are often in stressful situations. The stress of child rearing has been reported to influence the mental health of mothers. Hardiness, one of the individual factors affecting the cognitive evaluation of stress, may relate to stress for mothers of early neonatal babies. The aim of the present study is to clarify the relationship between stressors, stress reactions and hardiness of mothers with early neonatal babies.

Methods

We conducted a cross‐sectional study using self‐administered questionnaires. Survey items included demographic characteristics, hardiness, stressors, and stress reactions. A total of 226 mothers returned the completed questionnaire. Data analyzed correlation, t tests and multiple regression using SPSS 24.0.

Results

The mothers' hardiness was not related to their demographic characteristics. Hardiness had a negative correlation with stressors and stress reactions. Hardiness mitigated especially anxiety/uncertainty and depression/feeling of insufficiency. Compared with those with high levels of hardiness, mothers with low hardiness exhibited higher levels of newborn baby stressors, breast‐feeding stressors, anxiety/uncertainty and depression/feeling of insufficiency.

Conclusion

Hardiness showed a buffering relationship with stressors and stress reactions, especially anxiety. Understanding hardiness levels may be useful for choosing which nursing care methods are implemented as each mother begins child rearing.
Deficiency of Meis1, a transcriptional regulator, in mice and worms: Neurochemical and behavioral characterizations with implications in the restless legs syndrome
Authors: Lyu Shangru , Xing Hong , Liu Yuning , Girdhar Pallavi , Zhang Keer , Yokoi Fumiaki , Xiao Rui , Li Yuqing
Published: September 2020

Restless legs syndrome is a sleep‐related sensorimotor neurological disease affecting up to 10% of the population. Genetic analyses have identified Myeloid Ecotropic viral Integration Site 1 (MEIS1), a transcriptional regulator, to be associated with not only the restless legs syndrome but also self‐reported symptoms of insomnia and sleep. This study is to determine if Meis1 deficiency in mice can lead to restless legs syndrome‐like phenotypes, and if it is the case, what the underlying mechanisms are. We used two genetic model systems, Caenorhabditis elegans and mice. Egg retention assay and fluorescent reporters were used with C. elegans. For mice, we performed behavioral tests, serum and brain iron detection, qRT‐PCR, western blot, immunohistochemistry, and in vitro brain‐slice recording. Our results showed that with C. elegans, the function of dop‐3, an orthologue of DRD2, was diminished after the knockdown of unc‐62, an ortholog of MEIS1. Additionally, unc‐62 knockdown led to enhanced transcription of the orthologue of tyrosine hydroxylase, cat‐2. Meis1 knockout mice were hyperactive and had a rest‐phase‐specific increased probability of waking. Moreover, Meis1 knockout mice had increased serum ferritin and altered striatal dopaminergic and cholinergic systems. Specifically, Meis1 knockout mice showed an increased mRNA level but decreased protein level of tyrosine hydroxylase in the striatum. Furthermore, Meis1 knockout mice had increased striatal dopamine turnover and decreased spontaneous firing regularity of striatal cholinergic interneurons. Our data suggest that Meis1 knockout mice have restless legs syndrome‐like motor restlessness and changes in serum ferritin levels. The symptoms may be related to dysfunctional dopaminergic and cholinergic systems.

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Comparative osteology of the hynobiid complex Liua‐Protohynobius‐Pseudohynobius (Amphibia, Urodela): Ⅰ. Cranial anatomy of Pseudohynobius
Authors: Jia Jia , Gao Ke‐Qin , Jiang Jian‐ping , Bever Gabriel S. , Xiong Rongchuan , Wei Gang
Published: September 2020

Hynobiidae are a clade of salamanders that diverged early within the crown radiation and that retain a considerable number of features plesiomorphic for the group. Their evolutionary history is informed by a fossil record that extends to the Middle Jurassic Bathonian time. Our understanding of the evolution within the total group of Hynobiidae has benefited considerably from recent discoveries of stem hynobiids but is constrained by inadequate anatomical knowledge of some extant forms. Pseudohynobius is a derived hynobiid clade consisting of five to seven extant species living endemic to southwestern China. Although this clade has been recognized for over 37 years, osteological details of these extant hynobiids remain elusive, which undoubtedly has contributed to taxonomic controversies over the hynobiid complex Liua‐Protohynobius‐Pseudohynobius. Here we provide a bone‐by‐bone study of the cranium in the five extant species of Pseudohynobius (Ps. flavomaculatus, Ps. guizhouensis, Ps. jinfo, Ps. kuankuoshuiensis and Ps. shuichengensis) based on x‐ray computer tomography data for 18 specimens. Our results indicate that the cranium in each of these species has a combination of differences in morphology, proportions and articulation patterns in both dermal and endochondral bones. Our study establishes a range of intraspecific differences that will serve as organizing hypotheses for future studies as more extensive collections of these species become available. Morphological features in the cranium for terrestrial ecological adaptation in Hynobiidae are summarized. Based on the results, we also discuss the evolution and development of several potential synapomorphies of Hynobiidae, including features of the orbitosphenoid and articular.
Disruption, worries and autonomy in the everyday lives of adolescents with type 1 diabetes and their family members: A qualitative study of intrafamilial challenges
Authors: Overgaard Mathilde , Lundby‐Christensen Louise , Grabowski Dan
Published: September 2020

Aim

To explore daily life with type 1 diabetes in families with an adolescent with type 1 diabetes.

Background

Management of adolescent type 1 diabetes is carried out in the context of everyday life, thus involving and affecting the entire family. Type 1 diabetes causes disruption of family life, but the specific experiences and challenges of adolescents with type 1 diabetes, siblings and parents are not well‐explored. Specifically, research is lacking on the siblings’ experience of adolescents with type 1 diabetes.

Design

A qualitative design using participatory workshops.

Methods

A sample of 21 families comprising adolescents with type 1 diabetes (aged 8–18) (N = 20), their parents (N = 29) and siblings (N = 10) participated in four workshops exploring everyday life in families with adolescent diabetes from the perspective of all family members. Data were analysed using systematic text condensation. The COREQ checklist was used preparing the manuscript.

Results

Family life with type 1 diabetes was characterised by three overarching themes: (a) the perpetual challenges and disruptive nature of life with diabetes, (b) different ways of worrying about diabetes and (c) diabetes autonomy and emancipation from parents. All family members’ lives were marked by these aspects, however in different ways and to varying degrees.

Conclusions

Our findings emphasise that type 1 diabetes is indeed a family illness affecting all family members. The study provides insight into the unique experiences of adolescents with diabetes, their parents and siblings, all of whom encounter diabetes‐related challenges in their daily lives.

Relevance to clinical practice

The findings call for the inclusion of all family members of adolescents with type 1 diabetes in both research and healthcare practice. Family‐oriented approaches targeting adolescents with diabetes as well as their parents and siblings will enable provision of nursing care that can meet the needs of the entire family.
Evaluation of the Saxon test for patients with hyposalivation without Sjögren’s syndrome
Authors: Ono Minagi Hitomi , Yamanaka Yoshie , Sakai Takayoshi
Published: September 2020

Background

Dry mouth is associated with salivary gland hypofunction, which may result from several conditions such as Sjögren's syndrome (SS), head and neck cancers, and side effects of medications. The Saxon test is a useful diagnostic method for hyposalivation in clinical settings. However, previous reports indicate that the test has mostly been used for patients with SS.

Objective(s)

In the present study, we focused on patients with dry mouth who were not diagnosed with SS (patients without SS).

Methods

For patients without SS (n = 302), we examined the factors affecting Saxon test scores using multiple regression analysis. Additionally, we performed a correlation analysis comparing the Saxon test with other diagnostic methods.

Results

In 57.6% patients, the Saxon test score was more than 2.00 g/2 min, which is considered negative for hyposalivation. Multiple regression analysis revealed that the age and sex of patients significantly influenced test scores. The mean Saxon test score was less than 2.00 g/2 min in older patients and women. Moreover, the test showed a significant correlation with other methods used to measure salivary flow.

Conclusion

The Saxon test is useful not only for patients with SS but also for patients without SS.
Embodied semiotic resources in Research Group Meetings: How language competence is framed
Authors: Kimura Daisuke , Canagarajah Suresh
Published: September 2020

Drawing from Interactional Sociolinguistics (IS), this article presents an analysis of a Research Group Meeting in Microbiology occurring at a mid‐western US university. We focus on the performance of a South Korean postdoctoral scholar who claims limited proficiency in English and demonstrate how he makes valued contributions by leveraging embodied semiotic resources alongside verbal ones. The analysis also highlights the co‐participants’ openness in accepting non‐standard linguistic and discourse features in working toward shared professional goals because of the way this activity is framed. Such an orientation to interaction suggests distributed practice, where co‐participants take joint responsibility for the generation of meanings. Based on the findings, we question institutional policies that privilege advanced proficiency in normative English grammar for skilled migrants, which leads to unfairly judging their competence. We encourage a focus on how participants frame their tasks to judge what semiotic resources are critical for different professional interactions. Findings also have theoretical implications that help IS develop in the direction of embodiment, beyond verbal contextualization cues, individual competence, and intercultural misunderstandings.
Selecting Health Need Indicators for Spatial Equity Analysis in the New Zealand Primary Care Context
Authors: Whitehead Jesse , Pearson Amber L. , Lawrenson Ross , Atatoa Carr Polly
Published: September 2020

Purpose

To examine potential indicators of health need for primary care in spatial equity research, and evidence of the Inverse Care Law in the Waikato region of New Zealand.

Methods

A cross‐sectional analysis of 7 health need indicators (ambulatory sensitive hospitalizations; cancer rate; mortality rate; New Zealand index of multiple deprivation‐health domain; age; New Zealand index of deprivation; smoking rate) that were identified through a systematic review was carried out. Values of indicators were mapped and analyzed using geographic information systems (GIS). Spearman's correlations were calculated between indicators, and clusters of high need were identified through spatial autocorrelation. The impact of incorporating indicator‐based weightings into an accessibility model was tested using analysis of variance and Spearman's correlations. General practice service spatial equity was assessed by comparing clusters of high access versus need, and quantified through the Gini coefficient.

Findings

Ambulatory sensitive hospitalization (ASH) rates were significantly correlated with all indicators. Health needs were significantly clustered, but incorporating indicator weightings into the spatial accessibility analysis did not impact accessibility scores. A misalignment of access and need, and a Gini coefficient of 0.281 suggest that services are not equitably distributed.

Conclusion

ASH rates seem a robust indicator of health need. However, data access issues may restrict their use. Area‐level socioeconomic deprivation measures incorporate some social determinants of health, and they have potential for wider use. High need clusters vary spatially according to the indicator used. GIS techniques can identify “hot‐spots” of need, but these can be masked in accessibility models.
Introducing a novel approach to the cross‐cultural measurement of stigma versus social integration using methods from the field of cognitive anthropology
Authors: Holleman Mirjam
Published: September 2020

This study combines current theories and methods from the field of disability studies and cognitive anthropology in the development of a cross culturally replicable and comparative model for evaluating stigma toward, versus social integration of, people with disabilities in society. Weaknesses in previous ways of measuring and comparing ‘social integration’ are addressed, as well as known challenges of measuring attitudes and stigma toward disability, especially in a cross‐culturally applicable and comparative way. A new application to previously existing methods in the field of cognitive anthropology is introduced which addresses these challenges. A case study conducted in Poland is described which illustrates the proposed methods. In conclusion, a roadmap for future research is provided which briefly reiterates the steps needed to replicate the study in various cultural contexts. Understanding the ways in which people with disabilities are perceived to deviate from culturally shared norms in a society may pave the way for the development of more effective and culturally targeted social policies in an effort to promote the social integration of all members of society.
Loss to follow‐up in the hepatitis C care cascade: A substantial problem but opportunity for micro‐elimination
Authors: van Dijk Marleen , Drenth Joost P.H. ,   the HepNed study group
Published: September 2020

Since the advent of direct‐acting antivirals, elimination of hepatitis C viral (HCV) infections seems within reach. However, studies on the HCV cascade of care show suboptimal progression through each step for all patient groups. Loss to follow‐up (LTFU) is a major issue and is a barrier to HCV elimination. This review summarizes the scale of the LTFU problem and proposes a micro‐elimination approach. Retrieving LTFU patients and re‐engaging them with care again has shown to be feasible in the Netherlands. Micro‐elimination through retrieval can contribute to reaching the World Health Organization's viral hepatitis elimination targets by 2030.
Metabolic alterations in dairy cows with subclinical ketosis after treatment with carboxymethyl chitosan‐loaded, reduced glutathione nanoparticles
Authors: Zhao Chang , Bai Yunlong , Fu Shixin , Wu Ling , Xia Cheng , Xu Chuang
Published: September 2020

Background

Subclinical ketosis (SCK) causes economic losses in the dairy industry because it reduces the milk production and reproductive performance of cows.

Hypothesis/Objectives

To evaluate whether carboxymethyl chitosan‐loaded reduced glutathione (CMC‐rGSH) nanoparticles can alleviate the incidence or degree of SCK in a herd.

Animals

Holstein dairy cows 21 days postpartum (n = 15).

Methods

The trial uses a prospective study. Five cows with serum β‐hydroxybutyric acid (BHBA) ≥1.20 mmol/L and aspartate aminotransferase (AST) <100 IU/L were assigned to group T1, 5 cows with BHBA ≥1.20 mmol/L and AST >100 IU/L to group T2, and 5 cows with BHBA <1.00 mmol/L and AST <100 IU/L to group C. Carboxymethyl chitosan‐loaded reduced glutathione (0.012 mg/kg body weight per cow) was administered to cows in T1 and T2 once daily via jugular vein for 6 days after diagnosis. Serum from all groups were collected 1 day before administration, then on days 1, 3, 5, 7, 10, and 15 after administration to determine the changes in biochemical index and 1H‐NMR.

Results

The difference in liver function or energy metabolism indices in T1, T2, and C disappeared at day 7 and day 10 after the administration (P > .05). Valine, lactate, alanine, lysine, creatinine, glucose, tyrosine, phenylalanine, formate, and oxalacetic acid levels, and decrease in isoleucine, leucine, proline, acetate, trimethylamine N‐oxide, glycine, and BHBA levels were greater (P < .05) at day 7 than day 0 for cows in T2.

Conclusions and Clinical Importance

Carboxymethyl chitosan‐loaded reduced glutathione treatment might alleviate SCK by enhancing gluconeogenesis and reducing ketogenesis in amino acids.
Jim Grimsley: Current state of research
Authors: Trušník Roman
Published: September 2020

Jim Grimsley (b. 1955) is a southern author of literary fiction, literature of the fantastic as well as numerous plays whose road to publishing success in the United States has been a thorny one. Grimsley had published two novels in Germany with translations to French and Dutch under way before his first novel, Winter Birds, was put out in 1994 by Algonquin Books of Chapel Hill following 10 years of futile attempts to get the book to press in his home country. Since the publication of Winter Birds in the United States, he has published six literary novels, three science fiction or fantasy novels, a collection of short stories, a book of plays, and a memoir in English. Although Grimsley explores topical themes in his fiction such as child abuse, class issues in the United States, same‐sex relationships in the American South, as well as the relationship between technology and society, he surprisingly remains one of the most under‐researched contemporary American writers. Nevertheless, the amount of research on the author has been growing in the last 20 years, so there can be no doubt about his inclusion in the canon of contemporary southern literature. The present article provides an overview of scholarship on Grimsley both in the United States and Europe, identifying several main research areas: (southern/queer) Gothic elements, abuse in all its forms, southern culture and its elements (region, space, class), gay identity, literature of the fantastic, and theatrical plays. As this overview and bibliography of research into Grimsley up to the present is meant to further current research and stimulate interest in the author and his works, the article also identifies new areas that deserve scholarly attention.
Pregnancy complicated by allergic bronchopulmonary aspergillosis: A case‐control study
Authors: Sehgal Inderpaul Singh , Dhooria Sahajal , Thurai Prasad Kuruswamy , Muthu Valliappan , Aggarwal Ashutosh Nath , Chakrabarti Arunaloke , Agarwal Ritesh
Published: September 2020

Background

Whether allergic bronchopulmonary aspergillosis (ABPA) affects maternal and perinatal outcomes during pregnancy or vice versa is unknown.

Objective

To evaluate the course of ABPA and its consequence on maternal and perinatal outcomes during pregnancy.

Methods

We retrospectively included pregnant women with ABPA (cases) and compared them with non‐pregnant ABPA subjects (controls). We recorded the following details in cases and controls: demographical characteristics, radiological findings, pulmonary function, duration of symptoms and the number of asthma and ABPA exacerbations during follow‐up. We also recorded the maternal and perinatal outcomes in the cases.

Results

We included nine cases and 38 controls with a similar age range. All the cases had achieved remission of ABPA before pregnancy and were receiving inhaled medications for asthma control. Serum total IgE levels, the extent of bronchiectasis on CT thorax and pulmonary function were comparable in the two groups. The mean number of asthma (53 vs 7) and ABPA (62 vs 16) exacerbations per 100 person‐years was significantly higher in cases compared to the controls. We did not observe any maternal complications. One neonate had low birthweight.

Conclusions

The risk of asthma and ABPA exacerbations is significantly higher in pregnant subjects with ABPA than non‐pregnant women with ABPA. However, maternal and perinatal outcomes are good.
Visual memory recall‐induced focal seizures: A case report
Authors: Nishimura Takuya , Okazaki Shuhei , Nagayama Hiroshi , Ihara Masafumi , Nagatsuka Kazuyuki
Published: September 2020

An 82‐year‐old woman presented with a complaint of sudden difficulty in chanting the Heart Sutra because visual hallucinations of Tetris‐like color blocks disturbed the image of the Sutra in her mind. Neuropsychological examination revealed transient impairment of visual memory recall with hallucinations. Physical examination showed no abnormalities except mild hypertension. She was alert, oriented with normal motor, sensory, and cerebellar function. She was diagnosed with mid‐temporal lobe seizures based on electroencephalography and single‐photon emission computed tomography (SPECT) findings. Subtraction ictal SPECT co‐registered to MRI (SISCOM) examination was useful in detecting the seizure focus. Symptoms resolved completely after the administration of antiepileptic drugs. This case report provides new insights into the mechanism of visual memory recall.
Heat‐induced changes in the abundance of wheat Rubisco activase isoforms
Authors: Degen Gustaf E. , Orr Douglas J. , Carmo‐Silva Elizabete
Published: September 2020

TheTriticum aestivum(wheat) genome encodes three isoforms of Rubisco activase (Rca) differing in thermostability, which could be exploited to improve the resilience of this crop to global warming. We hypothesized that elevated temperatures would cause an increase in the relative abundance of heat‐stable Rca1β.

Wheat plants were grown at 25° C : 18°C (day : night) and exposed to heat stress (38° C : 22°C) for up to 5 d at pre‐anthesis. Carbon (C) assimilation, Rubisco activity, CA1Pase activity, transcripts of Rca1β, Rca2β, and Rca2α, and the quantities of the corresponding protein products were measured during and after heat stress.

The transcript ofRca1βincreased 40‐fold in 4 h at elevated temperatures and returned to the original level after 4 h upon return of plants to control temperatures. Rca1β comprised up to 2% of the total Rca protein in unstressed leaves but increased three‐fold in leaves exposed to elevated temperatures for 5 d and remained high at 4 h after heat stress.

These results show that elevated temperatures cause rapid changes inRcagene expression and adaptive changes in Rca isoform abundance. The improved understanding of the regulation of C assimilation under heat stress will inform efforts to improve wheat productivity and climate resilience.
DLK2 regulates arbuscule hyphal branching during arbuscular mycorrhizal symbiosis
Authors: Ho‐Plágaro Tania , Morcillo Rafael J. L. , Tamayo‐Navarrete María Isabel , Huertas Raúl , Molinero‐Rosales Nuria , López‐Ráez Juan Antonio , Macho Alberto P. , García‐Garrido José Manuel
Published: September 2020

D14 and KAI2 receptors enable plants to distinguish between strigolactones (SLs) and karrikins (KARs), respectively, in order to trigger appropriate environmental and developmental responses. Both receptors are related to the regulation of arbuscular mycorrhiza (AM) formation and are members of the RsbQ‐like family of α,β‐hydrolases. DLK2 proteins, whose function remains unknown, constitute a third clade from the RsbQ‐like protein family. We investigated whether the tomato SlDLK2 is a new regulatory component in the AM symbiosis.

Genetic approaches were conducted to analyze SlDLK2 expression and to understand SlDLK2 function in AM symbiosis.

We show that SlDLK2 expression in roots is AM‐dependent and is associated with cells containing arbuscules. SlDLK2 ectopic expression arrests arbuscule branching and downregulates AM‐responsive genes, even in the absence of symbiosis; while the opposite effect was observed upon SlDLK2 silencing. Moreover, SlDLK2 overexpression in Medicago truncatula roots showed the same altered phenotype observed in tomato roots. Interestingly, SlDLK2 interacts with DELLA, a protein that regulates arbuscule formation/degradation in AM roots.

We propose that SlDLK2 is a new component of the complex plant‐mediated mechanism regulating the life cycle of arbuscules in AM symbiosis.