bluuebunny/crossref_metadata_2025 huggingface dataset:
Online video psychoeducation for electroconvulsive therapy in India: A randomized controlled trial
Authors: Tsai Jack , Huang Minda , He Hongbo , Rosenheck Robert A.
Published: May 2020

Despite its effectiveness, electroconvulsive therapy (ECT) has been widely but diminishingly used in India. The current study evaluated a video psychoeducation on ECT offered to adults in India who screened positive for depression. Participants were randomly assigned to receive either video or brochure psychoeducation. Both video and brochure psychoeducation significantly improved participants' perceptions, knowledge, and willingness to receive ECT with only a few significant differences between the two modalities. Together, these findings suggest that psychoeducation is effective. Video psychoeducation which can be inexpensive and widely distributed may represent an important way to encourage patients to consider ECT as an option.
Effect of ageing on antiretroviral drug pharmacokinetics using clinical data combined with modelling and simulation
Authors: Stader Felix , Courlet Perrine , Kinvig Hannah , Battegay Manuel , Decosterd Laurent A. , Penny Melissa A. , Siccardi Marco , Marzolini Catia
Published: May 2020

Aims

The impact of ageing on antiretroviral pharmacokinetics remains uncertain, leading to missing dosing recommendations for elderly people living with human immunodeficiency virus (HIV: PLWH). The objective of this study was to investigate whether ageing leads to clinically relevant pharmacokinetic changes of antiretrovirals that would support a dose adjustment based on the age of the treated PLWH.

Methods

Plasma concentrations for 10 first‐line antiretrovirals were obtained in PLWH ≥55 years, participating in the Swiss HIV Cohort Study, and used to proof the predictive performance of our physiologically based pharmacokinetic (PBPK) model. The verified PBPK model predicted the continuous effect of ageing on HIV drug pharmacokinetics across adulthood (20–99 years). The impact of ethnicity on age‐related pharmacokinetic changes between whites and other races was statistically analysed.

Results

Clinically observed concentration–time profiles of all investigated antiretrovirals were generally within the 95% confidence interval of the PBPK simulations, demonstrating the predictive power of the modelling approach used. The predicted decline in drug clearance drove age‐related pharmacokinetic changes of antiretrovirals, resulting in a maximal 70% [95% confidence interval: 40%, 120%] increase in antiretrovirals exposure across adulthood. Peak concentration, time to peak concentration and apparent volume of distribution were predicted to be unaltered by ageing. There was no statistically significant difference of age‐related pharmacokinetic changes between studied ethnicities.

Conclusion

Dose adjustment for antiretrovirals based on the age of male and female PLWH isa priorinot necessary in the absence of severe comorbidities considering the large safety margin of the current first‐line HIV treatments.
Erythema multiforme, Stevens‐Johnson syndrome/toxic epidermal necrolysis – diagnosis and treatment
Authors: Grünwald Pavel , Mockenhaupt Maja , Panzer Rüdiger , Emmert Steffen
Published: May 2020

Prior to the first international consensus classification published in 1993, the clinical distinction between erythema multiforme (EM), Stevens‐Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) had been subject to uncertainty and controversy for more than a century. Based on this classification, the three conditions are defined by the morphology of the individual lesions and their pattern of distribution. Etiopathogenetically, the majority of EM cases is caused by infections (primarily herpes simplex virus andMycoplasma pneumoniae), whereas SJS/TEN are predominantly triggered by drugs. The SCORTEN (score of toxic epidermal necrolysis) can and should be used to assess disease prognosis in patients with SJS/TEN.

While supportive treatment is generally considered sufficient for EM, there is still uncertainty as to the type of systemic therapy required for SJS/TEN. Given the lack of high‐quality therapeutic trials and (in some cases) conflicting results, it is currently impossible to issue definitive recommendations for any given immunomodulatory therapy. While there is always a trade‐off between rapid onset of treatment‐induced immunosuppression and an uptick in infection risk, there has been increasing evidence that cyclosporine in particular may be able to halt disease progression (i.e. skin detachment) and lower mortality rates.

Assistance in diagnosis and management of the aforementioned conditions may be obtained from the Center for the Documentation of Severe Skin Reactions (dZh) at the Department of Dermatology, University Medical Center, Freiburg, Germany.
Rosacea and perioral dermatitis: a single‐center retrospective analysis of the clinical presentation of 1032 patients
Authors: Hoepfner Andreas , Marsela Enklajd , Clanner‐Engelshofen Benjamin M. , Horvath Orsolya N. , Sardy Miklos , French Lars E. , Reinholz Markus
Published: May 2020

Background

Rosacea is a common chronic inflammatory cutaneous disorder affecting nearly 5.5 % of the adult population. Our aim was to evaluate the prevalence and epidemiology of rosacea and perioral dermatitis (POD) in an ambulatory care setting.

Methods

We retrospectively analyzed medical data of patients with a confirmed diagnosis of rosacea or perioral dermatitis (POD) presenting at our university hospital outpatient clinic during a 3‐year period.

Results

Out of 1032 patients, 81.5 % were diagnosed with rosacea and 18.5 % with POD. Overall prevalence was 1.4 % for rosacea and 0.3 % for POD. 69.3 % of the analyzed patients were female. Overall mean age was 49.3 ± 7.7 (1–92) years; the women’s average age was less than the men’s. Patients with POD were younger and predominantly female, whereas patients with phymatous rosacea were older and predominantly male. The most common phenotypes were papulopustular rosacea (68.4 %), erythematotelangiectatic rosacea (22.5 %), and phymatous rosacea (8.0 %). Special forms of rosacea were diagnosed in 15.8 % of the patients; the most frequent were ocular rosacea (6.9 %) and steroid‐induced rosacea (5.4 %).

Conclusions

The large patient cohort analyzed in our study provides a good estimate of the frequency of the rosacea subtypes, special forms and of perioral dermatitis in a hospital‐based outpatient care setting.
German S1 guidelines for the diagnosis and treatment of perianal dermatitis (anal eczema)
Authors: Weyandt Gerhard , Breitkopf Claudia , Werner Ricardo Niklas , Zidane Miriam , Furtwängler Alex , Jongen Johannes , Rothhaar Alex , Schaefer Daniel , Lenhard Bernhard
Published: May 2020

Perianal dermatitis (anal eczema, perianal eczema) is one of the most common proctological conditions. It may occur as a sequela or a presenting symptom of various proctological, dermatological, allergic or pathogen‐induced disorders. The three main types of anal eczema are irritant‐toxic, atopic and allergic contact dermatitis. Adequate and successful treatment requires a comprehensive diagnostic workup to determine disease etiology and includes treatment/elimination of causative factors as well as nonpharmacological interventions (avoidance of aggravating factors). In addition, adjuvant topical anti‐inflammatory and/or specific symptomatic treatment may be required. The present guidelines contain recommendations for the diagnostic and therapeutic management of perianal dermatitis. Target users of these guidelines are clinicians in the fields of dermatology and proctology, as well as all other specialties involved in the management of patients with perianal dermatitis, both in hospital and office‐based settings.
Cryptic speciation in gentoo penguins is driven by geographic isolation and regional marine conditions: Unforeseen vulnerabilities to global change
Authors: Pertierra Luis R. , Segovia Nicolás I. , Noll Daly , Martinez Pablo A. , Pliscoff Patricio , Barbosa Andrés , Aragón Pedro , Raya Rey Andrea , Pistorius Pierre , Trathan Phil , Polanowski Andrea , Bonadonna Francesco , Le Bohec Céline , Bi Ke , Wang‐Claypool Cynthia Y. , González‐Acuña Daniel , Dantas Gisele P. M. , Bowie Rauri C. K. , Poulin Elie , Vianna Juliana A.
Published: May 2020

Aim

The conservation of biodiversity is hampered by data deficiencies, with many new species and subspecies awaiting description or reclassification. Population genomics and ecological niche modelling offer complementary new tools for uncovering functional units of phylogenetic diversity. We hypothesize that phylogenetically delineated lineages of gentoo penguins (Pygoscelis papua) distributed across Antarctica and sub‐Antarctic Islands are subject to spatially explicit ecological conditions that have limited gene flow, facilitating genetic differentiation, and thereby speciation processes.

Location

Antarctica and sub‐Antarctic area.

Methods

We identify divergent lineages for gentoo penguins using ddRAD‐seq and mtDNA, and generated species distribution models (SDMs) based on terrestrial and marine parameters.

Results

Analyses of our genomic data supports the existence of four major lineages of gentoo penguin: (i) spanning the sub‐Antarctic archipelagos north of the Antarctic Polar Front (APF); (ii) Kerguelen Island; (iii) South America; and (iv) across maritime Antarctic and the Scotia Arc archipelagos. The APF, a major current system around Antarctica, acts as the most important barrier separating regional sister lineages. Our ecological analyses spanning both the terrestrial (breeding sites) and marine (feeding sites) realms recover limited niche overlap among the major lineages of gentoo penguin. We observe this pattern to correspond more closely with regional differentiation of marine conditions than to terrestrial macroenvironmental features.

Main conclusions

Recognition of regional genetic lineages as discrete evolutionary entities that occupy distinct ecological niches and also differ morphologically should be considered a priority for conservation. Gentoo penguins provide a good example of how conservation policy can be directly impacted by new insights obtained through the integration of larger genomic datasets with novel approaches to ecological modelling. This is particularly pertinent to polar environments that are among the most rapidly changing environments on earth.
Maximizing detection probability for effective large‐scale nocturnal bird monitoring
Authors: Zuberogoitia Iñigo , Martínez José E. , González‐Oreja José Antonio , de Buitrago Carlos González , Belamendia Gorka , Zabala Jabi , Laso Maite , Pagaldai Nerea , Jiménez‐Franco María V.
Published: May 2020

Aim

Our specific objectives were to (a) estimate detection probabilities of nocturnal bird species, after taking into account survey‐specific covariates, and (b) investigate the influence of site‐specific covariates on owl and nightjar abundance, integrating effects of imperfect detection.

Innovation

We conceived a survey protocol to estimate probabilities of detection and estimates of abundance of owls and nightjars in a large area, the Basque Country, northern Spain.

Main Conclusions

Our results show that detection probability was strongly influenced by playback broadcast and by observer experience. Date irregularly affected species according to their reproductive periods, and we also found that vocal activity gradually diminished proportionally to the hour after sunset. Tawny owl (Strix aluco) was the most abundant and widely distributed species. Its abundance was positively related to forest areas (mainly pine timber forests) and decreased in large urban and agricultural areas. Open space species were less common. Barn owls (Tyto alba), little owls (Athene noctua), Eurasian scops owls (Otus scops) and long‐eared owls (Asio otus) avoided forest areas, but showed different responses to agriculture, grass‐fields, scrub and urban areas. Finally, European nightjar (Caprimulgus europaeus) was moderately frequent, and its abundance was favoured by scrub areas and, weakly, by eucalyptus patches, whereas it was negatively affected by large forest areas. We have shown that it is fundamental to consider the effects of survey‐specific covariates in the methodology design and analytical development. Our results also indicate some ecological adaptations and population changes in the nocturnal bird community following an increase in urbanization and in the extent of timber plantations, and also the simplification of natural habitats.
Protein self‐marking by emerald ash borer: an evaluation of efficacy and persistence
Authors: Gula Scott W. , Lopez Vanessa M. , Ray Ann M. , Machtley Scott A. , Hagler James R. , Ginzel Matthew D.
Published: May 2020

Understanding the dispersal ability of invasive insects provides useful insights for developing effective management strategies. Historically, methods for marking insects for dispersal studies have been expensive, time‐consuming, labor‐intensive, and oftentimes ineffective, especially for woodboring beetles. Also, capturing or rearing insects requires human handling, which can alter behavior. Protein immunomarking is a well‐established technique for studying the dispersal of insects; however, it has not been applied to woodborers. This study evaluates the potential for using protein immunomarkers applied directly to woodborer‐infested trees to mark emerging beetles. Specifically, in the first experiment, we sprayed varying concentrations of ovalbumin (egg white) solution directly onto logs infested with emerald ash borer (EAB),Agrilus planipennisFairmaire (Coleoptera: Buprestidae, Agrilini). In turn, an enzyme‐linked immunosorbent assay was used to detect the presence of protein on emerged beetles. To test the persistence of the mark, we applied varying concentrations of albumin to freeze‐killed beetles, mounted them on pins, and placed them over various time intervals in an exposed location outdoors. Adult EAB self‐marked as they emerged from protein‐treated trees, with higher protein concentrations persisting for longer on the cuticle. This technique offers a convenient, inexpensive, and durable means of marking woodborers and circumvents the need for human handling, allowing for more natural behavior and more realistic estimates of dispersal. Protein self‐marking may find application in studies of woodborer dispersal within natural forest environments.
Phenotypic and genetic spectrum of epilepsy with myoclonic atonic seizures
Authors: Tang Shan , Addis Laura , Smith Anna , Topp Simon D. , Pendziwiat Manuela , Mei Davide , Parker Alasdair , Agrawal Shakti , Hughes Elaine , Lascelles Karine , Williams Ruth E. , Fallon Penny , Robinson Robert , Cross Helen J. , Hedderly Tammy , Eltze Christin , Kerr Tim , Desurkar Archana , Hussain Nahin , Kinali Maria , Bagnasco Irene , Vassallo Grace , Whitehouse William , Goyal Sushma , Absoud Michael ,   EuroEPINOMICS‐RES Consortium, Møller Rikke S. , Helbig Ingo , Weber Yvonne G. , Marini Carla , Guerrini Renzo , Simpson Michael A. , Pal Deb K.
Published: May 2020

Objective

We aimed to describe the extent of neurodevelopmental impairments and identify the genetic etiologies in a large cohort of patients with epilepsy with myoclonic atonic seizures (MAE).

Methods

We deeply phenotyped MAE patients for epilepsy features, intellectual disability, autism spectrum disorder, and attention‐deficit/hyperactivity disorder using standardized neuropsychological instruments. We performed exome analysis (whole exome sequencing) filtered on epilepsy and neuropsychiatric gene sets to identify genetic etiologies.

Results

We analyzed 101 patients with MAE (70% male). The median age of seizure onset was 34 months (range = 6‐72 months). The main seizure types were myoclonic atonic or atonic in 100%, generalized tonic‐clonic in 72%, myoclonic in 69%, absence in 60%, and tonic seizures in 19% of patients. We observed intellectual disability in 62% of patients, with extremely low adaptive behavioral scores in 69%. In addition, 24% exhibited symptoms of autism and 37% exhibited attention‐deficit/hyperactivity symptoms. We discovered pathogenic variants in 12 (14%) of 85 patients, including five previously published patients. These were pathogenic genetic variants in SYNGAP1 (n = 3), KIAA2022 (n = 2), and SLC6A1 (n = 2), as well as KCNA2, SCN2A, STX1B, KCNB1, and MECP2 (n = 1 each). We also identified three new candidate genes, ASH1L, CHD4, and SMARCA2 in one patient each.

Significance

MAE is associated with significant neurodevelopmental impairment. MAE is genetically heterogeneous, and we identified a pathogenic genetic etiology in 14% of this cohort by exome analysis. These findings suggest that MAE is a manifestation of several etiologies rather than a discrete syndromic entity.
Seasonal and diel plasticity of song type use in individual ovenbirds (Seiurus aurocapilla)
Authors: Thompson Megan J. , Pearse Kendriah A. , Foote Jennifer R.
Published: May 2020

Animal communication is an important aspect of ecology across taxa, and there is a growing area of research that examines how animals plastically adjust their signals to account for both abiotic and biotic factors. Song type use and the temporal plasticity of song have been described in many bird species, but as of yet, few studies have examined how song type use may change across both seasonal and diel timeframes, and no studies have considered individual‐level variation in plasticity. Using a hierarchical framework, we examined temporal patterns of primary and flight song use in ovenbirds (Seiurus aurocapilla; N = 21 individuals). We recorded ovenbird songs (N = 99,259) with autonomous recorders over 24‐hr periods once per week across a breeding season near Sault Ste. Marie, Canada. As predicted, the occurrence and frequency of both song types significantly decreased over the season and showed temporal separation over diel periods. Primary songs peaked at dawn and declined throughout the day, while flight songs peaked at dusk and night. Our results support that primary songs have multiple functions as they remained more frequent during dawn and morning across the breeding season, while flight songs likely serve an intersexual function as they decreased similarly for all diel periods as mating opportunities decreased. Individuals were consistent in how frequently they sang their primary songs, but not their flight songs, suggesting that flight songs are more plastically expressed. We highlight the importance of examining plasticity in animal communication at the individual level as we show that males significantly differed in both their song behaviours (random intercepts) and the seasonal plasticity (random slopes) in these behaviours. Integrating themes such as song type use, temporal plasticity, and individual variation will be important for examining the evolutionary mechanisms that shape animal communication systems.
Over‐expressed MST1 impaired spatial memory via disturbing neural oscillation patterns in mice
Authors: Shang Yingchun , Yan Yuxing , Chen Bin , Zhang Jianhai , Zhang Tao
Published: May 2020

The activated mammalian Ste20‐like serine/threonine kinases 1 (MST1) was found in the central nervous system diseases, such as cerebral ischemia, stroke and ALS, which were related with cognitions. The aim of this study was to examine the effect of elevated MST1 on memory functions in C57BL/6J mice. We also explored the underlying mechanism about the pattern alteration of neural oscillations, closely associated with cognitive dysfunctions, at different physiological rhythms, which were related to a wide range of basic and higher‐level cognitive activities. A mouse model of the adeno‐associated virus (AAV)‐mediated overexpression of MST1 was established. The behavioral experiments showed that spatial memory was significantly damaged in MST1 mice. The distribution of either theta or gamma power was clearly disturbed in MST1 animals. Moreover, the synchronization in both theta and gamma rhythms, and theta‐gamma cross‐frequency coupling were significantly weakened in MST1 mice. In addition, the expressions of GABAA receptor, GAD67 and parvalbumin (PV) were obviously increased in MST1 mice. Meanwhile, blocking MST1 activity could inhibit the activation of FOXO3a and YAP. The above data suggest that MST1‐overexpression may induce memory impairments via disturbing the patterns of neural activities, which is possibly associated with the abnormal GABAergic expression level.
Patterns of elderly people's long‐term care risks and determinants: A methodological study in a Japanese city
Authors: Sato (Osaki) Kanae , Zhang Junyi , Kazawa Kana , Moriyama Michiko
Published: May 2020

Aims

Existing analysis methods about the relationships between the long‐term care (LTC) risks and determinants of the elderly often experience issues of independence, linearity and homogeneity. Such methodological issues are particularly problematic when the relationships are complicated, making the prioritization of LTC interventions to groups with different care needs difficult. To overcome these shortcomings, this study made an initial attempt to identify representative patterns of elderly people's LTC risks associated with different determinants, from a methodological perspective.

Methods

A data mining approach (Exhaustive CHAID) is applied to data collected from 26 357 elderly people in a Japanese city in 2016. It can automatically segment the samples into a tree structure that accommodates nonlinear, heterogeneous and sequential relationships, without caring about issues of independence across determinants.

Results

In total, 16 representative patterns are derived, among which four patterns are considerably riskier (the unhealthy percentage >10.0%), and five are moderately riskier (the unhealthy percentage is 5.0%–10.0%). Age is the most important determinant, followed by locomotor function, cognitive function, homebound, gender and residential location, in that order, which all show heterogeneous associations with the risk patterns.

Conclusions

The Exhaustive CHAID is suitable to derive scientifically‐sound insights into an early screening of risk factors for pre‐frail groups and tailor‐made preventive LTC interventions for frail groups in a flexible and objective way. Geriatr Gerontol Int 2020; 20: 674–679.
Determination of the Isotopic Composition of an Enriched Hafnium Spike by MC‐ICP‐MS Using a Regression Model
Authors: Lin Ran , Lin Jie , Zong Keqing , Chen Kang , Tong Shuoyun , Feng Lanping , Zhang Wen , Li Ming , Liu Yongsheng , Hu Zhaochu , Zhou Lian
Published: May 2020

The isotope dilution (ID) method, owing to its high precision, is extensively used for the determination of element mass fractions in a wide range of natural samples. One of the prerequisites of the ID method is knowledge of the isotopic composition of an enriched spike, which is often challenging to accurately determine. In this study, we employ a regression mass bias correction model to accurately and precisely measure the isotopic composition of an enriched Hf spike (Lot No. 159293, Oak Ridge National Laboratory). A NIST SRM 3134 Re solution, whose isotopic composition was calibrated by an NRC IRIS‐1 Ir isotope standard, was used to calibrate the isotopic composition of the Hf spike. The obtained ratios of 176Hf/177Hf, 179Hf/177Hf and 180Hf/177Hf were 0.2406 ± 0.0005 (u, k = 1), 2.8620 ± 0.0005 (u, k = 1) and 384.65 ± 0.05 (u, k = 1), respectively, which meet the required precision levels for Hf isotopes in the application of the ID method. The combined uncertainties of the calibrated Re and Hf isotope ratios were evaluated using a Monte Carlo method, in which the uncertainty of the primary calibrator (IRIS‐1, 193Ir/191Ir = 1.6866 ± 0.0005, u, k = 1) was also taken into consideration. The precision of Hf spike was improved significantly compared with the SSB and C‐SSBIN methods. To the best of our knowledge, this is the first report of isotope ratio calibration in an enriched spike using the regression model. The precisely calibrated spike can lower the uncertainty of the Hf mass fraction significantly, thereby increasing the accuracy of the Lu‐Hf chronometer.
Laboratory issues in gene therapy and emicizumab
Authors: Bowyer Annette E. , Lowe Anna E. , Tiefenbacher Stefan
Published: May 2020

The treatment options for the haemostatic disorders, haemophilia A and haemophilia B, have progressed rapidly over the last decade. The introduction of extended half‐life recombinant factor VIII (FVIII) and factor IX (FIX) concentrates to replace these missing clotting factors highlighted discordance between one‐stage activated partial thromboplastin time (APTT)‐based clotting factor assays and chromogenic factor assays with some products. This raised awareness of the importance of investigation of potential reagent or assay differences by pharmaceutical companies. In 2017, the FVIII mimetic, emicizumab, was approved as a prophylactic treatment for haemophilia A patients with anti‐FVIII inhibitors. The mechanism of action of emicizumab causes interference with some commonly used haemostasis tests including the APTT and its associated one‐stage APTT‐based clotting assays. Chromogenic assays may also be affected but this is dependent on the particular constituents of the reagents. Chromogenic assays containing human factor IXa (FIXa) and factor X (FX) are sensitive to the presence of emicizumab but those containing bovine FIXa and FX are unaffected. Many haemostasis laboratories have been required to evaluate new assays to enable accurate monitoring of emicizumab in patient plasma. A number of gene therapy approaches have been trialled in both haemophilia A and haemophilia B but there are scant data published on the measurement of FVIII and FIX in these patients and whether there are discrepancies between reagents or assay methodologies.
Redefining prophylaxis in the modern era
Authors: Mahlangu Johnny N. , Blanchette Victor , Klamroth Robert
Published: May 2020

Prophylaxis is the globally accepted standard of care for persons with haemophilia and presents many advantages over episodic treatment. The prophylaxis benefits include bleed reduction, reduction in musculoskeletal complications and improvement in the quality of life. The currently evolving novel therapies for the management of haemophilia has ushered a new era characterized by improved prophylaxis targets and outcomes. These redefined targets and outcomes have necessitated the need to also redefine prophylaxis. In this state‐of‐the‐art review, we redefine prophylaxis in the modern era by revisiting its definition, presenting data to support higher trough levels to achieve with prophylaxis and introducing steady‐state haemostasis as a possible new target for prophylaxis.
Motivations for Environmental Alliances: Generating and Internalizing Environmental and Knowledge Value
Authors: Niesten Eva , Jolink Albert
Published: May 2020

Environmental alliances are a common response to societal sustainability demands. In environmental alliances, firms collaboratively exploit and explore environmental technologies to address market opportunities while simultaneously generating positive environmental impacts. A striking idiosyncrasy is that in addition to economic value, environmental alliances generate two types of external value: environmental value from positive effects on air, water, land and biodiversity, and knowledge value from innovations in environmental technologies. Research on motivations for environmental alliances is dispersed and underdeveloped compared to the well‐established literature on motivations for strategic alliances that emphasize economic value. This study therefore develops a classification of motivations for environmental alliances by combining the literature on strategic alliances and that on environmental and knowledge value. The resulting classification includes motivations for environmental alliances to generate environmental and knowledge value as well as motivations to create economic value by internalizing environmental and knowledge value. A systematic review of 123 articles on environmental inter‐firm alliances identifies specific motivations to populate the new classification. We show that alliance partners are motivated to share sustainable resources, reduce sustainability risk, respond to stakeholders or invest in specific sustainable assets to generate external value. They collaborate to reduce costs or enhance competitive advantage, reputation or legitimacy to internalize external value. The resource‐based view, resource‐dependence view, institutional theory and transaction cost economics have not previously distinguished between motivations to generate and internalize external value. We extend their area of application from strategic alliances to environmental alliances, and thus beyond the exclusive pursuit of economic value.
Quality of life improvements by durable pulmonary vein isolation in patients with atrial fibrillation
Authors: Inagaki Dai , Fukamizu Seiji , Tokioka Sayuri , Kawamura Iwanari , Kitamura Takeshi , Hojo Rintaro , Sakurada Harumizu , Hiraoka Masayasu
Published: May 2020

Introduction

Successful pulmonary vein isolation (PVI) can improve the quality of life (QOL) of patients with atrial fibrillation (AF). However, the role of durable PVI for such QOL improvement is not known. The aim of this study was to clarify the effectiveness of durable PVI in improving the QOL of patients with AF.

Methods and Results

We assessed 119 patients who underwent PVI (age 66.4 ± 9.6 years, 104 paroxysmal AF). A scheduled electrophysiological study was performed 6 months after the first PVI session—regardless of recurrence of AF—to assess the durability of PVI and to identify and re‐isolate reconnected pulmonary veins. QOL scores were evaluated by an AF‐specific QOL questionnaire and checked at baseline, 6  months, and 1 year after the first session. In patients without AF recurrence (nonrecurrence group, n = 93), the scores at 6 months improved compared with those at baseline; conversely, the scores did not improve in patients with AF recurrence (n = 26). Nevertheless, the scores at 1 year improved compared with those at 6 months in both groups. Within the nonrecurrence group, the score difference between 6 months and baseline was higher in the durable PVI group (n = 58) than that in the nondurable PVI group (n = 35).

Conclusions

The QOL of AF patients improved by the resumption of sinus rhythm following PVI. Patients with durable PVI had increased QOL scores compared with those with nondurable PVI. The durability of PVI may achieve further improvements in the QOL of patients with AF.
Up‐regulation of miR‐195 contributes to cardiac hypertrophy‐induced arrhythmia by targeting calcium and potassium channels
Authors: Xuan Lina , Zhu Yanmeng , Liu Yunqi , Yang Hua , Wang Shengjie , Li Qingqi , Yang Chao , Jiao Lei , Zhang Ying , Yang Baofeng , Sun Lihua
Published: May 2020

Previous studies have confirmed that miR‐195 expression is increased in cardiac hypertrophy, and the bioinformatics website predicted by Targetscan software shows that miR‐195 can directly target CACNB1, KCNJ2 and KCND3 to regulate Cavβ1, Kir2.1 and Kv4.3 proteins expression. The purpose of this study is to confirm the role of miR‐195 in arrhythmia caused by cardiac hypertrophy. The protein levels of Cavβ1, Kir2.1 and Kv4.3 in myocardium of HF mice were decreased. After miR‐195 was overexpressed in neonatal mice cardiomyocytes, the expression of ANP, BNP and β‐MHC was up‐regulated, and miR‐195 inhibitor reversed this phenomenon. Overexpression of miR‐195 reduced the estimated cardiac function of EF% and FS% in wild‐type (WT) mice. Transmission electron microscopy showed that the ultrastructure of cardiac tissues was damaged after miR‐195 overexpression by lentivirus in mice. miR‐195 overexpression increased the likelihood of arrhythmia induction and duration of arrhythmia in WT mice. Lenti‐miR‐195 inhibitor carried by lentivirus can reverse the decreased EF% and FS%, the increased incidence of arrhythmia and prolonged duration of arrhythmia induced by TAC in mice. After miR‐195 treatment, the protein expressions of Cavβ1, Kir2.1 and Kv4.3 were decreased in mice. The results were consistent at animal and cellular levels, respectively. Luciferase assay results showed that miR‐195 may directly target CACNB1, KCNJ2 and KCND3 to regulate the expression of Cavβ1, Kir2.1 and Kv4.3 proteins. MiR‐195 is involved in arrhythmia caused by cardiac hypertrophy by inhibiting Cavβ1, Kir2.1 and Kv4.3.
Stage‐specific regulation of Gremlin1 on the differentiation and expansion of human urinary induced pluripotent stem cells into endothelial progenitors
Authors: Chen Haixuan , Zhang Zhen , Wang Zhecun , Li Quhuan , Chen Hui , Guo Song , Bao Lin , Wang Zheng , Min Wang , Xiang Qiuling
Published: May 2020

Human urinary induced pluripotent stem cells (hUiPSCs) produced from exfoliated renal epithelial cells present in urine may provide a non‐invasive source of endothelial progenitors for the treatment of ischaemic diseases. However, their differentiation efficiency is unsatisfactory and the underlying mechanism of differentiation is still unknown. Gremlin1 (GREM1) is an important gene involved in cell differentiation. Therefore, we tried to elucidate the roles of GREM1 during the differentiation and expansion of endothelial progenitors. HUiPSCs were induced into endothelial progenitors by three stages. After differentiation, GREM1 was obviously increased in hUiPSC‐induced endothelial progenitors (hUiPSC‐EPs). RNA interference (RNAi) was used to silence GREM1 expression in three stages, respectively. We demonstrated a stage‐specific effect of GREM1 in decreasing hUiPSC‐EP differentiation in the mesoderm induction stage (Stage 1), while increasing differentiation in the endothelial progenitors' induction stage (Stage 2) and expansion stage (Stage 3). Exogenous addition of GREM1 recombinant protein in the endothelial progenitors' expansion stage (Stage 3) promoted the expansion of hUiPSC‐EPs although the activation of VEGFR2/Akt or VEGFR2/p42/44MAPK pathway. Our study provided a new non‐invasive source for endothelial progenitors, demonstrated critical roles of GREM1 in hUiPSC‐EP and afforded a novel strategy to improve stem cell‐based therapy for the ischaemic diseases.
Healthcare utilization and direct medical cost in the years during and after cancer diagnosis in patients with type 2 diabetes mellitus
Authors: Wu Tingting , Yang Fan , Chan Wendy Wing Lok , Lam Cindy Lo Kuen , Wong Carlos King Ho
Published: May 2020

Aims/Introduction

There is uncertainty about the direct medical costs of type 2 diabetes patients with cancers.

Materials and Methods

A population‐based retrospective cohort of 99,915 type 2 diabetes patients from the Hong Kong Hospital Authority between 2006 and 2017 was assembled. A total of 16,869 patients who had an initial cancer diagnosis after type 2 diabetes diagnosis were matched with 83,046 patients without cancer (controls) using a matching ratio of up to one‐to‐five propensity score‐matching method. Patients were divided into four categories according to life expectancy. Healthcare service utilization and direct medical costs during the index year, subsequent years and mortality year were compared between patients with and without cancer in each category.

Results

Medical costs of cancer patients in the index year ranged from $US27,533 for patients who died in <1 year to $US11,303 for those survived >3 years. Cancer patients had significantly greater expenditures than controls in the index year (all P < 0.001) and subsequent years ($US4,569 vs $US4,155, P < 0.001). Cancer patients also had greater costs in the year of death, and the difference was significant for patients who survived >3 years after the index year ($US32,558 vs $US28,260). For patients in both groups, patients who survived >3 years had significantly lower costs than those who died in <1 year. Costs incurred in the mortality year were greater than those in the index year and subsequent years. Hospitalization accounted for >90% of the medical costs for both groups in the mortality year.

Conclusions

Type 2 diabetes patients with cancers incurred greater medical costs in the diagnosis, ensuing and mortality years than type 2 diabetes patients without cancers.
Effect of drying air temperature on drying kinetics and physicochemical characteristics of dried banana
Authors: Macedo Leandro Levate , Vimercati Wallaf Costa , da Silva Araújo Cintia , Saraiva Sérgio Henriques , Teixeira Luciano José Quintão
Published: May 2020

This study aimed to evaluate the influence of drying air temperature on drying kinetics and the physicochemical properties of dried bananas. Banana slices were dried at 40, 60, and 80°C. Drying was terminated when the samples had a moisture of 20%. Mathematical models were fitted to the moisture ratio. A generalized model of moisture was developed, to predict the moisture of samples as a function of drying time and temperature. The effective moisture diffusivity (Deff), activation energy and the drying rate (DR) were calculated. Electrical energy consumption was measured. The moisture, water activity, reducing and total sugar content, acidity, hardness, and color of the dried bananas were evaluated. The moisture decreased during drying, obtaining a mean value of 20.132%. All mathematical models fitted well to the MR data, with a determination coefficient greater than 0.95. The Midilli model was that which best fitted. The higher temperature resulted in higher Deff (3.538 × 10−9 m2 s−1) and DR, less drying time (120 min) and electrical energy consumption (4.319 kWh), higher reducing sugar content (47.51%) and hardness (28.187 N), lower acidity (1.038%), more yellow tonality (78.04°), and higher chromaticity (18.49) of the dried bananas. The optimum temperature for drying bananas was 80°C.

Practical Applications

Banana is a fruit widely consumed in the world. However, it is very perishable, causing great waste and financial loss. Convective drying is a simple and low‐cost method, widely used in fruit processing to produce new products and extend the shelf life of food. The dried banana is a product of good sensory acceptance and therefore drying is a good alternative for processing the banana pulp. The temperature of the drying air is one of the principal parameters of this process since it influences the drying kinetics and the physicochemical properties of the dry product. Therefore, it is important to study different drying air temperatures to determine the best drying condition for dried banana production, to optimize the dried banana process and properties.
Queensland Paediatric Cardiac Service: Lessons from evolution to a unified service in a tertiary children's hospital
Authors: Justo Robert , Ward Cameron , Slater Anthony , McEniery Julie , Sargent Phil , Isles Alan , Karl Tom R , Alphonso Nelson
Published: May 2020

We describe a complex change process for the paediatric cardiac service in Queensland that involved transitioning the service out of an essentially adult hospital into one of two children's hospitals in Brisbane. This initial step was complex as the governance was changed from Queensland Health to Mater Health, an independent faith‐based organisation who became the new employer. Six years later, the service was again transitioned; this time to the newly constructed Queensland Children's Hospital, with a Hospital and Health Services Board as the employer under the aegis of Queensland Health. This was a complex journey. As with all change processes there was resistance to change on the part of some individuals. Five years on from the second major change, the service is settled, has an excellent workplace culture, has excellent clinical outcomes and has become research intensive.
Sleep patterns and insomnia in a large population‐based study of middle‐aged and older adults: The Tromsø study 2015–2016
Authors: Sivertsen Børge , Pallesen Ståle , Friborg Oddgeir , Nilsen Kristian Bernhard , Bakke Øystein Kvåle , Goll Jonas Bjørnskov , Hopstock Laila Arnesdatter
Published: May 2020

Epidemiological studies assessing adult sleep duration have yielded inconsistent findings and there are still large variations in estimation of insomnia prevalence according to the most recent diagnostic criteria. Our objective was to describe sleep patterns in a large population of middle‐aged and older adults, by employing accurate measures of both sleep duration and insomnia. Data stem from the Tromsø Study (2015–2016), an ongoing population‐based study in northern Norway comprising citizens aged 40 years and older (n = 21,083, attendance = 64.7%). Sleep parameters were reported separately for weekdays and weekends and included bedtime, rise time, sleep latency and total sleep time. Insomnia was defined according to recent diagnostic criteria (International Classification of Sleep Disorders; ICSD‐3). The results show that 20% (95% confidence interval,19.4–20.6) fulfilled the inclusion criteria for insomnia. The prevalence was especially high among women (25%), for whom the prevalence also increased with age. For men, the prevalence was around 15% across all age groups. In all, 42% of the women reported sleeping <7 hr (mean sleep duration of 7:07 hr), whereas the corresponding proportion among males was 52% (mean sleep duration of 6:55 hr). We conclude that the proportion of middle‐aged and older adults not getting the recommended amount of sleep is worryingly high, as is also the observed prevalence of insomnia. This warrants attention as a public health problem in this population.
Evaluation of profibrotic gene transcription in renal tissues from cats with naturally occurring chronic kidney disease
Authors: Lourenço Bianca N. , Coleman Amanda E. , Tarigo Jaime L. , Berghaus Roy D. , Brown Cathy A. , Rissi Daniel R. , Stanton James B. , Brown Scott A. , Schmiedt Chad W.
Published: May 2020

Background

Increased gene transcription of hypoxia‐induced mediators of fibrosis in renal tissue has been identified in experimentally induced, ischemic chronic kidney disease (CKD).

Objective

To characterize hypoxia‐induced profibrotic pathways in naturally occurring CKD in cats.

Animals

Twelve client‐owned cats with CKD and 8 healthy control cats.

Methods

In this prospective, cross‐sectional study, bilateral renal tissue samples were assessed histologically for inflammation, tubular atrophy, and fibrosis, and by reverse transcription‐quantitative PCR for characterization of transcript levels of hypoxia‐inducible factor‐1α (HIF1A), matrix metalloproteinases‐2 (MMP2), ‐7 (MMP7), and ‐9 (MMP9), tissue inhibitor of metalloproteinase‐1 (TIMP1), transforming growth factor‐β1 (TGFB1), and vascular endothelial growth factor‐A (VEGFA). Linear mixed models were used to compare gene transcription between diseased and healthy kidneys, and to examine the association between transcript levels and serum creatinine concentration for all cats, and between transcript levels and histologic scores of diseased kidneys.

Results

Kidneys from cats with CKD had significantly higher transcript levels of HIF1A, MMP2, MMP7, MMP9, TIMP1, and TGFB1 (all P < .001), and lower levels of VEGFA (P = .006) than those from control cats. Transcript levels of MMP7 (P = .05) and TIMP1 (P = .005) were positively associated with serum creatinine in cats with CKD, but not in control cats. In diseased kidneys, transcript levels of MMP2 (P = .002), MMP7 (P = .02), and TIMP1 (P = .02) were positively, whereas those of VEGFA (P = .003) were negatively, associated with histologic score severity.

Conclusion and Clinical Significance

Evaluation of the expression of the corresponding proteins in larger populations could identify therapeutic targets and/or biomarkers of tubulointerstitial fibrosis in cats.
A pilot study of optical neuronavigation‐guided brain biopsy in the horse using anatomic landmarks and fiducial arrays for patient registration
Authors: Santistevan Lawrence , Easley Jeremiah , Ruple Audrey , Monck Sam , Randall Elissa , Wininger Fred , Packer Rebecca A.
Published: May 2020

Background

Optical neuronavigation‐guided intracranial surgery has become increasingly common in veterinary medicine, but its use has not yet been described in horses.

Objectives

To determine the feasibility of optical neuronavigation‐guided intracranial biopsy procedures in the horse, compare the use of the standard fiducial array and anatomic landmarks for patient registration, and evaluate surgeon experience.

Animals

Six equine cadaver heads.

Methods

Computed tomography images of each specimen were acquired, with the fiducial array rigidly secured to the frontal bone. Six targets were selected in each specimen. Patient registration was performed separately for 3 targets using the fiducial array, and for 3 targets using anatomic landmarks. In lieu of biopsy, 1 mm diameter wire seeds were placed at each target. Postoperative images were coregistered with the planning scan to calculate Euclidian distance from the tip of the seed to the target.

Results

No statistical difference between registration techniques was identified. The impact of surgeon experience was examined for each technique using a Mann‐Whitney U test. The experienced surgeon was significantly closer to the intended target (median = 2.52 mm) than were the novice surgeons (median = 6.55 mm) using the fiducial array (P = .001). Although not statistically significant (P = .31), for the experienced surgeon the median distance to target was similar when registering with the fiducial array (2.47 mm) and anatomic landmarks (2.58 mm).

Conclusions and Clinical Importance

Registration using both fiducial arrays and anatomic landmarks for brain biopsy using optical neuronavigation in horses is feasible.
Low prevalence and disease severity of COVID‐19 in post‐liver transplant recipients—A single centre experience
Authors: Verma Anita , Khorsandi Shirin Elizabeth , Dolcet Annalisa , Prachalias Andreas , Suddle Abid , Heaton Nigel , Jassem Wayel
Published: May 2020

Coronavirus disease 2019 (COVID‐19) caused by a novel coronavirus called severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is driving a present day global pandemic. Immunosuppressed patients are regarded as a high‐risk cohort. The following is a short report on COVID‐19 in liver transplant recipients (n = 5) from a high volume UK liver transplant unit with a large follow‐up cohort (n = 4500). Based on this limited data, liver transplant recipients appear to have a low incidence of COVID‐19, with less severe symptoms than expected, when compared with the general population and other solid organ recipients. This possibly could be related to self‐isolation adherence and/or the ‘ideal’ level of immunosuppression that favourably modulates the immune response to COVID‐19.
The Role of Positive Emotions in Education: A Neuroscience Perspective
Authors: Li Lu , Gow Andrew Douglas Isherwood , Zhou Jiaxian
Published: May 2020

Humans are inherently emotional creatures due to our social nature, and emotions are able to influence how well we learn and even affect academic outcomes. Emotions are rarely a chief concern in educational settings, and we will discuss the mechanisms underlying how emotions are processed in the brain and how they influence the key aspects of learning—attention, memory, and motivation. The brain mechanisms of emotional and cognitive relationships are then detailed in order to provide some context within the modern developments of neuroscience. This will help to clarify the relationship between emotions and cognition, and hope to put forward a theoretical map based on neuroscience that helps us to better understand the pivotal role of emotions in students' cognitive activities and ultimately their performance. Various strategies, based on research findings, aimed at creating more positive learning environments are then put forward.