bluuebunny/crossref_metadata_2025 huggingface dataset:
Aktivierung der katalytischen Aktivität von Thrombin für die Bildung von Fibrin durch Ultraschall
Authors: Zhao Pengkun , Huo Shuaidong , Fan Jilin , Chen Junlin , Kiessling Fabian , Boersma Arnold J. , Göstl Robert , Herrmann Andreas
Published: May 2021

Die Regulierung der Aktivität von Enzymen ist eine Methode zur Steuerung biologischer Funktionen. Wir berichten über zwei Systeme, die die ultraschallinduzierte Aktivierung von Thrombin ermöglichen, das für die sekundäre Hämostase wichtig ist. Erstens entwickelten wir Polyaptamere, die spezifisch an Thrombin binden können und dessen katalytische Aktivität hemmen. Mit Hilfe von Ultraschall, der Trägheitskavitation erzeugt, und therapeutisch‐medizinischem fokussiertem Ultraschall lösen sich die Wechselwirkungen zwischen Polyaptamer und Enzym, wodurch die Aktivität zur Katalyse der Umwandlung von Fibrinogen in Fibrin wiederhergestellt wird. Zweitens verwendeten wir gespaltene Aptamere, die an die Oberfläche von Gold‐Nanopartikeln (AuNPs) konjugiert sind. In Gegenwart von Thrombin assemblieren diese zu einer Aptamer‐Tertiärstruktur, induzieren die Aggregation der AuNPs und deaktivieren das Enzym. Durch Behandlung mit Ultraschall lösen sich die AuNP‐Aggregate reversibel, setzen das Enzym frei und aktivieren es. Wir glauben, dass dieser Ansatz eine Blaupause für die Steuerung der Funktion anderer Proteine durch mechanische Stimuli im Bereich der Sonogenetik sein wird.
Extreme primordial black holes
Authors: Chongchitnan Siri , Chantavat Teeraparb , Zunder Jenna
Published: May 2021

We present a formalism for calculating the probability distribution of the most massive primordial black holes (PBHs) expected within an observational volume. We show how current observational upper bounds on the fraction of PBHs in dark matter translate to constraints on extreme masses of primordial black holes. We demonstrate the power of our formalism via a case study, and argue that our formalism can be used to produce extreme‐value distributions for a wide range of PBH formation theories.
A guided‐inquiry investigation of genetic variants using Oxford nanopore sequencing for an undergraduate molecular biology laboratory course
Authors: Rodriguez Princess D. , Mariani Michael , Gay Jamie , Hogan Tyler C. , Amiel Eyal , Deming Paula B. , Frietze Seth
Published: May 2021

Next Generation Sequencing (NGS) has become an important tool in the biological sciences and has a growing number of applications across medical fields. Currently, few undergraduate programs provide training in the design and implementation of NGS applications. Here, we describe an inquiry‐based laboratory exercise for a college‐level molecular biology laboratory course that uses real‐time MinION deep sequencing and bioinformatics to investigate characteristic genetic variants found in cancer cell‐lines. The overall goal for students was to identify non‐small cell lung cancer (NSCLC) cell‐lines based on their unique genomic profiles. The units described in this laboratory highlight core principles in multiplex PCR primer design, real‐time deep sequencing, and bioinformatics analysis for genetic variants. We found that the MinION device is an appropriate, feasible tool that provides a comprehensive, hands‐on NGS experience for undergraduates. Student evaluations demonstrated increased confidence in using molecular techniques and enhanced understanding of NGS concepts. Overall, this exercise provides a pedagogical tool for incorporating NGS approaches in the teaching laboratory as way of enhancing students' comprehension of genomic sequence analysis. Further, this NGS lab module can easily be added to a variety of lab‐based courses to help undergraduate students learn current DNA sequencing methods with limited effort and cost.
Trametinib therapy for children with neurofibromatosis type 1 and life‐threatening plexiform neurofibroma or treatment‐refractory low‐grade glioma
Authors: Ronsley Rebecca , Hounjet Celine D. , Cheng Sylvia , Rassekh Shahrad Rod , Duncan Walter J. , Dunham Christopher , Gardiner Jane , Ghag Arvindera , Ludemann Jeffrey P. , Wensley David , Rehmus Wingfield , Sargent Michael A. , Hukin Juliette
Published: May 2021

Purpose

To describe a series of children with extensive PNF or treatment refractory PLGG treated on a compassionate basis with trametinib.

Methods

We report on six patients with NF‐1 treated with trametinib on a compassionate basis at British Columbia Children's Hospital since 2017. Data were collected retrospectively from the patient record. RAPNO and volumetric criteria were used to evaluate the response of intracranial and extracranial lesions, respectively.

Results

Subjects were 21 months to 14 years old at the time of initiation of trametinib therapy and 3/6 subjects are male. Duration of therapy was 4–28 months at the time of this report. All patients had partial response or were stable on analysis. Two patients with life‐threatening PNF had a partial radiographic response in tandem with significant clinical improvement and developmental catch up. One subject discontinued therapy after 6 months due to paronychia and inadequate response. The most common adverse effect (AE) was grade 1–2 paronychia or dermatitis in 5/6 patients. There were no grade 3 or 4 AEs. At the time of this report, five patients remain on therapy.

Conclusion

Trametinib is an effective therapy for advanced PNF and refractory PLGG in patients with NF‐1 and is well tolerated in children. Further data and clinical trials are required to assess tolerance, efficacy and durability of response, and length of treatment required in such patients.
Electrochemical Synthesis of Organic Polysulfides from Disulfides by Sulfur Insertion from S8 and an Unexpected Solvent Effect on the Product Distribution
Authors: Fährmann Jan , Hilt Gerhard
Published: May 2021

An electrochemical synthesis of organic polysulfides through sulfur insertion from elemental sulfur to disulfides or thiols is introduced. The highly economic, low‐sensitive and low‐priced reaction gives a mixture of polysulfides, whose distribution can be influenced by the addition of different amounts of carbon disulfide as co‐solvent. To describe the variable distribution function of the polysulfides, a novel parameter, the “absorbance average sulfur amount in polysulfides” (SAP) was introduced and defined on the basis of the “number average molar mass” used in polymer chemistry. Various organic polysulfides were synthesized with variable volume fractions of carbon disulfide, and the yield of each polysulfide was determined by quantitative 13C NMR. Moreover, by using two symmetrical disulfides or a disulfide and a thiol as starting materials, a mixture of symmetrical and asymmetrical polysulfides could be obtained.
Hydroxyapatite Growth on Amelogenin‐Amelotin Recombinamers
Authors: Athanasiadou Dimitra , Danesi Alexander L. , Umbrio Liana , Holcroft James , Ganss Bernhard , Carneiro Karina M. M.
Published: May 2021

Strategies to improve hydroxyapatite mineralization for enamel repair are essential for tissue regeneration. Amelogenin and amelotin (AMTN) are enamel matrix proteins playing critical roles in enamel formation. Amelogenin acts as a scaffold for hydroxyapatite, while AMTN (specifically its ‘SSEEL’ domain) is necessary for proper enamel mineralization. The functional relationship between recombinant AMTN and amelogenin, and their combined ability to guide uniaxial hydroxyapatite growth in vitro has been investigated recently. However, incorporation of the active domain of AMTN within recombinant amelogenins has not been studied yet. Here we describe the synthesis of modified amelogenin by inserting, internally and at its C‐terminus, the mineralizing AMTN‐derived motif SSEEL. C‐terminus modified amelogenin promoted hydroxyapatite formation, whereas internal incorporation of the motif initially resulted in amorphous calcium phosphate formation. Here we show that modified amelogenin with the mineralizing AMTN‐motif SSEEL can promote hydroxyapatite growth. These results give new insights for mineralized tissue regeneration using recombinamer proteins.
Evaluation of potential complication of interstitial lung disease with abemaciclib and palbociclib treatments
Authors: Nawa Hideki , Niimura Takahiro , Yagi Kenta , Goda Mitsuhiro , Zamami Yoshito , Ishizawa Keisuke
Published: May 2021

Background

Various cyclin‐dependent kinase 4/6 (CDK4/6) inhibitors have demonstrated promising anti‐tumor effects. The Japanese Ministry of Health, Labour and Welfare has issued a warning about interstitial lung diseases as an adverse effect of CDK4/6 inhibitors. However, a large‐scale evaluation of potential complications has not been conducted to date, and the occurrence of these adverse effects is unclear.

Aim

The aim of this study was to evaluate the clinical incidence of interstitial lung disease caused by two CDK4/6 inhibitors, abemaciclib and palbociclib, and assess the relationship between each drug and interstitial lung disease.

Methods and results

We evaluated the relationship between the CDK4/6 inhibitors (abemaciclib and palbociclib) and interstitial lung disease in clinical practice using data from the Japanese Adverse Drug Event Report (JADER) database and FDA Adverse Event Reporting System (FAERS) to detect adverse event signals with reported odds ratios (RORs). Furthermore, we performed an adverse event‐time analysis for each drug using data from the JADER database to examine the time of onset of the adverse events.

The analysis of the reports in the JADER database showed that the lower limit of the 95% confidence interval (CI) of ROR for abemaciclib was >1 regardless of age, and a signal was detected. Interstitial lung disease associated with abemaciclib and palbociclib use has been reported, with an average onset period from treatment initiation [median (25th‐75th quartile)] of 65.1 [56.0 days (25.3‐98.3 days)] and 53.1 days [38.0 days (10.8‐76.0 days)], respectively. The analysis of the reports in the FAERS showed that the lower limit of the 95% CI of the ROR for the two drugs was >1, and a signal was detected.

Conclusion

Treatment with abemaciclib and palbociclib is associated with a potential complication of interstitial lung disease, regardless of age.
An institutional audit of the use of novel drugs in pediatric oncology
Authors: Lee Justin , Gillam Lynn , Kouw Sarah , McCarthy Maria C. , Hansford Jordan R.
Published: May 2021

Background

Significant challenges persist in treating children with rare, relapsed, or refractory malignancies. Novel molecularly targeted drugs promise improved outcomes for these children with reduced toxicity. However, there is often limited evidence to substantiate their clinical efficacy and guide their use. This raises issues for clinical decision‐making, ethical concerns surrounding equity of access to these often‐expensive agents, and the management of families' expectations for cure. This audit evaluated the off‐label use of novel drugs and associated clinical outcomes in order to guide the development of future clinical and ethical guidelines.

Aim

To evaluate the patterns in the off‐label use of novel drugs for treating childhood cancer and the associated clinical outcomes to guide prospective studies and inform ethical and clinical governance protocols for the use of these agents.

Methods

A retrospective audit was performed for all patients who received novel drugs off‐label as treatment for their malignancy at an Australian pediatric oncology center between 2010 and 2019.

Results

One hundred patients with 32 unique diagnoses received 133 novel drugs across 124 regimens. Eighty‐four patients received these drugs at the second line of treatment or greater. Novel drug median cost was $15 521 AUD (Range: $6.53 AUD to $258 339 AUD) and was primarily funded by the hospital (N = 60/133, 45.1%) or compassionate access from pharmaceutical companies (N = 52/133, 39.1%). Decision‐making related to novel drugs was inconsistently documented. Ninety‐one of 124 treatment regimens commenced between 2010 and 2019 resulted in objective responses (73.4%), but only 35 were still ongoing upon review in June 2020 (38.5%). Median response duration was 12.6 months (Range: 0‐93.2 months).

Conclusions

While novel drugs were largely unable to definitively cure patients, most achieved objective responses. Prospective trials and more rigorous documentation are needed to fully inform the future use of these agents given the heterogeneity of their applications.
Investigating function of long noncoding RNA of HOTAIRM1 in progression of SKOV3 ovarian cancer cells
Authors: Ye Licui , Meng Xia , Xiang Rui , Li Wen , Wang Jingyi
Published: May 2021

Ovarian cancer is one of the most heterogeneous malignancies in the field of gynecologic oncology. Deregulation of long noncoding RNAs (lncRNAs) is implicated in carcinogenesis. Therefore, the present study was conducted to investigate the possible role of lncRNA of HOXA transcript antisense intergenic RNA myeloid‐specific 1(HOTAIRM1) in progression of SKOV3 cells in ovarian cancer and also its underlying molecular mechanisms. HOTAIRM1 expression level will be measured by real‐time polymerase chain reaction (PCR) in SKOV3 cells. For determining the effect of HOTAIRM1 silencing on progression of SKOV3 cells, siHOTAIRM1 will be designed and transfected into cells using a liposomal approach. MTT and trypan blue assays will be used to determine the effect of HOTAIRM1 silencing on cell proliferation. Apoptosis of the cells will be detected by flow cytometry. Furthermore, expressions of apoptosis‐related genes and Wnt pathway‐related proteins and genes will be analyzed by Western blot and real‐time PCR. HOTAIRM1 was overexpressed in SKOV3 cells. Silencing of HOTAIRM1 alleviated cell proliferation, and increased cell apoptosis of SKOV3 cells. Moreover, siHOTAIRM1 significantly increased expression of pro‐apoptotic agents, such as Bad and Bax, while it decreased expressions of Bid and Bcl‐2 (anti‐apoptotic agents). Also, silencing of HOTAIRM1 resulted in a suppressed expression of Wnt pathway‐related proteins and also expression of its downstream target gene, matrix metalloproteinase 9(MMP9). Our findings provided new insights into function of lncRNA of HOTAIRM1 in progression of ovarian cancer by modulating Wnt pathway and its downstream target gene, MMP9.
Understanding the unexplained: The magnitude and correlates of individual differences in residual variance
Authors: Mitchell David J. , Beckmann Christa , Biro Peter A.
Published: May 2021

Behavioral and physiological ecologists have long been interested in explaining the causes and consequences of trait variation, with a focus on individual differences in mean values. However, the majority of phenotypic variation typically occurs within individuals, rather than among individuals (as indicated by average repeatability being less than 0.5). Recent studies have further shown that individuals can also differ in the magnitude of variation that is unexplained by individual variation or environmental factors (i.e., residual variation). The significance of residual variation, or why individuals differ, is largely unexplained, but is important from evolutionary, methodological, and statistical perspectives. Here, we broadly reviewed literature on individual variation in behavior and physiology, and located 39 datasets with sufficient repeated measures to evaluate individual differences in residual variance. We then analyzed these datasets using methods that permit direct comparisons of parameters across studies. This revealed substantial and widespread individual differences in residual variance. The magnitude of individual variation appeared larger in behavioral traits than in physiological traits, and heterogeneity was greater in more controlled situations. We discuss potential ecological and evolutionary implications of individual differences in residual variance and suggest productive future research directions.
Courtship with two spoons—Anatomy and presumed function of the bizarre antennae of Cardiocondyla zoserka ant males
Authors: Heinze Jürgen , Marschall Jella , Lautenschläger Birgit , Seifert Bernhard , Gratiashvili Nana , Strohm Erhard
Published: May 2021

Mating in ants often occurs on the wing during nuptial flights or on the ground when scattered female sexuals attract males by pheromones. In both scenarios, there is little opportunity for males to engage in prolonged aggressive competition or elaborate courtship displays. Male morphology is therefore adapted to locating female sexuals and mating, and it lacks specific weapons or other traits associated with courtship. In contrast, sexuals of the ant genus Cardiocondyla typically mate in their natal nests. As a consequence, in many species winged males have been replaced by wingless fighter or territorial males, which kill or expel rival males with their strong mandibles and show complex mating behavior. However, no wingless males are known from Cardiocondyla zoserka from West Africa, and instead, winged males have evolved a bizarre secondary sexual trait: uniquely shaped antennae with spoon‐like tips that show heavily sculptured ventral surfaces with numerous invaginations. We here report on the courtship behavior of C. zoserka males and describe antennal glands with class 3 gland cells, which presumably secrete a close range sex pheromone. Antennal glands have not yet been found in males of other ant species, including a close relative of C. zoserka, suggesting that in ants with intranidal mating sexual selection can rapidly lead to highly divergent adaptations and the evolution of novel structures.
Revisiting the drivers of acoustic similarities in tropical anuran assemblages
Authors: Sugai Larissa Sayuri Moreira , Llusia Diego , Siqueira Tadeu , Silva Thiago S. F.
Published: May 2021

Acoustic signaling is key in mediating mate choice, which directly impacts individual fitness. Because background noise and habitat structure can impair signal transmission, the acoustic space of mixed‐species assemblages has long been hypothesized to reflect selective pressures against signal interference and degradation. However, other potential drivers that received far less attention can drive similar outputs on the acoustic space. Phylogenetic niche conservatism and allometric constraints may also modulate species acoustic features, and the acoustic space of communities could be a side‐effect of ecological assembly processes involving other traits (e.g., environmental filtering). Additionally, the acoustic space can also reflect the sorting of species relying on public information through extended communication networks. Using an integrative approach, we revisit the potential drivers of the acoustic space by addressing the distribution of acoustic traits, body size, and phylogenetic relatedness in tropical anuran assemblages across gradients of environmental heterogeneity in the Pantanal wetlands. We found the overall acoustic space to be aggregated compared with null expectations, even when accounting for confounding effects of body size. Across assemblages, acoustic and phylogenetic differences were positively related, while acoustic and body size similarities were negatively related, although to a minor extent. We suggest that acoustic partitioning, acoustic adaptation, and allometric constraints play a minor role in shaping the acoustic output of tropical anuran assemblages and that phylogenetic niche conservatism and public information use would influence between‐assemblage variation. Our findings highlight an overlooked multivariate nature of the acoustic dimension and underscore the importance of including the ecological context of communities to understand drivers of the acoustic space.
Long‐term clinical and haemodynamic results after transcatheter annuloplasty for secondary mitral regurgitation
Authors: Lavall Daniel , Bruns Julius , Stegmann Tina , Hagendorff Andreas , Stöbe Stephan , Laufs Ulrich
Published: May 2021

Aims

The study sought to investigate the long‐term outcome after transcatheter mitral valve annuloplasty for secondary mitral regurgitation (MR).

Methods and results

Consecutive patients with symptomatic secondary MR undergoing transcatheter mitral valve annuloplasty with the Carillon device at Leipzig University Hospital between 2012 and 2018 were studied prospectively. Left ventricular (LV) function and MR severity were quantified by standardized echocardiography. 33 patients were included. Mean age was 75 ± 10 years, and 20 patients were women. A Society of Thoracic Surgeons score of 8.1 ± 7.2% indicated high‐risk status. In 24 patients, MR resulted from LV remodelling and dysfunction, eight suffered from left atrial dilatation, and one patient had MR due to combined primary and secondary aetiology. LV ejection fraction at baseline was (median) 38% [inter‐quartile range (IQR) 30–49%]. During the mean follow‐up time of 45 ± 20 months, 17 patients died, two patients withdraw consent, and four patients were lost. Of the remaining patients, four were hospitalized for decompensated heart failure. Two of these patients underwent additional transcatheter edge‐to‐edge mitral valve repair. At follow‐up, New York Heart Association (NYHA) functional class improved from 95% in Class III/IV at baseline to 70% in Class I/II with no patients in NYHA Class IV (P < 0.0001). Mitral regurgitant volume was reduced from 27 mL (IQR 25–42 mL) to 8 mL (IQR 3–17 mL) (P = 0.018) and regurgitant fraction from 42% (IQR 34–54%) to 11% (IQR 8–24%) (P = 0.014). LV end‐diastolic volume index [92 mL/m2 (IQR 74–107 mL/m2) vs. 67 mL/m2 (IQR 46–101 mL/m2), P = 0.065] and end‐systolic volume index [50 mL/m2 (IQR 44–69 mL/m2) vs. 32 mL/m2 (IQR 20–53 mL/m2), P = 0.037] decreased. Total stroke volume remained unchanged [38 mL/m2 (IQR 33–43 mL/m2) vs. 33 mL/m2 (IQR 26–44 mL/m2), P = 0.695], while LV ejection fraction increased [43% (IQR 35–49%) vs. 54% (IQR 46–57%), P = 0.014]. Forward stroke volume, heart rate, and forward cardiac output were not significantly altered.

Conclusions

Among high‐risk patients undergoing transcatheter mitral valve annuloplasty for symptomatic secondary MR, mortality was ~50% at 4 years. In the surviving patients, reduced MR severity was associated with reduced NYHA functional class, reverse LV remodelling, and improved LV function.
Sipuleucel‐T associated inflammatory cardiomyopathy: a case report and observations from a large pharmacovigilance database
Authors: Moey Melissa Y.Y. , Jiwani Rahim A. , Takeda Kotaro , Prenshaw Karyn , Kreeger R. Wayne , Inzerillo John , Liles Darla K. , Marcu C. Bogdan , Lebrun‐Vignes Bénédicte , Morris D. Lynn , Ardhanari Sivakumar , Salem Joe‐Elie
Published: May 2021

Aims

The major cardiovascular (CV) adverse effects observed with sipuleucel‐T from large multi‐institutional clinical trials included thromboembolic events, myocardial infarction, and congestive heart failure in up to 0.3% of patients with CV risk factors. The incidence, outcomes, and mechanisms in real‐world clinical settings of these CV adverse effects to date have not been fully elucidated. Our study identified a patient with sipuleucel‐T‐induced inflammatory cardiomyopathy, which led to the identification of CV adverse effects associated with sipuleucel‐T from a large pharmacovigilance database and elucidation of its potential mechanisms.

Methods and results

Using the MedDRA term ‘cardiac disorders’ (System Organ Class level), CV adverse events associated with sipuleucel‐T versus all other drugs were reviewed from VigiBase, a large pharmacovigilance database. Disproportionality analysis was calculated by the information component (IC), a Bayesian disproportionality indicator. A positive IC025 (IC 95% lower end credibility interval) value (>0) is the traditional threshold used in statistical signal detection at the Uppsala Monitoring Centre. From VigiBase, the total number of CV adverse drug reaction reported with sipuleucel‐T was 306 out of a total of 22 980 104 adverse drug reactions in VigiBase on 10/25/2020. MedDRA preferred terms levels were grouped into major CV adverse drug reaction categories where we observed significant reports of myocardial ischaemia, supraventricular tachycardia (particularly atrial fibrillation/atrial flutter), congestive heart failure, and valvular disorders. Myocardial ischemia included acute myocardial infarction (IC025 2.3) with n = 4/26 (15%) of these individual case safety reports considered fatal. Among patients with ‘cardiac failure congestive’ (IC025 1.5), 11 of these 43 cases (26%) were fatal with 42 (98%) of these cases considered to be solely due to sipuleucel‐T.

Conclusions

Patients with CV risk factors who are receiving sipuleucel‐T may be at higher risk for congestive heart failure, myocardial ischemia, and supraventricular tachycardia. Electrocardiograms during weekly sipuleucel‐T infusions and left ventricular function monitoring with echocardiogram should be considered in these patients. Our findings are suggestive of another rare presentation of T‐cell‐mediated CV toxicity with cancer immunotherapy.
Clamped member fatigue characteristics of bolted connections subject toout‐of‐planeloading
Authors: Zambino Lee W. , Ural Ani
Published: May 2021

In the presence of significant cyclic loading, the design of safe and efficient structural connections requires accurate determination of the clamped member stresses, amongst other considerations. Connections with pretensioned bolts and loading applied parallel to the bolt axis constitute a challenging analysis task that is underrepresented in the literature. To address this, parametric finite element analysis was performed on a representative bolted connection subject to out‐of‐plane loading and comprised of an aluminum member and a pretensioned steel bolt – a typical configuration in the aerospace industry. Of particular interest were the flexural stresses and their contribution to fatigue damage along the member faying surface. The analysis results demonstrated that both the location and magnitude of the stress extrema varied greatly with the geometric and loading parameters considered. To quantify regions most susceptible to fatigue damage, an equivalent stress formulation in conjunction with a critical plane approach was implemented. Contour plots were generated illustrating these regions and regression analysis was performed relating the parametric geometry and load quantities to the maximum equivalent and principal stresses. Regions of greatest fatigue susceptibility were shown to vary both radially and tangentially about the fastener. The data presented are intended to improve both the efficiency and safety of bolted connections.
Association between serum 25‐hydroxyvitamin D concentrations and obesity in one‐year‐old Chinese infants
Authors: Guo Bingbing , Zhang Yue , Lu Jianan , Guo Shuang , Jiang Yingtong , Pei Jingjing , Wang Ran , Zhang Chen , Teng Haoyue , Chen Qiuyu , Jiang Xinye , Yin Jieyun
Published: May 2021

Recent studies suggested that vitamin D is linked with obesity, but evidence in infants is scarce. Therefore, we aimed to make an exploration in infants. A total of 414 infants at one year old who visited Maternity and Child Health Care Hospital of Wuxi in China were recruited. Finger‐stick blood sampling was conducted in all the subjects, and serum 25‐hydroxyvitamin D [25(OH)D] concentrations were measured. Maternal characteristics during pregnancy and infantile information were collected by questionnaires or extracting from medical records. Multivariable linear models were performed to assess the relationship between 25(OH)D and body mass index (BMI), while multivariable logistic regression models were used to examine the association between 25(OH)D and obesity. Among the 414 infants, 69 (16.67%) and 81 (19.57%) infants were defined as obesity and vitamin D deficiency [25(OH)D < 50 nmol/L], respectively. The mean (SD) of 25(OH)D concentration was 68.05 (19.05) in infants without obesity, which was significantly higher than that of obese infants [60.36(18.49), p = .002]. Inverse linear relationships were observed between 25(OH)D level and BMI (β = −0.017, p = .004) as well as BMI Z‐score (β = −0.010, p = .004). Furthermore, vitamin D deficiency was associated with an increased risk of obesity of infants (adjusted odds ratio = 2.74, 95% confidence interval = 1.20–6.25, with 25(OH)D ≥ 75 nmol/L as a reference). The results showed that serum 25(OH)D concentrations were significantly lower in infants with obesity, suggesting vitamin D deficiency may be an independent risk factor for obesity among one‐year‐old Chinese infants.
Multianalytical investigation of wasters from the Tower 8/Porta di Nola refuse middens in Pompeii: Sr–Nd isotopic, chemical, petrographic, and mineralogical analyses
Authors: Guarino Vincenza , De Bonis Alberto , Peña J. Theodore , Verde Maria , Morra Vincenzo
Published: May 2021

A total of nine representative pottery fragments belonging to ferruginous, carbonate, and thin‐walled wares were recovered in refuse middens outside the fortification wall of Pompeii and subjected to a program of multianalytical operations (thermal ionization mass spectrometry, X‐ray fluorescence, X‐ray powder diffraction analysis, scanning electron microscopy–energy‐dispersive spectrometry techniques, optical microscopy). The fragments bear manufacturing defects, indicating their local production in workshops located somewhere at Pompeii. These three groups display a similar volcanic coarse component that exhibits distinct chemical compositions. The volcanic component consists of alkali feldspar, clinopyroxene, plagioclase, minor garnet, and rock fragments (with primarily plagioclase and leucite), pointing to an origin from the Somma‐Vesuvius. The fingerprint of the Sr–Nd isotopes of carbonate ware suggests an affinity with high‐CaO clays from Rufoli, a subdivision of Salerno. Sr–Nd isotopes also suggest that clays from the Sorrentine Peninsula were used: A clay mixture of different argillified pyroclastic materials was employed for the low‐CaO ferruginous ware, whereas the low‐CaO thin‐walled ware was manufactured with a marine varicolored clay. The distribution of materials likely occurred by sea via the port at Salernum and Surrentum. The combination of different types of complementary data obtained through this program of analysis illustrates the importance of combining both quantitative petrographic and chemical characterization in the evaluation of archaeological pottery.
Occult parotid involvement in early‐stage squamous cell carcinoma of the external auditory canal
Authors: Chang Jae Won , Lee Seulgi , Lee Jeon Mi , Moon In Seok , Cho Young‐Sang , Cho Yang‐Sun , Choi Jin Woong
Published: May 2021

Background

The importance of elective parotidectomy in early‐stage squamous cell carcinoma (SCC) of the external auditory canal (EAC) is not well established.

Methods

A retrospective study of 43 patients with early‐stage SCC of the EAC who underwent parotidectomy in conjunction with lateral temporal bone resection at three centers.

Results

Overall occult parotid involvement (OPI) rate in early‐stage SCC of the EAC was 13.9% (6/43). When considering both the anteroposterior position and the bony‐cartilaginous position, patients with SCC in both the anterior wall and cartilaginous portion exhibited significantly higher OPI than other locations (37.5% vs. 0%, p = 0.001), with an increase in the OPI predictive value.

Conclusion

SCC located in either the anterior wall of the EAC or the cartilaginous portion of the EAC or both simultaneously showed a high prevalence of OPI, and elective parotidectomy should be considered in those patients.
Key Elements on the Pathway to HCV Elimination: Lessons Learned From the AASLD HCV Special Interest Group 2020
Authors: Feld Jordan J. , Ward John W.
Published: May 2021

With a decade left to reach the ambitious goals for viral hepatitis elimination set out by the World Health Organization, many challenges remain. Despite the remarkable improvements in therapy for hepatitis C virus (HCV) infection, most people living with the infection remain undiagnosed, and only a fraction have received curative therapy. Accordingly, the 2020 HCV Special Interest Group symposium at the annual American Association for the Study of Liver Diseases Liver Meeting examined policies and strategies for the scale‐up of HCV testing and expanded access to HCV care and treatment outside the specialty setting, including primary care and drug treatment and settings for care of persons who inject drugs and other marginalized populations at risk for HCV infection. The importance of these paradigms in elimination efforts, including micro‐elimination strategies, was explored, and the session also included discussion of hepatitis C vaccine development and other strategies to reduce mortality through the use of organs from HCV‐infected organ donors for HCV‐negative recipients. In this review, the key concepts raised at this important symposium are summarized.
Nonmetastatic castration‐resistant prostate cancer treated with salvage focal brachytherapy after external beam radiotherapy
Authors: Yoshida Soichiro , Matsuoka Yoh , Toda Kazuma , Uehara Sho , Tanaka Hajime , Yokoyama Minato , Saito Kazutaka , Yoshimura Ryoichi , Fujii Yasuhisa
Published: May 2021

Introduction

The efficacy of salvage local therapy after external beam radiotherapy has recently gained attention. However, a challenge with these therapies is the risk of significant genitourinary and gastrointestinal toxicity. Focal brachytherapy may be a treatment option because of its potential to reduce side effects.

Case presentation

A patient with castration‐resistant prostate cancer was found to be free of metastases on whole‐body magnetic resonance imaging following external beam radiotherapy, and prostate biopsy revealed a localized recurrence in the ventral prostate. The patient underwent salvage focal brachytherapy and had a prostate‐specific antigen progression‐free survival of 23 months. No adverse effects were observed following salvage brachytherapy.

Conclusion

Our case suggests that salvage focal brachytherapy may be an effective local treatment option for nonmetastatic castration‐resistant prostate cancer that has relapsed after external beam radiotherapy, wherein the lesion is confined to a small area within the prostate.
Retrograde ureteroscopic lithotripsy in cross‐fused renal ectopia
Authors: Somiya Shinya , Takahashi Toshifumi , Ito Katsuhiro , Higashi Yoshihito , Yamada Hitoshi , Kanno Toru
Published: May 2021

Introduction

Cross‐fused renal ectopia is a rare congenital malformation, and few cases of urolithiasis have been treated by retrograde ureteroscopic lithotripsy. We report a case of urolithiasis in right‐to‐left and superior‐type cross‐fused renal ectopia, successfully treated by the retrograde approach.

Case presentation

A 69‐year‐old woman with two 14‐mm renal stones in cross‐fused renal ectopia underwent retrograde ureteroscopic lithotripsy. Although we did not recognize the anomaly preoperatively, we could diagnose urolithiasis in the ectopic kidney intraoperatively. The patient had no complication, and follow‐up computed tomography after 3 months showed only a 5‐mm renal stone.

Conclusion

Although urolithiasis in patients with cross‐fused renal ectopia is a challenging condition for the urologist, the retrograde approach is a safe and effective treatment method. It is necessary to carefully examine the urinary tract especially in a patient with a history of unidentified solitary kidney.
User involvement in digital systems design: Case studies of mobile money innovation in Kenya
Authors: Ongwae Juliet , Duncombe Richard
Published: May 2021

This research explores the design of mobile money value‐added services in Kenya that engage marginalized users during the design process. Building on past research that sets out principles for user centered design (UCD), and drawing upon evidence from three case studies, the research finds that system designers follow UCD principles, but decisions to involve users are largely born out of pragmatism, to increase the probability of acceptance of the system, whereas the users main concern were the associated costs, and there was (at least in the early stages) resistance to involvement. This resistance was borne out of a tension between the motivation of the system designers (which was largely non‐altruistic) and the motivation of the users who became involved in the projects through self‐interest or some coercion. The research concludes that system designers require greater appreciation of diversity in interests, asymmetric power and cross‐cultural differences when applying UCD methods. The research extends current knowledge with regard to design interventions in the development of mobile money applications in sub‐Saharan Africa and the recommendations formulated from this research provide practitioners with actionable knowledge to reflect on their current tools and techniques to ensure better localized design processes.
ACT‐enhanced group behavior therapy for trichotillomania and skin‐picking disorder: A feasibility study
Authors: Asplund Mia , Rück Christian , Lenhard Fabian , Gunnarsson Tove , Bellander Martin , Delby Hanna , Ivanov Volen Z.
Published: May 2021

Objective

To evaluate the feasibility and efficacy of ACT‐enhanced Group Behavior Therapy (AEGBT) for mixed diagnosis groups including patients with trichotillomania (TTM) and skin‐picking disorder (SPD) in routine psychiatric care.

Method

Adult patients (N = 40) with TTM and/or SPD received 10 weeks of AEGBT followed by five booster sessions. The primary outcome measure for TTM was the Massachusetts General Hospital Hairpulling Scale (MGH‐HPS) and for SPD the Skin Picking Scale‐Revised (SPS‐R), assessed at posttreatment and at booster sessions.

Results

Results showed significant reductions in hair pulling and skin‐picking severity from baseline to posttreatment and large effect sizes at posttreatment. Improvements remained significant at the 12‐month follow‐up for patients with SPD, but not for patients with TTM. Group attendance was high and few patients dropped out from treatment. The group format enabled therapists to see 25% more patients compared with an individual format.

Conclusion

The results provide initial support for the feasibility and efficacy of an adapted treatment approach for TTM and SPD.
Prognostic impact of muscle and fat mass in patients with heart failure
Authors: Konishi Masaaki , Akiyama Eiichi , Matsuzawa Yasushi , Sato Ryosuke , Kikuchi Shinnosuke , Nakahashi Hidefumi , Maejima Nobuhiko , Iwahashi Noriaki , Kosuge Masami , Ebina Toshiaki , Hibi Kiyoshi , Misumi Toshihiro , von Haehling Stephan , Anker Stefan D. , Tamura Kouichi , Kimura Kazuo
Published: May 2021

Background

Cachexia, characterized by loss of muscle with or without loss of fat mass, is a poor prognostic factor in patients with heart failure (HF). However, there is limited investigation on the prognostic impact of muscle and fat mass separately in HF. We hypothesized that muscle and fat mass have different effects on the prognosis of HF.

Methods

This was an observational cohort study of 418 patients (59% were men) admitted with a diagnosis of HF (71 ± 13 years [mean ± standard deviation]), with left ventricular ejection fraction (LVEF) of 39 ± 16%, including 31.3%, 14.8%, and 53.8% of patients with preserved LVEF (LVEF ≥ 50%), mid‐range LVEF (40–50%), and reduced (<40%) LVEF, respectively. Dual‐energy X‐ray absorptiometry was performed with the patients in the stable state after decongestion therapy.

Results

The mean body mass index of patients was 22.1 ± 4.6 kg/m2, and the mean appendicular skeletal mass (ASM) index was 6.88 ± 1.23 kg/m2 in men and 5.59 ± 0.92 in women; 54.1% of the patients showed reduced muscle mass defined by the international cut‐off value (7.0 kg/m2 for men and 5.4 for women). The mean fat mass was 20.4 ± 7.2% in men and 27.2 ± 8.6% in women. During a median follow‐up of 37 months, 92 (22.0%) of 418 patients with HF died (1 and 3 year mortality: 8.4% and 17.3%, respectively). Lower values of both skeletal muscle and fat mass were independently associated with increased risk of mortality adjusted for age, sex, haemoglobin, New York Heart Association functional class, and height squared (hazard ratio with 95% confidence interval of 0.825 [0.747–0.908] per 1 kg increase of ASM, P < 0.001, and 0.954 [0.916–0.993] per 1 kg increase of fat mass, P = 0.018, respectively).

Conclusions

More than half of the patients with HF showed reduced muscle mass. Lower values of both muscle and fat mass were associated with higher mortality in HF.
Bioderived and degradable polymers for transient electronics
Authors: Uva Azalea , Lin Angela , Babi Jon , Tran Helen
Published: May 2021

As single‐use electronics become more prevalent in our society, a shift towards devices with alternative disposal fates will be required to address rising levels of electronic and plastic waste. Adopting transient electronics is one solution for inadvertent litter of future single‐use electronics as they are designed to automatically break down in environmental conditions after their intended use. However, the selection of appropriate source materials to make these transient devices is vital to ensure environmental compatibility. This mini‐review aims to highlight recent advancements in bioderived polymers that can be used as substrates or encapsulants, the largest weight percentage in a device, in transient electronics. The chemical and biological degradation of these bioderived polymers is also discussed to present potential non‐toxic byproducts and factors affecting degradation rates. Lastly, the potential outlook of transient electronics in biomedical, environmental, and consumer applications are proposed to demonstrate the wide scope of opportunities to be explored. © 2021 Society of Chemical Industry (SCI).
Genetic counselor use of self‐involving responses in a clinical setting: A qualitative investigation
Authors: Kashmola‐Perez Iman , McCarthy Veach Patricia , Schema Lynn , Redlinger‐Grosse Krista
Published: May 2021

Self‐involving responses are direct expressions of genetic counselors’ here‐and‐now feelings about/reactions to patients. Strategic, sparing use of self‐involving responses may enhance practitioner genuineness, likeability, and trustworthiness, decrease patient anxiety, and increase patient trust and engagement. Conversely, they may threaten patients who are uncomfortable with emotional expression or confuse them about the counselor's intentions. Despite theorized benefits and risks, no study has explored genetic counselor self‐involving responses. This study explored whether clinical genetic counselors use self‐involving responses with their patients, reasons for doing so, and their perceptions of when and why the responses work well versus poorly. Two‐hundred sixty‐eight genetic counselors, invited via a National Society of Genetic Counselors e‐blast, completed an online screening survey. Eighty‐nine percent reported using self‐involving responses with patients, and 17 were purposively selected to participate in semi‐structured phone interviews. Thematic analysis yielded themes regarding potential benefits, risks, counselor factors and context, and patient factors related to using self‐involving responses. Benefits include conveying counselor conditions for facilitating counseling process (e.g., genuineness, building rapport, focusing the session, and encouraging the patient to open‐up), and counseling outcomes by validating decision‐making. Risks of use include hindering counseling processes and outcomes by misperceiving patient feelings, boundary crossing, and being unduly directive. Factors, both from the counselor and the context of the session, include comfort with the technique, mastery of clinical skills, minimal knowledge of patient emotions, type of counseling session, and counselor practice specialty. Patient factors include prior rapport with the counselor, and patient emotionality and cultural background. Findings underscore the need for training about this technique. Future research could examine patients’ perceptions of self‐involving statements and differences in self‐involvement across practice specialties and counseling modalities.
The impact of autopsy participation on clinical residency
Authors: Katayama Kohta , Nishizaki Yuji , Shinozaki Tomohiro , Saitoh Yuta , Yano Tetsuhiro , Aoki Takuya , Noguchi Masayuki , Tokuda Yasuharu
Published: May 2021

Background

Autopsy has had an essential role in ensuring the quality of education and medical care. However, its role in clinical residency has not been clarified. This study assessed actual autopsy circumstances during clinical residency and evaluated the association between autopsy and clinical knowledge.

Methods

We conducted a cross‐sectional study involving postgraduate second year residents in Japan who took the General Medicine In‐Training Examination in 2019. We modeled the General Medicine In‐Training Examination scores of the residents to examine their association with autopsy experiences and the number of autopsy experiences to assess its predictors.

Results

Of 2715 postgraduate second year residents, 353 (13.8%) had no autopsy participation, and 1015 (39.7%) had only one experience. Although autopsy participation was not related to the mean General Medicine In‐Training Examination score, the residents' clinicopathological conference participation, self‐study for more than 60 min per day, and wish to be pathologists were significantly associated with autopsy experiences. They experienced more autopsies when they belonged to small‐sized hospitals in rural areas performing many autopsies.

Conclusion

We reported the current status of autopsy in clinical residency and showed that more than half of the residents experienced no or only one autopsy. General Medicine In‐Training Examination scores were not correlated with the number of autopsy experiences.