bluuebunny/crossref_metadata_2025 huggingface dataset:
Leaf phosphorus fractionation in rice to understand internal phosphorus-use efficiency
Authors: Hayes Patrick E , Adem Getnet D , Pariasca-Tanaka Juan , Wissuwa Matthias
Published: November 2021

Background and Aims

Phosphorus (P) availability is often limiting for rice (Oryza sativa) production. Improving internal P-use efficiency (PUE) is crucial to sustainable food production, particularly in low-input systems. A critical aspect of PUE in plants, and one that remains poorly understood, is the investment of leaf P in different chemical P fractions (nucleic acid-P, lipid-P, inorganic-P, metabolite-P and residual-P). The overarching objective of this study was to understand how these key P fractions influence PUE.

Methods

Three high-PUE and two low-PUE rice genotypes were grown in hydroponics with contrasting P supplies. We measured PUE, total P, P fractions, photosynthesis and biomass.

Key Results

Low investment in lipid-P was strongly associated with increased photosynthetic PUE (PPUE), achieved by reducing total leaf P concentration while maintaining rapid photosynthetic rates. All low-P plants exhibited a low investment in inorganic-P and lipid-P, but not nucleic acid-P. In addition, whole-plant PUE was strongly associated with reduced total P concentration, increased biomass and increased preferential allocation of resources to the youngest mature leaves.

Conclusions

Lipid remodelling has been shown in rice before, but we show for the first time that reduced lipid-P investment improves PUE in rice without reducing photosynthesis. This presents a novel pathway for increasing PUE by targeting varieties with reduced lipid-P investment. This will benefit rice production in low-P soils and in areas where fertilizer use is limited, improving global food security by reducing P fertilizer demands and food production costs.
Stomatal closure during water deficit is controlled by below-ground hydraulics
Authors: Abdalla Mohanned , Ahmed Mutez Ali , Cai Gaochao , Wankmüller Fabian , Schwartz Nimrod , Litig Or , Javaux Mathieu , Carminati Andrea
Published: November 2021

Background and Aims

Stomatal closure allows plants to promptly respond to water shortage. Although the coordination between stomatal regulation, leaf and xylem hydraulics has been extensively investigated, the impact of below-ground hydraulics on stomatal regulation remains unknown.

Methods

We used a novel root pressure chamber to measure, during soil drying, the relation between transpiration rate (E) and leaf xylem water pressure (ψleaf-x) in tomato shoots grafted onto two contrasting rootstocks, a long and a short one. In parallel, we also measured the E(ψleaf-x) relation without pressurization. A soil–plant hydraulic model was used to reproduce the measurements. We hypothesize that (1) stomata close when the E(ψleaf-x) relation becomes non-linear and (2) non-linearity occurs at higher soil water contents and lower transpiration rates in short-rooted plants.

Key Results

The E(ψleaf-x) relation was linear in wet conditions and became non-linear as the soil dried. Changing below-ground traits (i.e. root system) significantly affected the E(ψleaf-x) relation during soil drying. Plants with shorter root systems required larger gradients in soil water pressure to sustain the same transpiration rate and exhibited an earlier non-linearity and stomatal closure.

Conclusions

We conclude that, during soil drying, stomatal regulation is controlled by below-ground hydraulics in a predictable way. The model suggests that the loss of hydraulic conductivity occurred in soil. These results prove that stomatal regulation is intimately tied to root and soil hydraulic conductances.
Müllerian mimicry and the coloration patterns of sympatric coral snakes
Authors: Bosque Renan Janke , Hyseni Chaz , Santos Maria Luiza Gonçalves , Rangel Eduardo , Da Silva Dias Camila Juliana , Hearin Jacob Beathea , Da Silva Nelson Jorge , Domingos Fabrícius Maia Chaves Bicalho , Colli Guarino Rinaldi , Noonan Brice Patrick
Published: November 2021

Coral snakes in the genus Micrurus are venomous, aposematic organisms that signal danger to predators through vivid coloration. Previous studies found that they serve as models to several harmless species of Batesian mimics. However, the extent to which Micrurus species engage in Müllerian mimicry remains poorly understood. We integrate detailed morphological and geographical distribution data to investigate if coral snakes are Müllerian mimics. We found that coloration is spatially structured and that Micrurus species tend to be more similar where they co-occur. Though long supposed, we demonstrate for the first time that coral snakes might indeed be Müllerian mimics as they show some convergence in coloration patterns. Additionally, we found that the length of red-coloured rings in Micrurus is conserved, even at large geographic scales. This finding suggests that bright red rings may be under more substantial stabilizing selection than other aspects of coloration and probably function as a generalized signal for deterring predators.
Extending Procedural Justice Theory to the Chinese Context: The Role of Collective Efficacy
Authors: Wu Guangzhen , Liu Jianhong
Published: November 2021

Recognizing that prior research has paid limited attention to the relevance of neighbourhood context to the procedural justice model of regulation, this study, based on data collected from a recent survey of 2,245 residents in a southeast city in China, examined the relationship between procedural fairness, collective efficacy and citizens’ willingness to cooperate with the police, with a special focus on the role of collective efficacy in the function of the procedural justice theoretical framework. The results of this study revealed that the association between perceived collective efficacy and willingness to cooperate with the police was stronger than that between procedural fairness and the outcome variable. Additionally, this study demonstrated a moderating role of perceived collective efficacy on the relationship between procedural fairness and cooperation (the link between procedural fairness and cooperation was stronger for those with a low level of perceived collective efficacy), further highlighting the relevance of citizens’ perceptions of neighbourhood context to their attitudinal behaviours towards the police. These findings have important implications for the direction of efforts to foster citizens’ support and cooperation.
Whole-genome sequencing: identification of additional pathogenic variation across the genome
Authors: Mills James Dominic , Sisodiya Sanjay M
Published: November 2021

This scientific commentary refers to ‘Genome sequencing identifies rare tandem repeat expansions and copy number variants in Lennox–Gastaut syndrome’, by Qaiser et al. (https://doi.org/10.1093/braincomms/fcab207).
Inflammatory Bowel Diseases Benefit from Enhanced Recovery After Surgery [ERAS] Protocol: A Systematic Review with Practical Implications
Authors: Vigorita Vincenzo , Cano-Valderrama Oscar , Celentano Valerio , Vinci Danilo , Millán Monica , Spinelli Antonino , Pellino Gianluca
Published: November 2021

Background

Enhanced Recovery After Surgery [ERAS] is widely adopted in patients undergoing colorectal surgery, with demonstrated benefits. Few studies have assessed the feasibility, safety, and effectiveness of ERAS in patients with inflammatory bowel diseases [IBD]. The aim of this study was to investigate the current adoption and outcomes of ERAS in IBD.

Methods

This PRISMA-compliant systematic review of the literature included all articles reporting on adult patients with IBD who underwent colorectal surgery within an ERAS pathway. PubMed/MEDLINE, Cochrane Library, and Web of Science were searched. Endpoints included ERAS adoption, perioperative outcomes, and ERAS items more consistently reported, with associated evidence levels [EL] [PROSPERO CRD42021238653].

Results

Out of 217 studies, 16 totalling 2347 patients were included. The median number of patients treated was 50.5. Malnutrition and anaemia optimisation were only included as ERAS items in six and four articles, respectively. Most of the studies included the following items: drinking clear fluids until 2 h before the surgery, fluid restriction, nausea prophylaxis, early feeding, and early mobilisation. Only two studies included postoperative stoma-team and IBD-team evaluation before discharge. Highest EL were observed for ileocaecal Crohn’s disease resection [EL2]. Median in-hospital stay was 5.2 [2.9–10.7] days. Surgical site infections and anastomotic leaks ranged between 3.1–23.5% and 0–3.4%, respectively. Complications occurred in 5.7-48%, and mortality did not exceed 1%.

Conclusions

Evidence on ERAS in IBD is lacking, but this group of patients might benefit from consistent adoption of the pathway. Future studies should define if IBD-specific ERAS pathways and selection criteria are needed.
Wind Speed and Direction Drive Assisted Dispersal of Asian Citrus Psyllid
Authors: Antolínez Carlos A , Martini Xavier , Stelinski Lukasz L , Rivera Monique J
Published: November 2021

Wind directly influences the spread of vector-borne plant pathogens by driving the passive dispersal of vectors to potentially new areas. Here, we evaluated the effect of wind speed and direction on the dispersal of the Asian citrus psyllid (ACP), Diaphorina citri (Kuwayama) (Hemiptera: Psyllidae), the vector of the bacteria causing huanglongbing (HLB), a lethal disease of citrus. The effect of different wind speeds on short or long-distance dispersal of ACP was investigated using a high-speed wind tunnel under laboratory conditions. The effect of wind direction on ACP dispersal under field conditions was evaluated using custom-made wind vane-style traps. In wind tunnel assays, ACP remained on plants until wind treatments reached ≥48 km/h when psyllids were mostly dislodged from plants and moved by the wind. For a short-distance, wind-driven movement (movement by the wind from one plant to another), the effect of wind speed was not significant at any of the wind speed treatments tested. Wind vane traps placed in a Florida citrus grove captured significantly more ACP on the windward side, suggesting that ACP were moved with the wind. The number of ACP found on the windward side of traps was significantly higher from May to August. These results indicate that ACP is likely to disperse with prevailing wind direction and that settled ACP may become dislodged and moved at random by high wind speeds occurring in areas of significant citrus production (southern California, Florida, or Texas).
Cardiovascular risk in high-hazard occupations: the role of occupational cardiology
Authors: Parsons Iain T , Nicol Edward D , Holdsworth David , Guettler Norbert , Rienks Rienk , Davos Constantinos H , Halle Martin , Parati Gianfranco
Published: November 2021

Work is beneficial for health, but many individuals develop cardiovascular disease (CVD) during their working lives. Occupational cardiology is an emerging field that combines traditional cardiology sub-specialisms with prevention and risk management unique to specific employment characteristics and conditions. In some occupational settings incapacitation through CVD has the potential to be catastrophic due to the nature of work and/or the working environment. These are often termed ‘hazardous’ or ‘high-hazard’ occupations. Consequently, many organizations that employ individuals in high-hazard roles undertake pre-employment medicals and periodic medical examinations to screen for CVD. The identification of CVD that exceeds predefined employer (or regulatory body) risk thresholds can result in occupational restriction, or disqualification, which may be temporary or permanent. This article will review the evidence related to occupational cardiology for several high-hazard occupations related to aviation and space, diving, high altitude, emergency workers, commercial transportation, and the military. The article will focus on environmental risk, screening, surveillance, and risk management for the prevention of events precipitated by CVD. Occupational cardiology is a challenging field that requires a broad understanding of general cardiology, environmental, and occupational medicine principles. There is a current lack of consensus and contemporary evidence which requires further research. Provision of evidence-based, but individualized, risk stratification and treatment plans is required from specialists that understand the complex interaction between work and the cardiovascular system. There is a current lack of consensus and contemporary evidence in occupational cardiology and further research is required.
A Review of Bee Captures in Pest Monitoring Traps and Future Directions for Research and Collaboration
Authors: Spears Lori R , Christman Morgan E , Koch Jonathan B U , Looney Chris , Ramirez Ricardo A
Published: November 2021

Bees provide an important ecosystem service by contributing to the pollination of crop and wild plant species. Multiple bee species, however, are in decline due to factors such as habitat loss and fragmentation, inadequate food availability, improper management practices, climate change, and pressures from pathogens and pests, including exotic species. Concerns about pollinator declines and implications for ecosystem services have led to efforts to create and restore pollinator habitat, refine pest management practices, improve detection of pests and exotic species that threaten native bees, and monitor populations to identify and protect vulnerable bee species and communities. A variety of methods are used to monitor bee populations, some of which use visual stimuli that mimic natural cues used to locate floral resources. Bees also find their way into traps that use both visual and olfactory cues to attract pest insects. On one hand, researchers work to improve pest monitoring tools to increase target captures and reduce bee bycatch. On the other, analysis of bee bycatch can help assess biodiversity, determine population fluctuations and range expansions or contractions, support monitoring efforts, and identify patterns and processes of broader ecological interest. These different fields of research should not be seen as conflicting goals, but rather an opportunity for greater complementarity and collaboration. This article reviews the biological and ecological bases for bee attraction to traps, summarizes recent trends in bycatch research, highlights future research priorities, and identifies opportunities for collaborative data sharing to maximize existing resources.
Comparing two probabilities: an essay in honour of Herman Chernoff
Authors: Kadane Joseph B
Published: November 2021

This is a story of a lawsuit in Japan, about an alleged incident in America thirty years before. The focus of the analysis is comparing the rates of skips in ballpoint pen writing in a diary. Chernoff proposed several methods to address the comparison between the skips observed in different passages in the diary. I also give my own alternative analysis of the data.
A Molecular switch for FLOWERING LOCUS C activation determines flowering time in Arabidopsis
Authors: Shen Lisha , Zhang Yu , Sawettalake Nunchanoke
Published: November 2021

Plants have evolved sophisticated mechanisms to ensure flowering in favorable conditions for reproductive success. In the model plant Arabidopsis thaliana, FLOWERING LOCUS C (FLC) acts as a central repressor of flowering and the major determinant for winter cold requirement for flowering. FLC is activated in winter annuals by the FRIGIDA (FRI) activator complex containing FRI, FLC EXPRESSOR (FLX), and FLX-LIKE 4 (FLX4), among which FLX and FLX4 are also essential for establishing basal FLC expression in summer annuals. Here we show that a plant RNA polymerase II C-terminal domain phosphatase, C-TERMINAL DOMAIN PHOSPHATASE-LIKE 3 (CPL3), interacts with and dephosphorylates FLX4 through their scaffold protein FLX to inhibit flowering. CPL3-mediated dephosphorylation of FLX4 serves as a key molecular switch that enables binding of dephosphorylated FLX4 to the FLC locus to promote FLC expression, thus repressing flowering in both winter and summer annuals of Arabidopsis. Our findings reveal a molecular switch underlying the activation of FLC for flowering time control.
Laws of Nature: Necessary and Contingent
Authors: Kimpton-Nye Samuel
Published: November 2021

This paper shows how a niche account of the metaphysics of laws of nature and physical properties—the Powers-BSA—can underpin both a sense in which the laws are metaphysically necessary and a sense in which it is true that the laws could have been different. The ability to reconcile entrenched disagreement should count in favour of a philosophical theory, so this paper constitutes a novel argument for the Powers-BSA by showing how it can reconcile disagreement about the laws’ modal status. This paper also constitutes a defence of modal necessitarianism, the interesting and controversial view according to which all worlds are nomologically identical, because it shows how the modal necessitarian can appease the orthodox contingentist about laws.
Animal models of vasculitis
Authors: Shochet Lani , Kitching A. Richard
Published: November 2021

Purpose of review

Vasculitis describes a wide spectrum of rare, inflammatory, multisystem disorders. These heterogenous diseases all have inflammation of blood vessels as a central feature. However, they differ in terms of their genetic and environmental risk factors, disease pathogenesis, clinical presentations and treatment strategies. Many animal models of vasculitis exist, each resembling a different human clinical phenotype. This review provides an overview of recently published findings from experimental animal models of vasculitis.

Recent findings

Several new animal models have been described during the review period. New insights gleaned from existing animal models regarding cause, disease effector mechanisms and novel treatments identified in established animal models are discussed.

Animal models continue to be an important tool for understanding disease pathogenesis, especially in rare and complex diseases such as vasculitis. They also provide an invaluable platform for development and preclinical testing of new treatments.
Rationale and Study Design for Evaluating the Efficacy and Safety of Intracardiac Echocardiography-Guided Minimal-Fluoroscopy Ablation in Patients with Paroxysmal Atrial Fibrillation: A Non-Inferior, Multi-Center, Prospective Randomized Controlled Trial (PAF-ICE Trial)
Authors: Jiang Ruhong , Liu Xingpeng , Zhang Jidong , Chen Yu , Wang Rui , Wu Mengzuo , Long Deyong , Li Jia , Wang Haixiong , Fan Jie , Ju Weizhu , Ge Weili , Liu Xu , Deng Hai , Wang Weijian , Yang Pingzhen , Li Ding , Huang Xiaobo , Liu Xiongtao , Tao Hailong , Zei Paul C. , Tung Roderick , Wang Xunzhang , Jiang Chenyang
Published: November 2021

The feasibility and safety of intracardiac echocardiography (ICE)-guided catheter ablation for atrial fibrillation (AF) using a minimal/zero-fluoroscopy approach have recently been reported. This approach helps to reduce ionizing radiation exposure and orthopedic complications resulting from using lead aprons. The objectives of this planned prospective, multicenter randomized controlled trial (RCT) (paroxysmal AF (PAF)-ICE trial; ChiCTR2000033624) are to evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF and the impact on occupational hazards among lab staff.

Patients will be randomized in a 1:1 ratio to 2 groups: minimal fluoroscopy group (n = 216) and traditional approach group (n = 216). In the minimal fluoroscopy group, an ICE catheter will be used for geometry/anatomic construction, transseptal puncture, catheter tracking, and effusion monitoring. Pulmonary vein isolation (PVI) will be performed using an open-irrigated radiofrequency SmartTouch Surround Flow or SmartTouch catheter (Biosense Webster, Diamond Bar, California, USA), and confirmed by a multipolar Lasso or PentaRay catheter (Biosense Webster). In the traditional approach group, an ICE catheter will not be used. Transseptal puncture will be performed under fluoroscopic guidance, with all geometries constructed by mapping the catheters. The primary efficacy endpoint is freedom from AF recurrence (without antiarrhythmic medications) at 12 months after ablation. Other endpoints include duration of lead apron use, measures of intra-procedural efficiency, and peri-procedural complications. This RCT will evaluate the efficacy and safety of ICE-guided minimal-fluoroscopy ablation in patients with PAF, also evaluate the benefits to lab staff (regarding reducing occupational hazards) related to this “minimal/zero-fluoroscopy” and “leadless” mode.
Liver Fibrosis Scoring Systems as Novel Tools for Predicting Recurrent Cardiovascular Events in Patients with a Prior Cardiovascular Event
Authors: Liu Huihui , Cao Yexuan , Jin Jinglu , Guo Yuanlin , Zhu Chenggang , Wu Naqiong , Hua Qi , Li Yanfang , Hong Lifeng , Dong Qian , Li Jianjun
Published: November 2021

Objective:

Regarding the secondary prevention of cardiovascular disease (CVD), there is great interest in preventing recurrent cardiovascular events (RCVEs). The prognostic importance of liver fibrosis scores (LFSs) has previously been reported in various CVDs. We hypothesized that LFSs might also be useful predictors for RCVEs in patients with prior cardiovascular events (CVEs). Herein, we aimed to evaluate the associations of LFSs with RCVEs in a large, real-world cohort of coronary artery disease (CAD) patients with a prior CVE.

Methods:

In this multicenter prospective study, 6527 consecutive patients with angiography-diagnosed CAD who had experienced a prior CVE (acute coronary syndrome, stroke, percutaneous coronary intervention, or coronary artery bypass grafting) were enrolled. LFSs were computed according to the published formulas: non-alcoholic fatty liver disease fibrosis score (NFS) includes age, body mass index (BMI), impaired fasting glycemia or diabetes mellitus (DM), aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio, platelets, and albumin; fibrosis-4 (FIB-4) includes age, AST, ALT, and platelets; Forns score includes age, gamma-glutamyltransferase (GGT), and platelets; BARD includes BMI, AST/ALT ratio, and DM; GGT/platelet ratio includes GGT and platelets; AST/ALT ratio includes AST and ALT; and AST/platelet ratio index includes AST and platelets. The originally reported cutoffs were used for the categorization of low-, intermediate-, and high-score subgroups. All patients were followed up for the occurrence of RCVEs (comprising cardiovascular death, non-fatal myocardial infarction, and stroke). Cox and Poisson regression analyses were used to assess the relationship of baseline LFSs with the risk of RCVE.

Results:

During a mean follow-up of (54.67 ± 18.80) months, 532 (8.2%) RCVEs were recorded. Intermediate and high NFS, FIB-4, Forns, and BARD scores were independently associated with an increased risk of RCVE (hazard ratios ranging from 1.42 to 1.75 for intermediate scores and 1.35 to 2.52 for high scores). In the subgroup analyses of sex, age, BMI, DM, and hypertension status, the increased risk of RCVEs with high LFSs (NFS, FIB-4, Forns, and BARD) was maintained across the different subgroups (all P < 0.05).

Conclusion:

This study showed that LFSs are indeed independently associated with RCVEs, suggesting that LFSs may be used as novel tools for risk stratification in CAD patients with a prior CVE.
Vascular Smooth Muscle Cell Development and Cardiovascular Malformations
Authors: Qi Lihua , Kong Wei , Fu Yi
Published: November 2021

Vascular smooth muscle cells (VSMCs) have diverse biological functions that include maintaining the vascular structure and recruiting progenitors to form the embryonic vascular system. Accumulating evidence suggests that the VSMCs are not just derived from the mesoderm, as previously thought, but have diverse developmental origins. Lineage tracing analysis indicates that VSMCs have at least 7 different origins, thereby giving it the characteristic of a mosaic tissue. The crucial role of the diverse origins of the VSMCs has been recognized in relation to blood vessel function and diseases such as arteriosclerosis. The VSMC distribution in cardiovascular development and whether and how their heterogeneous origins contribute to the overall cardiovascular development continue to be topics of research. Here, we review the current state of research, mainly focusing on the role of VSMCs in cardiovascular development. We emphasize the following biological pathways: (1) normal course of development of VSMCs and their diverse origins in relation to cardiovascular development, (2) signaling regulation of progenitor cell development and differentiation into VSMCs, and (3) abnormal development of vascular smooth muscle and the associated cardiovascular malformations.
Efficacy and safety of salmeterol/fluticasone compared with montelukast alone (or add-on therapy to fluticasone) in the treatment of bronchial asthma in children and adolescents: a systematic review and meta-analysis
Authors: Zhou Xiao-Jian , Qin Zhen , Lu Jiao , Hong Jian-Guo
Published: November 2021

Background:

Despite the recommendation of inhaled corticosteroids (ICSs) plus long-acting beta 2-agonist (LABA) and leukotriene receptor antagonist (LTRA) or ICS/LTRA as stepwise approaches in asthmatic children, there is a lack of published systematic review comparing the efficacy and safety of the two therapies in children and adolescents aged 4 to 18 years. This study aimed to compare the safety and efficacy of salmeterol/fluticasone (SFC) vs. montelukast (MON), or combination of montelukast and fluticasone (MFC) in children and adolescents aged 4 to 18 years with bronchial asthma.

Methods:

A systematic search was conducted in MEDLINE, EMBASE, the Cochrane Library, China BioMedical Literature Database, Chinese National Knowledge Infrastructure, VIP Database for Chinese Technical Periodical, and Wanfang for randomized controlled trials (RCTs) published from inception to May 24, 2021. Interventions are as follows: SFC vs. MON, or combination of MFC, with no limitation of dosage or duration. Primary and secondary outcome measures were as follows: the primary outcome of interest was the risk of asthma exacerbation. Secondary outcomes included risk of hospitalization, pulmonary function, asthma control level, quality of life, and adverse events (AEs). A random-effects (I
2 ≥ 50%) or fixed-effects model (I
2 < 50%) was used to calculate pooled effect estimates, comparing the outcomes between the intervention and control groups where feasible.

Results:

Of the 1006 articles identified, 21 studies met the inclusion criteria with 2643 individuals; two were at low risk of bias. As no primary outcomes were similar after an identical treatment duration in the included studies, meta-analysis could not be performed. However, more studies favored SFC, instead of MON, owing to a lower risk of asthma exacerbation in the SFC group. As for secondary outcome, SFC showed a significant improvement of peak expiratory flow (PEF)%pred after 4 weeks compared with MFC (mean difference [MD]: 5.45; 95% confidence interval [CI]: 1.57–9.34; I
2 = 95%; P = 0.006). As for asthma control level, SFC also showed a higher full-controlled level (risk ratio [RR]: 1.51; 95% CI: 1.24–1.85; I
2 = 0; P < 0.001) and higher childhood asthma control test score after 4 weeks of treatment (MD: 2.30; 95% CI: 1.39–3.21; I
2 = 72%; P < 0.001) compared with MFC.

Conclusions:

SFC may be more effective than MFC for the treatment of asthma in children and adolescents, especially in improving asthma control level. However, there is insufficient evidence to make firm conclusive statements on the use of SFC or MON in children and adolescents aged 4 to 18 years with asthma. Further research is needed, particularly a combination of good-quality long-term prospective studies and well-designed RCTs.

PROSPERO registration number:

CRD42019133156.
Perceived Barriers and Facilitators in Accessing Cervical Cancer Screening
Authors: Kayser Karen , Washington Ariel , Anderson Georgia , Harris Lesley M. , Lee Hee Yun , LaJoie A. Scott
Published: November 2021

Although advancements in cervical cancer prevention have helped reduce the incidence, mortality, and prevalence, access to these preventive services has not been experienced equally by all women in the United States. The purpose of this study was to learn about the factors that affect access to preventive services in a low-income, primarily Black community. Using a community-based participatory research approach, women were recruited to participate in 7 focus groups, with 6 to 8 women per group (N = 45). Participants were mainly Black (64%), with a mean age of 46 years, and 60% reporting completing at least some college. The discussions were transcribed, and text data were organized using Dedoose software. Guided by qualitative content analysis, the data were analyzed through an iterative process of coding and condensing the codes into themes. Ten types of barriers and 11 facilitators relating to cervical cancer screening access were identified and grouped into 7 themes. Participants provided suggestions for promoting cervical cancer screening in their community. On the basis of the findings of the data, the researchers conceptualized and mapped culturally and geographically appropriate interventions to promote cervical cancer screening within the community of interest.
The evolving role of the Women's Health Specialist in cancer prevention and survivorship
Authors: Castiel Mercedes , Morgan Jessica C. , Naaman Sandra
Published: November 2021

Importance and Objective:

This review provides a framework for primary care physicians, internists, family doctors, NP's, PA's, and oncologists caring for women—henceforth referred to as Women's Health Specialists—to identify and screen patients who may be at high risk for inherited cancer syndromes; an intervention referred to as previvorship care. For women who undergo risk-reducing oophorectomy, survivorship care is critical to optimizing quality of life thereafter. In this paper, we review management of the unique survivorship needs and management options for women at risk for or with a cancer diagnosis, highlighting the importance of interdisciplinary care.

Methods:

To review the available previvorship and survivorship management strategies, a Pub Med search was performed using keywords “survivorship,” “genetics,” “cancer,” “menopause,” “hormone therapy,” “screening” in addition to review of guidelines, position statements and expert, and committee opinions from the American College of OBGYN, the American Society of Clinical Oncology, The North American Menopause Society, the National Comprehensive Cancer Network , and the American Society for Reproductive Medicine.

Discussion and Conclusion:

Women's Health Specialists are in a unique position to identify and screen women who may be at risk for inherited cancer syndromes as well as provide necessary survivorship management following transition from their oncologists’ care.
Pediatric Antifungal Prescribing Patterns Identify Significant Opportunities to Rationalize Antifungal Use in Children
Authors: Ferreras-Antolín Laura , Irwin Adam , Atra Ayad , Chapelle Faye , Drysdale Simon B. , Emonts Marieke , McMaster Paddy , Paulus Stephane , Patel Sanjay , Rompola Menie , Vergnano Stefania , Whittaker Elizabeth , Warris Adilia
Published: November 2021

Objective:

The need for pediatric antifungal stewardship programs has been driven by an increasing consumption of antifungals for prophylactic and empirical use. Drivers and rational of antifungal prescribing need to be identified to optimize prescription behaviors.

Methods:

A prospective modified weekly Point Prevalence Survey capturing antifungal prescriptions for children (> 90 days to < 18 years of age) in 12 centers in England during 26 consecutive weeks was performed. Demographic, diagnostic and treatment information was collected for each patient. Data were entered into an online REDCap database.

Results:

One thousand two hundred fifty-eight prescriptions were included for 656 pediatric patients, 44.9% were girls, with a median age of 6.4 years (interquartile range, 2.5–11.3). Most common underlying condition was malignancy (55.5%). Four hundred nineteen (63.9%) received antifungals for prophylaxis, and 237 (36.1%) for treatment. Among patients receiving antifungal prophylaxis, 40.2% did not belong to a high-risk group. In those receiving antifungal treatment, 45.9%, 29.4%, 5.1% and 19.6% had a diagnosis of suspected, possible, probable of proven invasive fungal disease (IFD), respectively. Proven IFD was diagnosed in 78 patients, 84.6% (n = 66) suffered from invasive candidiasis and 15.4% (n = 12) from an invasive mold infection. Liposomal amphotericin B was the most commonly prescribed antifungal for both prophylaxis (36.6%) and empiric and preemptive treatment (47.9%). Throughout the duration of the study, 72 (11.0%) patients received combination antifungal therapy.

Conclusions:

Antifungal use in pediatric patients is dominated by liposomal amphotericin B and often without evidence for the presence of IFD. A significant proportion of prophylactic and empiric antifungal use was seen in pediatric patients not at high-risk for IFD.
What messages predict intention to self-manage low back pain? A study of attitudes towards patient education
Authors: O'Hagan Edel T. , Di Pietro Flavia , Traeger Adrian C. , Cashin Aidan G. , Hodges Paul W. , Wand Benedict M. , O'Neill Sean , Schabrun Siobhan M. , Harris Ian A. , McAuley James H.
Published: November 2021

This observational study evaluated people's attitudes towards educational statements and tested whether this predicted intention to self-manage low back pain (LBP). People with or without LBP who were older than 18 years and fluent in written English were recruited. Participants completed an online survey asking demographic questions and questions on the presence or absence of LBP, its duration, and intensity. We assessed attitude toward educational statements and conducted linear regression analyses to investigate the relationship between attitude toward each statement and intention to self-manage. We recruited 656 participants, n = 345 (53.6%), with LBP of varying duration. On average, participants had a positive attitude toward all statements except one; participants with chronic LBP had a negative attitude toward a statement relating to the cause of LBP. The effect of attitude on intention to self-manage was dependent on whether someone had LBP and for how long. For example, increased intention to self-manage was predicted by a positive attitude toward educational statements related to staying active (β = 0.22 [CI 0.11-0.33]) in participants without pain, statements about reassurance (β = 0.33 [CI 0.16-0.49]) for participants with acute or subacute LBP, and statements about the severity of back pain (β = 0.25 [CI 0.18-0.33]) for participants with chronic LBP. We noted differences in attitude toward educational messages and individuals' intention to self-manage LBP depending on pain duration. Self-management could be encouraged with specific reassurance in people with acute or subacute LBP and education about severity in people with chronic LBP.
miR-544-3p mediates arthritis pain through regulation of FcγRI
Authors: Liu Yan , Jeon Sang-Min , Caterina Michael J. , Qu Lintao
Published: November 2021

Chronic joint pain is a major symptom in rheumatoid arthritis (RA) and its adequate treatment represents an unmet medical need. Noncoding microRNAs (miRNAs) have been implicated in the pathogenesis of RA as negative regulators of specific target mRNAs. Yet, their significance in RA pain is still not well defined. We and other groups recently identified neuronally expressed FcγRI as a key driver of arthritis pain in mouse RA models. Thus, we tested the hypothesis that miRNAs that target and regulate neuronal FcγRI attenuate RA pain. Here, we show that miR-544-3p was robustly downregulated, whereas FcγRI was significantly upregulated in the dorsal root ganglion (DRG) in mouse RA models. Intrathecal injection of miR-544-3p mimic attenuated established mechanical and heat hyperalgesia partly through the downregulation of FcγRI in the DRG in a mouse model of collagen II–induced arthritis. Moreover, this effect was likely mediated, at least in part, by FcγRI because miR-544-3p mimic downregulated Fcgr1 mRNA expression in the DRG during arthritis and genetic deletion of Fcgr1 produced similar antihyperalgesic effects in the collagen II–induced arthritis model. This notion was further supported by a dual luciferase assay showing that miR-544-3p directly targeted Fcgr1 3′UTR. In naïve mice, miR-544-3p mediated acute joint pain hypersensitivity induced by IgG immune complex through the regulation of FcγRI. These findings suggest that miR-544-3p causally participates in the maintenance of arthritis pain by targeting neuronal FcγRI, and thus define miR-544-3p as a new potential therapeutic target for treating RA pain.
Primary cutaneous NK/T cell lymphoma
Authors: Zhu Shihao , Liu Zhijie , Jia Xuesong
Published: November 2021

Introduction:

Extranodal NK/T-cell lymphoma (nasal type) most commonly affects the nasal cavity and nasopharynx, followed by the skin. Epidermal mass as the first manifestation is rare, and they appear as multiple red and purple patches, often accompanied by ulcers.

Patient concerns:

The patient is a 79-year-old male with no significant medical history. The patient reported with erythema and nodules on his right forearm for a duration of one month.

Diagnosis:

According to the patient's clinical manifestations, histopathological examination of the skin lesions, and immunohistochemical results, the diagnosis was cutaneous extranodal NK/T cell lymphoma.

Interventions and outcomes:

The patient was first treated with one week of anti-infection and anti-inflammatory drugs but the size of the skin nodules became larger, with involvement of the surrounding normal skin. Hence, tumor resection and skin grafting were performed. The patient refused to receive further radiotherapy and chemotherapy. After being discharged from the hospital, the patient passed away one week later.

Conclusion:

Skin lesions as the initial presentation is a rare occurrence in Extranodal NK/T cell lymphoma. Hence, clinicians should be alert to skin involvement in extranodal NK/T cell lymphoma as early diagnosis is critical.
18F-FDG PET/CT for the evaluation of male breast cancer: a systematic review
Authors: Dondi Francesco , Albano Domenico , Giubbini Raffaele , Bertagna Francesco
Published: November 2021

Background

In the last years, some studies on the usefulness of 18F-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) for the evaluation of male breast cancer (MBC) have been produced. The aim of this review is to analyze the usefulness of 18F-FDG PET/CT and its diagnostic performances for the assessment of MBC.

Methods

A wide literature search of the PubMed/MEDLINE, Scopus, Embase and Cochrane library databases was made to find relevant published articles on the role of 18F-FDG PET/CT for the evaluation of MBC. Moreover, quality assessment including the risk of bias and applicability concerns was carried out using QUADAS-2 evaluation.

Results

The comprehensive computer literature search revealed 3178 articles. On reviewing the titles and abstracts, 3170 articles were excluded because the reported data were not within the field of interest and finally eight studies were included in the review, for a total of 176 male patients. The studies considered revealed high diagnostic accuracy of 18F-FDG PET/CT for the evaluation of MBC both at staging and restaging of disease. Moreover, its added values compared to conventional imaging are starting to emerge and insight into its controversial prognostic importance is growing.

Conclusion

Despite some limitations affecting our review, 18F-FDG PET/CT seems to be a valuable tool to assess MBC. Further research studies are required to better underline the role of hybrid imaging with 18F-FDG for the evaluation of MBC, especially in comparison with female breast cancer.
Developments in optimizing transperineal prostate biopsy
Authors: Cheng Emily , Davuluri Meenakshi , Lewicki Patrick J. , Hu Jim C. , Basourakos Spyridon P.
Published: November 2021

Purpose of review

Prostate biopsy is a very commonly performed office procedure leading to the diagnosis of the most prevalent solid-organ malignancy in American men. Although the transrectal technique for prostate biopsy remains the gold standard, there is increasing interest in the transperineal approach as it offers a clean, percutaneous approach that significantly decreases the risk for infection. In this review, we discuss emerging developments in transperineal prostate biopsy that may optimize the way biopsies are performed in clinical practice.

Recent findings

Similarly, to transrectal biopsy, the transperineal approach also allows for the performance of systematic and MRI-targeted biopsy cores. As transperineal biopsy obviates the translocation of rectal bacteria to the prostate or bloodstream, in contrast to transrectal biopsy, it is feasible to forgo peri-procedural antibiotics in accordance with professional guidelines. This may attenuate antimicrobial resistance that may be associated with augmented prophylaxis. In addition, although transperineal biopsy may be traditionally performed under general anesthesia using a template grid, it may also be performed freehand under local anesthesia or sedation. Avoiding prophylactic antibiotics and general anesthesia as well as reducing infections/hospitalizations for transperineal biopsy scaled nationally will likely result in significant healthcare savings.

Transperineal biopsy with combined systematic and MRI-targeted cores, offers several advantages over conventional transrectal biopsy. Transperineal biopsy under local anesthesia and without periprocedural antibiotic is emerging as a promising method for prostate cancer diagnosis and surveillance.
Multi-modal investigation of the schizophrenia-associated 3q29 genomic interval reveals global genetic diversity with unique haplotypes and segments that increase the risk for non-allelic homologous recombination
Authors: Yilmaz Feyza , Gurusamy Umamaheswaran , Mosley Trenell J. , Mostovoy Yulia , Shaikh Tamim H. , Zwick Michael E. , Kwok Pui-Yan , Lee Charles , Mulle Jennifer G.
Published: November 2021

Chromosomal rearrangements that alter the copy number of dosage-sensitive genes can result in genomic disorders, such as the 3q29 deletion syndrome. At the 3q29 region, non-allelic homologous recombination (NAHR) between paralogous copies of segmental duplications (SDs) leads to a recurrent ∼1.6 Mbp deletion or duplication, causing neurodevelopmental and psychiatric phenotypes. However, risk factors contributing to NAHR at this locus are not well understood. In this study, we used an optical mapping approach to identify structural variations within the 3q29 interval. We identified 18 novel haplotypes among 161 unaffected individuals and used this information to characterize this region in 18 probands with either the 3q29 deletion or 3q29 duplication syndrome. A significant amount of variation in haplotype prevalence was observed between populations. Within probands, we narrowed down the breakpoints to a ∼5 kbp segment within the SD blocks in 89% of the 3q29 deletion and duplication cases studied. Furthermore, all 3q29 deletion and duplication cases could be categorized into one of five distinct classes based on their breakpoints. Contrary to previous findings for other recurrent deletion and duplication loci, there was no evidence for inversions in either parent of the probands mediating the deletion or duplication seen in this syndrome.
Sexual Behaviours and Sexual Health Among Middle-Aged and Older Adults in Britain: A Latent Class Analysis of The Natsal-3
Authors: Khan Junead , Greaves Emily , Tanton Clare , Kuper Hannah , Shakespeare Thomas , Kpokiri Eneyi E. , Wang Yun , Ong Jason J. , Day Suzanne , Pan Stephen W. , Tang Weiming , Wang Bingyi , Peng Xin , Liang Bowen , Zou Huachun , Tucker Joseph D. , Wu Dan
Published: November 2021

Objectives

Population-representative studies of the sexual health of middle-aged and older adults are lacking in aging societies. This study aimed to identify latent patterns of sexual behaviours and health of people aged 45-74.

Methods

We conducted a latent class analysis of the National Attitudes and Sexual Lifestyles Survey (Natsal-3), a nationally representative survey conducted in Britain in 2011.

Results

Of the 5260 respondents aged 45-74, 49% of men and 45% of women belonged to the Content Caseys class who reported good sexual health. The Infrequent Indigos (31% of men, 44% of women) were characterized by a lack of sexual activity, reported some dissatisfaction, and were more likely to have a disability. The Low-Functioning Lees (12% of men, 8% of women) reported some more disability and had issues with sexual functioning and higher levels of distress. The Multiple-Partnered Morgans (9% of men, 2% of women) were characterized by a greater number of sexual partners and several risk behaviours.

Conclusions

The use of these four classes can aid in improved targeting of tailored sexual health services to improve sexual function, sexual satisfaction, reduce distress and risky behaviours among middle-aged and older adults. These services should be inclusive of the disabled community.

Bullet points

About half of these respondents were classified as Content Caseys who reported few issues concerning their sex lives.

Over a third who reported no recent sexual activity, the vast majority of whom are single, were classified as Infrequent Indigos.

Nearly 10% were classified Low-Functioning Lees due to the greater probability of reporting sexual function issues and distress.

The rest were classified as Multiple Partner Morgans as a result of a high likelihood of having multiple partners and unsafe sex.