bluuebunny/crossref_metadata_2025 huggingface dataset:
Antioxidant and hepatoprotective effects against acute CCl4‐induced liver damage in mice from red‐fleshed apple flesh flavonoid extract
Authors: Zou Qi , Wang Nan , Gao Zheng , Xu Haifeng , Yang Guanxian , Zhang Tianliang , Guo Zhangwen , Zhang Zongying , Jia Le , Chen Xuesen
Published: September 2020

Apple (Malus domesticaBorkh.) is an important fruit tree species worldwide. Apple fruits are favored by consumers because of their antioxidative, anti‐inflammatory, and antitumor effects as well as their protective effects against cardiovascular diseases and other health benefits. There is considerable interest in red‐fleshed apple fruits among breeders because of their high flavonoid and anthocyanin contents. However, the flavonoids extracted from red‐fleshed apple fruits must still be functionally characterized, especially regarding their protective effects against certain pathologies. In this study, the flavonoid components and contents in the extracts prepared from red‐fleshed apple cultivar “Meihong” were determined. Additionally, thein vitroantioxidant activities and protective effects of the extracts against CCl4‐induced acute liver injury were investigated. The red‐fleshed apple flesh flavonoid extract (RAFF) exhibited strongin vitroantioxidant activities. Compared with the model control mice treated with CCl4, the mice pretreated with high (800 mg/kg·bw), middle (400 mg/kg·bw), and low (200 mg/kg·bw) RAFF doses had significantly lower CCl4‐induced serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase activities. Moreover, the RAFF pretreatment also significantly decreased the liver malondialdehyde activity and prevented the CCl4‐induced decrease in liver superoxide dismutase, glutathione peroxidase, catalase, and reduced glutathione levels. Furthermore, a histopathological examination revealed that RAFF inhibited the inflammatory cell infiltration and cell boundary loss caused by CCl4in the liver. Thus, RAFF is a natural antioxidant with significant antioxidative activities and liver protective effects. The results of this study may be relevant for enhancing the application of the red‐fleshed apple fruit extract as a food additive.

Practical Application

We took the self‐selected red‐fleshed apple cultivar “Meihong” as the unique research material, and the active ingredients of its flavonoid extract,in vitroantioxidant activity and hepatoprotective effect were analyzed. It is of great significance to promote the development of the red‐fleshed apple industry, and also provides an important reference for the development of natural antioxidants.
Physicochemical characteristics of green banana flour and its use in the development of konjac‐green banana noodles
Authors: Yu Ashley Hui Min , Phoon Pui Yeu , Ng Grace Cui Fang , Henry Christiani Jeyakumar
Published: September 2020

Asian noodles typically have high glycemic index, and an unbalanced diet heavily laden with carbohydrates has been linked to weight gain and obesity.Shiratakinoodles from Japan is made from konjac glucomannan (KGM) and water and is widely known for its multiple health benefits and ability to promote satiety. However, it imparts negligible nutritional value due to its low energy content. In this study, the feasibility of making low calorie, gluten‐free Shirataki noodles with improved nutritional value was shown by adding green banana flour (GBF), an underutilized subproduct of low commercial value and significance in the food industry. The optimal KGM‐GBF noodles (with 6% w/w KGM, 35% w/w GBF) had 27% lower total energy content, 13% lower carbohydrate content, 5.4% higher fiber content, 2% higher ash content, and 80% hardness (as measured by texture profile analysis) when compared to commercial yellow alkaline wheat noodles. Multiple regression analysis showed that KGM level was a more influential factor than GBF level on the hardness of cooked KGM‐GBF noodles (P< 0.01). The compatibility of GBF with KGM in noodle making lay in GBF's high gelatinizing and pasting temperatures, which allowed optimal KGM hydration during dough formation to develop the primary network structure in the noodles. Through this study, the potential of GBF as a functional food ingredient in product processing and nutrition enhancement was demonstrated.

Practical Application

The addition of green banana flour can improve the nutritional value and sensorial properties of konjac (Shirataki) noodles. This offers a gluten‐free and low glycemic index alternative to wheat and starch noodles currently available commercially. A novel method of noodle‐making to create KGM noodles, without the use of high alkalinity, was developed.
Decline in lizard species diversity, abundance and ectoparasite load across an elevational gradient in the Australian alps
Authors: Hamilton Katelyn , Goulet Celine T. , Drummond Emily M. , Senior Anna F. , Schroder Mellesa , Gardner Michael G. , While Geoffrey M. , Chapple David G.
Published: September 2020

The rapid changes in altitude, and associated habitat, of mountain ecosystems make them ideal natural laboratories for testing the effect of environmental heterogeneity on species assemblage. Our understanding of the sensitivity of Australian reptiles to elevational clines is limited. We examined lizard distribution across three elevation zones (montane, subalpine and alpine), spanning from 900 to 1840 m above sea level, in the Australian alps. We aimed to examine how elevation influences species diversity and abundance, and ectoparasite load, and whether species alter their habitat use amongst different elevational zones. Active searches were conducted across the elevation zones to identify lizard community structure (at least 16 species) across elevational zones, along with skink habitat preferences and the ectoparasite load. Skink diversity and abundance were negatively correlated with increased elevation. The alpine zone had significantly lower diversity and abundance of skinks. Habitat use differed amongst both elevations and species. Ectoparasite prevalence was also significantly diminished in the alpine zone. Ectoparasites only infected a subset of the skink community, with ectoparasite load increasing as the active season progressed. This study provides evidence of the complex interplay between elevation and species diversity, as well as the differences in ectoparasite pressure along elevational gradients in the Australian alps.
Safe and rapid implementation of telemedicine fracture clinics: the impact of the COVID‐19 pandemic
Authors: Smith Ariella J. , Pfister Benjamin F. , Woo Elise W. Y. , Walters Benjamin J. , Blacket Benedict , Page Nicholas , Drobetz Herwig
Published: September 2020

Background

The coronavirus disease outbreak in December 2019 rapidly spread around the world with profound effects on healthcare systems. In March 2020, all elective surgery and elective outpatient clinics were cancelled in our institution, a regional hospital in Northern New South Wales, Australia. With regard to orthopaedic fracture clinics, a telehealth system was implemented on an emergency basis for patient and staff safety to prevent disease transmission. The aim of our study was to investigate whether rapid implementation of telehealth for orthopaedic fracture clinics resulted in an increase in complications.

Methods

A retrospective cohort study of all patients with orthopaedic fracture clinic appointments at a regional New South Wales hospital between 17 March and 8 May 2020 was undertaken. There were 191 patients, including 390 appointments of which 23.1% were conducted via telehealth, namely by phone call. Complications requiring phone calls to the orthopaedic team, presentations to the emergency department, admission to hospital or return to theatre, were recorded.

Results

There was no increase in complications following emergent implementation of telehealth for orthopaedic fracture clinic follow‐up in our institution. Patients in the telehealth group were significantly older than those in the clinic group.

Conclusion

The study demonstrates that application of telehealth fracture clinics in a regional Australian setting can be achieved without increasing complication rates and can be used to formulate a rapid telehealth implementation plan if a similar scenario occurs in the future.
Metelkova as Autonomous Heterotopia
Authors: Siegrist Nathan , Thörn Håkan
Published: September 2020

This article examines conflicts concerning urban space, focusing on relationships between autonomous space and neoliberal urbanism through the empirical example of the cultural centre AKC Metelkova Mesto in Ljubljana, Slovenia. Through a thematic discourse analysis of activist interviews and collective statements by activist groups connected to Metelkova, research questions concern how urban conflict is constructed from the vantage point of autonomous space; what role autonomous space is assigned in relation to such conflict; and how tensions and antagonisms within the autonomous space can be understood. Theoretically we engage in a reinterpretation of the notion of heterotopia in conjunction with critical urban theory, analysing Metelkova as an autonomous heterotopia. Further, we argue that theoretisations of autonomous spaces need to consider experiences from Central and Eastern Europe, in which the conditions are shaped and constructed in conjunction with particular configurations of abruptly implemented neoliberal governance and the rise of the authoritarianism.
Clusterin suppresses spermatogenic cell apoptosis to alleviate diabetes‐induced testicular damage by inhibiting autophagy via the PI3K/AKT/mTOR axis
Authors: Tian Yuan , Xiao Yue‐Hai , Geng Tian , Sun Chao , Gu Jiang , Tang Kai‐Fa , Liu Bei , Liu Yi‐Meng , Sun Fa
Published: September 2020

Background information

Diabetes‐induced testicular dysfunction is characterised by abnormal apoptosis of spermatogenic cells, but the underlying mechanism is poorly understood. This study aimed to investigate the roles of clusterin (CLU) in testicular damage associated with diabetes pathogenesis, as well as the molecular mechanism.

A rat diabetes model was established using streptozocin, and the mouse spermatogenic cell line GC‐1 spg was treated with high glucose as a cellular model. CLU was overexpressed in GC‐1 spg cells, followed by detection of serum testosterone, cell proliferation, cell apoptosis and autophagy.

Results

CLU expression was significantly reduced and LC3 expression was elevated in testis tissues in the rat diabetes model and high glucose‐treated GC‐1 spg cells. High glucose led to suppressed viability, enhanced apoptosis, reduced Bcl‐2 expression, elevated Bax expression and cleavage of Caspase‐3/‐9 in GC‐1 spg cells, and these effects were abrogated by CLU overexpression. Additionally, CLU overexpression repressed LC3 and Beclin‐1 expression, reduced the LC3II/LC3I ratio and promoted p62 expression in GC‐1 spg cells in the presence of high glucose, and these effects were all mitigated by rapamycin treatment. Inhibition of PI3K/AKT/mTOR signalling with LY294002 activated autophagy in CLU‐overexpressing GC‐1 spg cells under high glucose conditions. CLU overexpression repressed autophagy and alleviated testicular damage in diabetic rats, which was also abrogated by LY294002 treatment.

Conclusions

CLU expression is suppressed during diabetes‐induced testicular damage, whereas CLU overexpression alleviates diabetes‐induced testicular damage by activating PI3K/AKT/mTOR signalling to inhibit autophagy and further repress spermatogenic cell apoptosis.
Retracted: First‐line pembrolizumab vs chemotherapy in metastatic non‐small‐cell lung cancer: KEYNOTE‐024 Japan subset
Authors: Satouchi Miyako , Nosaki Kaname , Takahashi Toshiaki , Nakagawa Kazuhiko , Aoe Keisuke , Kurata Takayasu , Sekine Akimasa , Horiike Atsushi , Fukuhara Tatsuro , Sugawara Shunichi , Umemura Shigeki , Saka Hideo , Okamoto Isamu , Yamamoto Nobuyuki , Sakai Hiroshi , Kishi Kazuma , Katakami Nobuyuki , Horinouchi Hidehito , Hida Toyoaki , Okamoto Hiroaki , Atagi Shinji , Ohira Tatsuo , Han Shi Rong , Noguchi Kazuo , Ebiana Victoria , Hotta Katsuyuki
Published: September 2020

This prespecified subanalysis of the global, randomized controlled phase III KEYNOTE‐024 study of pembrolizumab vs chemotherapy in previously untreated metastatic non‐small‐cell lung cancer without EGFR/ALK alterations and a programmed death ligand 1 (PD‐L1) tumor proportion score of 50% or higher evaluated clinical outcomes among patients enrolled in Japan. Treatment consisted of pembrolizumab 200 mg every 3 weeks (35 cycles) or platinum‐based chemotherapy (four to six cycles). The primary end‐point was progression‐free survival; secondary end‐points included overall survival and safety. Of 305 patients randomized in KEYNOTE‐024 overall, 40 patients were enrolled in Japan (all received treatment: pembrolizumab, n = 21; chemotherapy, n = 19). Median progression‐free survival was 41.4 (95% confidence interval [CI], 4.2‐42.5) months with pembrolizumab and 4.1 (95% CI, 2.8‐8.3) months with chemotherapy (hazard ratio [HR], 0.27 [95% CI, 0.11‐0.65]; one‐sided, nominal P = .001). Median overall survival was not reached (NR) (95% CI, 22.9‒NR) and 21.5 (95% CI, 5.2‐35.0) months, respectively (HR, 0.39 [95% CI, 0.17‐0.91]; one‐sided, nominal P = .012). Treatment‐related adverse events occurred in 21/21 (100%) pembrolizumab‐treated and 18/19 (95%) chemotherapy‐treated patients; eight patients (38%) and nine patients (47%), respectively, had grade 3‐5 events. Immune‐mediated adverse events and infusion reactions occurred in 11 pembrolizumab‐treated patients (52%) and four chemotherapy‐treated patients (21%), respectively; four patients (19%) and one patient (5%), respectively, had grade 3‐5 events. Consistent with results from KEYNOTE‐024 overall, first‐line pembrolizumab improved progression‐free survival and overall survival vs chemotherapy with manageable safety among Japanese patients with metastatic non‐small‐cell lung cancer without EGFR/ALK alterations and a PD‐L1 tumor proportion score of 50% or higher. The trial is registered with Clinicaltrials.gov: NCT02142738.
Body composition in women with premature ovarian insufficiency using hormone therapy and the relation to cardiovascular risk markers: A case‐control study
Authors: Freitas Alberto T. A. , Donovan Giraldo Andrea E. , Pravatta Rezende Gabriela , Yela Daniela A. , Jales Rodrigo M. , Benetti‐Pinto Cristina L.
Published: September 2020

Objective

To compare body composition between women with premature ovarian insufficiency (POI) using hormone therapy and controls with normal ovarian function, and to correlate body composition with cardiovascular risk markers in the POI group.

Patients and design

A case‐control study of 70 women with POI matched by age and body mass index with 70 controls.

Measurements

All were submitted to whole‐body dual‐energy X‐ray absorptiometry (DXA) to analyse body composition. In the POI group, total cholesterol, HDL‐cholesterol, LDL‐cholesterol, VLDL‐cholesterol, triglycerides, glucose, insulin, transaminases and C‐reactive protein levels were measured, as well as the thickness of the carotid artery intima‐media complex.

Results

Total mass, fat mass, lean mass (total, percentage and index) and the android/gynoid (A/G) ratio were similar in both groups; however, bone mineral content was lower (P < .001) in the POI group. Lean and fat mass indexes were 14.19 ± 1.63 and 11.04 ± 3.58, respectively, and the percentage of gynoid to android fat was higher (51.17 ± 6.71% versus 47.74 ± 9.19%; A/G ratio = 0.93 ± 0.15) in the POI group. In addition, the increase in total mass correlated positively with glucose and ALT levels and negatively with HDL‐cholesterol. Increased A/G ratio was the measurement most frequently associated with cardiovascular risk markers.

Conclusion

The body composition of women with POI using hormone therapy is similar to that of women with normal ovarian function with regard to lean and fat mass content and fat distribution. In women with POI, the higher the A/G ratio, the worse the cardiovascular risk markers.
Does forest thinning reduce fire severity in Australian eucalypt forests?
Authors: Taylor Chris , Blanchard Wade , Lindenmayer David B.
Published: September 2020

Forest thinning has been proposed to reduce fire severity. However, evidence to support this strategy in Australia is scant. We completed a detailed empirical analysis of stand history data from forests burned in wildfires in 2009 in south‐eastern Australia, to address the question: Does forest thinning reduce fire severity? The answer varied depending on fire type (Crown Burn vs. Crown Burn/Crown Scorch), forest type, and stand age. For the statistical relationship for Crown Burn, there were no thinning effects in ash‐type forests. For mixed species forests, thinning reduced the probability of Crown Burn in young stands but increased it in older stands. Data for the fire severity category of Crown Burn/Crown Scorch revealed that thinning generally elevated fire severity, irrespective of stand age, forest type, or fire zone. Except for 20‐ to 40‐year‐old mixed species forest subject to Crown Burn, proposals for thinning to reduce fire severity have limited support.
Strategic advertising of online news articles as an intervention to influence wildlife product consumers
Authors: Doughty Hunter , Wright Joss , Veríssimo Diogo , Lee Janice S. H. , Oliver Kathryn , Milner‐Gulland E. J.
Published: September 2020

Changing human behavior is essential for biodiversity conservation, but robust approaches for large scale change are needed. Concepts like repeat message exposure and social reinforcement, as well as mechanisms like online news coverage and targeted advertisements, are currently used by private and public sectors, and could prove powerful for conservation. Thus, to explore their potential in influencing wildlife consumption, we used online advertisements through Facebook, Google, and Outbrain, to promote news articles discussing the use of a Critically Endangered antelope (the Saiga tatarica) as a traditional Chinese medicine in Singapore. Our message, tailored to middle‐aged Chinese Singaporean women, framed saiga horn products as being no longer socially endorsed. Through advert performance and in‐depth analyses of Facebook user engagement, we assessed audience response. Our message pervaded Singapore's online media (e.g., our adverts were shown almost five million times; and the story ran on seven news outlets), and resulted in widespread desirable audience responses (e.g., 63% of Facebook users' engagements included identifiably positive features like calls for public action to reduce saiga horn consumption, anger at having unknowingly used a Critically Endangered species, and self‐pledges to no longer use it; only 13% of engagements included identifiably negative features). This work shows that targeted dissemination of online news articles can have promising results, and may have wide applicability to conservation.
Investigating the capabilities of information technologies to support policymaking in COVID‐19 crisis management; a systematic review and expert opinions
Authors: Mehraeen Mohammad , Dadkhah Mehdi , Mehraeen AmirReza
Published: September 2020

Background

Today, numerous countries are fighting to protect themselves against the Covid‐19 crisis, while the policymakers are confounded and empty handed in dealing with this chaotic circumstance. The infection and its impacts have made it difficult to make optimal and suitable decisions. New information technologies play significant roles in such critical situations to address and relieve stress during the coronavirus crisis. This article endeavours to recognize the challenges policymakers have typically experienced during pandemic diseases, including Covid‐19, and, accordingly, new information technology capabilities to encounter with them.

Material and methods

The current study utilizes the synthesis of findings of experts’ opinions within the systematic review process as the research method to recognize the best available evidence drawn from text and opinion to offer practical guidance for policymakers.

Results

The results illustrate that the challenges fall into two categories including; encountering the disease and reducing the results of the disease. Furthermore, Internet of things, cloud computing, machine learning and social networking play the most significant roles to address these challenges.
Microglial phagocytosis dysfunction in the dentate gyrus is related to local neuronal activity in a genetic model of epilepsy
Authors: Sierra‐Torre Virginia , Plaza‐Zabala Ainhoa , Bonifazi Paolo , Abiega Oihane , Díaz‐Aparicio Irune , Tegelberg Saara , Lehesjoki Anna‐Elina , Valero Jorge , Sierra Amanda
Published: September 2020

Objective

Microglial phagocytosis of apoptotic cells is an essential component of the brain regenerative response during neurodegeneration. Whereas it is very efficient in physiological conditions, it is impaired in mouse and human mesial temporal lobe epilepsy, and now we extend our studies to a model of progressive myoclonus epilepsy type 1 in mice lacking cystatin B (CSTB).

Methods

We used confocal imaging and stereology‐based quantification of apoptosis and phagocytosis of the hippocampus of Cstb knockout (KO) mice, an in vitro model of phagocytosis and siRNAs to acutely reduce Cstb expression, and a virtual three‐dimensional (3D) model to analyze the physical relationship between apoptosis, phagocytosis, and active hippocampal neurons.

Results

Microglial phagocytosis was impaired in the hippocampus of Cstb KO mice at 1 month of age, when seizures arise and hippocampal atrophy begins. This impairment was not related to the lack of Cstb in microglia alone, as shown by in vitro experiments with microglial Cstb depletion. The phagocytosis impairment was also unrelated to seizures, as it was also present in Cstb KO mice at postnatal day 14, before seizures begin. Importantly, phagocytosis impairment was restricted to the granule cell layer and spared the subgranular zone, where there are no active neurons. Furthermore, apoptotic cells (both phagocytosed and not phagocytosed) in Cstb‐deficient mice were at close proximity to active cFos+ neurons, and a virtual 3D model demonstrated that the physical relationship between apoptotic cells and cFos+ neurons was specific for Cstb KO mice.

Significance

These results suggest a complex crosstalk between apoptosis, phagocytosis, and neuronal activity, hinting that local neuronal activity could be related to phagocytosis dysfunction in Cstb KO mice. Overall, these data suggest that phagocytosis impairment is an early feature of hippocampal damage in epilepsy and opens novel therapeutic approaches for epileptic patients based on targeting microglial phagocytosis.
Everyday sexism and racism in the ivory tower: The experiences of early career researchers on the intersection of gender and ethnicity in the academic workplace
Authors: Bourabain Dounia
Published: September 2020

The academic workplace is often described as a place of merit and equal opportunities. However, research shows a leaky pipeline where the share of women and people of color decreases in the higher echelons of academia. Explanations are often structural, referring to the access barriers women are confronted with, such as hiring and recruitment. This research investigates what goes wrong in the early phases of a female academic's career. From an intersectional perspective, I study the experiences with everyday sexism and racism of PhD and postdoctoral researchers across disciplines. After conducting 50 in‐depth interviews, four processes are discovered: smokescreen of equality, everyday cloning, patronization, and paternalism.
Efficacy of a novel sequential treatment regimen containing bismuth forHelicobacter pylorieradication in Turkish children
Authors: Arslan Melike , Balamtekin Necati , Günal Armağan
Published: September 2020

Background

Eradication rates ofHelicobacter pylori(H pylori) with standard triple therapy are gradually decreasing all over the world, including in children, due to the development of strains resistant to antimicrobials. Sequential therapy can be used as an alternative method to increase eradication rates.

Materials and Methods

A total of 75 patients ≥ 8 years of age withH pylorigastritis were included in the study. According to Rome IV criteria, 38 patients had functional abdominal pain and dyspepsia, and 37 patients had alarm findings suggesting organic disease. Patients were treated with a novel sequential therapy consisting of the proton pump inhibitor (PPI)‐lansoprazole (1 mg/kg/day, maximum 30 mg daily), amoxicillin (50 mg/kg/d in two doses, maximum 2 × 1000 mg) for 7 days followed by PPI‐lansoprazole (1 mg/kg/d, maximum 30 mg daily), metronidazole (20 mg/kg/day in two doses, maximum 2 x 500 mg), tetracycline (50 mg/kg/d divided into four equal doses, maximum 4 x 500 mg), and bismuth subsalicylate (262 mg QID in patients ≤ 10 years of age, 524 mg QID in patients > 10 years of age in days 8‐14). Eradication status was evaluated byH pyloristool antigen test 8 weeks after the completion of treatment.

Results

The mean age of the patients was 15.1 ± 2.4 years and 51 (68%) were female. No patient discontinued therapy due to side effects. All patients had antral gastritis (76.0%) or pangastritis (24.0%). The peptic ulcer rate was 6.6%. Eradication therapy was given to all patients with or without peptic ulcer.H pylorieradication was achieved in 69 (92.0%) patients and symptoms improved in 61 of those eradicated.

Conclusions

As a first‐line treatment forH pylorieradication in children, administering a novel sequential therapy including bismuth for 14 days provides a high rate of eradication.
Effects of alcohol consumption on multiple hepatocarcinogenesis in patients with fatty liver disease
Authors: Ochiai Yorinari , Kawamura Yusuke , Kobayashi Masahiro , Shindoh Junichi , Kobayashi Yuta , Okubo Satoshi , Muraishi Nozomu , Kajiwara Akira , Iritani Soichi , Fujiyama Shunichiro , Hosaka Tetsuya , Saitoh Satoshi , Sezaki Hitomi , Akuta Norio , Suzuki Fumitaka , Suzuki Yoshiyuki , Ikeda Kenji , Arase Yasuji , Hashimoto Masaji , Kumada Hiromitsu
Published: September 2020

Aim

The number of patients with fatty liver disease (FLD) is increasing globally. Ethanol consumption in FLD is known to be associated with an increased risk of hepatocellular carcinoma (HCC), but the effects of alcohol consumption on the occurrence of multiple HCCs remain unclear. We explored the relationship between the daily ethanol intake and the HCC number.

Methods

This single‐center retrospective study enrolled 114 patients without viral or immune hepatitis undergoing first‐line HCC treatment who had been diagnosed with FLD by abdominal ultrasonography or a liver biopsy at the same time as or before HCC detection. We categorized patients into four groups according to the daily alcohol consumption (<20 g: non‐alcoholic fatty liver disease, n = 45; 20–39 g: low‐intermediate ethanol intake with FLD, n = 13; 40–69 g: high‐intermediate ethanol intake with FLD, n = 31; ≥70 g: alcoholic fatty liver disease, n = 25). The relationship between the daily ethanol consumption and the number of HCCs (single or multiple) was examined.

Results

The risk of multiple HCCs was significantly higher in the high‐intermediate ethanol intake with FLD (HR 2.89, 95% CI 1.04–8.02, P = 0.042) and alcoholic fatty liver disease (HR 3.14, 95% CI 1.07–9.22, P = 0.037) groups than in the others. A multivariate analysis showed that a daily ethanol intake ≥40 g was associated with a significantly increased risk of multiple HCCs (HR 2.82, 95% CI 1.16–6.88, P = 0.023).

Conclusions

Our findings suggest that a high daily ethanol intake might lead to multiple hepatocarcinogenesis in patients with FLD.
Laboratory practices for manual blood film review: Results of an IQMH patterns of practice survey
Authors: Leung Elaine , Johnston Anna , Olsen Brian , Chang Hong , Martin Tracy , Wozniak Miranda , Good David
Published: September 2020

Introduction

Examination of a blood film is the second most common hematology test, after the complete blood count. Interpretation of a peripheral blood film by trained laboratory professionals provides valuable diagnostic information. The Institute for Quality Management in Healthcare (IQMH) Hematology Scientific Committee developed a questionnaire to gather information regarding current practices for manual blood film review and reporting from laboratories participating in IQMH Morphology proficiency testing (PT) surveys.

Methods

An online survey was distributed to 174 laboratories, 97% submitted results.

Results

Of the respondents, the majority (82%) indicated affiliation with small‐ or medium‐sized hospitals (<500 beds). 80% of respondents had core laboratory technologists performing manual blood film reviews, while only 2% utilized dedicated hematology technologists with morphology expertise. All respondents had a policy for manual blood film review by a technologist, 70% did not have blood films reviewed by a senior/charge technologist prior to review by a physician. The majority (88%) of participants included morphological findings in their critical result list; of these, 98% include malaria and 88% include the first‐time finding of blasts as critical results. 59% of participants indicated that they have a procedure in place to ensure that interpretation and confirmation of first‐time potentially significant morphological findings are available from a physician at all times.

Conclusion

This survey identified significant variation in blood film review and reporting practices across participating laboratories. The IQMH Hematology Scientific Committee will develop best practice recommendations to guide and standardize practice.
Integrating Bottom‐up into Top‐down: The Role of Local Actors in Labour Market Integration of Syrian Refugees in Turkey
Authors: Siviş Selin
Published: September 2020

As Turkey has become one of the leading receiving countries for asylum seekers and refugees, not only new legislative initiatives regarding the legal status of Syrians, but also immigration policies have moved to the forefront of Turkey’s agenda. In parallel with recent developments, the new Regulation on Work Permits for People under Temporary Protection was enacted in 2016. Among the 3,5 million, almost half of Syrian refugees residing in Turkey are of working age population, yet the majority have been engaged in the informal labour market. We know little about how this permit to work takes effect at the local level. Drawing on structured interviews with local actors in Adana, this article shows that the absence of an integration policy drives local actors to engage in the formulation of their own integration approach, what I call “integration work”, which results in varying degrees of collaboration within the same province.
From functions to mechanisms of the prototypic complement C5 antibody BB5.1
Authors: Milling Simon
Published: September 2020

Antibodies that bind complement components were first identified over 30 years ago. Investigations into their functions in animal models motivated clinical studies that have now generated licensed products and a strong pipeline of future therapeutics. Despite this, the mechanisms of action of one of the first effective C5‐binding antibodies, BB5.1, were not known. Here, we report a new study that reveals these mechanisms, enabling new approaches for designing C5‐binding molecules for therapeutic use.
Mealtime support for adults with intellectual disabilities: Understanding an everyday activity
Authors: Redley Marcus
Published: September 2020

Background

Mealtime support has a direct bearing on the diet‐related health of men and women with intellectual disabilities as well as opportunities for expressing dietary preferences.

Method

Semi‐structured interviews with a sample of direct support staff providing mealtime support to adults with intellectual disabilities.

Results

When managing tensions between a person's dietary preferences and ensuring safe and adequate nutrition and hydration, direct support staff are sensitive to a wide range of factors. These include the following: clinical advice; service users’ rights to choose; their (in)capacity to weigh up risks; how service users communicate; the constituents of a healthy diet; and a duty to protect service users' health.

Conclusions

Those responsible for setting standards and regulating the care practices need to look beyond too simple ideas of choice and safety to recognize ways in which providing support at mealtimes is a complex activity with serious consequences for people's health and well‐being.
What difficulties do people with mild intellectual disabilities experience when seeking medical help from their GP? A qualitative study
Authors: Oosterveld‐Vlug Mariska , Oldenkamp Marloes , Mastebroek Mathilde , Boeije Hennie
Published: September 2020

Background

People with intellectual disabilities often have low health literacy as a result of their limited language comprehension. The aim of this study was to explore the difficulties Dutch people with intellectual disabilities experience during the process of considering and seeking medical help from their GP. The study was intended as input for an online intervention supporting health literacy.

Methods

A qualitative study, in which 12 semi‐structured interviews were conducted with people with mild intellectual disabilities and 4 with relatives of people with mild intellectual disabilities. The interviews were analysed following the principles of thematic analysis.

Results

Difficulties were experienced in the following activities: assessing and proactively reacting to health complaints, processing health information, communicating with a GP and retaining information from the consultation. Support workers and relatives play an important role in all these activities.

Conclusions

To increase the capacity of people with intellectual disabilities to manage their health and seek care from their GP, it is important to support them in the activities they find difficult. Recommendations resulting from the study have been incorporated in an online intervention.
Risk of forced marriage amongst people with learning disabilities in the UK: Perspectives of South Asian carers
Authors: McCarthy Michelle , Clawson Rachael , Patterson Anne , Fyson Rachel , Khan Luftha
Published: September 2020

Background

People with intellectual disabilities are at increased risk of forced marriage compared to those without intellectual disabilities. In the UK, this risk is particularly, though not exclusively, associated with South Asian communities and is linked to the desire to secure long‐term care.

Method

Focus groups and semi‐structured interviews were undertaken with South Asian parents and family carers (n = 22) of adults with intellectual disability and the resultant data thematically analysed.

Results

Although securing care for their intellectually disabled relative was identified as a key motivator for forced marriage, other important themes also emerged. These included cultural and religious beliefs about disability and marriage, and limited understanding of relevant laws. Factors militating against forced marriage were also identified, including fears of abuse and neglect.

Conclusions

Implications for the provision of services and the need for improved access to information on forced marriage of people with intellectual disabilities are highlighted.
Influence of altitude on hypertension phenotypes and responses to antihypertensive therapy: Review of the literature and design of the INTERVENCION trial
Authors: Medina‐Lezama Josefina , Herrera‐Enriquez Karela , Narvaez‐Guerra Offdan , Chirinos Julio A.
Published: September 2020

Systemic arterial hypertension constitutes the leading cause of mortality worldwide, and affects people living at different altitudes above sea level (AASL). AASL has a major impact on cardiovascular function and various biologic pathways that regulate blood pressure–related phenotypes, but whether it affects the clinical response to antihypertensive therapy is unknown. The hemodynamic adaptations observed among lowlanders acutely exposed to high altitude (HA) is distinct from those observed among HA dwellers. However, the phenotypic patterns of hypertension and the response to standard antihypertensive agents among adults chronically exposed to different AASL are poorly understood. The authors describe the protocol for the INTERVENCION trial, a randomized clinical trial designed to assess the effects of three first‐line antihypertensive monotherapies (a thiazide diuretic, an angiotensin receptor blocker, and a calcium channel blocker) on peripheral and central blood pressure, in‐office blood pressure, and ambulatory blood pressure hemodynamics of hypertensive patients living at different AASL (low altitude, intermediate altitude, and high altitude). The primary end point is the reduction in 24‐hour brachial systolic blood pressure. The INTERVENCION trial will provide the first clinical trial data regarding the influence of AASL on the response to antihypertensive monotherapy, as well as the hemodynamic characteristics of arterial hypertension at different AASL.
Abnormal cardiac and metabolic measures correlate significantly with lower performance and activity in overweight chronic liver disease
Authors: Price Jillian , Escheik Carey , Weinstein Ali , Winter Patrice , Gerber Lynn , Younossi Zobair
Published: September 2020

People with Hepatitis C (HCV) and non‐alcoholic fatty liver disease (NAFLD) in the United States follow national trends toward a sedentary lifestyle and are increasingly at risk for hypertension. The intent of this study was to identify potential correlates of exercise tolerance in people with two types of chronic liver disease (CLD)‐NAFLD and HCV. Measures included cardiac output, oxygen consumption and stroke volume, blood pressure, distance walked in 6 minutes, clinical laboratory tests, and medications influencing the autonomic nervous system, patient self‐reports of activity, fatigue, and health‐related quality of life (HRQL). A total of 67 patients completed the 6‐minute walk test [45.1% Female, Age 51.7 ± 8.0 years, Body Mass Index 32.8 ± 5.9, 60% HCV]. At baseline, 70% had either diastolic (DBP) or systolic blood pressure outside normal range. Performance and cardiorespiratory measures correlated strongly with one another, but not with activity. Patients with abnormal DBP reported significantly lower maximum activity (MAS; r = −.254, P = .041, CI = −0.51 to −0.010; MAS 70.6 vs 82.5), significantly higher DBP post‐6‐minute walk test (r = .524, P = .0001, CI = 0.287‐0.762) and significantly lower overall HRQL items related to physical domains (r = .273, P = .029, CI = −0.518 to −0.029). Mental‐domain HRQL and depression measures did not correlate significantly with blood pressure. This study reports a significant correlation between both pre‐hypertensive and hypertensive DBP, poor physical‐domain self‐reports, HRQL, and performance in CLD patients.
Puerarin inhibits titanium particle‐induced osteolysis and RANKL‐induced osteoclastogenesis via suppression of the NF‐κB signaling pathway
Authors: Tang Wenkai , Xiao Long , Ge Gaoran , Zhong Mengdan , Zhu Jie , Qin Jialin , Feng Chencheng , Zhang Wenhao , Bai Jiaxiang , Zhu Xuesong , Wei Minggang , Geng Dechun , Wang Zhirong
Published: September 2020

Osteolysis around the prosthesis and subsequent aseptic loosening are the main causes of prosthesis failure. Inflammation due to wear particles and osteoclast activation are the key factors in osteolysis and are also potential targets for the treatment of osteolysis. However, it is not clear whether puerarin can inhibit chronic inflammation and alleviate osteolysis. In this study, we investigated the effect of puerarin on Ti particle‐induced inflammatory osteolysis in vivo in rat femoral models and in vitro in receptor activator of nuclear factor kappa‐B ligand (RANKL)‐induced osteoclast activation models. Our in vivo results showed that puerarin significantly inhibited Ti particle‐induced osteolysis and the expression of matrix metallopeptidase 9 (MMP‐9), nuclear factor of activated T cells 1 (NFATc1), tumour necrosis factor (TNF)‐α and interleukin (IL)‐6. In vitro, puerarin prevented RANKL‐induced osteoclast differentiation, bone resorption and F‐actin ring formation in a concentration‐dependent manner. Furthermore, puerarin decreased the phosphorylation of p65 and prevented p65 moving from the cytoplasm to the nucleus. Puerarin also reduced the expression of osteoclast‐specific factors and inhibited the inflammatory response. In conclusion, our study proves that puerarin can block the NF‐κB signalling pathway to inhibit osteoclast activation and inflammatory processes, which provides a new direction for the treatment of osteolysis‐related diseases.
A phase 4, randomized, head‐to‐head trial comparing the efficacy of subcutaneous injections of brodalumab to oral administrations of fumaric acid esters in adults with moderate‐to‐severe plaque psoriasis (CHANGE)
Authors: Pinter A. , Hoffmann M. , Reich K. , Augustin M. , Kaplan K. , Gudjónsdóttir S.D. , Delvin T. , Mrowietz U. ,   the CHANGE investigator group
Published: September 2020

Background

Brodalumab is a fully human monoclonal immunoglobulin IgG2 antibody that binds to the human IL‐17 receptor subunit A and by that inhibits the biologic action of IL‐17A, IL‐17F, IL‐17C and IL‐17E. Therapy with fumaric acid esters (FAE) is a well established and widely used first‐line systemic treatment for subjects with moderate‐to‐severe plaque psoriasis.

Objectives

To compare brodalumab to FAE in terms of clinical efficacy, patient‐reported outcomes and safety in subjects with moderate‐to‐severe plaque psoriasis who were naïve to systemic treatment.

Methods

Eligible subjects were randomized 1 : 1 to 210 mg brodalumab injections or oral FAE according to product label in this 24‐week, open‐label, assessor‐blinded, multi‐centre, head‐to‐head phase 4 trial. The primary endpoints were having PASI75 and having sPGA score of 0 or 1 (sPGA 0/1). Subjects with missing values for the primary endpoints were considered non‐responders.

Results

A total of 210 subjects were randomized. 91/105 subjects completed brodalumab treatment and 58/105 subjects completed FAE treatment. At Week 24, significantly more subjects in the brodalumab group compared to the FAE group had PASI75 (81.0% vs. 38.1%, P < 0.001) and sPGA 0/1 (64.8% vs. 20.0%, P < 0.001). In the brodalumab group, the median time to both PASI75 and to PASI90 was significantly shorter than in the FAE group (4.1 weeks vs. 16.4 weeks, and 7.4 weeks vs. 24.4 weeks, respectively, P < 0.0001 for both). The rate of adverse events was lower in subjects treated with brodalumab compared to subjects treated with FAE (616.4 vs. 1195.8 events per 100 exposure years). No new safety signals were detected for brodalumab.

Conclusions

Brodalumab was associated with rapid and significant improvements in signs and symptoms of moderate‐to‐severe plaque psoriasis, with a superior efficacy profile to what was observed with FAE in systemic‐naïve subjects over 24 weeks.
Infection of the Carpathian brook lamprey (Eudontomyzon danfordi Regan, 1911) with a dermocystid parasite in the Tisza River Basin, Hungary
Authors: Sellyei Boglárka , Cech Gábor , Varga Ádám , Molnár Kálmán , Székely Csaba , Somogyi Dóra , Nyeste Krisztián , Antal László
Published: September 2020

The Carpathian brook lamprey (Eudontomyzon danfordi Regan, 1911) is an endemic protected species of Cephalaspidomorphi in the Carpathian Basin. No parasites have become known from these jawless vertebrates to date. Here, the authors describe an infection from a single specimen manifesting in protuberant skin cysts 7–10 mm in diameter, scattered on the body surface. Similar dermal infection was observed in 25 of the 274 lampreys recorded in the population survey. Skin cysts filled with round spore‐like structures of a dermocystid parasite were found. These particles measured 8–14 µm in diameter and had an about 0.5 µm thick wall, and containing mainly a granular mass and a relatively scarce plasma. No hyphae were recorded. Despite conspicuous morphological changes in the skin, no inflammatory reactions were found. The molecular analysis of 18S rDNA showed similarity to dermocystid species of several fish species but differed from them approximately by 2%. This is the first record of a dermocystid parasite infecting a jawless vertebrate.
Hypochlorous acid water prevents postoperative intrauterine infection after microwave endometrial ablation
Authors: Tsuda Akira , Kanaoka Yasushi
Published: September 2020

Aim

We investigated the effects of uterine cavity lavage using hypochlorous acid water (HClO) on preventing postoperative intrauterine infection after microwave endometrial ablation (MEA).

Methods

Four hundred and eleven consecutive patients were enrolled in this study. The patients were divided into two groups: 214 cases in 2014–2016 with disinfection using povidone‐iodine antiseptic solution alone (group A) and 197 cases in 2017–2019 with additional intrauterine douche using HClO (group B). HClO was used at a concentration of 200 ppm of residual chlorine. One gram of Ceftriaxone Sodium Hydrate was administered by drip infusion during MEA in both groups. Oral antibiotics were administered after MEA only in group A but not in group B.

Results

Mean patient age (mean ± SD; years old) was 44.5 ± 4.6 in group A and 44.8 ± 5.4 in group B, and mean operation time (min) was 30.4 ± 19.1 in group A and 34.4 ± 22.6 in group B, respectively. Neither were significantly different between groups. The combined ablation techniques i.e. transcervical microwave myolysis and transcervical microwave adenomyolysis did not increase frequency of infection. Postoperative intrauterine infection cases in group B (8 cases) were significantly lower than those in group A (28 cases) (Chi‐square test, P = 0.001). Hysterectomy was performed in three severe intrauterine infection cases in group A, but no cases of severe intrauterine infection was found in group B. No adverse effect of HClO was seen.

Conclusion

Intrauterine douche using HClO decreases postoperative intrauterine infection after MEA.
Discrepancy between immunohistochemistry and sequencing for BRAF V600E in odontogenic tumours: Comparative analysis of two VE1 antibodies
Authors: Oh Kyu‐Young , Cho Sung‐Dae , Yoon Hye‐Jung , Lee Jae‐Il , Hong Seong‐Doo
Published: September 2020

Background

Although immunohistochemistry (IHC) along with molecular tests has been investigated in ameloblastoma for BRAF V600E detection, VE1 IHC has not been studied in odontogenic carcinomas (OCs) and benign mixed epithelial and mesenchymal odontogenic tumours (BMOTs). Here, we performed BRAF V600E mutation analysis, examined the expression pattern of VE1 IHC, and comparatively evaluated the performance of two VE1 antibodies in ameloblastomas, OCs and BMOTs.

Methods

BRAF V600E detection was performed using Sanger sequencing in a total of 47 odontogenic tumours: 28 ameloblastomas, 6 OCs and 13 BMOTs. VE1 IHC was conducted using two different antibodies (IHC‐A and IHC‐V), and their performance was analysed by calculating the sensitivity and specificity compared with sequencing.

Results

BRAF V600E mutations were identified in 24/28 (85.7%) ameloblastomas, 2/5 (40.0%) ameloblastic carcinomas (ACs), 3/7 (42.9%) ameloblastic fibromas and 1/2 (50.0%) ameloblastic fibro‐odontomas. In the presence of the mutation, VE1 showed diffuse cytoplasmic staining in ameloblastomas and ACs, whereas all BMOTs were negative for VE1. IHC‐A and IHC‐V yielded a sensitivity of 76.7% and 60.0%, respectively, although both antibodies showed 100% specificity.

Conclusion

OCs and BMOTs have BRAF V600E mutations in common at lower frequencies than ameloblastoma. Diffuse VE1 cytoplasmic staining in AC suggests the utility of MAPK‐targeted therapy as selectively applied in ameloblastoma, and consistent VE1 false‐negative expression in BMOTs requires further investigation. Considering the high specificity but low sensitivity of VE1 IHC, molecular tests should be performed to determine the presence of BRAF V600E mutations in odontogenic tumours.