bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of citizenship status, Latino ethnicity, and household language on health insurance coverage for U.S. adolescents, 2007‐2016
Authors: Knipper Sarah H. , Rivers Wesley , Goodman Julia M.
Published: August 2019

Objective/Study Question

To examine changes in uninsurance rates among U.S. adolescents ages 12‐17 and assess whether trends over time differed by citizenship status, Latino ethnicity, and household language.

Data Sources/Study Setting

2007‐2016 National Health Insurance Survey (NHIS).

Study Design

Multivariable logistic regression and postestimation marginal effects were used to assess changes in the current uninsured rate. Logistic regression models were used to determine significant trends over time for each demographic group and compare them to trends in the broader adolescent population. Marginal effects were employed to calculate adjusted outcome probabilities for each year.

Principal Findings

Across all 12‐ to 17‐year‐olds, the unadjusted uninsured rate dropped significantly between 2007 and 2016, from 10.2 percent to 6.0 percent. For noncitizen youth, the probability of being uninsured increased from 26.6 percent in 2007 to 28.4 percent in 2016, after controlling for covariates. Latino youth and those in Spanish‐speaking households saw declines in their adjusted uninsurance rate that was proportional to non‐Latino and English‐speaking youth.

Conclusions

Most adolescents saw significant improvements in health insurance coverage between 2007 and 2016; however, disparities remain among Spanish‐speaking and Latino adolescents and no improvements were seen among noncitizen youth. This suggests a need for equity‐focused eligibility, outreach, and enrollment policies that expand insurance options for these populations.
Incidental hepatic steatosis in radiology reports: a survey of emergency department clinicians’ perspectives and current practice
Authors: Kutaiba Numan , Rotella Joe‐Anthony , Ardalan Zaid , Testro Adam
Published: August 2019

Introduction

Hepatic steatosis is a relatively common incidental finding on computed tomography (CT) studies performed for patients in the emergency department (ED). The aim of our survey was to explore the preferences and perspectives of emergency physicians regarding reporting of incidental findings with a focus on hepatic steatosis.

Methods

A prospective web‐based questionnaire was conducted and distributed electronically to emergency clinicians with anonymous collection of responses.

Results

A total of 236 responses were received. The true response rate could not be determined due to different methods of electronic distribution. However, there was an estimated representation of 8.3% for ED physicians and 2.5% for trainees. The median time spent on the survey was less than 3 minutes. Seventy‐seven per cent answered yes to giving an incidental finding more significance if mentioned in the conclusion section. More than half of respondents (60.2%) reported that they would like hepatic steatosis to be mentioned in a CT report while 30% reported that it was irrelevant in the emergency setting and 10% reported that they did not want it mentioned in the report. The majority (83.1%) reported that they would include this finding in the discharge summary for GP follow‐up and less than half (44.1%) would mention it to patients.

Conclusion

Our survey highlights the importance of clear communication between radiologists and ED physicians when incidental findings are encountered. Radiologists play an important role in alerting ED physicians and clinicians who have access to patients’ radiology reports to the presence of incidental findings including hepatic steatosis.
Central Nervous System Correlates of “Objective” Neuropathy in Alcohol Use Disorder
Authors: Zahr Natalie M. , Pohl Kilian M. , Pfefferbaum Adolf , Sullivan Edith V.
Published: August 2019

Background

Among the neurological consequences of alcoholism is peripheral neuropathy. Relative to human immunodeficiency virus (HIV) or diabetes‐related neuropathies, neuropathy associated with alcohol use disorders (AUD) is understudied. In both the diabetes and HIV literature, emerging evidence supports a central nervous system (CNS) component to peripheral neuropathy.

Methods

In seeking a central substrate for AUD‐related neuropathy, the current study was conducted in 154 individuals with AUD (43 women, age 21 to 74 years) and 99 healthy controls (41 women, age 21 to 77 years) and explored subjective symptoms (self‐report) and objective signs (perception of vibration, deep tendon ankle reflex, position sense, 2‐point discrimination) of neuropathy separately. In addition to regional brain volumes, risk factors for AUD‐related neuropathy, including age, sex, total lifetime ethanol consumed, nutritional indices (i.e., thiamine, folate), and measures of liver integrity (i.e., γ‐glutamyltransferase), were evaluated.

Results

The AUD group described more subjective symptoms of neuropathy and was more frequently impaired on bilateral perception of vibration. From 5 correlates, the number of AUD‐related seizures was most significantly associated with subjective symptoms of neuropathy. There were 15 correlates of impaired perception of vibration among the AUD participants: Of these, age and volume of frontal precentral cortex were the most robust predictors.

Conclusions

This study supports CNS involvement in objective signs of neuropathy in AUD.
Distribution of the spider community in the olive grove agroecosystem (Portugal): potential bioindicators
Authors: Benhadi‐Marín Jacinto , Pereira José A. , Sousa José P. , Santos Sónia A.P.
Published: August 2019

Spiders are successful natural enemies in different crops. Research on the role of spiders as natural enemies within agroecosystems needs to address the distribution of their communities across different spatial scales, as well as the dominant species.

We studied the spatial distribution of the community of spiders of the olive agroecosystem in Northeastern Portugal and investigated potential species that could be used as bioindicators of agricultural management in the olive grove.

We found nine functional groups (ambushers, foliage runner hunters, ground hunters, orb‐web builders, sheet web builders, sensing web‐builders, space web builders, stalkers and wandering sheet/tangle weavers) encompassing a community that changed significantly across the horizontal and vertical gradient.

We propose Thanatus vulgaris Simon, 1870 as potential bioindicator for the ground of the olive grove central area and Ozyptila pauxilla (Simon, 1870) for the ground of the olive grove peripheral area.

Adjacent shrubland areas could play an important role in biological control of pests, allowing the exchange of species and individuals with the olive crop. The role of agrobiont species as indicators of agricultural managements deserves further investigation towards the enhancement of the effectiveness of spiders within low‐impact crop management in arable landscapes.
Inferring the population structure of the Maghreb sheep breeds using a medium‐density SNP chip
Authors: Ben Jemaa S. , Kdidi S. , Gdura A. M. , Dayhum A. S. , Eldaghayes I. M. , Boussaha M. , Rebours E. , Yahyaoui M. H.
Published: August 2019

North Africa has a great diversity of indigenous sheep breeds whose origin is linked to its environmental characteristics and to certain historical events that took place in the region. To date, few genome‐wide studies have been conducted to investigate the population structure of North African indigenous sheep. The objective of the present study was to provide a detailed assessment of the genetic structure and admixture patterns of six Maghreb sheep populations using the Illumina 50K Ovine BeadChip and comparisons with 22 global populations of sheep and mouflon. Regardless of the method of analysis used, patterns of multiple hybridization events were observed within all North African populations, leading to a heterogeneous genetic architecture that varies according to the breed. The Barbarine population showed the lowest genetic heterogeneity and major southwest Asian ancestry, providing additional support to the Asian origin of the North African fat‐tailed sheep. All other breeds presented substantial Merino introgression ranging from 15% for D'man to 31% for Black Thibar. We highlighted several signals of ancestral introgression between North African and southern European sheep. In addition, we identified two opposite gradients of ancestry, southwest Asian and central European, occurring between North Africa and central Europe. Our results provide further evidence of the weak global population structure of sheep resulting from high levels of gene flow among breeds occurring worldwide. At the regional level, signs of recent admixture among North African populations, resulting in a change of the original genomic architecture of minority breeds, were also detected.
Associations of Th2, Th17, Treg cells, and IgA+ memory B cells with atopic disease in children: The Generation R Study
Authors: Looman Kirsten I. M. , van Meel Evelien R. , Grosserichter‐Wagener Christina , Vissers Floor J. M. , Klingenberg Janice H. , de Jong Nicolette W. , de Jongste Johan C. , Pasmans Suzanne G. M. A. , Duijts Liesbeth , van Zelm Menno C. , Moll Henriëtte A.
Published: August 2019

Background

New insights into immune cells could contribute to treatment and monitoring of atopic disease. Because nongenetic factors shape the human immune system, we here studied these immune cells in a large cohort with atopic children with adjustment for prenatal and postnatal confounders.

Methods

Information on atopic dermatitis, inhalant‐ and food‐allergic sensitization, asthma lung function scores was obtained from 855 10‐year‐old children within the Generation R cohort. 11‐color flow cytometry was performed to determine CD27+ and CD27−IgG+, IgE+ and IgA+ memory B cells, Th1, Th2, Th17, and Treg‐memory cells from venous blood. Associations between any atopic disease, the individual atopic diseases, and immune cell numbers were determined.

Results

Children with any atopic disease had higher Th2, Treg, Treg‐memory, and CD27+IgA+ memory B‐cell numbers compared to children without atopic disease. When studying the individual diseases compared to children without the individual diseases, children with atopic dermatitis, inhalant‐, and food‐allergic sensitization had higher memory Treg cell numbers 12.3% (95% CI 4.2; 21.0), (11.1% (95% CI 3.0; 19.8), (23.7% (95% CI 7.9; 41.8), respectively. Children with food‐allergic sensitization had higher total B and CD27+IgA+ memory B‐cell numbers (15.2% [95% CI 3.2; 28.7], 22.5% [95% CI 3.9; 44.3], respectively). No associations were observed between asthma and B‐ or T‐cell numbers.

Conclusion

Children with any atopic disease and children with inhalant‐ and food‐allergic sensitization or atopic dermatitis had higher circulating memory Treg cells, but not higher IgE+B‐cell numbers. The associations of higher Treg and CD27+IgA+ B‐cell numbers in children with food‐allergic sensitization are suggestive of TGF‐β‐mediated compensation for chronic inflammation.
Comparison of tensile properties of xenopericardium from three animal species and finite element analysis for bioprosthetic heart valve tissue
Authors: Rassoli Aisa , Fatouraee Nasser , Guidoin Robert , Zhang Ze
Published: August 2019

Bioprosthetic heart valves still have poor long‐term durability due to calcification and mechanical failure. The function and performance of bioprostheses is known to depend on the collagen architecture and mechanical behavior of the target tissue. So it is necessary to select an appropriate tissue for such prostheses. In this study, porcine, equine, and bovine pericardia were compared histologically and mechanically. The specimens were analyzed under light microscopy. The planar biaxial tests were performed on the tissue samples by applying synchronic loads along the axial (fiber direction) and perpendicular directions. The measured biaxial data were then fitted into both the modified Mooney‐Rivlin model and the anisotropic four parameter Fung‐type model. The modified Mooney‐Rivlin model was applied to the modeling of the bovine, equine, and porcine pericardia using finite element analysis. The equine pericardium illustrated a wavy collagen bundle architecture similar to bovine pericardium, whereas the collagen bundles in the porcine pericardium were thinner and structured. Wavy pericardia may be preferable candidates for transcutaneous aortic valves because they are less likely to be delaminated during crimping. Based on the biaxial tensile test, the specimens indicated some degree of anisotropy; the anisotropy rates of the equine specimens were almost identical, and higher than the other two specimens. In general, porcine pericardium appeared stiffer, based on the greater strain energy magnitude and the average slope of the stress–stretch curves. Moreover, it was less distensible (due to lower areal strain) than the other two pericardial tissues. Furthermore, the porcine model induced localized high stress regions during the systolic and diastolic phases of the cardiac cycle. However, increased mechanical stress on the bioprosthetic leaflets may cause tissue degeneration and reduce the long‐term durability of the valve. Based on our observations, the pericardial specimens behaved as anisotropic and nonlinear tissues—well‐characterized by both the modified Mooney‐Rivlin and the Fung‐type models. The results indicate that, compared to bovine pericardium, equine tissue is mechanically and histologically more appropriate for manufacturing heart valve prostheses. The results of this study can be used in the design and manufacture of bioprosthetic heart valves.
Subfoveal choroidal thickness at age 9 years in relation to clinical and perinatal characteristics in the population‐based Generation R Study
Authors: Biyik Kevser Zehra , Tideman Jan Willem L. , Polling Jan Roelof , Buitendijk Gabriëlle H. S. , Jaddoe Vincent V. W. , Larsen Michael , Klaver Caroline C. W.
Published: August 2019

Purpose

To assess the association between clinical and perinatal characteristics and subfoveal choroidal thickness in 9‐year‐old children.

Methods

The study included data from the population‐based Generation R cohort, whose participants underwent cycloplegic refractometry, ocular biometry, height, weight and subfoveal choroidal thickness measurements using a swept‐source optical coherence tomography (SS‐OCT) instrument. Birth parameters were obtained using medical records. Statistical analyses were performed using multivariate regression models adjusted for age, ethnicity and sex.

Results

A total of 1018 children (52.5% girls, 47.5% boys) with a mean age of 9.9 ± 0.3 years and a mean cycloplegic spherical equivalent refraction of 0.80 ± 1.1 D in boys and 0.81 ± 1.4 in girls were eligible for analysis. The subfoveal choroid was 17 μm thicker in girls (298 ± 60.6 μm) than in boys (281 ± 55.0 μm; p < 0.001), a difference of 9.1 μm persisting after adjustment for age, ethnicity and axial length (p = 0.017). Subfoveal choroidal thickness decreased with increasing ocular axial length (−16.2 μm/mm, 95% CI −21.2 to −12.4, p < 0.001) and with increasing myopic refraction (−10.0 μm/D, 95% CI 6.8–13.1; p < 0.001, adjusted for age, ethnicity, axial length and sex) while it increased with increasing body height (1.3 μm/cm, 95% CI 0.8 to 1.9, p < 0.001). Additionally, choroidal thickness increased with increasing birthweight (13.0 μm/kg; 95% CI 0.006–0.020; p < 0.001) and increasing size for gestational age (8.2 μm/kg; 95% CI 4.6–11.8; p < 0.001). Smoking up until the time that pregnancy became known was associated with a thinner choroid (p = 0.016). There was no detectable effect of alcohol consumption. The distributions of axial length, refraction and choroidal thickness were narrower than in older populations.

Conclusion

The subfoveal choroid was thicker in girls than in boys, and higher body height, higher birthweight and larger size for gestational age were associated with a thicker subfoveal choroid. The implications of these findings for myopia development need further evaluation in longitudinal studies.
Extraperitoneal single‐port robot‐assisted radical prostatectomy: initial experience and description of technique
Authors: Kaouk Jihad , Valero Rair , Sawczyn Guilherme , Garisto Juan
Published: August 2019

Objective

To describe our technique of extraperitoneal single‐port (SP) robot‐assisted radical prostatectomy (RARP) and present our clinical experience with the first 10 cases.

Patients and Methods

In all, 10 consecutive patients diagnosed with localised prostate cancer underwent extraperitoneal SP‐RARP using the da Vinci SP® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). Exclusion criteria included previous surgery through an infra‐umbilical midline incision, prostate size >100 g, or preoperative evidence of extraprostatic disease. All surgeries were performed by a single surgeon with previous experience of >3000 cases in robotic surgery. Demographics and perioperative information were collected including: operative time, estimated blood loss (EBL), complications, length of stay, and days with Foley catheter. The extraperitoneal SP‐RARP is performed as follows. Firstly, a 3‐cm incision ~2 cm below the umbilicus is made. Dissection of the extraperitoneal space is achieved using a kidney shaped Spacemaker™ balloon (Covidien, Dublin, Ireland), placed through the infra‐umbilical incision caudally reaching the retropubic space. Thereafter, the balloon is deployed; the space is created and verified under direct vision with a laparoscopic endoscope. A GelPOINT® mini advanced access platform (Applied Medical, Rancho Santa Margarita, CA, USA) is inserted and a dedicated 25‐mm multichannel port is placed with a 12‐mm accessory laparoscopic port through the gel‐seal cap into the same incision. The da Vinci SP surgical platform robot is docked with the patient in a supine position. RARP is performed replicating the technique previously described for multi‐arm platforms or transperitoneal SP‐RARP. No drain and no additional assistant ports were utilised.

Results

The patient's ages ranged between 48 and 70 years, and the mean preoperative prostate‐specific antigen (PSA) level was 9 ng/mL. No conversions or intraoperative complications were recorded. The median (interquartile range) operative time was 197.5 (185.5–229.7) min. EBL ranged between 50 and 400 mL, six patients were discharged on the same day as the surgery and the median time with a Foley catheter after surgery was 8 days.

Conclusions

Extraperitoneal SP‐RARP is a feasible and safe surgical option to treat localised prostate cancer. In our early experience, promising results and possible advantages were found such as: a small single incision, no additional ports, no Trendelenburg positioning, minimal postoperative pain and use of opioids, and same day discharge. Further investigations need to be done to validate these advantages.
Family Welfare Effort, Total Fertility, and In Vitro Fertilization: Explaining the Israeli Anomaly
Authors: Shenhav‐Goldberg Rachel , Brym Robert , Lenton‐Brym Talia
Published: August 2019

The theory of family welfare effort is a leading macro‐sociological explanation of variation in human fertility. It holds that states which provide universally available, inexpensive, high‐quality day care, generous parental leave, and flexible work schedules lower the opportunity cost of motherhood. They thus enable women, especially those in lower socioeconomic strata, to have the number of babies they want. A considerable body of research supports this theory. However, it is based almost exclusively on analyses of Western European and North American countries. This paper examines the Israeli case because Israel's total fertility rate is anomalously high given its family welfare effort. Based on a review of the relevant literature and a reanalysis of data from various published sources, it explains the country's unusually high total fertility rate as the product of (1) religious and nationalistic sentiment that is heightened by the Jewish population's perception of a demographic threat in the form of a burgeoning Palestinian population and (2) the state's resulting support for pro‐natal policies, including the world's most extensive in vitro fertilization (IVF) system. The paper also suggests that Israel's IVF policy may not be in harmony with the interests of many women insofar as even women with an extremely low likelihood of becoming pregnant are encouraged to undergo the often lengthy, emotionally and physically painful, and risky process of IVF.
FoxP3 in Treg cell biology: a molecular and structural perspective
Authors: Deng G , Song X , Greene M I
Published: August 2019

Regulatory T cells (Tregs) are specialized in immune suppression and play a dominant role in peripheral immune tolerance. Treg cell lineage development and function maintenance is determined by the forkhead box protein 3 (FoxP3) transcriptional factor, whose activity is fine-tuned by its post-translational modifications (PTMs) and interaction partners. In this review, we summarize current studies in the crystal structures, the PTMs and interaction partners of FoxP3 protein, and discuss how these insights may provide a roadmap for new approaches to modulate Treg suppression, and new therapies to enhance immune tolerance in autoimmune diseases.
Sense of Belonging and Commitment as Mediators of the Effect of Community Features on Active Involvement in the Community
Authors: Zanbar Lea
Published: August 2019

Citizens’ active involvement in the community is aimed at improving their welfare and addressing social needs and other urban issues. The current study investigated factors that contribute to such involvement, and empirically examined the theoretical assumption that community belonging and commitment mediate their effect on community involvement. The sample consisted of 1,014 Israeli respondents who completed a self–report questionnaire tapping community features (size, social support, three dimensions of citizens’ perceptions of local services, and leaders), mediating variables representing the individual's attitudes toward the community (belonging, commitment), and the outcome of active involvement in the community. Path analysis supported by indirect effect examination indicated that the effect of some variables was fully mediated by community belonging and commitment. Elsewhere, the mediation reversed the direction of the effect, changing it from negative to positive. Theoretical and practical implications are discussed, including operative suggestions for professionals in the field of community interventions.
Environmental solutions sparked by environmental history
Authors: McAfee Dominic , Alleway Heidi K. , Connell Sean D.
Published: August 2019

Environmental solutions require a decision‐making process that is ultimately political, in that they involve decisions with uncertain outcomes and stakeholders with conflicting viewpoints. If this process seeks broad alignment between the government and public, then reconciling conflicting viewpoints is a key to the legitimacy of these decisions. We show that ecological baselines can be particularly powerful tools for creating a common understanding for public support (legitimacy) and conformity to new rules or regulations (legality) that enable the solution. They are powerful because they move the discussion of solutions from the abstract to the concrete by providing a conceptual model for a common expectation (e.g., restoring habitat). They provide narratives of the past (ecological histories) that readjust the future expectations of individuals on how to perceive and respond to new policy. While ecological baselines offer scientists benchmarks for reinstating ecological functions, they also normalize public and government discussion of solutions. This social normalization of public issues may assist government policy and influence social views, practices, and behaviors that adopt the policy. For science to more effectively inform conservation, we encourage interdisciplinary thinking (science‐ and human‐centered) because it can provide public support and government legitimacy for investing in environmental solutions.
The Ebola Crisis in Sierra Leone: Mediating Containment and Engagement in Humanitarian Emergencies
Authors: Enria Luisa
Published: August 2019

This article explores how framings of the 2014–16 outbreak of Ebola as a crisis, its causes, nature and consequences gave rise to two seemingly contradictory types of interventions within affected communities in Sierra Leone: a militarized state of emergency on the one hand, and efforts to foster local engagement and ownership on the other. Teasing out explicitly the underlying logic of these two modes of response, we are able to discern the convergence between containment and engagement approaches that are at the heart of contemporary humanitarianism. Rather than being opposed or contradictory, the article shows how they were mutually constitutive, through negotiations between different ways of knowing and responding to the Ebola crisis. The resulting divisive practices, juxtaposing ‘Ebola heroes’ and ‘dangerous bodies’, re‐ordered the landscapes that individuals had to navigate in order to manage uncertainty. Tracing these logics through to the ‘subjects’ of intervention, the article tells the story of one traditional healer's ‘epistemic navigations’ in his efforts to survive both the epidemic and its response. Bringing these dynamics and their consequences to the fore in the Sierra Leonean case invites broader reflections on a humanitarian assemblage increasingly reliant on the mutual constitution of containment and engagement, security and resilience, in its approach to managing ‘at risk’ populations.
Six‐year retrospective analysis of endoscopic ultrasonography‐guided pancreatic ductal interventions at a tertiary referral center
Authors: Dalal Ankit , Patil Gaurav , Maydeo Amit
Published: August 2019

Background and Aim

Endoscopic ultrasonography‐guided pancreatic ductal intervention (EUS‐PDI) serves as a rescue therapy in patients with failure of retrograde access to the pancreatic duct (PD) at the time of endoscopic retrograde pancreatography (ERP). We review our experience of this procedure.

Methods

This is a retrospective study of patients who underwent EUS‐PDI for an unsuccessful ERP and altered anatomy.

Results

A total of 44 (65.9% male) patients underwent EUS‐PDI with a mean age of 43.5 years, (range: 23–67). Transgastric rendezvous technique was carried out in 23/44 (52.3%), transgastric pancreaticogastrostomy in 18/44 (40.9%) and transduodenal pancreaticobulbostomy in 3/44 (6.8%). Overall technical and clinical success was seen in 88.6% (39/44) and 81.8% (36/44), respectively. Technical success of transgastric rendezvous was 95.6% and that of transgastric pancreaticogastrostomy was 77.8%. Two of seven patients with failure to access the PD had successfully undergone EUS‐PD stenting at subsequent attempt. Ten immediate adverse events (AE) were noted which included abdominal pain (n = 4), pancreatitis (n = 2), fever (n = 2), minor bleeding (n = 1), and stripping of wire (n = 1). Delayed AE included stent blockage in 12/39 (30.8%) and spontaneous stent migration in 5/39 (12.8%) which were managed with stent exchange at follow up. The rendezvous technique was associated with fewer AE than transgastric pancreaticogastrostomy.

Conclusions

Endoscopic ultrasonography‐PDI is an effective treatment modality and salvage therapy in patients with unsuccessful ERP. Technical and clinical success seen with this study is comparable to studies conducted across the world. EUS‐PDI needs to show cost‐effectiveness in future studies.
A rapid and holistic approach to screen susceptibility of Prunus species to Armillaria root rot
Authors: Devkota Pratima , Hammerschmidt Raymond
Published: August 2019

We describe a holistic in vitro technique for inoculating roots of Prunus species with Armillaria solidipes, which is faster and more successful than previous methods. This method allows associated active and passive host defences to be assessed. Sterile root segments of three Prunus spp. were placed next to or on top of 14‐day‐old cultures of A. solidipes. At 21 day, the success of fungal penetration and length of the fungal colonization, and host responses were evaluated. Also, an anti‐Armillaria and anti‐Cladosporium activity detection assays were conducted by utilizing the root periderm, the first tissue that needs to be penetrated by fungus. These methods revealed the variation in the relative tolerance of three Prunus spp. to A. solidipes. The overall success of fungal colonization in the wounded and intact root, host defence, and antifungal activity significantly differed among three Prunus spp. Results indicate that this in vitro method can be used as a preliminary step in screening tree species to Armillaria spp.
ALA‐PDT alleviates the psoriasis by inhibiting JAK signalling pathway
Authors: Yi Fei , Zheng Xiaoli , Fang Fang , Zhang Jiaan , Zhou Bingrong , Chen Xiangsheng
Published: August 2019

Background

Photodynamic therapy (PDT) with 5‐aminolevulinic acid (ALA) is a well‐known treatment for non‐hypertrophic actinic keratoses and superficial basal‐cell carcinomas.

Objectives

In this study, we first revealed that ALA‐PDT treatment effectively ameliorated the psoriasis‐like lesion in imiquimod (IMQ)‐induced mouse model and further explored the potential molecular mechanism and related signalling pathways during the treatment. Besides, we also confirmed a significant alleviation of ALA‐PDT therapy on IFN‐γ‐induced over‐proliferation of keratinocytes.

Methods

H&E staining was conducted to reveal the histological changes of mice in different groups. The different expression levels of RNA were illustrated by using QRT‐PCR. Western blot was performed to confirm the various expression levels of protein in mice. In vitro, cell proliferation and cell cycle were evaluated by cell counting kit‐8 and flow cytometry assay, respectively.

Results

The result showed that ALA‐PDT’s anti‐proliferation effect and regulation on Socs1/3, JAK1/2 and K17 in IFN‐γ‐induced keratinocytes were largely weakened by NAC, indicating that ALA‐PDT attenuated the proliferation of IFN‐γ‐induced keratinocytes by enhancing ROS level.

Conclusions

These results demonstrated that ALA‐PDT largely activated the productivity of Socs1/3 in a ROS‐dependent manner. Socs1/3 is a potential blocker in JAK signalling pathway and inhibits the proliferation and keratinization of keratinocytes in psoriasis.
Functional analysis of natural PCSK9 mutants in modern and archaic humans
Authors: Mikaeeli Sepideh , Susan‐Resiga Delia , Girard Emmanuelle , Ben Djoudi Ouadda Ali , Day Robert , Prost Stefan , Seidah Nabil G.
Published: August 2019

PCSK9 is the last member of the proprotein convertases (PCs) family and its gene is mutated in ~ 2% to 3% of individuals with familial hypercholesterolemia (FH). This protein enhances the degradation of the low‐density lipoprotein receptor (LDLR) and hence increases the levels of circulating LDL‐cholesterol (LDLc). Studies of the underlying mechanism(s) regulating the activity of different mutations in the PCSK9 gene are ongoing as they enhance our understanding of the biology and clinical relevance of PCSK9 and its partners. In an attempt to unravel the regulation of PCSK9 transcription and possibly identify mutation ‘hot spot’ regions with alterations in CpG methylation, we present for the first time the complete methylome profile of the PCSK9 gene in modern and archaic humanoids. Our data showed that the genomes of modern humans and archaic PCSK9 exhibit a similar methylation pattern. Next, we defined the mechanistic consequences of three PCSK9 natural mutations (PCSK9‐R96L, ‐R105W, and ‐P174S) and one archaic Denisovan mutation (PCSK9‐H449L) using various complementary cellular and in vitro binding assays. Our results showed that the PCSK9‐H449L is a loss‐of‐function (LOF) mutation, likely due to its lower binding affinity to the LDLR. Similarly, PCSK9‐R96L and ‐R105W are LOF mutations, even though they have been identified in FH patients. The PCSK9‐R105W mutation leads to a significantly lower autocatalytic processing of proPCSK9. PCSK9‐P174S resulted in a LOF in both extracellular and intracellular pathways. In conclusion, our extensive analyses revealed that all studied mutations result in PCSK9 LOF, via various mechanisms, leading to lower levels of LDLc.
Vom Unsagbaren sprechen. Trauma in Psychologie und Literatur am Beispiel Paul Celans
Authors: Hutmacher Fabian
Published: August 2019

Für Psychologen sind Traumastörungen das Resultat einer pathologischen Erinnerungsstruktur: Traumatische Erlebnisse lassen den Betroffenen keine Ruhe und entziehen sich ihrer Kontrolle. Dementsprechend stellt der Versuch, traumatische Erlebnisse im Rahmen einer Erzählung artikulierbar zu machen, einen zentralen Ansatzpunkt traumatherapeutischer Interventionen dar. Eine Übertragung dieser klinisch‐psychologischen Einsichten auf die Analyse literarischer Texte, in denen sich jemand traumatische Erlebnisse von der Seele schreibt, liegt deshalb nahe. Gleichzeitig ist so eine Übertragung nicht unproblematisch: Wer beispielsweise die als Reaktion auf die Shoah entstandenen Texte als individuelle Bewältigungsversuche einzelner Traumatisierter im Sinne einer Schreibtherapie zu lesen versucht, verkennt den kollektiven Rahmen, in dem dieses Ringen um Worte stattfand. Dieser Aufsatz illustriert dies beispielhaft an Leben und Werk Paul Celans.
Body fat accrual trajectories for a sample of Asian‐Canadian and Caucasian‐Canadian children and youth: A longitudinal DXA‐based study
Authors: McConnell‐Nzunga Jennifer , Naylor Patti‐Jean , Macdonald Heather M. , Rhodes Ryan E. , Hofer Scott M. , McKay Heather A.
Published: August 2019

Background

Body fat accrual trajectories can be used to monitor trends in body fat mass and identify potential health risks. Currently, no body fat percent (BF%) centile distance and velocity curves exist for Canadian youth.

Objectives

To develop sex‐specific and ethnic‐specific BF% centile distance and velocity curves for White and Asian‐Canadian youth.

Methods

We utilized 4734 observations from 944 participants (female = 487; Asian = 532) to create sex‐specific BF% velocity curves for age 10 to 18 years and sex‐specific and ethnic‐specific BF% percentile distance curves for ages 9 to 18 years for White and Asian children. BF% was derived from whole body DXA scans.

Results

BF% centile distance curves for Asian and White girls were similar. BF% at most centiles plateaued around age 16 for Asian but not for White boys. Velocity curves for boys declined from age 11 to 13 years and then increased until age 18 years. For girls from 10 to 15 years, velocity curves converged towards the 50th centile then remained flat from 16 to 18 years.

Conclusions

BF% distance and velocity centiles can be used to identify when an individual veers from an average BF% accrual trajectory. In future, these curves may be used to investigate differences in fat mass and accrual across Canada.
Introduction of portable bedside echocardiography to acute general medicine
Authors: Maxwell Allan Gordon , Jardine David L.
Published: August 2019

We reviewed the medical records of all patients who underwent portable bedside echocardiography under general medicine over a 15‐month period. The mean age of patients was 67 years (range 16–95) (n = 201). Indications for scanning included syncope (27%), murmur (17%) and dyspnoea (14%); findings included valve abnormalities (46%), left ventricular hypertrophy (26%) and dilated left ventricle (15%). Bedside echocardiography is a useful extension of the physical examination but is operator‐dependent, and its routine use in general medicine will depend on the availability of training, group reporting sessions and quality assurance.
Seasonality of hip fracture and vitamin D deficiency persists in a sub‐tropical climate
Authors: Lara Alvarez Sonia E. , Bell Kate , Ward Nicola , Cooke Cameron , Inder Warrick J.
Published: August 2019

Both hip fractures and vitamin D (25‐hydroxyvitamin D (25‐OHD)) deficiency are more common in winter in regions with temperate climates, but few data exist for a sub‐tropical climate. In a South East Queensland tertiary hospital over a 7‐year period, there were significantly more hip fractures in winter than the other three seasons (analysis of variance P = 0.003), with associated higher frequency of 25‐OHD deficiency – 42.5% in winter compared to 28.5% in summer, odds ratio 1.86 (95% confidence interval 1.35–2.56), P = 0.0001. Seasonality of hip fracture and 25‐OHD deficiency occurs even in a sub‐tropical climate.
Do Opioids Help Injured Workers Recover and Get Back to Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability
Authors: Savych Bogdan , Neumark David , Lea Randall
Published: August 2019

We estimate the effect of opioid prescriptions on the duration of temporary disability benefits among workers with work‐related low‐back injuries, based on variation in local opioid prescribing patterns, which predict whether injured workers receive opioid prescriptions. More longer term opioid prescribing leads to considerably lengthier durations of temporary disability.
Effect of furosemide on muscle cramps in patients with liver cirrhosis
Authors: Sawada Yasuhiko , Kawaratani Hideto , Kubo Takuya , Fujinaga Yukihisa , Furukawa Masanori , Saikawa Soichiro , Sato Shinya , Takaya Hiroaki , Kaji Kosuke , Shimozato Naotaka , Moriya Kei , Namisaki Tadashi , Akahane Takemi , Mitoro Akira , Yoshiji Hitoshi
Published: August 2019

Background and Aim

Patients with cirrhosis usually experience muscle cramps of varying severity. Although diuretics have been reported to cause muscle cramps, clinical evidence is limited. Also, it has been pointed out that the use of diuretics is associated with the progression of sarcopenia in patients with cirrhosis. We conducted a questionnaire survey to clarify the effects of diuretics and skeletal muscle loss on muscle cramps.

Methods

Overall, we enrolled 152 adults with cirrhosis in this study. Cramp questionnaires were obtained after informed consent. Study variables (demographics, physical findings, serum metabolic panel, and drugs taken that affect muscle cramps) were extracted from medical records. Body composition, including muscle volume, was analyzed using a bioelectrical impedance analysis method, and muscle strength (handgrip) was evaluated at enrollment. Cross‐sectional skeletal muscle area was evaluated on computed tomography imaging at the L3 vertebral level to investigate the relationship between muscle cramps and sarcopenia.

Results

The proportion of furosemide administration was higher in patients with cramping compared with those without. On a multivariate logistic regression analysis, furosemide use was a significant factor in the presence of muscle cramps. Furthermore, regarding factors contributing to muscle cramp severity, furosemide use was extracted by multivariate logistic regression analysis. In the presence or severity of muscle cramps, skeletal muscles did not show any significant difference.

Conclusions

Furosemide use for patients with cirrhosis was considered a risk factor for occurrence and severity of muscle cramps. On the other hand, skeletal muscle mass loss was not associated with muscle cramps.
Driving Fitness in Different Forms of Dementia: An Update
Authors: Toepper Max , Falkenstein Michael
Published: August 2019

BACKGROUND/OBJECTIVES

Most forms of dementia are associated with progressive cognitive and noncognitive impairments that can severely affect fitness to drive. Whether safe driving is still possible in the single case, however, is often difficult to decide and may be dependent on both severity and type of the respective dementia syndrome. Particularly in early disease stages, Alzheimer disease dementia (ADD) and different types of non‐Alzheimer dementias, such as vascular dementia (VaD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB), and Parkinson disease dementia (PDD), might differentially affect fitness to drive.

DESIGN

To examine the effects of severity and type of dementia on driving fitness, we conducted a systematic review with qualitative narrative synthesis, involving different driving outcomes in different forms and stages of dementia.

SETTING

Literature research included MEDLINE and PsycINFO databases with a focus on the most relevant and recent publications on the topic.

PARTICIPANTS

The population of interest included older drivers in different stages of ADD and different forms of non‐Alzheimer dementias (VaD, FTD, DLB, and PDD).

MEASUREMENTS

Narrative description of driving outcomes in the population of interest.

RESULTS

Overall, previous studies suggest that driving fitness is severely impaired in moderate and severe dementia, irrespective of the type of dementia. In milder disease stages, fitness to drive appears to be more severely impaired in non‐Alzheimer dementias than in ADD, since the non‐Alzheimer syndromes are not only associated with driving‐relevant cognitive but noncognitive risk factors, such as behavioral or motor symptoms.

CONCLUSIONS

Based on these findings, practical recommendations are presented, including a risk evaluation for driving safety, depending on severity and type of different dementia syndromes. J Am Geriatr Soc 67:2186–2192, 2019
BEYOND THE STARS
Authors: Sterck Olivier
Published: August 2019

It is frequent to hear in economic seminars or read in academic papers that an effect is economically significant or economically important. Yet, the economic literature is vague on what economic importance means and how it should be measured. In this paper, I show that existing measures of economic importance are flawed and misused. I derive a new metric that measures, in percentage terms, the contribution of each explanatory variable to deviations in the dependent variable, ceteris paribus. As an illustration, the method is applied to study the determinants of migration and the determinants of fertility.
Establishment of patient‐derived xenograft model in ovarian cancer and its influence factors analysis
Authors: Wu Jianfa , Zheng Yunxi , Tian Qi , Yao Ming , Yi Xiaofang
Published: August 2019

Aim

Patient‐derived xenograft (PDX) model has been applied to the study of breast cancer, lung cancer, colon cancer and other cancers. However, its feasibility in ovarian cancer has not been understood. This study aimed to establish ovarian cancer PDX model and reveal its influence factors.

Methods

In this study, 27 patients in Obstetrics and Gynecology Hospital affiliated to Fudan University from May 2015 to May 2016 were employed to explore the method of PDX model in ovarian cancer and verify its feasibility.

Results

Finally, five cases of PDX models were successfully established, and the tumor formation rate (TFR) was 18.52%. In addition, immunohistochemistry and transcriptome sequencing analysis showed that tumor of PDX model have similar gene expression, gene splicing, gene fusion and single nucleotide polymorphisms with primary tumor (R2 = 0.741). Furthermore, it was revealed that compared to epithelial ovarian cancer, the TFR of PDX models with nonepithelial ovarian cancer was higher, while other factors such as the initiation site of tumor, the degree of tumor malignancy, the stage of tumor, the type of tumor and the species of experimental animals were not associated with the TFR.

Conclusion

Ovarian cancer PDX model, as a new scientific research model, can better keep the biological characteristics of primary tumor, which has great research value in ovarian cancer.
The dynamic effect of direct‐acting antiviral treatments on the risk of hepatocellular carcinoma in patients with cirrhosis and chronic hepatitis C
Authors: Lusivika‐Nzinga Clovis , Fontaine Hélène , Dorival Céline , Simony Mélanie , Pol Stanislas , Carrat Fabrice ,   the ANRS/AFEF Hepather study group
Published: August 2019

There is still some controversy over a potentially increased short‐term risk of developing hepatocellular carcinoma (HCC) after the initiation of direct‐acting antiviral (DAA) therapy, even though a decreased long‐term risk of HCC has been reported following a sustained virological response in patients with chronic hepatitis C virus (HCV) infection. We characterized the time‐varying effect of DAAs on the risk of the occurrence of HCC in patients with cirrhosis and HCV infection. We analysed patients with cirrhosis and chronic HCV infection from the ANRS CO22 HEPATHER cohort study. We excluded patients with active HBV coinfection, liver transplantation or a past history of HCC. We used a flexible weighted effect cumulative exposure Cox model to characterize the time‐varying effect of DAAs on the risk of HCC. A total of 3595 patients, mean age 59.3 years old, 65% men, were eligible for the study. Median follow‐up was 36.8 months (IQR 24.6‐47.1). DAAs were started during follow‐up in 3292 patients. Three hundred and fifty‐six HCCs were reported (275 treated, 81 untreated). Overall, a constant decrease in the risk of occurrence of HCC (vs untreated) was found from the start of treatment. Results were similar in patients without a history of decompensated cirrhosis (DC). Analysis of patients with a past history of DC showed a nonsignificant increase in the occurrence of HCC over the first 6 months, while the HR was significantly decreased at 14 months. These findings support the urgent initiation of DAAs in all patients.
A scoping review of social‐behaviour change techniques applied in complementary feeding interventions
Authors: Webb Girard Aimee , Waugh Emma , Sawyer Sarah , Golding Lenette , Ramakrishnan Usha
Published: August 2019

Education and other strategies to promote optimal complementary feeding can significantly improve practices, but little is known about the specific techniques successful interventions use to achieve behaviour change. We reviewed the literature for complementary feeding interventions in low‐/middle‐income countries (LMIC) published since 2000. We systematically applied a validated taxonomy mapping process to code specific behaviour change techniques (BCTs) used in each intervention; effectiveness ratios for each BCT were estimated. Sixty‐four interventions met inclusion criteria, were abstracted, BCTs identified, and coded. Dietary diversity was the most commonly assessed component of complementary feeding, and interpersonal communication, either individually or in groups, was the most commonly used delivery platform. Of the 93 BCTs available for mapping, the 64 interventions included in this review applied a total of 28 BCTs. Interventions used a median of six techniques (max = 13; min = 2). All interventions used “instruction on how to perform the behaviour.” Other commonly applied BCTs included “use of a credible source” (n = 46), “demonstration of the behaviour” (n = 35), and “providing information about health consequences” (n = 30). Forty‐three interventions reported strategies to shift the physical or social environment. Among BCTs used in >20 interventions, five had effectiveness ratios >0.8: “provision of/enabling social support”; “providing information about health consequences”; “demonstration of the behaviour”; and “adding objects to the environment” namely, food, supplements, or agricultural inputs. The limited reporting of theory‐based BCTs in complementary feeding interventions may impede efforts to improve and scale effective programs and reduce the global burden of malnutrition.