bluuebunny/crossref_metadata_2025 huggingface dataset:
PNPT1, MYO15A, PTPRQ, and SLC12A2‐associated genetic and phenotypic heterogeneity among hearing impaired assortative mating families in Southern India
Authors: Vanniya. S Paridhy , Chandru Jayasankaran , Jeffrey Justin Margret , Rabinowitz Tom , Brownstein Zippora , Krishnamoorthy Mathuravalli , Avraham Karen B. , Cheng Le , Shomron Noam , Srisailapathy C. R. Srikumari
Published: August 2021

The study was conducted between 2018 and 2020. From a cohort of 113 hearing impaired (HI), five non‐DFNB12 probands identified with heterozygous CDH23 variants were subjected to exome analysis. This resolved the etiology of hearing loss (HL) in four South Indian assortative mating families.

Six variants, including three novel ones, were identified in four genes: PNPT1 p.(Ala46Gly) and p.(Asn540Ser), MYO15A p.(Leu1485Pro) and p.(Tyr1891Ter), PTPRQ p.(Gln1336Ter), and SLC12A2 p.(Pro988Ser). Compound heterozygous PNPT1 variants were associated with DFNB70 causing prelingual profound sensorineural hearing loss (SNHL), vestibular dysfunction, and unilateral progressive vision loss in one family. In the second family, MYO15A variants in the myosin motor domain, including a novel variant, causing DFNB3, were found to be associated with prelingual profound SNHL. A novel PTPRQ variant was associated with postlingual progressive sensorineural/mixed HL and vestibular dysfunction in the third family with DFNB84A. In the fourth family, the SLC12A2 novel variant was found to segregate with severe‐to‐profound HL causing DFNA78, across three generations. Our results suggest a high level of allelic, genotypic, and phenotypic heterogeneity of HL in these families. This study is the first to report the association of PNPT1, PTPRQ, and SLC12A2 variants with HL in the Indian population.
Laparoscopic totally extraperitoneal hernia repair performed by surgical trainees: overcoming the learning curve
Authors: Hannan Enda , Duggan William , Harding Tim , Brosnan Conor , Maguire Donal , Stafford Anthony T
Published: August 2021

Background

Surgical trainees struggle to obtain experience in laparoscopic inguinal hernia repair (LIHR) due to a perceived steep learning curve. The purpose of this study was to compare outcomes in totally extraperitoneal (TEP) repair performed by surgical consultants and trainees under supervision as part of a standardised training regimen to assess the safety of residency training in this technique.

Methods

A retrospective review of patients managed by TEP repair by either a consultant or a supervised trainee was performed. Demographic, perioperative and postoperative data were collected and compared. All trainees underwent a standardised approach to teaching TEP repair.

Results

Trainees performed 133 procedures and consultants performed 121 procedures. Estimated blood loss was minimal in both cohorts. A significant difference was noted in mean operating time between consultants and trainees (33 vs. 50 min). However, it was also observed that the trainee mean operating time reduced significantly with experience (from 61 to 42 min). No statistically significant difference was demonstrated in postoperative complications, recurrence rate or length of stay. All trainees achieved the ability to complete a laparoscopic TEP repair under unscrubbed consultant supervision during a 1‐year placement.

Conclusion

With senior supervision and in the presence of a structured training regimen, trainees can safely and effectively perform LIHR, progressing to performing the procedure under unscrubbed consultant supervision. This is valuable information that can serve to inform the structure and direction of surgical training programmes as the ability to offer LIHR is increasingly becoming an expectation of consultant surgeons.
Long‐term outcomes of breast reconstruction and the need for revision surgery
Authors: Finlay Ben , Kollias Victoria , Hall Kelly A. , Clement Zackariah , Bingham Janne , Whitfield Robert , Kollias James , Bochner Melissa
Published: August 2021

Background

Breast reconstruction (BR) often forms part of a patient's breast cancer journey. Revision surgery may be required to maintain the integrity of a BR, although this is not commonly reported in the literature. Different reconstructive methods may have differing requirements for revision. It is important for patients and surgeons to understand the factors leading to the need for revision surgery.

Methods

This retrospective cohort study analyses BRs performed by oncoplastic breast surgeons in public and private settings between 2005 and 2014, with follow‐up until December 2018. Surgical and patient factors were examined, including types of BR, complications and reasons for revision surgery.

Results

A total of 390 women with 540 reconstructions were included, with a median follow‐up of 61 months. Twenty‐eight percent (151/540) of reconstructions required at least one revision operation. Overall, implant‐based reconstructions (direct‐to‐implant [DTI] and two‐stage expander‐implant) had a higher revision rate compared to pedicled flap reconstructions (odds ratio 1.91, 95% confidence interval 1.08, 3.38). DTI reconstructions had the highest odds, and pedicled flap without implants the lowest odds of requiring revision. Post‐reconstruction radiotherapy increased the chance of revision surgery, while pre‐reconstruction radiotherapy did not. Odds of revision were higher in implant‐based reconstructions compared to pedicled flap reconstructions that had radiotherapy. Other factors increasing the rates of revision surgery were being a current smoker and post‐operative infection.

Conclusion

Almost one‐third of reconstructive patients require revision surgery. Autologous pedicled flap reconstructions have lower rates of revision compared to implant‐based reconstructions. Radiotherapy increases the need for revision surgery, particularly in implant‐based reconstructions.
Mental health monitoring in parents after very preterm birth
Authors: Vriend Eline , Leemhuis Aleid , Flierman Monique , van Schie Petra , Nollet Frans , Jeukens‐Visser Martine
Published: August 2021

Aim

To evaluate parental mental health monitoring during follow‐up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age.

Methods

Parents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers.

Results

In 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status.

Conclusion

The mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow‐up care.
Free‐range system and supplementation of 25‐hydroxicholecalciferol increases the performance and serum vitamin levels in mixed‐parity sows
Authors: Panisson Josiane C. , Oliveira Nathália C. , Sá‐Fortes Cristina M. , Passos Adsos A. , da Silva Claudia C. , Araújo Wagner A. G. , Lopes Idael M. G. , Costa Gleison M. S. , Ataíde Iara Q. , Silva Bruno A. N.
Published: August 2021

Improvements in sow productivity have raised questions regarding dietary vitamin D recommendations. The present study aimed to evaluate the effects of the housing system with access to sunlight exposure and supplementation of 25‐hydroxicholecalciferol on performance and serum levels of 25(OH)D3in sows during gestation and lactation. Sows were distributed in an experimental design with two housing systems: gestation crates or gestation free‐range system with external area for sunlight exposure; and two diets: 0 or 50 μg of 25‐hydroxicholecalciferol kg−1. The use of 25‐hydroxicholecalciferol tended (P = 0.052) to improve total born and influenced (P = 0.046) on number of born alive. Litter weight at birth was also increased (P = 0.01) by 25‐hydroxicholecalciferol supplementation; 25‐hydroxicholecalciferol supplementation and housing system (free‐range with sunlight exposure) tended to increase weaning weight (P = 0.07) and litter daily gain (P = 0.051) during lactation. Exposure to sunlight and 25‐hydroxicholecalciferol supplementation increased 25(OH)D3serum levels when compared with control treatment during gestation (136.95 vs. 113.92 ng mL−1;P = 0.035) and lactation (120.29 vs. 88.93 ng mL−1;P = 0.026). In conclusion, the association of 25‐hydroxicholecalciferol supplementation with exposure to sunlight during gestation improved significantly 25(OH)D3serum levels and consequently performance traits in gestation and lactation.
Analysis of fecal nutrients and particle size in captive proboscis monkeys (Nasalis larvatus) fed seasonal dietary foliage at a Japanese zoo
Authors: Kawasaki Ryuta , Kawakita Maki , Kurosawa Kenta , Asano Sanae , Kajikawa Hiroshi
Published: August 2021

One male and three female captive proboscis monkeys (Nasalis larvatus) were used as test animals to compare fecal nutrients after being fed seasonal foliage. Foliage and fecal samples were collected during three seasons (spring, summer, and winter). We analyzed crude ash (CA), ether extract (EE), crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), and acid detergent lignin (ADL). In addition to the above components, for the fecal samples, we examined total fecal nitrogen (TFN), nitrogen in fecal NDF (NDF‐N), metabolic fecal nitrogen (MFN), and particle size distribution (MPS). Seasonal differences in foliage components were observed, with NDF and ADF being lowest in spring (p < 0.05). Fecal NDF and ADF also tended to be lowest in spring. Further, the distribution of fecal particle size indicated that MPS tended to increase in winter. The mean fecal NDF content (47.4%) for all three seasons measured in this study was as much as 1.3 times lower than previously reported values in free‐ranging specimens. These data provide useful information that can be used to find some suitable food items for the endangered highly folivorous monkeys in captivity.
Out‐of‐hospital cardiac arrest and differential risk of cardiac and non‐cardiac QT‐prolonging drugs in 37 000 cases
Authors: Eroglu Talip E. , Barcella Carlo A. , Blom Marieke T. , Mohr Grimur H. , Souverein Patrick C. , Torp‐Pedersen Christian , Folke Fredrik , Wissenberg Mads , de Boer Anthonius , Schwartz Peter J. , Gislason Gunnar H. , Tan Hanno L. ,   for the ESCAPE‐NET Investigators
Published: August 2021

Aims

Drugs that prolong the QT interval, either by design (cardiac QT‐prolonging drugs: anti‐arrhythmics) or as off‐target effect (non‐cardiac QT‐prolonging drugs), may increase the risk of ventricular arrhythmias and out‐of‐hospital cardiac arrest (OHCA). Risk mitigation measures were instituted, in particular, surrounding prescription of cardiac QT‐prolonging drugs. We studied OHCA risk of both drug types in current clinical practice.

Methods

Using data from large population‐based OHCA registries in the Netherlands and Denmark, we conducted two independent case–control studies. OHCA cases with presumed cardiac causes were matched on age/sex/index date with up to five non‐OHCA controls. We calculated odds ratios (ORs) for the association of cardiac or non‐cardiac QT‐prolonging drugs with OHCA risk using conditional logistic regression analyses.

Results

We identified 2503 OHCA cases and 10 543 non‐OHCA controls in the Netherlands, and 35 017 OHCA cases and 175 085 non‐OHCA controls in Denmark. Compared to no use of QT‐prolonging drugs, use of non‐cardiac QT‐prolonging drugs (Netherlands: cases: 3.0%, controls: 1.9%; Denmark: cases: 14.9%, controls: 7.5%) was associated with increased OHCA risk (Netherlands: OR 1.37 [95% CI: 1.03–1.81]; Denmark: OR 1.63 [95% CI: 1.57–1.70]). The association between cardiac QT‐prolonging drugs (Netherlands: cases: 4.0%, controls: 2.5%; Denmark: cases: 2.1%, controls: 0.9%) and OHCA was weaker (Netherlands: OR 1.17 [95% CI: 0.92–1.50]; Denmark: OR 1.21 [95% CI: 1.09–1.33]), although users of cardiac QT‐prolonging drugs had more medication use and comorbidities associated with OHCA risk than users of non‐cardiac QT‐prolonging drugs.

Conclusion

In clinical practice, cardiac QT‐prolonging drugs confer lower OHCA risk than non‐cardiac QT‐prolonging drugs, although users of the former have higher a priori risk. This is likely due to risk mitigation measures surrounding prescription of cardiac QT‐prolonging drugs.
Decoding the intricacies of the mast cell compartment
Authors: Carter Melody C. , Metcalfe Dean D.
Published: August 2021

Historically, understanding of the human mast cell (MC) compartment has lagged behind the appreciation of other cell lineages. MCs exist in vascularised tissues but do not under normal circumstances circulate in blood, and there has been no pharmacological agent identified that totally and selectively inhibits human MC function. There are no substantiated accounts of an apparently healthy individual who is severely lacking in MCs. Thus, some of the approaches employed to understand the function of a specific immune cell are not available to the MC biologist. The disease categories that have provided the greatest insight into MC biology have been monoclonal and IgE‐mediated MC disorders. This has led to the categorisation of MC diseases as intrinsic or extrinsic to the MC compartment and to the recognition of the role of mediators in MC activation disorders. Mastocytosis as a clonal disorder not only impacts the MC compartment through changes intrinsic to the MC, but also by the effects of episodes of significant release of MC mediators. The availability of newer therapeutic approaches developed to treat monoclonal MC disorders offer insights into how to more selectively approach management of MC centric diseases.
Observing physicians acting with different levels of empathy modulates later assessed pain tolerance
Authors: Käthner Ivo , Eidel Matthias , Häge Anne‐Sophie , Gram Annika , Pauli Paul
Published: August 2021

Objectives

The patient–physician relationship is essential for treatment success. Previous studies demonstrated that physicians who behave empathic in their interaction with patients have a positive effect on health outcomes. In this study, we investigated if the mere perception of physicians as empathic/not empathic modulates pain despite an emotionally neutral interaction with the patients.

Methods

N = 60 women took part in an experimental study that simulated a clinical interaction. In the paradigm, each participant watched two immersive 360° videos via a head‐mounted display from a patient’s perspective. The physicians in the videos behaved either empathic or not empathic towards a third person. Importantly, these physicians remained emotionally neutral in the subsequent virtual interaction with the participants. Finally, participants received a controlled, painful pressure stimulus within the narratives of the videos.

Results

The physicians in the high compared with the low empathy videos were rated as more empathic and more likable, indicating successful experimental manipulation. In spite of later neutral behaviour of physicians, this short observation of physicians’ behaviour towards a third person was sufficient to modulate pain tolerance of the participants.

Conclusions

The finding of this study that the mere observation of physicians’ behaviour towards a third person modulates pain, despite a neutral direct interaction with the participants, has important clinical implications. Further, the proposed paradigm enables investigating aspects of patient–physician communication that are difficult to examine in a clinical setting.
What do we know about growth of vessel elements of secondary xylem in woody plants?
Authors: Miodek Adam , Gizińska Aldona , Włoch Wiesław , Kojs Paweł
Published: August 2021

Despite extensive knowledge about vessel element growth and the determination of the axial course of vessels, these processes are still not fully understood. They are usually explained as resulting primarily from hormonal regulation in stems. This review focuses on an increasingly discussed aspect – mechanical conditions in the vascular cambium. Mechanical conditions in cambial tissue are important for the growth of vessel elements, as well as other cambial derivatives. In relation to the type of stress acting on cambial cells (compressiveversustensile stress) we: (i) discuss the shape of the enlarging vessel elements observed in anatomical sections; (ii) present hypotheses regarding the location of intrusive growth of vessel elements and cambial initials; (iii) explain the relationship between the growth of vessel elements and fibres; and (iv) consider the effect of mechanical stress in determining the course of a vessel. We also highlight the relationship between mechanical stress and transport of the most extensively studied plant hormone – auxin. We conclude that the integration of a biomechanical factor with the commonly acknowledged hormonal regulation could significantly enhance the analysis of the formation of vessel elements as well as entire vessels, which transport water and minerals in numerous plant species.
Tumor‐associated macrophage‐derived transforming growth factor‐β promotes colorectal cancer progression through HIF1‐TRIB3 signaling
Authors: Liu Changfu , Zhang Weihao , Wang Junfeng , Si Tongguo , Xing Wenge
Published: August 2021

Tumor‐associated macrophages (TAMs), one of the most common cell components in the tumor microenvironment, have been reported as key contributors to cancer‐related inflammation and enhanced metastatic progression of tumors. To explore the underlying mechanism of TAM‐induced tumor progression, TAMs were isolated from colorectal cancer patients, and the functional interaction with colorectal cancer cells was analyzed. Our study found that coculture of TAMs contributed to a glycolytic state in colorectal cancer, which promoted the stem‐like phenotypes and invasion of tumor cells. TAMs produced the cytokine transforming growth factor‐β to support hypoxia‐inducible factor 1α (HIF1α) expression, thereby upregulating Tribbles pseudokinase 3 (TRIB3) in tumor cells. Elevated expression of TRIB3 resulted in activation of the β‐catenin/Wnt signaling pathway, which eventually enhanced the stem‐like phenotypes and cell invasion in colorectal cancer. Our findings provided evidence that TAMs promoted colorectal cancer progression in a HIF1α/TRIB3‐dependent manner, and blockade of HIF1α signals efficiently improved the outcome of chemotherapy, describing an innovative approach for colorectal cancer treatment.
Racial discrimination and the moderating effects of racial and ethnic socialization on the mental health of Asian American youth
Authors: Park Michael , Choi Yoonsun , Yasui Miwa , Hedeker Donald ,   Specificity, Commonality, and Generalizability in Social‐Emotional Development Special Section Editors
Published: August 2021

This study investigates trajectories of racial discrimination, racial and ethnic socialization (RES), and their interaction effects with social positions (nativity and gender) on mental health. A longitudinal study of 786 Filipino American (FA) and Korean American (KA) youth from the Midwestern United States (Mage.Wave1 = 15) confirmed that discrimination increased and significantly contributed to the upward trend of mental health distress, whereas the impact of RES differed by its type and by ethnicity. For example, promotion of mistrust and ethnic‐heritage socialization were protective among U.S.‐born FA youth, but for KA youth, preparation for bias was protective regardless of nativity and gender. This study highlights the importance of considering social positions to better understand the role of RES in youth psychological adjustment.
Ethics of folk medicine among the Igbo
Authors: Ogu John Mark
Published: August 2021

Folk medicine, also known as traditional medicine, is an ancient cultural practice used to contain and manage illnesses and diseases. It is not wrong to say that western/modern medicine developed from folk medicine because medicine was practiced with herbs, divination, and superstition. Some people continue to rely on spiritual powers, divination, and herds in treating ill health. Folk medicine continues to be an integral part of healthcare among many ethnic groups despite the advent of western/modern medicine. Its preference and resilience are based on tradition, choice, inexpensiveness, and easy access. Omenala‐tradition is the foundation of folk, and its operating principle is Ọfọ and Ogu. This work looks at the main ethical underpinnings of Igbo folk medicine of South‐Eastern Nigeria in the context of Omenala. It concludes that the ethical principle of Ọfọ and Ogu make treatment efficacious, promote patient‐healer relationships, and guides healers and patients.
Association of peripapillary hyper‐reflective ovoid masslike structures and disease duration in primary progressive multiple sclerosis
Authors: Wicklein Rebecca , Wauschkuhn Josephine , Giglhuber Katrin , Kümpfel Tania , Hemmer Bernhard , Havla Joachim , Knier Benjamin
Published: August 2021

Background and purpose

Peripapillary hyper‐reflective ovoid masslike structures (PHOMS) are a novel finding during retinal optical coherence tomography in patients with multiple sclerosis (MS). To date, there are no data on the occurrence of PHOMS in early MS. The aim of this study was to investigate the frequency of PHOMS in patients with first diagnosed early relapsing–remitting MS (RRMS) and to search for associations of PHOMS with disease patterns in different MS subtypes.

Methods

This was a cross‐sectional analysis in two different cohorts: cohort 1, consisting of early RRMS patients (n = 349); cohort 2, consisting of patients with primary progressive MS (PPMS) (n = 66) and RRMS (n = 65).

Results

Peripapillary hyper‐reflective ovoid masslike structures were detected in 18.3% of patients with early RRMS. The occurrence of PHOMS was not associated with age, disease duration and disability. Investigating clinical patterns and the occurrence of PHOMS (cohort 2), an association of PHOMS with higher Expanded Disability Status Scale measures (PHOMS 4.9, 3.7–6.1; no PHOMS 3.5, 3.0–5.3; p = 0.03) and longer disease durations (PHOMS 6.5 years, 1.9–11.0; no PHOMS 1.0 years, 0.0–4.0, p = 0.0007) was found in patients with PPMS but not RRMS. After p value adjustment, the disease duration appeared to be more relevant (β = 0.16, p = 0.06).

Conclusion

Peripapillary hyper‐reflective ovoid masslike structures were found in 18% of patients with early MS. The presence of PHOMS might be associated with disease progression only in PPMS but not RRMS, suggesting that PHOMS might be embedded in neurodegenerative processes.
Female Western Australian magpies discriminate between familiar and unfamiliar human voices
Authors: Dutour Mylène , Walsh Sarah L. , Speechley Elizabeth M. , Ridley Amanda R.
Published: August 2021

The ability to recognize familiar and unfamiliar individuals is important as it plays a central role in many social interactions. Previous research has found that some animal species can discriminate among conspecifics, and recent findings indicate that some species are also able to discriminate among heterospecifics, including humans. The ability to discriminate between humans based on voice recognition has been thoroughly investigated in domestic species and in some wild species housed in captivity. However, human voice recognition remains largely untested in wild animals living in their natural environment. In the present study, we investigated whether wild Western Australian magpies can discriminate between the voices of familiar and unfamiliar humans using playback experiments. Magpies showed an increase in vigilance when exposed to playback of unfamiliar voices compared with familiar, suggesting that magpies perceive unfamiliar humans as a greater threat. These results provide the first evidence that birds in their natural environment have the capacity to discriminate between humans using vocal recognition. Given that humans can represent a threat for wild animals, this capacity to discriminate based on vocal familiarity may be beneficial.
Medical informatization of management system for admission office under convolutional neural network
Authors: Wang Guan , Li Dandan , Ge Jinling , Wang Tao
Published: August 2021

The study aims to construct a client/server model of a three‐tier architecture based on the convolutional neural network (CNN), which is responsible for information management in admission office, including eight aspects of the registration management, admission management, prepayment management, inpatient charge management, settlement management, report statistics management, information query management, and help management. The test results of the system show that the management system constructed can run 48 h trouble‐free for registration services, no‐fee discharge services, inpatient charge services, and settlement services, and the average response time of the system is less than 10 s. The management system constructed for the admission office realizes the medical informatization, and heightens the work efficiency of relevant workers.
Improvements in quality of life and work productivity with up to 6 months of fremanezumab treatment in patients with episodic and chronic migraine and documented inadequate response to 2 to 4 classes of migraine‐preventive medications in the phase 3b FOCUS study
Authors: Spierings Egilius L. H. , Ning Xiaoping , Ramirez Campos Verena , Cohen Joshua M. , Barash Steve , Buse Dawn C.
Published: August 2021

Background

Migraine is associated with depression as well as negative impact on quality of life and work productivity. Fremanezumab, a fully humanized monoclonal antibody (IgG2Δa), selectively targets the calcitonin gene‐related peptide and has proven efficacy for the preventive treatment of migraine.

Objective

In this open‐label extension (OLE) of the phase 3b FOCUS study, we assessed patient‐reported outcomes (PROs) over time.

Methods

Patients with episodic migraine (EM) and chronic migraine (CM) completing the 12‐week, double‐blind (DB) period of the FOCUS trial entered the 12‐week OLE and received three monthly doses of fremanezumab (225 mg). PROs included the Migraine‐Specific Quality of Life (MSQoL) questionnaire (role function—restrictive [RFR], role function—preventive [RFP], and emotional function [EF] domains), EuroQol‐5‐Dimension‐5‐Level (EQ‐5D‐5L) questionnaire, Patient Global Impression of Change (PGIC) assessment, Work Productivity and Activity Impairment (WPAI) questionnaire, and 9‐Item Patient Health Questionnaire (PHQ‐9).

Results

A total of 838 patients were randomized in the DB period, 807 entered the OLE at 3 months, and 772 were still enrolled at 6 months. At 6 months, patients in the quarterly fremanezumab, monthly fremanezumab, and placebo DB randomization groups, respectively, reported improvements in RFR (mean [standard deviation] change from baseline: 24.6 [21.9]; 22.9 [21.3]; 20.8 [26.5]), RFP (19.6 [20.0]; 18.3 [19.7]; 16.0 [19.9]), and EF (22.5 [24.2]; 19.1 [23.6]; 17.2 [24.7]) domains of the MSQoL questionnaire, the EQ‐5D‐5L questionnaire (8.0 [19.6]; 7.3 [21.1]; 6.6 [21.0]), all four domains of the WPAI questionnaire, and the PHQ‐9 (−2.4 [5.3]; −1.6 [5.5]; −2.0 [4.9]); 77.1% (209/271), 75.4% (205/272), and 68.8% (181/263) of patients were identified as PGIC responders.

Conclusion

Among patients with EM or CM and prior inadequate response to multiple migraine‐preventive medication classes, progressive improvements in MSQoL, depression, and work productivity were achieved during 6 months of fremanezumab treatment.
Vivax malaria detection using a parasitic red blood cell flag generated by the Sysmex XN‐9000 hematology analyzer
Authors: Huh Hee Jin , Chung Jae‐Woo , Park Seong Yeon , Chae Seok‐Lae
Published: August 2021

Introduction

A Sysmex XN‐series hematology analyzer (Sysmex), the next generation up from the Sysmex XE‐series, can provide information regarding malaria infection in the form of a parasitic red blood cell (pRBC) flag. This study aimed to determine the usefulness of the pRBC flag for early detection and follow‐up in patients infected with Plasmodium vivax.

Methods

A total of 221 patients with fever for whom CBC and malaria microscopy had been requested were analyzed. Sixty‐seven individuals were diagnosed with P vivax infection, and 154 were diagnosed with other febrile diseases. The sensitivity and specificity of the pRBC flag for malaria parasite detection and the relationship between parasite density and presence of the pRBC flag were determined. The concordance rate between malaria microscopy and pRBC flag in 147 follow‐up cases was calculated.

Results

The pRBC flag was detected in 56 of 67 malaria patients (sensitivity, 83.6%; specificity, 100%). The patients with the pRBC flag at initial diagnosis revealed significantly higher parasite density than the patients without the pRBC flag (P < .05). The concordance rate between malaria microscopy and pRBC flag in the follow‐up cases was 53.1%.

Conclusion

Considering its high sensitivity in malaria‐suspicious patients, unexpected vivax malaria cases can be detected with the pRBC flag when CBC is done in a routine laboratory setting. The pRBC flag provided by the Sysmex XN series is a valuable tool for vivax malaria detection.
Perceived COVID‐19‐associated discrimination, mental health and professional‐turnover intention among frontline clinical nurses: The mediating role of resilience
Authors: Labrague Leodoro J. , De los Santos Janet Alexis A. , Fronda Dennis C.
Published: August 2021

COVID‐19‐associated discrimination (CAD) is an important issue that may adversely affect frontline nurses’ work effectiveness and well‐being. This study examined the relationships between frontline nurses’ perceptions of COVID‐19‐associated discrimination and their resilience, mental health, and professional‐turnover intention. This cross‐sectional descriptive study involved 259 frontline nurses in the Central Philippines and used four online self‐report measures. The results revealed that frontline nurses perceived a moderate level of COVID‐19‐associated discrimination. Frontline nurses who perceived a higher level of discrimination during the coronavirus pandemic reported poorer mental health and higher professional‐turnover intention. Resilience acted as a mediator and reduced the effects of COVID‐19‐associated discrimination on nurses’ mental health and their professional‐turnover intention. Proactive measures to reduce the negative consequences of discrimination during the pandemic, and efforts to foster resilience in nurses who are in the forefront of the fight against the highly transmissible virus, should be given high priority by hospital and nursing administrators to better support nurses’ mental health and foster retention.
Lamivudine improves cognitive decline in SAMP8 mice: Integrating in vivo pharmacological evaluation and network pharmacology
Authors: Li Ming , Zhao Jie , Tang Qi , Zhang Qingchen , Wang Yong , Zhang Jian , Hao Yingying , Bai Xiaohui , Lu Zhiming
Published: August 2021

The reverse transcriptase inhibitors such as lamivudine (3TC) play important roles in anti‐ageing, but their effects on neurodegenerative diseases caused by ageing are not clear, especially on the functions of the nervous system such as cognition. In this study, we administered 3TC to senescence‐accelerated mouse prone 8 (SAMP8) mice by gastric perfusion (100 mg/kg) for 4 weeks. Our results showed that 3TC significantly improved the ageing status of SAMP8 mice, especially the decline of cognitive ability evaluated by the Morris water maze test. To further investigate the molecular mechanisms of improving the ageing status of SAMP8 mice by 3TC, the qPCR and tissue staining methods were used to study the brain tissues (i.e., hippocampus and cortex) of mice, while the network pharmacology analysis was applied to investigate the potential targets of 3TC. The results showed that the mRNA levels of genes related to long interspersed element‐1, type 1 interferon response, the senescence‐associated secretion phenotype and the Alzheimer's disease in the hippocampus and cortex of SAMP8 mice were increased due to senescence, but this trend was reversed partially by 3TC. Results of histological studies showed that 3TC reduced the death of hippocampal neurons, while the results of network pharmacology analysis indicated that 3TC may exert its influence through multiple pathways, including the oestrogen signalling and the PI3K/Akt and neuroactive ligand‐receptor interaction signalling pathways, which we have verified through in vitro experiments. These findings provide evidence for the therapeutic potential of 3TC in the treatment of neurodegenerative diseases.
Impact of fever thresholds in detection of COVID‐19 in Department of Veterans Affairs Community Living Center residents
Authors: Bej Taissa , Kothadia Sonya , Wilson Brigid M. , Song Sunah , Briggs Janet M. , Banks Richard E. , Donskey Curtis J. , Perez Federico , Jump Robin L. P.
Published: August 2021

Background

Among nursing home residents, for whom age and frailty can blunt febrile responses to illness, the temperature used to define fever can influence the clinical recognition of COVID‐19 symptoms. To assess the potential for differences in the definition of fever to characterize nursing home residents with COVID‐19 infections as symptomatic, pre‐symptomatic, or asymptomatic, we conducted a retrospective study on a national cohort of Department of Veterans Affairs (VA) Community Living Center (CLC) residents tested for SARS‐CoV‐2.

Methods

Residents with positive SARS‐CoV‐2 tests were classified as asymptomatic if they did not experience any symptoms, and as symptomatic or pre‐symptomatic if the experienced a fever (>100.4°F) before or following a positive SARS‐CoV‐2 test, respectively. All‐cause 30‐day mortality was assessed as was the influence of a lower temperature threshold (>99.0°F) on classification of residents with positive SARS‐CoV‐2 tests.

Results

From March 2020 through November 2020, VA CLCs tested 11,908 residents for SARS‐CoV‐2 using RT‐PCR, with a positivity of rate of 13% (1557). Among residents with positive tests and using >100.4°F, 321 (21%) were symptomatic, 425 (27%) were pre‐symptomatic, and 811 (52%) were asymptomatic. All‐cause 30‐day mortality among residents with symptomatic and pre‐symptomatic COVID‐19 infections was 24% and 26%, respectively, while those with an asymptomatic infection had mortality rates similar to residents with negative SAR‐CoV‐2 tests (10% and 5%, respectively). Using >99.0°F would have increased the number of residents categorized as symptomatic at the time of testing from 321 to 773.

Conclusions

All‐cause 30‐day mortality was similar among VA CLC residents with symptomatic or pre‐symptomatic COVID‐19 infection, and lower than rates reported in non‐VA nursing homes. A lower temperature threshold would increase the number of residents recognized as having symptomatic infection, potentially leading to earlier detection and more rapid implementation of therapeutic interventions and infection prevention and control measures.
Diagnostic performance of HPV E6/E7 mRNA testing towards HPV‐DNA testing and p16/Ki67 immunostaining as a biomarker of high‐risk HPV recurrence in Greek women surgically treated for their cervical lesions
Authors: Carcea Fausto , Vavoulidis Eleftherios , Petousis Stamatios , Papandreou Panagiotis , Siarkou Chrysoula Margioula , Nasioutziki Maria , Papanikolaou Alexios , Dinas Konstantinos , Daniilidis Angelos
Published: August 2021

Aim

To evaluate the diagnostic performance of E6/E7 HPV‐mRNA overexpression towards HPV‐DNA testing and p16/Ki67 immunocytochemistry in a post‐op population to verify if this biomarker can be effectively used as indicator of successful cervical intraepithelial neoplasia (CIN) treatment.

Methods

Our study retrospectively analyzed 197 patients of our Colposcopy Clinic between January 2013 and September 2020 coming with an abnormal Pap smear suggestive for colposcopy, and after a series of follow‐ups including liquid‐based cytology (LBC) and punch‐biopsy sampling, there were surgically treated. LBC was used for cytology and molecular analysis of the three HPV‐related biomarkers.

Results

Six months after treatment, 93% of the HPV‐mRNA‐positive women became negative while this applied to only 80.2% of the HPV‐DNA‐positive women. HPV persistence was 6.9% at 6–12 months after treatment. The comparison among cytology, colposcopy, HPV‐DNA test, and HPV‐mRNA test after treatment revealed that the last one is the only with a strong correlation with actual severity (histology during treatment) (ρ = 0.345, p = 0.006) implying that clinical cases with more severe CIN may have higher chances of unsuccessful treatment. HPV‐mRNA test had higher sensitivity (100%), specificity (96.88%), and positive predictive value (45.45%) for CIN2+ recurrent lesions when compared with HPV‐DNA testing (80%, 82.81%, 10.81% respectively) and p16/Ki67 immunocytochemistry (80%, 95.83%, 33.33% respectively) while their negative predictive values were similar.

Conclusions

E6/E7 mRNA detection has higher diagnostic values for the prediction of treatment failure compared with HPV‐DNA testing and p16/Ki67 immunocytochemistry, and as an outcome could be used as predictive indicator of CIN‐treatment status.
Sensory properties and consumer acceptance of ready‐to‐drink vanilla protein beverages
Authors: Liu Yaozheng , Toro‐Gipson Rachel S. Del , Drake MaryAnne
Published: August 2021

Ready‐to‐drink (RTD) protein beverages are growing in popularity in the US market. Protein beverages vary in protein amount and source and as such, have substantially different sensory experiences. This study applied descriptive analysis and consumer acceptance testing to identify sensory properties and drivers of like and dislike in vanilla RTD protein beverages. A category survey with 33 beverages were conducted by a trained panel. Ten representative beverages were evaluated by vanilla protein beverage consumers (n = 150) for overall and specific liking attributes. Twenty sensory attributes were identified. The drivers of liking for vanilla RTD protein beverages included cooked/milky, caramelized, and vanilla/vanillin flavors, sweet and salty tastes, and viscosity, while the drivers of dislike were green pea and cereal/grainy flavors. Consumer clusters were differentiated by preferences for vanilla flavor intensity, viscosity and their tolerances for bitter taste and astringency. Consumer clusters were also distinguished by preferences for natural label, protein type, carbohydrate content, and sweeteners.

Practical applications

The ideal vanilla ready‐to‐drink (RTD) protein beverage for all consumers is a sweet and viscous beverage with intense milky and caramelized flavors with high protein content. This study adapted a lexicon for vanilla RTD beverages, demonstrated the intrinsic drivers of liking for vanilla RTD protein beverages and provides insights on consumer preferences to guide further product development of RTD protein beverages.
Histopathologic, phenotypic, and molecular criteria to discriminate low‐grade intestinal T‐cell lymphoma in cats from lymphoplasmacytic enteritis
Authors: Freiche Valérie , Paulin Mathieu V. , Cordonnier Nathalie , Huet Hélène , Turba Maria‐Elena , Macintyre Elizabeth , Molina Thierry‐Jo , Hermine Olivier , Couronné Lucile , Bruneau Julie
Published: August 2021

Background

Differentiation of low‐grade intestinal T‐cell lymphoma (LGITL) from lymphoplasmacytic enteritis (LPE) in cats is a diagnostic challenge for pathologists.

Objective

Characterize histologic, immunohistochemical, and molecular features of LGITL and LPE.

Animals

Forty‐four client‐owned cats, 22 diagnosed with LGITL and 22 with LPE.

Methods

Prospective, cohort study. Clinical suspicion of LGITL or LPE was based on persistent gastrointestinal signs, unresponsive to empirical treatments. All cats underwent a standardized diagnostic evaluation, including biopsy (preferentially full‐thickness), and were diagnosed with LGITL or LPE after review of clinical, laboratory, sonographic, histologic, immunohistochemical, and clonality results.

Results

A monomorphic lymphocytic population (22/22, 100%) and in‐depth mucosal infiltration (15/22, 68%) were hallmarks of LGITL. Epithelial patterns (nests and plaques) were significantly more frequent in LGITL (11/22, 50%) than in LPE (1/22, 5%) cases (P = .001). A CD3+ lymphocytic apical‐to‐basal gradient was observed in 9/22 (41%) of LGITL vs 1/22 (5%) of LPE cases (P = .004). Most LPE cases (17/18, 94%) featured marked fibrosis in the superficial part of the lamina propria. The Ki‐67 20%‐ and 30%‐thresholds discriminated between LGITL and LPE within both the epithelium (specificity >95%) and lamina propria (specificity >95%), respectively. All LGITL cases were CD3+ pSTAT3− and pSTAT5+. T‐cell receptor gamma chain gene rearrangements indicated monoclonality in 86% of LGITL cases. Surprisingly, 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%).

Conclusions and Clinical Importance

We identified new histologic, immunohistochemical, and clonality criteria to distinguish LGITL from LPE.
Rethinking Christian and Jewish Exceptionalisms☆
Authors: Batnitzky Leora
Published: August 2021

This article argues that Christianity and Judaism, as they have developed historically, express complementary but opposing exceptionalist perspectives. The article defines “exceptionalism” in terms of the singular mission that Jews and Christians each claim for themselves and the varied Jewish and Christian conceptions of how their missions relate to non‐Jews and non‐Christians respectively. While Jewish exceptionalism consists in the demand to be left alone to live its God‐given mission with not much concern for what God expects from the other nations save that it is different from what God expects from the Jews, Christian exceptionalism demands that all peoples follow its singular vision of redemption through Christ. This article develops these arguments by way of considering competing readings of the Book of Ruth, continuing debates about the Apostle Paul in recent historical scholarship, as well as history’s role in theological reflection. The article argues that Christians and Jews need to reckon with their respective exceptionalisms on their own decidedly singular terms, and not on the terms of each other, since to do otherwise would be to renounce their respective exceptionalisms and to lose the theological singularity that defines each faith tradition. Nevertheless, the article concludes by calling for more intellectual honesty from Christians and Jews regarding what their exceptionalisms do and do not entail as well as for the enduring importance of bringing historical research to bear on theology.
Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta‐analysis
Authors: Lee Yung , Anvari Sama , Chu Megan M. , Lovrics Olivia , Khondker Adree , Malhan Roshan , Aditya Ishan , Doumouras Aristithes G. , Walsh Michael , Hong Dennis
Published: August 2021

The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta‐analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle‐Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of −0.24 (95%CI −0.21 to −0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of −1.13 (95%CI: −0.83 to −2.07, I2 = 13%), but there was reduced likelihood of having uACR >30 mg/g or above with a RR of −3.03 (95%CI: −1.44 to −6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
Environmental conditions and seed traits affect seed dispersal patterns in a slug–legume model system
Authors: Pufal Gesine , Skarbek Carl
Published: August 2021

The outcome of seed fate (probability of predation or dispersal) depends on the interplay between granivores and seed traits. Furthermore, changing environmental conditions affecting granivore behavior might additionally alter seed dispersal patterns.

Based on microcosm experiments and time‐lapse videos, we tested in a structural equation model how dry or wet conditions in a slug–legume seed system affect slug movement behavior, thus influencing seed encounter, ingestion and dispersal locations. We additionally analyzed how interactions between slug weight, chemical and morphological seed traits determine the fate of ingested seeds and used point pattern analysis of seed locations to detect potential dispersal patterns.

While dry or wet conditions had no direct effect on the time slugs spent moving, dry conditions significantly increased the slug's homing behavior. Higher slug movement increased the chance of seed encounter, smaller seeds with low seed coat permeability were preferably ingested and the proportion of ingested seeds increased with increasing seed oil content. A high proportion of ingested seeds was dispersed via endozoochory, but none of the tested seed traits could explain seed fate.

Endozoochory led to clumped dispersal patterns around the slug's shelter with clustering significantly more pronounced for seeds in dry conditions due to increased homing behavior in slugs. These dispersal patterns indicate potential directed dispersal to moist microsites but whether this leads to higher recruitment and hence successful directed dispersal remains to be tested.
Teleological powers
Authors: Paolini Paoletti Michele
Published: August 2021

In this article, I develop a metaphysical account of final causes grounded on contemporary powers metaphysics. After having presented some key elements of an Aristotle‐inspired teleology, i.e., the study of final causes within Aristotelian tradition, I introduce powers. Moreover, I present some theses about their nature and features. Afterward, I distinguish between two kinds of powers that are expected to play the roles traditionally attributed to final causes: weakly teleological powers and strongly teleological powers. Weakly teleological powers are those powers that ground the possession of all the other powers of a substance. Strongly teleological powers are those powers that ground the activation of all the other powers of a substance. Within this framework, I then develop some options to deal with human teleology, i.e., with the study of human behavior in light of final causes. Finally, in the last Section, I briefly compare my account with other accounts of teleology and of specific sorts of powers that somehow resemble teleological powers.