bluuebunny/crossref_metadata_2025 huggingface dataset:
A prospective study comparing rectal water contrast‐transvaginal ultrasonography with sonovaginography for the diagnosis of deep posterior endometriosis
Authors: Barra Fabio , Leone Roberti Maggiore Umberto , Evangelisti Giulio , Scala Carolina , Alessandri Franco , Vellone Valerio Gaetano , Stabilini Cesare , Ferrero Simone
Published: June 2021

Introduction

Preoperative assessment of deep endometriotic (DE) nodules is necessary to inform patients about the possible treatments and provide informed consent in case of surgery. This study aims to investigate the diagnostic performance of rectal water‐contrast transvaginal ultrasonography (RWC‐TVS) and sonovaginography (SVG) in women with suspicion of posterior DE.

Material and methods

This prospective comparative study (NCT04296760) enrolled women with clinical suspicion of DE at our institution (Piazza della Vittoria 14 SRL, Genoa, Italy). Exclusion criteria were previous diagnosis of DE by imaging techniques or laparoscopy. All patients underwent RWC‐TVS and SVG, independently performed by two gynecological sonologists blinded to the other technique's results. Patients underwent laparoscopic surgery within the following three months; imaging findings were compared with surgical and histological results.

Results

In 208 of 281 (74.0%) patients included, posterior DE was surgically confirmed in rectosigmoid (n = 88), vagina (n = 21), rectovaginal septum (n = 34) and uterosacral ligaments (n = 156). RWC‐TVS and SVG demonstrated similar sensitivity (SE; 93.8% vs 89.4%; p = 0.210) and specificity (SP; 86.3% vs 79.4%; p = 0.481) in diagnosing posterior DE. Specifically, both examinations had similar accuracy in detecting nodules of uterosacral ligaments (p = 0.779), vagina (p = 0.688) and rectovaginal septum (p = 0.824). RWC‐TVS had higher SE (95.2% vs 82.0%; p = 0.003) and similar SP (99.5% vs 98.5%; p = 0.500) in diagnosing rectosigmoid endometriosis and estimated better infiltration of intestinal submucosa (p = 0.039), and distance between these nodules and anal verge (p < 0.001); only RWC‐TVS allowed the estimation of bowel lumen stenosis. A similar proportion of discomfort was experienced during both examinations (p = 0.191), although a statistically higher mean visual analog score was reported during RWC‐TVS (p < 0.001).

Conclusions

Although RWC‐TVS and SVG have similar accuracy in the diagnosis of DE, RWC‐TVS performed better in assessment of the characteristics of rectosigmoid endometriosis.
Biallelic mutations in KATNAL2 cause male infertility due to oligo‐astheno‐teratozoospermia
Authors: Wei Xiaoli , Liu Wensheng , Zhu Xingshen , Li Youzhu , Zhang Xiaoya , Chen Jing , Isachenko Vladimir , Sha Yanwei , Lu Zhongxian
Published: June 2021

Oligo‐astheno‐teratozoospermia (OAT) is a common cause of male infertility, and most of idiopathic OAT patients are thought to be caused by genetic defects. Here, we recruited 38 primary infertile patients with the OAT phenotype and 40 adult men with proven fertility for genetic analysis and identified biallelic mutations of KATNAL2 by whole‐exome sequencing in two cases. F013/II:1, from a consanguineous family, carried the KATNAL2 c.328C > T:p.Arg110X homozygous mutations. The other carried c.55A > G: p.Lys19Glu and c.169C > T: p Arg57Trp biallelic mutations. None of the KATNAL2 variants were found in the 40 adult men with proven fertility. The spermatozoa from patients with KATNAL2 biallelic mutations exhibited conspicuous defects in maturation, head morphology, and the structure of mitochondrial sheaths and flagella. KATNAL2 was mainly expressed in the pericentriolar material and mitochondrial sheath of the spermatozoa from control subjects, but it was undetectable in the spermatozoa from the patients. Furthermore, Katnal2 null male mice were infertile and displayed an OAT phenotype. Our results proved that the biallelic mutations in KATNAL2 cause male infertility and OAT in humans for the first time, to our knowledge, which could enrich the genetic defect spectrum of OAT and be beneficial for its accurate genetic screening and clinical diagnosis.
Laparoscopic wedge resection as an alternative to laparoscopic oncological colon resection for benign endoscopically unresectable colon polyps
Authors: Marres Carla Christine Maria , Smit Marieke P. C. M. , van der Bilt Jarmila D. W. , Buskens Christianne J. , Mundt Marco W. , Verbeek Paul C. M. , Bemelman Willem A. , van de Ven Anthony Willem Hendrik
Published: June 2021

Aim

The aim of this study was to investigate, by comparing clinical and histological outcomes, whether laparoscopic (hybrid) wedge resection (LWR) could be a less invasive and safe alternative to laparoscopic oncological colon resection (OCR) for patients with an endoscopically unresectable, suspected benign, colon polyp.

Method

All patients with an endoscopically unresectable colon polyp who were referred for surgery between 2009 and 2018 and without biopsy‐proven colon cancer were identified from a prospectively maintained database. Patients with macroscopic features of malignancy during endoscopy were excluded. Clinical and histological results for patients who underwent OCR or LWR were reviewed.

Results

One hundred‐and‐twenty‐two patients were included. Ninety‐seven patients underwent OCR and 25 LWR. Major complications occurred in 16.7% (n = 16) of the OCR group compared with 4.0% (n = 1) of the LWR group (p = 0.06). In the OCR group the anastomotic leakage rate was 6.3% (n = 6) and the mortality rate 3.1% (n = 3). No anastomotic leakage or deaths occurred in the LWR group. The median length of hospital stay after OCR was 5 days [interquartile range (IQR) 5–9 days)] compared with 2 days (IQR 2–4 days) after LWR (p < 0.0001). Definite pathology showed a malignancy rate of 4.2% (n = 4) in the OCR group and 4.0% (n = 1) (without high‐risk features) in the LWR group.

Conclusion

This study shows that LWR was associated with significantly lower complication rates and acceptable oncological risks compared with OCR. Therefore we suggest that LWR is a safe alternative treatment, next to other endoscopic options. The treatment that is most suitable for an individual patient should be discussed in a multidisciplinary meeting.
Social isolation of adolescent male rats increases anxiety and K+‐induced dopamine release in the nucleus accumbens: Role of CRF‐R1
Authors: Novoa Javier , Rivero Carlos J. , Pérez‐Cardona Enrique U. , Freire‐Arvelo Jaime A. , Zegers Juan , Yarur Héctor E. , Santiago‐Marerro Iván G. , Agosto‐Rivera José L. , González‐Pérez Jorge L. , Gysling Katia , Segarra Annabell C.
Published: June 2021

Early life adversity can disrupt development leading to emotional and cognitive disorders. This study investigated the effects of social isolation after weaning on anxiety, body weight and locomotion, and on extracellular dopamine (DA) and glutamate (GLU) in the nucleus accumbens (NAc) and their modulation by corticotropin releasing factor receptor 1. On the day of weaning, male rats were housed singly or in groups for 10 consecutive days. Anxiety‐like behaviors were assessed by an elevated plus maze (EPM) and an open field test (OF). Neurotransmitter levels were measured by in vivo microdialysis. Single‐housed rats spent less time, and entered more, into the closed arms of an EPM than group‐housed rats. They also spent less time in the center of an OF, weighed more and showed greater locomotion. In the NAc, no differences in CRF, or in basal extracellular DA or GLU between groups, were observed. A depolarizing stimulus increased DA release in both groups but to higher levels in isolated rats, whereas GLU increased only in single‐housed rats. Blocking CRF‐R1 receptors with CP‐154,526 decreased DA release in single‐housed but not in group‐housed rats. The corticotropin releasing factor receptor type 1 receptor antagonist also decreased GLU in group‐housed animals. These results show that isolating adolescent rats increases anxiety, body weight and ambulation, as well as the sensitivity of dopaminergic neurons to a depolarizing stimulus. This study provides further evidence of the detrimental effects of social isolation during early development and indicates that dysregulation of the CRF system in the NAc may contribute to the pathologies observed.
Imaging findings and clinical outcome of foot pain attributable to insertional deep digital flexor tendon injury and/or fluid signal within the flexor surface of the distal phalanx
Authors: Hewitt‐Dedman C. L. , Biggi M. , Van Zadelhoff C. , Schwarz T. , Reardon R. J. M. , Taylor S. E.
Published: June 2021

Background

Insertional deep digital flexor tendon (DDFT) lesions with concurrent injury to the flexor surface of the distal phalanx are uncommon and there is limited information regarding prognosis.

Objectives

To provide descriptive data on horses with insertional DDFT injuries and determine whether there is any association between magnetic resonance imaging (MRI) findings, and outcome.

Study design

Retrospective case series.

Methods

Horses with lameness localised to the foot that underwent low field standing MRI between January 2015 and April 2019 were included. Injury of the DDFT, presence of short tau inversion recovery (STIR) hyperintensity at the flexor surface of the distal phalanx and concurrent lesions were recorded. Follow‐up information was obtained by telephone questionnaire.

Results

Thirty‐two horses fulfilled the inclusion criteria. Thirty‐one limbs had DDFT insertional lesions on MRI with three limbs showing hyperintense STIR signal of the flexor surface of the distal phalanx without a tendon lesion. Seventeen DDFT lesions were graded as mild and 14 as severe. Thirteen limbs showed hyperintense STIR signal within the tendon and 15 limbs showed hyperintense STIR signal within the flexor surface of the distal phalanx at the insertion of the DDFT and/or the distal sesamoidean impar ligament (DSIL). Eight horses returned to previous athletic function, 8 returned to a lower level of athletic activity, 4 were retired, 9 were subjected to euthanasia and 3 were lost to follow‐up. No significant association was found between DDFT lesion severity, hyperintense STIR signal within the DDFT, hyperintense STIR signal at the flexor surface of the distal phalanx and outcome post‐injury.

Main limitations

Small sample size and reliance on clients to provide accurate follow‐up information.

Conclusions

Insertional DDF tendinopathy carries a guarded prognosis for return to previous athletic function. The presence of hyperintense STIR signal at the flexor surface of the distal phalanx did not appear to influence the prognosis.
Geochemistry of caldera‐forming and resurgent magmas in the Pliocene Hiwada caldera, northeast Japan: An example of a monotonous intermediate system
Authors: Yamamoto Takahiro
Published: June 2021

The 2.9‐Ma Hotokezawa Ignimbrite, which was ejected from the Aizu caldera cluster in the northeast Japan arc, is a typical monotonous intermediate ignimbrite, with 40–50 vol% crystals and an eruptive volume of >140 km3 dense‐rock equivalent. This ignimbrite filled Hiwada caldera and was deformed by post‐caldera plutonic intrusions that formed a resurgent dome. The Hotokezawa Ignimbrite is a calc‐alkaline, medium‐K dacite to rhyolite with SiO2 contents of 67.9–71.3 wt%, and has homogeneous trace‐element abundances and Sr–Nd isotopic ratios. These geochemical features suggest that the Hotokezawa magma was formed by partial melting of amphibolitic crustal rocks. This crystal‐rich magma did not appear during the post‐caldera stage. Therefore, it is plausible that the chamber of eruptible magma was emptied by the caldera‐forming eruption. In contrast, post‐caldera plutonic rocks exhibit a variety of compositions and have a clear SiO2 gap corresponding to the caldera‐forming magma: the early pluton (tonalite) and later ones (quartz porphyry, granite porphyries, and granite) contain 62.0–66.6 and 71.2–76.5 wt% SiO2, respectively. The tonalite and the Hotokezawa Ignimbrite form a continuous trend in their major‐element variations. The Sr–Nd isotopic ratios of the ignimbrite and tonalite overlap, but those of the porphyries and granite are more enriched. The early tonalite represents the more basic part of the Hiwada caldera system that was held in small pockets separate from the main magma chamber, because its trace‐element abundances are varied and distinct from those of the Hotokezawa Ignimbrite. The distinct compositional change from the Hotokezawa Ignimbrite to the late porphyries and granite indicates that the partial melting crust generating felsic magma was renewed by the subsequent intrusion of the mantle melts. The new felsic magma ascended through subsidence‐related faults into the shallow caldera system and emplaced as laccoliths forming the resurgent dome.
Histological evaluation of a novel phosphorylated pullulan‐based pulp capping material: An in vivo study on rat molars
Authors: Islam Rafiqul , Toida Yu , Chen Fei , Tanaka Toru , Inoue Satoshi , Kitamura Tetsuya , Yoshida Yasuhiro , Chowdhury Abu Faem Mohammad Almas , Ahmed Hany Mohamed Aly , Sano Hidehiko
Published: June 2021

Aim

To evaluate the dental pulp response to a novel mineral trioxide aggregate containing phosphorylated pullulan (MTAPPL) in rats after direct pulp capping.

Methods

Ninety‐six cavities were prepared in the maxillary first molars of 56 male Wistar rats. The dental pulps were intentionally exposed and randomly divided into four groups according to the application of pulp capping materials: MTAPPL; phosphorylated pullulan (PPL); a conventional MTA (Nex‐Cem MTA, NCMTA; positive control); and Super‐Bond (SB; negative control). All cavities were restored with SB and observed for pulpal responses at 1‐, 3‐, 7‐ and 28‐day intervals using a histological scoring system. Statistical analysis was performed using Kruskal–Wallis and Mann–Whitney U‐test with Bonferroni's correction, and the level of significance was set at 0.05. DMP1 and CD34 antigen were used to evaluate odontoblast differentiation and pulpal vascularization, respectively.

Results

On day 1, mild inflammatory cells were present in MTAPPL and NCMTA groups; fewer inflammatory cells were present in the PPL, whereas SB was associated with a mild‐to‐moderate inflammatory response. A significant difference was observed between PPL and SB (p < .05). No mineralized tissue deposition was observed. On day 3, moderate‐to‐severe inflammatory cells were present in PPL and SB, whereas MTAPPL and NCMTA had a mild inflammatory response. Initial mineralized tissue deposition was observed in the NCMTA, MTAPPL and SB. A significant difference was observed between MTAPPL and PPL (p < .05). On day 7, a thin layer of mineralized tissue was observed in all tested groups with no or mild inflammatory response. On day 28, no inflammatory response was observed in MTAPPL, whereas NCMTA, PPL and SB had mild inflammatory responses. A significant difference was observed between MTAPPL and SB (p < .05). Complete mineralized tissue barrier formation was observed in MTAPPL, NCMTA and PPL with no significant difference (p > .05). SB exhibited incomplete mineralized tissue barriers, significantly different from NCMTA, MTAPPL and PPL (p < .05). The staining with CD34 was positive in all the groups on all observation days.

Conclusion

The favourable pulpal responses and induction of mineralized tissue formation associated with MTAPPL indicate its potential application as a direct pulp capping material.
Fibroblast pathology in inflammatory joint disease
Authors: Marsh Lucy‐Jayne , Kemble Samuel , Reis Nisa Patricia , Singh Ruchir , Croft Adam P.
Published: June 2021

Rheumatoid arthritis is an immune‐mediated inflammatory disease in which fibroblasts contribute to both joint damage and inflammation. Fibroblasts are a major cell constituent of the lining of the joint cavity called the synovial membrane. Under resting conditions, fibroblasts have an important role in maintaining joint homeostasis, producing extracellular matrix and joint lubricants. In contrast, during joint inflammation, fibroblasts contribute to disease pathology by producing pathogenic levels of inflammatory mediators that drive the recruitment and retention of inflammatory cells within the joint. Recent advances in single‐cell profiling techniques have transformed our ability to examine fibroblast biology, leading to the identification of specific fibroblast subsets, defining a previously underappreciated heterogeneity of disease‐associated fibroblast populations. These studies are challenging the previously held dogma that fibroblasts are homogeneous and are providing unique insights into their role in inflammatory joint pathology. In this review, we discuss the recent advances in our understanding of how fibroblast heterogeneity contributes to joint pathology in rheumatoid arthritis. Finally, we address how these insights could lead to the development of novel therapies that directly target selective populations of fibroblasts in the future.
Evolution of life cycles and reproductive traits: Insights from the brown algae
Authors: Heesch Svenja , Serrano‐Serrano Martha , Barrera‐Redondo Josué , Luthringer Rémy , Peters Akira F. , Destombe Christophe , Cock J. Mark , Valero Myriam , Roze Denis , Salamin Nicolas , Coelho Susana M.
Published: June 2021

A vast diversity of types of life cycles exists in nature, and several theories have been advanced to explain how this diversity has evolved and how each type of life cycle is retained over evolutionary time. Here, we exploited the diversity of life cycles and reproductive traits of the brown algae (Phaeophyceae) to test several hypotheses on the evolution of life cycles. We investigated the evolutionary dynamics of four life‐history traits: life cycle, sexual system, level of gamete dimorphism and gamete parthenogenetic capacity. We assigned states to up to 77 representative species of the taxonomic diversity of the brown algal group, in a multi‐gene phylogeny. We used maximum likelihood and Bayesian analyses of correlated evolution, while taking the phylogeny into account, to test for correlations between traits and to investigate the chronological sequence of trait acquisition. Our analyses are consistent with the prediction that diploid growth evolves when sexual reproduction is preferred over asexual reproduction, possibly because it allows the complementation of deleterious mutations. We also found that haploid sex determination is ancestral in relation to diploid sex determination. However, our results could not address whether increased zygotic and diploid growth are associated with increased sexual dimorphism. Our analyses suggest that in the brown algae, isogamous species evolved from anisogamous ancestors, contrary to the commonly reported pattern where evolution proceeds from isogamy to anisogamy.
Association between metabolic syndrome and incidence of cholelithiasis in the Korean population
Authors: Kim Yeji , Oh Chang‐Mo , Ha Eunhee , Park Sung Keun , Jung Ju Young , Ryoo Jae‐Hong
Published: June 2021

Background and Aim

Cholelithiasis is one of the most common gastrointestinal diseases worldwide. The metabolic syndrome (MetS), a combination of various metabolic abnormalities, is also common with a continually increasing prevalence. These diseases are associated with several risk factors. However, data on the association between MetS components and cholelithiasis are insufficient. This study aimed to analyze the association of MetS and its components with the incidence of cholelithiasis using national data from the Korean population.

Methods

Data were obtained from the National Health Insurance Corporation of Korea, and 207 850 individuals without cholelithiasis in 2009 were enrolled and followed up until 2013. A multivariate Cox proportional hazard model was used to calculate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of cholelithiasis according to the presence of MetS and the number of MetS components. Furthermore, the risk of cholelithiasis was evaluated in individuals with a single metabolic component.

Results

The multivariate adjusted HRs and 95% CIs for incident cholelithiasis according to 1, 2, 3, and 4–5 MetS components were 1.08 (0.93–1.24), 1.22 (1.06–1.41), 1.35 (1.17–1.57), and 1.35 (1.15–1.57), respectively (P < 0.001). This increasing trend was observed in both sexes. Compared with participants with no metabolic components, those with low high‐density lipoprotein (HDL) cholesterol had a significantly increased risk for cholelithiasis (adjusted HR, 1.39 [95% CI, 1.05–1.85]).

Conclusions

Metabolic syndrome is a potential risk factor for cholelithiasis. Low HDL cholesterol level is the most relevant factor among MetS components for incident cholelithiasis.
Efficacy of an artificial neural network algorithm based on thick‐slab magnetic resonance cholangiopancreatography images for the automated diagnosis of common bile duct stones
Authors: Hou Jong‐Uk , Park Se Woo , Park Seon Mee , Park Da Hae , Park Chan Hyuk , Min Seonjeong
Published: June 2021

Background and Aim

Magnetic resonance cholangiopancreatography (MRCP) can accurately diagnose common bile duct (CBD) stones but is laborious to interpret. We developed an artificial neural network (ANN) capable of automatically assisting physicians with the diagnosis of CBD stones. This study aimed to evaluate the ANN's diagnostic performance for detecting CBD stones in thick‐slab MRCP images and identify clinical factors predictive of accurate diagnosis.

Methods

The presence of CBD stones was confirmed via direct visualization through endoscopic retrograde cholangiopancreatography (ERCP). The absence of CBD stones was confirmed by either a negative endoscopic ultrasound accompanied by clinical improvements or negative findings on ERCP. Our base networks were constructed using state‐of‐the‐art EfficientNet‐B5 neural network models, which are widely used for image classification.

Results

In total, 3156 images were collected from 789 patients. Of these, 2628 images from 657 patients were used for training. An additional 1924 images from 481 patients were prospectively collected for validation. Across the entire prospective validation cohort, the ANN achieved a sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of 93.03%, 97.05%, 97.01%, 93.12%, and 95.01%, respectively. Similarly, a radiologist achieved a sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy 91.16%, 93.25%, 93.22%, 90.20%, and 91.68%, respectively. In multivariate analysis, only bile duct diameter > 10 mm (odds ratio = 2.45, 95% confidence interval [1.08–6.07], P = 0.040) was related to ANN diagnostic accuracy.

Conclusion

Our ANN algorithm automatically and quickly diagnoses CBD stones in thick‐slab MRCP images, therein aiding physicians with optimizing clinical practice, such as whether to perform ERCP.
Impact of group visits for older patients with heart failure on advance care planning outcomes: Preliminary data
Authors: Ahluwalia Sangeeta C. , Bandini Julia I. , Coulourides Kogan Alexis , Bekelman David B. , Olsen Bonnie , Phillips Jessica , Sudore Rebecca L.
Published: June 2021

Objective

Advance care planning (ACP) is critically important for heart failure patients, yet important challenges exist. Group visits can be a helpful way to engage patients and caregivers in identifying values and preferences for future care in a resource‐efficient way. We sought to evaluate the impact of group visits for ACP among older adults with heart failure and their caregivers on ACP‐related outcomes.

Methods

We conducted a mixed‐methods pilot study evaluating the impact of an ACP group visit for older adults with heart failure and their caregivers on ACP‐related outcomes including readiness and self‐efficacy. The evidence‐based PREPARE for Your Care video‐based intervention was used to guide the group visits. Twenty patients and 10 caregivers attended one of the five 90‐min group visits led by a trained facilitator. Group visit participants completed pre‐, post‐, and 1‐month follow‐up surveys using validated 5‐point ACP readiness and self‐efficacy scales. Qualitative feedback obtained within 3 days of a group visit was analyzed using a directed content analysis.

Results

Patient participants had a median age of 78 years. Approximately half were female while caregiver participants were mostly female. Participants were predominantly white. Patient readiness scores improved significantly pre‐to‐post (+0.53; p = 0.002) but was not sustained at 1‐month follow‐up. Patient and caregiver self‐efficacy showed some improvement pre‐to‐post but was also not sustained at follow‐up. Interviews revealed positive impacts of group visits across the three themes: encouraging reviewing or revisiting prior ACP activities, motivating patients to take direct steps towards ACP, and serving as a “wake‐up” call to action.

Conclusions

Disease‐focused group visits may have a short‐term effect on ACP outcomes but ongoing touchpoints are likely necessary to sustain ACP over time. The results highlight a need for follow‐up ACP conversations after a single group visit. Timing for follow‐ups and the ideal person to follow‐up ACP conversations needs to be explored.
Increasing the energy efficiency of a data center based on machine learning
Authors: Yang Zhen , Du Jinhong , Lin Yiting , Du Zhen , Xia Li , Zhao Qianchuan , Guan Xiaohong
Published: June 2021

Energy efficiency of data centers (DCs) is of great concern due to their large amount of energy consumption and the foreseeable growth in the demand of digital services in the future. The past decade witnessed improvements of the energy efficiency of DCs from an extensive margin—a shift from small to large, more efficient DCs. Improvements from the intensive margin, that is, from more efficient operation, would be critical in limiting the energy consumption and environmental impact of DCs in the upcoming period. Machine learning algorithms have advantages in optimizing the operation of DCs to improve energy efficiency as they have shown the potential of discovering control strategies not found by traditional method, and producing working condition‐dependent control strategies. This study proposes ready‐to‐use machine learning methods with practical details to decrease the most commonly used energy efficiency metric—power usage effectiveness in DCs. We achieved an accurate prediction by properly selecting the features used in the proposed prediction models established by neural network, light gradient boosting machine, recurrent neural network, and random forests. The proposed approaches are implemented in one of the largest hyperscale DCs in China—Tencent Tianjin DC, to optimize the set points of controllable variables in the cooling system and to detect and adjust the unreasonable working conditions in the modular data centers. The lower bound of PUE reduction was 0.005 with the proposed approaches, leading to about 1500 MWh (0.24% of the total designed electricity consumption of this DC) of energy saved per year in this hyperscale DC. The proposed methods have the potential to be transferred to DCs of similar scale, and the framework of our work could serve as a guide for machine learning‐based optimization of environmental indicators in other complex product/service systems.
Compositional variation in early‐life parenting structures alters oxytocin and vasopressin 1a receptor development in prairie voles (Microtus ochrogaster)
Authors: Rogers Forrest D. , Freeman Sara M. , Anderson Marina , Palumbo Michelle C. , Bales Karen L.
Published: June 2021

Paternal absence can significantly alter bio‐behavioural development in many biparental species. This effect has generally been demonstrated by comparing the development of offspring reared under biparental care with those reared by a single mother. However, studies employing this design conflate two significant modifications to early‐life experience: removal of father‐specific qualities and the general reduction of offspring‐directed care. In the socially monogamous prairie vole (Microtus ochrogaster), the experience of paternal absence without substitution during development inhibits partner preference formation in adulthood, a hallmark of social monogamy, in females and males. Employing alloparents as substitutes for fathers, our previous work demonstrated that paternal absence affects pair‐bond formation in female offspring via reducedquantityof care, although it affects pair‐bond formation in male offspring by means of a missing paternalquality(or qualities). Here, we present evidence that paternal absence (with and without alloparental substitution) may alter the ontogeny of neural oxytocin receptor (OXTR) and/or vasopressin 1a receptor (AVPR1a) distribution in male and female prairie voles. Compared to biparentally reared controls (BPC), male offspring reared in mother only (MON) and maternal‐plus‐alloparental (MPA) conditions show lower densities of OXTR in the central amygdala; and MPA males show lower densities of OXTR in the caudate putamen and nucleus accumbens. Early‐life experience was not associated with differences in AVPR1a density in males. However, MON and MPA females show greater densities of AVPR1a in the medial amygdala than BPC; and MPA females show greater densities of AVPR1a in the ventromedial nucleus of the hypothalamus. We also demonstrate with corticosterone concentrations that MON and MPA offspring are not differentially susceptible to a stressor (ie, social isolation) than BPC offspring. These findings suggest that paternal absence, although likely not a salient early‐life stressor, has neuroendocrine consequences for offspring, some of which may affect partner preference formation.
Core competencies of clinical nurse specialists: A comparison across three Nordic countries
Authors: Jokiniemi Krista , Hølge‐Hazelton Bibi , Kristofersson Gisli Kort , Frederiksen Kirsten , Kilpatrick Kelley , Mikkonen Santtu
Published: June 2021

Aim

To describe and compare the clinical nurse specialist core competency use in Finland, Denmark and Iceland.

Background

Clinical nurse specialist roles were first developed more than 60 years ago in the United States. Within the Nordic countries, the clinical nurse specialist role emerged around 2000. There is scarcity of clinical nurse specialist competency descriptions outside of North America, and research has been limited to examine or validate established competencies across different countries.

Design

A descriptive correlational study.

Methods

An online survey was conducted from May to September 2019. A population sample of clinical nurse specialists in Finland, Denmark and Iceland was recruited. A validated self‐report questionnaire of clinical nurse specialist competencies was used. The data were analysed using descriptive and inferential statistics, and the STROBE checklist was used as the reporting guideline.

Results

A total sample of 184 clinical nurse specialists, 52 from Finland, 95 from Denmark and 37 from Iceland, participated in the study (response rate = 72%, 35% and 48%, respectively). Overall, clinical nurse specialists utilised the organisational competency most frequently followed by the patient, clinical nursing leadership and scholarship competency. Univariate analysis of variance test between‐country effects showed statistically significant difference in patient competency (p = .000) and in organisational competency (p < .05). There were no statistically significant differences between counties in the utilisation of clinical nursing leadership and scholarship competency.

Conclusion

A small variability was found in the comparison of the clinical nurse specialist use of core competency in the spheres of patient, nursing, organisation and scholarship within three Nordic countries.

Relevance to clinical practice

The CNS competency scale may be utilised in benchmarking clinical nurse specialist roles and practice within and across countries. The long‐term goal for the competency descriptions is to enhance the clinical nurse specialist role clarity, integration and evaluation as well as inform post‐graduate education.
Digital Workflow for Establishing the Posterior Palatal Seal on a Digital Complete Denture
Authors: Lee Ju‐Hyoung
Published: June 2021

The posterior palatal seal (PPS) plays important roles in improving denture retention, preventing food and debris from entering under the denture base, reducing the gag reflex, providing more strength across the denture, and making the distal border less noticeable to the tongue. Digital dentures have become popular, owing to the use of computer‐aided design and computer‐aided manufacturing and rapid prototyping technologies. However, limited research has been conducted on a digital workflow to establish the PPS. This article presents a technique to establish the PPS by using digital technologies for providing the advantages of the PPS to patients wearing digital dentures.
Entrepreneurial ways of designing and designerly ways of entrepreneuring: Exploring the relationship between design thinking and effectuation theory
Authors: Klenner Nico Florian , Gemser Gerda , Karpen Ingo Oswald
Published: June 2021

Scholars have suggested that design thinking and effectuation theory may enrich each other. However, to date, we lack deeper theorizing and empirical evidence to further advance this valuable discourse for the benefit of innovation management. Our qualitative study draws on 41 in‐depth interviews with Australian designer‐founders, with the aim to provide a theoretical perspective on and empirical insights into the relationship between the behavioral practices of design thinking and the cognitive principles of effectuation. The contributions are twofold. First, our study explains how design thinking practices enable designer‐founders to enact the cognitive principles of effectuation. Uncovering these “entrepreneurial ways of designing” provides an explanation for the effectiveness of design thinking for entrepreneurial innovation and new venture creation. Second, our study sheds light on the ways in which designer‐founders interpret effectuation principles through the professional values and norms embodied in design thinking. These “designerly ways of entrepreneuring” resemble particular, normative interpretations of effectual action. By doing so, our study offers empirical substantiation and theoretical elaboration of the ways in which design thinking functions as an approach for entrepreneurial innovation and new venture creation. Through shedding light on the “entrepreneurial ways of designing” and “designerly ways of entrepreneuring” exhibited by designer‐founders, our research reveals the reciprocal relationship between design thinking and effectuation theory.
Evaluation of a continuous glucose monitoring system in neonatal foals
Authors: Wong David , Malik Caitlin , Dembek Katarzyna , Estell Krista , Marchitello Megan , Wilson Katie
Published: June 2021

Background

Monitoring blood glucose concentrations is common in critically ill neonatal foals, especially septic foals and those receiving naso‐esophageal feedings or IV parenteral nutrition. Glucose typically is measured using a point‐of‐care (POC) glucometer but requires repeated restraint and blood collections, which may cause irritation at venipuncture sites and increased demands on nursing staff. Continuous glucose monitoring systems (CGMS) may provide an accurate alternative for monitoring blood glucose concentration.

Objectives

To determine the correlation and accuracy of a CGMS to monitor neonatal foals' blood glucose concentrations as compared to a POC glucometer and laboratory chemistry analysis (CHEM).

Animals

Samples from 4 healthy and 4 ill neonatal foals.

Methods

A CGMS was placed on each foal, and glucose measurements acquired from this device were compared to simultaneous measurements of blood glucose concentration using a POC glucometer and CHEM.

Results

Two‐hundred matched glucose measurements were collected from 8 neonatal foals. The mean bias (95% limits of agreement) between CGMS and CHEM, CGMS and POC glucometer, and POC glucometer and CHEM was 3.97 mg/dL (−32.5 to 40.4), 18.2 mg/dL (−28.8 to 65.2), and 22.18 mg/dL (−9.3 to 53.67), respectively. The Pearson's correlation coefficient (r) was significantly correlated among all devices: GCMS and CHEM (r = 0.81), CGMS and POC glucometer (r = 0.77) and POC glucometer‐CHEM (r = 0.92).

Conclusions and Clinical Importance

Within the blood glucose concentration ranges in this study (78‐212 mg/dL), CGMS measurements were significantly correlated with CHEM, suggesting that it is an acceptable method to provide meaningful, immediate, and continuous glucose concentration measurements in neonatal foals while eliminating the need for repeated restraint and blood collection.
Mucormycosis in patients with COVID‐19: A cross‐sectional descriptive multicentre study from Iran
Authors: Pakdel Farzad , Ahmadikia Kazem , Salehi Mohammadreza , Tabari Azin , Jafari Rozita , Mehrparvar Golfam , Rezaie Yasaman , Rajaeih Shahin , Alijani Neda , Barac Aleksandra , Abdollahi Alireza , Khodavaisy Sadegh
Published: June 2021

Purpose

The aim of the study was to report clinical features, contributing factors and outcome of patients with coronavirus disease 2019 (COVID‐19)‐associated mucormycosis (CAM).

Methods

A cross‐sectional descriptive multicentre study was conducted on patients with biopsy‐proven mucormycosis with RT‐PCR‐confirmed COVID‐19 from April to September 2020. Demographics, the time interval between COVID‐19 and mucormycosis, underlying systemic diseases, clinical features, course of disease and outcomes were collected and analysed.

Results

Fifteen patients with COVID‐19 and rhino‐orbital mucormycosis were observed. The median age of patients was 52 years (range 14–71), and 66% were male. The median interval time between COVID‐19 disease and diagnosis of mucormycosis was seven (range: 1–37) days. Among all, 13 patients (86%) had diabetes mellitus, while 7 (46.6%) previously received intravenous corticosteroid therapy. Five patients (33%) underwent orbital exenteration, while seven (47%) patients died from mucormycosis. Six patients (40%) received combined antifungal therapy and none that received combined antifungal therapy died.

Conclusion

Clinicians should be aware that mucormycosis may be complication of COVID‐19 in high‐risk patients. Poor control of diabetes mellitus is an important predisposing factor for CAM. Systematic surveillance for control of diabetes mellitus and educating physician about the early diagnosis of CAM are suggested.
Diabetes mellitus and oral lichen planus: A systematic review and meta‐analysis
Authors: Mallah Narmeen , Ignacio Varela‐Centelles Pablo , Seoane‐Romero Javier , Takkouche Bahi
Published: June 2021

Objective

To undertake a meta‐analysis of the association of Oral Lichen Planus (OLP) with diabetes, two diseases with an important impact on public health and the economy, but the evidence of which about their association is inconsistent.

Methods

Relevant studies were localized by searching MEDLINE, EMBASE, Conference Proceedings, and other databases from inception to October 2020, without restrictions. The reference lists of included studies and of related reviews were also inspected. Global pooled odds ratios were calculated, and predefined subgroup analyses were performed. The heterogeneity between studies and publication bias was assessed and sensitivity analysis was carried out.

Results

Thirty‐two studies were included in the meta‐analysis. Pooled ORs showed a moderate association between diabetes and OLP [OR: 1.87 (95%CI: 1.57, 2.34)]. The association is limited to studies carried out on adults only [OR: 2.12 (95%CI: 1.75, 2.57)] and is observed in all study designs. Globally, the heterogeneity was low to moderate. Studies carried out in European populations show a stronger association of diabetes and OLP than Asiatic studies [OR: 2.49 (95%CI: 1.87, 3.32) and 1.60 (95%CI: 1.25, 2.03), respectively].

Conclusions

Diabetes and OLP are moderately associated. Systematic diagnosis of diabetes in OLP patients could prove useful.
Diverse clinical features and diagnostic delay in monogenic inborn errors of immunity: A call for access to genetic testing
Authors: Branch Anna , Modi Bhavi , Bahrani Bahar , Hildebrand Kyla J. , Cameron Scott B. , Junker Anne K. , Turvey Stuart E. , Biggs Catherine M.
Published: June 2021

Background

Inborn errors of immunity (IEIs) are a group of conditions affecting immune system development and function. Due to their clinical heterogeneity and lack of provider awareness, patients suffer from long diagnostic delays that increase morbidity and mortality. Next‐generation sequencing facilitates earlier diagnosis and treatment of IEIs, but too often patients are unable to see the benefit of this technology due to gaps in providers’ knowledge regarding which patients to test and barriers to accessing sequencing.

Methods

Here, we provide detailed clinical phenotyping and describe the impact of genetic sequencing on a cohort of 43 patients with monogenic IEIs seen in a tertiary care center from 2014 to 2019. Data were abstracted from a chart review, and a panel of clinical immunologists were consulted on the impact of genetic sequencing on their patients.

Results

We found that our patients had significant diagnostic delays, averaging 3.3 years; had diverse manifestations of immune system dysfunction; and had demonstrated highly complex medical needs, with on average 7.9 subspecialties involved in their care and 4.9 hospitalizations prior to definitive treatment. Our results also demonstrate the benefits of genetic testing, as it provided the majority of our patients with a diagnosis, and positively impacted their treatment, follow‐up, and prognosis.

Conclusion

This paper expands the paucity of literature on genetically confirmed IEIs in North America and supports the expansion of access to genetic testing for patients with clinical features suggesting IEI, such as those presented in our cohort.
Anti‐plasma cell treatment in refractory autoimmune hemolytic anemia in a child with multivisceral transplant
Authors: Ghobrial Shahira , Gonzalez Corina Elena , Kaufman Stuart , Yazigi Nada , Matsumoto Cal , Fishbein Thomas , Hawksworth Jason , Ekong Udeme D. , Kroemer Alexander , Khan Khalid
Published: June 2021

Background

Warm‐antibody AIHA is known to complicate solid organ (SOT) and HSCT, the disease maybe refractory to standard therapy. Immunosuppressive therapies as well as IVIG, and rituximab have been the main stay of treatment. Over the past decade, B‐lymphocyte targeted, anti‐CD‐20 antibody has been recognized in the treatment of autoimmune diseases and utilized in AIHA. Bortezomib, a proteasome inhibitor that causes apoptosis of plasma cells, is an appealing targeted therapy in secondary AIHA and has demonstrated efficacy in HSCT patients. From our experience, we advocate for early targeted therapy that combines B cell with plasma cell depletion.

Case Report

We describe a 4‐year‐old‐girl with stage III neuroblastoma, complicated with intestinal necrosis needing multivisceral transplant developed warm AIHA 1‐year after transplantation, and following an adenovirus infection. She received immunoglobulin therapy, rituximab, sirolimus, plasmapheresis, and long‐term prednisolone with no sustained benefit while developing spinal fractures related to the latter therapy. She received bortezomib for intractable AIHA in combination with rituximab with no appreciable adverse effects. Three years later the child remains in remission with normal reticulocyte and recovered B cells. In the interim, she required chelation therapy for iron overload related to blood transfusion requirement during the treatment of AIHA.

Conclusion

We propose early targeted anti‐plasma cell therapy with steroid burst, IVIG, rituximab, and possible plasmapheresis may reduce morbidity in secondary refractory w‐AIHA.
Correct response negativity may reflect subjective value of reaction time under regulatory fit in a speed‐rewarded task
Authors: Files Benjamin T. , Pollard Kimberly A. , Oiknine Ashley H. , Khooshabeh Peter , Passaro Antony D.
Published: June 2021

Error‐related negativity (ERN), an electroencephalogram (EEG) component following an erroneous response, has been associated with the subjective motivational relevance of error commission. A smaller EEG event, the correct response negativity (CRN), occurs after a correct response. It is unclear why correct behavior evokes a neural response similar to error commission. CRN might reflect suboptimal performance: in tasks where speed is motivationally relevant (i.e., incentivized), a correct but slow response may be experienced as a minor error. The literature is mixed on the relationship between CRN and response time (RT), possibly due to different motivational structures, tasks, or individual traits. We examined ERN and CRN in a go/no‐go task where correctness and speed were encouraged using a points‐based feedback system. A key individual trait, regulatory focus, describes a person's tendency to seek gains (promotion focus) and avoid losses (prevention focus). Trait regulatory focus was measured, and participants were randomly assigned to one of three conditions: points gain, points loss, and informative‐only feedback. Participants committed too few errors to reliably model ERN effects. CRN amplitude related to RT in all feedback conditions, with slower responses having larger CRN. Participants with stronger promotion focus had a more exaggerated RT/CRN relationship in the point gain condition, suggesting that regulatory fit influences the motivational relevance of speed and thus the negative subjective experience and CRN for slower responses. These findings are consistent with the claim that CRN reflects RT when RT is motivationally relevant and that the CRN/RT relationship reflects the degree of subjective motivational relevance.
Proper Generalized Decomposition Based Model Order Reduction Applied to Problems Defined in Degenerated Domains
Authors: Ghnatios Chady , Bognet Brice , Barasinski Anais , Chinesta Francisco
Published: June 2021

Nowadays, the use of simulation in industrial applications is a routine practice. However, the need of considering high fidelity models and their associated solutions is demanding for more efficient solvers. Despite the remarkable progress accomplished in hardware and software in the last decades, the ability to simulate high fidelity 3D models, taking into consideration all their richness is still challenging. For example, if we wish to simulate a 3D problem including 10 parameters, each of them taking 10 different values we should solve 1010 3D problems. This issue is known as the curse of dimensionality, and compromises the solution of models defined in high dimensional spaces.
3-D ultrasound elasticity imaging for targeted prostate biopsy guidance
Authors: Chan Derek , Cody Morris D. , J. Polascik Thomas , L. Palmeri Mark , R. Nightingale Kathryn
Published: June 2021

We will present a recent work on the development of an ultrasound system that provides co-registered 3-D acoustic radiation force impulse (ARFI) imaging, shear wave elasticity imaging (SWEI), and B-mode imaging volumes to guide a targeted biopsy of prostate cancer.
Transmission-reflection optoacoustic ultrasound (TROPUS) computed tomography of whole mice
Authors: Razansky Daniel , Lafci Berkan , Luis Dean-Ben Xose
Published: June 2021

We present a hybrid transmission-reflection optoacoustic ultrasound (TROPUS) small animal imaging platform that combines optoacoustic tomography with both reflection- and transmission-mode ultrasound computed tomography. The system features full-view cross-sectional tomographic imaging geometry for concomitant noninvasive mapping of the absorbed optical energy, acoustic reflectivity, speed of sound and acoustic attenuation in whole live mice with submillimeter resolution and unrivaled image quality.