bluuebunny/crossref_metadata_2025 huggingface dataset:
Hospital nurses’ experiences of assessing health status changes in stem‐cell transplanted patients in home care: A qualitative study
Authors: Wergeland Daniel , Harsten Kristine , Klarare Anna , Steindal Simen A.
Published: November 2021

Aims and objectives

To explore hospital nurses’ experience assessing changes in the health status of stem‐cell transplanted patients in home care (HC).

Background

Stem‐cell transplanted patients in HC are treated at home instead of in hospital wards. Hospital nurses visit patients daily and play a key role in assessing the patients’ health status. Previous studies on HC for stem‐cell transplanted patients focus mainly on safety in HC versus hospital care. No studies regarding nurses’ experience assessing patients’ health status at home when patients undergo stem‐cell transplantation were found.

Design

Qualitative study with an explorative design.

Methods

Data were collected via 14 individual semi‐structured interviews with hospital nurses working with stem‐cell transplanted patients in HC. Data were analysed using systematic text condensation. The reporting of the study was guided by the COREQ checklist.

Results

Three categories emerged from the data analysis: 1) Effective communication and clinical intuition enhances the assessment of patients’ general health condition; 2) It is challenging to rely on one's own judgment in remote assessment; and 3) There are key facilitators in performing remote clinical assessments.

Conclusions

Effective communication and clinical intuition enhanced the assessment of patients’ general health conditions. The lack of physical presence during remote assessments made using clinical intuition in the assessment process difficult. Experience with hematopoietic stem‐cell transplantation was seen as important to facilitate accurate remote clinical assessments.

Relevance to clinical practice

Nurses with responsibility for hospital at‐home telephone care should receive training in remote communication and should shadow hospital at‐home nurses during in home visits to gain experience assessing patients’ health status. Telehealth aspects such as videoconferencing and remote patient monitoring should be considered for more accurate remote assessment. This could potentially result in more effective assessments and reduced readmissions and could promote nurses’ confidence in their assessments.
Extremely high anti‐Mullerian hormone levels detected during infertility workup revealing sex cord tumor with annular tubules and underlying Peutz–Jeghers syndrome: A case report
Authors: Yucel Cicek Ozge Senem , Gezer Sener , Cakir Ozgur , Hekimoglu Gurbuz Rumeysa
Published: November 2021

We report an infertile, but otherwise asymptomatic woman, whose extremely high anti‐Mullerian hormone (AMH) level detected during infertility investigation led to the diagnosis of sex cord tumor with annular tubules (SCTAT) which is a very rare sex cord‐stromal tumor (SCST) and eventually revealed a previously undiagnosed hereditary cancer syndrome, Peutz–Jeghers syndrome (PJS). A 33‐year‐old woman attended Kocaeli University ART Clinic for infertility evaluation. Her AMH level was 319.63 ng/ml. Detection of bilateral ovarian cysts required surgical evaluation. The histopathological examination of ovaries revealed SCTAT. The strong association of SCTAT with PJS raised the suspicion of this syndrome. Whole STK11 gene sequencing confirmed PJS diagnosis. AMH has become a widely used tool in the evaluation of infertile women. Clinicians dealing with infertility should be familiar with the utility of AMH measurement besides being a marker of ovarian reserve. Detection of high AMH concentrations should raise the suspicion of an SCST.
Clinical characteristics and hematological parameters associated with disease severity in COVID‐19 positive pregnant women undergoing cesarean section: A single‐center experience
Authors: Arslan Baris , Bicer Ilhan G. , Sahin Tuna , Vay Merve , Dilek Okan , Destegul Emre
Published: November 2021

Aim

The study aimed to describe clinical characteristics and outcomes of pregnant women with COVID‐19 undergoing cesarean section, and evaluated the association of blood values at admission with severe COVID‐19 disease in this group of patients.

Method

We retrospectively analyzed the clinical data of 110 patients infected with COVID‐19 who underwent cesarean section at Adana City Education and Research Hospital in Turkey. The COVID‐19 severity of the patients was classified as either severe or nonsevere disease according to World Health Organization of COVID‐19 clinical management guidance. We compared blood values, clinical characteristics, and outcomes between severe and nonsevere patients. Receiver operating characteristics (ROC) curves analyses and area under the ROC curve (AUC) value was calculated to evaluate the predictive value of blood parameters on the COVID‐19 severity.

Results

Of the 110 women, 12 were severe cases. Severe patients had higher ferritin, neutrophil‐to‐lymphocyte ratio (NLR), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), and procalcitonin levels on admission (p < 0.05). The ROC analysis demonstrated AUC of NLR, LDH, AST, ALT, ferritin, and procalcitonin was 0.757, 0.856, 0.840, 0.771, 0.821, and 0.698, respectively. The LDH had a maximum specificity (90.8%), with the cutoff value of 365. The O‐blood group was more likely to have severe illness than the non‐O‐blood group (relative risk: 3.6; 95% confidence interval; 1.2–10.4).

Conclusion

This study shows that LDH values at admission are an early and powerful predictor of severe infection for pregnant women with COVID‐19 who will undergo a cesarean section.
Effect of Different Preparation Depths for an Inlay‐Retained Fixed Partial Denture on the Accuracy of Different Intraoral Scanners: An In Vitro Study
Authors: Khaled Mohamed , Sabet Ahmed , Ebeid Kamal , Salah Tarek
Published: November 2021

Purpose

The aim was to evaluate the effect of different preparation depths for inlay‐retained fixed partial dentures on the accuracy of intraoral scanners.

Materials and Methods

Tooth preparations for two inlay‐retained fixed partial dentures were done and divided according to depth of the preparation. Group A: 2 mm pulpal floor depth, 3 mm gingival floor depth and Group B: 3 mm pulpal floor depth, 4mm gingival floor depth. The CEREC Omnicam 4.4.4, Omnicam 4.6.2. Trios3 and Medit i500 intraoral scanners were used in this study. Tooth preparations were scanned by each scanner 10 times. The STL files obtained from the intraoral scanners were compared to the reference models (trueness) and within each test group (precision) using a 3D comparison software. Data were then statistically analyzed.

Results

Regarding trueness, two‐way ANOVA revealed significant differences between the different types of scanners (p < 0.001) (Omnicam 4.4.4: 65.09 ± 2.87 Omnicam 4.6.1: 52.73 ± 3.31 Medit i500: 58.45 ± 2.63 Trios 3: 41.79 ± 4.42). Preparation depth had no significant influence on the trueness (p = 0.083). For precision two‐way ANOVA revealed significant differences between the different types of scanners (p < 0.001). Preparation depth had no significant influence on the precision (p = 0.111). Statistically significant interactions were found between the different variables.

Conclusions

The depth of preparation did not have an influence on the accuracy of different scanners. However, the type of scanner influenced the accuracy of digital impressions with Trios3 showing the highest accuracy.
Technology heterogeneity and market structure
Authors: Eling Martin , Jia Ruo , Lin Jieyu , Rothschild Casey
Published: November 2021

New technologies may allow principals or firms to learn more quickly about the characteristics of their agents or clients—at some cost of employing that technology. We study the implications of this speed‐versus‐cost tradeoff for equilibrium pricing and purchasing decisions in insurance markets featuring adverse selection. In particular, we study dynamic competitive equilibrium in a theoretical model featuring individuals who differ in their privately known risk types and featuring two types of insurers: conventional insurers who employ a legacy learning technology and tech insurers who employ a new technology. Equilibrium in our model features sorting of low‐risk types into tech firms and high‐risk types into conventional firms. We show, intuitively, that lowering the technology cost raises this cutoff and thus increases the equilibrium market share of tech firms. Perhaps counter‐intuitively, however, we show that adverse selection effects within the conventional market can cause an attempt by conventional insurers to catch up with tech firms—by increasing the speed at which they learn about the risk types of their insureds—to backfire and lead to an increase in the market share of tech firms. Our results are readily adapted to bank lending and labor market settings.
Linked selection, ancient polymorphism, and ecological adaptation shape the genomic landscape of divergence in Quercus dentata
Authors: Zhou Biao‐Feng , Shi Yong , Chen Xue‐Yan , Yuan Shuai , Liang Yi‐Ye , Wang Baosheng
Published: November 2021

Multiple evolutionary forces contribute to heterogeneous genomic landscapes; however, disentangling their relative contributions is challenging. We sampled nine populations across the distribution of Quercus dentata, a dominant forest tree in East Asia, and used whole‐genome sequencing data to investigate mechanisms underlying divergence. We identified two genetic groups (north and south) that diverged ~1.84 million years ago, consistent with the uplift of the Qinling Mountains during the Pleistocene. The north group experienced a bottleneck during the middle–late Pleistocene and expanded from multiple refugia. The south group experienced a more severe bottleneck and showed high population differentiation, probably due to long‐term isolation and habitat fragmentation. We detected genomic islands with elevated relative differentiation (FST) scattered across the genome. Among these, 65.9% showed reduced absolute divergence (dXY) consistent with linked selection, while the remaining (34.1%) showed elevated dXY suggestive of divergent sorting of ancient polymorphisms. The recombination rate in genomic islands was lower than background, suggesting the importance of genome structure in shaping the genomic landscape. We detected 108 single nucleotide polymorphisms significantly associated with environmental factors, 12 of which clustered in a region of ~500 kb. This region showed multiple signals of positive selection in the north group, including the enrichment of XP‐extended haplotype homozygosity scores, an elevated population branch statistic, and an excess of high‐frequency derived alleles. In addition, we found that linkage disequilibrium was low and derived haplotypes declined rapidly in this region, indicating selection on standing variation. Our results clarify the evolutionary processes driving genomic divergence in Q. dentata.
Performance of lymph node cytopathology in diagnosis and characterization of lymphoma in dogs
Authors: Martini Valeria , Marano Giuseppe , Aresu Luca , Bonfanti Ugo , Boracchi Patrizia , Caniatti Mario , Cian Francesco , Gambini Matteo , Marconato Laura , Masserdotti Carlo , Nicoletti Arturo , Riondato Fulvio , Roccabianca Paola , Stefanello Damiano , Teske Erik , Comazzi Stefano
Published: November 2021

Background

Cytopathology is a minimally invasive and convenient diagnostic procedure, often used as a substitute for histopathology to diagnose and characterize lymphoma in dogs.

Objectives

Assess the diagnostic performance of cytopathology in diagnosing lymphoma and its histopathological subtypes in dogs.

Animals

One‐hundred and sixty‐one lymph node samples from 139 dogs with enlarged peripheral lymph nodes.

Methods

Based only on cytopathology, 6 examiners independently provided the following interpretations on each sample: (a) lymphoma vs nonlymphoma; (b) grade and phenotype; and (c) World Health Organization (WHO) histopathological subtype. Histopathology and immunohistochemistry (IHC) findings were used as reference standards to evaluate diagnostic performance of cytopathology. Clinical, clinicopathologic, and imaging data also were considered in the definitive diagnosis.

Results

Classification accuracy for lymphoma consistently was >80% for all examiners, whereas it was >60% for low grade T‐cell lymphomas, >30% for high grade B‐cell lymphomas, >20% for high grade T‐cell lymphomas, and <40% for low grade B‐cell lymphomas. Interobserver agreement evaluated by kappa scores was 0.55 and 0.32 for identification of lymphoma cases, and of grade plus immunophenotype, respectively.

Conclusions and Clinical Importance

Cytopathology may result in accurate diagnosis of lymphoma, but accuracy decreases when further characterization is needed. Cytopathology represents a fundamental aid in identifying lymphoma and can be used as a screening test to predict grade and phenotype. However, these results must be confirmed using other ancillary techniques, including flow cytometry, histopathology, and immunohistochemistry (IHC).
Consistent genetic divergence observed among pelagic Sargassum morphotypes in the western North Atlantic
Authors: Dibner Skye , Martin Lindsay , Thibaut Thierry , Aurelle Didier , Blanfuné Aurélie , Whittaker Kerry , Cooney Laura , Schell Jeffrey M. , Goodwin Deborah S. , Siuda Amy N. S.
Published: November 2021

Sargassum natans and Sargassum fluitans are uniquely holopelagic macroalgae, providing open ocean nursery and foraging habitat for commercially and ecologically important species. Recent basin‐wide changes in pelagic Sargassum diversity and distribution have manifested in proliferation of a previously rare morphotype, Sargassum natans VIII, to rival biomass levels of historically dominant S. natans I and S. fluitans III. Precise genetic identification of these morphotypes can improve accuracy and interpretation of ecological studies as well as clarify evolutionary history and population connectivity. For 139 field samples collected from the subtropical and tropical North Atlantic, three mitochondrial genes (cox3, nad6, and mt16S rRNA) were used to examine genetic divergence among the three common pelagic Sargassum morphotypes. These gene sequences successfully differentiated among morphotypes regardless of geographic origin, confirming in situ morphology‐based identifications. Sargassum natans I and S. natans VIII exhibited divergence consistent with that between the S. natans‐complex and S. fluitans III. Phylogenetic analysis of these samples also indicated evolutionary divergence between Sargassum morphologies. The genetic divergence among morphotypes, compared with benthic Sargassum species, suggested that taxonomic reclassification of the three most common pelagic morphotypes may be warranted.
Venoms for all occasions: The functional toxin profiles of different anatomical regions in sea anemones are related to their ecological function
Authors: Ashwood Lauren M. , Undheim Eivind A. B. , Madio Bruno , Hamilton Brett R. , Daly Marymegan , Hurwood David A. , King Glenn F. , Prentis Peter J.
Published: November 2021

The phylum Cnidaria is the oldest extant venomous group and is defined by the presence of nematocysts, specialized organelles responsible for venom production and delivery. Although toxin peptides and the cells housing nematocysts are distributed across the entire animal, nematocyte and venom profiles have been shown to differ across morphological structures in actiniarians. In this study, we explore the relationship between patterns of toxin expression and the ecological roles of discrete anatomical structures in Telmatactis stephensoni. Specifically, using a combination of proteomic and transcriptomic approaches, we examined whether there is a direct correlation between the functional similarity of regions and the similarity of their associated toxin expression profiles. We report that the regionalization of toxin production is consistent with the partitioning of the ecological roles of venom across envenomating structures, and that three major functional regions are present in T. stephensoni: tentacles, epidermis and gastrodermis. Additionally, we find that most structures that serve similar functions not only have comparable putative toxin profiles but also similar nematocyst types. There was no overlap in the putative toxins identified using proteomics and transcriptomics, but the expression patterns of specific milked venom peptides were conserved across RNA‐sequencing and mass spectrometry imaging data sets. Furthermore, based on our data, it appears that acontia of T. stephensoni may be transcriptionally inactive and only mature nematocysts are present in the distal portions of the threads. Overall, we find that the venom profile of different anatomical regions in sea anemones varies according to its ecological functions.
Understanding parasite–brain microvascular interactions with engineered 3D blood–brain barrier models
Authors: Long Rory K. M. , Piatti Livia , Korbmacher François , Bernabeu Maria
Published: November 2021

Microbial interactions with the blood–brain barrier (BBB) can be highly pathogenic and are still not well understood. Among these, parasites present complex interactions with the brain microvasculature that are difficult to decipher using experimental animal models or reductionist 2D in vitro cultures. Novel 3D engineered blood–brain barrier models hold great promise to overcome limitations in traditional research approaches. These models better mimic the intricate 3D architecture of the brain microvasculature and recapitulate several aspects of BBB properties, physiology, and function. Moreover, they provide improved control over biophysical and biochemical experimental parameters and are compatible with advanced imaging and molecular biology techniques. Here, we review design considerations and methodologies utilized to successfully engineer BBB microvessels. Finally, we highlight the advantages and limitations of existing engineered models and propose applications to study parasite interactions with the BBB, including mechanisms of barrier disruption.
Xanthomonas transcriptome inside cauliflower hydathodes reveals bacterial virulence strategies and physiological adaptations at early infection stages
Authors: Luneau Julien S. , Cerutti Aude , Roux Brice , Carrère Sébastien , Jardinaud Marie‐Françoise , Gaillac Antoine , Gris Carine , Lauber Emmanuelle , Berthomé Richard , Arlat Matthieu , Boulanger Alice , Noël Laurent D.
Published: November 2021

Xanthomonas campestris pv. campestris (Xcc) is a seed‐transmitted vascular pathogen causing black rot disease on cultivated and wild Brassicaceae. Xcc enters the plant tissues preferentially via hydathodes, which are organs localized at leaf margins. To decipher both physiological and virulence strategies deployed by Xcc during early stages of infection, the transcriptomic profile of Xcc was analysed 3 days after entry into cauliflower hydathodes. Despite the absence of visible plant tissue alterations and despite a biotrophic lifestyle, 18% of Xcc genes were differentially expressed, including a striking repression of chemotaxis and motility functions. The Xcc full repertoire of virulence factors had not yet been activated but the expression of the HrpG regulon composed of 95 genes, including genes coding for the type III secretion machinery important for suppression of plant immunity, was induced. The expression of genes involved in metabolic adaptations such as catabolism of plant compounds, transport functions, sulphur and phosphate metabolism was upregulated while limited stress responses were observed 3 days postinfection. We confirmed experimentally that high‐affinity phosphate transport is needed for bacterial fitness inside hydathodes. This analysis provides information about the nutritional and stress status of bacteria during the early biotrophic infection stages and helps to decipher the adaptive strategy of Xcc to the hydathode environment.
The RavA/VemR two‐component system plays vital regulatory roles in the motility and virulence of Xanthomonas campestris
Authors: Lin Maojuan , Wu Kejian , Zhan Zhaohong , Mi Duo , Xia Yingying , Niu Xiaolei , Feng Shipeng , Chen Yinhua , He Chaozu , Tao Jun , Li Chunxia
Published: November 2021

Xanthomonas campestris pv. campestris (Xcc) can cause black rot in cruciferous plants worldwide. Two‐component systems (TCSs) are key for bacterial adaptation to various environments, including hosts. VemR is a TCS response regulator and crucial for Xcc motility and virulence. Here, we report that RavA is the cognate histidine kinase (HK) of VemR and elucidate the signalling pathway by which VemR regulates Xcc motility and virulence. Genetic analysis showed that VemR is epistatic to RavA. Using bacterial two‐hybrid experiments and pull‐down and phosphorylation assays, we found that RavA can interact with and phosphorylate VemR, suggesting that RavA is the cognate HK of VemR. In addition, we found that RpoN2 and FleQ are epistatic to VemR in regulating bacterial motility and virulence. In vivo and in vitro experiments demonstrated that VemR interacts with FleQ but not with RpoN2. RavA/VemR regulates the expression of the flagellin‐encoding gene fliC by activating the transcription of the rpoN2‐vemR‐fleQ and flhF‐fleN‐fliA operons. In summary, our data show that the RavA/VemR TCS regulates FleQ activity and thus influences the expression of motility‐related genes, thereby affecting Xcc motility and virulence. The identification of this novel signalling pathway will deepen our understanding of Xcc–plant interactions.
Invasive fungal infections in acute and chronic liver impairment: A systematic review
Authors: Lahmer Tobias , Peçanha‐Pietrobom Paula M. , Schmid Roland M. , Colombo Arnaldo Lopes
Published: November 2021

Patients with acute and chronic liver impairment are susceptible to invasive fungal infections such as candidemia and invasive pulmonary aspergillosis as a result of cirrhosis‐associated immune dysfunction, humoral immunodeficiency, cell‐mediated dysfunction and systemic inflammation. Besides classical risk factors for invasive fungal infection, acute‐on‐chronic liver failure, corticosteroid use, gastrointestinal bleeding, and prophylactic use of antibiotics are all additional conditions which are related to the potential development of fungal infections. Therefore, high‐risk patients should be carefully followed by microbiological surveillance including cultures but also by imaging and fungal biomarkers for providing early diagnosis. Echinocandins are still the mainstay and first line antifungal therapy in cases of invasive candidiasis. Due to concerns of liver toxicity and in cases of renal impairment liposomal amphotericin B is a suitable alternative to voriconazole in patients with invasive pulmonary aspergillosis. Although, data of isavucoanzole and posaconazole use in those patients are also promising more specific studies in the subgroup of patients with liver impairment are needed. Especially, due to the late diagnosis and multiple organ dysfunction usually present in patients with liver impairment morbidity and mortality rates remain high. Based on the broad spectrum of diverse reports with varying content and quality and in some cases lack of evidence we performed a systematic review on this topic.
Demographics and long‐term outcomes of children with end‐stage kidney disease: A 20‐year territory‐wide study
Authors: Chan Eugene Yu Hin , Yap Desmond Yat Hin , Wong Wilfred Hing Sang , Ho Tsz Wai , Tong Pak Chiu , Lai Wai Ming , Chan Tak Mao , Ma Alison Lap Tak
Published: November 2021

Aim

To evaluate the demographics and long‐term patient outcomes of children with end‐stage kidney disease in Hong Kong.

Methods

We conducted a cohort study at the Paediatric Nephrology Centre, the designated site providing kidney replacement therapy (KRT) for children in Hong Kong. The clinical characteristics and outcomes of all children who initiated chronic KRT before 19 years, between 2001 and 2020, were analysed.

Results

One hundred forty‐seven children (50% male) received KRT at a mean age of 11.4 ± 5.7 years. The incidence of ESKD was 6.28 per million age‐related population (pmarp). The leading cause of ESKD was congenital anomalies (33%). Ten children (7%) had pre‐emptive kidney transplants, 104 (71%) and 33 (22%) patients received automated peritoneal dialysis and haemodialysis as initial KRT. The incidence of ESKD increased over time, and were 4.38, 5.07, 6.15 and 9.17 pmarp during 2001–2005, 2006–2010, 2011–2015 and 2016–2020, respectively (p = .005). Ninty‐seven patients (66%) received kidney transplants and the median time to receive a kidney graft was 3.7 years (95% CI 3.1–4.3). Only 10 patients had pre‐emptive kidney transplants. The mortality rate was 9.1 deaths per 1000‐patient‐years (95%CI 4.6–16.2). The survival probabilities at 1‐, 5‐, 10‐ and 15‐year were 100%, 94.8% (95%CI 90.7–98.9%), 89.7% (95% CI 83.4%–95.9%), 87.1% (95% CI 79.3%–94.9%), respectively. Standardised mortality ratio was 54.5. 72% of deaths were due to infections. Young infants and those without kidney transplants were associated with worse survival (p < .01). Multivariate analysis demonstrated that dialysis was the only factor associated with significantly increased risk of death (HRadj 12.9, 95% CI 2.7–63.2, p = .002).

Conclusion

We observed an increasing incidence of paediatric ESKD in Hong Kong with considerable waiting time to kidney transplant. Mortality risk is comparable to other developed countries and is highest among dialysis population. Efforts should be made to facilitate early access to paediatric kidney transplantation in Hong Kong.
Association of left ventricular hypertrophy and functional impairment with cardiovascular outcomes and mortality among patients with chronic kidney disease, results from theC‐STRIDEstudy
Authors: Wang Jinwei , Lv Jicheng , He Kevin , Wang Fang , Gao Bixia , Zhao Ming‐Hui , Zhang Luxia ,   The Chinese Cohort Study of Chronic Kidney Disease (C‐STRIDE)
Published: November 2021

Aim

Left ventricular hypertrophy and impaired systolic and diastolic function are commonly seen in patients with chronic kidney disease (CKD), but relationships between the disorders and cardiovascular outcomes are not well established among the patients.

Methods

Totally, 2020 patients with CKD Stages 1–4 were used in the analysis. Left ventricular hypertrophy was defined by left ventricular mass index >49.2 g/m2.7in men and > 46.7 g/m2.7in women. Incident heart failure, non‐heart failure cardiovascular events, and all‐cause mortality were recorded longitudinally. Cox proportional hazards regression model was used to evaluate the association between the echo parameters and the outcomes, with death treated as the competing risk event for the cardiovascular events.

Results

After a median follow‐up of 4.5 years, 53 heart failure, 76 non‐heart failure cardiovascular events and 82 deaths occurred. No overall association was found between left ventricular hypertrophy and subsequent heart failure, but the relationship was significant among patients with no diabetes with the multivariable adjusted hazard ratio of 3.66 (95% confidence interval: 1.42–9.46). Ejection fraction<55% was associated with both heart failure and non‐heart failure cardiovascular events with hazard ratios of 3.16 (1.28–7.77) and 2.76 (1.08–7.04), respectively. E/A ratio ≤ 0.75 was associated with non‐heart failure cardiovascular events [hazard ratio = 2.03 (1.09–3.80)], compared with E/A ratio of 0.76–1.49.

Conclusion

Associations of reduced left ventricular ejection fraction with both heart failure and non‐heart failure cardiovascular events and of impaired left ventricular diastolic function with non‐heart failure cardiovascular events were validated in a Chinese cohort of CKD.
What keeps an island community COVID‐19 free in a global pandemic?
Authors: Oliver Pam , Lindsay Neil , Kearns Robin
Published: November 2021

The COVID pandemic has offered opportunities for islands and other relatively isolated communities to establish pandemic‐protection boundaries. A July 2020 survey of Waiheke Island residents sought views on how the island had remained COVID‐19 free, despite proximity to a city of 1.6 million (Auckland, NZ). Many attributed that status to ‘pure luck’ or a ‘moat’ effect. However, many also attributed freedom from COVID‐19 to reinforcing high‐level community cohesiveness and shared values. The Waiheke community's response can be seen as a microcosm of New Zealand as an island nation and an exemplar of a response to pandemic threats uniquely possible for small islands.
Social entrepreneurship in obesity prevention: A scoping review
Authors: Chia Audrey , Ong Junyu , Bundele Anjali , Lim Yee Wei
Published: November 2021

We conducted a scoping review of social ventures in obesity and developed a taxonomy of their interventions and business models. Sources included PubMed, Business Source Premier, ABI Inform, Factiva, Google, Facebook, Twitter, social entrepreneurship networks (Ashoka, Skoll, and Schwab), and social entrepreneurship competitions. Our review identified 512 social ventures in 32 countries; 93% originated from developed countries. Their areas of intervention included diet and nutrition, urban farming, physical activity, access to healthy food, and health literacy. They addressed factors beyond health such as education, affordability, employment, and the built and natural environments. To support their programs of work, social ventures developed various business models with multiple revenue or resource streams. Social ventures designed double‐duty interventions that were aligned with additional meaningful social or environmental objectives. This “bundling” of objectives allowed social ventures to appeal to a wider target audience. Most of the social ventures were initiated, supported, or sustained by local communities. Social ventures offer financially self‐sufficient approaches to obesity reduction and could potentially relieve the burden on healthcare systems. Policymakers should consider social entrepreneurs as partners in obesity prevention.
Variation in glucocorticoid sensitivity and the relation with obesity
Authors: Lengton Robin , Iyer Anand M. , van der Valk Eline S. , Hoogeveen Ellen K. , Meijer Onno C. , van der Voorn Bibian , van Rossum Elisabeth F. C.
Published: November 2021

Increasing evidence points to a relation between increased glucocorticoid (GC) exposure and weight gain. In support, long‐term cortisol measurements using hair analysis revealed that many individuals with obesity appear to have cortisol values in the high physiological range. The mechanisms behind this relationship need to be determined in order to develop targeted therapy to reach sustainable weight loss in these subgroups.

The effect of GCs is not only determined by the plasma concentration of GCs but also by individual differences in GC sensitivity and the target tissue, which can be analyzed by functional GC assays. GC sensitivity is influenced by multiple genetic and acquired (e.g., disease‐related) factors, including intracellular GC availability, hormone binding affinity, and expression levels of the GC receptors and their isoforms, as well as factors involved in the modulation of gene transcription. Interindividual differences in GC sensitivity also play a role in the response to exogenous GCs, with respect to both therapeutic and adverse effects.

Accordingly, in this review, we summarize current knowledge on mechanisms that influence GC sensitivity and their relationships with obesity and discuss personalized treatment options targeting the GC receptor.
Chlorhexidine mouthwash reduces the salivary viral load of SARS‐CoV‐2: A randomized clinical trial
Authors: Costa Denis Damião , Brites Carlos , Vaz Sara Nunes , de Santana Daniele Souza , dos Santos Jean Nunes , Cury Patricia Ramos
Published: November 2021

Objectives

This study aimed to evaluate the effect of 0.12% chlorhexidine gluconate on the salivary load of SARS‐CoV‐2.

Materials and Methods

A randomized, double‐blind, placebo‐controlled trial was performed on 100 participants positive for SARS‐CoV‐2. In the test group (n = 50), volunteers gargled with a mouthwash containing 15 ml of 0.12% chlorhexidine gluconate for 1 min, while the control group (n = 50) used a placebo. Saliva samples were obtained before (baseline) and 5 and 60 min after using the solutions. Real‐time reverse transcription polymerase chain reaction assays (qRT‐PCR) were carried out and the cycle threshold (Ct) was computed. The chi‐square test and t‐test were used for group comparison (p ≤ 0.05).

Results

The differences in Ct values between the 5‐min evaluation and baseline (test group: 2.19 ± 4.30; control: −0.40 ± 3.87, p = 0.002) and between 60 min and baseline (test group: 2.45 ± 3.88; control: 0.76 ± 4.41, p = 0.05) were significantly greater in the test group, revealing a reduction of viral load. Furthermore, there was a reduction in the load of SARS‐CoV‐2 in 72% of the volunteers using chlorhexidine versus 30% in the control group (p = 0.001).

Conclusions

Chlorhexidine gluconate (0.12%) was effective in reducing salivary SARS‐CoV‐2 load for at least 60 min.
Contralateral retrodiscal transforaminal approach for percutaneous epidural adhesiolysis: A technical description and retrospective comparative study
Authors: You Ki‐Han , Park Hyun‐Jin , Son In‐Seok , Chung Hoon‐Jae , Kang Min‐Seok
Published: November 2021

Objectives

Retrodiscal transforaminal (RdTF) epidural steroid injection (ESI) is clinically comparable to conventional transforaminal ESI and can avoid catastrophic complications. However, it poses a risk of inadvertent intradiscal, intravascular, and intrathecal injections. Therefore, we aimed to evaluate the feasibility of percutaneous epidural adhesiolysis (PEA) using the contralateral (Contra)‐RdTF approach.

Methods

The electronic medical records of 332 patients with unilateral lumbar radiculopathy due to foraminal disk pathology were reviewed. Patients were categorized into two groups: Group A (ESI using the RdTF approach) and Group B (PEA using the Contra‐RdTF approach). Effective pain relief (EPR; ≥50% pain relief from baseline) in patients was evaluated using the visual analog scale (VAS) at 4 and 12 weeks after the procedure. The presence of unintended fluoroscopic findings and complications was recorded.

Results

A total of 119 patients were enrolled in the final analysis: 81 in Group A and 38 in Group B. Both groups showed lesser VAS scores after 4 and 12 weeks than at baseline (p < 0.05). However, the proportion of patients with EPR was significantly greater in Group B after 12 weeks (p = 0.015). No complications, including intrathecal injection, infectious discitis, and neurologic deterioration, were reported. However, inadvertent intradiscal and intravascular injections were reported to be significantly higher in Group A than in Group B (14.8% and 0%, respectively; p = 0.009).

Conclusions

Although applications of this study are limited by its retrospective design, the results suggest that PEA using the Contra‐RdTF approach is feasible because it can achieve EPR and avoid unintended fluoroscopic findings.
Morphogene‐assisted transformation of Sorghum bicolor allows more efficient genome editing
Authors: Aregawi Kiflom , Shen Jianqiang , Pierroz Grady , Sharma Manoj K. , Dahlberg Jeffery , Owiti Judith , Lemaux Peggy G.
Published: November 2021

Sorghum bicolor (L.) Moench, the fifth most important cereal worldwide, is a multi‐use crop for feed, food, forage and fuel. To enhance the sorghum and other important crop plants, establishing gene function is essential for their improvement. For sorghum, identifying genes associated with its notable abiotic stress tolerances requires a detailed molecular understanding of the genes associated with those traits. The limits of this knowledge became evident from our earlier in‐depth sorghum transcriptome study showing that over 40% of its transcriptome had not been annotated. Here, we describe a full spectrum of tools to engineer, edit, annotate and characterize sorghum’s genes. Efforts to develop those tools began with a morphogene‐assisted transformation (MAT) method that led to accelerated transformation times, nearly half the time required with classical callus‐based, non‐MAT approaches. These efforts also led to expanded numbers of amenable genotypes, including several not previously transformed or historically recalcitrant. Another transformation advance, termed altruistic, involved introducing a gene of interest in a separate Agrobacterium strain from the one with morphogenes, leading to plants with the gene of interest but without morphogenes. The MAT approach was also successfully used to edit a target exemplary gene, phytoene desaturase. To identify single‐copy transformed plants, we adapted a high‐throughput technique and also developed a novel method to determine transgene independent integration. These efforts led to an efficient method to determine gene function, expediting research in numerous genotypes of this widely grown, multi‐use crop.
Incidence, antibiotic treatment and outcomes of lactational mastitis: Findings from The Norwegian Mother, Father and Child Cohort Study (MoBa)
Authors: Grzeskowiak Luke E. , Saha Moni R. , Ingman Wendy V. , Nordeng Hedvig , Ystrom Eivind , Amir Lisa H.
Published: November 2021

Background

Mastitis is a common and distressing maternal postpartum condition, but the relationship between mastitis timing and antibiotic treatment and breastfeeding outcomes and postnatal mental health is unclear.

Objectives

To describe the incidence of mastitis and treatment with antibiotics in first 6 months postpartum, and to investigate the impact of mastitis timing and antibiotic treatment on breastfeeding practices and postnatal mental health.

Methods

This study is based on 79,985 mother‐infant dyads in the Norwegian Mother, Father and Child Cohort Study (MoBa). Women were classified according to self‐reported mastitis within first month (‘early’) or 1–6 months (‘later’) postpartum and antibiotic treatment. Breastfeeding outcomes included predominant or any breastfeeding and abrupt breastfeeding cessation until 6 months postpartum. Maternal mental health was assessed by self‐report at 6 months postpartum.

Results

The incidence of mastitis was 18.8%, with 36.8% reporting treatment with antibiotics. Women reporting early mastitis were less likely to report predominant breastfeeding (adjustedd relative risk [aRR] 0.92, 95% confidence interval [CI] 0.86, 0.99) and any breastfeeding for 6 months (aRR 0.97, 95% CI 0.96, 0.98) than women who did not report mastitis, and more likely to report abrupt breastfeeding cessation (aRR 1.37, 95% CI 1.23, 1.53). Late‐onset mastitis was not associated with poorer breastfeeding outcomes. Among women reporting mastitis, the risk of abrupt breastfeeding cessation was higher in those also reporting antibiotic use. Mastitis was associated with an increased risk of mental health problems postpartum which was highest among those reporting no antibiotic use (aRR 1.29, 95% CI 1.18, 1.41), in contrast to those also reporting antibiotic use (aRR 1.08, 95% CI 0.96, 1.22).

Conclusions

Lactational mastitis and its associated treatment with antibiotics are common. Early (<1 month postpartum) mastitis appears to be a modest risk factor for suboptimal breastfeeding outcomes. In addition, mastitis is associated with poorer mental health.
Integrated physiological and comparative proteomics analysis of contrasting genotypes of pearl millet reveals underlying salt‐responsive mechanisms
Authors: Jha Shweta , Maity Sudipa , Singh Jawahar , Chouhan Chaya , Tak Nisha , Ambatipudi Kiran
Published: November 2021

Salinity stress poses a significant risk to plant development and agricultural yield. Therefore, elucidation of stress‐response mechanisms has become essential to identify salt‐tolerance genes in plants. In the present study, two genotypes of pearl millet (Pennisetum glaucum L.) with contrasting tolerance for salinity exhibited differential morpho‐physiological and proteomic responses under 150 mM NaCl. The genotype IC 325825 was shown to withstand the stress better than IP 17224. The salt‐tolerance potential of IC 325825 was associated with its ability to maintain intracellular osmotic, ionic, and redox homeostasis and membrane integrity under stress. The IC 325825 genotype exhibited a higher abundance of C4 photosynthesis enzymes, efficient enzymatic and non‐enzymatic antioxidant system, and lower Na+/K+ ratio compared with IP 17224. Comparative proteomics analysis revealed greater metabolic perturbation in IP 17224 under salinity, in contrast to IC 325825 that harbored pro‐active stress‐responsive machinery, allowing its survival and better adaptability under salt stress. The differentially abundant proteins were in silico characterized for their functions, subcellular‐localization, associated pathways, and protein–protein interaction. These proteins were mainly involved in photosynthesis/response to light stimulus, carbohydrate and energy metabolism, and stress responses. Proteomics data were validated through expression profiling of the selected genes, revealing a poor correlation between protein abundance and their relative transcript levels. This study has provided novel insights into salt adaptive mechanisms in P. glaucum, demonstrating the power of proteomics‐based approaches. The critical proteins identified in the present study could be further explored as potential objects for engineering stress tolerance in salt‐sensitive major crops.
Joint GWAS and WGCNA uncover the genetic control of calcium accumulation under salt treatment in maize seedlings
Authors: Liang Tianhu , Qing Chunyan , Liu Peng , Zou Chaoying , Yuan Guangsheng , Pan Guangtang , Shen Yaou , Ma Langlang
Published: November 2021

Soil salinization is an important factor threatening the yield and quality of maize. Ca2+ plays a considerable role in regulating plant growth under salt stress. Herein, we examined the shoot Ca2+ concentrations, root Ca2+ concentrations, and transport coefficients of seedlings in an association panel composed of 305 maize inbred lines under normal and salt conditions. A genome‐wide association study was conducted by using the investigated phenotypes and 46,408 single‐nucleotide polymorphisms of the panel. As a result, 53 significant SNPs were specifically detected under salt treatment, and 544 genes were identified in the linkage disequilibrium regions of these SNPs. According to the expression data of the 544 genes, we carried out a weighted coexpression network analysis. Combining the enrichment analyses and functional annotations, four hub genes (GRMZM2G051032, GRMZM2G004314, GRMZM2G421669, and GRMZM2G123314) were finally determined, which were then used to evaluate the genetic variation effects by gene‐based association analysis. Only GRMZM2G123314, which encodes a pentatricopeptide repeat protein, was significantly associated with Ca2+ transport and the haplotype G‐CT was identified as the superior haplotype. Our study brings novel insights into the genetic and molecular mechanisms of salt stress response and contributes to the development of salt‐tolerant varieties in maize.
Nodulating white lupins take advantage of the reciprocal interplay between N and P nutritional responses
Authors: Buoso Sara , Zamboni Anita , Franco Alessandro , Commisso Mauro , Guzzo Flavia , Varanini Zeno , Pinton Roberto , Tomasi Nicola , Zanin Laura
Published: November 2021

The low bioavailability of nutrients, especially nitrogen (N) and phosphorus (P), is one of the most limiting factors for crop production. In this study, under N‐ and P‐free nutrient solution (−N−P), nodulating white lupin plants developed some nodules and analogous cluster root structures characterized by different morphological, physiological, and molecular responses than those observed upon single nutrient deficiency (strong acidification of external media, a better nutritional status than −N+P and +N−P plants). The multi‐elemental analysis highlighted that the concentrations of nutrients in white lupin plants were mainly affected by P availability. Gene‐expression analyses provided evidence of interconnections between N and P nutritional pathways that are active to promote N and P balance in plants. The root exudome was mainly characterized by N availability in nutrient solution, and, in particular, the absence of N and P in the nutrient solution triggered a high release of phenolic compounds, nucleosides monophosphate and saponines by roots. These morphological, physiological, and molecular responses result from a close interplay between N and P nutritional pathways. They contribute to the good development of nodulating white lupin plants when grown on N‐ and P‐free media. This study provides evidence that limited N and P availability in the nutrient solution can promote white lupin‐Bradyrhizobium symbiosis, which is favourable for the sustainability of legume production.
The importance of ecophysiological traits in response of Festuca rubra to changing climate
Authors: Kosová Veronika , Hájek Tomáš , Hadincová Věroslava , Münzbergová Zuzana
Published: November 2021

Knowledge of the ability of plants to respond to climate change via phenotypic plasticity or genetic adaptation in ecophysiological traits and of the link of these traits to fitness is still limited. We studied the clonal grass Festuca rubra from 11 localities representing factorially crossed gradients of temperature and precipitation and cultivated them in growth chambers simulating temperature and moisture regime in the four extreme localities. We measured net photosynthetic rate, Fv/Fm, specific leaf area, osmotic potential and stomatal density and length and tested their relationship to proxies of fitness. We found strong phenotypic plasticity in photosynthetic traits and genetic differentiation in stomatal traits. The effects of temperature and moisture interacted (either as conditions of origin or growth chambers), as were effects of growth and origin. The relationships between the ecophysiological and fitness‐related traits were significant but weak. Phenotypic plasticity and genetic differentiation of the species indicate the potential ability of F. rubra to adapt to novel climatic conditions. The most important challenge for the plants seems to be increasing moisture exposing plants to hypoxia. However, the plants have the potential to respond to increased moisture by changes in stomatal size and density and adjustments of osmotic potential. Changes in ecophysiological traits translate into variation in plant fitness, but the selection on the traits is relatively weak and depends on actual conditions. Despite the selection, the plants do not show strong local adaptation and local adaptation is thus likely not restricting species ability to adjust to novel conditions.