bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review: management of localised low‐grade upper gastrointestinal neuroendocrine tumours
Authors: Exarchou Klaire , Howes Nathan , Pritchard David Mark
Published: May 2020

Background

Neuroendocrine tumours (NETs) of the stomach and duodenum are rare, but are increasing in incidence. Optimal management of localised, low‐grade gastric and duodenal NETs remains controversial.

Aims

To systematically review recent literature that has evaluated the management of localised low‐grade gastric and duodenal NETs.

Methods

A systematic literature search was conducted. Articles were screened and eligible articles fully assessed. Additional articles were identified through the included articles’ reference lists.

Results

Several relevant retrospective case series were identified, but there was considerable heterogeneity between studies and they reported a variety of parameters. Type I gastric NETs had an excellent prognosis and conservative management approaches such as endoscopic surveillance/resection were appropriate in most cases. Many type III gastric NETs were low grade and appeared to have a better prognosis than has previously been appreciated. Endoscopic rather than surgical resection was therefore effective in some patients who had small, low‐grade tumours. Duodenal NETs were more heterogenous. Endoscopic resection was generally safe and effective in patients who had small, low‐grade, nonfunctional, non‐ampullary tumours. However, some patients, especially those with larger or ampullary duodenal NETs, required surgical resection.

Conclusions

Most type I gastric NETs behave indolently and surgical resection is only rarely indicated. Some type III gastric and duodenal NETs have a worse prognosis, but selected patients who have small, localised, nonfunctional, low‐grade tumours are adequately and safely treated by endoscopic resection. Due to the complexity of this area, a multidisciplinary approach to management is strongly recommended.
The importance of understanding end user acceptability of new technology to support animal health management
Authors: Hayes L , Manyweathers J , Langstaff I , Howard D , Hernández‐Jover M
Published: May 2020

This pilot study investigates the acceptability of a mobile application (app) developed to assist livestock producers make better animal health decisions with the support of a local veterinarian. With the increase in new technologies available for producers, acceptability evaluation is important to ensure that technology is designed considering end users' needs. An acceptability qualitative study, using semi‐structured interviews, was designed including a purposive selection of sheep producers and livestock veterinarians. Eleven producers and six veterinarians participated in the study. Results suggest that producers would use such a tool to contact private veterinarians in non‐emergency situations to obtain animal health advice. From veterinarians' perspective, while features of the app, such as messaging and notifications, were considered useful, concerns were raised about its capacity to enhance business opportunities and potential privacy implications. This study highlights the importance of engaging with end users in the early stages of the design and the introduction of new technology to maximise potential for adoption.
Interpretive Community, Intersubjective Experiences, and Supervisees’ Paradoxes
Authors: Yerushalmi Hanoch
Published: May 2020

Contemporary theorists believe that each expert's discourse has meaning only in the context of an interpretive community. For therapists, the analytic community serves this purpose, helping them to construct their patients’ experiences and to hold inherent intersubjective paradoxes; the community provides them with a vantage point from which they learn to acknowledge, tolerate, and accept these paradoxes. I will examine the role of this vantage point in holding one of the central paradoxes for therapists: the uniqueness of each therapeutic relationship which urges them to ‘reinvent psychoanalysis’ with each patient, and its similarity to other therapeutic relationships which urges them to draw on the analytic community's theoretical schemas. I will suggest that supervisors help their supervisees in this internal struggle by representing the analytic community's vantage point and by holding a parallel paradox: the uniqueness of each supervisory relationship, which urges them to ‘reinvent’ the theory of supervision for each supervisee, and its similarity to other supervisory relationships, which urges them to draw on the analytic community's theoretical supervisory schemas. Reasonably, the supervisors’ capacity to hold these paradoxes is gradually internalized by their supervisees, facilitating their growth as therapists.
Human alkaline ceramidase 2 promotes the growth, invasion, and migration of hepatocellular carcinoma cells via sphingomyelin phosphodiesterase acid‐like 3B
Authors: Liu Binggang , Xiao Juan , Dong Mingjun , Qiu Zhidong , Jin Junfei
Published: May 2020

Hepatocellular carcinoma (HCC) is the most common type of liver cancer. It has a poor prognosis because it is often diagnosed at the advanced stage when treatments are limited. In addition, HCC pathogenesis is not fully understood, and this has affected early diagnosis and treatment of this disease. Human alkaline ceramidase 2 (ACER2), a key enzyme that regulates hydrolysis of cellular ceramides, affects cancer cell survival, however its role in HCC has not been well characterized. Our results showed that ACER2 is overexpressed in HCC tissues and cell lines. In addition, high ACER2 protein expression was associated with tumor growth; ACER2 knockdown resulted in decreased cell growth and migration. Sphingomyelin phosphodiesterase acid‐like 3B (SMPDL3B) promoted HCC cell growth, invasion, and migration; SMPDL3B knockdown had a significant inhibitory effect on HCC tumor growth in vivo. Moreover, ACER2 positively regulated the protein level of SMPDL3B. Of note, ACER2/SMPDL3B promoted ceramide hydrolysis and S1P production. This axis induced HCC survival and could be blocked by inhibition of S1P formation. In conclusion, ACER2 promoted HCC cell survival and migration, possibly via SMPDL3B. Thus, inhibition of ACER2/SMPDL3B may be a novel therapeutic target for HCC treatment.
Potential impacts of COVID‐19 on Canadian farmland markets
Authors: Lawley Chad
Published: May 2020

Evidence from the past 50 years suggests that changes in Canadian farmland values are influenced by farming returns, real interest rates, and exchange rates. Residential and commercial development also affects the value of farmland close to major urban centers. The COVID‐19 economic shutdown is expected to reduce crop and livestock returns, which will put downward pressure on farmland values. The magnitude of this downward pressure will depend on the extent and the length of the recession. The evolution of interest rates over the next months and years could have a significant impact on farmland values. Historically, low real interest rates have coincided with higher farmland values, whereas high real interest rates have caused significant reductions in farmland values. The development value of farmland close to major cities could be negatively impacted by a sharp downturn in residential and commercial property markets.
A genoscape‐network model for conservation prioritization in a migratory bird
Authors: Ruegg Kristen C. , Harrigan Ryan J. , Saracco James F. , Smith Thomas B. , Taylor Caz M.
Published: May 2020

Migratory animals are declining worldwide and coordinated conservation efforts are needed to reverse current trends. We devised a novel genoscape‐network model that combines genetic analyses with species distribution modeling and demographic data to overcome challenges with conceptualizing alternative risk factors in migratory species across their full annual cycle. We applied our method to the long distance, Neotropical migratory bird, Wilson's Warbler (Cardellina pusilla). Despite a lack of data from some wintering locations, we demonstrated how the results can be used to help prioritize conservation of breeding and wintering areas. For example, we showed that when genetic, demographic, and network modeling results were considered together it became clear that conservation recommendations will differ depending on whether the goal is to preserve unique genetic lineages or the largest number of birds per unit area. More specifically, if preservation of genetic lineages is the goal, then limited resources should be focused on preserving habitat in the California Sierra, Basin Rockies, or Coastal California, where the 3 most vulnerable genetic lineages breed, or in western Mexico, where 2 of the 3 most vulnerable lineages overwinter. Alternatively, if preservation of the largest number of individuals per unit area is the goal, then limited conservation dollars should be placed in the Pacific Northwest or Central America, where densities are estimated to be the highest. Overall, our results demonstrated the utility of adopting a genetically based network model for integrating multiple types of data across vast geographic scales and better inform conservation decision‐making for migratory animals.
Larval lake sturgeon production and drift behaviour in the Menominee and Oconto Rivers, Wisconsin
Authors: Lawrence David A. , Elliott Robert F. , Donofrio Michael C. , Forsythe Patrick S.
Published: May 2020

Lake sturgeon (Acipenser fulvescens) have been negatively impacted by barriers to migration, pollution and overharvest. Biological data such as the timing of spawning activity and larval drift have provided a better understanding of larval production success or failure on a site‐specific basis. However, many river systems that serve as reproductive locations for remnant lake sturgeon populations remain understudied. The objective of this study was to compare and contrast aspects of larval lake sturgeon drift within and between the Oconto and Menominee Rivers over multiple reproductive seasons. Differences in larval drift chronology, the size of drifting larvae during the season and the cross‐sectional profile of drifting individuals as a function of river velocity were evaluated. D‐frame drift nets were deployed at a single transect below spawning sites in the Menominee (2012, 2013 and 2014) and Oconto Rivers (2013, 2014 and 2015). A total of 4,442 larvae were captured across all seasons. Larvae exhibited nonrandom drift profiles related to water velocity, and larvae size was related to horizontal drift location. The seasonal increase in body size of drifting larvae also differed among drift events within and between years and across rivers. This information will provide a better understanding of lake sturgeon early life history and has practical management connections including spawning site protection/enhancement and river flow mitigation.
Seizure‐related apneas have an inconsistent linkage to amygdala seizure spread
Authors: Park Katherine , Kanth Kiran , Bajwa Sami , Girgis Fady , Shahlaie Kiarash , Seyal Masud
Published: May 2020

Objective

Sudden unexpected death in epilepsy (SUDEP) is a frequent cause of death in epilepsy. Respiratory dysfunction is implicated as a critical factor in SUDEP pathophysiology. Human studies have shown that electrical stimulation of the amygdala resulted in apnea, indicating that the amygdala has a role in respiration control. Unilateral amygdala stimulation resulted in immediate onset of respiratory dysfunction occurring only during nose breathing. In small numbers of patients, some but not all spontaneous seizures resulted in apnea occurring shortly after seizure spread to the amygdala. With this study we aimed to determine whether seizure onset or spread to the amygdala was necessary and sufficient to cause apnea.

Methods

We investigated the temporal relationship between apnea/hypopnea (AH) onset and initial seizure involvement within the amygdala in patients with implanted depth electrodes.

Results

Data from 17 patients (11 female) with 47 seizures were analyzed. With seven seizures (three patients), AH preceded amygdala seizure involvement by 2 to 55 seconds. There was no AH with four seizures (three patients) that involved the amygdala. With eight seizures (four patients) AH occurred within 2 seconds following amygdala seizure onset. With 28 seizures, AH started >2 seconds after amygdala seizure onset (range 3‐158 seconds). Following seizure onset, there was a significant difference between AH onset time and amygdala seizure onset (P < .001). The mean ± standard deviation (SD) AH onset was 27.8 ± 41.06 seconds, and the mean time to amygdala involvement was 8.83 ± 20.19 seconds.

Significance

There is a wide range of AH onset times relative to amygdala seizure involvement. With some seizures, amygdala seizure involvement occurs without AH. With other seizures, AH precedes amygdala seizures, suggesting that, with spontaneous seizures, involvement of the amygdala may not be crucial to induction of AH with all seizures. Other pathophysiology impacting brainstem respiratory networks may be of greater relevance to seizure‐triggered apneas.
Equine granulosa cell tumours among other ovarian conditions: Diagnostic challenges
Authors: Renaudin Catherine D. , Kelleman Audrey A. , Keel Kevin , McCracken Jaye L. , Ball Barry A. , Ferris Ryan A. , McCue Patrick M. , Dujovne Ghislaine , Conley Alan J.
Published: May 2020

Background

Granulosa cell tumours (GCT) are the most common ovarian tumours in mares. While the classical presentation may not represent diagnostic challenges, diagnosis is not easy in the early stages.

Objectives

Illustrate the variability in the presentation and serum biomarkers associated with ovarian abnormalities in the mare.

Study design

Retrospective case series.

Methods

Nonclassical cases of GCTs and other ovarian conditions were identified and behaviour, GCT endocrine results, palpation and ultrasonographic findings are described and the diagnostic value of each is discussed.

Results

Mares in this case series with GCTs had been presenting clinical signs ranging from no behavioural changes to behaviours including aggression, stallion‐like and inability to work under saddle. Hormonal profiles of endocrinologically functional GCTs can be erratic and unpredictable. The clinical form and ultrasonographic appearance may also vary with time from an initially enlarged/anovulatory follicular structure that later develops a multicystic ‘honeycomb’ appearance. Mares with GCTs can also present with persistent anovulatory follicles or apparent luteal tissue that are unresponsive to treatment. If both ovaries are of relatively normal size and symmetry, but hormonal biomarkers are markedly increased (AMH >10 ng/mL, inhibin B and/or testosterone >100 pg/mL; 0.37 nmol/L), it is likely that a functional GCT is present. Still, it can be a challenge to decide which ovary to remove. Post‐surgical endocrine testing can be helpful, especially if histopathology is not performed or a GCT is not found.

Main limitations

Cases limited to 14.

Conclusions

Granulosa cell tumours present with a wide variety of clinical signs that do not fit what is commonly described as ‘classic’. Only if AMH, testosterone and inhibin B concentrations are markedly increased, and there is an abnormally enlarged ovary, the diagnosis of a GCT is more confident. In the presence of normal size ovaries, normal hormonal biomarkers and abnormal behaviour, it is more likely that the ovaries are not involved.
Shading effects on canopy and tillering characteristics of continuously stocked palisadegrass in a silvopastoral system in the Amazon biome
Authors: Gomes Fagner Junior , Pedreira Bruno Carneiro , Santos Patrícia Menezes , Bosi Cristiam , Pedreira Carlos Guilherme Silveira
Published: May 2020

In silvopastoral (SP) systems, forage responses depend on the microenvironment in which the plants develop. Our objective was to evaluate canopy and tillering characteristics of shaded 'Marandu' palisadegrass [Brachiaria brizantha (Hochst A Rich) Stapf, syn. Urochloa brizantha] under continuous stocking in a SP system. Treatments were one full sun (FS) and three shaded systems (silvopasture, SP) corresponding to distances from tree groves: 7.5 m north (SP1), and 15 m (SP2) and 7.5 m south (SP3) studied during two rainy seasons (Year 1 and Year 2). The tree in the SP system was Eucalyptus urograndis (hybrid of Eucalyptus grandis W. Hill ex Maiden × Eucalyptus urophylla S. T. Blake). The photosynthetic active radiation was greater in FS (923 μmol m-2 s-1), followed by SP2 (811 μmol m-2 s-1), SP1 (727 μmol m-2 s-1) and SP3 (673 μmol m-2 s-1). Forage accumulation in FS was 15% greater than the mean of SP1, SP2 and SP3 (10,663 kg DM/ha). There was no difference in net accumulation of leaf, stem and dead material, averaging 3,302, 3,420 and 4,063 kg DM/ha respectively. Leaf accumulation and accumulation rate were greater in Year 2, and leaf accumulation rate was similar among treatments (19 kg DM ha−1 day−1). Leaf proportion increased 14% from Year 1 to Year 2. Specific leaf area was greater for treatments SP1 and SP3 (193 cm2/g). Tiller population density was similar across treatments in Year 1. Shaded palisadegrass maintains leaf productivity similar to FS under continuous stocking in an SP system.
When new public management fails: Infrastructure public–private partnerships and political constraints in developing and transitional economies
Authors: Bertelli Anthony M. , Mele Valentina , Whitford Andrew B.
Published: May 2020

Amidst calls for more scrutiny of the failure of infrastructure public–private partnerships (PPPs), uncertainty about how we can measure failure remains, and little systematic evidence illuminates its likelihood. Our mixed‐methods design explores the notion of failure and identifies the conditions under which it happens. The first phase of our research employs documentary analysis and semistructured expert interviews, and identifies project cancellation as capturing the most severe occurrences of failure. A second phase statistically analyzes a unique World Bank data set capturing the provisions of over 4,000 infrastructure PPPs launched between 1990 and 2015 in 89 countries. We find robust evidence supporting the theoretical claim that PPPs are less likely to be canceled in countries with more veto points among their political institutions to restrain politicians from intervening in policy implementation. Cancellation is a rare, but valid indicator of failure, and the importance of veto players clarifies how political risk operates in this context.
Preparation of grape seed polypeptide and its calcium chelate with determination of calcium bioaccessibility and structural characterisation
Authors: Jiang Yuhan , Li Jing , Zhao Huan , Zhao Runtian , Xu Yi , Lyu Xiaoling
Published: May 2020

Grape seed polypeptide (GSPP) was obtained by liquid fermentation with Bacillus subtilis TK15.015 from waste grape seed pomace. Its chelation ability with calcium ions was excellent. Simulation of in vitro gastrointestinal digestion showed that GSPP and calcium chelate (GSPP‐Ca) slowly released calcium and decreased stomach stimulation. The solubility and transmission rate of GSPP‐Ca after digestion in the gastrointestinal tract for 8 h maintained high levels of 74.4% and 46.4%, respectively, which far exceeded the levels achieved by other calcium supplements. Structural characterisation showed that calcium ions mainly react with binding sites present in peptides such as carboxyl oxygen, hydroxyl oxygen, amino nitrogen and amide bonds. GSPP‐Ca may be a state in which a calcium‐encapsulating complex formed, leaving calcium ions in a soluble state, suggesting its possible use as a high‐quality calcium supplement.
Amino acid, structure and antioxidant properties of Haematococcus pluvialis protein hydrolysates produced by different proteases
Authors: Zhu Yunping , Zhao Xiaoyan , Zhang Xiaowei , Liu Hongkai , Ao Qiang
Published: May 2020

The impact of different protease hydrolysis on the amino acid, structure and antioxidant properties of H. pluvialis protein (HP) was investigated. Results showed that the hydrolysate obtained by Alcalase exhibited the highest degree of hydrolysis (20.59%) and peptide yield (92.64%). The essential amino acid, hydrophobic, sulphur and aromatic amino acid contents of enzyme hydrolysates were significantly higher than HP (P < 0.05). FTIR spectra showed that the β‐sheet proportion of HP hydrolysates were higher compared with HP, the proportion of random coil structure was lower. The α‐helix content of the hydrolysate obtained by Alcalase was the highest, while the turn proportion was the lowest. The Trypsin derived hydrolysate presented the best DPPH and ABTS scavenging ability, and ferric reducing antioxidant power than other HPHs. These results suggested that HP hydrolysates have a great potential as natural functional ingredients in food manufacture.
Effect of particle size on flow behaviour and physical properties of semi‐ripe plantain (AAB Musa spp) powders
Authors: Irie Kady Rosine , Petit Jérémy , Gnagne Eliane Hadiowe , Kouadio Olivier Kouadio , Gaiani Claire , Scher Joël , Amani Georges N’Guessan
Published: May 2020

This work was conducted to study the influence of particle size and shape on the flow behaviour of semi‐ripe plantain powders. An improved plantain variety (Big Ebanga), two hybrids (FHIA 21 and PITA 3), and a local variety (Corne 1, as reference material) were powdered by successive drying, milling, and sieving into three granulometric classes: unsieved (<500 µm), fine fraction (<180 µm; class 1), and coarse fraction (between 180 and 500 µm; class 2), thus differing in particle size distribution. Physical properties (water activity, particle size distribution, shape factors) were characterised and flow properties (basic flowability energy, compressibility, fluidisability, cohesion, etc.) were investigated using the FT4 powder rheometer. Convexity of unsieved and fine powders was slightly higher than for coarse powders. Fine powders of all plantain varieties were found to have the lowest water activity and the lowest flowability in unconfined conditions. Unsieved and fine powders presented a fluidised state at the end of the FT4 standard aeration test and their minimum fluidisation velocity was low, confirming the good fluidisability of these powders.
Clarifying the Dominant Logic Construct by Disentangling and Reassembling its Dimensions
Authors: Engelmann Alexander , Kump Barbara , Schweiger Christina
Published: May 2020

Since its introduction, Prahalad and Bettis's concept of dominant logic has informed a variety of scholarly conversations in management and strategy research. However, scholars have interpreted dominant logic in different ways, emphasizing different aspects, such as managerial mindsets, administrative tools and management functions, as defining elements. Similarly, empirical studies have captured various aspects, such as meanings of entrepreneurs, observable strategic decisions and business model similarity, as indicators of dominant logic. Consequently, the concept lacks analytical clarity, and it is difficult to compare or generalize findings from this diverse set of studies. The aim of this review is to improve conceptual clarity by analysing, comparing and evaluating the existing interpretations and assessments of dominant logic in 94 studies. In the first part of the review, by disentangling the interpretations of the concept, we show that dominant logic consists of four defining dimensions: (i) shared mental models; (ii) values and premises; (iii) organizational practices; and (iv) organizing structures. In the second part, we reassemble dominant logic into an integrative model and theorize about how these dimensions operate in concert to produce a firm's dominant logic. Thus, our main contribution is a clarification and synthesis of the literature, which comes with implications on how future research can conceptualize and operationalize dominant logic more consistently.
Incorporating the Clinical Frailty Scale into routine outpatient nephrology practice: an observational study of feasibility and associations
Authors: Kumarasinghe Anuttara Panchali , Chakera Aron , Chan Kien , Dogra Sharan , Broers Sally , Maher Sean , Inderjeeth Charles , Jacques Angela
Published: May 2020

Background

There is an unmet need for routine and accurate prognostication of older adults with end‐stage kidney disease (ESKD) and subsequently inadequate advance care planning. Frailty, a clinical syndrome of increased vulnerability, is predictive of adverse health outcomes in the renal population. We propose the Clinical Frailty Scale (CFS) as a feasible tool for routine use in the nephrology outpatient setting to address this unmet need.

Aims

To assess feasibility and associations of incorporating CFS assessment into routine outpatient nephrology practice in the pre‐dialysis setting.

Methods

CFS was integrated into the outpatient nephrology clinic proforma. A convenience sample of 138 patients aged >50 years, with estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2, attending the outpatient service between September 2018 and April 2019 was included.

Results

Eighty‐one CFS assessments were completed by nephrologists, nephrology advanced trainees and clinical nurse specialists. CFS completion rates were 79% from the multidisciplinary Low Clearance Clinic and 41% from nurse‐led Pre‐dialysis Education Clinic.

Planned modality of ESKD management varied with degree of frailty (P < 0.001). 21% of patients who had CFS completed were planned for Conservative Management of ESKD, in contrast to only 5% of those who did not have CFS assessment completed (P < 0.001).

Conclusion

Frailty assessment via CFS was feasible in outpatient practice when integrated into routine clinical assessment in a dedicated clinic.

Planned ESKD management varied with the degree of frailty. Completion of frailty assessment, when compared with non‐completion, appears to be associated with increased planned conservative management of ESKD.
Cryopreservation of lipoaspirates: in vitro measurement of the viability of adipose‐derived stem cell and lipid peroxidation
Authors: Kim Dong Yeon , Kim Eunjin , Kim Ki Joo , Jun Young‐Joon , Rhie Jong‐Won
Published: May 2020

As the storage time of the fat tissue passes by, lipid peroxidation and creation of by‐products may take place. The objective of this study was to evaluate the cell viability and functional changes of adipose‐derived stem cells (ADSCs) in the cryopreserved lipoaspirates at different temperatures in accordance with lipid peroxidation. Lipoaspirates acquired from liposuction were divided into four different temperature groups and stored at 4°C, −20°C, −80°C, and −196°C. After isolating ADSC from each sample, gross cell morphology and cell viability were compared with doubling time and colony‐forming unit (CFU) formation ability. Acid value, that is, thiobarbituric acid value was measured to assess lipid peroxidation. No viable ADSC was observed in −20°C and −196°C samples for past 1 week and a superior number of the live cells were detected in the 4°C group compared with the −80°C group. However, the persistence of cell division and CFU formation after 1 week was only observed in adipocytes stored at −80°C. Lipid peroxidation mainly occurred at 4°C and −20°C storage samples. If the lipoaspirates were planned to be cryopreserved, it is advised to store at −80°C. However, the number of actually functional ADSCs is very low. Furthermore, even in the cryopreserved status, continuous lipid peroxidation and by‐product creation took place, suggesting shorter preservation period as possible in the clinics.
Facilitators and barriers of using digital technology for the management of diabetic foot ulcers: A qualitative systematic review
Authors: Foong Hui Foh , Kyaw Bhone Myint , Upton Zee , Tudor Car Lorainne
Published: May 2020

The use of digital technology has been shown to be effective in managing chronic conditions. Telemedicine and mobile application are two common applications of digital technology in managing diabetic foot ulcers (DFU). The facilitators and barriers of using it for DFU management are yet to be explored. This is a qualitative systematic review. Five bibliography databases and grey literature sources were searched (2000‐2019). Two reviewers independently screened the citations, extracted the data, assessed the quality of the included studies, and performed thematic synthesis. Three studies on patients and five studies on healthcare practitioners (HCPs) were included. Two studies focused on the use of mobile applications and six on telemedicine. In studies on patients, four analytical themes were generated: the relationships with HCPs; the attitude towards the usage of digital technology; the role of wound image taking; and impact of digital technology on DFU care, encompassing 15 facilitators (eg, enabling community support, improving wound care knowledge) and 12 barriers (eg, lack of technological savviness, difficulty reading on smartphones). Three analytical themes were generated from studies on HCPs: the impact of digital technology on HCPs; the role of digital technology in DFU care; and organisation of DFU care delivery, encompassing 17 facilitators (eg, adequate wound care training, digital technology enables holistic care) and 16 barriers (eg, lack of multidisciplinary approach in caring for DFU, lack of direct contact in care provision). Patients and HCPs reported various barriers and facilitators relating to different aspects of using digital technology in DFU management. Our findings can help inform future research as well as the adoption of digital technology in DFU management.
Identification of two novel mutations in POU4F3 gene associated with autosomal dominant hearing loss in Chinese families
Authors: Bai Xiaohui , Zhang Fengguo , Xiao Yun , Jin Yu , Zheng Qingyin , Wang Haibo , Xu Lei
Published: May 2020

Autosomal dominant non‐syndromic hearing loss is genetically heterogeneous with 47 genes identified to date, including POU4F3. In this study, by using a next‐generation sequencing panel targeting 127 deafness genes, we identified a pathogenic frameshift mutation c.704_705del and a missense mutation c.593G>A in two three‐generation Chinese families with late‐onset progressive ADNSHL, respectively. The novel mutations of POU4F3 co‐segregated with the deafness phenotype in these two families. c.704_705del caused a frameshift p.T235fs and c.593G>A caused an amino acid substitution of p.R198H. Both mutations led to an abnormal and incomplete protein structure. POU4F3 with either of the two mutations was transiently transfected into HEI‐OC1 and HEK 293 cell lines and immunofluorescence assay was performed to investigate the subcellular localization of mutated protein. The results indicated that both c.704_705del (p.T235fs) and c.593G>A (p.R198H) could impair the nuclear localization function of POU4F3. The p.R198H POU4F3 protein was detected as a weak band of the correct molecular weight, indicating that the stability of p.R198H POU4F3 differed from that of the wild‐type protein. While, the p.T235fs POU4F3 protein was expressed with a smaller molecular weight, implying this mutation result in a frameshift and premature termination of the POU4F3 protein. In summary, we report two novel mutations of POU4F3 associated with progressive ADNSHL and explored their effects on POU4F3 nuclear localization. These findings expanded the mutation spectrum of POU4F3 and provided new knowledge for the pathogenesis of POU4F3 in hearing loss.
Implementation of Hip Fracture Co‐Management Program (AGS CoCare: Ortho®) in a Large Health System
Authors: Sinvani Liron , Goldin Mark , Roofeh Regina , Idriss Nayla , Goldman Ariel , Klein Zachary , Mendelson Daniel Ari , Carney Maria Torroella
Published: May 2020

OBJECTIVES

Acute hip fracture is common and leads to significant morbidity and mortality. Co‐management programs, such as American Geriatric Society (AGS) CoCare: Ortho®, that optimize perioperative care of older adults, have demonstrated improved outcomes. Yet there is substantial variation in hip fracture care nationally. Our objective was to describe the implementation of AGS CoCare: Ortho® across a large integrated health system.

DESIGN

Program implementation of four phases.

SETTING

Large integrated health system.

PARTICIPANTS

One tertiary and three community hospitals.

MEASUREMENTS

The first two phases were communication and system‐level planning. The communication phase consisted of getting health system leadership buy‐in, creating an interdisciplinary steering committee, and building a business model. The planning phase consisted of choosing process and outcome measures, ensuring accurate and timely data collection, and creating standardized order sets and physician documentation.

RESULTS

The second two phases were hospital‐level planning and implementation. The planning phase consisted of identifying sites and developing the co‐management structure. The implementation phase consisted of identifying and engaging frontline staff, rolling out the program, optimizing workflow, and educating providers.

CONCLUSION

The program was implemented at four diverse sites. Major lessons learned included the need for an engaged steering committee to oversee the program; the importance of standardizing order sets and documentation; the utilization of hospitalists as co‐managers; the benefit of developing and actively using a data dashboard; the challenge of ensuring wide uptake of education modules; and the need to take proactive steps to improve multidisciplinary communication. J Am Geriatr Soc 68:1706‐1713, 2020.
Reply to: Outcomes and Patient Goals: Comment on “Chronic Disease Decision Making and ‘What Matters Most’”
Authors: Fried Terri R. , Street Richard L. , Cohen Andrew B.
Published: May 2020

This is a response to the article by Paul Falzer.
Reply to Ruth Palan Lopez, PhD, GNP‐BC
Authors: Ouslander Joseph G. , D'Adamo Heather , Yoshikawa Thomas
Published: May 2020

This letter comments on the letter by Ruth Palan Lopez
Comment on: Coronavirus Disease 2019 in Geriatrics and Long‐Term Care: The ABCDs of COVID‐19
Authors: Wachholz Patrick A. , Jacinto Alessandro F.
Published: May 2020

See the Reply by D'Adamo et al
Nutritional status, food choices, barriers and facilitators to healthy nutrition in pregnant women with severe mental illness: a mixed methods approach
Authors: Frayne J. , Hauck Y. , Sivakumar P. , Nguyen T. , Liira H. , Morgan V. A.
Published: May 2020

Background

Although widely acknowledged that adequate maternal nutrition is important for mother and baby, limited research has focussed on women with severe mental illnesses (SMI) in pregnancy. The present study reports on nutritional factors and food choices and investigates barriers and facilitators to healthy nutritional choices by pregnant women with SMI.

Methods

A prospective mixed method study was undertaken of 38 pregnant women with SMI, including a cross‐sectional survey, a food frequency questionnaire and 12 postnatal qualitative interviews, with integrated analysis of all data.

Results

Elevated rates of obesity (35%) were found, with 82% of women having above the recommended gestational weight gain. Despite perceived knowledge, 32% of women did not meet any of the Five Food Group serving recommendations for pregnancy and consumed above‐recommended levels for processed (19%) and sugar snacks (51%). Thematic analysis identified four main barriers: a discrepancy between knowledge and action, food cravings, mental health, and physical health. During pregnancy, food cravings were reported in 66% of women, psychological distress in 71% and physical distress in 37%. Screening identified 19% with potential eating disordered behaviours. Despite the challenges, several facilitators were identified and covered three themes: access to a dietitian, information delivery and support, and comprehensive care.

Discussion

Women with SMI in pregnancy struggle with issues of obesity, gestational weight gain, food cravings and possible eating disorder behaviours. They have additional challenges when pregnant, with management of their mental health and physical health having a direct impact. Interventional strategies in this population should incorporate findings from this research.
Advances in therapeutic vaccines for treating human papillomavirus‐related cervical intraepithelial neoplasia
Authors: Barra Fabio , Della Corte Luigi , Noberasco Giovanni , Foreste Virginia , Riemma Gaetano , Di Filippo Claudia , Bifulco Giuseppe , Orsi Andrea , Icardi Giancarlo , Ferrero Simone
Published: May 2020

Aim

Human papillomavirus (HPV) is the etiologic agent of the majority of cervical intraepithelial lesions (CIN) and cervical cancers. While prophylactic HPV vaccines prevent infections from the main high‐risk HPV types associated with cervical cancer, alternative nonsurgical and nonablative therapeutics to treat HPV infection and preinvasive HPV diseases have been experimentally investigated. Therapeutic vaccines are an emerging investigational strategy. This review aims to introduce the results of the main clinical trials on the use of therapeutic vaccines for treating HPV infection and ‐related CIN, reporting the ongoing studies on this field.

Methods

Data research was conducted using MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library querying for all articles related to therapeutic vaccines for the treatment of HPV‐related CIN. Selection criteria included randomized clinical trials, nonrandomized controlled studies and review articles.

Results

Preliminary data are available on the evaluation of therapeutic vaccines for treating cervical HPV infections and CIN. Despite having in vitro demonstrated to obtain humoral and cytotoxic responses, therapeutic vaccines have not yet clinically demonstrated consistent success; moreover, each class of therapeutic vaccines has advantages and limitations. Early clinical data are available in the literature for these compounds, except for MVA E2, which reached the phase III clinical trial status, obtaining positive clinical outcomes.

Conclusion

Despite promising results, to date many obstacles are still present before hypothesize an introduction in the clinical practice within the next years. Further studies will draw a definitive conclusion on the role of therapeutic vaccines in this setting.
Effects of Ficopomatus enigmaticus ecosystem‐engineered habitat structure on population parameters of the amphipod Melita palmata: A NIS‐NIS interaction study
Authors: Bazterrica María Cielo , Barón Pedro J. , Álvarez Graciela , Obenat Sandra M.
Published: May 2020

The variability of some population (demo) parameters of the gammarid amphipod Melita palmata was associated with contrasting habitat structures created by the non‐indigenous reef‐builder polychaete Ficopomatus enigmaticus in the Mar Chiquita coastal lagoon (37°40 S, 57°23 W, Argentina). Sampling of M. palmata was conducted biweekly during the reproductive period in F. enigmaticus reefs and sediment from reef‐free areas, accounting for the vertical distribution and the presence/absence of macroalgae. Males, females (non‐ovigerous and ovigerous), and juveniles are present in both reefs and sediment, but the abundance of M. palmata is several orders of magnitude higher in reefs. Reefs’ M. palmata population (demo) displays variations in: (a) abundance, (b) mean size, and (c) proportions of demographic categories. In reefs, females show a higher proportion of ovigerous specimens and a female‐biased sex ratio, contrasting the 1:1 ratio observed in sediment. Individuals are more abundant in the surface layer covered with macroalgae in reefs (small sizes) and macroalgae or valves in sediment. The association of M. palmata to F. enigmaticus reefs drives its permanency in the system, enhancing its reproductive potential via different reproductive traits and habitat use, with a reduced potential to spread to marginal areas.
Lower prevalence of aortic dilatation among preemptive pediatric renal transplant recipients – A cross‐sectional cohort study
Authors: Surak Aimann , Filler Guido , Sharma Ajay Parkash , Torres Canchala Laura Alejandra , Grattan Michael
Published: May 2020

Background

Aortic dilatation is a cardiovascular complication in pediatric renal transplant recipients and may have an increased risk of aortic dissection, aortic rupture, and death. Studies failed to show an association between blood pressure and aortic dilatation; however, 24‐hours ambulatory blood pressure monitoring (ABPM) was not performed. There was also no comparison between preemptive transplantation and dialysis.

Methods

After ethics approval, a retrospective cross‐sectional study was performed on all prevalent pediatric renal transplant recipients from a single tertiary care center. The presence of aortic dilatation was determined using standard echocardiographic measurements, and those with other risk factors for aortic dilatation were excluded. Associations between 24‐hours ABPM, renal function, dialysis history, and aortic dimensions were determined.

Results

We enrolled 37 participants with the following characteristics: 46% female, mean age 14.5 ± 3.7 years, 16% preemptive transplantation, and median end‐stage renal disease (ESRD) combined vintage (time from ESRD onset to echocardiogram) 597 days (range 289‐1290 days). We found 16/37 patients (43%) with aortic dilatation at any level, mostly mild. There was no association between 24‐hours ABPM measurements and aortic dilatation. None of the preemptively transplanted children had aortic dilatation.

Conclusion

This study confirms a high prevalence of aortic dilatation among pediatric renal transplant recipients, which appears to be independent of hypertension on 24‐hour ABPM. Patients with preemptive renal transplantation did not have aortic dilatation, suggesting that the effects of dialysis may contribute to the high prevalence of this complication. Pediatric cardiologists need to carefully assess aortic dimensions in these at‐risk patients.
Staging Science: Authoritativeness and Fragility of Models and Measurement in the COVID‐19 Crisis
Authors: Van Dooren Wouter , Noordegraaf Mirko
Published: May 2020

In the COVID‐19 crisis, society pins its hopes on science to play an authoritative role in reducing uncertainty and ambiguity. But is science up to the task? This is far from self‐evident. The demands on science in times of crisis run counter to the values of good, normal science. Crisis science needs to be fast, univocal, personalized, and direct, while normal science is slow, contentious, collective, and sensitive to complexity. Science can only play its atypical role if it is staged in the public arena. Some patterns of staging stand out: personalization, visualization, and connection to lived experiences. So far, the staging of science has been successful, but it is fragile. The COVID‐19 crisis shows the potential of well‐staged forms of alliance between science and policy, but when the general assumption is that scientists will “solve” societal “problems,” the staging of science has gone too far.
Defective Microspore Development 1 is required for microspore cell integrity and pollen wall formation in rice
Authors: Ren Lijun , Zhao Tingting , Zhang Lei , Du Guijie , Shen Yi , Tang Ding , Li Yafei , Luo Qiong , Cheng Zhukuan
Published: May 2020

Highly coordinated pollen wall patterning is essential for male reproductive development. Here, we report the identification of Defective Microspore Development 1 (DMD1), which encodes a nuclear‐localized protein possessing transactivation activity. DMD1 is preferentially expressed in the tapetum and microspores during post‐meiotic development. Mutations in DMD1 cause a male‐sterile phenotype with impaired microspore cell integrity. The mutants display abnormal callose degradation, accompanied by inhibited primexine thickening in the newly released microspores. Several genes associated with callose degradation and primexine formation are downregulated in dmd1 anthers. In addition, irregular Ubisch body morphology and discontinuous endexine occur, and the baculum is completely absent in dmd1. DMD1 interacts with Tapetum Degeneration Retardation (TDR), a basic helix‐loop‐helix transcription factor required for exine formation. Taken together, our results suggest that DMD1 is responsible for microspore cell integrity, primexine formation and exine pattern formation during Oryza sativa (rice) microspore development.
The parotid secretory protein BPIFA2 is a salivary surfactant that affects lipopolysaccharide action
Authors: Nandula Seshagiri Rao , Huxford Ian , Wheeler Thomas T. , Aparicio Conrado , Gorr Sven‐Ulrik
Published: May 2020

New Findings

What is the central question of this study?

The salivary protein BPIFA2 binds lipopolysaccharide, but its physiological function is not known. This study uses a new knockout mouse model to explore the physiological role of BPIFA2 in the oral cavity and systemic physiology.

What is the main finding and its importance?

BPIFA2 is a crucial surfactant in mouse saliva. In its absence, saliva exhibits the surface tension of water. Depletion of BPIFA2 affects salivary and ingested lipopolysaccharide and leads to systemic sequelae that include increased insulin secretion and metabolomic changes. These results suggest that the lipopolysaccharide‐binding activity of BPIFA2 affects the activity of ingested lipopolysaccharide in the intestine and that BPIFA2 depletion causes mild metabolic endotoxaemia.

Saliva plays important roles in the mastication, swallowing and digestion of food, speech and lubrication of the oral mucosa, antimicrobial and anti‐inflammatory activities, and the control of body temperature in grooming animals. The salivary protein BPIFA [BPI fold containing family A member 2; former names: parotid secretory protein (PSP), SPLUN2 and C20orf70] is related to lipid‐binding and lipopolysaccharide (LPS)‐binding proteins expressed in the mucosa. Indeed, BPIFA2 binds LPS, but the physiological role of BPIFA2 remains to be determined. To address this question,Bpifa2knockout (Bpifa2tm1(KOMP)Vlcg) (KO) mice were phenotyped, with emphasis on the saliva and salivary glands. Stimulated whole saliva collected from KO mice was less able to spread on a hydrophobic surface than wild‐type saliva, and the surface tension of KO saliva was close to that of water. These data suggest that BPIFA2 is a salivary surfactant that is mainly responsible for the low surface tension of mouse saliva. The reduced surfactant activity of KO saliva did not affect consumption of dry food or grooming, but saliva from KO mice contained less LPS than wild‐type saliva. Indeed, mice lacking BPIFA2 responded to ingested LPS with an increased stool frequency, suggesting that BPIFA2 plays a role in the solubilization and activity of ingested LPS. Consistent with these findings, BPIFA2‐depleted mice also showed increased insulin secretion and metabolomic changes that were consistent with a mild endotoxaemia. These results support the distal physiological function of a salivary protein and reinforce the connection between oral biology and systemic disease.
Tenebrio molitor and its gut bacteria growth in polystyrene (PS) presence as the sole source carbon
Authors: Peña-Pascagaza Paula M , López-Ramírez Nathalia A , Ballen-Segura Miguel A
Published: May 2020

Although polystyrene (PS) is considered a non-biodegradable material, recent work has shown the degradation capacity of this material by microorganisms, especially those that are part of the natural microbiota of the digestive tract of some invertebrates. The present work sought to evaluate the growth of the larva of the mealworm (Tenebrio molitor) and its bacteria, using PS as the sole source of carbon. In this way it was possible to demonstrate the consumption of PS plates by the larva, found in holes and tunnels in the material, however, nutritionally it is not enough for the larva to gain biomass, notably reducing its size and time survival. Similarly, bacteria isolated from the digestive tract of T. molitor presented the ability to generate biofilms o n PS s heets, g enerating c hanges ( cracks, holes, etc.) in them, which were observed under scanning electron microscopy (SEM), indicating the possible use of this material as a carbon source for its growth.