bluuebunny/crossref_metadata_2025 huggingface dataset:
Left and right atrial speckle tracking: Comparison of three methods of time reference gating
Authors: Palmer Cassady , Truong Vien T. , Klas Berthold , Wolking Sarah , Ornella Allison , Young Michael , Ngo Tam N. M. , Tretter Justin T. , Nagueh Sherif F. , Mazur Wojciech
Published: June 2020

Background

Atrial function has a close interdependence with ventricular function and plays a central role in maintaining optimal cardiac function. There are two well‐defined timing methods used to determine the start point. The aim of this prospective study was to objectively assess the influence of gating method selection on reported left and right strain values within the same group of healthy subjects.

Methods

101 volunteers (44 male, 57 female) had adequate tracking for analysis on TomTec Imaging Systems (Unterschleissheim, Germany). The median age was 41 years (range 19‐79 years, interquartile range 30‐52 years). Atrial strain by 2D‐speckle tracking echocardiography was evaluated using two commonly applied zero baseline time reference methods: R‐R gating and P‐P gating, in addition to volume gating (defining end‐systole at the atrial maximum and end‐diastole at the atrial minimum).

Results

True atrial minimum occurred prior to the onset of the QRS in most healthy volunteers. There was a significant difference for LA and RA reservoir strain between volume gating and R‐R gating (mean difference, 4.63%; P < .001 for LA; mean difference, 4.23%; P < .001 for RA), as well as volume gating and P‐P gating (mean difference, 5.26%; P < .001 for LA; mean difference, 6.24%; P < .001 for RA). Noticeably, reservoir strain was comparable between R‐R gating and P‐P gating (mean difference, 0.58%, P = .06) in LA, but not on RA (mean difference, 2.02%, P < .001).

Conclusions

There was variability in atrial strain values depending on the zero baseline time reference method used.
Officer retention and military spending: the rise of the military‐industrial complex during the Second World War
Authors: RAHMAN AHMED S.
Published: June 2020

This article examines how the regional distribution of US military personnel contributed to military expenditures around the country. We first discuss a theory of political economy for military spending—officers who remain in service can eventually help channel military funds and employment to their respective regions of origin, through direct military spending decisions or indirect political channels. Further, if officer retention is positively related to less industrialization at home (fewer work opportunities at home induce greater service lengths), this channel will induce greater progressiveness in military spending. To test these ideas we use the personnel records of officers serving in the US Navy from 1870 to the late 1930s. Tracking the tenure of all officers, we construct measures of ‘military representation’ across US counties. Through ordinary least squares, Tobit, and instrumental variable approaches, we find that senior naval officer representation across regions positively and robustly predicts regional naval spending (but not spending from other branches) during the Second World War.
Psychometric analysis of a measure of acceptance of new technologies (UTAUT), applied to the use of haptic virtual simulators in dental students
Authors: González Bravo Luis , Fernández Sagredo Marcelo , Torres Martínez Pilar , Barrios Penna Carolina , Fonseca Molina Juan , Stanciu Ionut Dorin , Nistor Nicolae
Published: June 2020

Background

The aims of this study are (a) to assess the psychometric quality of an instrument of acceptance of new technologies adapted from the UTAUT model, (b) to validate the UTAUT model as a valid measure to be applied in dental education, and (c) to determine which factors of the UTAUT model predict the behavioural intention of using a haptic virtual simulator (HVS).

Methods

A cross‐sectional design study with a sample of 265 dentistry students was carried out.

Results

Using structural equation modelling, confirmatory factor analysis verified the adequacy of four‐factor model, although the only factor that directly predicts behavioural intention is performance expectancy. Internal consistency coefficients of each factor ranged from 0.800 to 0.969.

Discussion

These findings, as well as the predictive power of performance expectancy on behaviour intention, are in line with previous evidence found in the literature.

Conclusion

These findings suggest that the UTAUT scale has adequate reliability and construct factorial validity; therefore, UTAUT model could be a valuable approach to assess haptic virtual simulator acceptance in dental education.
Behavioural diversity in fishing—Towards a next generation of fishery models
Authors: Wijermans Nanda , Boonstra Wiebren J. , Orach Kirill , Hentati‐Sundberg Jonas , Schlüter Maja
Published: June 2020

Despite improved knowledge and stricter regulations, numerous fish stocks remain overharvested. Previous research has shown that fisheries management may fail when the models and assessments used to inform management are based on unrealistic assumptions regarding fishers' decision‐making and responses to policies. Improving the understanding of fisher behaviour requires addressing its diversity and complexity through the integration of social science knowledge into modelling. In our paper, we review and synthesize state‐of‐the‐art research on both social science's understanding of fisher behaviour and the representation of fisher decision‐making in scientific models. We then develop and experiment with an agent‐based social–ecological fisheries model that formalizes three different fishing styles. Thereby we reflect on the implications of our incorporation of behavioural diversity and contrast it with the predominant assumption in fishery models: fishing practices being driven by rational profit maximizing. We envision a next generation of fisheries models and management that account for social scientific knowledge on individual and collective human behaviours. Through our agent‐based model, we demonstrate how such an integration is possible and propose a scientific approach for reducing uncertainty based on human behavioural diversity in fisheries. This study serves to lay the foundations for a next generation of social–ecological fishery models that account for human behavioural diversity and social and ecological complexity that are relevant for a realistic assessment and management of fishery sustainability problems.
Isotopically anomalous organic carbon in the aftermath of the Marinoan snowball Earth
Authors: Liljestrand Frasier L. , Laakso Thomas A. , Macdonald Francis A. , Schrag Daniel P. , Johnston David T.
Published: June 2020

Throughout most of the sedimentary record, the marine carbon cycle is interpreted as being in isotopic steady state. This is most commonly inferred via isotopic reconstructions, where two export fluxes (organic carbon and carbonate) are offset by a constant isotopic fractionation of ~25 (termed

). Sedimentary deposits immediately overlying the Marinoan snowball Earth diamictites, however, stray from this prediction. In stratigraphic sections from the Ol Formation (Mongolia) and Sheepbed Formation (Canada), we observe a temporary excursion where the organic matter has anomalously heavy

C and is grossly decoupled from the carbonate

C. This signal may reflect the unique biogeochemical conditions that persisted in the aftermath of snowball Earth. For example, physical oceanographic modeling suggests that a strong density gradient caused the ocean to remain stratified for about 50,000 years after termination of the Marinoan snowball event, during which time the surface ocean and continental weathering consumed the large atmospheric CO2 reservoir. Further, we now better understand how

C records of carbonate can be post‐depostionally altered and thus be misleading. In an attempt to explain the observed carbon isotope record, we developed a model that tracks the fluxes and isotopic values of carbon between the surface ocean, deep ocean, and atmosphere. By comparing the model output to the sedimentary data, stratification alone cannot generate the anomalous observed isotopic signal. Reproducing the heavy

C in organic matter requires the progressively diminishing contribution of an additional anomalous source of organic matter. The exact source of this organic matter is unclear.
Standardized short‐term acute heat stress assays resolve historical differences in coral thermotolerance across microhabitat reef sites
Authors: Voolstra Christian R. , Buitrago‐López Carol , Perna Gabriela , Cárdenas Anny , Hume Benjamin C. C. , Rädecker Nils , Barshis Daniel J.
Published: June 2020

Coral bleaching is one of the main drivers of reef degradation. Most corals bleach and suffer mortality at just 1–2°C above their maximum monthly mean temperatures, but some species and genotypes resist or recover better than others. Here, we conducted a series of 18‐hr short‐term acute heat stress assays side‐by‐side with a 21‐day long‐term heat stress experiment to assess the ability of both approaches to resolve coral thermotolerance differences reflective of in situ reef temperature thresholds. Using a suite of physiological parameters (photosynthetic efficiency, coral whitening, chlorophyll a, host protein, algal symbiont counts, and algal type association), we assessed bleaching susceptibility of Stylophora pistillata colonies from the windward/exposed and leeward/protected sites of a nearshore coral reef in the central Red Sea, which had previously shown differential mortality during a natural bleaching event. Photosynthetic efficiency was most indicative of the expected higher thermal tolerance in corals from the protected reef site, denoted by an increased retention of dark‐adapted maximum quantum yields at higher temperatures. These differences were resolved using both experimental setups, as corroborated by a positive linear relationship, not observed for the other parameters. Notably, short‐term acute heat stress assays resolved per‐colony (genotype) differences that may have been masked by acclimation effects in the long‐term experiment. Using our newly developed portable experimental system termed the Coral Bleaching Automated Stress System (CBASS), we thus highlight the potential of mobile, standardized short‐term acute heat stress assays to resolve fine‐scale differences in coral thermotolerance. Accordingly, such a system may be suitable for large‐scale determination and complement existing approaches to identify resilient genotypes/reefs for downstream experimental examination and prioritization of reef sites for conservation/restoration. Development of such a framework is consistent with the recommendations of the National Academy of Sciences and the Reef Restoration and Adaptation Program committees for new intervention and restoration strategies.
The role of the Neotropics as a source of world tetrapod biodiversity
Authors: Meseguer Andrea S. , Antoine Pierre‐Olivier , Fouquet Antoine , Delsuc Frédéric , Condamine Fabien L.
Published: June 2020

Aim

The Neotropics currently host outstanding levels of species richness, with one‐third of the global tetrapod species. The underlying causes of these extraordinary levels of biodiversity are a topic debated in evolutionary ecology, but the main processes at work remain elusive.

Location

Neotropics.

Time period

Cenozoic and Mesozoic.

Major taxa studied

Tetrapods.

Methods

Using global phylogenies for amphibians, birds, lepidosaurs and mammals, biogeographical and time‐variable (trait‐dependent and trait‐independent) diversification models, we examined changes in speciation and extinction rates through time in the Neotropics in relationship to other areas of the world, and estimated the time of Neotropical colonizations.

Results

We found that from the origin of lepidosaurs and mammals until the Pliocene (the Miocene for birds), diversification rates within the Neotropics were lower than rates in other regions (i.e., turnover was high). Afterwards, extinction decreased relative to speciation, and Neotropical diversification outpaced diversification in other regions. Dispersal out of the Neotropics also increased after the Pliocene (the Miocene for birds), exceeding into‐the‐Neotropics migrations. For amphibians, diversification rates in the Neotropics have been higher than in other areas through time, and dispersal out of the Neotropics decreased in the Cenozoic.

Main conclusions

The common view that the Neotropics are an ancient source of world species diversity, with high in situ speciation, dispersal to other areas and low extinction, might be true only for amphibians. For mammals, birds and lepidosaurs, the Neotropics acted as a diversity sink from their origin until the Miocene–Pliocene (i.e., diversification rates were lower and turnover higher than in other areas). Only afterwards did the region turn into a diversity source. Our study highlights that models accounting for rates of diversification that vary through time could improve our capacity to assess evolutionary dynamics over long time‐scales.
GATA2 functions in adrenal chromaffin cells
Authors: Watanabe‐Asaka Tomomi , Hayashi Moyuru , Engel James Douglas , Kawai Yoshiko , Moriguchi Takashi
Published: June 2020

Catecholamine synthesized in the sympathoadrenal system, including sympathetic neurons and adrenal chromaffin cells, is vital for cardiovascular homeostasis. It has been reported that GATA2, a zinc finger transcription factor, is expressed in murine sympathoadrenal progenitor cells. However, a physiological role for GATA2 in adrenal chromaffin cells has not been established. In this study, we demonstrate that GATA2 is specifically expressed in adrenal chromaffin cells. We examined the consequences of Gata2 loss‐of‐function mutations, exploiting a Gata2 conditional knockout allele crossed to neural crest‐specific Wnt1‐Cre transgenic mice (Gata2 NC‐CKO). The vast majority of Gata2 NC‐CKO embryos died by embryonic day 14.5 (e14.5) and exhibited a decrease in catecholamine‐producing adrenal chromaffin cells, implying that a potential catecholamine defect might lead to the observed embryonic lethality. When intercrossed pregnant dams were fed with synthetic adrenaline analogs, the lethality of the Gata2 NC‐CKO embryos was partially rescued, indicating that placental transfer of the adrenaline analogs complements the lethal catecholamine deficiency in the Gata2 NC‐CKO embryos. These results demonstrate that GATA2 participates in the development of neuroendocrine adrenaline biosynthesis, which is essential for fetal survival.
Development of a portable reverse transcription loop‐mediated isothermal amplification system to detect the E1 region of Chikungunya virus in a cost‐effective manner
Authors: Saechue Benjawan , Kamiyama Naganori , Wang Yinan , Fukuda Chiaki , Watanabe Kei , Soga Yasuhiro , Goto Mizuki , Dewayani Astri , Ariki Shimpei , Hirose Haruna , Ozaka Sotaro , Sachi Nozomi , Hidano Shinya , Faisal Khaledul , Chowdhury Rajashree , Anik Ashfaq Khan Md. , Hossain Faria , Ghosh Prakash , Shirin Tahmina , Mondal Dinesh , Murakami Kazunari , Kobayashi Takashi
Published: June 2020

Chikungunya fever is a mosquito‐borne disease cause of persistent arthralgia. The current diagnosis of Chikungunya virus (CHIKV) relies on a conventional reverse transcription polymerase chain reaction assay. Reverse transcription loop‐mediated isothermal amplification (RT‐LAMP) is a rapid and simple tool used for DNA‐based diagnosis of a variety of infectious diseases. In this study, we established an RT‐LAMP system to recognize CHIKV by targeting the envelope protein 1 (E1) gene that could also detect CHIKV at a concentration of 8 PFU without incorrectly detecting other mosquito‐borne viruses. The system also amplified the E1 genome in the serum of CHIKV‐infected mice with high sensitivity and specificity. Moreover, we established a dry RT‐LAMP system that can be transported without a cold chain, which detected the virus genome in CHIKV‐infected patient samples with high accuracy. Thus, the dry RT‐LAMP system has great potential to be applied as a novel CHIKV screening kit in endemic areas.
Headache Virtual Visit Toolbox: The Transition From Bedside Manners to Webside Manners
Authors: Begasse de Dhaem Olivia , Bernstein Carolyn
Published: June 2020

The COVID‐19 health emergency has led many Headache providers to transition to virtual care overnight without preparation. We review our experience and discuss tips to bring humanity to the virtual visits.
Systematic review about etiologic association to the leukoerythroblastic reaction
Authors: Tabares Calvache Ebellins , Tabares Calvache Allison Dessiret , Faulhaber Gustavo Adolpho Moreira
Published: June 2020

Background and purpose

Leukoerythroblastic reaction (LER) is characterized by the presence of immature erythroid cells and myeloid precursors (metamyelocytes, myelocytes, promyelocytes, myeloblasts, and blasts) as well as, exclusively in myelofibrotic disorders, teardrop cells in the peripheral blood (J Pathol Bacteriol, 42, 1936, 541; Semaine Med, 22, 1902, 373). Research on how to interpret LER and its meaning in clinical practice is scarce, and there is no consensus on the diagnostic criteria. We summarize the current evidence with the aim of clarifying the knowledge on this subject.

Methods

We conducted a comprehensive search of the PubMed‐MEDLINE, EMBASE and ELSEVIER databases, the Cochrane Library, Google Scholar, and medical journals to identify relevant papers.

Results

Our search identified 425 papers, of which, 35 (11 trials and 24 case reports) ultimately met the inclusion criteria. These showed two principal groups of diseases associated with leukoerythroblastosis (LEB), corresponding to solid and hematological malignancies. The other etiologies, in order of frequency, were hemolytic diseases, infection, and others, while hemorrhage was only reported in the trials group.

Conclusion

The literature on LER is scarce and heterogeneous. The etiological factors of LER are diverse, and its presence in malignant disease is an indicator of disease progression and an adverse prognosis suggesting poor survival. In those cases where LER had neither hematological nor solid neoplasms, its manifestation, prognosis and its impact on our daily clinical practice are unknown.
Human Resource Management–Performance Research: Is Everyone Really on the Same Page on Employee Involvement?
Authors: Wood Stephen
Published: June 2020

Differences in the treatment of involvement in the human resource management (HRM)–performance research stream have been underplayed, as commentaries concentrate on showing that HRM produces a performance premium, and more recently on exploring the mechanisms explaining this. This paper first identifies the two initial concerns of the research stream – the value of employee involvement and the holistic treatment of HRM – and the way these are joined to present a unified view of the area. It then reviews the studies, confirming that involvement has been underplayed or neglected completely, and is only prioritized in a minority. A divide is identified between HRM as an orientation towards fostering employee involvement – seen as a managerial philosophy – and as a technology – a set of practices constituting high‐performance work systems. The paper then argues that acknowledgement of this divide matters, and concludes by drawing out some implications for how we should progress the research stream.
The MAIT TCRβ chain contributes to discrimination of microbial ligand
Authors: Narayanan Gitanjali A , McLaren James E , Meermeier Erin W , Ladell Kristin , Swarbrick Gwendolyn M , Price David A , Tran Jessica G , Worley Aneta H , Vogt Todd , Wong Emily B , Lewinsohn David M
Published: June 2020

Mucosal‐associated invariant T (MAIT) cells are key players in the immune response against microbial infection. The MAIT T‐cell receptor (TCR) recognizes a diverse array of microbial ligands, and recent reports have highlighted the variability in the MAIT TCR that could further contribute to discrimination of ligand. The MAIT TCR complementarity determining region (CDR)3β sequence displays a high level of diversity across individuals, and clonotype usage appears to be dependent on antigenic exposure. To address the relationship between the MAIT TCR and microbial ligand, we utilized a previously defined panel of MAIT cell clones that demonstrated variability in responses against different microbial infections. Sequencing of these clones revealed four pairs, each with shared (identical) CDR3α and different CDR3β sequences. These pairs demonstrated varied responses against microbially infected dendritic cells as well as against 5‐(2‐oxopropylideneamino)‐6‐d‐ribitylaminouracil, a ligand abundant in Salmonella enterica serovar Typhimurium, suggesting that the CDR3β contributes to differences in ligand discrimination. Taken together, these results highlight a key role for the MAIT CDR3β region in distinguishing between MR1‐bound antigens and ligands.
Hydration of polyphase Ca3SiO5‐Ca3Al2O6 in the presence of gypsum and Na2SO4
Authors: Joseph Shiju , Skibsted Jørgen , Cizer Özlem
Published: June 2020

Alite (Ca3SiO5: C3S*) and calcium aluminate (Ca3Al2O6: C3A) are the major phases in Portland cement, which have an essential role in the development of early age properties. The effects of gypsum content, fineness, and Na2SO4 addition on the early‐stage hydration kinetics are investigated for polyphase (co‐sintered) Ca3SiO5‐Ca3Al2O6 model systems using calorimetry, X‐ ray diffraction, thermal analysis, and solid‐state 27Al and 29Si nuclear magnetic resonance (NMR) spectroscopy. The results demonstrate that the hydration of C3A significantly affects the hydration of C3S. The C3S and C3A hydration is hindered considerably in severely over‐sulfated systems (where C3A hydration is suppressed due to a very high gypsum content) and systems with additional Na2SO4. Although there is a considerable amount of Al incorporation in the C‐S‐H phase, no clear trends with respect to gypsum content, hydration age or Na2SO4 addition are observed for the AlIV/Si ratios of the C‐S‐H phase determined from 29Si NMR. With the addition of Na2SO4, recrystallization of ettringite from the AFm phases is postponed from 1 day to 7 days.

*Cement chemistry notation: C‐CaO, S‐SiO2, A‐Al2O3, ‐SO3, N‐Na2O.
Hoopoe Upupa epops male feeding effort is related to female cosmetic egg colouration
Authors: Díaz Lora Silvia , Pérez‐Contreras Tomás , Azcárate‐García Manuel , Martínez Bueno Manuel , Soler Juan José , Martín‐Vivaldi Manuel
Published: June 2020

Avian eggshell colouration might function as a post‐mating sexually selected signal of female quality, influencing male parental investment and, hence, reproductive success. This hypothesis has been tested for intrinsic eggshell pigments as biliverdin (blue‐green colouration) and/or protoporphyrin (brown coloured spots), but never for colourations applied post‐laying. Post‐laying staining colouration due to, for instance, uropygial secretion of the female could reflect its phenotypic properties and, thus, might be a cue for male investment in reproduction. In hoopoes, the uropygial gland of incubating females hosts symbiotic bacteria that are responsible for the brown colour of their uropygial secretion and of the eggshells, as they cover their bluish‐grey eggshells with gland secretion after laying. The secretion protects embryos from pathogenic trans‐shell infections and, thus, egg colouration may function as a cue or even as a post‐mating sexually selected signal of antimicrobial potential in hoopoes. In a wild hoopoe population breeding in nest boxes in Spain, we test this hypothesis by exploring whether egg colour predicts male parental investment. In accordance with the hypothesis, we found that the amount of food provided by males to incubating females was higher in nests with less saturated eggshell colours. This relationship was affected by female body condition. High quality females in terms of body condition and/or in secretion colour obtained better males in terms of provisioning effort during incubation. Given that eggshell saturation is negatively related to density of bacterial symbionts in uropygial secretions, one possibility is that males may regulate their parental investment in accordance to the expected characteristics of mutualistic bacteria hosted in uropygial glands and deposited on eggshells. We discuss alternative explanations for our results, concluding that the post‐mating sexual selection hypothesis is the most likely but experimental modification of egg colour is needed to test it further.
Environmental correlates of reptile variation on the Houtman Abrolhos archipelago, eastern Indian Ocean
Authors: How Richard A. , Cowan Mark A. , Teale Roy J. , Schmitt Lincoln H.
Published: June 2020

Aim

To examine the relationships between island environmental attributes, both biotic and abiotic, and three measures of reptilian variation—species assemblage, species richness and body size distributions.

Location

Houtman Abrolhos archipelago, Western Australia.

Taxon

Reptiles.

Methods

Nineteen islands were sampled from 2002 to 2012 using foraging and trapping. Body size (snout‐vent length) was measured on first capture. Island size varied from 0.3 to 587 ha, encompassing the three geomorphic island types, the three bathymetric groups and a range of other environmental attributes.

Results

From about 1,500 captures, 24 reptile species were recorded, including three previously undocumented on the archipelago, and 54 records of species not previously recorded on specific islands. Four significantly different reptile assemblage groups were identified. These were highly correlated with geomorphological composition—two groups encompassing the three large aeolianite islands; another the high rock islands and the largest composite island; and a fourth consisting of the remaining composite islands with one very small high rock island. Both assemblage and richness on islands were significantly correlated with island area, geomorphology and native plant species richness. Of the 13 species captured frequently, 11 showed statistically significant inter‐island variation in body size, and two exhibited sexual dimorphism. In three species, size was also correlated with environmental attributes, including reptile species richness, native plant richness, geomorphology and island area. Six of the eleven species captured on the two largest islands (both aeolianite) differed in size on these adjacent islands.

Main Conclusions

High inter‐island variation in body size and assemblage composition suggest strong differential selection since the most recent isolation event at 6,500 bp. Anthropogenic disturbances over the last 150 years have resulted in several island extinctions. Species assemblage and richness are strongly associated with environmental attributes. Inter‐island body size variation in three species revealed idiosyncratic responses to environmental pressures. Results provide guidance for effective conservation and management strategies, and evidence for the extinction debts inherent in more recently fragmented mainland habitats.
Electrophysiologic evidence of epicardial connections between low right atrium and remote right atrial region or coronary sinus musculature: Relevance for catheter ablation of typical atrial flutter
Authors: Chaumont Corentin , Saoudi Nadir , Savouré Arnaud , Lațcu Decebal G. , Anselme Frédéric
Published: June 2020

Background

The coronary sinus (CS) is surrounded by a myocardial coat with extensive connections to the left and right atria that contributes to the interatrial electrical connection. Whereas epicardial connections between CS musculature and the left atrium have largely been demonstrated, clinically relevant epicardial connections from the CS musculature toward the low right atrium (LRA) and epicardial connections between two regions of the right atrium remain questionable.

Methods

Five patients underwent electrophysiology (EP) study for typical atrial flutter (AFl) using either conventional multipolar catheters (four patients) or three‐dimensional high‐density mapping system (one patient).

Results

All five patients had a similar sequence of events during the EP studies. After several cavotricuspid isthmus (CTI) radiofrequency (RF) applications, double potentials were recorded along the ablation line while tachycardia persisted. The right atrial activation pattern strongly suggested the presence of a complete endocardial CTI line of the block. Based on the detailed conventional atrial mapping, RF applications at the middle cardiac vein/CS ostium allowed sinus rhythm restoration in four patients. High‐density mapping showed an early breakthrough site at the septal side of the ablation line, close to the CS ostium during counterclockwise AFl, in the fifth patient. RF applications at this site resulted in tachycardia termination.

Conclusion

Our observations suggested the existence of epicardial fibers connecting the LRA with either the CS musculature or a remote right atrial region. When AFl ablation fails whereas evidence for the local endocardial block is observed, the operators should integrate this finding in the diagnosis and ablation strategy.
Large‐scale transcriptome profiles reveal robust 20‐signatures metabolic prediction models and novel role of G6PC in clear cell renal cell carcinoma
Authors: Xu Wen‐Hao , Xu Yue , Tian Xi , Anwaier Aihetaimujiang , Liu Wang‐Rui , Wang Jun , Zhu Wen‐Kai , Cao Da‐Long , Wang Hong‐Kai , Shi Guo‐Hai , Qu Yuan‐Yuan , Zhang Hai‐Liang , Ye Ding‐Wei
Published: June 2020

Clear cell renal cell carcinoma (ccRCC) is the most common and highly malignant pathological type of kidney cancer. We sought to establish a metabolic signature to improve post‐operative risk stratification and identify novel targets in the prediction models for ccRCC patients. A total of 58 metabolic differential expressed genes (MDEGs) were identified with significant prognostic value. LASSO regression analysis constructed 20‐mRNA signatures models, metabolic prediction models (MPMs), in ccRCC patients from two cohorts. Risk score of MPMs significantly predicts prognosis for ccRCC patients in TCGA (P < 0.001, HR = 3.131, AUC = 0.768) and CPTAC cohorts (P = 0.046, HR = 2.893, AUC = 0.777). In addition, G6PC, a hub gene in PPI network of MPMs, shows significantly prognostic value in 718 ccRCC patients from multiply cohorts. Next, G6Pase was detected high expressed in normal kidney tissues than ccRCC tissues. It suggested that low G6Pase expression significantly correlated with poor prognosis (P < 0.0001, HR = 0.316) and aggressive progression (P < 0.0001, HR = 0.414) in 322 ccRCC patients from FUSCC cohort. Meanwhile, promoter methylation level of G6PC was significantly higher in ccRCC samples with aggressive progression status. G6PC significantly participates in abnormal immune infiltration of ccRCC microenvironment, showing significantly negative association with check‐point immune signatures, dendritic cells, Th1 cells, etc. In conclusion, this study first provided the opportunity to comprehensively elucidate the prognostic MDEGs landscape, established novel prognostic model MPMs using large‐scale ccRCC transcriptome data and identified G6PC as potential prognostic target in 1,040 ccRCC patients from multiply cohorts. These finding could assist in managing risk assessment and shed valuable insights into treatment strategies of ccRCC.
Effect of the FreeStyle Libre™ flash glucose monitoring system on glycemic control in individuals with type 2 diabetes treated with basal–bolus insulin therapy: An open label, prospective, multicenter trial in Japan
Authors: Ogawa Wataru , Hirota Yushi , Osonoi Takeshi , Tosaki Takahiro , Kato Yoshiro , Utsunomiya Kazunori , Nishimura Rimei , Nakamura Jiro
Published: June 2020

Aims/Introduction

We investigated the effect of FreeStyle LibreTM on glycemic control in Japanese type 2 diabetes patients treated with basal–bolus insulin therapy.

Materials and Methods

This prospective, 90‐day single‐arm study enrolled 94 adults with type 2 diabetes treated with insulin. A 14‐day masked baseline phase was followed by an 11‐week treatment phase during which participants used the device to monitor glucose levels. The primary end‐point was time spent in hypoglycemia (<70 mg/dL) for baseline versus study end (days 76–90). Secondary end‐points included other measures of glycemic control, along with patient satisfaction using the Japanese Diabetes Treatment and Satisfaction Questionnaire.

Results

Time spent in hypoglycemia was low at baseline (0.51 ± 0.93 h/day) and did not significantly decrease at study end (0.47 ± 0.63 h/day, P = 0.6354). Time in range, time in hyperglycemia and estimated A1c all improved versus baseline (by +1.7 ± 3.0 h/day, −1.6 ± .4 h/day and −0.4 ± 0.8%, respectively, P < 0.0001 in each). Finger stick tests fell from 2.9 ± 1.3 to 1.9 ± 1.4/day, and mean scanning frequency during the intervention phase was 11.3/day. The mean treatment satisfaction score increased by 11.8 ± 5.3 (P < 0.0001). Two severe hypoglycemia‐related adverse events were reported; one of which was possibly related to the device. Three participants reported mild device‐related skin trauma, site discomfort or subcutaneous bleeding.

Conclusions

Use of FreeStyle Libre by Japanese type 2 patients diabetes treated with basal–bolus insulin therapy showed a low baseline of hypoglycemia, and enabled improved glycemic control and treatment satisfaction.
Sodium–glucose cotransporter 2 inhibitors represent a paradigm shift in the prevention of heart failure in type 2 diabetes patients
Authors: Kashiwagi Atsunori , Araki Shinchi , Maegawa Hiroshi
Published: June 2020

Recent major clinical trials of the use of sodium–glucose cotransporter 2 (SGLT2) inhibitors in patients with type 2 diabetes have shown that they reduce three‐point major adverse cardiovascular events, cardiovascular death, hospitalization for heart failure (HF) and a composite renal outcome. These beneficial effects of SGLT2 inhibitors are also evident in type 2 diabetes patients with a previous history of atherosclerotic cardiovascular disease or advanced renal disease. HF is a major determinant of the prognosis of diabetes patients. Although HF with low ejection fraction can be effectively treated with antihypertensive drugs, these treatments do not reduce mortality in HF patients with preserved ejection fraction (HFpEF). HFpEF is clinically characterized by left ventricular diastolic dysfunction, perivascular fibrosis and stiffness of cardiomyocytes, defined as “cardiomyopathy”. Therefore, HFpEF is considered to be an entirely separate entity to HF with low ejection fraction. Recent studies have suggested that HFpEF might be treatable using SGLT2 inhibitors, which ameliorate visceral adiposity, insulin resistance, hyperglycemia, hyperlipidemia, volume overload, hypertension and cardiac inflammation. In the final part of the present review, we discuss the biochemical and molecular mechanisms of the effects of SGLT2 inhibitors in type 2 diabetes patients with HFpEF. These involve amelioration of the low nitric oxide production and oxidative stress, a reduction in cardiac inflammatory cytokine signaling, inhibition of Ca2+ overload, and an improvement in cardiac energy metabolism as a result of ketone body production. Investigations of the beneficial effects of SGLT2 inhibitors on cardiorenal outcomes, including hospitalization for HF, are now being carried out in preclinical and clinical studies.
Hospital performance standards and medical pricing: The impact of information disclosure in cardiac care
Authors: Dor Avi , Encinosa William , Carey Kathleen
Published: June 2020

A policy concern is that the initiation of Hospital Compare (HC) reporting in Medicare provided leverage to insurers in price negotiations for lowering private sector prices without regard to hospital performance. Using the sequential Nash bargaining framework we provide economic intuition to the contrary: while average hospital prices decline under quality disclosures, hospitals with above‐average quality are able to exert a stronger bargaining position, consequently capturing prices above the market rate. To explore this issue empirically we estimate variants of difference‐in‐difference models, examining the effects of the three main scores (heart attack, heart failure, and combined mortalities) on transaction prices of related hospital procedures. States which had similar mandated reporting systems in place before the initiation of HC form the control group. Analyzing claims data of privately insured patients, we find that HC exerted downward pressure on prices. However, hospitals rated “above‐average” captured higher prices, thereby offsetting the overall policy effect fully or partially. Leads and lags analysis lends further support for our difference‐in‐difference approach. We find that highly ranked hospitals received a quality premium of 8–14%, comparable to price effects found in other health care markets. We conclude that HC was effective at constraining prices without penalizing high performers.
Effect of cement color and tooth‐shaded background on the final color of lithium disilicate and zirconia‐reinforced lithium silicate ceramics: An in vitro study
Authors: Yildirim Bengisu , Recen Duygu , Tekeli Simsek Aysıla
Published: June 2020

Objective

To evaluate the translucency and effects of different cement colors on the final shade of lithium disilicate ceramics (LDS) and zirconia‐reinforced lithium silicate ceramics (ZLS) over an A1 and A3 tooth‐shaded background.

Materials and Methods

Eighty‐eight rectangular‐shaped specimens were sliced from LDS and ZLS blocks. The final thickness of the specimens was set at 0.8 ± 0.01 mm. Spectrophotometric measurements for the translucency were taken against black and white backgrounds. Composite resin tooth‐shaded background disks were fabricated in two shades (A1 and A3), as were resin cement disks (opaque and translucent) (n = 11). Next, the ceramic specimens and tooth‐shaded backgrounds were connected with glycerin, and baseline measurements were taken. These measurements were used as a reference. Then, the ceramic specimens, cement specimens, and tooth‐shaded backgrounds were connected together with glycerin, and a second set of measurements was taken. The CIEDE2000 (ΔE00) color formula was used to calculate the translucency and color differences. A Mann‐Whitney U test was also performed for the translucency, and a three‐way ANOVA (analysis of variance) test was performed for the ΔE00 values (α = .05).

Results

The LDS and ZLS groups had similar translucency (P = .055). The ΔE00 values of the specimens were significantly affected by the cement color and tooth‐shaded backgrounds in the LDS and ZLS groups (P < .05). Using the opaque cement color resulted in statistically significant differences against the light and dark (A1 and A3) tooth‐shaded backgrounds in both the LDS and ZLS groups (P = .022 and P = .006).

Conclusions

The material type did not affect the translucency or final color. However, the cement color did affect the final shade when thin ceramic restorations were used.

Clinical Significance

It should be noted that the cement color and tooth‐shaded background used may change the final color of thin high translucency ceramic restorations that contain lithium disilicate and zirconia‐reinforced lithium silicate.
Lower household income is associated with an increased risk of hospital readmission in patients with decompensated cirrhosis
Authors: Brahmania Mayur , Wiskar Katie , Walley Keith R , Celi Leo A , Rush Barret
Published: June 2020

Background and Aim

The impact of household income, a surrogate of socioeconomic status, on hospital readmission rates for patients with decompensated cirrhosis has not been well characterized.

Methods

The Nationwide Readmission Database from 2012 to 2014 was used to study the association of lower median household income on 30‐, 90‐, and 180‐day hospital readmission rates for patients with decompensated cirrhosis.

Results

From the 42 679 001 hospital admissions contained in the sample, there were 82 598 patients with decompensated cirrhosis who survived a hospital admission in the first 6 months of the year. During a uniform 6‐month follow‐up period, 25 914 (31.4%), 39 928 (48.3%), and 47 496 (57.5%) patients were readmitted at 30, 90, and 180 days, respectively. After controlling for demographic and clinical confounders, patients residing in the three lowest income quartiles were significantly more likely to be readmitted at 30 days than those in the fourth quartile (first quartile, odds ratio [OR] 1.32 [95% confidence interval, CI, 1.17–1.47, P < 0.01]; second quartile, OR 1.25 [95% CI 1.13–1.38, P < 0.01]; and third quartile, OR 1.08 [95% CI 0.97–1.20, P = 0.07]). The association between lower socioeconomic status and the higher risk of readmissions persisted at 90 days (first quartile, OR 1.21 [95% CI 1.14–1.30, P < 0.01]) and 180 days (first quartile, OR 1.32 [95% CI 1.20–1.44, P < 0.01]).

Conclusion

Patients with decompensated cirrhosis residing in the lowest income quartile had a 32% higher odds of hospital readmissions at 30, 90, and 180 days compared with those in the highest income quartile.
Morphological plasticity of the tuberoinfundibular dopaminergic neurones in the rat during the oestrous cycle and lactation
Authors: Yip Siew Hoong , Araujo‐Lopes Roberta , Szawka Raphael E. , York Jade , Hyland Brian , Grattan David R. , Bunn Stephen J.
Published: June 2020

The hypothalamic tuberoinfundibular dopaminergic (TIDA) neurones are critical with respect to regulating prolactin secretion from the anterior pituitary. Under most physiological conditions, they are stimulated by prolactin to release dopamine into the median eminence which subsequently suppresses further prolactin secretion from the lactotrophs. During lactation, the TIDA neurones are known to undergo both electrophysiological and neurochemical changes that alleviate this negative‐feedback, thus allowing circulating prolactin levels to rise. The present study aimed to determine whether TIDA neurone morphology, most notably spine density, is also modified during lactation. This was achieved by stereotaxically injecting the arcuate nucleus of female, tyrosine hydroxylase‐promoter driven Cre‐recombinase transgenic rats with Cre‐dependent adeno‐associated virus‐expressing Brainbow. This resulted in the highly specifici transfection of between 10% and 30% of the TIDA neurones, thus allowing the morphologies on multiple individual neurones to be examined in a single hypothalamic slice. The transfected neurones exhibited a range of complex forms, including a diversity of soma and location of axonal origin. Neuronal spine counting showed that the density of somatic, but not dendritic, spines was significantly higher during lactation than at any other reproductive stage. There was also a significant fall in somatic spine density across the oestrous cycle from dioestrus to oestrus. Although the functional characteristics of the additional somatic spines have not been determined, if, as might be expected, they represent an increased excitatory input to the TIDA neurones, this could have important physiological implications by perhaps supporting altered neurotransmitter release at their neuroendocrine terminals. Enhanced excitatory input may, for example, favour the release of the opioid peptide enkephalin rather than dopamine, which is potentially significant because the expression of the peptide is known to increase in the TIDA neurones during lactation and, in contrast to dopamine, it stimulates rather than inhibits prolactin secretion from the pituitary.
Mealtime: A circadian disruptor and determinant of energy balance?
Authors: Ruddick‐Collins Leonie C. , Morgan Peter J. , Johnstone Alexandra M.
Published: June 2020

Circadian rhythms play a critical role in the physiological processes involved in energy metabolism and energy balance (EB). A large array of metabolic processes, including the expression of many energy‐regulating endocrine hormones, display temporal rhythms that are driven by both the circadian clock and food intake. Mealtime has been shown to be a compelling zeitgeber in peripheral tissue rhythms. Inconsistent signalling to the periphery, because of mismatched input from the central clock vs time of eating, results in circadian disruption in which central and/or peripheral rhythms are asynchronously time shifted or their amplitudes reduced. A growing body of evidence supports the negative health effects of circadian disruption, with strong evidence in murine models that mealtime‐induced circadian disruption results in various metabolic consequences, including energy imbalance and weight gain. Increased weight gain has been reported to occur even without differences in energy intake, indicating an effect of circadian disruption on energy expenditure. However, the translation of these findings to humans is not well established because the ability to undertake rigorously controlled dietary studies that explore the chronic effects on energy regulation is challenging. Establishing the neuroendocrine changes in response to both acute and chronic variations in mealtime, along with observations in populations with routinely abnormal mealtimes, may provide greater insight into underlying mechanisms that influence long‐term weight management under different meal patterns. Human studies should explore mechanisms through relevant biomarkers; for example, cortisol, leptin, ghrelin and other energy‐regulating neuroendocrine factors. Mistiming between aggregate hormonal signals, or between hormones with their receptors, may cause reduced signalling intensity and hormonal resistance. Understanding how mealtimes may impact on the coordination of endocrine factors is essential for untangling the complex regulation of EB. Here a review is provided on current evidence of the impacts of mealtime on energy metabolism and the underlying neuroendocrine mechanisms, with a specific focus on human research.
Payday lending, crime, and bankruptcy: Is there a connection?
Authors: Barth James R. , Hilliard Jitka , Jahera John S. , Lee Kang B. , Sun Yanfei
Published: June 2020

The payday lending industry has been the subject of controversy over the years. This is largely due to the high fee structure of payday loans and the view of some that the industry targets economically vulnerable groups. For these reasons, some states prohibit payday lending, while others impose regulatory restrictions on their operations. Despite the prohibitions and restrictions, the industry nonetheless serves a significant segment of the U.S. population. Our purpose is to determine whether in addition to providing loans to individuals, access to payday lenders is associated with less property crime and fewer bankruptcies. Using a unique data set obtained directly from all state regulatory authorities, we find evidence, contrary to some earlier studies, that the presence of payday lenders may help reduce property crime as well as personal bankruptcies.