bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Panama as an intercontinental land bridge for large mammals
Authors: Meyer Ninon F. V. , Moreno Ricardo , Sutherland Christopher , de la Torre J. Antonio , Esser Helen J. , Jordan Christopher A. , Olmos Melva , Ortega Josué , Reyna‐Hurtado Rafael , Valdes Samuel , Jansen Patrick A.
Published: August 2019

Habitat fragmentation is a primary driver of wildlife loss, and establishment of biological corridors is a common strategy to mitigate this problem. A flagship example is the Mesoamerican Biological Corridor (MBC), which aims to connect protected forest areas between Mexico and Panama to allow dispersal and gene flow of forest organisms. Because forests across Central America have continued to degrade, the functioning of the MBC has been questioned, but reliable estimates of species occurrence were unavailable. Large mammals are suitable indicators of forest functioning, so we assessed their conservation status across the Isthmus of Panama, the narrowest section of the MBC. We used large‐scale camera‐trap surveys and hierarchical multispecies occupancy models in a Bayesian framework to estimate the occupancy of 9 medium to large mammals and developed an occupancy‐weighted connectivity metric to evaluate species‐specific functional connectivity. White‐lipped peccary (Tayassu pecari), jaguar (Panthera onca), giant anteater (Myrmecophaga tridactyla), white‐tailed deer (Odocoileus virginianus), and tapir (Tapirus bairdii) had low expected occupancy along the MBC in Panama. Puma (Puma concolor), red brocket deer (Mazama temama), ocelot (Leopardus pardalis), and collared peccary (Pecari tajacu), which are more adaptable, had higher occupancy, even in areas with low forest cover near infrastructure. However, the majority of species were subject to ≥1 gap that was larger than their known dispersal distances, suggesting poor connectivity along the MBC in Panama. Based on our results, forests in Darien, Donoso–Santa Fe, and La Amistad International Park are critical for survival of large terrestrial mammals in Panama and 2 areas need restoration.
An Innovative Disease‐Drug‐Trial Framework to Guide Binge Eating Disorder Drug Development: A Case Study for Topiramate
Authors: Kalaria Shamir N. , McElroy Susan L. , Gobburu Jogarao , Gopalakrishnan Mathangi
Published: August 2019

As with other psychiatric disorders, development of drugs to treat binge‐eating disorder (BED) has been hampered by high placebo response and dropout rates in randomized controlled trials (RCTs). Although not approved for use in BED, several RCTs have suggested that topiramate is efficacious for BED in obese individuals. Using data from a positive investigator‐initiated RCT of topiramate in 61 obese individuals with BED, the objective of the present study is (i) to develop a quantitative disease‐drug‐trial framework to inform future BED clinical trial designs, and (ii) to determine the optimal topiramate dose to achieve therapeutic efficacy. Disease‐drug‐trial models were developed separately for the two efficacy measures, namely, longitudinal normalized weekly binge‐eating episode frequency (BEF) and binge day frequency (BDF). Model building consisted of (i) developing a placebo effect model that describes response from the placebo group, (ii) adding a drug effect to the placebo model to describe dose‐response relationships, and (iii) developing a parametric time to event model to characterize patient dropout patterns. The placebo effect on normalized BEF and BDF over time demonstrated a maximum decrease of ~ 57% by 5 weeks. Participants had a higher dropout probability if no weight loss occurred during the trial period. The identified dose‐response relationship demonstrated a daily dose of 125 mg was needed to exhibit a marked reduction in weekly BEF. The developed comprehensive disease‐drug‐trial model will be utilized to simulate different clinical trial designs to increase the success for future BED drug development programs.
An elderly woman with cervical lymphadenopathy and lung mass
Authors: Gupta Parikshaa , Prasad Kuruswamy T. , Singh Navneet , Srinivasan Radhika , Gupta Nalini , Nada Ritambhara , Rajwanshi Arvind
Published: August 2019

Although patients with non‐small cell lung carcinoma (NSCLC) harbouring mutations in the epidermal growth factor receptor (EGFR) gene can show a remarkable initial response to treatment with EGFR‐tyrosine kinase inhibitors, resistance often develops and the disease progresses. A case of SCLC developing after such treatment for a NSCLC is described, diagnosed on fine needle aspiration cytology and cell‐block immunocytochemistry.
Pleural effusion in a human immunodeficiency virus‐infected patient
Authors: Martínez‐Girón Rafael , Martínez‐Torre Santiago
Published: August 2019

A 39‐year‐old HIV positive male was admitted to hospital following discovering of a right pleural effusion. The underlying diagnosis is discussed in this interactive case discussion.
Health‐related behaviours in a remote Indigenous population with Type 2 diabetes: a Central Australian primary care survey in the Telehealth Eye and Associated Medical Services Network [TEAMSnet] project
Authors: Xu D. , Jenkins A. , Ryan C. , Keech A. , Brown A. , Boffa J. , O'Dea K. , Bursell S.E. , Brazionis L. ,   the CRE in Diabetic Retinopathy and the TEAMSnet Study Group
Published: August 2019

Aim

There is a wealth of data concerning the health behaviours of Indigenous Australians, but the health behaviours of Indigenous Australians with diabetes are not systematically documented. At the clinical level, understanding a person's health behaviours can help identify and address barriers to diabetes care and promote good clinical outcomes.

Methods

We used a novel survey tool to systematically collect health behaviour data on Smoking, Nutrition, Alcohol consumption, Physical activity and Emotional well‐being (SNAPE) from Indigenous Australians with Type 2 diabetes in a remote primary care setting in Alice Springs.

Results

At least one of the five surveys in the SNAPE tool was completed by 210 participants: 30% male, mean age 52.6 years (range 22.9 – 87.4). Fifty per cent of men and 23% of women were current smokers (P < 0.001). None of the participants reported an adequate intake of vegetables. Only 9.6% reported an adequate fruit intake. Some 49% of men and 32% of women consumed alcohol in the past year (P = 0.022), and 46% of drinkers were considered high‐risk or likely‐dependent drinkers. On average, participants walked 10 min or more at a time 6.0 days a week and spent 4.8 h sitting on a weekday. Mean adapted Patient Health Questionnaire 9 score was 4.61, with 34% of participants having mild depressive symptoms and 11% having moderate‐severe depressive symptoms.

Conclusions

Our SNAPE survey tool results present a high‐risk, disadvantaged Indigenous population with Type 2 diabetes. More resources will be needed to sustainably implement interventions with the goal of improving health behaviours and subsequent long‐term health.
IDegLira improves patient‐reported outcomes while using a simple regimen with fewer injections and dose adjustments compared with basal–bolus therapy
Authors: Miller Eden , Doshi Ankur , Grøn Randi , Jódar Esteban , Őrsy Petra , Ranthe Mattis F. , Sugimoto Danny , Tentolouris Nikolaos , Viljoen Adie , Billings Liana K.
Published: August 2019

Aims

Basal–bolus therapy is associated with greater treatment burden and lower adherence compared with more simplified regimens. This post hoc analysis studied the difference between insulin degludec/liraglutide (IDegLira) and basal–bolus therapy on number of injections, dose adjustments and patient outcomes in the DUAL VII trial.

Materials and methods

DUAL VII was a 26‐week, open‐label trial in which patients with uncontrolled type 2 diabetes who were using metformin and insulin glargine 100 units/mL (20–50 U) were randomized 1:1 to IDegLira (N = 252) or basal–bolus (insulin glargine U100 + insulin aspart ≤4 times/day) (N = 254). This post hoc analysis reports the observed mean number of injections and cumulative dose adjustments during 26 weeks of treatment. Patient‐reported outcomes (Treatment‐Related Impact Measure – Diabetes [TRIM‐D] and Short Form‐36 Health Survey version 2 [SF‐36v2]) were collected at scheduled visits and change from baseline scores calculated.

Results

The clinical benefits (non‐inferior HbA1c reductions, weight benefit, less hypoglycaemia) of IDegLira vs basal–bolus therapy were achieved with fewer cumulative dose adjustments (16.6 vs 217.2, respectively) and fewer injections (1 vs ≥3 per day, respectively). Patients treated with IDegLira experienced significant improvements across all TRIM‐D domains compared with those undergoing basal–bolus therapy. The SF‐36v2 showed improvements in both treatment arms with no significant difference between arms in the physical component summary, but there was a significant improvement in patients treated with IDegLira in the mental component summary (P = .0228).

Conclusions

These findings, combined with the DUAL VII results, suggest that IDegLira, through a more simplified regimen versus basal–bolus therapy, may help improve patient adherence and improve patient outcomes related to diabetes management, treatment burden and mental health, which in turn may assist in the timely achievement of glycaemic control in clinical practice.
A standardized imaging protocol improves quality and reduces practice variability in echocardiographic assessment of ventricular function by first‐year pediatric cardiology fellows
Authors: White Brian R. , Ho Deborah Y. , Rogers Lindsay S. , Natarajan Shobha S.
Published: August 2019

Background

Echocardiography education for pediatric cardiology fellows has been a recent focus leading to the implementation of “boot camps.” Less is described about continuing education through fellowship and improving image quality. We noticed practice variation in echocardiograms assessing ventricular function performed on nights and weekends. Thus, we implemented a standardized protocol and assessed its impact on imaging and reporting completeness.

Methods

We created an imaging protocol for the assessment of ventricular function in the acute setting. The protocol included demographic information, a list of images to be obtained, and the methods to quantify ventricular function. The protocol was explained to first‐year fellows and distributed on an electronic quick reference card. Echocardiograms independently performed by first‐year fellows during their first 4 months of on‐call time were assessed pre‐ and postintervention using a standard rubric.

Results

Compliance with demographic reporting was high pre‐ and postintervention, but significantly improved after the standardized protocol (P < 0.001). Use of the protocol increased the median number of unique images obtained per echocardiogram from 13 to 17 (out of 23 required views, P < 0.001). Particularly improved was the performance of quantitative evaluations of function, including Simpson's method for left ventricular ejection fraction (four chamber: 40% vs 67%, P < 0.001; two chamber: 33% vs 67%, P < 0.001) and tricuspid annular plane systolic excursion (45% vs 80%, P < 0.001).

Conclusions

The introduction of a standardized imaging protocol and its distribution to first‐year fellows resulted in improvements in echocardiographic reporting completeness and increased the quality of information obtained by providing more quantitative assessments of ventricular function.
Egg concealment is an antipredatory strategy in a cavity‐nesting bird
Authors: Saavedra Irene , Amo Luisa
Published: August 2019

Birds have developed different behavioural strategies to reduce the risk of predation during the breeding period. Bird species that nest in the open often cover their eggs to decrease the risk of predators detecting the clutches. However, in cavity nesters, the potential functions of egg covering have not been explored despite some bird species that nest in cavities also covering their eggs as open nesters do. We analysed whether egg covering is an antipredatory behaviour in the blue tit (Cyanistes caeruleus). We simulated an increase in the perceived risk of predation at experimental nests by adding predator scent inside the nest boxes during the egg‐laying period, whilst adding lemon essence or water to control nest boxes. Birds exposed to predator chemical cues in the nest of experimental pairs more frequently covered their eggs than birds exposed to an odorous control. These results suggest that egg covering may have evolved as an antipredatory behaviour also in cavity nesters to reduce the risk of egg predation and thus increase reproductive success in birds.
Training practices, speed and distances undertaken by Thoroughbred racehorses in Victoria, Australia
Authors: Morrice‐West A. V. , Hitchens P. L. , Walmsley E. A. , Stevenson M. A. , Whitton R. C.
Published: August 2019

Background

Musculoskeletal injuries (MSI) in racehorses are commonly due to bone fatigue, a function of the number of cycles (strides) and the magnitude of load applied to the limb. These parameters can be estimated using speed and distance, with greater than 6000 m/month at a gallop (>14 m/s), in combination with canter distances greater than 44,000 m/month, reported to increase fracture risk. Despite their importance, there are limited data on the distances and speeds horses are exposed to during training.

Objectives

Estimate training volume at different speeds undertaken by Australian Thoroughbred racehorses.

Study design

Cross‐sectional study.

Methods

Registered trainers (n = 66) in Victoria, Australia were surveyed. Questions were designed to assess the full training workload from initial pre‐training to training performed to achieve and maintain race fitness, as well as information on rest periods. Descriptive analyses were stratified by trainer‐ and horse‐level factors, with assessment of variance within and between groups. Cluster analyses were used to identify similar workload intensity groups.

Results

Horse‐level factors (age, targeted race distance) were associated with workload (younger<older, sprinters<stayers). Trainer categorisation did not influence workload, but there was significant variation in volume of total gallop exercise between trainers (median gallop distance 8000 m/month [IQR 6400–12,000]). Cluster analyses identified four workload programmes (medians): low‐intensity (4800 m/month), medium‐volume (8000 m/month), medium‐volume with a higher proportion of high‐speed workouts (12,800 m/month) and high‐volume programmes (19,200 m/month), with 23, 50, 17 and 9% of trainers predominately training racehorses under each of the respective programmes. Horses 3‐years and older were rested twice yearly for 6.3 (95% CI 5.7, 6.8) weeks, with more experienced trainers resting horses for shorter periods (P = 0.03).

Main limitations

Possible selection bias, subjective reporting of workloads by trainers.

Conclusions

Australian Thoroughbred training programmes include high volumes of galloping with more than half exceeding previously reported risk levels for MSI.
Plasmodium falciparum Apn1 homolog is a mitochondrial base excision repair protein with restricted enzymatic functions
Authors: Tiwari Anupama , Kuldeep Jitendra , Siddiqi Mohammad Imran , Habib Saman
Published: August 2019

The malaria parasite carries two organelles, the apicoplast and mitochondrion, whose DNA genomes must be maintained for optimal function and parasite survival under genotoxic stress. DNA repair mechanism(s) operative within these organelles were explored by mining the Plasmodium falciparum nuclear genome for sequences encoding proteins of major DNA repair pathways with predicted targeting to either organelle. Of the panel of enzymes identified for base excision repair (BER), we characterized the apurinic/apyrimidinic (AP) endonuclease PfApn1—an EndoIV whose homolog is not known in humans. PfApn1 targeted to the mitochondrion and functioned as an AP endonuclease requiring both Zn2+ and Mn2+ ions for maximal activity. Mutation of the critical third metal‐binding site residue H542 resulted in the loss of Mn2+ (but not Zn2+) binding indicating that Mn2+ bound PfApn1 at this site; this was further supported by molecular dynamic simulation. CD spectra analysis further showed requirement of both metal ions for the attainment of PfApn1 β‐strand‐rich optimal conformation. PfApn1 also functioned as a 3′‐phosphatase that would enable removal of 3′‐blocks for DNA polymerase activity during BER. Interestingly, unlike Escherichia coli and yeast EndoIV homologs, PfApn1 lacked 3′–5′ exonuclease activity and also did not cleave damaged bases by nucleotide incision repair (NIR). Uncoupling of endonuclease/phosphatase and exonuclease/NIR in PfApn1 suggests that amino acid residues distinct from those critical for endonuclease function are required for exonuclease activity and NIR. Characterization of a critical mitochondrion‐targeted AP endonuclease provides evidence for a functional BER pathway in the parasite organelle.
Modification of HDL by reactive aldehydes alters select cardioprotective functions of HDL in macrophages
Authors: Schill Rebecca L. , Knaack Darcy A. , Powers Hayley R. , Chen Yiliang , Yang Moua , Schill Daniel J. , Silverstein Roy L. , Sahoo Daisy
Published: August 2019

While increased levels of high‐density lipoprotein (HDL)‐cholesterol correlate with protection against cardiovascular disease, recent findings demonstrate that HDL function, rather than HDL‐cholesterol levels, may be a better indicator of cardiovascular risk. One mechanism by which HDL function can be compromised is through modification by reactive aldehydes such as acrolein (Acro), 4‐hydroxynonenal, and malondialdehyde (MDA). In this study, we tested the hypothesis that modification of HDL with reactive aldehydes would impair HDL’s athero‐protective functions in macrophages. Compared to native HDL, Acro‐ and MDA‐modified HDL have impaired abilities to promote migration of primary peritoneal macrophages isolated from C57BL6/J mice. Incubation of macrophages with MDA‐HDL also led to an increased ability to generate reactive oxygen species. Our studies revealed that the changes in HDL function following aldehyde modification are likely not through activation of canonical nuclear factor‐kappa B signaling pathways. Consistent with this finding, treatment of either noncholesterol‐loaded macrophages or foam cells with modified forms of HDL does not lead to significant changes in expression levels of inflammatory markers. Importantly, our data also demonstrate that changes in HDL function are dependent on the type of modification present on the HDL particle. Our findings suggest that modification of HDL with reactive aldehydes can impair some, but not all, of HDL’s athero‐protective functions in macrophages.
Scavenger receptor A impairs interferon response to HBV infection by limiting TRAF3 ubiquitination through recruiting OTUB1
Authors: Xie Mengying , Yin Yue , Chen Liqian , Yin Aiping , Liu Yan , Liu Yunzhi , Dong Lijun , Lai Qintao , Zhou Jia , Zhang Liyun , Xu Min , Chen Zhengliang , Zuo Daming
Published: August 2019

The battle between hepatitis B virus (HBV) infection and the host immune defense determines the outcome of the disease. Scavenger receptor A (SRA) is a phagocytic pattern recognition receptor involved in various cellular processes, including lipid metabolism, recognition, and clearance of pathogens or modified self‐molecules. Emerging evidence pointed out that SRA might act as an immunomodulator that contributes to innate immune defense against invading pathogens. Herein, we examined the role of SRA in the initiation of type I interferon (IFN) response to HBV infection and the virus clearance. Our results showed that SRA‐deficient (SRA−/−) mice were resistant to HBV infection developed by hydrodynamic injection of HBV replicon plasmid. We found lower levels of HBV DNA and viral protein expression in SRA−/− mice, which was associated with enhanced type I IFN production, compared with wild‐type controls. Besides, we performed gain and loss of function experiments and determined that SRA inhibits innate antiviral immune responses to HBV. SRA could interact directly with tumor necrosis factor receptor‐associated factor 3 (TRAF3) and inhibit its K63‐linked ubiquitination. Moreover, we provided evidence that SRA negatively regulates the stability of TRAF3 protein by promoting the recruitment of OTUB1 to TRAF3. Our findings indicate that SRA plays a crucial role in innate immune signaling by targeting TRAF3 for degradation and balancing the innate antiviral immunity.
An evaluation of European initiatives established to encourage industry‐led development of selective fishing gears
Authors: Feekings Jordan , O’Neill Finbarr G. , Krag Ludvig , Ulrich Clara , Veiga Malta Tiago
Published: August 2019

There are numerous examples from across Europe where collaborative science‐industry initiatives, which provide a bottom‐up approach to trawl gear development, have been successful in developing selective gears. For fishers, the collaborative approach creates a sense of ownership and control over the gears developed and often a greater desire for them to achieve their objectives. Despite the many benefits of collaborative initiatives, a lack of clarity and transparency, incorrect incentives, unclear communication, and distrust or diverging perceptions can inhibit their performance. The present review examines the different collaborative approaches to fishing gear development that have been established within Europe, highlighting their salient features, comparing their objectives, and discussing the types and effectiveness of the incentives offered. Also examined is how the reform of the European Union's (EU) Common Fisheries Policy (CFP), together with the proposed reform of the technical measures framework, can potentially improve the flexibility in the technical regulations and allow for such initiatives to be a central part in improving the state of fish stocks throughout the EU. Finally, a framework is proposed on how initiatives pertaining to industry‐led fishing gear development might look like under the reformed CFP.
Precipitation amount and event size interact to reduce ecosystem functioning during dry years in a mesic grassland
Authors: Felton Andrew J. , Slette Ingrid J. , Smith Melinda D. , Knapp Alan K.
Published: August 2019

Ongoing intensification of the hydrological cycle is altering rainfall regimes by increasing the frequency of extreme wet and dry years and the size of individual rainfall events. Despite long‐standing recognition of the importance of precipitation amount and variability for most terrestrial ecosystem processes, we lack understanding of their interactive effects on ecosystem functioning. We quantified this interaction in native grassland by experimentally eliminating temporal variability in growing season rainfall over a wide range of precipitation amounts, from extreme wet to dry conditions. We contrasted the rain use efficiency (RUE) of above‐ground net primary productivity (ANPP) under conditions of experimentally reduced versus naturally high rainfall variability using a 32‐year precipitation–ANPP dataset from the same site as our experiment. We found that increased growing season rainfall variability can reduce RUE and thus ecosystem functioning by as much as 42% during dry years, but that such impacts weaken as years become wetter. During low precipitation years, RUE is lowest when rainfall event sizes are relatively large, and when a larger proportion of total rainfall is derived from large events. Thus, a shift towards precipitation regimes dominated by fewer but larger rainfall events, already documented over much of the globe, can be expected to reduce the functioning of mesic ecosystems primarily during drought, when ecosystem processes are already compromised by low water availability.
Visualization of sequential conversion of human intermediately reprogrammed stem cells into iPS cells
Authors: Teshigawara Rika , Hirano Kunio , Nagata Shogo , Huang Denggao , Tada Takashi
Published: August 2019

Analysis of gene expression in single cells is required to understand somatic cell reprogramming into human induced pluripotent stem cells (iPSCs). To facilitate this, we established intermediately reprogrammed stem cells (iRSCs), pre‐iPSC lines. The iRSC‐iPSC conversion system enables the reproducible monitoring of reprogramming events and the analysis of progressive gene expression profiles using single‐cell microarray analysis and genome editing. Here, single‐cell microarray analysis showed the stage‐specific sequential gene activation during the conversion of iRSCs into iPSCs, using OCT4, TDGF1 and E‐CADHERIN as marker genes. Out of 75 OCT4‐related genes, which were significantly up‐regulated after the activation of OCT4, and entry into the mesenchymal‐to‐epithelial transition (MET), LIN28 (LIN28A) and FOXO1 were selected for applying to gene expression visualization. Multicolored visualization was achieved by the genome editing of LIN28 or FOXO1 with mCherry into OCT4‐GFP iRSCs. Fluorescent analysis of gene activity in individual cells showed that OCT4 was dispensable for maintenance, but required for activation, of the LIN28 and FOXO1 expression in reprogramming.
Increase in subjective well‐being and psychological health after application of C8‐silk lipoamino acid functionalized pigments included in a foundation
Authors: Cabannes M. , Risselada C. , Chaisemartin L. , Pasquet J. , Couval E. , Berthon J.Y. , Filaire E.
Published: August 2019

Objective

The aim of this study was to evaluate the effects of two foundations before (D0) and after 5 days of application (D6) on psychophysiological parameters in order to compare C8‐silk lipoamino acid functionalized pigments (FA) versus pure pigments (FP).

Methods

Assessment of self‐esteem, stress, mood and emotion using psychological tests and evaluation of salivary cortisol concentrations were realized on 40 healthy females using a crossover study design at D0 and D6. Four saliva samples were taken on the awakening (C1), 30 min after the awakening (during the foundation application (C2)), 1 h after the foundation application (C3) and at 1900 h (C4) at DO and D6. Area under the curve was calculated in order to obtain information about the total amount of a given substance excreted in a specific time period.

Results

Five days of daily application of the foundation containing the pigments treated with the C8‐silk lipoamino acids induced a significant increase (P < 0.001) in self‐esteem and pleasant emotion (P < 0.05), and a significant decrease in general stress (P < 0.05). This was not the case after the FP application. Cortisol concentrations presented a pronounced diurnal rhythm whatever the foundation used. At DO, no significant differences were observed between the groups. At D6, cortisol concentrations measured 30 min and 1 h after the FA application were significantly lower (P < 0.05: C6.2, P < 0.05 C6.3, respectively) than those reported after FP application. AUC, a global stress response indicator, was significantly lower in FA group as compared to FP group after 5 days of application. Subjects found a decrease in tiredness signs and thought that FA has a good coverage.

Conclusion

Our results show that incorporation of C8‐silk lipoamino acid as agent of pigment functionalization brings new benefits to a foundation. Adopting a psychophysiological approach, which is not invasive to the subjects, we show the measurement of cortisol at the same time that psychological indicators provide a scientific approach to examine the beneficial effects of a cosmetic product.
Okara flours from chickpea and soy are thickeners: increased dough viscosity and moisture content in gluten‐free bread
Authors: Lian Heying , Luo Kaibin , Gong Yuxin , Zhang Shiji , Serventi Luca
Published: August 2019

The by‐product of plant‐based beverages, okara, can be dried in a nutritious flour, but it generates dense bakery products due to high water absorption. Gluten‐free bread often tastes dry, so the objective of this work was evaluating okara flour as thickener for mouthfeel enhancement. Proximate analysis revealed that chickpea okara contained more starch than soy (35.3 vs. 3.41 g/100 g), less insoluble fibre (43.3 vs. 57.0 g/100 g) and protein (9.51 vs. 18.1 g/100 g). Water absorption capacity was higher in okara than flour and for soy (8.29 vs. 6.01 g g−1, respectively). When added to a gluten‐free batter, both okara flours significantly increased viscosity. Upon addition of either okara to gluten‐free bread (2% w/w) moisture content increased from 31.6 to 33.5 and 36.5 g/100 g, while crumb hardness increased by up to 45% and specific loaf volume decreased by up to 42%. Soy okara flour enhanced moistness of gluten‐free bread.
Climate change is a health issue: what can doctors do?
Authors: Sainsbury Peter , Charlesworth Kate , Madden Lynne , Capon Anthony , Stewart Greg , Pencheon David
Published: August 2019

The visit to Australia by Dr David Pencheon, Founding Director of the National Health Service (NHS) Sustainable Development Unit, in April–May 2018 generated considerable interest and engagement. Dr Pencheon's overarching messages were that climate change is a health issue and that doctors and health systems have an opportunity, and responsibility, to lead climate action. This article distils Dr Pencheon's presentations into three themes: (i) carbon accounting; (ii) transformational change in our systems of healthcare; and (iii) a health system fit for the future. For each theme, we highlight promising initiatives that are already underway in Australia that are starting to transform our health system into one fit for a future environmentally sustainable world. We suggest practical ways in which doctors can lead the transformation through personal action and influence broader systems.
Comparing the Montreal Cognitive Assessment and Rowland Universal Dementia Assessment Scale in a multicultural rehabilitation setting
Authors: Emerson Andrew , Muruganantham Poorani , Park Min Y. , Pillay Deren , Vasan Nikhil , Park Seong J. , Van Kim L. , Pampapathi Preethi , Seow Cui S. , Yau Siu‐Ming
Published: August 2019

In Australia it is recommended that all older people undergoing rehabilitation have a cognitive screen. We performed a longitudinal study comparing the correlation of two cognitive screening tools – the Rowland Universal Dementia Assessment Scale (RUDAS) and Montreal Cognitive Assessment (MoCA) with discharge outcomes in a geriatric inpatient setting. The RUDAS cut‐off (<23/30) was associated with discharge to a nursing home (sensitivity 52%, specificity 70%). This was also noted with a MoCA cut‐off <18/30 (sensitivity 57%, specificity 69%). Furthermore the association between the RUDAS and discharge destination was independent of its association with the Functional Independence Measure (r = 0.116; P = 0.275) and had a shorter administration time. Both RUDAS and MoCA scores could be used as predictors of discharge destination in a multicultural population.
Infectious processes and systemic lupus erythematosus
Authors: Illescas‐Montes Rebeca , Corona‐Castro Claudia Cristina , Melguizo‐Rodríguez Lucia , Ruiz Concepción , Costela‐Ruiz Víctor J.
Published: August 2019

Systemic lupus erythematosus (SLE) is an autoimmune chronic inflammatory disease of unknown etiology, although genetic and environmental factors appear to contribute to its pathogenesis. Specifically, infectious processes are associated with SLE onset and exacerbation. However, we are far from a complete understanding of the interactions between infectious agents and the host, explaining the interest in gathering updated scientific information on this topic. According to the literature, the pathogens most frequently associated with SLE are viruses, notably human endogenous retroviruses, Epstein–Barr virus, parvovirus B19, cytomegalovirus and human immunodeficiency virus type 1, alongside certain bacterial components that can also trigger activation of the immune system. The mechanisms underlying autoreactivity remain unclear but various explanations have been proposed, including immunological changes responsible for infectious processes or molecular mimicry between host structures and those of infectious agents.
The British Home Stores pension scheme: privatised looting?
Authors: Clark Ian
Published: August 2019

On entering administration, British Home Stores owed its pension scheme £571 million—a significant employment relations issue of historical wage theft by investor–owner managers. The article locates ‘lawful’ looting of business assets in a framework that builds on Ackerlof and Romer's theory of bankruptcy for profit and connects this to an empirical narrative on business re‐structuring at British Home Stores towards administration.
Dynamic contributions of intermittent and perennial streams to fish beta diversity in dryland rivers
Authors: Rogosch Jane S. , Olden Julian D.
Published: August 2019

Aim

To determine the role of flow intermittence and species origin in shaping freshwater fish beta diversity across dryland riverscapes.

Location

Verde and Little Colorado River basins, United States.

Methods

Fish beta diversity was investigated in two large rivers with marked differences in basin‐wide flow intermittence. Local site (continually flowing perennial vs. periodically flowing intermittent) and species (native vs. non‐native) contributions to beta diversity were compared within each basin and over multiple decades (1987–2013) in relation to changing hydrologic conditions. Metacommunity dynamics were quantified using changes in alpha‐ (local), beta‐ and gamma‐ (regional) diversity through time.

Results

Beta‐diversity patterns varied in relation to basin‐wide intermittence. Intermittent sites were most influential to beta diversity where basin‐wide intermittence was lower (Verde River), whereas perennial sites were most influential where basin‐wide intermittence was higher (Little Colorado River). In intermittent sites, native fish species contributions to beta diversity tended to be higher than non‐native species contributions. The relative contributions of perennial and intermittent sites to β‐diversity within each basin were invariant to annual flow regimes, whether atypically lower or higher than average flows, but somewhat related to intra‐annual flow variation. Native species contributions to β‐diversity increased in years with high flow conditions in the Verde River. Over time, beta diversity decreased in the lower intermittence Verde River, indicating taxonomic homogenization, but remained relatively unchanged in the Little Colorado River.

Main Conclusions

Investigations of beta‐diversity components over time are considered pivotal for conservation prioritization and planning. We found that both intermittent and perennial streams play complementary roles in supporting fish beta diversity, and that their relative contributions increase as basin wide availability of the habitat type decreases. Moreover, contributions of intermittent streams to overall beta diversity were relatively consistent through time and supported native fish diversity. Despite weakening policy protections of intermittent streams, these habitats are critical for supporting local species persistence and regional biodiversity.
Association of alprazolam with major cardiovascular events in patients with hypertension
Authors: Yeh Chao‐Bin , Tsai Ming‐Che , Teng Ying‐Hock , Ku Min‐Sho , Huang Jing‐Yang , Wang Bo‐Yuan , Tai Chia‐Ling , Kornelius Edy , Ho Sai‐Wai
Published: August 2019

Rationale

Anxiety is a mediator for emotional reactivity and acute blood pressure elevations, which are associated with an increased risk of cardiovascular death. Alprazolam is a common medication for anxiolysis. We hypothesized that alprazolam usage can reduce the risk of major adverse cardiovascular events (MACEs) in patients with hypertension.

Methods

A retrospective cohort study was performed using datasets from Taiwanese Health and Welfare Data. Patients with hypertension were divided into exposed (Alprazolam‐exposed) and control groups (non‐Alprazolam‐exposed) with 1:1 propensity score matching. The study endpoint was the occurrence of MACE. Adjusted hazard ratio (aHR) of MACE risk was estimated using the multiple Cox proportional hazard model. Age‐stratified analysis was performed to evaluate the interaction of age and alprazolam use with MACEs.

Results

The study cohort consisted of 335 517 alprazolam‐exposed patients and 1:1 PSM controls. The mean age was 63.62 ± 12.71 years in the Alprazolam‐exposed population. Alprazolam exposure was significantly associated with reduced risk of MACEs (aHR = 0.965, 95% CI = 0.954‐0.977), including ischemic stroke (aHR = 0.958, 95% CI = 0.940‐0.976), hemorrhagic stroke (aHR = 0.856, 95% CI = 0.821‐0.892), myocardial infarction (aHR = 0.933, 95% CI = 0.900‐0.968), sudden cardiac death (aHR = 0.955, 95% CI = 0.916‐0.996), and all‐cause mortality (aHR = 0.921, 95% CI = 0.909‐0.932). In the age‐subgroup analysis, alprazolam showed the greatest risk reduction effect in hemorrhagic stroke for patients aged <65 years (aHR = 0.779, 95% CI = 0.727‐0.835).

Conclusion

Alprazolam usage in patients with hypertension was associated with a slightly reduced risk of MACEs and all‐cause mortality, and up to 22% reduced risk of hemorrhagic stroke was observed in alprazolam users aged <65 years.
Evaluation of sensory and texture profile analysis properties of stored Khalal Barhi dates nondestructively using Vis/NIR spectroscopy
Authors: Alhamdan Abdullah M. , Fickak Adil , Atia Ahmed R.
Published: August 2019

It is important to facilitate evaluating fruit quality during harvesting and postharvest operations with simple, fast, and nondestructive tests. The purpose of this study was to evaluate TPA Barhi dates texture parameters (hardiness, cohesiveness, and chewiness) at three maturity stages: Kimri (green), Khalal (green to yellow), and Rutab (brown). The Khalal stage can be further classified into three phases: 80, 90, and 100% yellow utilizing spectra analysis. The texture properties of fresh fruit were found to correlate well with the cross validation spectra analysis resulting in a high determination coefficient (R2) 0.905 for hardiness, 0.803 for cohesiveness, and fairly well (0.675) for chewiness. The effect of stored fruits (under room, cold, and controlled atmosphere) on TPA properties was also examined. The TPA fruits were highly effected by storage conditions where the shelflife of Barhi fruits were found to be 20, 40, and 120 days corresponding to room, cold, and CA storages, respectively. In conclusion, near‐infrared (NIR) spectroscopy is a powerful and effective nondestructive method to evaluate the texture parameters of Barhi fruit at different maturity stages during various harvest and postharvest operational chain.

Practical Applications

The study proves the success of correlating NIR with texture parameters of fresh Barhi fruit at different stages of maturity.

This can be utilized in commercial nondestructive on‐line sorting of fruits based on their mechanical properties utilizing NIR instrumentation.

NIR can be utilized to decide marketing destinations for fruits. Furthermore, NIR is a useful tool in deciding storing fruit in cold or controlled atmosphere storage or immediate marketing.

The shelflife of Barhi fruits were found to be 20, 40, and 120 days corresponding to room, cold, and CA storage, respectively.

Further studies may utilize NIR in predicting the shelflife of stored Barhi fruits based on texture.

From the results of this study, links of sensory tests with NIR spectra would be encouraged for future studies. It will save time, efforts, and cost for producers and processors as well as in marketing.
Effect of parenting stress, self‐esteem and parent–child interaction in parents of children with allergic rhinitis on self‐esteem of children: Analysis of Actor‐partner Interdependence Model
Authors: Jeong Won Han , Hun‐ha Cho
Published: August 2019

Aim

It is important to focus on the early identification of factors that promote children's self‐esteem, to foster the healthy development of children with allergic rhinitis. This study aimed to identify the effects of parents' parenting stress, self‐esteem, and parent–child interaction on the self‐esteem of children with allergic rhinitis.

Methods

Structural equation modeling was used to verify the conceptual model. This study was conducted on 656 children with symptoms of allergic rhinitis and their parents who participated in the 8th Panel Study on Korean Children (PSKC). Data collection involved a questionnaire on parents' parenting stress, self‐esteem, parent–child interaction and self‐esteem of children. Secondary data from the PSKC were analyzed using Actor‐partner Interdependence Model. Data were analyzed using SPSS‐WIN Version 20.0 and AMOS Version 20.0.

Results

In the high self‐esteem group, the father's parenting stress had a partner effect on the mother's self‐esteem, while the mother's self‐esteem affected her parent–child interaction, which in turn affected the child's self‐esteem. In the low self‐esteem group, the father's parenting stress affected the mother's self‐esteem, the father's self‐esteem had a partner effect on the mother's parent–child interaction, and the mother's self‐esteem had an indirect effect on the child's self‐esteem.

Conclusions

This study was conducted to provide basic data to help understand the interactions among variables related to the self‐esteem of children with allergic rhinitis. The findings indicate that the model has utility in developing effective nursing intervention to promote self‐esteem of children with allergic rhinitis.
A girl with acute kissing ulcers of the vulva
Authors: Amoroso Stefano , Ottaviani‐Giammarco Chiara , Massaro Marta , Spagnut Giulia
Published: August 2019

See Answer
Prescription Drug Abuse Among Patients in Rural Dental Practices Reported by Members of the National Dental PBRN
Authors: McCauley Jenna L. , Nelson Joni D. , Gilbert Gregg H. , Gordan Valeria , Durand Scott H. , Mungia Rahma , Meyerowitz Cyril , Leite Renata S. , Fillingim Roger B. , Brady Kathleen T. ,   National Dental PBRN Collaborative Group
Published: August 2019

Purpose

This study compared rural to nonrural dentists with respect to opioid prescribing practices, perceptions about prescription drug abuse among patients, and training relevant to pain management and addictions.

Methods

A web‐based, cross‐sectional questionnaire was administered to practicing dentist members of the National Dental Practice‐Based Research Network (PBRN; N = 822) and linked with network enrollment questionnaire data regarding practitioner demographics and practice characteristics. Pain management prescribing practices and perceptions regarding relevance and scope of addiction and drug diversion among patients were assessed. Rural practice was defined as a practice whose ZIP Code has more than 50% of its population in either a nonmetropolitan county and/or a rural Census tract.

Findings

Rural dentists were significantly more likely than their nonrural counterparts to recommend nonsteroidal anti‐inflammatory agents/acetaminophen in combination with prescribing an opioid [F (1,820) = 4.59, P = .03]. Compared to nonrural dentists, rural dentists were more likely to report that opioid abuse/diversion was a problem in their practices [χ2 [1, n = 807] = 6.85, P < .001], were more likely to have suspected a patient of abuse or diversion [χ2 [1, n = 807] = 10.12, P = .001], and were more likely to have refrained from prescribing due to suspicions of abuse or diversion [χ2 [1, n = 807] = 12.49, P < .001].

Conclusion

Rural dentists may be disproportionately impacted by patients’ opioid abuse and represent a viable target for educational outreach that encourages screening, identification, and referral of patients in need of drug abuse treatment.
Non‐alcoholic fatty liver disease alters expression of genes governing hepatic nitrogen conversion
Authors: Eriksen Peter Lykke , Vilstrup Hendrik , Rigbolt Kristoffer , Suppli Malte P. , Sørensen Michael , Heebøll Sara , Veidal Sanne S. , Knop Fillip K. , Thomsen Karen Louise
Published: August 2019

Background & Aims

We recently showed that the functional capacity for ureagenesis is deficient in non‐alcoholic fatty liver disease (NAFLD) patients. The aim of this study was to assess expression of urea cycle‐related genes to elucidate a possible gene regulatory basis to the functional problem.

Methods

Liver mRNA expression analyses within the gene pathway governing hepatic nitrogen conversion were performed in 20 non‐diabetic, biopsy‐proven NAFLD patients (8 simple steatosis; 12 non‐alcoholic steatohepatitis [NASH]) and 12 obese and 14 lean healthy individuals. Sixteen NAFLD patients were included for gene expression validation. Relationship between gene expressions and functional capacity for ureagenesis was described.

Results

Gene expression of most urea cycle‐related enzymes were downregulated in NAFLD vs both control groups; markedly so for the urea cycle flux‐generating carbamoyl phosphate synthetase (CPS1) (~3.5‐fold, P < .0001). In NASH, CPS1 downregulation paralleled the deficit in ureagenesis (P = .03). Additionally, expression of several genes involved in amino acid uptake and degradation, and the glucagon receptor gene, were downregulated in NAFLD. Conversely, glutamine synthetase (GS) expression increased >1.5‐fold (P ≤ .03), inversely related to CPS1 expression (P = .004).

Conclusions

NAFLD downregulated the expression of urea cycle‐related genes. Downregulation of urea cycle flux‐generating CPS1 correlated with the loss of functional capacity for ureagenesis in NASH. On gene level, these changes coincided with an increase in the major ammonia scavenging enzyme GS. The effects seemed related to a fatty liver as such rather than NASH or obesity. The findings support gene regulatory mechanisms involved in the deficient ureagenesis of NAFLD, but it remains unexplained how hepatocyte fat accumulation exerts these effects.
Characteristics of keratinocyte carcinomas in Hispanics compared to non‐Hispanic whites: A retrospective 5‐year study
Authors: Cheng Judy , Rajanala Susruthi , Widjajahakim Rafael , Maymone Mayra B. C. , Vashi Neelam A.
Published: August 2019

Background

Hispanics are one of the fastest growing populations in the United States. Few studies have characterized the patterns of keratinocyte carcinoma presentation in Hispanics.

Objective

The study aimed to compare the clinical and histologic characteristics of keratinocyte carcinomas in Hispanics and non‐Hispanic whites.

Materials and Methods

A five‐year retrospective chart review was conducted at a single academic center to identify all histologically‐confirmed cases of keratinocyte carcinomas. Tumor characteristics were then compared between Hispanics and non‐Hispanic whites.

Results

A total of 197 tumors were identified of which 76% occurred in non‐Hispanic whites and 24% in Hispanics. Tumor diameter was not larger and histologic subtype was not more aggressive in Hispanics compared to non‐Hispanic whites. Age of diagnosis of basal cell carcinoma was younger among Hispanics compared to non‐Hispanic whites (P < .05).

Conclusion

Hispanics were not more likely to present with more high‐risk keratinocyte carcinomas compared to non‐Hispanic whites in terms of tumor diameter, differentiation and subtype.