bluuebunny/crossref_metadata_2025 huggingface dataset:
Benefits of robotic cystectomy compared with open cystectomy in an Enhanced Recovery After Surgery program: A propensity‐matched analysis
Authors: Tan Yu Guang , Allen John Carson , Tay Kae Jack , Huang Hong Hong , Lee Lui Shiong
Published: July 2020

Objectives

To compare the perioperative and oncological outcomes between robot‐assisted radical cystectomy with intracorporeal urinary diversion versus open cystectomy for bladder cancer in a contemporary Enhanced Recovery After Surgery cohort.

Methods

All consecutive patients who underwent radical cystectomy and managed under an Enhanced Recovery After Surgery protocol, from December 2013 to October 2018, were reviewed. Propensity score adjustment was carried out to reduce biases attributable to covariate imbalances.

Results

There were 19 robot‐assisted radical cystectomy with intracorporeal urinary diversion and 21 open cystectomy patients. The robot‐assisted radical cystectomy with intracorporeal urinary diversion cohort was associated with lower estimated blood loss (397 vs 787 mL, P = 0.05), with a trend toward shorter duration of ileus and postoperative opioid administration. These benefits were apparent, despite a longer operative time (581 vs 446 mins, P = 0.03), a higher proportion of orthotopic bladder reconstruction (26.3 vs 9.5%, P = 0.08), a more prevalent use of neoadjuvant chemotherapy and a higher number of salvage cystectomies for the robot‐assisted radical cystectomy with intracorporeal urinary diversion group. Comparable perioperative complications and length of hospital stay were observed. The pathological and intermediate oncological outcomes were similar in both groups (locally advanced disease: 52.6 vs 47.6%, P = 0.85; lymph node yield: 29 vs 34, P = 0.23). The mean recurrence‐free survival and overall survival in the robot‐assisted radical cystectomy with intracorporeal urinary diversion group was 37.5 and 43.0 months, respectively, compared with 21.4 (P = 0.09) and 35.5 (P = 0.14) months, respectively, in open cystectomy.

Conclusion

Robot‐assisted radical cystectomy with intracorporeal urinary diversion has perioperative benefits of lower estimated blood loss, with a trend toward faster bowel recovery and a shorter duration of opioid analgesia when compared with open cystectomy. Robot‐assisted radical cystectomy with intracorporeal urinary diversion also achieves similar intermediate‐term oncological and survival outcomes.
MHC class I transactivator NLRC5 in host immunity, cancer and beyond
Authors: Cho Steven X. , Vijayan Saptha , Yoo Ji‐Seung , Watanabe Toshiyuki , Ouda Ryota , An Ning , Kobayashi Koichi S.
Published: July 2020

The presentation of antigenic peptides by major histocompatibility complex (MHC) class I and class II molecules is crucial for activation of the adaptive immune system. The nucleotide‐binding domain and leucine‐rich repeat receptor family members CIITA and NLRC5 function as the major transcriptional activators of MHC class II and class I gene expression, respectively. Since the identification of NLRC5 as the master regulator of MHC class I and class‐I‐related genes, there have been major advances in understanding the function of NLRC5 in infectious diseases and cancer. Here, we discuss the biological significance and mechanism of NLRC5‐dependent MHC class I expression.
Hydrogen sulphide ameliorating skeletal muscle atrophy in db/db mice via Muscle RING finger 1 S‐sulfhydration
Authors: Lu Fangping , Lu Baoling , Zhang Linxue , Wen JingChen , Wang Mengyi , Zhang Shiwu , Li Qianzhu , Shu Feng , Sun Yu , Liu Ning , Peng Shuo , Zhao Yajun , Dong Shiyun , Zhao Dechao , Lu Fanghao , Zhang Weihua
Published: July 2020

Muscle atrophy occurs in many pathological states, including cancer, diabetes and sepsis, whose results primarily from accelerated protein degradation and activation of the ubiquitin‐proteasome pathway. Expression of Muscle RING finger 1 (MuRF1), an E3 ubiquitin ligase, was increased to induce the loss of muscle mass in diabetic condition. However, hydrogen sulphide (H2S) plays a crucial role in the variety of physiological functions, including antihypertension, antiproliferation and antioxidant. In this study, db/db mice and C2C12 myoblasts treated by high glucose and palmitate and oleate were chose as animal and cellular models. We explored how exogenous H2S attenuated the degradation of skeletal muscle via the modification of MuRF1 S‐sulfhydration in db/db mice. Our results show cystathionine‐r‐lyase expression, and H2S level in skeletal muscle of db/db mice was reduced. Simultaneously, exogenous H2S could alleviate ROS production and reverse expression of ER stress protein markers. Exogenous H2S could decrease the ubiquitination level of MYOM1 and MYH4 in db/db mice. In addition, exogenous H2S reduced the interaction between MuRF1 with MYOM1 and MYH4 via MuRF1 S‐sulfhydration. Based on these results, we establish that H2S prevented the degradation of skeletal muscle via MuRF1 S‐sulfhydration at the site of Cys44 in db/db mice.
Migration patterns of a potamodromous piscivore, asp (Leuciscus aspius), in a river–lake system
Authors: Kärgenberg Einar , Økland Finn , Thalfeldt Mart , Thorstad Eva B. , Sandlund Odd Terje , Tambets Meelis
Published: July 2020

Potamodromous fishes require safe migration routes between spawning, feeding and wintering habitats to complete their life cycle. As knowledge on asp migrations is restricted, this work investigated the movements of adult asp tagged with acoustic transmitters for 3 years in the large Peipsi‐Emajõgi‐Võrtsjärv lake–river system, Estonia, which is free of migration barriers. Asp showed complex migration patterns, moving between and within different waterbodies (lakes, river, tributaries) in all seasons, but with a tendency to repeat habitat use patterns between years. Lakes were mainly used for feeding during spring and summer (after spawning 65% of the fish migrated to Lake Peipsi), and more so by large fish. The majority (80–96%) of the fish spent the winter in the rivers, mostly close to their subsequent spawning area. Spawning areas were in swift‐flowing waters in tributaries and the main river. The results indicate that asp may benefit from an extensive and diverse complex of habitats, and any migration barrier during any season may restrict the natural habitat use by asp. Maintenance and restoration of habitat heterogeneity and connectivity is critical to protect behaviourally diverse fish populations and increase resilience in rivers negatively impacted by various human activities.
An integrated analysis to predict micro‐RNAs targeting both stemness and metastasis in human gastric cancer
Authors: Azimi Mahnaz , Totonchi Mehdi , Rahimi Mahsa , Firouzi Javad , Sahranavard Parisa , Emami Razavi Amirnader , Memari Fereidoon , Kamali Fatemeh , Ebrahimi Marzieh
Published: July 2020

Background and Aim

Cancer stem cells (CSCs), a subpopulation of tumor cells, assess the capacity of self‐renewal, metastasis, and therapeutic resistance. Regulation of CSCs and their epithelial to mesenchymal transition (EMT) potential is one of the promising strategies to eliminate cancer or to inhibit metastasis. Micro‐RNAs (miRNAs) as regulators of several cell properties, such as self‐renewal, metastasis, and resistance to the drug, could be proper targets in cancer diagnosis and therapy. The aim of the present study is to select common miRNAs targeting both self‐renewal and metastasis in gastric cancer.

Methods

Stemness‐related and EMT‐related genes were selected by literature mining. The common miRNAs targeting genes were chosen using different databases and r programming language. The expression pattern of selected miRNAs and genes was evaluated in gastrospheres—as a gastric CSC model—and gastric tumor biopsies.

Results

Based on the integrated analysis, six miRNAs common to both stemness and metastasis were identified. miR‐200c‐3p and miR‐520c‐3p overexpressed in MKN‐45 gastrospheres and grade III tumors. In AGS spheres, however, miR‐520c‐3p and miR‐200c‐3p upregulation and miR‐34a‐5p downregulation were similar to grade II tumors. Interestingly, miR‐200c‐3p and miR‐520c‐3p indicated a positive correlation with OCT4 and NOTCH1 expression in grade III tumors and MKN‐45 spheres. Protein–protein network revealed that the EMT acquisition can be induced by stemness activation through intermediated core‐regulatory genes, including CTNNB1, CTNND1, MAML1, KAT2A, and MAML3.

Conclusion

The upregulation of mir‐200c‐3p and mir‐520c‐3p could effect on stemness and metastasis in gastric cancer as well as gastric CSCs. Therefore, they can be used as diagnosis and prognostic factors.
Objectively Measured Daily Step Counts and Prevalence of Frailty in 3,616 Older Adults
Authors: Watanabe Daiki , Yoshida Tsukasa , Watanabe Yuya , Yamada Yosuke , Kimura Misaka , Group Kyoto‐Kameoka Study
Published: July 2020

OBJECTIVES

Although previous studies have reported lower mortality and morbidity in people with higher daily step counts, the association between frailty and objectively measured step counts has not been evaluated well. We investigated the association between step counts and prevalence of frailty in community‐dwelling older adults.

DESIGN

A cross‐sectional study.

SETTING

The Kyoto‐Kameoka study in Japan.

PARTICIPANTS

We used data of 3,616 Japanese older adults, aged 65 years or older, with valid daily step count data, obtained by an accelerometer‐based pedometer.

MEASUREMENTS

The step count during 4 or more days was objectively obtained by a validated triaxial accelerometer. Participants were classified by quartiles (Qs) based on their step counts. Frailty was defined using the Fried phenotype (FP) model and the Kihon Checklist (KCL). We evaluated the association between prevalence of frailty and step counts using multivariate logistic regression and the restricted cubic spline model.

RESULTS

Mean step counts across low‐to‐high Qs of distribution were 1,759, 2,988, 4,377, and 7,200 steps/day, respectively. The prevalence of frailty, as defined by the FP model and KCL, was 11.3% and 26.8%, respectively. After adjusting for confounders, there was a negative association between the odds ratio (OR) and prevalence of frailty, as defined by the FP model among people with higher step counts (Q1: reference; Q2: OR = 0.73; 95% confidence interval (CI) = 0.56–0.96; Q3: OR = 0.56; 95% CI = 0.42–0.76; and Q4: OR = 0.41; 95% CI = 0.30–0.57; P for trend <.001). The mean step count of the population was 4,081. The OR of frailty for a 1,000‐steps/day increment was 0.74 (95% CI = 0.58–0.91) and 0.85 (95% CI = 0.72–0.97) below 4,000 steps and above 4,000 steps, respectively. In the spline model, this relationship was similar between the FP model and KCL.

CONCLUSION

These findings suggest that slightly increasing the current step count, as by 1,000 steps/day (about 10 minutes of activity), may potentially prevent frailty. J Am Geriatr Soc 68:2310–2318, 2020.
Geriatrics Scholarly Concentration Programs Among U.S. Medical Schools
Authors: Wilson Lindsay A. , Gilliam Meredith A. , Richmond Natalie L. , Mournighan Kimberly J. , Perfect Chelsea R. , Buhr Gwendolen T.
Published: July 2020

OBJECTIVES

To identify and describe geriatric scholarly concentration programs (GSCPs) among U.S. medical schools.

DESIGN

Survey and interview.

SETTING

Allopathic and osteopathic medical schools in the United States.

PARTICIPANTS AND METHODS

We used a systematic internet search, forum postings, and word of mouth to identify all U.S. allopathic and osteopathic medical schools with existing GSCPs. GSCP directors completed an online survey. We conducted interviews with key faculty of two representative programs.

MEASUREMENTS

GSCP size, goals, duration of activity, requirements, funding sources, and student outcomes.

RESULTS

Nine GSCPs were identified, and eight responded to the survey. The number of current medical student participants ranged from 0 to 28, with a mean cohort size of 23. All programs included the following components: formal mentoring, clinical experiences in geriatric medicine beyond the standard medical school curriculum, and research. Half required students to complete an independent research project. GSCPs reported challenges, including low student interest, lack of availability of faculty mentors, and budget constraints; however, student satisfaction was high. Among three programs that reported on the residency matches of their graduates, half matched into a residency with a geriatric subspecialty training option.

CONCLUSIONS

Among U.S. medical schools, there are few GSCPs. The GSCP model may help compensate for limited exposure to geriatric competencies in the standard medical school curriculum for a subset of interested students and may increase interest in geriatrics subspecialty training.
Association between maternal socioeconomic factors, decision‐making status, and dental utilization by children with early childhood caries in sub‐urban Nigeria
Authors: Folayan Morenike Oluwatoyin , Alade Micheal , Adeniyi Abiola , El Tantawi Maha , Finlayson Tracy L.
Published: July 2020

Aim

To determine the association between maternal education, income, and decision‐making status and the presence of early childhood caries (ECC) and dental‐service utilization among young children.

Methods

This cross‐sectional study was based on data from a household survey of 1,549 mother‐preschool‐aged‐child dyads conducted in Ife Central Local Government Area, Nigeria. The explanatory variables were maternal education, income, and decision‐making status (related to healthcare, large household purchases, and visits to family/relatives). Outcome variables were the presence of ECC and the child's history of dental‐service utilization. Poisson regression analyses were conducted to identify factors associated with outcomes; the models were adjusted for maternal age, child's socioeconomic status, oral hygiene status, and frequency of sugar consumption.

Results

The study recruited 1,549 mother–child dyads, of which 66 (4.3 percent) children had ECC, and 90 (5.9 percent) children had a history of dental‐service utilization. Fewer than half (42.3 percent) of the mothers earned between N18,001($49.00) and 60,000 ($168.00) per month. Also, 896 (57.8 percent) reported not making any independent decisions, 152 (9.8 percent) made one of three decisions independently, and 313 (20.2 percent) made two or three decisions independently. In the adjusted model, children of mothers with monthly income higher than N60,000 were more likely to have used dental services than were those whose mother's monthly income was less than or equal to N18,000 (adjusted prevalence ratio = 2.29; 95%CI: 1.30–4.02; P = 0.004). No other maternal factor was associated with ECC.

Conclusions

Although maternal socioeconomic factors and decision‐making abilities were not associated with ECC prevalence, more preschool children whose mothers had high income used dental services.
Patient Aligned Care Team (PACT) Performance in Urban and Rural VHA Primary Care Clinics: A Mixed Methods Study
Authors: Lampman Michelle A. , Steffensmeier Kenda R. Stewart , Reisinger Heather Schacht , Sarrazin Mary Vaughan , Steffen Melissa J. A. , Solimeo Samantha L. , Stewart Greg L. , Mueller Keith J.
Published: July 2020

Purpose

To assess differences in Patient Aligned Care Team (PACT) performance between rural and urban primary care clinics within the Veterans Health Administration (VHA).

Methods

An Explanatory Sequential Mixed Methods design was conducted using VHA administrative data to assess performance of a national sample of 891 VHA primary care clinics. Generalized Estimating Equations with repeated measures were used to estimate associations between rurality and process‐oriented endpoints including: chronic disease management through telehealth; use of telephone visits, group visits or secured messaging; same‐day access; continuity with primary care provider; and postdischarge follow‐up. Qualitative data collected during on‐site visits with 5 clinics were used to provide insights into PACT processes from the perspectives of staff in rural and urban clinics.

Findings

After adjusting for patient‐ and practice‐level characteristics, clinics located in large rural or small/isolated rural areas demonstrated difficulty enhancing access through use of telephone visits, group visits, or secured messaging and completing postdischarge follow‐up calls, compared to urban clinics. Qualitative analysis indicated that staff from both rural and urban clinics reported similar barriers implementing these PACT processes. Both patient and staff behaviors and preferences impact implementation of these processes. Distance to care and access to high‐speed Internet were also reported as barriers.

Conclusions

This study contributes to the understanding of PACT performance in rural settings by highlighting ways contextual and behavioral factors relate to performance. Increasing implementation of patient‐centered medical home (PCMH) models, such as PACT, will require additional attention to the complex relationships between the practice and surrounding context.
Pharmacokinetics and pharmacogenetics of sorafenib in patients with hepatocellular carcinoma: Implications for combination trials
Authors: Díaz‐González Álvaro , Sapena Víctor , Boix Loreto , Brunet Mercè , Torres Ferrán , LLarch Neus , Samper Esther , Millán Olga , Corominas Josep , Iserte Gemma , Sanduzzi‐Zamparelli Marco , da Fonseca Leonardo G. , Darnell Anna , Belmonte Ernest , Forner Alejandro , Ayuso Carmen , Bruix Jordi , Reig María
Published: July 2020

Background & Aims

Sorafenib and lenvatinib are the first‐line treatments approved in hepatocellular carcinoma (HCC), but information is lacking about the relationships between their pharmacokinetics, patients pharmacogenetic profiles, adverse events (AE) and overall survival. We aimed to elucidate these relationships of tyrosine Kinase Inhibitors, such as sorafenib, in order to improve the design of trials testing it in combination with checkpoint inhibitors.

Methods

We assessed the pharmacokinetics of sorafenib and its N‐oxide metabolite at day‐0, day‐7, day‐30, day‐60, day‐90, day‐120, day‐150 and day‐180 and nine single‐nucleotide polymorphisms (SNP) in five genes related to sorafenib metabolism/transport to identify the best point for starting the combination between tyrosine kinases and checkpoint inhibitors.

Results

We prospectively included 49 patients (96% cirrhotic, 37% hepatitis‐C, 82% Child‐Pugh‐A and 59% BCLC‐C). Pharmacokinetic values peaked at day‐7 and progressively declined until day‐60. In the 16 patients without further dose modifications after day‐60, pharmacokinetic values remained stable through day‐180 (sorafenib P = .90; N‐oxide P = .93). Pharmacokinetic values were higher in patients with early dermatological adverse events and lower in patients with early diarrhoea. Sorafenib and N‐oxide pharmacokinetic values varied linearly with different alleles of MRP2*3972.

Conclusions

Sorafenib's pharmacokinetics is heterogeneous across HCC patients. This heterogeneity affects adverse events development and must be taken into account in setting the dose and timing of its combination with checkpoint inhibitors.
Nanophase iron carbides in fine‐grained rims in CM2 carbonaceous chondrites: Formation of organic material by Fischer–Tropsch catalysis in the solar nebula
Authors: Brearley Adrian J.
Published: July 2020

Transmission electron microscope studies of fine‐grained rims in three CM2 carbonaceous chondrites, Y‐791198, Murchison, and ALH 81002, have revealed the presence of widespread nanoparticles with a distinctive core–shell structure, invariably associated with carbonaceous material. These nanoparticles vary in size from ~20 nm up to 50 nm in diameter and consist of a core of Fe,Ni carbide surrounded by a continuous layer of polycrystalline magnetite. These magnetite shells are 5–7 nm in thickness irrespective of the diameter of the core Fe,Ni carbide grains. A narrow layer of amorphous carbon a few nanometers in thickness is present separating the carbide core from the magnetite shell in all the nanoparticles observed. The Fe,Ni carbide phases that constitute the core are consistent with both haxonite and cohenite, based on electron diffraction data, energy dispersive X‐ray analysis, and electron energy loss spectroscopy. Z‐contrast scanning transmission electron microscopy shows that these core–shell magnetite‐carbide nanoparticles can occur as individual isolated grains, but more commonly occur in clusters of multiple particles. In addition, energy‐filtered transmission electron microscopy (EFTEM) images show that in all cases, the nanoparticles are embedded within regions of carbonaceous material or are coated with carbonaceous material. The observed nanostructures of the carbides and their association with carbonaceous material can be interpreted as being indicative of Fischer–Tropsch‐type (FTT) reactions catalyzed by nanophase Fe,Ni metal grains that were carburized during the catalysis reaction. The most likely environment for these FTT reactions appears to be the solar nebula consistent with the high thermal stability of haxonite and cohenite, compared with other carbides and the evidence of localized catalytic graphitization of the carbonaceous material. However, the possibility that such reactions occurred within the CM parent body cannot be excluded, although this scenario seems unlikely, because the kinetics of the reaction would be extremely slow at the temperatures inferred for CM asteroidal parent bodies. In addition, carbides are unlikely to be stable under the oxidizing conditions of alteration experienced by CM chondrites. Instead, it is most probable that the magnetite rims on all the carbide particles are the product of parent body oxidation of Fe,Ni carbides, but this oxidation was incomplete, because of the buildup of an impermeable layer of amorphous carbon at the interface between the magnetite and the carbide phase that arrested the reaction before it went to completion. These observations suggest that although FTT catalysis reactions may not have been the major mechanism of organic material formation within the solar nebula, they nevertheless contributed to the inventory of complex insoluble organic matter that is present in carbonaceous chondrites.
Postpartum sex taboos and child growth in Tanzania: Implications for child care
Authors: Mchome Zaina , Bailey Ajay , Kessy Flora , Darak Shrinivas , Haisma Hinke
Published: July 2020

The social context and cultural meaning systems shape caregivers' perceptions about child growth and inform their attention to episodes of poor growth. Thus, understanding community members' beliefs about the aetiology of poor child growth is important for effective responses to child malnutrition. We present an analysis of caregivers' narratives on the risks surrounding child growth during postpartum period and highlight how the meanings attached to these risks shape child care practices. We collected data using 19 focus group discussions, 30 in‐depth interviews and five key informant interviews with caregivers of under‐five children in south‐eastern Tanzania. Parental non‐adherence to postpartum sexual abstinence norms was a dominant cultural explanation for poor growth and development in a child, including different forms of malnutrition. In case sexual abstinence is not maintained or when a mother conceives while still lactating, caregivers would wean their infants abruptly and completely to prevent poor growth. Mothers whose babies were growing poorly were often stigmatized for breaking sex taboos by the community and by health care workers. The stigma that mothers face reduced their self‐esteem and deterred them from taking their children to the child health clinics. Traditional rather than biomedical care was often sought to remedy growth problems in children, particularly when violation of sexual abstinence was suspected. When designing culturally sensitive interventions aimed at promoting healthy child growth and effective breastfeeding in the community, it is important to recognize and address people's existing misconceptions about early resumption of sexual intercourse and a new pregnancy during lactation period.
Impacts of the Toba eruption and montane forest expansion on diversification in Sumatran parachuting frogs (Rhacophorus)
Authors: O’Connell Kyle A. , Oaks Jamie R. , Hamidy Amir , Shaney Kyle J. , Kurniawan Nia , Smith Eric N. , Fujita Matthew K.
Published: July 2020

Catastrophic events, such as volcanic eruptions, can have profound impacts on the demographic histories of resident taxa. Due to its presumed effect on biodiversity, the Pleistocene eruption of super‐volcano Toba has received abundant attention. We test the effects of the Toba eruption on the diversification, genetic diversity, and demography of three co‐distributed species of parachuting frogs (Genus Rhacophorus) on Sumatra. We generate target‐capture data (~950 loci and ~440,000 bp) for three species of parachuting frogs and use these data paired with previously generated double digest restriction‐site associated DNA (ddRADseq) data to estimate population structure and genetic diversity, to test for population size changes using demographic modelling, and to estimate the temporal clustering of size change events using a full‐likelihood Bayesian method. We find that populations around Toba exhibit reduced genetic diversity compared with southern populations, and that northern populations exhibit a shift in effective population size around the time of the eruption (~80 kya). However, we infer a stronger signal of expansion in southern populations around ~400 kya, and at least two of the northern populations may have also expanded at this time. Taken together, these findings suggest that the Toba eruption precipitated population declines in northern populations, but that the demographic history of these three species was also strongly impacted by mid‐Pleistocene forest expansion during glacial periods. We propose local rather than regional effects of the Toba eruption, and emphasize the dynamic nature of diversification on the Sunda Shelf.
A nuclear protein NsiA from Epichloë festucae interacts with a MAP kinase MpkB and regulates the expression of genes required for symbiotic infection and hyphal cell fusion
Authors: Tanaka Aiko , Kamiya Shota , Ozaki Yoshino , Kameoka Shinichi , Kayano Yuka , Saikia Sanjay , Akano Fumitake , Uemura Aiko , Takagi Hiroki , Terauchi Ryohei , Maruyama Jun‐ichi , Hammadeh Hamzeh Haj , Fleissner André , Scott Barry , Takemoto Daigo
Published: July 2020

The endophytic fungus Epichloë festucae systemically colonizes the intercellular spaces of cool‐season grasses to establish a mutualistic symbiosis. Hyphal growth of the endophyte within the host plant is tightly regulated and synchronized with the growth of the host plant. A genetic screen to identify symbiotic genes identified mutant FR405 that had an antagonistic interaction with the host plant. Perennial ryegrass infected with the FR405 mutant were stunted and underwent premature senescence and death. The disrupted gene in FR405 encodes a nuclear‐localized protein, designated as NsiA for nuclear protein for symbiotic infection. Like previously isolated symbiotic mutants the nsiA mutant is defective in hyphal cell fusion. NsiA interacts with Ste12, a C2H2 zinc‐finger transcription factor, and a MAP kinase MpkB. Both are known as essential components for cell fusion in other fungal species. In E. festucae, MpkB, but not Ste12, is essential for cell fusion. Expression of several genes required for cell fusion and symbiosis, including proA/adv‐1, pro41/ham‐6, ham7, ham8, and ham9 were downregulated in the nsiA mutant. However, the NsiA ortholog in Neurospora crassa was not essential for hyphal cell fusion. These results demonstrate that the roles of NsiA and Ste12 orthologs in hyphal cell fusion are distinctive between fungal species.
Prevalence and risk factors of delirium in the intensive care unit: An observational study
Authors: Gravante Francesco , Giannarelli Diana , Pucci Antonello , Gagliardi Anna Maria , Mitello Lucia , Montagna Attilio , Latina Roberto
Published: July 2020

Background

Several risk factors, such as age, alcohol abuse, dementia, and severe illness, can contribute to the development of delirium. However, limited information is available in the literature regarding the risk of delirium among surgical, trauma, neurological, and medical intensive care patients.

Aim

To describe the prevalence of risk factors associated with delirium in intensive care units.

Design

This study used an observational design.

Methods

We enrolled 165 patients hospitalized in two intensive care units in Italy. Patients were first evaluated using the Prediction of Delirium model and were subsequently evaluated using the Intensive Care Delirium Screening Checklist; evaluation lasted a maximum of 5 days for each admitted patient after sedation. A logistic regression model was used to identify the prevalence and risk factors of delirium.

Results

The average age of the patients was 57.6 (SD = 18.3) years, and the patients were predominantly male (65.0%). The majority of patients had been subjected to trauma (38.8%); 37.6% had undergone general surgical interventions, and 23.6% had undergone medical interventions. Delirium occurred in 55.8% of the 165 patients. The risk of delirium was independently associated with coma (odds ratio = 10.6; 95% confidence interval, 3.08‐39.9) and the Acute Physiology and Chronic Health Evaluation II score (odds ratio = 4.27; 95% confidence interval, 1.58‐11.53).

Conclusions

This study confirmed that coma and the Acute Physiology and Chronic Health Evaluation II score were non‐modifiable risk factors for delirium. Further studies could categorize the different types of coma. Proper delirium management could limit the impact on the recovery of these patients, their autonomy, and their reintegration into the social and professional world.

Relevance to clinical practice

Delirium increases intensive care unit and hospital length of stay. Early identification and risk factor assessment by critical care nurses are considered the key factors in the treatment of delirium.
Development of an intensive care oral care frequency assessment scale
Authors: Doğu Kökcü Özlem , Terzi Banu
Published: July 2020

Background

Oral care and frequency of oral care is important for intensive care patients in order to prevent the risk of ventilator‐associated pneumonia. However, there are no scales to assess the frequency of oral care specific to intensive care units (ICUs).

Aims and Objectives

This study aimed to develop a valid and reliable tool, “Intensive Care Oral Care Frequency Assessment Scale (ICOCFAS)”, for assessing the frequency of nurses' oral care in critical ill patients.

Design

This was an instrument development study.

Methods

The validity and reliability of the ICOCFAS, which consists of nine items, were tested using content validity (five expert opinions), construct validity (factor analysis), item analysis, and internal consistency analysis methods. The population of the research consisted of inpatients at the ICU of a hospital in Sakarya, Turkey. The research was conducted with 73 patients in the ICU.

Results

Expert opinions on the content validity indicated that the scale was admissible. The Kaiser‐Meyer‐Olkin (KMO) coefficient was calculated at 0.800, and the Chi‐square value of the Bartlett test was considerably significant (χ2 = 270.539; P < .001). Using a path diagram in confirmatory factor analysis, Chi‐square/df ratio values were calculated as 1.49, standardized root mean square residual as 0.077, comparative fit index as 0.97, and root mean square error of approximation as 0.082. Cronbach's alpha was 0.851. The correlations between the items and total scores were 0.455 to 0.835 and were statistically significant (P < .001).

Conclusions

The ICOCFAS is an efficient tool with high validity and reliability for assessing oral care frequency in the ICU.

Relevance to clinical practice

The ICOCFAS is a valid and reliable tool for Turkish society for assessing the frequency of oral care of patients in the ICU. It is recommended for various national and international studies with different patients in ICUs.
Alpine plant growth and reproduction dynamics in a warmer world
Authors: Dolezal Jiri , Kurnotova Margareta , Stastna Petra , Klimesova Jitka
Published: July 2020

Climate warming may stimulate growth and reproduction in cold‐adapted plants, but also reduce their performance due to warming‐induced drought limitation. We tested this theory using a unique experiment with the alpine forb Rumex alpinus.

We examined how climate warming over the past four decades affected its annual rhizome growth, leaf production and flowering, and whether responses varied between alpine, subalpine and montane populations.

Before the period of accelerated warming in the 1970s and 1980s, the primary limitation on growth had been cold temperatures and short growing seasons. Increased summer temperatures in the 1990s and 2000s enhanced rhizome growth and leaf production, but not flowering. Alpine and subalpine plants profit more than montane plants, currently producing three times longer annual rhizome increments and twice as many leaves as 40 yr ago, and achieving nearly the same values as montane plants. During the warmest 2005–2015 period, growth became contingent on summer precipitation and began to decrease across all populations, likely due to an increasing water shortage in dense monospecific stands. Warming releases plants from cold limitations but induces water shortage.

Rumex alpinus exceeds its thermal optimum and becomes water‐limited as the climate warms. Our results suggest that warming‐induced responses in alpine plants will not be one‐sided shifts to higher growth and reproduction, but rather multidimensional and spatiotemporally variable.
ETHYLENE RESPONSE FACTOR 115 integrates jasmonate and cytokinin signaling machineries to repress adventitious rooting in Arabidopsis
Authors: Lakehal Abdellah , Dob Asma , Rahneshan Zahra , Novák Ondřej , Escamez Sacha , Alallaq Sanaria , Strnad Miroslav , Tuominen Hannele , Bellini Catherine
Published: July 2020

Adventitious root initiation (ARI) is a de novo organogenesis program and a key adaptive trait in plants. Several hormones regulate ARI but the underlying genetic architecture that integrates the hormonal crosstalk governing this process remains largely elusive.

In this study, we use genetics, genome editing, transcriptomics, hormone profiling and cell biological approaches to demonstrate a crucial role played by the APETALA2/ETHYLENE RESPONSE FACTOR 115 transcription factor.

We demonstrate that ERF115 functions as a repressor of ARI by activating the cytokinin (CK) signaling machinery. We also demonstrate that ERF115 is transcriptionally activated by jasmonate (JA), an oxylipin‐derived phytohormone, which represses ARI in NINJA‐dependent and independent manners. Our data indicate that NINJA‐dependent JA signaling in pericycle cells blocks early events of ARI.

Altogether, our results reveal a previously unreported molecular network involving cooperative crosstalk between JA and CK machineries that represses ARI.
Spaces of possibilities: a theoretical analysis of mentoring from a regulatory perspective
Authors: Ziegler Albert , Gryc Katharina L. , Hopp Manuel D. S. , Stoeger Heidrun
Published: July 2020

A review of the literature on the effectiveness of mentoring reveals a paradox: on the one hand, there is evidence that mentoring can be highly effective. On the other hand, meta‐analyses usually only show small to moderate effect sizes, and sometimes even negative effects. To better understand this mentoring paradox, we discuss three fundamental problems in mentoring research. We propose working definitions and theoretical premises to overcome these problems. We apply various systemic concepts to the field of mentoring that might help to resolve the mentoring paradox. We introduce mentees’ actiotopes and their interaction with other systems as the unit of analysis, and the regulations for which mentors are responsible for in the context of mentoring as the categories of analysis. To systemize and elaborate on the regulatory dimensions of mentoring, we introduce the nonagonal framework of regulation in mentoring (NFR‐M). To facilitate the analysis of ongoing changes caused by mentoring and therefore a dynamic understanding of mentoring, we introduce the concept of spaces of possibilities in mentoring (M‐spaces). Finally, we introduce the concepts of the Athena Mentor to explain why mentors can differ so dramatically in the effectiveness of the regulations they are responsible for in the context of mentoring. We conclude by describing how mentoring comparisons based on the NFR‐M, mentors’ regulatory insight, regulatory power, and M‐spaces can help to resolve the mentoring paradox.
Targeting the β‐adrenergic receptor in the clinical management of congenital long QT syndrome
Authors: Saadeh Khalil , Shivkumar Kalyanam , Jeevaratnam Kamalan
Published: July 2020

The long QT syndrome (LQTS) is largely treated pharmacologically with β‐blockers, despite the role of sympathetic activity in LQTS being poorly understood. Using the trigger–substrate model of cardiac arrhythmias in this review, we amalgamate current experimental and clinical data from both animal and human studies to explain the mechanism of adrenergic stimulation and blockade on LQT arrhythmic risk and hence assess the efficacy of β‐adrenoceptor blockade in the management of LQTS. In LQTS1 and LQTS2, sympathetic stimulation increases arrhythmic risk by enhancing early afterdepolarizations and transmural dispersion of repolarization. β‐Blockers successfully reduce cardiac events by reducing these triggers and substrates; however, these effects are less marked in LQTS2 compared with LQTS1. In LQTS3, clinical and experimental investigations of the effects of sympathetic stimulation and β‐blocker use have produced contradictory findings, resulting in significant clinical uncertainty. We offer explanations for these contradicting results relating to study sample size, the dose of the β‐blocker administered associated with its off‐target Na+ channel effects, as well as the type of β‐blocker used. We conclude that the antiarrhythmic efficacy of β‐blockers is a genotype‐specific phenomenon, and hence the use of β‐blockers in clinical practice should be genotype dependent.
Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review
Authors: Zhang Peng , Zhang Xiu‐zhen , Tao Fu‐lin , Li Qing‐hu , Zhou Dong‐sheng , Liu Fan‐xiao
Published: July 2020

Background

A coronal fracture of the distal femoral condyle, known as a Hoffa fracture, seldom occurs and is easy to misdiagnose. Surgery treatment, including open anatomic reduction and internal fixation, is the primary method of treatment. However, cases involving nonunion are extremely rare.

Case Presentation

We reported two cases in a 56‐year‐old female who visited our outpatient clinic with complaints of locking sensation, swelling, and pain, and a 64‐year‐old male patient who need additional care after having undergone surgery for a distal femur fracture. They presented with nonunion ofa Hoffa fracture (Letenneur type II), and these cases of nonunion were resolved surgically with debridement, two cannulated lag screws, a lateral extra‐articular buttress plate, and the liberal use of autologous bone grafts. After surgery, the two patients were allowed to bear partial weight and perform exercises. They were allowed to walk with full weight‐bearing after 3 months. No early complications, such as infection and loss of reduction, were noted after the revision surgery. At the one‐year follow‐up, both patients had excellent function and reported minimal pain, with a Lysholm score of 94.

Conclusions

Our case reports highlight the importance of the liberal use of autologous bone grafts, which allow stable reconstruction of the affected femoral condyle, thereby restoring joint congruence. A lateral extra‐articular buttress plate in combination with two cannulated lag screws is recommended for nonunion in Hoffa fracture patients, and they need to be closely followed up to detect complications promptly, especially those related to nonunion.
Gloria Anzaldúa as philosopher: The early years (1962–1987)
Authors: Alessandri Mariana
Published: July 2020

It's time that philosophers read Gloria Anzaldúa as a philosopher. Scholars have been hinting at it for some time, but in describing her they still tend to choose the terms “theorist,” “feminist,” and “thinker” instead of “philosopher.” Anzaldúa fits into all of these categories, but from her notes, we know that Anzaldúa also thought of herself as a philosopher. In 2002, for instance, she called herself a “feminist‐visionary‐spiritual‐activist‐poet‐philosopher fiction writer.” This essay argues that we should grant Anzaldúa's wish to be considered a philosopher in addition to the other appellations, and focuses on works that she read and wrote in the first half of her scholarly career, including the publication ofBorderlands/La Fronterain 1987. The evidence for the claim that Anzaldúa thought of herself as a philosopher is mostly archival, but some of it also appears in her published works. Once philosophers explicitly begin to recognize Anzaldúa as a philosopher, comparisons between her and other already recognized philosophers will become fuller and bear more fruit.
Face masks for community use: An awareness call to the differences in materials
Authors: Sousa‐Pinto Bernardo , Fonte Ana Paula , Lopes Antónia Andrade , Oliveira Bruno , Fonseca João Almeida , Costa‐Pereira Altamiro , Correia Osvaldo
Published: July 2020

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Universal face masking in community: Material, design, and considerations—reply
Authors: Sunjaya Anthony P. , Jenkins Christine
Published: July 2020

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Theory‐of‐mind during childhood: Investigating syntactic and executive contributions
Authors: Burnel Morgane , Durrleman Stéphanie , Reboul Anne , Carré Arnaud , Baciu Monica , Perrone‐Bertolotti Marcela
Published: July 2020

Both syntax and Executive Functions (EF) are involved in Theory‐of‐Mind (ToM) but their contributory roles have mainly been studied separately. Moreover, researchers have mostly administered False Belief (FB) tasks while they may not be representative of all ToM abilities. Studies of adults give valuable information regarding whether syntax and EF are useful for ToM reasoning (i.e.,Reasoningaccount), however, only the study of children brings direct evidence in favor of ToM emergence (i.e.,Emergenceaccount). Also, because the ToM tasks used often entail verbal and executive demands, the links observed could mostly result from such confounds (i.e.,Expressionaccount). We evaluated ToM, syntactic and EF abilities in 126 children (3‐11 y.o.) using a set of ToM tasks with minimal verbal and executive demands. Our goals were to assess (1) the hierarchical contribution of syntax and EF to ToM, (2) whether results previously obtained for FB tasks are representative of ToM in general, (3) whether the ToM‐syntax and ToM‐EF links are constant (i.e.,Reasoningaccount) or decrease during development (i.e.,Emergenceaccounts). Results of stepwise regression analyses showed a predominant role of syntax over EF to predict ToM abilities. The comparison of results for ToM and FB tasks showed that FB is not always representative of ToM. Finally, there was no moderating effect of age on the syntax‐ToM or EF‐ToM relations, thus suggestive of theReasoningaccount rather than theEmergenceaccount.
Toward integrating research on parent–child emotion talk and linguistic theory: A spotlight on parents’ (in)direct communication
Authors: Hernandez Erika , Carmichael Katie , Dunsmore Julie C.
Published: July 2020

Parent–child discussions about emotion are a key socialization influence on children’s socio‐emotional development. Extant research on parent–child discussions about emotion largely focuses on three main types of discourse content: parental elaboration, parental use of emotion labels and explanations, and parental emotion coaching. A new direction involves distinguishing between parents’ direct and indirect communication of discourse content. This distinction may be vital when considering the role of children’s communicative competence in their developing socio‐emotional competence. We integrate literature on (in)direct communication, a concept prominent in linguistics, and emotion socialization. We argue that parental indirect communication can teach children communicative competence in the context of emotion talk. We discuss literature from the developmental and linguistic fields on parents’ teaching of communicative skills, as well as potential cognitive, relational, and emotional functions of indirectness, with communication and its socialization embedded within cultural context. Finally, we suggest new research directions examining the role of parental indirect communication in children’s socio‐emotional development. By integrating developmental and linguistic literatures, we provide a novel approach to the study of parental emotion socialization through parent–child discourse.
On the identification of cohesive zone model for curved crack in mortar
Authors: Vargas R. , Tsitova A. , Bernachy‐Barbe F. , Bary B. , Canto R. B. , Hild F.
Published: July 2020

This paper proposes an approach to defining the path of a curved crack in a single‐edge notched specimen with gray level residuals extracted from digital image correlation, followed by the calibration of the parameters of a cohesive zone model. Only the experimental force is used in the cost function minimized via finite element model updating. The displacement and gray level residual fields allow for the validation of the calibrated parameters. Last, the results are confronted with those given by a straight crack to highlight the benefits of accounting for the actual crack path.
The extent of chloroquine underdosing in adult patients with malaria by Plasmodium vivax from an endemic area of the Brazilian Amazon basin
Authors: Valéria Dias Ferreira Michelle , Gabryelle Nunes Cardoso Mello Amanda , Sena Luann Wendel Pereira , Regina Matos Lopes Tamyris , Luiz Fernandes Vieira José
Published: July 2020

Objectives

To evaluate the extent of chloroquine underdosing and to measure the concentrations of chloroquine and desethylchloroquine in adult patients with P. vivax malaria in the Brazilian Amazon basin.

Methods

Prospective study of cases in male adult patients with malaria by Plasmodium vivax treated with a total dose of 1500 mg chloroquine over three days and a short course of primaquine. Patients were weighed at admission, and the dose per mg/kg was determined. Blood samples were collected at 24 and 168 h after enrolment, and the concentrations of chloroquine and desethylchloroquine were measured in plasma by high‐performance liquid chromatography with fluorescence detection.

Results

Of 61 patients were included in the study, and 60% received a total dose of chloroquine below 25 mg/kg. Plasma chloroquine concentrations ranged from 90 to 184 ng/ml and from 175 to 827 ng/ml at 24 and 168 hours. For desethylchloroquine, the values ranged from 32 to 144 ng/ml and from 90 to 440 ng/ml at 24 and 168 h. There were no significant correlations between the plasma levels of chloroquine and the doses administered (mg/kg) at 24 and 196 h. Similar results were found for desethylchloroquine.

Conclusion

There is widespread suboptimal dosing of chloroquine that is probably due to the dosing regimen based on patient age, which reduces the drug exposure with a possible influence on parasite clearance.