bluuebunny/crossref_metadata_2025 huggingface dataset:
Non‐sedation—Does it improve health‐related quality of life after critical illness? A 3‐month follow‐up sub‐study of the NONSEDA trial
Authors: Olsen Hanne T. , Nedergaard Helene K. , Hough Catherine L. , Korkmaz Serkan , Jensen Hanne I. , Strøm Thomas , Toft Palle
Published: December 2020

Background

Critical illness is associated with severely impaired health‐related quality of life (HRQoL) for years following discharge. The NONSEDA trial was a multicenter randomized trial on non‐sedation versus sedation with a daily wake‐up trial in critically ill, mechanically ventilated patients in Scandinavia. The aim of this sub‐study was to assess the effect of non‐sedation on HRQoL and degree of independence in activities in daily living (ADL) 3 months post‐ICU.

Methods

All survivors were asked to complete the Medical Outcomes Study Short‐Form 36 questionnaire (SF‐36) and the Barthel Index 3 months post‐ICU. To limit missing data, reminders were sent. If unsuccessful, telephone interviews could be used. Outcomes were the level of HRQoL and ADL‐function in each group. All outcomes were assessed blinded.

Results

Of the 700 patients included 412 survived to follow‐up. A total of 344 survivors participated (82%). Baseline data were equal between the two groups. Mean SF‐36 scores for the non‐sedated vs sedated patients were as follows: Physical Function 45 vs 40, P = .69, Bodily Pain: 61 vs 52, P = .81, General Health: 50 vs 50, P = .84, Vitality: 42 vs 44, P = .85, Social Function: 75 vs 63, P = .85, Role Emotional: 58 vs 50, P = .82, Mental Health: 70 vs 70, P = .89, Role Physical: 25 vs 28, P = .32, Physical Component Score: 38 vs 37, P = .81, Mental Component Score: 48 vs 46, P = .94, Barthel Index: 20 vs 20, P = .74.

Conclusion

Randomization to non‐sedation neither improved nor impaired health‐related quality of life or degree of independence in activities in daily living 3 months post‐ICU discharge.
Impact of surgical staging for aggressive histology rectal cancers: a retrospective review
Authors: Kazi Mufaddal , Nekkanti Sri Siddhartha , Rohila Jitender , Patel Swapnil , Sukumar Vivek , Desouza Ashwin , Saklani Avanish
Published: December 2020

Background

Poorly differentiated adenocarcinomas and signet ring adenocarcinomas are aggressive histological subtypes of rectal cancer with a high incidence of occult peritoneal metastasis.

Methods

This was a retrospective review of aggressive histology of rectal cancer patients who underwent pre‐treatment surgical staging as part of ovarian transposition or ostomy creation for diversion at a single tertiary cancer centre between January 2014 and December 2019.

Results

A total of 117 patients underwent surgical staging and were deemed non‐metastatic on imaging. Surgical staging led to the detection of metastasis in 29.9% of patients. This led to modification in treatment protocol in 20.5% and change in intent of therapy in 15.4%. The majority (80%) was found to have peritoneal disease with peritoneal carcinomatosis index <17. Only T4 disease predicted the presence of metastasis on surgical staging with an odds ratio of 2.69 (P = 0.035).

Conclusions

A significant proportion of patients with aggressive histology rectal cancers are upstaged after surgical staging. Further investigation of this tool for staging is warranted.
Two different treatment regimens of ranibizumab 0.5 mg for neovascular age‐related macular degeneration with or without polypoidal choroidal vasculopathy in Chinese patients: results from the Phase IV, randomized, DRAGON study
Authors: Li Xiaoxin , Zhu Qi , Egger Anna , Chang Liu , Wolf Sebastian , Song Yanping , Zhang Junjun , Dong Fangtian , Xu Xun , Weisberger Annemarie
Published: December 2020

Purpose

To evaluate the efficacy and safety of monthly and pro re nata (PRN, guided by visual acuity stabilization and disease activity criteria) ranibizumab regimens in Chinese patients with neovascular age‐related macular degeneration (nAMD) and polypoidal choroidal vasculopathy (PCV).

Methods

This double‐masked study randomized nAMD patients (1:1) to ranibizumab monthly from baseline to Month (M) 11 to a PRN regimen from M12 to M23 (monthly group, n = 167) versus ranibizumab three monthly doses followed by a PRN regimen up to M23 (PRN group, n = 166). Subgroups were assessed based on the presence/absence of PCV (indicated by indocyanine green angiography).

Results

Of 334 randomized patients, 41.7% had PCV at baseline. Mean average best‐corrected visual acuity (BCVA) change from M3 to M4 through M12 was 3.3 letters with monthly and 1.7 letters with PRN (mean difference: 1.6; 95% CI: −2.95, −0.20, primary end‐point). Mean change in BCVA from baseline (monthly/PRN, 53.8/53.7) to M12 and M24 was 12.3 and 11.3 letters in monthly and 9.6 and 9.3 letters in PRN group. Corresponding values for patients with PCV/without PCV were 12.7/12.1 letters (M12) and 12.3/10.6 letters (M24) in monthly and 9.4/9.4 letters (M12) and 9.7/8.7 letters (M24) in PRN groups. The mean number of injections was 11.4 (monthly) and 8.2 (PRN) from Day 1 to M11 and 4.8 (monthly) and 5.0 (PRN) from M12 to M23. No new safety findings were reported.

Conclusions

The study results support the use of either ranibizumab monthly or PRN regimens in Chinese patients with nAMD, regardless of presence of PCV.
Defining the surgical footprint in cataract surgery: patient‐related outcomes dependent on the experience of the surgeon
Authors: Jacobsen Mads F. , Holm Lars M. , Erichsen Jesper H. , Konge Lars , Siersma Volkert , la Cour Morten , Thomsen Ann Sofia S.
Published: December 2020

Purpose

To investigate which patient‐related outcomes are dependent on the experience of the cataract surgeon.

Methods

The study was designed as a prospective observational study. Novice (<150 surgeries performed) and experienced (>1000 surgeries performed) cataract surgeons from the Department of Ophthalmology, Rigshospitalet – Glostrup and Nordsjællands Hospital – Hillerød were included in the study. Patients operated by the included surgeons were examined preoperatively, 1 day, 3 days, and 3 weeks after standard, noncomplicated cataract surgery. Primary outcomes were change in central corneal thickness and endothelial cell loss. Secondary outcomes were best‐corrected visual acuity, intraocular pressure, aqueous flare, central macular thickness, and surgical complications.

Results

Surgery performed by novice surgeons resulted in significantly lower visual acuity (mean −3.6 letters (Early Treatment Diabetic Retinopathy Study (ETDRS)); 95% CI: −7.3; −0.4, p = 0.03) and greater corneal thickness (mean 26.7 µm; 95% CI: 6.8; 46.6, p = 0.01) on the first day postoperative than surgery performed by experienced surgeons.

Conclusion

The experience of the cataract surgeon affected visual acuity and central corneal thickness in the immediate postoperative period. In the future, these patient‐related outcomes may be used to assess the technical proficiency of surgical trainees and investigate the effect of different training programs.
Prader‐Willi Syndrome in children: Quality of life and caregiver burden
Authors: Meade Christina , Martin Ruth , McCrann Ann , Lyons Jacqueline , Meehan Judith , Hoey Hilary , Roche Edna
Published: December 2020

Prader‐Willi syndrome is a complex condition requiring constant care and supervision of the affected child.

Aim

To evaluate quality of life and caregiver burden in children with Prader‐Willi syndrome.

Methods

All children with Prader‐Willi syndrome, attending a tertiary referral centre, were invited to participate (n = 44). Quality of life was evaluated using the PedsQL questionnaire. Family impact modules and parent proxy reports evaluated the impact on the quality of life of the child and family. Additional challenges were captured using a burden questionnaire.

Results

Nineteen children participated. Median age was 7.9 years (0.6–18.1 years). Majority were female (n = 14, 74%). Median age at diagnosis was 2.5 weeks (range birth–2 years 8 months). Growth hormone treatment was in place for the majority (n = 14, 74%). Increased weight and age were identified as significantly impacting on family functioning and relationships. Parents perceived increased weight and age to have a significant negative impact on their child's psychosocial health and social functioning.

Caregivers of children >12 years reported an increased burden of care. Disruption to routines, restriction of social activities and psychological difficulties were reported as increasing caregiver burden.

Conclusion

Prader‐Willi syndrome impacts significantly on quality of life for both the affected child and the family.
Hydrolysed formula, delayed food introduction and fatty acids for atopic dermatitis prevention in infancy
Authors: Golpanian Rachel Shireen , Aickara Divya J. , Bellodi Schmidt Fernanda , Smith Peter K. , Yosipovitch Gil
Published: December 2020

Aim

The role of nutrition in preventing atopic diseases including atopic dermatitis has recently gained interest in the medical community. Caregivers of infants and children at an increased risk for developing atopic dermatitis often employ exclusion diets or other measures in hopes of preventing the development of this burdensome disease. This paper reviews the current literature in regard to the role of preventative dietary measures in the context of atopic dermatitis, with a special focus on the topics of hydrolysed formula, early vs. delayed introduction of certain foods and fatty acid supplementation.

Methods

Literature pertaining to preventative dietary measures for infants at risk for atopic dermatitis was reviewed.

Results

Analysis of the literature suggests that hydrolysed formula should not be routinely offered to infants for prevention of atopic dermatitis. Formulas utilised should contain concentrations of polyunsaturated fatty acids similar to that in breast milk. Finally, infant caregivers should not delay or restrict introduction of food, which can be more harmful than helpful to the patient.

Conclusion

Recommendations to caretakers providing for infants at risk for atopic dermatitis should include infant consumption of breast milk and avoid delayed introduction of foods.
Population pharmacokinetic modelling of intravenous immunoglobulin in patients with predominantly antibody deficiencies
Authors: Lee Jian Lynn , Mohd Saffian Shamin , Makmor‐Bakry Mohd , Islahudin Farida , Alias Hamidah , Noh Lokman Mohd , Ismail Intan Hakimah , Mohamed Shah Noraida
Published: December 2020

Aims

There is considerable interpatient variability in the pharmacokinetics (PK) of intravenous immunoglobulin G (IVIG), causing difficulty in optimizing individual dosage regimen. This study aims to estimate the population PK parameters of IVIG and to investigate the impact of genetic polymorphism of the FcRn gene and clinical variability on the PK of IVIG in patients with predominantly antibody deficiencies.

Methods

Patients were recruited from four hospitals. Clinical data were recorded and blood samples were taken for PK and genetic studies. Population PK parameters were estimated by nonlinear mixed‐effects modelling in Monolix®. Models were evaluated using the difference in objective function value, goodness‐of‐fit plots, visual predictive check and bootstrap analysis. Monte Carlo simulation was conducted to evaluate different dosing regimens for IVIG.

Results

A total of 30 blood samples were analysed from 10 patients. The immunoglobulin G concentration data were best described by a one‐compartment model with linear elimination. The final model included both volume of distribution (Vd) and clearance (CL) based on patient's individual weight. Goodness‐of‐fit plots indicated that the model fit the data adequately, with minor model mis‐specification. Genetic polymorphism of the FcRn gene and the presence of bronchiectasis did not affect the PK of IVIG. Simulation showed that 3–4‐weekly dosing intervals were sufficient to maintain IgG levels of 5 g L−1, with more frequent intervals needed to achieve higher trough levels.

Conclusions

Body weight significantly affects the PK parameters of IVIG. Genetic and other clinical factors investigated did not affect the disposition of IVIG.
The effect of formalism on unethical decision making: The mediating effect of moral disengagement and moderating effect of moral attentiveness
Authors: Dong Rui , Lu Ting , Hu Qiaolong , Ni Shiguang
Published: December 2020

This study examined the relationship between formalism and unethical decision making among Chinese working adults. A total of 316 Chinese adult employees completed measures of ethical predispositions, unethical decision making, moral disengagement, and moral attentiveness. The results showed that formalism was related to a weaker propensity to morally disengage. Moral disengagement positively predicted unethical decision making and mediated the relationship between formalism and unethical decision making. Further, perceptual moral attentiveness negatively moderated the relationship between formalism and moral disengagement. The theoretical and practical implications of these findings are presented.
Discoidin domain receptors orchestrate cancer progression: A focus on cancer therapies
Authors: Gao Yuan , Zhou Jiuli , Li Jin
Published: December 2020

Discoidin domain receptors (DDR), including DDR1 and DDR2, are special types of the transmembrane receptor tyrosine kinase superfamily. DDR are activated by binding to the triple‐helical collagen and, in turn, DDR can activate signal transduction pathways that regulate cell‐collagen interactions involved in multiple physiological and pathological processes such as cell proliferation, migration, apoptosis, and cytokine secretion. Recently, DDR have been found to contribute to various diseases, including cancer. In addition, aberrant expressions of DDR have been reported in various human cancers, which indicates that DDR1 and DDR2 could be new targets for cancer treatment. Considerable effort has been made to design DDR inhibitors and several molecules have shown therapeutic effects in pre–clinical models. In this article, we review the recent literature on the role of DDR in cancer progression, the development status of DDR inhibitors, and the clinical potential of targeting DDR in cancer therapies.
Path‐based Monte Carlo Denoising Using a Three‐Scale Neural Network
Authors: Lin Weiheng , Wang Beibei , Yang Jian , Wang Lu , Yan Ling‐Qi
Published: December 2020

Monte Carlo rendering is widely used in the movie industry. Since it is costly to produce noise‐free results directly, Monte Carlo denoising is often applied as a post‐process. Recently, deep learning methods have been successfully leveraged in Monte Carlo denoising. They are able to produce high quality denoised results, even with very low sample rate, e.g. 4 spp (sample per pixel). However, for difficult scene configurations, some details could be blurred in the denoised results. In this paper, we aim at preserving more details from inputs rendered with low spp. We propose a novel denoising pipeline that handles three‐scale features ‐ pixel, sample and path ‐ to preserve sharp details, uses an improved Res2Net feature extractor to reduce the network parameters and a smooth feature attention mechanism to remove low‐frequency splotches. As a result, our method achieves higher denoising quality and preserves better details than the previous methods.
Urban sprawl into Natura 2000 network over Europe
Authors: Concepción Elena D.
Published: December 2020

Urban growth is a major threat to biodiversity conservation at the global scale. Its impacts are expected to be especially detrimental when it sprawls into the landscape and reaches sites of high conservation value due to the species and ecosystems they host, such as protected areas. I analyzed the degree of urbanization (i.e., urban cover and growth rate) from 2006 to 2015 in protected sites in the Natura 2000 network, which, according to the Habitats and Birds Directives, harbor species and habitats of high conservation concern in Europe. I used data on the degree of land imperviousness from COPERNICUS to calculate and compare urban covers and growth rates inside and outside Natura 2000. I also analyzed the relationships of urban cover and growth rates with a set of characteristics of Natura sites. Urban cover inside Natura 2000 was 10 times lower than outside (0.4% vs. 4%) throughout the European Union. However, the rates of urban growth were slightly higher inside than outside Natura 2000 (4.8% vs. 3.9%), which indicates an incipient urban sprawl inside the network. In general, Natura sites affected most by urbanization were those surrounded by densely populated areas (i.e., urban clusters) that had a low number of species or habitats of conservation concern, albeit some member states had high urban cover or growth rate or both in protected sites with a large number of species or habitats of high conservation value. Small Natura sites had more urban cover than large sites, but urban growth rates were highest in large Natura sites. Natura 2000 is protected against urbanization to some extent, but there is room for improvement. Member states must enact stricter legal protection and control law enforcement to halt urban sprawl into protected areas under the greatest pressure from urban sprawl (i.e., close to urban clusters). Such actions are particularly needed in Natura sites with high urban cover and growth rates and areas where urbanization is affecting small Natura sites of high conservation value, which are especially vulnerable and concentrated in the Mediterranean region.
Predictive score for immediate extubation after liver transplantation
Authors: Suphathamwit Aphichat , Pongraweewan Orawan , Lakkam Samonporn , Tovikkai Chutwichai
Published: December 2020

Introduction

Evidence suggests that immediate extubation after liver transplantation provides graft and economic benefits without compromising patient outcomes. This study tried to determine the incidence of immediate extubation, demonstrate related factors, and develop a predictive model from the significant factors.

Methods

This retrospective descriptive study included 240 out of 271 liver transplantation patients in the hospital liver transplant registry between 2004 and 2016. Extubated and non‐extubated groups were statistically compared.

Results

The incidence of immediate extubation was 32.1%. It was associated with a MELD score ≤ 25 (adjusted OR, 5.17; 95% CI, 1.64–16.24; p = .005); packed red cells (PRC) transfusion ≤1600 ml (adjusted OR, 3.45; 95% CI, 1.82–6.53; p < .001); and no requirement for post‐operative vasopressors (adjusted OR, 5.83; 95% CI, 2.30–14.77; p < .001). The immediate‐extubation group had fewer complications and shorter hospital stays. A Siriraj Liver transplant Extubation Score (SLES) of 5 yielded the best prediction of safe immediate extubation.

Conclusions

An incidence of 32.1% was found for immediate extubation following liver transplantation. Associated factors were a MELD score ≤ 25, a lower amount of transfused blood, and no requirement for post‐operative vasopressors. An SLES score of 5 predicted safe immediate extubation.
What is the background for the histological diagnosis of autoimmune pancreatitis?
Authors: Kanno Atsushi , Lefor Alan Kawarai , Yamamoto Hironori
Published: December 2020

This Editorial refers to the article by S.B. Yoon et al., p 1024‐1033 of this issue.
Major depression and clinical outcomes in patients with heart failure with preserved ejection fraction
Authors: Liu Jian , Guo Zejun , Fan Meida , Liang Weihao , He Xin , Wu Dexi , Dong Yugang , Zhu Wengen , Liu Chen
Published: December 2020

Objective

Limited data have been published concerning about depression in heart failure with preserved ejection fraction (HFpEF). Besides, among HFpEF patients with depression, the efficacy of antidepressants is poorly defined. Therefore, our current study was aimed to examine the relationship between major depression and clinical outcomes in HFpEF patients and further address the effects of antidepressants on prognosis in patients with major depression and HFpEF.

Methods

A total of 1431 patients enrolled in the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist Trial (TOPCAT) were divided into 2 groups according to the baseline depression status. Major depression was diagnosed if the Patient Health Questionnaire‐9 score (PHQ‐9) ≥ 10. Univariable and multivariable Cox proportional hazards models tested the association of major depression with outcomes and the effects of antidepressants among HFpEF patients with major depression during a follow‐up of 6 years.

Results

26.7% (382/1431) of patients were diagnosed with major depression. After multivariable adjustment, major depression at baseline was not significantly associated with cardiovascular outcomes (fully adjusted hazard ratio (aHR) 0.95 [0.76‐1.18] for primary outcomes; aHR: 0.86 [0.67‐1.10] for HF hospitalization; aHR: 1.06 [0.91‐1.23] for any hospitalization; aHR: 1.00 [0.70‐1.43] for cardiovascular death; aHR: 1.24 [0.96‐1.61] for all‐cause death). Additionally, among HFpEF patients with major depression, the use of antidepressants was not associated with adverse events (P > .05 for all analyses).

Conclusions

In HFpEF patients, major depression at baseline did not increase mortality or rehospitalization. Additionally, treatment with antidepressants might not improve prognosis among HFpEF patients with major depression. Future studies are warranted to explore the effects of antidepressants on HFpEF patients with depression.
Difference in laminated mouthguard thickness according to the laminate order
Authors: Mizuhashi Fumi , Koide Kaoru , Watarai Yuko
Published: December 2020

Background/Aim

Mouthguard thickness should be maintained to prevent oral trauma by protecting the teeth and the surrounding soft tissue. The aim of this study was to examine the difference in laminated mouthguard thickness according to the laminate order.

Materials and methods

The mouthguard sheets used in this study were 2.0 mm and 3.0 mm ethylene‐vinyl acetate. The sheets were pressure‐formed using a pressure former, and the laminated mouthguard was fabricated. Two laminate conditions were examined. One condition used the 2.0‐mm sheet for the first layer and the 3.0‐mm sheet for the second layer (condition 2F3S) and the other condition used the 3.0‐mm sheet for the first layer and 2.0‐mm sheet for the second layer (condition 3F2S). The first layer was trimmed to cover the labial surface and incisal edge of the anterior teeth and the buccal and occlusal surfaces of the posterior teeth. The second layer was formed over the first layer. The mouthguard thickness was measured at the labial surface of the central incisor and the buccal and occlusal surfaces of the first molar. Differences in thickness by measurement region of mouthguards formed under different laminate conditions were analyzed by two‐way analysis of variance.

Results

The mouthguard thickness was significantly different at the measured regions of the central incisors and the first molars (p < .01). The thickness at the labial surface of the central incisor and at the buccal and occlusal surfaces of the first molar became statistically significantly larger with the 3F2S condition than that for the 2F3S condition (p < .05 or p < .01).

Conclusions

The thickness of the laminated mouthguard became larger when the sheet thickness of the first layer was greater. It is recommended to use the thicker mouthguard sheet as the first layer when fabricating a laminated mouthguard.
Forest responses to last‐millennium hydroclimate variability are governed by spatial variations in ecosystem sensitivity
Authors: Rollinson Christine R. , Dawson Andria , Raiho Ann M. , Williams John W. , Dietze Michael C. , Hickler Thomas , Jackson Stephen T. , McLachlan Jason , JP Moore David , Poulter Benjamin , Quaife Tristan , Steinkamp Jörg , Trachsel Mathias
Published: December 2020

Forecasts of future forest change are governed by ecosystem sensitivity to climate change, but ecosystem model projections are under‐constrained by data at multidecadal and longer timescales. Here, we quantify ecosystem sensitivity to centennial‐scale hydroclimate variability, by comparing dendroclimatic and pollen‐inferred reconstructions of drought, forest composition and biomass for the last millennium with five ecosystem model simulations. In both observations and models, spatial patterns in ecosystem responses to hydroclimate variability are strongly governed by ecosystem sensitivity rather than climate exposure. Ecosystem sensitivity was higher in models than observations and highest in simpler models. Model‐data comparisons suggest that interactions among biodiversity, demography and ecophysiology processes dampen the sensitivity of forest composition and biomass to climate variability and change. Integrating ecosystem models with observations from timescales extending beyond the instrumental record can better understand and forecast the mechanisms regulating forest sensitivity to climate variability in a complex and changing world.
Differential effects of the SARS‐CoV‐2 pandemic on patients presenting to a neurological emergency room depending on their triage score in an area with low COVID‐19 incidence
Authors: Millán Margit , Nagel Simon , Gumbinger Christoph , Busetto Loraine , Purrucker Jan C. , Hametner Christian , Ringleb Peter A. , Mundiyanapurath Sibu
Published: December 2020

Background

We analyzed the effects of the SARS‐CoV‐2 pandemic on neurologic emergencies, depending on the patients' triage score in a setting with relatively few COVID‐19 cases and without lack of resources.

Methods

Consecutive patients of a tertiary care center with a dedicated neurologic emergency room (nER) were analyzed. The time period of the first lockdown in Germany (calendar weeks 12–17, 2020) was retrospectively compared to the corresponding period in 2019 regarding the number of patients presenting to the nER, the number of patients with specific triage scores (Heidelberg Neurological Triage Score), the number of patients with stroke, and the quality of stroke care.

Results

A total of 4330 patients were included. Fewer patients presented themselves in 2020 compared to 2019 (median [interquartile range] per week: 134 [118–143] vs. 187 [182–192]; p = 0.015). The median numbers of patients per week with triage 1 (emergent) and 4 (non‐urgent) were comparable (51 [43–58] vs. 59 [54–62]; p = 0.132, and 10 [4–16] vs. 16 [7–18]; p = 0.310, respectively).The median number of patients per week declined in categories 2 and 3 in 2020 (41 [37–45] vs. 57 [52–61]; p = 0.004, and 28 [23–35] vs. 61 [52–63]; p = 0.002, respectively. No change was observed in the absolute number of strokes (138 in 2019 and 141 in 2020). Quality metrics of stroke revascularization therapies (symptom‐to‐door time, door‐to‐needle time or relative number of therapies) and stroke severity remained constant.

Conclusion

During the lockdown period in 2020, the number of patients with emergent symptoms remained constant, while fewer patients with urgent symptoms presented to the nER. This may imply behavioral changes in care‐seeking behavior.
The geomagnetic field does not appear to influence navigation in Eastern painted turtles
Authors: Krochmal Aaron R. , Roth Timothy C. , Simmons Nathaniel T.
Published: December 2020

Geomagnetic cues provide important information to guide aspects of migration, from the general direction of movement to informing an animal's specific location on the planet. Although such cues are used by many long‐distant migrants, its use for short‐ and moderate‐distance migrations is less clear. We have been studying overland migratory movements in a population of Eastern painted turtles where animals use one of four precise, highly predictable routes to locate water sources during migration. Our previous work suggests a strong role of learning and spatial memory in this precise navigation, but the cues used and the context for their use are unknown. Here, we present a series of controlled field experiments in which we test the hypothesis that geomagnetic cues are utilized when Chrysemys picta engage in these intricate, overland movements. We fitted turtles with 3,309 Gauss magnets (n = 10) or aluminum disk controls (n = 5) and surveyed their ability to locate and navigate their routes during migration; turtles were similarly tested for these abilities outside of the context of migration (magnets, n = 30; control, n = 30). Strong magnets (3,309 Gauss) on their carapaces did not disrupt turtles’ ability to locate the paths or the precision with which they navigated them. Turtles, irrespective of treatment, found their paths and/or navigated their paths with the same high precision that we observed in controls and our previous work, both within and outside of the context of migration. Thus, alternative types of cues must be in use that explain the high precision and high reliability of path location over time. Future studies should examine alternative cues used in migratory navigation and the creation of complex and specific paths.
The impact of land finance on urban land use efficiency: A panel threshold model for Chinese provinces
Authors: Wang Peng , Shao Zinan , Wang Jian , Wu Qun
Published: December 2020

The improvement of urban land use efficiency has become the main goal for developing countries in response to rapid urbanization. This paper explores the impact of land finance on urban land use efficiency (ULUE) on the provincial level using land conveyance fee and land‐related tax data from China between 2004 and 2016. First, a super‐efficiency data envelopment analysis model was applied to measure ULUE. The results showed that ULUE was highest in eastern China, followed by central China, and ULUE was lowest in western China. Then, a provincial panel threshold model was built for an empirical analysis. In particular, a double threshold was identified in the relationship between the land conveyance fee and ULUE. A significant positive effect on ULUE was found when the percentage of the new construction land supply quantity remained below 0.401. However, this effect became negative when the percentage of threshold variables exceeded 0.842. Moreover, land‐related tax was found to exert significant negative effects on ULUE when the percentage of the new construction land supply quantity remained below 0.842. Insignificant positive effects were found when the percentage exceeded this level. The empirical results suggested that the relationship between land finance and ULUE is nonlinear; excessive land finance will negatively impact ULUE.
The Primigenius Felix Culpa
Authors: Cawdron Harvey
Published: December 2020

The primal sin is an unprecedented event because it is the moment at which creation first became corrupted. This makes it remarkably difficult to explain. In contemporary analytic discussions of the primal sin, a dichotomy has emerged. Generally, scholars working in this area accept inexplicability to avoid blaming God, resulting in a labelling of the primal sin as mysterious. In this paper, I will outline a Felix Culpa model of the primal sin, which I shall call the Primigenius Felix Culpa model. Through this model, I will suggest that the primal sin was made inevitable by God to maximise the value of the actual world. I will argue that, despite inheriting many of the disadvantages that come with a Felix Culpa, this model significantly reduces the inexplicability of the primal sin.
Dynamic string‐averaging CQ‐methods for the split feasibility problem with percentage violation constraints arising in radiation therapy treatment planning
Authors: Brooke Mark , Censor Yair , Gibali Aviv
Published: December 2020

We study a feasibility‐seeking problem with percentage violation constraints (PVCs). These are additional constraints that are appended to an existing family of constraints, which single out certain subsets of the existing constraints and declare that up to a specified fraction of the number of constraints in each subset is allowed to be violated by up to a specified percentage of the existing bounds. Our motivation to investigate problems with PVCs comes from the field of radiation therapy treatment planning (RTTP) wherein the fully discretized inverse planning problem is formulated as a split feasibility problem and the PVCs give rise to nonconvex constraints. Following the CQ algorithm of Byrne (2002, Inverse Problems, Vol. 18, pp. 441–53), we develop a string‐averaging CQ‐method that uses only projections onto the individual sets that are half‐spaces represented by linear inequalities. The question of extending our theoretical results to the nonconvex sets case is still open. We describe how our results apply to RTTP and provide a numerical example.
Weather and landscape influences on pollinator visitation of flowering winter oilseeds (field pennycress and winter camelina)
Authors: Forcella Frank , Patel Swetabh , Lenssen Andrew W. , Hoerning Cody , Wells M. Scott , Gesch Russ W. , Berti Marisol T.
Published: December 2020

Flowers of field pennycress (Thlaspi arvsense L.) and winter camelina (Camelina sativa (L.) Crantz.) produce abundant pollen and nectar in early spring and thereby may be valuable for pollinators. Insects observed in field plots of these flowers were classified into seven easily identifiable groups (bumblebee, honeybee, solitary bee, butterfly/moth, beetle, fly and other) and monitored for 2 years at three sites in the Upper Midwest region of the USA. Average seasonal observations across years and sites varied from 1.6 to 5.3 total insects/min for field pennycress and 1.4 to 4.5 insects/min for winter camelina. Lowest visitation rates occurred in central Iowa and highest rates in south‐eastern Minnesota for both crops. Multiple regressions showed that visitation rates for specific insect groups were correlated poorly but significantly (p < .10) with select variables. For example, in field pennycress, visitation by combined bumblebees and honeybees (Apidae) increased with greater air temperature at sampling time and annual site precipitation, whereas fly (Diptera) visitation was related to sampling date and flower cover. Similarly, in winter camelina, solitary bees were linked to increasing air temperature at sampling time and annual site precipitation, whereas flies were correlated with wind speed and flower cover at sampling. Field pennycress and winter camelina are reliably attractive to beneficial pollinating insects across a wide geographic region, but visitation rates and proportional representation of various insect groups depended on a range of site and weather characteristics.
Mindfulness‐based cognitive therapy in functional dyspepsia: A pilot randomized trial
Authors: Teh Kevin Kim‐Jun , Ng Yi‐Kang , Doshi Kinjal , Tay Shu‐Wen , Hao Ying , Ang Lui‐Yee , Foong Henry Lew‐Yuen , Ong Andrew Ming‐Liang , Siah Kewin Tien‐Ho , Chan Webber Pak‐Wo , Ong Wai‐Choung , Mesenas Steven Joseph , Lim Chee‐Hooi , Wang Yu‐Tien
Published: December 2020

Background and Aim

Patients with functional dyspepsia (FD) often have concomitant anxiety and depression. Mindfulness‐based cognitive therapy (MBCT) combines the principles of cognitive behavioral therapy and mindfulness. It is a group‐based therapy and has been shown to be efficacious in functional gastrointestinal disorders. There are no randomized controlled trials (RCTs) evaluating MBCT in FD. We aimed to evaluate feasibility and efficacy of MBCT in FD management.

Methods

We performed a mixed‐method single‐center pilot randomized trial of 28 patients fulfilling ROME‐III criteria for FD. Fifteen patients were randomized to an 8‐week MBCT program while 13 underwent treatment‐as‐usual (TAU). Patients completed questionnaires at baseline and at week 8. Two focus‐groups were conducted. Feasibility of recruitment, acceptability of randomization, procedures and intervention, handout compliance and feasibility of quantitative measures were assessed. The primary outcome was subjective‐clinical‐assessment of FD symptoms (SCA‐FD). Secondary outcome measures included Short‐form Nepean Dyspepsia Index (SF‐NDI), subjective‐clinical‐assessment of general health (SCA‐GH), EuroQoL‐Visual Analog Scale (EuroQoL‐VAS), and Depression, Anxiety and Stress Scale–21 Items (DASS‐21).

Results

Twelve of 15 patients in the MBCT group completed the program. There was a trend towards symptom improvement, with 90% in the MBCT group reporting improvement in SCA‐FD compared with 45% in TAU(P = 0.063). Patients who underwent MBCT reported greater improvement in SF‐NDI (mean change: −8.8 (SD: 7.5) vs −0.7 (7.2), P = 0.018) and DASS‐21 (−19.8 (29.5) vs −5.5 (6.6) P = 0.13) compared with TAU. There was no difference in SCA‐GH and EuroQoL‐VAS. Based on SCA‐FD improvement, the eventual RCT will require 50 patients (25 in each group).

Conclusions

Mindfulness‐based cognitive therapy is likely efficacious for FD, and it would be feasible to conduct a RCT.
Birth Outcomes of Women with Obesity Enrolled for Care at Freestanding Birth Centers in the United States
Authors: Jevitt Cecilia M. , Stapleton Susan , Deng Yanhong , Song Xuemei , Wang Kaicheng , Jolles Diana R.
Published: December 2020

Introduction

Current US guidelines for the care of women with obesity generalize obesity‐related risks to all women regardless of overall health status and assume that birth will occur in hospitals. Perinatal outcomes for women with obesity in US freestanding birth centers need documentation.

Methods

Pregnancies recorded in the American Association of Birth Centers Perinatal Data Registry were analyzed (n = 4,455) to form 2 groups of primiparous women (n = 964; 1:1 matching of women with normal body mass indices [BMIs] and women with obese BMIs [>30]), using propensity score matching to address the imbalance of potential confounders. Groups were compared on a range of outcomes. Differences between groups were evaluated using χ2 test for categorical variables and Student's t test for continuous variables. Paired t test and McNemar's test evaluated the differences among the matched pairs.

Results

The majority of women with obese BMIs experienced uncomplicated perinatal courses and vaginal births. There were no significant differences in antenatal complications, proportion of prolonged pregnancy, prolonged first and second stage labor, rupture of membranes longer than 24 hours, postpartum hemorrhage, or newborn outcomes between women with obese BMIs and normal BMIs. Among all women with intrapartum referrals or transfers (25.3%), the primary indications were prolonged first stage or second stage (55.4%), inadequate pain relief (14.8%), client choice or psychological issue (7.0%), and meconium (5.3%). Primiparous women with obesity who started labor at a birth center had a 30.7% transfer rate and an 11.1% cesarean birth rate.

Discussion

Women with obese BMIs without medical comorbidity can receive safe and effective midwifery care at freestanding birth centers while anticipating a low risk for cesarean birth. The risks of potential, obesity‐related perinatal complications should be discussed with women when choosing place of birth; however, pregnancy complicated by obesity must be viewed holistically, not simply through the lens of obesity.
BRAF p.V600E status in epithelial areas of ameloblastoma with different histological aspects: Implications to the clinical practice
Authors: Sant’Ana Maria Sissa Pereira , dos Santos Costa Sara Ferreira , da Silva Maísa Pereira , Martins‐Chaves Roberta Rayra , Pereira Thaís dos Santos Fontes , de Oliveira Eduardo Morato , Martínez Pedraza Ricardo , de Castro Wagner Henriques , Gomes Carolina Cavaliéri , Gomez Ricardo Santiago , Fonseca Felipe Paiva
Published: December 2020

Background

BRAF p.V600E is reported in up to 80% of ameloblastomas. Despite the high frequency, the presence of this mutation in different histopathological areas of the tumour has not been investigated. This information has an important role in the use of BRAF p.V600E assessment as an auxiliary tool in the differential diagnosis between unicystic ameloblastoma and other odontogenic cystic lesions, especially when only incisional biopsies are available. Therefore, the purpose of the present study was to investigate BRAF p.V600E heterogeneity in unicystic ameloblastoma.

Methods

Five cases of ameloblastoma and two dentigerous cysts were analysed. The regions exhibiting different microscopic characteristics were selected from each ameloblastoma case and manually dissected. TaqMan allele‐specific qPCR or Sanger sequencing was performed to determine BRAF p.V600E status.

Results

We screened the mutation in a small cohort of UA and no molecular heterogeneity was found. Four cases of ameloblastoma (80%) exhibited BRAF p.V600E in all different areas evaluated. One case did not harbour the mutation in any microscopic region analysed. The BRAF mutation was absent in the dentigerous cysts.

Conclusion

Ameloblastomas appear to exhibit a homogeneous profile regarding the BRAF p.V600E no matter what histological feature is observed under light microscopy, suggesting that this molecular test may contribute to establish the correct diagnosis in cases microscopically resembling other odontogenic lesions.
Mothers’ Narratives on their Immigration Experiences: Associations with Maternal Relatedness and Adolescent Adjustment
Authors: Sher‐Censor Efrat , Mizrachi‐Zinman Arava
Published: December 2020

We examined the hypothesis that lower maternal relatedness mediates the associations of immigrant mothers’ acculturative stress and lack of benefit finding in immigration with poorer adjustment of their adolescents in terms of more externalizing problems and lower school achievements and self‐worth. Participants were 93 adolescents (47.31% girls, Mage = 16.04) and their mothers (Mage = 45.83) from middle‐class families. Mothers immigrated to Israel from the Former Soviet Union or Western countries (Myears‐in‐Israel = 19.75). We used a multimethod multi‐informant approach that included a novel narrative procedure for assessing acculturative stress and benefit finding. Structural Equation Modeling supported the hypothesis, suggesting that research on and practice with adolescents in immigrant families should consider the meaning parents derive from their immigration experiences.
Revealing the clinical phenotype of atypical neuronal ceroid lipofuscinosis type 2 disease: Insights from the largest cohort in the world
Authors: Lourenço Charles M , Pessoa Andre , Mendes Carmen C , Rivera‐Nieto Carolina , Vergara Diane , Troncoso Mónica , Gardner Emily , Mallorens Francisca , Tavera Lina , Lizcano Luis A , Atanacio Nora , Guelbert Norberto , Specola Norma , Mancilla Nury , de Souza Carolina F M , Mole Sara E
Published: December 2020

Aim

Neuronal ceroid lipofuscinosis type 2 (CLN2) disease is an autosomal recessive inherited neurodegenerative lysosomal storage disorder caused by deficient tripeptidyl peptidase 1 (TPP1) enzyme, leading to progressive deterioration of neurological functions commonly occurring in children aged 2–4 years and culminating in early death. Atypical cases associated with earlier or later symptom onset, or even protracted course, have already been reported. Such variable manifestations may constitute an additional challenge to early diagnosis and initiation of appropriate treatment. The present work aimed to analyse clinical data from a cohort of Latin American CLN2 patients with atypical phenotypes.

Methods

Experts in inborn errors of metabolism from Latin America selected patients from their centres who were deemed by the clinicians to have atypical forms of CLN2, according to the current literature on this topic and their practical experience. Clinical and genetic data from the medical records were retrospectively revised. All cases were presented and analysed by these experts at an Advisory Board Meeting in São Paulo, Brazil, in October 2018.

Results

Seizures, language abnormalities and behavioural disorders were found as the first manifestations, appearing at the median age of 6 years, an older age than classically described for the late infantile form. Three novel mutations were also identified.

Conclusion

Our findings reinforce the inclusion of CLN2 in the differential diagnosis of children presenting with seizures, behavioural disorders and language abnormalities. Early diagnosis will allow early initiation of specific therapy.
Effect of storage duration on egg quality, embryo mortality and hatchability in FUNAAB‐ɑ chickens
Authors: Abioja Monsuru Oladimeji , Abiona John Adesanya , Akinjute Obafemi Foluso , Ojoawo Henry T.
Published: December 2020

Effect of extended storage on egg quality, embryo mortality and hatchability in FUNAAB‐ɑ chickens was determined. Hatchable eggs (n = 288; weighing 53.2 ± 4.67 g) collected from a flock of FUNAAB‐ɑ layer breeder hens aged 32 weeks were stored in egg tray with broad end up under 16 ± 1.5°C for either 0, 4, 8, 12, 16 or 20 d. Before incubation, eight eggs from each group were evaluated for internal and external quality traits. Remaining eggs were set in an incubator and transferred into hatcher on embryonic day 18. Data collected were subjected to one‐way analysis of variance. Egg weight loss (EWL; p < .001), surface area (p < .001), yolk diameter (p < .001), inner and outer blastoderm diameters (p < .05) and dead in germ (DIG; p < .001) increased with storage duration while yolk height (p < .001), yolk index (p < .001), albumen weight (p < .05), albumen height (p < .05), albumen index (p < .01), Haugh's unit (HU; p < .05), fertility (p < .001), hatchability of set (HATCHS; p < .001) and fertile eggs (p < .05) decreased. Weight losses of 0, 1.2, 2.2, 3.4, 4.6 and 6.1% were recorded in egg stored for 0, 4, 8, 12, 16 and 20 days respectively. Eggs stored beyond 8 days exhibited higher DIG and lower HATCHS. Shell percentage in 4 days storage (11.4%) was lower (p < .05) than in 16 days storage (13.4%). Shell thickness was similar in eggs stored for 0 to 12 days, but 8 days storage (0.60 mm) had thinner (p < .01) shell than day 16 (0.71 mm) and day 20 (0.73 mm) storage. Internal quality unit (IQU) was higher (p < .05) in fresh eggs (180.4) than in 12 days (167.8) and 20 days (167.8) stored eggs. Extended storage of FUNAAB‐ɑ eggs caused EWL, surface area shrinkage, lowered HU and IQU, loss of yolk and albumen quality, increased blastoderm diameters and DIG, and decreased egg fertility and HATCHS from day 8 forward. Storing FUNAAB‐ɑ eggs beyond 8 days reduced quality parameters; therefore, other mitigating factors are recommended when storing beyond 8 days.
Evaluation of large volume yeast interfering RNA lure‐and‐kill ovitraps for attraction and control of Aedes mosquitoes
Authors: Hapairai L. K. , Mysore K. , James L. D. , Scheel N. D. , Realey J. S. , Sun L. , Gerber L. E. , Feng R. S. , Romero‐Severson E. , Mohammed A. , Duman‐Scheel M. , Severson D. W.
Published: December 2020

Aedes mosquitoes (Diptera: Culicidae), principle vectors of several arboviruses, typically lay eggs in man‐made water‐filled containers located near human dwellings. Given the widespread emergence of insecticide resistance, stable and biofriendly alternatives for mosquito larviciding are needed. Laboratory studies have demonstrated that inactivated yeast interfering RNA tablets targeting key larval developmental genes can be used to facilitate effective larvicidal activity while also promoting selective gravid female oviposition behaviour. Here we examined the efficacy of transferring this technology toward development of lure‐and‐kill ovitraps targeting Aedes aegypti (L.) and Aedes albopictus (Skuse) female mosquitoes. Insectary, simulated field and semi‐field experiments demonstrated that two mosquito‐specific yeast interfering RNA pesticides induce high levels of mortality among larvae of both species in treated large volume containers. Small‐scale field trials conducted in Trinidad, West Indies demonstrated that large volume ovitrap containers baited with inactivated yeast tablets lure significantly more gravid females than traps containing only water and were highly attractive to both A. aegypti and A. albopictus females. These studies indicate that development of biorational yeast interfering RNA‐baited ovitraps may represent a new tool for control of Aedes mosquitoes, including deployment in existing lure‐and‐kill ovitrap technologies or traditional container larviciding programs.