bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficiency of vein viewing on pain and anxiety of children during peripheral cannula intervention: A randomized controlled study
Authors: Bayram Dilek , Topan Aysel
Published: August 2020

Aim

The purpose of this research is to estimate the efficiency of vein viewing device on 9–12 year‐old children's pain and anxiety.

Methods

The research has been designed as an experimental study including pre‐and post‐test and control groups. Data were collected with personal information form, facial expressions rating scale, state anxiety scale, vein viewing device and a peripheral cannula. Both groups were applied to the state anxiety scale before and after the procedure while the facial expressions rating scale was applied during the procedure.

Results

Statistically significant difference was found between experimental and control groups regarding processing time, number of transaction attempts and facial expressions rating scale score averages. While there was no difference regarding the state anxiety scales average points of children in experimental and control groups before the procedure, a statistically significant difference was found in an advanced level regarding post‐processing state anxiety levels.

Conclusions

Usage of vein viewing device during peripheral cannula intervention reduces children's pain and anxiety levels and shortens the durations of the initiative.
Correlation between serum granulysin level and clinical activity in patients with alopecia areata before and after tofacitinib therapy
Authors: Oba Muazzez Cigdem , Askin Ozge , Balci Ekmekci Ozlem , Serdaroglu Server
Published: August 2020

Background

Alopecia areata (AA) is a common immune‐mediated disorder. Destruction of anagen hair follicles by cytotoxic T cells (CTL) plays a major role in the pathogenesis of AA. Serum granulysin has been shown to reflect overall activity of CTLs.

Aims

In this study, we aimed to compare serum granulysin levels in patients with AA before and after therapy and to analyze correlation between serum granulysin levels and disease severity.

Methods

We evaluated the Severity of Alopecia Tool (SALT) score and serum granuysin levels of 38 AA patients at baseline and at 6th month of therapy. Thirty‐three patients were treated with tofacitinib 5 mg b.i.d, and five patients were treated with topical immunotherapy. Serum granulysin levels were measured by enzyme‐linked immunosorbent assay.

Results

A moderate correlation was found between SALT scores and serum granulysin level at baseline (r = .378, P = .019). Baseline serum granulysin levels were significantly higher in patients with alopecia totalis/universalis compared with patients with patchy AA (P = .004, Z = 2.778). Serum granulysin levels significantly decreased in patients treated with tofacitinib compared to baseline (P = .001). The reduction in serum granulysin levels after tofacitinib therapy correlated with the reduction in SALT scores (P = .001).

Conclusions

Our results suggest serum granulysin levels to be a good correlate of immunological activity of AA. We also assume granulysin to be a potential mediator of follicle attack, the effects of which is blocked by tofacitinib therapy. Therefore, changes in serum granulysin levels under therapy can reflect the downregulation of immunological activity of AA.
Classifications and injection strategy for lip reshaping in Asians
Authors: Peng Jui‐Hui , Peng Hsien‐Li Peter
Published: August 2020

Filler injections have become very popular in recent decades. Of the various injection procedures, lip injection is an important aspect of filler injection, especially for Caucasian patients. Asians tend to have fuller lips than Caucasians, necessitating a different approach to lip injection. Classification systems for the lip for aesthetic treatment purposes can help a physician assess a patient accordingly, and a simple classification of Asian lips into four types for injection approaches is proposed in this paper. Each patient type is discussed in terms of trait and categorization, injection area, injection techniques, injection goals, and sample patients with treatment results.
Serum TWEAK: A cutoff between segmental and nonsegmental vitiligo
Authors: El‐Taweel Abd El‐Aziz Ibrahim , Abdelrahman Amira Mohamed Noureldin , Sabry Sarah , Salem Rehab Mohammed
Published: August 2020

Background

TWEAK/Fn14 is expressed in many tissues including the skin, playing an important role in many inflammatory, autoimmune, and neoplastic cutaneous disorders.

Aims

To assess the serum levels of tumor necrosis factor‐like weak inducer of apoptosis (TWEAK) in vitiligo patients.

Methods

This case‐control study included 100 subjects (50 vitiligo patients and 50 control subjects) recruited from Dermatology Outpatient Clinic, Benha University. All patients were subjected tocomplete cutaneous examination, to evaluate the clinical type, distribution and severity of vitiligo using the Vitiligo Area Scoring Index (VASI).

Results

TWEAK serum levels were significantly higher in patients than in the control subjects (644.76 ± 688.93 vs 282.75 ± 125.67, respectively). Serum levels were significantly elevated in segmental versus nonsegmental vitiligo. Receiver operating characteristic (ROC) analysis revealed that TWEAK shows 80% sensitivity and 56.67% specificity in diagnosing vitiligo and 100% sensitivity and 80.09% specificity in differentiating segmental from nonsegmental vitiligo.

Conclusion

TWEAK may play a role in vitiligo pathogenesis. It may be used in the differentiation between segmental and nonsegmental vitiligo and represent a promising therapeutic target in vitiligo.
Differentiation in a market of imitation: The evolving world of aesthetic dermatology
Authors: Wang Jordan V. , Saedi Nazanin , Geronemus Roy G.
Published: August 2020

This commentary examines the recent general movement in the field of cosmetic dermatology toward imitation and reproduction. The issues of medical spas, nonphysician operators, and counterfeit products have recently garnered interest in aesthetic dermatology. As physicians, it is our professional and bioethical responsibility to ensure that our patients are educated on the presence of medical spas, nonphysician operators, and counterfeit products in our field, especially given the discrepancies in patient safety and outcomes. There are also actions that dermatologists can take in order to help differentiate themselves in this current market. This will not only protect our field, but also our patients, who we are obligated to provide high‐quality care for as physicians.
Bleaching and skin‐lightening practice among female students in South India: A cross‐sectional survey
Authors: Jagadeesan Soumya , Kaliyadan Feroze , Ashique Karalikkattil T. , Karunakaran Aditi
Published: August 2020

Background

Bleaching with skin‐lightening preparations is a common practice in our society. Particularly, a practice simply known as “bleaching”—referring to application of skin‐lightening chemicals including ammonia, hydrogen peroxide, and hypochlorite, repeated at intervals, as a salon‐based or home‐based procedure appears wide‐spread among young females in India. However, there is limited medical literature on “bleaching.”

Aims

We aimed to estimate the prevalence of “bleaching” among female students of our campus and to assess the knowledge, attitude, and practices regarding “bleaching” in the same population.

Methods

A cross‐sectional, questionnaire‐based survey was conducted among the female students of the campus following a presurvey focus group discussion with a representative group. A pilot survey conducted to standardize the survey questionnaire showed a high reliability (Cronbach's alpha > 0.7). Descriptive statistical methods were used to assess survey results, and frequencies were presented as percentages.

Results

A total of 880 valid responses were analyzed (age group 17‐30 years, mean age‐20.24 years). 34.77% had done “bleaching” at least once. 63.8% of respondents did not know the ingredients, and 40.5% did not know about the side effects of “bleaching.” 60.06% of those who bleached had experienced an adverse effect. 58.18% respondents knew about “bleaching” from friends/relatives and 17% from parlors. Only 2.3% respondents had consulted a dermatologist, and only 22.8% had used sunscreens. Top motivation to bleach was to lighten facial hairs (19.5%), for a “lighter” complexion (15.1%) and achieve “glow” before a function (15.2%).

Conclusion

Facial skin and hair “bleaching” is common in our society, and awareness regarding “bleaching” is low even among educated youth.
Exosomal lncRNA UCA1 from cancer‐associated fibroblasts enhances chemoresistance in vulvar squamous cell carcinoma cells
Authors: Gao Qianqian , Fang Xiaohui , Chen Yufang , Li Ziyan , Wang Meihua
Published: August 2020

Aim

In the current work, we aimed to explore whether Cancer‐associated fibroblasts (CAF) exosomes played crucial roles in vulvar squamous cell carcinoma (VSCC) chemoresistance via mediating long noncoding RNAs (lncRNA).

Methods

The IC50 value and cell apoptosis were assessed by the Cell Counting‐8 Kit (CCK‐8) assay and flow cytometry, respectively. Western blot analysis was used for the measurement of protein levels. The levels of urothelial cancer‐associated 1 (UCA1), miR‐103a and WEE1 G2 checkpoint kinase (WEE1) mRNA were detected by quantitative real‐time polymerase chain reaction (qRT‐PCR). The target relationships among miR‐103a, UCA1 and WEE1 were confirmed by dual‐luciferase reporter assays. Xenograft model mice were established to observe the impact of exosomal UCA1 on cisplatin (CDDP) resistance in vivo.

Results

Our data indicated that CAF enhanced CDDP resistance of VSCC cells in vitro. Extracellular UCA1 was transferred by exosomes derived from CAF. Exosomal UCA1 derived from CAF conferred VSCC cell resistance to CDDP. Moreover, UCA1 functioned as a miR‐103a sponge in VSCC cells. The promotion of exosomal UCA1 on VSCC cell resistance to CDDP was mediated by miR‐103a. WEE1 was a direct target of miR‐103a, and exosomal miR‐103a from CAF weakened CDDP resistance of VSCC cells by WEE1. Furthermore, exosomal UCA1 regulated WEE1 expression through sponging miR‐103a. Additionally, exosomal UCA1 enhanced tumor growth and CDDP resistance in vivo.

Conclusion

Our findings suggested exosomal UCA1 derived from CAF conferred VSCC cell resistance to CDDP in vitro and in vivo at least partly through the miR‐103a/WEE1 axis, highlighting a novel therapeutic method for improving the clinical benefits of CDDP chemotherapy in VSCC patients.
Comparison of novel two‐port and conventional multiport laparoscopic surgery approaches for benign adnexal masses: The Bagli method
Authors: Bağlı İhsan , Bademkıran Hanifi
Published: August 2020

Aim

This study primarily aims to describe the safety and efficacy of a novel two‐port (5 and 10‐mm) laparoscopic surgery (TPLS) approach for benign adnexal masses compared with conventional multiport laparoscopic surgery (CMLS) in excisional procedures such as salpingectomy and oophorectomy.

Methods

This is a retrospective case–control study. Forty‐four patients were divided into two groups: two‐port (5 mm and 10 mm) laparoscopic surgery group (n: 22) and conventional multiport (three/four port) laparoscopic surgery group (n: 22), with similar indications. All procedures, except ovarian detorsions, included salpingectomy, oophorectomy or salpingo‐ophorectomy. The groups were evaluated using their demographic, clinical, intraoperative and postoperative data, and survey questions that were asked were used for analyzing cosmetic satisfaction, surgical satisfaction and preference rates of the TPLS.

Results

There were no significant differences between the groups on demographic features. All patients were discharged within 24 h after both the procedures without any major (organ injury) or minor complication. Surgical satisfaction range was 8.82 (±1.01) in TPLS group and 7.27 (±1.6) in the CMLS group, and differences were significant (P = 0.002). Satisfaction with cosmesis was 95% in the TPLS group and 77% in the CMLS group, and this difference was not significant (P = 0.11). The preferences rate of TPLS was 68% among the 44 women.

Conclusion

Novel TPLS is feasible and safe in expert hands. In addition, it provides more surgical satisfaction to patients. However, there were not significant differences in long‐term cosmesis results between the TPLS and CMLS groups.
Screening for pre‐eclampsia: Performance of National Institute for Health and Care Excellence guidelines versus American College of Obstetricians and Gynecologists recommendations
Authors: Phumsiripaiboon Phumarin , Suksai Manaphat , Suntharasaj Thitima , Geater Alan
Published: August 2020

Aim

The purpose of this study was to compare the accuracy of the National Institute for Health and Care Excellence (NICE) guidelines and the American College of Obstetricians and Gynecologists (ACOG) recommendations for pre‐eclampsia (PE) screening.

Methods

This retrospective study included 4600 Thai pregnant women who received maternity care between January 2006 and December 2015 at Songklanagarind Hospital, a tertiary care center in southern Thailand. The medical data of each participant were assessed using the NICE and ACOG criteria to identify maternal risk for PE. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio for detecting pregnancies complicated with PE according to each guideline were calculated. Receiver operating characteristic (ROC) curves were constructed to compare the predictive performance.

Results

Pre‐eclampsia was found in 167 cases (3.63%). The ACOG recommendations achieved ROC area 0.70 (58.1% sensitivity with 82.4% specificity) for PE at any gestation and ROC area 0.66 (62.9% sensitivity with 69.0% specificity) for PE which required delivery before 37 weeks' gestation. ROC areas based on the NICE guidelines were 0.64 (35.3% sensitivity with 92.5% specificity) and 0.59 (34.8% sensitivity with 83.4% specificity) for all PE and preterm PE, respectively. The ACOG criteria were significantly more accurate than the NICE criteria for detecting maternal risk for all PE, preterm PE and nulliparity cases (P values <0.05).

Conclusion

For Thai pregnant women, screening for PE with maternal risk factors according to the ACOG recommendations was more effective in identifying high‐risk pregnancies than the NICE guidelines.
Uterine compression sutures with additional hemostatic procedures for the management of postpartum hemorrhage
Authors: Kwong Lee Ting , So Po Lam , Wong Sai Fun
Published: August 2020

Aim

The aim of the study was to evaluate the efficacies and possible short‐term complications in women receiving uterine compression sutures only and those with additional hemostatic procedures for the management of postpartum hemorrhage.

Methods

It was a retrospective study carried out from year 2009 to 2019 at a tertiary obstetric hospital and included 79 women who underwent uterine compression sutures (B‐Lynch sutures, Hayman's sutures and Cho's sutures) for primary postpartum hemorrhage. Thirty‐six of these women had additional hemostatic procedures (uterine artery ligation or embolization) performed for bleeding control.

Results

Of the 43 women who were primarily treated with uterine compression sutures only, the success rate to preserve the uterus was 97.7% (42/43). In women with uterine compression sutures and additional hemostatic procedures performed, the success rate was 75% (27/36). Among these two groups of women without peripartum hysterectomy, there were no significant differences in the incidence of secondary postpartum hemorrhage (14.8% vs. 11.9%; P = 0.729), postoperative endometritis (14.8% vs. 14.3%; P > 0.99) and retained products of conception (3.7% vs. 9.5%; P = 0.641) during their 6‐week postpartum checkup. Three women were diagnosed to have hematometra. No pyometra or uterine necrosis was noted.

Conclusion

Uterine compression sutures with additional hemostatic procedures are effective to control postpartum hemorrhage and prevent hysterectomy. The short‐term complication rate is low. Long‐term monitoring is needed to identify rare but potentially dangerous complications.
Collusion Along the Learning Curve: Theory and Evidence From the Semiconductor Industry*
Authors: Asmat Danial
Published: August 2020

I study the effectiveness of collusion during an international cartel in DRAM, a type of semiconductor characterized by learning‐by‐doing and multiproduct competition. First, by exploiting time and firm‐level variation in cartel activity, I estimate that cartel participants cut output more on the oldest product generation than on newer generations. This is consistent with a hypothesis that higher learning rates in newer generations make defection from collusive equilibria more attractive. Second, I formulate a test for defection from collusive equilibria in learning‐by‐doing industries. Third, I formalize these results in a theoretical framework and discuss implications for antitrust policy in high technology markets.
Network Localization of Central Hypoventilation Syndrome in Lateral Medullary Infarction
Authors: Prabhakar Appaswamy , Sivadasan Ajith , Shaikh Atif , Aaron Sanjith , Benjamin Rohit , Mani Arun Mathai , Mathew Vivek
Published: August 2020

BACKGROUND AND PURPOSE

The brainstem plays a key role in the control of respiration. Strokes involving the lateral medulla can rarely produce a central hypoventilation syndrome (CHS) characterized by loss of automatic respiration called Ondine's curse. In this study, we investigated the neuroanatomical correlates of CHS in patients with lateral medullary infarction (LMI).

METHODS

Cases of CHS following LMI were identified from searching our medical records and literature. Voxel‐based lesion‐symptom mapping and lesion network‐symptom‐mapping (LNSM) analysis was performed to identify the regions connected to the lesion sites based on normative functional connectome data.

RESULTS

Sixteen patients with CHS and 32 controls were included. The ventro‐lateral region of the rostral medulla showed a significant association with CHS. LNSM analysis showed connections of this region to the rostral ventro‐lateral medulla and caudal pons.

CONCLUSIONS

In patients with LMI, disruption of the respiratory control network, at the level of ventro‐lateral region of the rostral medulla, could result in CHS.
Application of WeChat‐assisted peri‐operative care in children with congenital megacolon
Authors: Shen Yong , Fang YiFan , Wu DianMing , Bai JianXi , Lin Yu
Published: August 2020

Aim

This study explored the clinical effects of WeChat‐based peri‐operative care on parents of children with congenital megacolon.

Methods

Participants were randomly divided into WeChat group and telephone group. This study explored parents' knowledge of the care of children with megacolon, the follow‐up rate of children, post‐operative defaecation function and complications.

Results

WeChat group scored better in nursing knowledge than telephone group, and the difference was statistically significant. The lost follow‐up rate in WeChat group was lower than that in telephone group, and the difference was statistically significant. Post‐operative defaecation was also better in the WeChat group than in the phone group. Most complications in the phone group were significantly higher than those in the WeChat group.

Conclusion

Peri‐operative care for parents of children with megacolon through WeChat can effectively enhance the level of parental care knowledge, improve defaecation, reduce the occurrence of certain complications and reduce lost follow‐up.
Acceptability of the culturally adapted ASQ‐TRAK developmental screening tool to caregivers of Aboriginal children
Authors: Johansen Kimberly , Jeyaseelan Deepa , Chan Yee P , Simpson Samantha , O'Keefe Maree , D'Aprano Anita
Published: August 2020

Aim

The Ages and Stages Questionnaire‐Talking about Raising Aboriginal Kids (ASQ‐TRAK) culturally adapted developmental screening tool is widely used in Australian Aboriginal communities. However, there has been limited exploration of the tool's acceptability to caregivers. The aim of the study is to determine the acceptability of the ASQ‐TRAK developmental screening tool to caregivers of Aboriginal children in urban, regional and remote South Australia.

Methods

Caregivers of Aboriginal children completed a survey regarding acceptability of the ASQ‐TRAK. Convenience samples of caregivers were invited to a telephone interview.

Results

Ninety‐two caregivers completed the survey (96% response). Acceptability (92%) and caregiver satisfaction (73%) were high. Families perceived the screen as easy to use and understand, strengths‐based and providing valuable information about their child's development.

Conclusions

The ASQ‐TRAK tool was highly acceptable to caregivers in Aboriginal communities in South Australia. The study highlights the importance of culturally safe practice and supports ASQ‐TRAK implementation. Broader use and further evaluation of the ASQ‐TRAK in Aboriginal communities needs consideration.
Dental caries and associated factors among adolescents aged 12 to 15 in Jiangxi Province, China
Authors: Zeng Liwei , Peng Yijing , Xu Titi , Wen Jianqiong , Wan Li , Ou Xiaoyan , Zhou Xiaojun
Published: August 2020

Background

The purpose of this survey was to examine the association of general characteristics, oral health knowledge, attitudes, behavior, and dental caries status among adolescents in Jiangxi Province and to provide a basis for future prevention of dental caries among middle school students.

Methods

A total of 8,160 adolescents aged 12 to 15 years were invited to participate in this survey by a stratified random cluster sampling method from 30 schools in five counties in Jiangxi Province. A self‐administered questionnaire was used to understand their basic characteristics, including oral health behaviors, knowledge, and attitudes. Chi‐square tests were used to compare dental caries status and general characteristics. Univariate and multivariate logistic regression analyses were used to study the effects of oral health knowledge, attitudes, and behavior on dental caries.

Results

The prevalence of dental caries in permanent teeth was 25.8 percent, and the mean DMFT score of 12‐ to 15‐year‐old adolescents was 0.48 ± 1.04. The prevalence in rural areas was higher than that in urban areas (P < 0.001). The prevalence was higher in girls than in boys (P < 0.001). No significant age differences were observed (P > 0.05) in the prevalence of dental caries. The multivariate logistic regression analysis indicated that the variables associated with dental caries were tooth brushing frequency, use of toothpaste, frequency of sugary milk intake, smoking, and oral health attitudes.

Conclusions

This study revealed that adolescent oral health behaviors and attitudes were associated with dental caries. It is important to implement targeted oral disease prevention and control measures among adolescents.
9-PAN promotes tubulin- and ROS-mediated cell death in human triple-negative breast cancer cells
Authors: Verma Prachi , Nagireddy Praveen Kumar Reddy , Prassanawar Shweta Shyam , Nirmala Jesuthankaraj Grace , Gupta Ankita , Kantevari Srinivas , Lopus Manu
Published: August 2020

Objectives

To examine the antiproliferative effect of a rationally designed, novel noscapine analogue, 9-((perfluorophenyl)methylene) aminonoscapine, ‘9-PAN’) on MDA-MB-231 breast cancer cell line, and to elucidate the underlying mechanism of action.

Methods

The rationally designed Schiff base-containing compound, 9-PAN, was characterized using IR, NMR and mass spectra analysis. The effect of the compound on cell viability was studied using an MTT assay. Cell cycle and cell death analyses were performed using flow cytometry. Binding interactions of 9-PAN with tubulin were studied using spectrofluorometry. Reactive oxygen species (ROS) generation and mitochondrial membrane potential (MMP) were investigated using the probes, DCFDA and rhodamine-123, respectively. Immunofluorescence imaging was used to visualize cellular microtubules.

Key findings

9-PAN inhibited cell proliferation (IC50 of 20 ± 0.3 µm) and colony formation (IC50, 6.2 ± 0.3 µm) by arresting the cells at G2/M phase of the cell cycle. It bound to tubulin in a concentration-dependent manner without considerably altering the tertiary conformation of the protein or the polymer mass of the microtubules in vitro. The noscapinoid substantially damaged cellular microtubule network and induced cell death, facilitated by elevated levels of ROS.

Conclusions

9-PAN exerts its antiproliferative effect by targeting tubulin and elevating ROS level in the cells.
Pinoresinol-4-O-β-D-glucopyranoside: a lignan from prunes (Prunus domestica) attenuates oxidative stress, hyperglycaemia and hepatic toxicity in vitro and in vivo
Authors: Youssef Fadia S , Ashour Mohamed L , El-Beshbishy Hesham A , Ahmed Hamza Alaaeldin , Singab Abdel Nasser B , Wink Michael
Published: August 2020

Objectives

This study aimed to explore the pharmacological properties of pinoresinol-4-O-β-D-glucopyranoside (PG), isolated from prunes.

Methods

In-vitro antioxidant activity was assessed using ferric reducing antioxidant power (FRAP) and 2,2'-azino-bis [3-ethylbenzothiazoline-6-sulfonic acid]-diammonium salt (ABTS) assays. In-vivo hepatoprotective activity was evaluated using CCl4-induced hepatotoxicity mouse model. The antihyperglycaemic activity was determined in vitro using α-glucosidase and α-amylase inhibiting activity and in vivo using streptozotocin-treated model. Molecular modelling was done on α-amylase, α-glucosidase, aldose reductase and peroxisome proliferator-activated receptor gamma.

Key findings

Pinoresinol-4-O-β-D-glucopyranoside showed promising antioxidant activity in FRAP and ABTS assays with total antioxidant capacity equal 418.47 and 1091.3 µmol/g in terms of ascorbic acid, respectively. PG (50 mg/kg b.w.) exhibited a hepatoprotective activity in vivo as it lowered AST and ALT levels. PG showed a potent in-vitro antihyperglycaemic activity as it inhibited α-glucosidase with an IC50 value of 48.13 μg/ml. PG caused a prominent decline in serum glucose level by 37.83% in streptozotocin-treated mice with promising elevation in insulin level of 25.37%. Oxidative stress markers were reduced by PG, and it showed a high fitting on α-amylase and α-glucosidase active sites.

Conclusions

Pinoresinol-4-O-β-D-glucopyranoside is a natural entity combating oxidative stress, hepatic damage and diabetes.
Morus nigra L. leaves improve the meat quality in finishing pigs
Authors: Fan Lujie , Peng Ying , Wu Dan , Hu Jianhong , Shi Xin’E , Yang Gongshe , Li Xiao
Published: August 2020

This study was conducted to evaluate effects of dietary Mulberry leaves on growth performance, carcass traits and meat quality in finishing pigs. Here, a total of 72 crossbred [(Landrace × Yorkshire) × Duroc] pigs with an average initial body weight of 70.03 ± 0.48 kg were used in this 45‐day feeding trial. The pigs were randomly divided into three groups (6 pigs/pen and 4 replicates/group). Dietary treatments included a control diet (without any Mulberry leaves) and diets supplemented with 5% non‐ or fermented Mulberry leaf powder (MF or FMF respectively). The present findings indicated that compared with the control group, administration of MF or FMF significantly improved gain: feed ratio (p < .05) and reduced the backfat thickness (p < .05). Meanwhile, dietary MF and FMF significantly enhanced triglyceride deposition in Longissimus dorsi muscles (p < .05). Besides, both of MF and FMF could effectively improve the antioxidant capacity by increasing the content of T‐AOC and SOD in serum and reduce the rancidity of pork. In conclusion, supplementary MF and FMF could promote gain: feed ratio, reduce backfat thickness, increase fat deposition in muscle and reduce the rancidity of pork.
Comparing the Health Workforce Provider Mix and the Distance Travelled for Mental Health Services by Rural and Urban Medicare Beneficiaries
Authors: Andrilla C. Holly A. , Garberson Lisa A. , Patterson Davis G. , Quigley Tim F. , Larson Eric H.
Published: August 2020

Purpose

To describe the mix of health professionals who care for rural and urban seniors suffering from mood and/or anxiety disorders, the quantity of services they receive, and to understand where beneficiaries receive care for mood and/or anxiety disorders and the distance and time they travel for care.

Methods

We used 2014 Medicare administrative claims data to examine access to health care for fee‐for‐service Medicare beneficiaries aged ≥ 65 years who received outpatient services for mood and anxiety disorders. We classified providers into 9 categories: (1) family physicians/general practice, (2) internists, (3) nurse practitioners (NPs) and physician assistants (PAs), (4) psychiatrists, (5) psychologists, (6) clinical social workers, (7) emergency medicine physicians, (8) other physicians, and (9) other providers. We calculated the 1‐way driving distance and travel time between the beneficiary residence and provider location. We classified beneficiaries into 1 of 4 geographic categories based on their residence ZIP Code.

Findings

Urban beneficiaries had an average of 2.7 visits for mood and anxiety disorders, while rural beneficiaries had 2.4. Generalist physicians and NPs/PAs provided 50.8% of all visits. Urban beneficiaries saw more behavioral health specialists (34.3%) than rural beneficiaries (16.1%). NPs and PAs provided more than twice as much of the care for rural beneficiaries (14.8%) as for urban beneficiaries (6.4%). Rural beneficiaries travelled about twice as far as urban beneficiaries.

Conclusions

Rural and urban Medicare beneficiaries received care for mood/anxiety disorders from different mixes of health care providers, and ensuring access for rural populations will require innovative solutions.
Electrolyte measurements differ between point‐of‐care and reference analysers in dogs with hypoadrenocorticism
Authors: Fowlie S. , Spence S. , Roberts E. , Ramsey I. K.
Published: August 2020

Introduction

Dogs treated for hypoadrenocorticism are monitored through analysis of their blood electrolytes. This is routinely performed with point‐of‐care analysers and doses of medications are adjusted based on the results.

Objectives

To investigate the performance of two point‐of‐care analysers (IDEXX Catalyst Dx and IDEXX VetStat) against a reference laboratory method for the measurement of blood sodium, potassium and chloride concentrations, as well as sodium: potassium ratios, in dogs diagnosed with and treated for hypoadrenocorticism.

Methods

Forty‐eight dogs were enrolled into a prospective cross‐sectional study. Paired blood samples were taken and tested on two point‐of‐care analysers and at a reference laboratory. Statistical analysis was then performed with Bland‐Altman analysis and Passing‐Bablok regression. The clinical effects of inaccurate electrolyte analysis were investigated.

Results

In total, 329 samples were tested on the Catalyst analyser, while another 72 samples were tested on the VetStat. Passing‐Bablok regression identified both proportional and constant bias for some analytes. There was poor agreement between sodium and chloride concentrations on both analysers. Both analysers tended to give higher results than the reference method for all analytes, except for potassium when measured on the VetStat.

Clinical Significance

There are inherent differences between the electrolyte concentrations measured by these two point‐of‐care analysers and reference laboratory methods in dogs with hypoadrenocorticism.
Unhealthy lifestyle habits and physical inactivity among Asian patients with non‐alcoholic fatty liver disease
Authors: Zhang Xinrong , Goh George B.‐B. , Chan Wah‐Kheong , Wong Grace L.‐H. , Fan Jian‐Gao , Seto Wai‐Kay , Huang Yi‐Hsiang , Lin Han‐Chieh , Lee I‐Cheng , Lee Hye Won , Kim Seung Up , Chow Wan Cheng , Wong Vincent W.‐S.
Published: August 2020

Background & Aims

Lifestyle modification is the cornerstone for the management of non‐alcoholic fatty liver disease (NAFLD). We aim to understand lifestyle habits of NAFLD patients, compare across Asian regions and identify area of deficiency.

Methods

In the multi‐centre controlled attenuation parameter (CAP)‐Asia study, we collected clinical data and lifestyle habit data of NAFLD patients from Singapore, mainland China, Hong Kong, Taiwan and Malaysia. Physical activity was assessed using the International Physical Activity Questionnaire.

Results

A total of 555 patients were included in the final analysis (mean age 54.5 ± 11.2 years, 54.1% men and median liver stiffness 6.7 kPa). More patients from mainland China (27.4%) and Taipei (25.0%) were smokers. Modest drinking was more common in Taiwan (25.0%) and Hong Kong (18.2%); only 1.3% had binge drinking. Majority of patients drank coffee (64.0%) and tea (80.2%), with varying amounts and durations in different regions. Soft drinks consumption was most common in Singapore (62.2%) and Malaysia (57.7%). Only 29.7% of patients met the Physical Activity Guidelines Recommendations, with no major differences across regions. Patients with liver stiffness <10 kPa were more likely to report any vigorous activity, and sitting time was an independent factor associated with high CAP. Tea and coffee consumption were independently associated with high CAP and liver stiffness, respectively.

Conclusions

Despite some heterogeneity, unhealthy lifestyle and physical inactivity are common across Asian regions. Patients with liver stiffness <10 kPa were more likely to report any vigorous activity. Healthcare providers may use the comparative data to identify areas of deficiency.
The transmission of unconventional monetary policy to bank credit supply: Evidence from the TLTRO
Authors: Afonso António , Sousa‐Leite Joana
Published: August 2020

We assess the transmission of the Targeted Longer‐Term Refinancing Operations (TLTRO) to the bank credit supply for the Euro area (2014–2017) and for Portugal (2011:02–2018:01), using a panel data setup. In order to estimate a causal effect, we construct an instrumental variable (IV) using the maximum borrowing allowance in the TLTRO. For the Euro area, we find a positive impact of the TLTRO on the amount of credit granted to the real economy, in particular in the less vulnerable countries. For Portugal, using a difference‐in‐differences model, we find that bidding banks set lower interest rates in relation to non‐bidding banks and the difference seems to be larger in 2016 and 2017.
Divergence, gene flow, and the origin of leapfrog geographic distributions: The history of colour pattern variation in Phyllobates poison‐dart frogs
Authors: Márquez Roberto , Linderoth Tyler P. , Mejía‐Vargas Daniel , Nielsen Rasmus , Amézquita Adolfo , Kronforst Marcus R.
Published: August 2020

The geographic distribution of phenotypic variation among closely related populations is a valuable source of information about the evolutionary processes that generate and maintain biodiversity. Leapfrog distributions, in which phenotypically similar populations are disjunctly distributed and separated by one or more phenotypically distinct populations, represent geographic replicates for the existence of a phenotype, and are therefore especially informative. These geographic patterns have mostly been studied from phylogenetic perspectives to understand how common ancestry and divergent evolution drive their formation. Other processes, such as gene flow between populations, have not received as much attention. Here, we investigate the roles of divergence and gene flow between populations in the origin and maintenance of a leapfrog distribution in Phyllobates poison frogs. We found evidence for high levels of gene flow between neighbouring populations but not over long distances, indicating that gene flow between populations exhibiting the central phenotype may have a homogenizing effect that maintains their similarity, and that introgression between ‘leapfroging’ taxa has not played a prominent role as a driver of phenotypic diversity in Phyllobates. Although phylogenetic analyses suggest that the leapfrog distribution was formed through independent evolution of the peripheral (i.e. leapfrogging) populations, the elevated levels of gene flow between geographically close populations poise alternative scenarios, such as the history of phenotypic change becoming decoupled from genome‐averaged patterns of divergence, which we cannot rule out. These results highlight the importance of incorporating gene flow between populations into the study of geographic variation in phenotypes, both as a driver of phenotypic diversity and as a confounding factor of phylogeographic inferences.
Signatures of selection in a recent invasion reveal adaptive divergence in a highly vagile invasive species
Authors: Stuart Katarina C. , Cardilini Adam P. A. , Cassey Phillip , Richardson Mark F. , Sherwin William B. , Rollins Lee A. , Sherman Craig D. H.
Published: August 2020

A detailed understanding of population genetics in invasive populations helps us to identify drivers of successful alien introductions. Here, we investigate putative signals of selection in Australian populations of invasive common starlings, Sturnus vulgaris, and seek to understand how these have been influenced by introduction history. We used reduced representation sequencing to determine population structure, and identify Single Nucleotide Polymorphisms (SNPs) that are putatively under selection. We found that since their introduction into Australia, starling populations have become genetically differentiated despite the potential for high levels of dispersal, and that starlings have responded to selective pressures imposed by a wide range of environmental conditions across their geographic range. Isolation by distance appears to have played a strong role in determining genetic substructure across the starling's Australian range. Analyses of candidate SNPs that are putatively under selection indicated that aridity, precipitation and temperature may be important factors driving adaptive variation across the starling's invasive range in Australia. However, we also noted that the historic introduction regime may leave footprints on sites flagged as being under adaptive selection, and encourage critical interpretation of selection analyses in non‐native populations.
Wolbachia modulates prevalence and viral load of Culex pipiens densoviruses in natural populations
Authors: Altinli Mine , Lequime Sebastian , Atyame Celestine , Justy Fabienne , Weill Mylene , Sicard Mathieu
Published: August 2020

The inadequacy of standard mosquito control strategies calls for ecologically safe novel approaches, for example the use of biological agents such as the endosymbiotic α‐proteobacteria Wolbachia or insect‐specific viruses (ISVs). Understanding the ecological interactions between these “biocontrol endosymbionts” is thus a fundamental step. Wolbachia are transmitted vertically from mother to offspring and modify their hosts’ phenotypes, including reproduction (e.g., cytoplasmic incompatibility) and survival (e.g., viral interference). In nature, Culex pipiens (sensu lato) mosquitoes are always found infected with genetically diverse Wolbachia called wPip that belong to five phylogenetic groups. In recent years, ISVs have also been discovered in these mosquito species, although their interactions with Wolbachia in nature are unknown. Here, we studied the interactions between a widely prevalent ISV, the Culex pipiens densovirus (CpDV, Densovirinae), and Wolbachia in northern Tunisian C. pipiens populations. We showed an influence of different Wolbachia groups on CpDV prevalence and a general positive correlation between Wolbachia and CpDV loads. By investigating the putative relationship between CpDV diversification and wPip groups in the different sites, we detected a signal linked to wPip groups in CpDV phylogeny in sites where all larvae were infected by the same wPip group. However, no such signal was detected where the wPip groups coexisted, suggesting CpDV horizontal transfer between hosts. Overall, our results provide good evidence for an ecological influence of Wolbachia on an ISV, CpDV, in natural populations and highlight the importance of integrating Wolbachia in our understanding of ISV ecology in nature.
Resident impression management within feedback conversations: A qualitative study
Authors: Huffman Brandon M. , Hafferty Frederic W. , Bhagra Anjali , Leasure Emily L. , Santivasi Wil L. , Sawatsky Adam P.
Published: August 2020

Introduction

Medical education is moving to conceptualise feedback as a bidirectional learning conversation. Within this conversation, learners experience a tension between assessment and feedback. That perceived tension affects learners’ outward performances. In this study, we aimed to characterise residents’ experiences with this tension and its effect on learner authenticity within feedback conversations.

Methods

In this constructivist grounded theory study, the authors were informed by Goffman's theory of impression management. During data analysis, Dweck's theory of mindset was adopted. The authors conducted semi‐structured interviews with 15 internal medicine residents. Data collection and analysis were conducted iteratively, using constant comparison to identify themes coinciding with impression management and mindset, ultimately developing a theoretical model to help explain residents’ responses to tensions within feedback conversations.

Results

Residents constantly felt ‘scrutinized’, and this affected their engagement in feedback conversations. They staged a performance within those conversations, linked to their underlying mindset: growth or fixed. Growth mindset was characterised by a focus on development as a physician and was associated with asking questions and seeking opportunities for growth. Fixed mindset was characterised by a focus on achieving a favourable evaluation and was associated with a hesitation to ask questions when faced with uncertainty and admit opportunities for growth, because they were concerned about impression management. Context influenced mindset and impression management. Residents adopted a fixed mindset and managed impressions when they perceived the permanence or consequences of evaluations within feedback. Residents adopted a growth mindset when they trusted the supervisor.

Discussion

Residents assess the context of feedback conversations, altering the authenticity of their behaviours. Context, including the perceptions of formal assessment and relationships with supervisors, affected residents’ mindset and impression management. Providing space for relationship‐building and clarifying the purpose and structure of assessment may be helpful in supporting effective learning conversations in graduate medical education.
High HMGA2 expression without gene rearrangement in meningiomas
Authors: Nagaishi Masaya , Nakae Ryuta , Matsumoto Yoshiyuki , Fujii Yoshiko , Sugiura Yoshiki , Takigawa Tomoji , Suzuki Kensuke
Published: August 2020

High mobility group AT‐hook 2 (HMGA2) is a non‐histone transcriptional regulator protein. Aberrant expression of the HMGA2 gene (HMGA2) and structural rearrangement at the chromosomal region 12q14 with HMGA2 involvement have been reported in several mesenchymal tumors. We analyzed truncated and full‐length HMGA2 expression in 55 cases of meningioma, the most common brain tumor of mesenchymal origin. Fluorescence in situ hybridization and 3′‐rapid amplification of cDNA ends were used to investigate the possibility of gene rearrangements. Moreover, the relationship between HMGA2 expression and clinicopathological features was assessed. Compared with normal brain tissues, 95% of the meningioma tissues exhibited increased HMGA2 expression. In 14 cases, the expression of truncated HMGA2 was more than two‐fold higher than that of paired full‐length HMGA2. Chromosomal translocation involving the chromosomal region 12q14 was undetectable. No significant correlation was found between the Ki‐67 labeling index and HMGA2 expression and between the HMGA2 expression and the clinicopathological features. The majority of the meningioma cases displayed increased HMGA2 expression, which was not attributed to the chromosomal rearrangement at the corresponding region. Similar to that in the other mesenchymal tumors, increased HMGA2 expression was not associated with tumor cell proliferation in meningiomas.
The use of impedance planimetry (Endoscopic Functional Lumen Imaging Probe, EndoFLIP®) in the gastrointestinal tract: A systematic review
Authors: Desprez Charlotte , Roman Sabine , Leroi Anne Marie , Gourcerol Guillaume
Published: August 2020

Background and purpose

The EndoFLIP® system is a method of delineating impedance and was first designed to investigate the characteristics of the esophago‐gastric junction. In the last decade, its use was widened to investigate other sphincteric and non‐sphincteric systems of the gastrointestinal tract. The objective of the present systematic review was to summarize the available data in literature on the use of the EndoFLIP® system in the gastrointestinal tract, including sphincteric and non‐sphincteric regions. We performed a systematic review in accordance with recommendations for systematic review using PRISMA guidelines without date restriction, until June 2020, using MEDLINE‐PubMed, Cochrane Library, and Google Scholar databases. Only articles written in English were included in the present review. Five hundred and six unique citations were identified from all database combined. Of those, 95 met the inclusion criteria. There was a lack of standardization among studies in terms of anesthetic drugs use, probe placement, and inflation protocol. In most cases, only small cohorts of patients were included. Most studies investigated the EGJ, with a potential use of the EndoFLIP® to identify a subgroup of patients with achalasia and for intraoperative assessment of treatment efficacy in achalasia. However, the use of EndoFLIP® in the esophageal body (esophageal panometry), other esophageal diseases (gastro‐esophageal reflux disease, eosinophilic esophagitis), and other sphincter regions (anal canal, pylorus) will need further confirmatory studies. The EndoFLIP® system provides detailed geometric data of the gastrointestinal lumen but further works are needed to determine its use in clinical practice.
Inflorescence preformation prior to winter: a surprisingly widespread strategy that drives phenology of temperate perennial herbs
Authors: Schnablová Renáta , Huang Lin , Klimešová Jitka , Šmarda Petr , Herben Tomáš
Published: August 2020

Organ preformation in overwintering buds of perennial plants has been known for almost two centuries. It is hypothesized to underlie fast growth and early flowering, but its frequency, phylogenetic distribution, and ecological relevance have never been systematically examined.

We microscopically observed inflorescence preformation in overwintering buds (IPB) in the autumn. We studied a phylogenetically and ecologically representative set of 330 species of temperate perennial angiosperms and linked these observations with quantitative data on species’ flowering phenology, genome size, and ecology.

IPB was observed in 34% of species examined (in 14% species the stamens and/or pistils were already developed). IPB is fairly phylogenetically conserved and frequent in many genera (Alchemilla, Carex, Euphorbia, Geranium, Primula, Pulmonaria) or families (Ranunculaceae, Euphorbiaceae, Violaceae, Boraginaceae). It was found in species of any genome size, although it was almost universal in those with large genomes. Compared with non‐IPB species, IPB species flowered 38 d earlier on average and were more common in shaded and undisturbed habitats.

IPB is a surprisingly widespread adaptation for early growth in predictable (undisturbed) conditions. It contributes to temporal niche differentiation and has important consequences for understanding plant phenology, genome size evolution, and phylogenetic structure of plant communities.