bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the first announced state of emergency owing to coronavirus disease 2019 on stress and blood pressure levels among patients with type 2 diabetes mellitus in Japan
Authors: Ito Shun , Kobayashi Kazuo , Chin Keiichi , Umezawa Shinichi , Yamamoto Hareaki , Nakano Shiro , Takada Nobukazu , Hatori Nobuo , Tamura Kouichi
Published: April 2022

Aims/Introduction

After the first coronavirus disease 2019 state of emergency announcement, there was an increase in stress that might have affected the self‐management of patients with type 2 diabetes mellitus. This study identified the changes in clinical findings and stress among patients with type 2 diabetes mellitus, and investigated the characteristics of patients who experienced an increase in blood pressure (BP) after the announcement.

Materials and Methods

Retrospectively, we scrutinized 310 patients with type 2 diabetes mellitus who were treated by the Sagamihara Physicians Association. After the announcement, 164 and 146 patients showed an increase (ΔBP >0 group) and decrease in BP (ΔBP ≤0 group), respectively. The propensity score matching method was used to compare the differences in clinical findings and stress‐related questionnaire responses between the two groups.

Results

After the announcement, 47% of patients experienced an increase in daily stress. Furthermore, 17% and 36% reported worsening dietary intake and a decrease in exercise, respectively. More patients reported that their dietary and salt intake had worsened in the ΔBP >0 group than in the ΔBP ≤0 group (9% vs 20%, P = 0.02, and 3% vs 10%, P = 0.04, respectively). Additionally, both systolic and diastolic BP measured in the office were significantly increased (P = 0.02 and P = 0.03, respectively); however, systolic BP measured at home significantly decreased (P = 0.01). The total stress scores were higher in the ΔBP >0 group than in the ΔBP ≤0 group (0.05 ± 2.61 and 0.93 ± 2.70, respectively, P = 0.03).

Conclusions

An increase in stress and, particularly, worsening dietary and salt intake were noted among patients with type 2 diabetes mellitus who experienced an increase in BP after the state of emergency announcement.
Sex‐specific markers undetected in green sunfish Lepomis cyanellus using restriction‐site associated DNA sequencing
Authors: Teal Chad N. , Coykendall D. Katharine , Campbell Matthew R. , Eardley Daniel L. , Delomas Thomas A. , Shira James T. , Schill Daniel J. , Bonar Scott A. , Culver Melanie
Published: April 2022

We used restriction‐site associated DNA sequencing for SNP discovery and genotyping of known‐sex green sunfish Lepomis cyanellus DNA samples to search for sex‐diagnostic single nucleotide polymorphisms (SNPs) and restriction‐site associated sequences present in one sex and absent in the other. The bioinformatic analyses discovered candidate SNPs and sex‐specific restriction‐site associated sequences that fit patterns of male or female heterogametic sex determination systems. However, when primers were developed and tested, no candidates reliably identified phenotypic sex. The top performing SNP candidate (ZW_218) correlated with phenotypic sex 63.0% of the time and the presence‐absence loci universally amplified in both sexes. We recommend further investigations that interrogate a larger fraction of the L. cyanellus genome. Additionally, studies on the effect of temperature and rearing density on sex determination, as well as breeding of sex‐reversed individuals, could provide more insights into the sex determination system of L. cyanellus.
Pirfenidone prevents esophageal stricture by inhibiting nucleotide binding oligomerization domain like receptor protein 3 inflammasome activation
Authors: Hirano Shinji , Higashimori Akira , Nagami Yasuaki , Nadatani Yuji , Tanigawa Tetsuya , Ominami Masaki , Fukunaga Shusei , Otani Koji , Hosomi Shuhei , Tanaka Fumio , Kamata Noriko , Taira Koichi , Watanabe Toshio , Fujiwara Yasuhiro
Published: April 2022

Background and Aim

Esophageal injury often results in a scar, leading to refractory strictures. The NLRP3 inflammasome activates caspase‐1, causing the maturation of interleukin (IL)‐1β. Here, we aimed to investigate the preventive effect of pirfenidone (PFD), an antifibrotic drug, on esophageal stricture after ulcer healing and studied its mechanism by focusing on the activation of the NLRP3 inflammasome.

Methods

Esophageal ulcers were induced in rats via the local application of acetic acid in the serosa. PFD was intraperitoneally administered to the rats 3 days after ulcer induction. The effect of PFD on esophageal stricture after ulcer healing was assessed by esophagography on day 9. The protein levels of mature caspase‐1 and IL‐1β were assessed by western blotting.

Results

The ulcers fully developed 3 days after induction and were almost scarred by day 9 with severe strictures. PFD promoted ulcer healing and attenuated fibrotic collagen in the submucosa by suppressing the increase in NLRP3, cleaved caspase‐1, and mature IL‐1β expression, improving stricture rate (PFD vs vehicle = 55% vs 81%). Exogenous IL‐1β abolished the therapeutic effects of PFD on ulcer healing and stricture formation. Furthermore, NLRP3 and caspase‐1 inhibitors mimicked the effects of PFD on ulcer healing and stricture formation, with suppression of the increase in cleaved caspase‐1 and mature IL‐1β proteins and expression of fibrosis‐related molecules including transforming growth factor (TGF)‐β1.

Conclusion

The NLRP3 inflammasome promotes esophageal stricture formation following ulcer healing, and PFD exerts potential prophylactic activity against strictures, possibly via the inhibition of the NLRP3/IL‐1β/TGF‐β1 axis.
Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States
Authors: Kotronia Eftychia , Brown Heather , Papacosta Olia , Lennon Lucy T. , Weyant Robert J. , Whincup Peter H. , Wannamethee Sasiwarang Goya , Ramsay Sheena E.
Published: April 2022

Background

Preventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults.

Methods

We used prospective data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) study (USA) (N = 3075, 71–80 years). Oral health measures included tooth loss, periodontal disease, self‐rated oral health, and self‐reported dry mouth. Participants were followed for onset of disability over a follow‐up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability.

Results

In the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self‐report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27–3.42; OR = 1.73, 95% CI 1.03–2.90). Fair/poor self‐rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13–3.06), and fair/poor self‐rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04–1.94).

Conclusions

Oral health problems in older adults, particularly tooth loss, self‐reported dry mouth and self‐rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.
Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: a systematic review and meta‐analysis of randomised clinical trials
Authors: Builes‐Montaño Carlos E. , Ortiz‐Cano Natalia A. , Ramirez‐Rincón Alex , Rojas‐Henao Natalia A.
Published: April 2022

Background and aims

Diabetes mellitus (DM) is one of the most prevalent chronic noncommunicable diseases globally, and the only way to reduce its complications is good glycaemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal‐related insulin doses as it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. The primary objective of this systematic review was to assess carbohydrate counting efficacy in reducing glycated haemoglobin (HbA1c) levels and safety by not increasing hypoglycaemia risk, inducing an increase in body weight or blood lipids, or reducing the quality of life of people with T1DM.

Methods

We included randomised controlled clinical trials with a parallel‐group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least 3 months and with no restrictions in language, age or settings. As a primary outcome, we consider the change of HbA1c levels within at least 3 months. Secondary outcomes were hypoglycaemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health‐related quality‐of‐life changes and questionnaires on satisfaction with treatment of diabetes.

Results

Data from 11 studies with 899 patients were retrieved with a mean follow‐up of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1clevels (SMD‐0.24%, 95% CI −0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful reduction in HbA1c levels (SMD‐0.52%, 95% CI −0.82 to −0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c levels compared with usual diabetes education. Carbohydrate counting does not relate to any substantial change in blood lipids, body weight, hypoglycaemia risk or daily insulin dose. Finally, we analysed the effect of trial duration on reduction in HbA1c levels and found no significant change related to time.

Conclusions

Carbohydrate counting is an efficacious technique to safely reduce the levels of HbA1c in adults and children compared with standard diabetes education, and its effect does not appear to change with prolonged time. Standardisation in reporting important outcomes such as hypoglycaemia and quality of life are vital to produce comparable evidence in carbohydrate counting clinical trials. This systematic review was registered in PROSPERO under code: CRD42020218499.
How is hydration assessed and managed in acute stroke? A qualitative study of healthcare staff’s knowledge, attitudes and experiences
Authors: Miller Colette , Gibson Josephine M. E. , Jones Stephanie , Timoroska Anne‐Marie , Maley Alex , Romagnoli Elisa , Chesworth Brigit M. , Watkins Caroline L.
Published: April 2022

Aims and objectives

To explore healthcare staff's experiences of how dehydration is identified and managed in hospitalised patients after acute stroke, and facilitators and challenges to optimising hydration.

Background

Optimal hydration post‐stroke reduces the risk of neurological deterioration and other complications. Patients are at risk of dehydration in acute stroke, particularly those with dysphagia.

Design

A descriptive qualitative study reported following the COREQ guidelines.

Methods

Semi‐structured interviews, utilising patient vignettes, were conducted in 2018 (Apr–Oct) with a purposive sample of 30 multidisciplinary staff members from two UK stroke units. Interviews were digitally recorded and transcribed verbatim. Content analysis identified common themes which were mapped to the Theoretical Domains Framework and the Behaviour Change Wheel.

Results

The themes were mapped to twelve of the fourteen domains in the Theoretical Domains Framework. Participants believed that inadequate hydration management had potentially serious consequences, and described complex knowledge, skills and cognitive elements to effective hydration care. Participants felt that maintaining hydration was a multidisciplinary responsibility requiring good communication. Although the performance of initial dysphagia screening was reinforced by external audit, other areas of post‐stroke hydration management were not; notably, there was no established method of assessing hydration. Barriers to maintaining good hydration included lack of staff, out‐of‐hours working patterns, low priority given to hydration, patients’ comorbidities and complex post‐stroke disabilities such as dysphagia, aphasia, inattention and hemiparesis.

Conclusion

Findings highlighted the importance of assessing and maintaining hydration but identified barriers to, and variation in, clinical practice. To provide optimal care, barriers to the prevention and treatment of dehydration after stroke must be further understood and addressed.

Relevance to clinical practice

Multidisciplinary teamwork is important in hydration care after stroke, but clarity is required about the specific contributions of each team member. Without this, hydration care becomes ‘everybody's and nobody's job’.
Melatonin prevents experimental central serous chorioretinopathy in rats
Authors: Yu Shanshan , Cui Kaixuan , Wu Peiqi , Wu Benjuan , Lu Xi , Huang Rong , Tang Xiaoyu , Lin Jianqiang , Yang Boyu , Zhao Jinfeng , He Qingjing , Liang Xiaoling , Xu Yue
Published: April 2022

Central serous chorioretinopathy (CSC) is a vision‐threatening disease with no validated treatment and unclear pathogenesis. It is characterized by dilation and leakage of choroidal vasculature, resulting in the accumulation of subretinal fluid, and serous detachment of the neurosensory retina. Numerous studies have demonstrated that melatonin had multiple protective effects against endothelial dysfunction, vascular inflammation, and blood–retinal barrier (BRB) breakdown. However, the effect of melatonin on CSC, and its exact pathogenesis, is not well understood thus far. In this study, an experimental model was established by intravitreal injection of aldosterone in rats, which mimicked the features of CSC. Our results found that melatonin administration in advance significantly inhibited aldosterone‐induced choroidal thickening and vasodilation by reducing the expression of calcium‐activated potassium channel KCa2.3, and attenuated tortuosity of choroid vessels. Moreover, melatonin protected the BRB integrity and prevented the decrease in tight junction protein (ZO‐1, occludin, and claudin‐1) levels in the rat model induced by aldosterone. Additionally, the data also showed that intraperitoneal injection of melatonin in advance inhibited aldosterone‐induced macrophage/microglia infiltration, and remarkably diminished the levels of inflammatory cytokines (interleukin‐6 [IL‐6], IL‐1β, and cyclooxygenase‐2), chemokines (chemokine C–C motif ligand 3, and C–X–C motif ligand 1), and matrix metalloproteinases (MMP‐2 and MMP‐9). Luzindole, as the nonselective MT1 and MT2 antagonist, and 4‐phenyl‐2‐propionamidotetraline, as the selective MT2 antagonist, neutralized the melatonin‐induced inhibition of choroidal thickening and choroidal vasodilation, indicating that melatonin might exert the effects via binding to its receptors. Furthermore, the IL‐17A/nuclear factor‐κB signaling pathway was activated by intravitreal administration of aldosterone, while it was suppressed in melatonin‐treated in advance rat eyes. This study indicates that melatonin could serve as a promising safe therapeutic strategy for CSC patients.
Mutational meltdown or controlled chain reaction: The dynamics of rapid plastome evolution in the hyperdiversity of Poaceae
Authors: Wang Jie , Fu Gao‐Fei , Tembrock Luke R. , Liao Xue‐Zhu , Ge Song , Wu Zhi‐Qiang
Published: April 2022

The study of genomic structural evolution associated with accelerated evolutionary rates that result in avoidance of meltdown and increase biodiversity is becoming ever more possible as the number of available plastomes increases. To more comprehensively analyze rate heterogeneity among monocots and within Poaceae, we sequenced plastomes from four Poaceae species, combined them with publicly available data from ~200 plastomes, and conducted comparative analyses to quantify the pattern of rate heterogeneity between different lineages, functional groups, and periods of evolutionary time. We compared structural differences across the Poaceae to quantify how changes in plastome size correspond to different genomic subunits and the evolution of IR–SC junction boundaries. The substitution rates among ancestral Poaceae were inferred to be exceptionally rapid compared to other monocots but slowed after divergence into extant lineages, which could not be sufficiently explained by positive selection. As such, rapid rates in the ancestral lineage leading to Poaceae might be more closely linked to large‐scale structural changes like the loss of ycf1 and ycf2. The total increase in plastome size across Poaceae was positively correlated with the total length of intergenic spacers, tandem repeats, and dispersed repeats as well as large single copy, and inverted repeats (IRs). The continuous evolution of IR–SC junction boundaries was asynchronous with sizes of total genome and subunits across Poaceae. Future work is needed to better understand what factors in ancestral Poaceae evolved to harness such rapid rates of plastome evolution, avoid a mutational meltdown, and escape the stagnation of strong purifying selection as well as if these factors could be utilized to synthetically control rates.
A comprehensive analysis of higher‐level phylogenetic relationships of Hemiptera based on transcriptome data
Authors: Song Nan , Zhang Heng
Published: April 2022

Hemiptera is the largest order of non‐holometabolous insects. Recent phylogenetic studies have contributed greatly to our understanding of the phylogeny of the group. However, parts of the hemipteran tree remain unclear. In this study, we have sequenced transcriptomes from five sternorrhynchan species, four exemplars from Aphididae, and one from Monophlebidae. The addition of published transcriptome data produced alignments of >105 000 amino acids from 224 hemipteran taxa in 30 superfamilies covering all suborder and infraorder clades. The data confirmed the Sternorrhyncha superfamily relationship of Aleyrodoidea + (Psylloidea + [Coccoidea + Aphidoidea]). In addition, phylogenomic analyses supported a basal split of Sternorrhyncha and the remaining hemipteran lineages. The Fulgoromorpha formed a sister clade to Cicadomorpha, with strong support. Therefore, our results supported the monophyly of Auchenorrhyncha. The Coleorrhyncha was robustly resolved as a sister group of Auchenorrhyncha, contrary to the concept of the Heteropterodea. Within Heteroptera, the Enicocephalomorpha, Dipsocoromorpha, and Gerromorpha were resolved as the earliest branching groups, while the Nepomorpha, Leptopodomorpha, Cimicomorpha, and Pentatomomorpha were the successive sister groups to the remaining clades in the series. The Cimicomorpha and Pentatomomorpha were sister groups that occupied the most apical branches of the heteropteran tree. Although some phylogenetic estimates yielded conflicting hypotheses for superfamily relationships of Cicadomorpha, Four‐cluster Likelihood Mapping (FcLM) analyses revealed a greater phylogenetic signal for the relationship of Membracoidea + (Cicadoidea + Cercopoidea).
Optimization by uniform design U8(83) approach for enhanced caffeine degradation in synthetic wastewater in bioreactor
Authors: Shanmugam M.K. , Gummadi S.N.
Published: April 2022

Coffee wastewater contains large amounts of caffeine which affects microflora and seed development to great extent. Although several physio-chemical methods available for caffeine degradation, they are not preferred for large-scale treatment. In this study, we optimized induced cell concentration, aeration and agitation rate for maximizing caffeine degradation rate in bioreactor using Uniform design. Maximum caffeine degradation rate of 23·59 mg L−1 h−1 was achieved. The reduction in chemical oxygen demand, biological oxygen demand and total organic carbon removal were found to be 72, 78 and 72% respectively. Mathematical model was developed through regression analysis and predicted maximum caffeine degradation rate of 24·2 mg L−1 h−1 under optimal conditions of 0·35 g L−1 biomass, 395 rev min−1 and 1·62 vvm. Experimental validation at optimum condition resulted in 22 mg L−1 h−1 of caffeine degradation rate. This is the first-ever bioreactor study showing highest caffeine degradation rate in synthetic coffee wastewater with limited experimental runs.
Dysfunctional presenteeism: Effects of physical and mental health on work performance
Authors: Bryan Mark L. , Bryce Andrew M. , Roberts Jennifer
Published: April 2022

Poor health in the workforce is costly to employers and the economy. This is partly due to health problems causing people to spend less time at work but is also due to people being less productive while at work. In this paper, we investigate the causes of dysfunctional presenteeism, defined as reduced productivity at work due to health problems. We find that both physical and mental health significantly predict the probability of dysfunctional presenteeism, and the effects of mental health problems seem to be worse than physical health. In comparison, changes to most other characteristics have little or no effect.
The generality and particularity of perception
Authors: Schellenberg Susanna
Published: April 2022

This paper responds to critical comments by Christopher Hill, Ram Neta, and Nico Orlandi on my book The Unity of Perception: Content, Consciousness, Evidence (OUP 2018). It addresses questions about why analyzing mental states in terms of capacities is more explanatory powerful than analyzing them in terms of processes. It further develops my view of functions and their relation to mental capacities. It clarifies the internalist commitments of my externalist view of content, consciousness, and evidence. The topics addressed include further the many‐properties problem, the relation between what is perceived and what is represented, as well as the evidential transparency principle.
Contributions of F‐specific subunits to the F plasmid‐encoded type IV secretion system and F pilus
Authors: Kishida Kouhei , Bosserman Rachel E. , Harb Laith , Khara Pratick , Song Liqiang , Hu Bo , Zeng Lanying , Christie Peter J.
Published: April 2022

F plasmids circulate widely among the Enterobacteriaceae through encoded type IV secretion systems (T4SSFs). Assembly of T4SSFs and associated F pili requires 10 VirB/VirD4‐like Tra subunits and eight or more F‐specific subunits. Recently, we presented evidence using in situ cryoelectron tomography (cryoET) that T4SSFs undergo structural transitions when activated for pilus production, and that assembled pili are deposited onto alternative basal platforms at the cell surface. Here, we deleted eight conserved F‐specific genes from the MOBF12C plasmid pED208 and quantitated effects on plasmid transfer, pilus production by fluorescence microscopy, and elaboration of T4SSF structures by in situ cryoET. Mutant phenotypes supported the assignment of F‐specific subunits into three functional Classes: (i) TraF, TraH, and TraW are required for all T4SSF‐associated activities, (ii) TraU, TraN, and TrbC are nonessential but contribute significantly to distinct T4SSF functions, and (iii) TrbB is essential for F pilus production but not for plasmid transfer. Equivalent mutations in a phylogenetically distantly related MOB12A F plasmid conferred similar phenotypes and generally supported these Class assignments. We present a new structure‐driven model in which F‐specific subunits contribute to distinct steps of T4SSF assembly or activation to regulate DNA transfer and F pilus dynamics and deposition onto alternative platforms.
Honesty Among Lawyers: Moral Character, Game Framing, and Honest Disclosures in Negotiations
Authors: Cohen Taya R. , Helzer Erik G. , Creo Robert A.
Published: April 2022

Lawyers have broad discretion in deciding how honestly to behave when negotiating. We propose that lawyers’ choices about whether to disclose information to correct misimpressions by opposing counsel are guided by their moral character and their cognitive framing of negotiation. To investigate this possibility, we surveyed 215 lawyers from across the United States, examining the degree to which honest disclosure is associated with lawyers’ moral character and their tendency to frame negotiation in game‐like terms—a construal of negotiation that we label game framing. We hypothesize that the more that lawyers view negotiation through a game frame—that is, the more they view negotiation as an adversarial context with arbitrary and artificial rules—the less honest they will be in situations in which honest disclosure is not mandated by professional rules of conduct. We further hypothesize that lawyers with higher levels of moral character will apply a game frame to negotiation to a lesser degree than will lawyers with lower levels of moral character, and that honesty when negotiating will be higher when lawyers have higher versus lower levels of moral character. Our study results support these hypotheses. This work suggests that focusing on game‐like aspects of negotiation can induce a less moral and ethical mindset. To the extent that teaching law students to “think like a lawyer” encourages them to adopt a game frame of negotiation, we can expect such training to reduce the likelihood of honest disclosure.
The landscape of fear has individual layers: an experimental test of among‐individual differences in perceived predation risk during foraging
Authors: Dammhahn Melanie , Lange Pauline , Eccard Jana A.
Published: April 2022

Perceived predation risk varies in space and time creating a landscape of fear. This key feature of an animal's environment is classically studied as a species‐specific property. However, individuals differ in how they solve the tradeoff between safety and reward and may, hence, differ consistently and predictively in perceived predation risk across landscapes. To test this hypothesis, we quantified among‐individual differences in boldness and activity and exposed behaviourally phenotyped male bank voles Myodes glareolus individually to two different experimental landscapes of risks in large outdoor enclosures and provided resources as discrete food patches. We manipulated perceived predation risk via vegetation height between 2 and > 30 cm and quantified patch use indirectly via RFID‐logging and giving‐up densities. We statistically disentangled among‐individual differences in microhabitat use from spatially varying perceived risk, i.e. landscape of fear. We found that individuals varied in mean vegetation height of their foraging microhabitats and that this microhabitat selection matched the intrinsic individual differences in perceived risk. As predicted by the patch use model, all individual's perceived higher risks when foraging in lower vegetation. However, individuals differed in their reaction norm slopes of perceived risk to vegetation height, and these differences in slopes were consistent across two different landscapes of risks and resources. We interpret these results as evidence for individual landscapes of fear, which could be predicted by among‐individual differences in activity and boldness. Since perceived predation risk affects when and where to forage, among‐individual differences in fear responses could act as a mode of intraspecific niche complementarity (i.e. individual niche specialization), help explain behavioural type by environment correlations, and will likely have cascading indirect effects on lower trophic levels.
Core Decompression Prevents Progression of Asymptomatic Type C Osteonecrosis of Femoral Head According to the Japanese Investigation Committee Classification: A Retrospective Study
Authors: Wang Qiu‐ru , An Jing‐jing , Zhang Wan‐li , Yang Zhou‐yuan , Zhao Xin , Kang Peng‐de
Published: April 2022

Objective

To evaluate whether core decompression could prevent progression of asymptomatic type C osteonecrosis of the femoral head (ONFH) according to the Japanese Investigation Committee (JIC) classification.

Methods

This retrospective cohort study included 124 hips (117 patients) with asymptomatic type C ONFH. Seventy‐one hips (67 patients) received core decompression (core decompression group) and 53 hips (50 patients) received no surgical treatment (control group). Clinical and radiological follow‐up was conducted at 6 and 12 months, then annually until 5 years. Clinical outcomes were evaluated in terms of the Oxford hip score and UCLA Activity Level rating. Radiological outcomes were evaluated using X‐ray and magnetic resonance imaging. Survival analysis was performed based on collapse of the femoral head as the first endpoint and total hip arthroplasty (THA) as the second endpoint.

Results

There were no significant differences in clinical outcomes between the core decompression group and the control group within 2 years after surgery. Patients in the core decompression group had significantly better Oxford hip score and UCLA Activity Level from year 3 to the end of follow‐up (P < 0.05). In year 5, the absolute difference in Oxford hip score (5.3 points) exceeded the reported minimal clinically important difference (MCID, 5.2 points). In years 3–5, the absolute difference in UCLA Activity Level rating (0.95 points, 0.95 points, and 0.99 points, respectively) exceeded the reported MCID (0.92 points). By 5‐year follow‐up, significantly fewer patients in the core decompression group had experienced femoral head collapse (40.8% vs 62.3%, P = 0.011) or received THA (26.8% vs 45.3%, p = 0.022).

Conclusions

Core decompression can prevent progression of asymptomatic type C ONFH according to the JIC classification, leading to better medium‐term hip function and activity levels than no surgical treatment. Core decompression is recommended for early intervention against asymptomatic type C ONFH.
Safety of dupilumab in a 5‐month‐old infant with severe atopic dermatitis
Authors: Havele Sonia A. , Khurana Michele C. , McMahon Patrick , Murthy Aditi S. , Perman Marissa J. , Treat James R.
Published: April 2022

Dupilumab is a fully humanized monoclonal antibody that suppresses Th2‐mediated inflammation by inhibiting signaling of interleukin‐4 and interleukin‐13 through the interleukin‐4 alpha receptor subunit, and is approved by the FDA for the treatment of moderate to severe atopic dermatitis (AD) in children 6 years of age and older. While initial data from phase 2 trials in children less than 6 years are promising, dupilumab use in children less than 6 months of age is not well studied. Here we present a case of a 5‐month‐old boy with severe primary AD, eosinophilia, hypogammaglobulinemia, and poor weight gain, who was successfully treated with dupilumab and experienced no serious adverse effects. To our knowledge, this is the youngest patient to receive dupilumab to date.
Full left/full right liver graft ex situ split during hypothermic oxygenated perfusion
Authors: Rossignol Guillaume , Muller Xavier , Mohkam Kayvan , Dubois Remi , Lesurtel Mickaël , Mabrut Jean‐Yves
Published: April 2022

Background

Ex vivo split liver transplantation in pediatric recipients has shown inferior results compared with whole grafts. One factor among others contributing to split grafts being considered as marginal is the prolonged static cold storage time related to ex vivo liver splitting. End ischemic hypothermic oxygenated perfusion is a validated strategy to improve outcomes of marginal whole grafts and may thus also benefit split liver grafts.

Method

We present the first case of full left/full right split procedure performed during hypothermic oxygenated perfusion.

Results

We present a standardized surgical two‐step approach where parenchymal transection was performed during end ischemic hypothermic oxygenated perfusion via the portal vein to shorten static cold storage duration. Both split grafts were successfully transplanted in a 4‐year‐old pediatric and a 38‐year‐old adult recipient. Despite high‐risk procedure (retransplantation), extended donor criteria including a prolonged cardiac arrest and high donor risk index (2,25), both grafts showed early recovery of hepatic function and low serum transaminase release. At 6 months, both recipients were alive with a normal liver biology and a functioning graft.

Conclusion

Although challenging, full left/full right liver split procedure during end ischemic hypothermic oxygenated perfusion can be successfully performed and is a promising strategy to improve post‐transplant outcomes.
Religious social capital and minority health: A concept analysis
Authors: Conley Cherie , Gonzalez‐Guarda Rosa , Randolph Schenita , Hardison‐Moody Annie , Fisher Edwin B. , Lipkus Isaac
Published: April 2022

Objective

Optimizing resources within environments where people live, work, and pray can aid nurses in improving public health. Religion and social capital significantly influence the health of individuals and communities, particularly among racial and ethnic minorities in the United States. A concept analysis of religious social capital was conducted to clarify how this resource is used in the context of health.

Design and Sample

Rodgers’ evolutionary concept analysis method guided this analysis. A search of PubMed, CINAHL, and PsycINFO, using keywords “religious social capital” and “health” yielded 152 publications.

Results

Antecedents were “defined religious social network,” “voluntary membership,” “shared values,” and “trust.” Attributes were “relationships (bonding bridging, and linking),” “information exchange and resource sharing,” and “reciprocal participation.” Consequences were “increased productivity,” “increased resources,” “better personal and community health,” and “trust.” A model case of African American women and HIV prevention was included to illustrate how religious social capital can be developed and optimized to promote health.

Conclusion

Religious social capital is defined as increased individual and collective capabilities that result from voluntary and reciprocal participation in bonding, bridging, or linking social network relationships and activities. Religious social capital is an accessible resource that can be leveraged to improve minority health.
Leishmania LiHyC protein is immunogenic and induces protection against visceral leishmaniasis
Authors: Machado Amanda S. , Lage Daniela P. , Vale Danniele L. , Freitas Camila S. , Linhares Flávia P. , Cardoso Jamille M. O. , Oliveira‐da‐Silva João A. , Pereira Isabela A. G. , Ramos Fernanda F. , Tavares Grasiele S. V. , Ludolf Fernanda , Bandeira Raquel S. , Maia Luiz G. N. , Menezes‐Souza Daniel , Duarte Mariana C. , Chávez‐Fumagalli Miguel A. , Roatt Bruno M. , Christodoulides Myron , Martins Vívian T. , Coelho Eduardo Antonio Ferraz
Published: April 2022

Treatment against visceral leishmaniasis (VL) presents problems by the toxicity of drugs, high cost and/or emergence of resistant strains. The diagnosis is hampered by variable sensitivity and/or specificity of tests. In this context, prophylactic vaccination could represent a control measure against disease. In this study, the protective efficacy of Leishmania LiHyC protein was evaluated in a murine model against Leishmania infantum infection. LiHyC was used as recombinant protein (rLiHyC) associated with saponin (rLiHyC/S) or Poloxamer 407‐based polymeric micelles (rLiHyC/M) to immunize mice. Animals received also saline, saponin or empty micelles as controls. The immunogenicity was evaluated before and after the challenge, and results showed that vaccination with rLiHyC/S or rLiHyC/M induced the production of high levels of interferon‐gamma (IFN‐γ), interleukin (IL)‐12 and granulocyte‐macrophage colony‐stimulating factor in cell culture supernatants, as well as higher IFN‐γ expression evaluated by RT‐qPCR and involvement from CD4+ and CD8+ T‐cell subtypes producing IFN‐γ, tumor necrosis factor‐α and IL‐2. A positive lymphoproliferative response was also found in cell cultures from vaccinated animals, besides high levels of rLiHyC‐ and parasite‐specific nitrite and IgG2a antibodies. Immunological assays correlated with significant reductions in the parasite load in the spleens, livers, bone marrows and draining lymph nodes from vaccinated mice, when compared to values found in the controls. The micellar composition showed slightly better immunological and parasitological data, as compared to rLiHyC/S. Results suggest that rLiHyC associated with adjuvants could be considered for future studies as a vaccine candidate against VL.
Severe maternal morbidity and other perinatal complications among women with physical, sensory, or intellectual and developmental disabilities
Authors: Horner‐Johnson Willi , Garg Bharti , Darney Blair G. , Biel Frances M. , Caughey Aaron B.
Published: April 2022

Background

Little is known about severe maternal morbidity (SMM) among women with disabilities.

Objective

We assessed differences in SMM and other perinatal complications by presence and type of disability. We hypothesised that SMM and other complications would be more common in births to women with disabilities than to women without disabilities.

Methods

We conducted a retrospective cohort study of California births from 2000 to 2012, using birth and death certificate data linked with hospital discharge data. We included singleton deliveries with gestational age of 23–42 weeks. We classified women as having any disability or not and identified disability type (physical, hearing, vision, intellectual/developmental disabilities [IDD]). Our primary outcome was a composite indicator of SMM. Secondary outcomes included additional perinatal complications: gestational hypertension, preeclampsia, gestational diabetes, venous thromboembolism, chorioamnionitis, puerperal endometritis and mental health disorders complicating pregnancy, childbirth or the puerperium. We used modified Poisson regression to obtain covariate‐adjusted relative risks (RR) and 95% confidence intervals (CI) for the association of disability status and type with SMM and secondary outcomes.

Results

Of 5,787,090 deliveries, 33,044 (0.6%) were to women with disabilities. Of these, 311 per 10,000 were complicated by SMM, compared with 84 per 10,000 deliveries to women without disabilities. In multivariable analyses, risk of SMM for births to women with disabilities was nearly three times that for women without disabilities (RR 2.84, 95% CI 2.67, 3.02). Proportion and risk of SMM were greatest for vision disability (793 per 10,000; RR 4.04, 95% CI 3.41, 4.78). Secondary outcomes were also more common among women with disabilities. In particular, more than a third of births to women with IDD (37.4%) were complicated by mental health disorders (versus 2.2% for women without disabilities).

Conclusion

As hypothesised, SMM and other perinatal complications were more common among women with disabilities than among women without disabilities.
Mineral supplementation (injectable) improved reproductive performance in Holstein cows managed in a warm summer environment
Authors: Del Río‐Avilés Andrea D. , Correa‐Calderón Abelardo , Avendaño‐Reyes Leonel , Macías‐Cruz Ulises , Thomas Milton G. , Enns R. Mark , Speidel Scott E. , Sánchez‐Castro Miguel A. , Zamorano‐Algandar Ricardo , López‐Castro Pedro A. , Luna‐Nevárez Pablo
Published: April 2022

Sustainability of dairy production depends largely on reproductive efficiency that is affected by heat stress due to high ambient temperature and humidity during summer. Supplementation of minerals has been proposed as a management strategy to minimize adverse impact of heat stress on fertility. The objective of this study was to determine the effects of an injectable mineral supplement (Fosfosan) containing selenium (Se), copper (Cu), potassium (K), magnesium (Mg) and phosphorus (P) on the ovarian structures, reproductive hormones and conception rate of heat‐stressed Holstein cows. Sixteen cows were assigned during summer to one of two treatments, a control group (CON; n = 8) and a mineral‐supplemented group (SUP; n = 8). Ambient temperature and relative humidity records were collected and processed to estimate the temperature–humidity index (THI), which confirmed a heat‐stressed environment during the study (avg. THI = 79.4). Cows were subjected to a fixed‐time artificial insemination (FTAI) program using the CIDR‐Synch synchronization protocol. Traits indicative of ovarian activity were recorded during and after this protocol, as well as serum concentrations of reproductive hormones. Pregnancy diagnosis was made 28 and 35 d after FTAI. A completely randomized block design with repeated measures over time was performed to study ovarian functional structures and its hormonal profiles. Correlations and regressions were estimated to study relationships between ovarian structures and related hormones. Mineral supplementation did not increase follicular diameter or follicular populations (p > .05), yet tended to increase corpus luteum diameter (p < .10), and it enhanced (p < .01) oestrogen and progesterone serum concentrations and improved (p < .05) cow's conception rate. Diameter of dominant follicles and corpus luteum was correlated (p < .05) with oestrogen and progesterone levels, respectively, but only in mineral‐treated cows. Two additional dairy herds were evaluated to confirm that mineral supplementation improved conception rate during the heat stress period (objective 2). Cows from dairy 1 received FTAI during winter (n = 401) and summer (n = 240), whereas cows from dairy 2 were bred after natural detected oestrus during winter (n = 558) and summer (n = 314). Conception rates were higher (p < .05) in winter than summer and they improved (p < .05) with mineral supplementation, but only in cows managed during summer. In conclusion, supplementation of minerals enhanced hormonal secretion from ovarian structures and improved conception rate in Holstein cows exposed to summer heat stress.
Applying the precautionary principle to Fukushima nuclear wastewater disposal at sea
Authors: Li Ruoying , Lyu Shuang
Published: April 2022

Nuclear power undoubtedly offers a cleaner alternative source of energy, but its use is recurrently threatened by nuclear catastrophes and inappropriate waste management. The nuclear accident at the Fukushima Daiichi nuclear power plant and the decision by the Japanese government to dispose its nuclear wastewater at sea best illustrate these problems. Instead of considering the best outcome for the environment, the decision is rather based on economic factors, such as on‐site tanks reaching full capacity. Endorsing the application of the precautionary principle for this case will protect health and the environment from irreversible damage, redistribute the disproportionate burden borne by the exposed population to the risk‐generators and ensure that the decision making can be justified based on shared wealth instead of shared risks.
Peritoneal calprotectin level in peritoneal dialysis patients
Authors: Sevik Gizem , Barutcu Atas Dilek , Ilgin Can , Asicioglu Ebru , Tuglular Serhan , Velioglu Arzu
Published: April 2022

Background

Calprotectin is an important molecule in the initiation and progression of the inflammatory process. Systemic and local intraperitoneal inflammation are distinct processes and consequences in peritoneal dialysis (PD). We aimed to evaluate dialysate calprotectin levels and its associations with peritonitis and dialysis adequacy in PD patients.

Methods

Forty‐four PD patients were included in this prospective study. Calprotectin concentration was evaluated in 24‐h peritoneal drainage fluid. Patients were followed‐up for 1 year, and peritonitis episodes were recorded. Dialysate calprotectin levels were compared to dialysis adequacy parameters and peritonitis frequency.

Results

The mean age of patients was 54.9±12.7 years. Median PD duration was 54 (23–76) months. Seventeen patients (38.6%) had previous peritonitis episodes. During follow‐up, 15 of 44 patients (34.1%) had peritonitis. The median calprotectin concentration was 79.5 (75.2–86.3) ng/ml. The patients were divided into low and high calprotectin groups according to median value. In the high calprotectin group, BMI was found higher (p = 0.04). There was no significant relationship between calprotectin concentration and peritonitis during follow‐up (p = 0.29). However, the patients that have had previous peritonitis had higher calprotectin concentrations (p = 0.02). The patients who had higher erythrocyte sedimentation rate (ESR) levels also had higher calprotectin concentrations (p = 0.01).

Conclusion

Peritoneal calprotectin concentrations were correlated with higher BMI and ESR, and it was higher in patients with previous peritonitis episodes. To our knowledge, this is the first study to examine the peritoneal calprotectin levels in PD patients. Further studies are needed to determine the use of peritoneal calprotectin as an inflammatory marker in PD.
The HLA‐C*15:250 allele identified in a volunteer bone marrow donor
Authors: Loginova Maria , Druzhinina Svetlana , Ivan Obukhov , Paramonov Igor , Zarubin Maksim
Published: April 2022

HLA‐C*15:250 differs from HLA‐C*15:02:01:01 in codon 120 in exon 3.
Characterization of KIR+NK cell subsets with a monoclonal antibody selectively recognizing KIR2DL1 and blocking the specific interaction with HLA‐C
Authors: Meazza Raffaella , Falco Michela , Canevali Paolo , Loiacono Fabrizio , Colomar‐Carando Natalia , Muntasell Aura , Rea Anna , Mingari Maria Cristina , Locatelli Franco , Moretta Lorenzo , Lopez‐Botet Miguel , Pende Daniela
Published: April 2022

The phenotypic identification of different NK cell subsets allows more in‐depth characterization of KIR repertoire and function, which are of potential interest in KIR and disease association studies. KIR genes are highly polymorphic, but a great homology exists among the various sequences and few monoclonal antibodies (mAbs) specifically recognize a single KIR. This is the case of HP‐DM1 which was demonstrated by analysis of cell transfectants and epitope mapping to be exclusively KIR2DL1‐specific, covering all allotypes identified to date, except for KIR2DL1*022 and *020, and also to react with KIR2DS1*013. Here, we compared in immunofluorescence analyses the staining of HP‐DM1 with other available mAbs to precisely identify KIR2DL1+ NK cells in potential donors for αβT/B‐depleted haplo‐HSCT, with known KIR genotype. HP‐DM1 mAb was used in combination with EB6 or 11PB6 (anti‐KIR2DL1/S1 and anti‐KIR2DL3*005), 143211 (anti‐KIR2DL1/S5), and HP‐MA4 (anti‐KIR2DL1/S1/S3/S5) mAbs, allowing the accurate identification of different KIR+ NK cell subsets. These phenotypic evaluations appeared useful to dissect the expression pattern of various KIR2D in NK cells from KIR2DL3*005+ individuals, particularly if KIR2DS1 is present. HP‐DM1 mAb remarkably refined NK cell phenotyping of donors carrying KIR2DS5, either in the centromeric or telomeric region. Functional assays with KIR2DL1+/S1+/S5+ NK cells confirmed that only HP‐DM1 exclusively reacts with KIR2DL1. Finally, we demonstrated that HP‐DM1 mAb blocked KIR2DL1 recognition of C2+ HLA‐C. Altogether, the data support that HP‐DM1 is a unique reagent valuable for characterizing KIR+ NK cell subsets.