bluuebunny/crossref_metadata_2025 huggingface dataset:
Capability, opportunity, and motivation to enact hygienic practices in the early stages of the COVID‐19 outbreak in the United Kingdom
Authors: Gibson Miller Jilly , Hartman Todd K. , Levita Liat , Martinez Anton P. , Mason Liam , McBride Orla , McKay Ryan , Murphy Jamie , Shevlin Mark , Stocks Thomas V. A. , Bennett Kate M. , Bentall Richard P.
Published: May 2020

Objectives

The COVID‐19 pandemic is one of the greatest global health threats facing humanity in recent memory. This study aimed to explore influences on hygienic practices, a set of key transmission behaviours, in relation to the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model of behaviour change (Michie et al., 2011).

Design

Data from the first wave of a longitudinal survey study were used, launched in the early stages of the UK COVID‐19 pandemic.

Methods

Participants were 2025 adults aged 18 and older, representative of the UK population, recruited by a survey company from a panel of research participants. Participants self‐reported motivation, capability, and opportunity to enact hygienic practices during the COVID‐19 outbreak.

Results

Using regression models, we found that all three COM‐B components significantly predicted good hygienic practices, with motivation having the greatest influence on behaviour. Breaking this down further, the subscales psychological capability, social opportunity, and reflective motivation positively influenced behaviour. Reflective motivation was largely driving behaviour, with those highest in reflective motivation scoring 51% more on the measure of hygienic practices compared with those with the lowest scores.

Conclusions

Our findings have clear implications for the design of behaviour change interventions to promote hygienic practices. Interventions should focus on increasing and maintaining motivation to act and include elements that promote and maintain social support and knowledge of COVID‐19 transmission. Groups in particular need of targeting for interventions to increase hygienic practices are males and those living in cities and suburbs.
Exposure to coronavirus news on mainstream media: The role of risk perceptions and depression
Authors: Olagoke Ayokunle A. , Olagoke Olakanmi O. , Hughes Ashley M.
Published: May 2020

Objective

The mainstream media tend to rely on news content that will increase risk perceptions of pandemic outbreaks to stimulate public response and persuade people to comply with preventive behaviours. The objective of this study was to examine associations between exposure to coronavirus disease (COVID‐19) news, risk perceptions, and depressive symptoms.

Methods

Cross‐sectional data were collected from 501 participants who were ≥18 years. Exposure to COVID‐19 news was assessed as our exposure variable. We screened for depression (outcome variable) with the Patient Health Questionnaire and examined the roles of risk perceptions. Multiple linear regressions and mediation analysis with 1000 bootstrap resamples were conducted.

Results

Participants were 55.29% female, 67.86% White with mean age 32.44 ± 11.94 years. After controlling for sociodemographic and socio‐economic factors, news exposure was positively associated with depressive symptoms β = .11; 95% confidence interval (95%CI) = 0.02–0.20. Mediation analysis showed that perceived vulnerability to COVID‐19 mediated 34.4% of this relationship (β = .04; 95%CI = 0.01–0.06).

Conclusion

Perceived vulnerability to COVID‐19 can serve as a pathway through which exposure to COVID‐19 news on mainstream media may be associated with depressive symptoms. Based on our findings, we offered recommendations for media–health partnership, practice, and research.
Analysis of the implementation level of best practices to facilitate the transition of young people with intellectual disabilities from childhood to adulthood in the Basque Country
Authors: Yurrebaso Atutxa Garazi , Martínez‐Rueda Natxo , Galarreta Lasa Javier
Published: May 2020

Accessible summary

The literature has identified practices that should be implemented by transitional educational programmes.

We asked professionals in schools and visited three schools to identify if these best practices are being applied.

Although these best practices are being realised partially, there are differences between the opinions of professionals and the practices of centres.

The main differences are related to individualised planning, participation of families, and coordination between centres.

Background

Although studies have long identified the practices that must be included in transition programmes to improve the outcomes for young people with intellectual disabilities when becoming adults, less information is available regarding the degree to which those best practices are being developed and/or implemented.

Materials and methods

This exploratory research assesses the implementation level of those best practices in a school programme to facilitate the transition to adult life in the Basque Country, Spain. The opinions of professionals were asked through an ad hoc questionnaire, and a case study of three schools was conducted through observation, documentation analysis, interviews and focus groups.

Results and discussion

The professionals were found to have a positive opinion of the implementation degree of the best practices, except for the inclusion dimension. Although analysing the cases partially confirmed this opinion, contradictions emerge as these best practices cannot always be identified in the running of schools. The dimensions with major discrepancy are related to the individualised transition planning, family involvement and interagency collaboration.

Conclusion

Despite having identified best practices in all dimensions, delving deep into the professionals' understanding concerning best practices is crucial.
Reconstruction of the Cenozoic deformation of the Bohai Bay Basin, North China
Authors: Zhu Yinbing , Liu Shaofeng , Zhang Bo , Gurnis Michael , Ma Pengfei
Published: May 2020

A well‐constrained plate deformation model may lead to an improved understanding of sedimentary basin formation and the connection between subduction history and over‐riding plate deformation. Building quantitative models of basin kinematics and deformation remains challenging often due to the lack of comprehensive constraints. The Bohai Bay Basin (BBB) is an important manifestation of the destruction of the North China Craton, and records the plate kinematic history of East Asia during the Cenozoic. Although a number of interpretations of the formation of the BBB have been proposed, few quantitative basin reconstruction models have been built to test and refine previous ideas. Here, we developed a quantitative deformation reconstruction of the BBB constrained with balanced cross‐sections and structural, stratigraphic and depositional age data. Our reconstruction suggests that the basin formation process was composed of three main stages: Paleocene‐early Eocene (65–42 Ma) extension initiation, middle Eocene‐early Oligocene (42–32.8 Ma) extension climax and post‐Oligocene (32.8–0 Ma) post‐extensional subsidence. The deformation of the BBB is spatially heterogeneous, and its velocity directions rotated clockwise during the basin formation process. The reconstruction supports the interpretation that the BBB formed via strike‐slip faulting and orthogonal extension and that the basin is classified as a composite extensional‐transtensional basin. We argue that the clockwise rotation of the basin velocity field was driven by the counter‐clockwise rotation in the direction of Pacific Plate subduction. The kinematics of the BBB imply that the Pacific Plate may have been sufficiently coupled to the over‐riding East Asian Plate during the critical period of Pacific Plate reorganization. The new reconstruction provides a quantitative basis for studies of deformation processes not only in the vicinity of the BBB, but also more broadly throughout East Asia.
Service design as an innovation approach in technology startups: a longitudinal multiple case study
Authors: Korper Ana Kustrak , Patrício Lia , Holmlid Stefan , Witell Lars
Published: May 2020

While service design has been accepted as a human‐centered and cocreative approach to service innovation, its role in technology‐driven contexts, specifically technology startups, has been largely unexplored. Previous research suggests that technology startups tend to focus on technical aspects of innovation, neglecting the value cocreation potential of service innovation that service design can facilitate. Focusing on value propositions as the main mechanisms of service innovation, this study explores how service design facilitates service innovation in technology startups. This longitudinal study examines the opportunities and challenges of introducing service design for the purpose of service innovation in five technology startups over a period of 11 months. Results reveal how service design facilitates the creation of new value propositions that expand the previous technology‐driven focus towards a human‐centered and cocreative one. Additionally, findings suggest that there are two levels of how service design becomes embedded in technology startups that are contingent on their life cycle stage. This contributes to the service innovation literature that views innovation as development of new value propositions and describes the key role of service design. The study also discusses managerial implications of the findings for technology startups and service designers and provides directions for future research.
Biasing human epidermal growth factor receptor 4 (HER4) tyrosine kinase signaling with antibodies: Induction of cell death by antibody‐dependent HER4 intracellular domain trafficking
Authors: Lanotte Romain , Garambois Véronique , Gaborit Nadège , Larbouret Christel , Musnier Astrid , Martineau Pierre , Pèlegrin André , Chardès Thierry
Published: May 2020

Human epidermal growth factor receptor 4 (HER4) isoforms have oncogenic or tumor suppressor functions depending on their susceptibility to proteolytic cleavage and HER4 intracellular domain (4ICD) translocation. Here, we report that the neuregulin 1 (NRG1) tumor suppressor mechanism through the HER4 JMa/CYT1 isoform can be mimicked by the agonist anti‐HER4 Ab C6. Neuregulin 1 induced cleavage of poly(ADP‐ribose) polymerase (PARP) and sub‐G1 DNA fragmentation, and also reduced the metabolic activity of HER3−/HER4+ cervical (C‐33A) and ovarian (COV318) cancer cells. This effect was confirmed in HER4 JMa/CYT1‐, but not JMa/CYT2‐transfected BT549 triple‐negative breast cancer cells. Neuregulin 1 favored 4ICD cleavage and retention in mitochondria in JMa/CYT1‐transfected BT549 cells, leading to reactive oxygen species (ROS) production through mitochondrial depolarization. Similarly, the anti‐HER4 Ab C6, which binds to a conformational epitope located on a.a. 575‐592 and 605‐620 of HER4 domain IV, induced 4ICD cleavage and retention in mitochondria, and mimicked NRG1‐mediated effects on PARP cleavage, ROS production, and mitochondrial membrane depolarization in cancer cells. In vivo, C6 reduced growth of COV434 and HCC1187 tumor cell xenografts in nude mice. Biasing 4ICD trafficking to mitochondria with anti‐HER4 Abs to mimic NRG1 suppressor functions could be an alternative anticancer strategy.
Suppressed immune profile in children with combined type 1 diabetes and celiac disease
Authors: Tompa A , Åkesson K , Karlsson S , Faresjö M
Published: May 2020

Children diagnosed with a combination of type 1 diabetes (T1D) and celiac disease (CD) show a dysregulated T helper type 1 (Th1)/Th17 response. Besides the cellular involvement, several soluble immune markers are involved in the autoimmune process of both T1D and CD. Only few studies have examined the peripheral pattern of different cytokines, chemokines and acute-phase proteins (APP) in children with combined T1D and CD. To our knowledge, no studies have evaluated the serum levels of adipocytokines and matrix metalloproteinases (MMPs) in this context. The purpose of the present study was to acquire more knowledge and to gain deeper understanding regarding the peripheral immunoregulatory milieu in children with both T1D and CD. The study included children diagnosed with both T1D and CD (n = 18), children with T1D (n = 27) or CD (n = 16) and reference children (n = 42). Sera were collected and analysis of 28 immune markers (cytokines, chemokines, APPs, adipocytokines and MMPs) was performed using the Luminex technique. The major findings showed that children with a double diagnosis had lower serum levels of interleukin (IL)-22, monocyte chemoattractant protein (MIP)-1α, monocyte chemoattractant protein (MCP)-1, procalcitonin, fibrinogen, visfatin and matrix metalloproteinase (MMP)-2. These results indicate a suppressed immune profile in children with combined T1D and CD, including Th17 cytokines, chemokines, APPs, adipocytokines and MMPs. We conclude that, besides cytokines and chemokines, other immune markers, e.g. APPs, adipocytokines and MMPs, are of importance for further investigations to elucidate the heterogeneous immune processes present in patients diagnosed with T1D in combination with CD.
Pathological role of excessive DNA as a trigger of keratinocyte proliferation in psoriasis
Authors: Luo Y , Hara T , Kawashima A , Ishido Y , Suzuki S , Ishii N , Kambara T , Suzuki K
Published: May 2020

Psoriasis is characterized by excessive growth and aberrant differentiation of epidermal keratinocytes due to persistent inflammation. However, the underlying mechanism that triggers immune activation in psoriasis is not clear. In this study, we explored excessive DNA as a potential trigger of psoriasis using cultured human keratinocytes and psoriatic skin tissues. We demonstrated that human genomic DNA fragments induced tumour necrosis factor (TNF)-α expression, hyperproliferation and over-expression of heparin-binding epidermal-like growth factor (HB-EGF) and transforming growth factor (TGF)-α, accompanied by defective expression of keratins 1 and 10 in cultured normal human epidermal keratinocytes, which have a similar phenotype to that of keratinocytes in psoriatic skin lesions. In psoriatic lesions, we found high levels of double-stranded (ds)DNA fragments, accompanying keratinocytes expressing Ki-67, HB-EGF and TNF-α. In addition, we showed that 1,25-dihydroxyvitamin D3 inhibited genomic DNA fragment-induced TNFA and interleukin-1β (IFNB) expression in human keratinocytes, and an intact function of cathelicidin anti-microbial peptide (CAMP) was required for this effect. These results suggest that excessive dsDNA fragments probably act as a risk factor for immune activation in psoriasis, and the active form of vitamin D can prevent genomic DNA-mediated skin inflammation via CAMP.
Refinement of the clinical and mutational spectrum of UBE2A deficiency syndrome
Authors: Cordeddu Viviana , Macke Erica L. , Radio Francesca Clementina , Lo Cicero Stefania , Pantaleoni Francesca , Tatti Massimo , Bellacchio Emanuele , Ciolfi Andrea , Agolini Emanuele , Bruselles Alessandro , Brunetti‐Pierri Nicola , Suri Mohnish , Josephs Katherine S. , McEntagart Meriel , Lanpher Brendan , Nickels Katherine C. , Haworth Andrea , Reed Laura , Cappuccio Gerarda , Mammi Isabella , Tarnowski Jessica M. , Novelli Antonio ,   Deciphering Developmental Disorders Study, Melis Daniela , Callewaert Bert , Dallapiccola Bruno , Klee Eric , Tartaglia Marco
Published: May 2020

UBE2A deficiency, that is, intellectual disability (ID) Nascimento type (MIM 300860), is an X‐linked syndrome characterized by developmental delay, moderate to severe ID, seizures, dysmorphisms, skin anomalies, and urogenital malformations. Forty affected subjects have been reported thus far, with 31 cases having intragenic UBE2A variants. Here, we report on additional eight affected subjects from seven unrelated families who were found to be hemizygous for previously unreported UBE2A missense variants (p.Glu62Lys, p.Arg95Cys, p.Thr99Ala, and p.Arg135Trp) or small in‐frame deletions (p.Val81_Ala83del, and p.Asp101del). A wide phenotypic spectrum was documented in these subjects, ranging from moderate ID associated with mild dysmorphisms to severe features including congenital heart defects (CHD), severe cognitive impairment, and pineal gland tumors. Four variants affected residues (Glu62, Arg95, Thr99 and Asp101) that contribute to stabilizing the structure of the E3 binding domain. The three‐residue in‐frame deletion, p.Val81_Ala83del, resulted from aberrant processing of the transcript. This variant and p.Arg135Trp mapped to regions of the protein located far from the E3 binding region, and caused variably accelerated protein degradation. By reviewing available clinical information, we revise the clinical and molecular profile of the disorder and document genotype‐phenotype correlations. Pineal gland cysts/tumors, CHD and hypogammaglobulinemia emerge as recurrent features.
Fight or flee: Outside director departures prior to contested management buyout offers
Authors: Arena Matteo P. , Dewally Michaël , Peck Sarah W.
Published: May 2020

Research Question/Issue

We investigate outside director departures prior to management buyout offers (MBOs). In these transactions, managers have both an information advantage and incentives to make a lowball offer to shareholders. Outside directors can safeguard against managerial self‐dealing by negotiating for the best terms for public shareholders from either management or another bidder.

Research Findings/Insights

It is typical that outside directors stay on the board through an MBO offer as MBOs are less likely to have changes in directors—either joining or leaving—relative to a control sample. After controlling for endogeneity as well as firm and director characteristics, we find that outside directors are more likely to leave when the offer is later contested. We do not find any evidence that departing directors are replaced by new outside directors who ensure shareholders get a higher premium nor do we find any evidence that the board acts as a public auctioneer. We also find that outside directors are more likely to depart when the buyout contest is longer. Our findings show that outside directors provide a weak internal monitoring mechanism as they leave precisely when shareholders need their expertise the most.

Theoretical/Academic Implications

Our results contribute to research that supports the notion that outside director departures are symptomatic of board weakness. The results of our study support the contention of other researchers that outside directors often fail to monitor managers.

Practitioner/Policy Implications

Our study offers useful information to M&A investment banking advisors and leverage buyout analysts by showing the mechanisms under which director turnover can affect the value and the outcome of MBOs.
Predictors of long‐term renal allograft survival after second kidney transplantation
Authors: O’Kelly John A. , Davis Niall F. , Ferede Atakelet A. , Breen Kieran J. , O’Kelly Patrick , MacCraith Eoin , Forde James , Mohan Ponnusamy , Power Richard , Smyth Gordon , Little Dilly M.
Published: May 2020

Introduction

Few studies investigate significant perioperative predictors for long‐term renal allograft survival after second kidney transplant (SKT). We compared long‐term survival following SKT with primary kidney transplant and determined predictors of renal allograft failure after SKT.

Methods

Outcomes of all primary or second kidney transplant recipients at a national kidney transplant center between 1993 and 2017 were reviewed. The primary outcomes measurements were renal allograft survival for both first and second kidney transplants. Secondary outcome measurements were incidence of delayed graft function (DGF), incidence of acute rejection (AR), and predictors for renal allograft survival in SKT recipients.

Results

In total, there were 392 SKTs and 2748 primary kidney transplants performed between 1993 and 2017. The 1‐, 5‐, and 10‐year death‐censored graft survival for deceased‐donor recipients was 95.3%, 88.7%, and 78.2% for primary kidney transplant and 94.9%, 87.1%, and 74.9% for SKT (P = .0288). Survival of primary renal allograft <6 years (HR 0.6, P = .017), AR episodes (HR 1.6, P = .031), DGF (HR 2.0, P = .005), and HLA‐DR MM (HR 1.7, P = .018) was independent predictors of long‐term renal allograft failure after SKT.

Conclusion

These findings may provide important information on long‐term survival outcomes after SKT and for identifying patients at risk for long‐term renal allograft failure after SKT.
Early effects of first‐line treatment with anti‐interleukin‐6 receptor antibody tocilizumab for chronic active antibody‐mediated rejection in kidney transplantation
Authors: Lavacca Antonio , Presta Roberto , Gai Chiara , Mella Alberto , Gallo Ester , Camussi Giovanni , Abbasciano Isabella , Barreca Antonella , Caorsi Cristiana , Fop Fabrizio , Messina Maria , Rossetti Maura , Biancone Luigi
Published: May 2020

Introduction

Chronic active antibody‐mediated rejection (cAMR) is a major determinant of late allograft failure. Rituximab/immunoglobulins (IVIg) + plasma exchange (PLEX) showed controversial results in cAMR treatment. Tocilizumab (TCZ), a humanized anti‐interleukin 6 receptor antibody, has been recently used as rescue therapy in patients non‐responsive to rituximab/IVIg/PLEX with favorable outcomes. Whether TCZ acts “per se” or requires a priming effect from previous treatments is currently unknown.

Methods

Fifteen patients with cAMR were treated with TCZ as a first‐line therapy and followed for a median time of 20.7 months.

Results

Despite the majority of patients experiencing advanced transplant glomerulopathy (TG) at diagnosis (60% with cg3), glomerular filtration rate and proteinuria stabilized during the follow‐up, with a significant reduction in donor‐specific antibodies. Protocol biopsies after 6 months demonstrated significant amelioration of microvascular inflammation and no TG, C4d deposition, or IF/TA progression. Gene‐expression and immunofluorescence analysis showed upregulation of three genes (TJP‐1, AKR1C3, and CASK) involved in podocyte, mesangial, and tubular restoration.

Conclusion

Tocilizumab adopted as a first‐line approach in cAMR was associated with early serological and histological improvements and functional stabilization even in advanced TG, suggesting a role for the use of TCZ alone with the avoidance of unnecessary previous immunosuppressants.
Fat necrosis with an associated lymphocytic infiltrate represents a histopathologic clue that distinguishes cellular dermatofibroma from dermatofibrosarcoma protuberans
Authors: Schechter Shula A. , Bresler Scott C. , Patel Rajiv M.
Published: May 2020

Background

Cellular dermatofibromas (CDFs) and dermatofibrosarcoma protuberans (DFSP) can be challenging to differentiate from one another. Morphologically, both entities commonly extend into the subcutis, exhibit high cellularity with limited cytologic atypia and have a mixed fascicular‐to‐storiform growth pattern. We sought to evaluate the significance of fat necrosis with an associated lymphocytic infiltrate as a histopathologic clue for distinguishing CDFs from DFSP.

Methods

We identified cases in our pathology database with a primary diagnosis of CDF or DFSP. Punch or excisional biopsy specimens with extension into the subcutis were selected. Previously biopsied lesions and specimens that did not interact with the subcutis were excluded. Histopathologic features were evaluated in hematoxylin and eosin stained sections.

Results

Fat necrosis with lymphocytic infiltrate was present in 20/20 cases of CDF. None of the 20 DFSP cases had fat necrosis with lymphocytic infiltrate although 4/20 had fat necrosis alone.

Conclusions

Fat necrosis with associated lymphocytic response can aid in the distinction between CDF and DFSP.
934. MORAEA RETICULATA
Authors: Rix Martyn , Duncan Graham , Strange Kit , Langhorne Joanna
Published: May 2020

Moraea reticulata Goldblatt from the Eastern Cape is illustrated and the history of its discovery and present distribution are given. Its cultivation at Kew is described.
935. VACHELLIA ANEGADENSIS
Authors: Bárrios Sara , Hamilton Martin , Corcoran Marcella , Woodfield‐Pascoe Nancy , Clubbe Colin
Published: May 2020

Vachellia anegadensis (Britton) Seigler & Ebinger, a spiny tree endemic to the British Virgin Islands (BVI), a Caribbean UK Overseas Territory, is described and illustrated. It is one of the four known endemic plant species to occur in the BVI, an archipelago of only 153 km2. It has been assessed as Endangered (EN) based on the IUCN categories and criteria. Its botanical history and conservation status are described, and ex situ propagation discussed.
939. STROBILANTHES GLUTINOSA
Authors: Wood John R.I. , Wise Rosemary
Published: May 2020

Strobilanthes glutinosa is described and illustrated. It is a winter‐flowering species native to the foothills of the northwestern Himalayas. Although frost sensitive, it appears to flourish as a cultivated plant in shaded places enjoying a mild moist climate.
PASSIFLORA ITATIAIENSIS
Authors: Vanderplank John
Published: May 2020

A new species of Passiflora L. in subgenus Decaloba (DC.) Rchb. from Rio de Janeiro State, Brazil is described; its history, taxonomy, distribution, ecology and cultivation are discussed.
PASSIFLORA TACANENSIS
Authors: Vanderplank John
Published: May 2020

Passiflora tacanensis Port.‐Utl. from Mount Tacaná in south eastern Mexico on the border with Guatemala is fully described for the first time with illustrations of flowers, leaves and pollen; its history and cultivation are provided.
Unexpected finding of inflammatory myofibroblastic tumour in two cytological specimens
Authors: Grosse Alexandra , Grosse Claudia
Published: May 2020

Diagnosing inflammatory myofibroblastic tumor (IMT) on cytology remains challenging, and the cytological features of IMT have been reported only in a limited number of studies to date. Two cases are described which were unexpected clincially. IMT in urine cytology has not previously been reported and IMT in the urogenital tract is very rare.
Bulky cervical tumour showing mixed unique cell clusters in cervical cytology
Authors: Yanazume Shintaro , Togami Shinichi , Kamio Masaki , Kitazono Ikumi , Hiraki Tsubasa , Tanimoto Akihide , Kobayashi Hiroaki
Published: May 2020

The cytological features of synchronous mucinous signet‐ring cell carcinoma and squamous cell carcinoma of the cervix have not been reported before. A case is described to emphasise that these two distinct carcinoma types can occur simultaneously in a high‐risk HPV infected cervix.
Histopathology of fluoroscopy‐induced radiation ulcer: a case series study in comparison with morphea
Authors: Liao Jia‐Bin , Chen WenChieh , Lee Herng‐Sheng , Wu Shiou‐Rong , Wei Kai‐Che
Published: May 2020

Background and objectives

Histopathologic diagnosis of fluoroscopy‐induced radiation ulcer (FIRU) can be challenging if the past history of radiation exposure is unknown. Morphea is the most important differential diagnosis. This study was intended to identify clinical and pathologic features that can be used to distinguish FIRU from morphea.

Patients and methods

We performed a retrospective study on 25 specimens from 15 patients with FIRU and 21 specimens from 21 patients with morphea. Clinical findings and pathological features were analyzed.

Results

Thirteen of 15 patients (86.7 %) with FIRU underwent angioplasty for coronary artery disease, and eleven patients had lesions in the right subscapular area. Compared with morphea, FIRU patients were more likely to display non‐inflammatory infiltrates (28 %), bizarre fibroblasts (100 %), sclerosis (48 %), telangiectasia (96 %), vascular damage (64 %), and loss of skin appendages (100 %). In morphea, bizarre fibroblasts were rare (14 %), while telangiectasia (62 %) and loss of skin appendages (62 %) were variable. Loss of CD34+ cells and compression of elastic fibers could not be used to distinguish between FIRU and morphea.

Conclusions

Skin lesion in the right subscapular area with presence of bizarre fibroblasts, sclerosis, telangiectasia, and loss of cutaneous appendages as seen with histology are highly characteristic of the radiation damage associated with fluoroscopic angiography.
Histopathologie des Röntgenulkus: Fallserie mit Vergleich zur zirkumskripten Sklerodermie
Authors: Liao Jia‐Bin , Chen WenChieh , Lee Herng‐Sheng , Wu Shiou‐Rong , Wei Kai‐Che
Published: May 2020

Hintergrund und Ziele

Die histopathologische Diagnose eines Fluoroskopie‐induzierten Röntgenulkus (RU) kann eine Herausforderung darstellen, insbesondere wenn keine Informationen über eine vorausgegangene Strahlenexposition vorliegen. Die wichtigste Differenzialdiagnose ist die zirkumskripte Sklerodermie (ZS). Ziel dieser Studie war die Identifikation klinischer und histopathologischer Merkmale, mit deren Hilfe sich RU und ZS unterscheiden lassen.

Patienten und Methodik

Wir führten eine retrospektive Studie an 25 Proben von 15 Patienten mit RU und 21 Proben von 21 Patienten mit ZS durch. Die klinischen Befunde und histopathologischen Merkmale wurden analysiert.

Ergebnisse

Dreizehn von 15 RU‐Patienten (86,7 %) hatten sich wegen einer koronaren Herzkrankheit einer Angioplastie unterzogen, bei elf Patienten befanden sich die Läsionen unterhalb des rechten Schulterblatts. Im Vergleich zu ZS‐Patienten zeigten sich bei RU‐Patienten häufiger nichtentzündliche Infiltrate (28 %), atypische „bizarre“ Fibroblasten (100 %), Sklerosen (48 %), Teleangiektasien (96 %), Gefäßschäden (64 %) und Verlust von Hautanhangsgebilden (100 %). Bei der ZS waren bizarre Fibroblasten selten (14 %), während Teleangiektasien (62 %) und Verlust von Hautanhangsgebilden (62 %) unterschiedlich häufig auftraten. Der Verlust von CD34+‐Zellen und die Kompression elastischer Fasern waren nicht geeignet, um zwischen RU und ZS zu unterscheiden.

Schlussfolgerungen

Hautläsionen im rechten subskapulären Bereich mit Nachweis von bizarren Fibroblasten, Sklerosen, Teleangiektasien und Verlust von Hautanhangsgebilden in der Histologie sind sehr charakteristisch für Strahlenschäden im Zusammenhang mit einer Durchleuchtung bei Angiographie.
Hautveränderungen bei internen Neoplasien
Authors: Alter Mareike , Mengoni Miriam , Gaffal Evelyn
Published: May 2020

Tumorerkrankungen innerer Organe können sich über charakteristische Hautveränderungen wie kutane Metastasen oder typische Effloreszenzen bei genetischen Tumor‐Syndromen äußern. Des Weiteren gibt es paraneoplastische Syndrome, welche dadurch gekennzeichnet sind, dass sie nur indirekt mit einer malignen Grunderkrankung in Verbindung stehen und selbst nicht maligne sind. Historisch werden „obligate“ von „fakultativen“ Paraneoplasien abgegrenzt, welche sich durch die Wahrscheinlichkeit einer möglichen Tumorassoziation unterscheiden. Dazu kommen noch unspezifische Hautsymptome, bei denen das Auftreten einer malignen Grunderkrankung eher gering ist. Eine weitere mögliche Einteilung richtet sich nach den pathophysiologischen Mechanismen, die den Hautveränderungen zugrunde liegen. Für den praktisch tätigen Dermatologen ist das Erkennen einer möglicherweise tumorassoziierten Dermatose vor allem deswegen von Bedeutung, da diese in vielen Fällen zur Erstdiagnose der malignen Grunderkrankung führen kann.
A new simple method of handmade face shield using A4‐size OHP sheet, during the COVID‐19 pandemic
Authors: Ino Yuji , Yano Tomonori , Yamamoto Hironori
Published: May 2020

Watch a video of this article
Endoscopic treatment of proton pump inhibitor‐refractory gastroesophageal reflux disease with anti‐reflux mucosectomy: Experience of 109 cases
Authors: Sumi Kazuya , Inoue Haruhiro , Kobayashi Yasutoshi , Iwaya Yugo , Abad Mary Raina Angeli , Fujiyoshi Yusuke , Shimamura Yuto , Ikeda Haruo , Onimaru Manabu
Published: May 2020

Objectives

Some patients with gastroesophageal reflux disease (GERD) are refractory to proton pump inhibitor (PPI) therapy. Anti‐reflux mucosectomy (ARMS) is a minimally invasive endoscopic procedure for treatment of GERD. In this study, we retrospectively evaluated the outcomes of ARMS performed in patients with PPI‐refractory GERD at our institution.

Methods

A total of 109 patients with PPI‐refractory GERD who underwent ARMS were retrospectively reviewed. Pre‐ and post‐ARMS questionnaire scores, acid exposure time (AET), DeMeester score, proximal extent, and PPI discontinuation rate were compared.

Results

There was a significant improvement in the symptom score (P < 0.01) and 40–50% of patients were able to discontinue PPI after ARMS. In patients who were followed up for 3 years, sustained improvement in subjective symptoms was observed. AET and DeMeester score significantly improved after ARMS (P < 0.01); however, there was no significant improvement in proximal extent (P = 0.0846).

Conclusions

Anti‐reflux mucosectomy is an effective minimally invasive therapy for patients with PPI‐refractory GERD. The therapeutic efficacy is attributable to suppression of acid backflow due to contraction of the scar tissue in cardia.
The evolutionary origins of natural pedagogy: Rhesus monkeys show sustained attention following nonsocial cues versus social communicative signals
Authors: Bettle Rosemary , Rosati Alexandra G.
Published: May 2020

The natural pedagogy hypothesis proposes that human infants preferentially attend to communicative signals from others, facilitating rapid cultural learning. In this view, sensitivity to such signals is a uniquely human adaptation and as such nonhuman animals should not produce or utilize these communicative signals. We test these evolutionary predictions by examining sensitivity to communicative cues in 206 rhesus monkeys (Macaca mulatta) using an expectancy looking time task modeled on prior work with infants. Monkeys observed a human actor who either made eye contact and vocalized to the monkey (social cue), or waved a fruit in front of her face and produced a tapping sound (nonsocial cue). The actor then either looked at an object (referential look) or looked toward empty space (look away). We found that, unlike human infants in analogous situations, rhesus monkeys looked longer at events following nonsocial cues, regardless of the demonstrator's subsequent looking behavior. Moreover younger and older monkeys showed similar patterns of responses across development. These results provide support for the natural pedagogy hypothesis, while also highlighting evolutionary changes in human sensitivity to communicative signals.
Attenuated brain responses to speech sounds in moderate preterm infants at term age
Authors: François Clément , Rodriguez‐Fornells Antoni , Teixidó Maria , Agut Thaïs , Bosch Laura
Published: May 2020

Recent findings have revealed that very preterm neonates already show the typical brain responses to place of articulation changes in stop consonants, but data on their sensitivity to other types of phonetic changes remain scarce. Here, we examined the impact of 7–8 weeks of extra‐uterine life on the automatic processing of syllables in 20 healthy moderate preterm infants (mean gestational age at birth 33 weeks) matched in maturational age with 20 full‐term neonates, thus differing in their previous auditory experience. This design allows elucidating the contribution of extra‐uterine auditory experience in the immature brain on the encoding of linguistically relevant speech features. Specifically, we collected brain responses to natural CV syllables differing in three dimensions using a multi‐feature mismatch paradigm, with the syllable/ba/ as the standard and three deviants: a pitch change, a vowel change to/bo/ and a consonant voice‐onset time (VOT) change to/pa/. No significant between‐group differences were found for pitch and consonant VOT deviants. However, moderate preterm infants showed attenuated responses to vowel deviants compared to full terms. These results suggest that moderate preterm infants' limited experience with low‐pass filtered speech prenatally can hinder vowel change detection and that exposure to natural speech after birth does not seem to contribute to improve this capacity. These data are in line with recent evidence suggesting a sequential development of a hierarchical functional architecture of speech processing that is highly sensitive to early auditory experience.
Hypothermia as an adjuvant treatment in paediatric refractory or super‐refractory status epilepticus
Authors: Legriel Stephane
Published: May 2020

Therapeutic hypothermia is among the adjuvant therapies suggested for refractory or super‐refractory status epilepticus (R/SR‐SE) in paediatric patients. Experimental evidence of neuroprotective and antiseizure effects provides a strong rationale for using therapeutic hypothermia in patients with status epilepticus. Thus, hypothermia between 20°C and 33°C in animals with status epilepticus is associated not only with significantly less neuronal damage, predominantly in the hippocampal CA1, CA2, and CA3 areas, but also with increased seizure latency and decreased seizure frequency and duration. Therapeutic hypothermia has rarely been used in paediatric R/SR‐SE. In the few reported cases, seizure control was markedly improved but nearly half the patients experienced recurrences after rewarming. Studies are needed to clarify the modalities and indications of therapeutic hypothermia in paediatric patients with R/SR‐SE.

What this paper adds

Hypothermia at 20°C to 33°C is neuroprotective and has antiseizure effects in experimental status epilepticus.

In children, antiseizure effects are marked but recurrences after rewarming are common.
Repeat transesophageal echocardiography in infective endocarditis: An analysis of contemporary utilization
Authors: Shafiyi Aylin , Anavekar Nandan S. , Virk Abinash , Sohail M. Rizwan , Lahr Brian D. , DeSimone Daniel C. , Wilson Walter R. , Baddour Larry M.
Published: May 2020

Background

Current guidelines from the American Heart Association (AHA) recommend repeating transesophageal echocardiography (TEE) in three to five days if there is high suspicion of IE despite an initial TEE that was negative. This recommendation, however, is based on limited published data.

Objectives

This investigation attempts to identify specific factors that prompted repeat TEE and evaluate the yield of IE‐related findings demonstrated by repeat TEE as compared to initial or prior TEE.

Methods

A retrospective cohort who had at least one repeat TEE during an index hospitalization or initial course of antimicrobial therapy for IE between January 2014 and September 2018. We assessed the impact of repeat TEE on IE diagnosis and patient management and included a comparative analysis of patients with initial TEE only.

Results

Overall, 59 (44.7%) of 132 IE patients underwent repeat TEE. In a comparative analysis that involved patients who had undergone an initial TEE only versus those who had repeat TEE, male gender (P = .029) and presence of a prosthetic valve or annuloplasty ring (P = .017) were significantly associated with repeat TEE. Importantly, 8 (17.4%) of repeat TEE were critical for IE diagnosis, 8 (17.4%) impacted antimicrobial management, and 11 (23.9%) supported cardiovascular surgical intervention.

Conclusions

From a population‐based cohort of incident IE cases, repeat TEE was more frequently (44.7%) done in patients with suspect or proven IE and associated complications than anticipated. Repeat TEE remains pivotal in a contemporary practice that involves critical aspects of IE diagnosis and management.
Cavitation phenomenon in mechanical prosthetic valves: Not only microbubbles
Authors: Vriz Olga , Arshi Fatma , Ahmed Mawada , Alhumaid Mohammed , Galzerano Domenico , Emmanual Shisamma , Kinsara Abdulhalim J. , Aladmawi Mohammed , Alamro Bandar , Alshahid Maie , Pedrizzettid Gianni
Published: May 2020

Introduction

Microbubbles (MBs) or cavitation is high‐velocity, echo‐bright findings present during the closing or opening of a mechanical valve (MVP). Cavitation bubble growth or gas emboli are less frequently described. We evaluated the hemodynamic parameters involved in the formation of gas emboli and the impact of gas emboli on requests for additional investigations.

Methods and Results

Transthoracic echocardiographic studies (TTE) of 57 patients (31 males, mean age 46.8 ± 13.8 years) with gas emboli were evaluated after heart valve replacement surgery. The majority (72%, n = 42) had a mitral or combined mitral/aortic MVP, with 28% (n = 16) an aortic MVP. The last TTE with and without gas emboli were considered for the same patient and the no emboli group was the control group (42 patients). The patient's blood pressure (BP) and heart rate (HR) were available for each TTE. Comparing the two TTEs, the systolic and diastolic BP, transmitral and aortic gradients, and left ventricular ejection fraction were similar but the HR (80.9 ± 18.7 vs 72.5 ± 13.9 bpm, P = .02) was significantly higher in the group with gas emboli. A TEE was performed 52 times in 27 patients, due to gas emboli, with one case positive for thrombus/vegetation. For 19 patients, a brain CT was requested. In two patients, the indication for the brain CT was gas emboli but the result was negative.

Conclusion

Gas emboli are frequently present and associated to an increased HR. They can cause the misdiagnosis of endocarditis or thrombus formation with significant additional requests for diagnostic examinations.
Ecological assembly rules on arthropod community inhabiting mistletoes
Authors: Lázaro‐González Alba , Hódar José A. , Zamora Regino
Published: May 2020

1. The colonisation of a new habitat by a community is led by deterministic and stochastic processes at different spatio‐temporal scales. Parasitic plants, such as mistletoe, represent a new habitat within forest canopy that is free to be colonised by many organisms.

2. This study investigates how ecological factors operating at forest and plant scales drive changes in both specialist (mistletoe‐dwelling) and tourist (transient visitors) arthropod communities inhabiting European mistletoe, Viscum album subsp. austriacum, in a Mediterranean pine forest. The influence of elevation along a broad elevational gradient was tested by sampling arthropod communities dwelling in mistletoe plants and host pine branches and the effects of mistletoe plant size, distances to other mistletoes, and temporal variation in arthropod assemblages inhabiting mistletoes.

3. The diversity of the specialist community remained constant along the elevational gradient and over the summer period, while the tourist and pine‐dwelling arthropod communities showed species turnover. Larger mistletoes were occupied by more species and individuals, whereas more isolated mistletoes presented the same equilibrium point as the more aggregated ones. Thus, mistletoe size is key to the composition of the arthropod community.

4. In conclusion, this study's findings indicate contrasting assembly rules for specialised and tourist arthropod communities associated with mistletoe. The specialist community was highly stable and followed a deterministic trophic sequence of colonisation as the assemblage rule: first, colonisation by the main specialist herbivore, Cacopsylla visci, and, second, by its predator Anthocoris visci. Meanwhile, the tourist community, being a subset of the arthropod assemblage of the pine, acts independent of mistletoe presence.
Neurological manifestations and neuro‐invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2
Authors: Vonck K. , Garrez I. , De Herdt V. , Hemelsoet D. , Laureys G. , Raedt R. , Boon P.
Published: May 2020

Background and purpose

Infections with coronaviruses are not always confined to the respiratory tract and various neurological manifestations have been reported. The aim of this study was to perform a review to describe neurological manifestations in patients with COVID‐19 and possible neuro‐invasive mechanisms of Sars‐CoV‐2.

Methods

PubMed, Web of Science and COVID‐dedicated databases were searched for the combination of COVID‐19 terminology and neurology terminology up to 10 May 2020. Social media channels were followed up between 15 March and 10 May 2020 for postings with the same scope. Neurological manifestations were extracted from the identified papers and combined to provide a useful summary for the neurologist in clinical practice.

Results

Neurological manifestations potentially related to COVID‐19 have been reported in large studies, case series and case reports and include acute cerebrovascular diseases, impaired consciousness, cranial nerve manifestations and autoimmune disorders such as the Guillain–Barré syndrome often present in patients with more severe COVID‐19. Cranial nerve symptoms such as olfactory and gustatory dysfunctions are highly prevalent in patients with mild to moderate COVID‐19 even without associated nasal symptoms and often present in an early stage of the disease.

Conclusion

Physicians should be aware of the neurological manifestations in patients with COVID‐19, especially when rapid clinical deterioration occurs. The neurological symptoms in COVID‐19 patients may be due to direct viral neurological injury or indirect neuroinflammatory and autoimmune mechanisms. No antiviral treatments against the virus or vaccines for its prevention are available and the long‐term consequences of the infection on human health remain uncertain especially with regard to the neurological system.
Stereotactic Laser Ablation for Mesial Temporal Lobe Epilepsy: A prospective, multicenter, single‐arm study
Authors: Sperling Michael R. , Gross Robert E. , Alvarez Guy E. , McKhann Guy M. , Salanova Vicenta , Gilmore Julie
Published: May 2020

Objective

To describe the development of the Stereotactic Laser Ablation for Temporal Lobe Epilepsy study protocol in the context of current practice. An ideal treatment for drug‐resistant epilepsy remains an ongoing area of research. Although there are several options available, each has challenges that not only make deciding on the appropriate treatment not clear‐cut but also create difficulties in designing clinical studies to provide evidence in support of the treatment.

Methods

A prospective, single‐arm, multicenter study designed to evaluate safety and efficacy of the VisualaseTM MRI‐Guided Laser Ablation System for the treatment of temporal lobe epilepsy will include up to 150 patients with a primary efficacy endpoint of seizure freedom (defined as Engel Class I) for the first 12 months following the procedure and a primary safety endpoint of incidence of qualifying device‐, procedure‐, or anesthesia‐related adverse events through 12 months following the procedure.

Results

Primary endpoints will be assessed against historical values of safety and efficacy of anterior temporal lobectomy.

Significance

The scientific and payor communities typically demand randomized controlled trials (RCTs) as definitive evidence for safety and efficacy claims. However, in circumstances where the medical device has already been cleared by regulatory authorities and is readily available in the market, an RCT may not be feasible to execute. It is therefore crucial to gain acceptance by both the scientific community and regulators to design a study that will satisfy all concerned.