bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID‐19 and breast fine needle aspiration cytology method: What should we change?
Authors: Nicosia Luca , Bozzini Anna Carla , Latronico Antuono , Addante Francesca , Mastropasqua Mauro Giuseppe , Meneghetti Lorenza , Mauri Giovanni , De Fiori Elvio , Montesano Marta , Di Tonno Clementina , Midolo De Luca Valeria , Casadio Chiara , Cassano Enrico
Published: February 2021

Introduction

Air‐dried slide preparation for fine needle aspiration cytology procedures is currently considered unsafe because of the risk of infectious aerosols of coronavirus 19. This study compares the safety and accuracy of two different protocols, one with and one without air‐dried slides.

Methods

Starting from 3 March 2020, we discontinued the use of air‐dried slides during breast fine needle aspiration procedures. We selected cases collected during two periods: 2 months before and 2 months after 3 March. In both groups, the number of procedures was recorded together with the distribution of the diagnostic categories and the concordance between cytological and histological results on surgical specimens for lesions suggestive of malignancy, using the chi‐squared test.

Results

Of the 100 procedures performed during the pre‐COVID‐19 period, 55% were negative (C2), 3% were non‐diagnostic (C1) and 40% were positive (C4 or C5). Of the 75 procedures obtained during the COVID‐19 period, 44% were negative (C2), 2.7% were non‐diagnostic (C1) and 52% were positive (C4 or C5). Despite the use of a new protocol during the COVID‐19 period, we observed concordance between cytological and histological results for lesions suggestive of malignancy. There was no statistically significant difference concerning the distribution of the diagnostic categories in the two groups.

Conclusions

Taking into account the slightly lower number of procedures being analysed during the COVID‐19 period, the introduction of a new protocol that does not include air‐dried slides is safe and reliable.
Haemosiderin‐laden mesothelial cells in ascitic fluid: A soft pointer for endometriosis in a female of reproductive age
Authors: Stephen Norton , Gochhait Debasis , Anbalagan Anandhi , Siddaraju Neelaiah
Published: February 2021

The phagocytic property of mesothelial cells has rarely been reported. This letter describes the presence of haemosiderin‐laden mesothelial cells in an ascitic fluid sample.
Metformin and carotid intima‐media thickness in never‐smokers with type 1 diabetes: The REMOVAL trial
Authors: Timmons Joseph G. , Greenlaw Nicola , Boyle James G. , Chaturvedi Nish , Ford Ian , Brouwers Martijn C. G. J. , Tillin Therese , Hramiak Irene , Hughes Alun D. , Jenkins Alicia J. , Klein Barbara E. K. , Klein Ron , Ooi Teik C. , Rossing Peter , Stehouwer Coen D. A. , Sattar Naveed , Colhoun Helen M. , Petrie John R. ,   for the REMOVAL Study Group
Published: February 2021

Aim

To determine whether metformin's effects on carotid artery intima‐media thickness (cIMT) in type 1 diabetes differ according to smoking status.

Methods

Regression model effect estimates for the effect of metformin versus placebo (double‐blind) on carotid IMT were calculated as a subgroup analysis of the REMOVAL trial.

Results

In 428 randomized participants (227 never‐smokers, 201 ever‐smokers), averaged mean carotid IMT progression (per year) was reduced by metformin versus placebo in never‐smokers (−0.012 mm, 95% CI −0.021 to −0.002; p = .0137) but not in ever‐smokers (0.003 mm, 95% CI −0.008 to 0.014; p = .5767); and similarly in non‐current smokers (−0.008 mm, 95% CI −0.015 to −0.00001; p = .0497) but not in current smokers (0.013 mm, 95% CI −0.007 to 0.032; p = .1887). Three‐way interaction terms (treatment*time*smoking status) were significant for never versus ever smoking (p = .0373, prespecified) and non‐current versus current smoking (p = .0496, exploratory). Averaged maximal carotid IMT progression (per year) was reduced by metformin versus placebo in never‐smokers (−0.020 mm, 95% CI −0.034 to −0.006; p = .0067) but not in ever‐smokers (−0.006 mm, 95% CI −0.020 to 0.008; p = .4067), although this analysis was not supported by a significant three‐way interaction term.

Conclusions

This subgroup analysis of the REMOVAL trial provides additional support for a potentially wider role of adjunct metformin therapy in cardiovascular risk management in type 1 diabetes, particularly for individuals who have never smoked cigarettes.
Variability in estimated glomerular filtration rate and the risk of major clinical outcomes in diabetes: Post hoc analysis from the ADVANCE trial
Authors: Jun Min , Harris Katie , Heerspink Hiddo J. L. , Badve Sunil V. , Jardine Meg J. , Harrap Stephen , Hamet Pavel , Marre Michel , Poulter Neil , Kotwal Sradha , Gallagher Martin , Perkovic Vlado , Chalmers John , Woodward Mark ,   ADVANCE Collaborative Group
Published: February 2021

There are limited data on whether estimated glomerular filtration rate (eGFR) variability modifies the risk of future clinical outcomes in type 2 diabetes (T2D). We assessed the association between 20‐month eGFR variability and the risk of major clinical outcomes in T2D among 8241 participants in the ADVANCE trial. Variability in eGFR (coefficient of variation [CVeGFR]) was calculated from three serum creatinine measurements over 20 months. Participants were classified into three groups by thirds of CVeGFR: low (≤6.4; reference), moderate (>6.4 to ≤12.1) and high (>12.1). The primary outcome was the composite of major macrovascular events, new or worsening nephropathy and all‐cause mortality. Cox regression models were used to estimate hazard ratios (HRs). Over a median follow‐up of 2.9 years following the 20‐month period, 932 (11.3%) primary outcomes were recorded. Compared with low variability, greater 20‐month eGFR variability was independently associated with higher risk of the primary outcome (HR for moderate and high variability: 1.07, 95% CI: 0.91–1.27 and 1.22, 95% CI: 1.03–1.45, respectively) with evidence of a positive linear trend (p = .015). These data indicate that eGFR variability predict changes in the risk of major clinical outcomes in T2D.
Lower risk of death and cardiovascular events in patients with diabetes initiating glucagon‐like peptide‐1 receptor agonists or sodium‐glucose cotransporter‐2 inhibitors: A real‐world study in two Italian cohorts
Authors: Baviera Marta , Genovese Stefano , Lepore Vito , Colacioppo Pierluca , Robusto Fabio , Tettamanti Mauro , D'Ettorre Antonio , Avanzini Fausto , Fortino Ida , Nicolucci Antonio , Roncaglioni Maria C. , Giorgino Francesco
Published: February 2021

Aim

To examine the efficacy and safety of glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) and sodium‐glucose cotransporter‐2 (SGLT2) inhibitors compared with other antihyperglycaemic agents (AHAs) in large and unselected populations of the Lombardy and Apulia regions in Italy.

Materials and Methods

An observational cohort study of first‐time users of GLP‐1RAs, SGLT2 inhibitors or other AHAs was conducted from 2010 to 2018. Death and cardiovascular (CV) events were evaluated using conditional Cox models in propensity‐score‐matched populations. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for each region and in a meta‐analysis for pooled risks.

Results

After propensity‐score matching, the Lombardy cohort included 18 716 and 11 683 patients and the Apulia cohort 9772 and 6046 patients for the GLP‐1RA and SGLT2 inhibitor groups, respectively. Use of GLP‐1RAs was associated with lower rates of death (HR 0.61, CI 0.56‐0.65, Lombardy; HR 0.63, CI 0.55‐0.71, Apulia), cerebrovascular disease and ischaemic stroke (HR 0.70, CI 0.63‐0.79; HR 0.72, CI 0.60‐0.87, Lombardy), peripheral vascular disease (HR 0.72, CI 0.64‐0.82, Lombardy; HR 0.80, CI 0.67‐0.98, Apulia), and lower limb complications (HR 0.67, CI 0.56‐0.81, Lombardy; HR 0.69, CI 0.51‐0.93, Apulia). Compared with other AHAs, SGLT2 inhibitor use decreased the risk of death (HR 0.47, CI 0.40‐0.54, Lombardy; HR 0.43, CI 0.32‐0.57, Apulia), cerebrovascular disease (HR 0.75, CI 0.61‐0.91, Lombardy; HR 0.72, CI 0.54‐0.96, Apulia), and heart failure (HR 0.56, CI 0.46‐0.70, Lombardy; HR 0.57, CI 0.42‐0.77, Apulia). In the pooled cohorts, a reduction in heart failure was also observed with GLP‐1RAs (HR 0.89, 95% CI 0.82‐0.97). Serious adverse events were quite low in frequency.

Conclusion

Our findings from real‐world practice confirm the favourable effect of GLP‐1RAs and SGLT2 inhibitors on death and CV outcomes across both regions consistently. Thus, these drug classes should be preferentially considered in a broad type 2 diabetes population beyond those with CV disease.
Innovation and Creativity in Times of Crisis
Authors: Hirica Andreea
Published: February 2021

Powered by immersive technologies, life was starting to look a lot like the Sci‐Fi scenario that I had been preaching.

A futures strategist confronts the realities that the pandemic has imposed on our lives, and ponders the roles that Design might play in society going forward.
Entering the Workforce During the Pandemic
Authors: Jaberi Sophia
Published: February 2021

At points in my job search when I was not getting any responses from potential employers, the most impactful thing I did was put myself out there and connect with others.

The pandemic hit just before graduation, making one young professional's job hunt and adjustment to work much different than she expected.
A Mind‐Blowing Period Which I Couldn't Be More Ready For
Authors: Ozkan Gulay
Published: February 2021

Chaotic periods require a different logic and practice… So I have a common practice that helps me to perform even better during crisis periods than in “normal” times.

Having a strategy for how to handle periods of crisis has proven an excellent blueprint for getting through the chaos and uncertainty of the past year.
Nanoparticles as potential external markers for mark–release–recapture studies on Tribolium castaneum
Authors: Gurdasani Komal , Li Li , Rafter Michelle A. , Daglish Gregory J. , Walter Gimme H.
Published: February 2021

Studies of insect movement are hampered by the small size of insects and the associated difficulty in tracking them in the environment. We tested the potential of quantum dots (QDs) to mark large numbers of insects very quickly. Our results demonstrate that green CdTe (cadmium tellurium) QDs were effective markers in the laboratory and can be applied to large numbers of insects very easily. Successful recaptures in the field demonstrate that QDs have great potential as external markers.
Beyond nitrogen: phosphorus – estimating the minimum niche dimensionality for resource competition between phytoplankton
Authors: Hofmann Peter , Clark Adam , Hoffmann Petra , Chatzinotas Antonis , Harpole W. Stanley , Dunker Susanne
Published: February 2021

The niche dimensionality required for coexistence is often discussed in terms of the number of limiting resources. N and P limitation are benchmarks for studying phytoplankton interactions. However, it is generally agreed that limitation by small numbers of resources cannot explain the high phytoplankton diversity observed in nature. Here, we parameterised resource competition models using experimental data for six phytoplankton species grown in monoculture with nine potential limiting resources. We tested predicted species biomass from these models against observations in two‐species experimental mixtures. Uptake rates were similar across species, following the classic Redfield ratio. Model accuracy levelled out at around three to five resources suggesting the minimum dimensionality of this system. The models included the resources Fe, Mg, Na and S. Models including only N and P always performed poorly. These results suggest that high‐dimensional information about resource limitation despite stoichiometric constraints may be needed to accurately predict community assembly.
PTPRJ promotes osteoclast maturation and activity by inhibiting Cbl‐mediated ubiquitination of NFATc1 in late osteoclastogenesis
Authors: Shalev Moran , Arman Esther , Stein Merle , Cohen‐Sharir Yael , Brumfeld Vlad , Kapishnikov Sergey , Royal Isabelle , Tuckermann Jan , Elson Ari
Published: February 2021

Bone‐resorbing osteoclasts (OCLs) are multinucleated phagocytes, whose central roles in regulating bone formation and homeostasis are critical for normal health and development. OCLs are produced from precursor monocytes in a multistage process that includes initial differentiation, cell–cell fusion, and subsequent functional and morphological maturation; the molecular regulation of osteoclastogenesis is not fully understood. Here, we identify the receptor‐type protein tyrosine phosphatase PTPRJ as an essential regulator specifically of OCL maturation. Monocytes from PTPRJ‐deficient (JKO) mice differentiate and fuse normally, but their maturation into functional OCLs and their ability to degrade bone are severely inhibited. In agreement, mice lacking PTPRJ throughout their bodies or only in OCLs exhibit increased bone mass due to reduced OCL‐mediated bone resorption. We further show that PTPRJ promotes OCL maturation by dephosphorylating the M‐CSF receptor (M‐CSFR) and Cbl, thus reducing the ubiquitination and degradation of the key osteoclastogenic transcription factor NFATc1. Loss of PTPRJ increases ubiquitination of NFATc1 and reduces its amounts at later stages of osteoclastogenesis, thereby inhibiting OCL maturation. PTPRJ thus fulfills an essential and cell‐autonomous role in promoting OCL maturation by balancing between the pro‐ and anti‐osteoclastogenic activities of the M‐CSFR and maintaining NFATc1 expression during late osteoclastogenesis.
Nasolabial cyst in an elderly patient: A case report
Authors: Rodrigues Bruno Teixeira Gonçalves , Fischer Ashley , Romañach Mário José , de Andrade Bruno Augusto Benevenuto , de Almeida Freire Nathália , Israel Mônica Simões
Published: February 2021

Introduction

Nasolabial Cyst (NC) or Klestadt's cyst is a relatively rare soft tissue developmental lesion of nasal alar region accounting for 0.7% of all non‐odontogenic cysts. NC usually presents as an asymptomatic swelling located in the anterior region of the maxilla lateral to midline—resulting in obliteration of nasolabial sulcus, nasal vestibule and maxillary labial sulcus and facial asymmetry—often observed on early stages by most patients due to cosmetics issues.

Case report

A 76‐year‐old woman was referred for evaluation of an asymptomatic facial swelling in the left upper lip region lasting 20 years. Extraoral clinical examination showed a left‐sided swelling lateral to midline near to the alar base resulting in facial asymmetry. Intraoral clinical examination revealed the presence of a single painless well‐defined nodular, sessile, non‐tender swelling covered by normal oral mucosa, and located in the upper labial mucosa in the left incisor's region. An excisional biopsy was performed, and microscopic examination revealed a cystic cavity lined by cuboidal to columnar epithelium with mucous cells. The underlying connective tissue showed chronic inflammatory infiltrate close to muscular tissue. Patient recovery was uneventful, and there are no signs of local recurrence in a 2‐year clinical follow‐up.

Conclusion

Clinicians should consider NC when evaluating an upper lip swelling extending to the nasolabial region of the elders.
Fashioning founders: Dress and gender in the entrepreneurial ecosystem
Authors: Richards Harriette , Mattioli Fabio
Published: February 2021

This article considers how entrepreneurs' fashion themselves as founders. Based on ethnographic research conducted in Australia, we discuss whether the informal dress codes of the startup world neutralize gender differences. Our findings suggest that informal dress codes reinforce the normative positionality of men as archetypal entrepreneurial actors. They reinscribe gendered hierarchies that affect the everyday entrepreneurial experience, and extend distinctly different allowances for nonconformity and unconventionality to men and women. Founders attempt to inhabit these gendered inequalities, performing a kind of esthetic labor that mobilizes their appearances to play into as well as counter the gendered expectations of the ecosystem and extract value from their personal and professional fashioning.
Quantifying the impact of braiding and combing on the integrity of natural African hair
Authors: Molamodi Kwezikazi , Fajuyigbe Damilola , Sewraj Poonam , Gichuri Julia , Sijako Babalwa , Galliano Anthony , Laurent Alice
Published: February 2021

Background

Afro hair breakage is most commonly attributed to grooming practices such as braiding, hair extensions and weaves, both for chemically treated hair and natural Afro hair. These grooming practices are also frequently associated with traction alopecia in clinical studies. However, there is little to no quantitative scientific data on the surface and internal hair fibre damage caused by grooming, including combing, on Afro hair.

Methods

Qualitative and quantitative techniques such as scanning electron microscopy, cuticle cohesion and tensile testing were used to determine the effects of frequent braiding on the integrity of female Afro hair in 15 frequent braiders and 15 occasional braiders (control group) in Johannesburg, South Africa. Frequent braiders were women who braided more than 8 times per year, while occasional braiders typically limit braiding to only twice 2 per year. The severity of traction alopecia was quantified in both groups using the standard Marginal Traction Alopecia Scoring system. Surface damage on naturally curly Afro hair, that was combed but not braided, was assessed as another hairstyle option.

Results

All measurements showed a relationship between surface and internal hair fibre damage and braiding frequency. Frequent braiders had thinner hair, with more cuticle damage as shown by SEM and cuticle cohesion assessments. Their hair fibres were also significantly weaker (p < 0.05), as shown by the tensile testing. In addition, they also had higher traction alopecia severity scores. In the combing impact assessment, a linear trend was observed between surface hair fibre damage and the number of combing strokes. Cuticle damage from 480 combing strokes was more severe than that from frequent braiding.

Conclusion

Frequent braiding and combing damage natural Afro hair. Quantification of damage caused by different grooming practices identifies a need to develop products that could help mitigate specific hair damage associated with grooming practices. The degree of damage and subsequent hair loss could also be minimized by education on best braiding practices to protect the hair fibre and avoid hair follicle miniaturization caused by high traction hairstyles.
The Looming Refugee Crisis in the EU: Right‐Wing Party Competition and Strategic Positioning
Authors: Downes James Floyd , Loveless Matthew , Lam Andrew
Published: February 2021

Despite a rise in the number of competitive far right parties leading up to the European refugee crisis, some centre right parties achieved or maintained electoral success. We argue that some centre right parties recognize the electoral opportunity for radical right parties to exploit the refugee crisis for electoral gains and strategically adopt hard‐line positions on immigration to maintain and even increase their electoral success. We test our theory of strategic positioning using data on party competition in national parliamentary elections across 28 EU member states at the start of the refugee crisis. Strategic positioning appears to be a particularly successful choice for centre right parties. The quantitative analysis is supported by case studies in Western Europe of Austria and The Netherlands. Whilst strategic positioning may produce short‐term electoral success, it also mainstreams radical immigration positions in contemporary European politics, with negative implications for liberal democracy in Europe.
Glyoxal‐induced formation of advanced glycation end‐products in type 1 collagen decreases both its strength and flexibility in vitro
Authors: Kitamura Kei‐ichiro , Hirayama Jun , Tabuchi Yoshiaki , Minami Takao , Matsubara Hajime , Hattori Atsuhiko , Suzuki Nobuo
Published: February 2021

The high plasma glucose induced in glucose metabolism disorders leads to the non‐enzymatic glucose‐dependent modification (glycation) of type 1 collagen, which is an essential component of bone tissue. The glycation of proteins induces the formation of advanced glycation end‐products, such as carboxymethyl arginine, which is preferentially generated in glycated collagen. However, the effect of advanced glycation end‐product formation on the characteristics of type 1 collagen remains unclear due to the lack of suitable in vitro experimental systems analyzing type 1 collagen. Here, we show that the glycation of type 1 collagen can be analyzed in vitro using a goldfish‐scale bone model. Our study using these scales provides evidence that the advanced glycation end‐product formation in type 1 collagen induced by glyoxal, the carboxymethyl arginine inducer, facilitates the crosslinking of type 1 collagen, decreasing both its strength and flexibility.
Chronic total occlusion percutaneous coronary intervention in octogenarians and nonagenarians
Authors: Vemmou Evangelia , Alaswad Khaldoon , Patel Mitul , Mahmud Ehtisham , Choi James W. , Jaffer Farouc A. , Doing Anthony H. , Dattilo Phil , Karmpaliotis Dimitri , Krestyaninov Oleg , Khelimskii Dmitrii , Nikolakopoulos Ilias , Karacsonyi Judit , Xenogiannis Iosif , Garcia Santiago , Burke M. Nicholas , Abi Rafeh Nidal , ElGuindy Ahmed , Goktekin Omer , Abdo Abir , Rangan Bavana V. , Abdullah Shuaib , Brilakis Emmanouil S.
Published: February 2021

Objective

The outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in octogenarians and nonagenarians have received limited study.

Methods

We compared in‐hospital outcomes of CTO PCI between patients ≥80 vs. <80‐years‐old in 6233 CTO PCIs performed between 2012 and 2020 at 33 U.S. and international centers.

Results

There were 415 octogenarians and nonagenarians in our study (7% of the total population). Compared with younger patients, octo‐ and nonagenarians were less likely to be men (73% vs. 83.2%, p < 0.0001) and more likely to have atrial fibrillation (27% vs. 12%, p < 0.0001) and prior coronary artery bypass graft surgery (CABG) (43% vs. 29%, p < 0.0001). They were more likely to have CTOs with moderate/severe calcification (71% vs. 46%, p < 0.0001), but had similar mean J‐CTO scores (2.5 ± 1.3 vs. 2.4 ± 1.3, p = 0.08). They had lower technical and procedural success (82.2% vs. 86.3%, p = 0.0201; 80.3% vs. 84.8%, p = 0.016, respectively) and higher incidence of in‐hospital major adverse cardiovascular events (3.4% vs. 1.8%, p = 0.021). On multivariable analysis PCI in octo‐ and nonagenarians was not independently associated with technical and procedural success or with in‐hospital MACE.

Conclusion

CTO PCI is feasible in octo‐ and nonagenarians, although success rates are lower, and the risk of complications is higher compared with younger patients, likely related to more comorbidities and higher coronary lesion complexity.
Histological and ultrasonographic alterations in skin and soft tissue in upper eyelid excised blepharoplasty due to ipsilateral eyebrow tattooing: (preliminary findings)
Authors: Jamshidian Tehrani Mansooreh , Mirghorbani Masoud , Najafi Laily , Sharif Kashani Shervin , Asadi Amoli Fahimeh , Asadi Khameneh Esmaeil
Published: February 2021

Background

Eyebrow tattooing (ET) is a relatively common cosmetic procedure for middle‐aged women which can hide age‐related ptosis.

Aims

We aimed to evaluate the periocular soft tissue changes following ET and its effects on upper eyelid blepharoplasty (UEBL).

Patients/Methods

In this non‐randomized prospective case‐controlled study, 28 subjects recruited, 14 with ET for at least 5 years and 14 without ET. Eyebrows ultrasonography was performed to measure the periocular soft tissue thickness including skin and subcutaneous tissue on the medial and lateral side of the eyebrow. Then, UEBL was performed with extended eyelid skin incisions. So, the excised tissues being evaluated histopathologically.

Results

The mean age of patients was 50.6 ± 0.6 and 51.2 ± 5.59 years in non‐eyebrow tattooing (NET) and ET groups, respectively (P = .78). In the ET group, soft tissue thickness was, respectively, equal to 5.90 ± 1.10 and 6.3 ± 0.95 mm on the lateral and medial side of the eyebrow, which were significantly thicker compared to the NET group (4.68 ± 0.69 and 4.78 ± 0.56 mm, respectively)(P = .001). Histopathological findings were ranging from edema‐congestion to chronic inflammation and dermal fibrosis which were more frequently seen in ET group. However, this difference was statistically significant only for dermal fibrosis (P = .02). Surgical wound complications were observed in 3 patients who were in the ET group (P = .22).

Conclusion

Subjects with eyebrow tattooing, as compared to a control group, showed a thicker eyebrow skin on ultrasonography and higher upper eyelid dermal fibrosis on histopathological examination.
Integrating nutrition into the education sector in low‐ and middle‐income countries: A framework for a win–win collaboration
Authors: Xu Yvonne Yiru , Sawadogo‐Lewis Talata , King Shannon E. , Mitchell Arlene , Roberton Timothy
Published: February 2021

Malnutrition—both undernutrition and overnutrition—is a public health concern worldwide and particularly in low‐ and middle‐income countries (LMICs). The education sector has high potential to improve immediate nutrition outcomes by providing food in schools and to have more long‐term impact through education. We developed a conceptual framework to show how the education sector can be leveraged for nutrition. We reviewed the literature to identify existing frameworks outlining how nutrition programs can be delivered by and through the education sector and used these to build a comprehensive framework. We first organized nutrition programs in the education sector into (1) school food, meals, and food environment; (2) nutrition and health education; (3) physical activity and education; (4) school health services; and (5) water, sanitation, and hygiene (WASH) sector. We then discuss how each one can be successfully implemented. We found high potential in improving nutrition standards and quality of school foods, meals and food environment, especially through collaboration with the agriculture sector. There is a need for well‐integrated, culturally appropriate nutrition and health education into the existing school curriculum. This must be supported by a skilled workforce—including nutrition and public health professionals and school staff. Parental and community engagement is cornerstone for program sustainability and success. Current monitoring and evaluation of nutrition programming in schools is weak, and effectiveness, including cost‐effectiveness, of interventions is not yet adequately quantified. Finally, we note that opportunities for leveraging the education sector in the fight against rising overweight and obesity rates are under‐researched and likely underutilized in LMICs.
Impact of worsening renal function on peak oxygen uptake in patients with acute myocardial infarction
Authors: Ogura Asami , Izawa Kazuhiro P. , Tawa Hideto , Kureha Fumie , Wada Masaaki , Kanai Masashi , Kubo Ikko , Yoshikawa Ryohei , Matsuda Yuichi
Published: February 2021

Aim

Worsening renal function (WRF) induced by acute myocardial infarction (AMI) is a strong predictor of cardiovascular events and mortality. Peak oxygen uptake may contribute to prognosis in AMI patients with WRF, however, the impact of WRF on peak oxygen uptake is unclear.

Methods

Among 154 patients with AMI who underwent emergency percutaneous coronary intervention and participated in phase II cardiac rehabilitation, those who underwent cardiopulmonary exercise testing were consecutively enrolled. WRF was defined as a ≥20% decrease in estimated glomerular filtration rate (eGFR [ml/min/1.73 m2]) from admission to that at cardiopulmonary exercise testing. The association of WRF with peak oxygen uptake was evaluated by multivariate regression analysis. The non‐WRF group was divided into two subgroups according to eGFR <60/≥60 at cardiopulmonary exercise testing, and eGFR at cardiopulmonary exercise testing and peak oxygen uptake of all three groups were compared.

Results

Ninety‐four patients were enrolled in the final analysis. Multiple linear regression analysis showed that WRF was associated with peak oxygen uptake (p = .003). Comparing the non‐WRF group with eGFR at cardiopulmonary exercise testing <60 and the WRF group, although eGFR at cardiopulmonary exercise testing was similar (p = 1.000), peak oxygen uptake in the WRF group was significantly lower (p = .026).

Conclusion

WRF, not eGFR at cardiopulmonary exercise testing was significantly associated with peak oxygen uptake in patients with AMI. This result suggests that when considering the relationship between renal function and peak oxygen uptake, WRF must be taken into account.
Malignant transformation of oral leukoplakia: Systematic review and meta‐analysis of the last 5 years
Authors: Aguirre‐Urizar José M. , Lafuente‐Ibáñez de Mendoza Irene , Warnakulasuriya Saman
Published: February 2021

Objective

Oral leukoplakia (OL) is the most frequently encountered oral potentially malignant disorder. The aims of this systematic review are to estimate the overall malignant transformation of OL and to assess the risk factors associated with malignant transformation of OL published in the last 5 years (2015–2020).

Materials and Methods

We performed a bibliographic search in PubMed, Scopus, Web of Science, Embase, and Cochrane databases with keywords “oral leukoplakia”, “oral cancer”, “oral carcinoma” and “oral squamous cell carcinoma”. Meta‐analysis was conducted using a random‐effects model.

Results

Twenty‐four studies were selected, that reported a total of 16,604 patients. Malignant transformation proportion varied between 1.1% and 40.8%. Female gender, non‐homogeneous clinical type, and presence of epithelial dysplasia were significantly related to MT. Other risk factors previously suggested did not show significant results.

Conclusions

The pooled proportion of malignant transformation MT was 9.8% (95% CI: 7.9–11.7). It is necessary to continue to conduct well‐designed prospective clinicopathological studies on OL, using a uniform definition for OL to reduce the risk of bias for evaluating various factors associated with the MT.
Development of nasal allergen challenge with cockroach in children with asthma
Authors: Rudman Spergel Amanda K. , Sever Michelle L. , Johnson Jacqueline , Gill Michelle A. , Schulten Veronique , Frazier April , Kercsmar Carolyn M. , Lovinsky‐Desir Stephanie , Searing Dan A. , Sette Alessandro , Shao Baomei , Teach Stephen J. , Gern James E. , Busse William W. , Togias Alkis , Wood Robert A. , Liu Andrew H. ,   the National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium
Published: February 2021

Background

Nasal allergen challenge (NAC) could be a means to assess indication and/or an outcome of allergen‐specific therapies, particularly for perennial allergens. NACs are not commonly conducted in children with asthma, and cockroach NACs are not well established. This study's objective was to identify a range of German cockroach extract doses that induce nasal symptoms and to assess the safety of cockroach NAC in children with asthma.

Methods

Ten adults (18‐37 years) followed by 25 children (8‐14 years) with well‐controlled, persistent asthma and cockroach sensitization underwent NAC with diluent followed by up to 8 escalating doses of cockroach extract (0.00381‐11.9 µg/mL Bla g 1). NAC outcome was determined by Total Nasal Symptom Score (TNSS) and/or sneeze score. Cockroach allergen–induced T‐cell activation and IL‐5 production were measured in peripheral blood mononuclear cells.

Results

67% (6/9) of adults and 68% (17/25) of children had a positive NAC at a median response dose of 0.120 µg/mL [IQR 0.0380‐0.379 µg/mL] of Bla g 1. Additionally, three children responded to diluent alone and did not receive any cockroach extract. Overall, 32% (11/34) were positive with sneezes alone, 15% (5/34) with TNSS alone, and 21% (7/34) with both criteria. At baseline, NAC responders had higher cockroach‐specific IgE (P = .03), lower cockroach‐specific IgG/IgE ratios (children, P = .002), and increased cockroach‐specific IL‐5–producing T lymphocytes (P = .045). The NAC was well tolerated.

Conclusion

We report the methodology of NAC development for children with persistent asthma and cockroach sensitization. This NAC could be considered a tool to confirm clinically relevant sensitization and to assess responses in therapeutic studies.
Non‐HLA AT1R antibodies are highly prevalent after pediatric intestinal transplantation
Authors: Chan Alvin P , Guerra Marjorie‐Anne R , Rossetti Maura , Hickey Michelle J , Venick Robert S , Marcus Elizabeth A , McDiarmid Suzanne V , Farmer Douglas G , Reed Elaine F , Wozniak Laura J
Published: February 2021

The role of angiotensin II type‐1 receptor (AT1R) antibodies in intestinal transplantation (ITx) is unclear. The aims were 1) to identify the prevalence of AT1R antibodies in pediatric ITx, compared to pediatric intestinal failure (IF), and 2) to determine whether AT1R antibodies were associated with graft dysfunction. 46 serum samples from 25 ITx patients (3 isolated ITx, 22 liver‐inclusive ITx) were collected during routine visits >6 months apart and during episodes of graft dysfunction as a result of infectious enteritis or rejection. For comparison, samples were collected from 7 IF control patients. AT1R antibodies were considered positive for levels >17 U/mL. The median (range) AT1R antibody level for ITx patients was 40.0 U/mL (7.2–40.0), compared to 7.0 U/mL (5.7–40.0) for IF patients (p = .02). There was a trend toward higher prevalence of AT1R antibodies in ITx compared with IF patients (68% versus 29%, p = .09). Among ITx patients, the prevalence of AT1R antibodies was not different between periods of active graft dysfunction and normal health (83% versus 67%, p = .31). For 16 patients with >2 samples, AT1R antibodies remained positive in 67% cases, developed in 14% cases, disappeared in 10% cases, and remained negative in 10% cases. The changes in AT1R antibodies did not correlate with de/sensitizing events. This is the first study of AT1R antibodies in pediatric ITx. AT1R antibodies are highly prevalent after ITx and may be triggered by immune activation associated with the transplant. However, their pathogenicity and clinical utility remain in question.
Molecular and physiological characterization of Arabidopsis–Colletotrichum gloeosporioides pathosystem
Authors: Gao Mengze , Wan Miting , Yang Liyun , Zhao Meng , Liu Xiaojin , Chen Jiajia , Liu Pandao , Jiang Lingyan , Luo Lijuan
Published: February 2021

Anthracnose is a destructive disease that affects a wide range of crop plants especially in tropical and subtropical regions. Colletotrichum spp. are the major pathogens causing anthracnose. In this study, we collected and identified the pathogen from diseased samples of Stylosanthes, a major tropical forage crop. The ability of the pathogen to naturally infect Arabidopsis thaliana was examined. Sequence analysis of ITS, ACT, CHS, and GAPDH genes showed the pathogen to be Colletotrichum gloeosporioides sensu lato (s.l.), and this was supported further by morphological characterization of representative isolates. The disease symptoms and cellular infection process of aggressive isolates (DZ‐19 and HK‐04) and a weak isolate (CJ‐04) were compared. DZ‐19 and HK‐04 caused more severe disease symptoms on both young seedlings and adult plants of Col‐0 and Ws‐2 ecotypes compared to CJ‐04. Furthermore, the more aggressive isolates showed faster and earlier germination of conidia, formation of appressoria, and growth and development of hyphae during the infection. Genetic analysis of the defence response and expression profiling of defence marker genes demonstrated the involvement of MAP kinase, Ca2+‐dependent protein kinase, salicylic acid, ethylene, and jasmonic acid pathways in the resistance against anthracnose. These results suggest that the Arabidopsis–Colletotrichum gloeosporioides pathosystem should provide a valuable tool for exploring the resistance mechanisms against this pathogen.
Patterns and drivers of structure, diversity, and composition in species‐rich shrublands restored after mining
Authors: Riviera Fiamma , Renton Michael , Dobrowolski Mark P , Veneklaas Erik J , Mucina Ladislav
Published: February 2021

Long‐term studies of vegetation recovery following post‐mining restoration in low‐productivity, high‐stress areas are limited, but essential for understanding underlying ecological processes and evaluating management practices. This study's goal was to describe temporal patterns of recovery (up to 37 years) in vegetation structure, floristic diversity, and composition following post‐mining restoration at two sites, and identify potential drivers of restoration outcomes, in the nutrient‐poor, seasonally dry, species‐rich, fire‐prone kwongan vegetation of southwest Western Australia. Vegetation development is progressing and restoration measures are within range of native reference values, but there is large variation in both patterns observed and restoration outcomes. Several patterns described share similarities with post‐fire recovery of kwongan, and post‐disturbance recovery of other low‐productivity, high‐stress, fire‐prone systems. However, differences in some patterns between sites indicate differences in the underlying mechanisms of recovery. Many management and environmental variables emerge as significant drivers of restoration outcomes but age, fire, and the planting of seedlings account for the largest amount of variation. Adaptive management at both sites appears to be facilitating improved restoration outcomes over time. Using a combination of space‐for‐time, plot level, and linear mixed effects modeling perspectives to examine patterns provides greater insights into restoration recovery than a chronosequence perspective alone. This study will inform restoration practices and outcomes not only in kwongan but in other comparable systems also.
What to train first: Balance or explosive strength? Impact on performance and intracortical inhibition
Authors: Lauber Benedikt , Gollhofer Albert , Taube Wolfgang
Published: February 2021

Explosive strength and balance training are commonly applied to enhance explosive strength and balance performance. Even though both training methods are frequently implemented, ordering effects have largely been neglected. Therefore, the present study aimed to investigate ordering effects of balance and explosive strength training on explosive strength and balance performance as well as changes in short‐interval intracortical inhibition (SICI). Two groups of subjects either participated in 4 weeks of balance training followed by 4 weeks of explosive strength training (BT‐ET) or vice versa (ET‐BT). Before, after 4 and 8 weeks, balance performance, as well as explosive strength, was tested. Additionally, SICI was tested during rest as well as during balance perturbations and explosive contractions. The results show a training specific increase in performance with an increase in balance control followed by an increase in explosive strength in the BT‐ET, while the ET‐BT increased its balance and explosive strength in the opposite order. There were no significant ordering effects. Both groups showed a significant decrease in SICI during the explosive contractions after the eight weeks of training. When SICI was tested during the balance perturbations, SICI initially increased after the first 4 weeks of training but returned to baseline until the end of the eight weeks. It is suggested that the decrease in SICI with prolonged training might show a disengagement of the motor cortex during the balance task. During the explosive contractions, the low SICI levels are beneficial to provide the necessary level of excitatory cortical drive.
Amniotic membrane grafting for traumatic complete spectaculectomy and keratomalacia in a Boelen’s python (Simaliaboeleni)
Authors: Ledbetter Eric C. , Marion Jonah S. , Morrisey James K.
Published: February 2021

Objective

To describe the surgical repair of traumatic complete spectaculectomy and keratomalacia in a snake.

Animals

A 10.5‐year‐old, female, Boelen's python (Simalia boeleni) was presented with iatrogenic, near‐complete spectaculectomy associated with bacterial keratitis, keratomalacia, and hypopyon.

Procedures

Corneal samples for cytological evaluation and bacterial culture were collected. Following medical stabilization of the bacterial keratitis, a double‐layered dry amniotic membrane graft was placed. The first amniotic membrane layer was placed over the cornea with the edges tucked under the peripheral remnants of the spectacle and secured in place with fibrin glue. The second amniotic membrane layer was placed over the entirety of the spectacle remnant and secured in place with a combination of fibrin glue and sutures. Topical and systemic antimicrobials, topical ophthalmic lubricants, and systemic non‐steroidal anti‐inflammatory therapy were administered postoperatively.

Results

Heterophilic keratitis was identified by cytology and Enterobacter cloacae, Pseudomonas aeruginosa, and Staphylococcus sciuri were cultured from the corneal samples. The amniotic membrane grafts remained in place for several weeks. At 4 months postoperatively, the spectacle was completely regenerated, the subspectacular space restored, and the cornea was transparent. Spectacular vascularization and fibrosis then slowly cleared over the following 6 months.

Conclusions and clinical relevance

Amniotic membrane grafting with fibrin glue is a relatively simple and effective surgical method to reconstruct extensive defects in the reptilian spectacle and to assist in the management of bacterial keratitis associated with spectacle avulsion.
Polyaxial pedicle screw external fixation to stabilize oblique mandibular fractures in three standing, sedated horses
Authors: Nelson Brad B. , Easley Jack , Steward Sara K. T. , Smanik Lauren E. , Koch Drew W. , Rawlinson Jennifer E. , Easley Jeremiah T.
Published: February 2021

Objective

To report the radiographic, surgical and postoperative features in horses with unstable oblique mandibular fractures secured with polyaxial pedicle screws (PPS) external fixation construct and intraoral wiring.

Animals

Three client‐owned horses.

Study design

Short case series.

Methods

Two horses each had a unilateral fracture, which did not improve after conservative management, and one horse had bilateral fractures. Clinical and radiographic features were documented. Polyaxial pedicle screw external fixators and intraoral tension band wiring were applied in standing horses after combining sedation and regional nerve anesthesia. Intraoral wires were implanted through a lateral buccotomy between teeth (two horses) or burred through exposed crown (one horse) and then secured around the incisors. The PPS were inserted under radiographic guidance to avoid tooth roots. Healing was assessed with radiographic examination. The PPS external fixator rod and intraoral wires were removed first. The mandible was manipulated, and, if it was stable, the PPS were removed.

Results

Implants were removed at 6, 8, or 10 weeks after the mandibles were palpably stable. Complications included broken wires in one horse, bone sequestration in one horse, and infection in one horse. Follow‐up communication with the owners 12 to 18 months later confirmed complete healing without further complications of the fractured mandibles or teeth.

Conclusion

Polyaxial pedicle screw external fixation led to fracture healing and a return to function in all three horses. The complications encountered did not preclude a successful outcome.

Clinical significance

Polyaxial pedicle screw external fixation coupled with intraoral wiring provides an alternative to treat unstable equine mandibular fractures without general anesthesia.
Intelligent-Agent Approach to Distance Learning
Authors: Fukuda Shuichi , Matsuura Yoshifusa , Kandie Kigen
Published: February 2021

With the proliferation of computers at home and in the work place, email, internet browsers, chat rooms, and network bandwidth availability, the traditional concept of skill training passed from experts to apprentices can now take on a new paradigm shift where these skills can be taught over the internet. With the primary goal of developing a general tool that supports the transfer of skill from an expert to a group of users, this paper proposes a new approach to distance learning, which we consider a subset of the above group, from the current one-to-one (or top-down) approach to a many-to-many (or bottom-up) approach. We introduce the concept of a network centric intelligent agent that will support the passing of knowledge from teacher to students.
Methods of 3D-Modelling With Parametric CAD-Systems of the Newest Generation
Authors: Grote Karl-H. , Schumann Soeren
Published: February 2021

The authors are searching for new ways of using CAD-systems in the engineering design process. This contents among others the creation as well as the refreshing and continued handling of computer-based, three-dimensional product models to be built as prototypes on the department’s Rapid Prototyping machine [1, 2, 3].

In spite of the many advantages of the C-technologies, on several areas a deficit in its dissemination and effective usage still is noticed.

The following paper will give an overview on how the parametrical, feature based 3D-CAD-modeler may support the engineering design process. It is described, which functionality the parametric functions of these modelers are offering to the user and how the work with parametrical CAD-systems is structured. Advises are given for a more competitive implementation and time saving work with these systems.
Piping Route Path Planning Using Genetic Algorithm
Authors: Ito Teruaki , Fukuda Shuichi
Published: February 2021

With the increasing diversity of personal preferences for products, the conventional style of design using a series of consecutive procedures is inadequate to create designs that satisfy those preferences under the frequent changes of requirements in design specifications. Under these circumstances, conceptual design plays a key role to comply with those preferences and requirements, and to shorten the lead time in product development. This is also true in the domain of piping layout design, where a designer makes design in a trial-and-error way to comply with the requirements frequently changed in specification until the final design is formulated.

The paper describes an approach of piping route path planning using genetic algorithm (GA). Optimization technique of GA generates a preliminary route path through evolution of genes which represent the piping route path. A designer evaluates the route path, modifies it, and repeats the procedure until the appropriate path is designed. In this way, a designer can interactively proceed the layout of piping in a collaborative manner using a design support system. The paper shows the procedure of the method and some results of simulation.
A Model for Software Interoperation in Engineering Enterprise Integration
Authors: Howie Cameron T. , Law Kincho H. , Kunz John C.
Published: February 2021

Engineering companies are seeking ways to achieve software interoperability between their internal applications and those of external vendors and customers. The emergence of open data exchange standards such as STEP, as well as the wide variety of possible implementation technologies, has led to our development of a model capable of supporting such software interoperation. Our model is independent of any specific implementation approach and protects proprietary knowledge of the software tools and data standards used within the participating organizations. It provides great flexibility in the configuration of software services and data exchange standards used. We have completed a formal description of the model and are now preparing to test it both locally at Stanford and with support from industrial corporations.