bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Experiential Games and Improved Risk Coverage Raise Demand for Index Insurance? Evidence from Kenya
Authors: Janzen Sarah , Magnan Nicholas , Mullally Conner , Shin Soye , Palmer I. Bailey , Oduol Judith , Hughes Karl
Published: August 2020

Uninsured risk impedes agricultural production, but traditional indemnity insurance is not a viable option for smallholder farmers due to market failures. Weather index insurance is often touted as an alternative risk management tool. Demand for weather index insurance, however, has been weak. One possible reason is basis risk, the mismatch between index insurance payouts and individual outcomes. We estimate the impact of two interventions on preferred coverage under a real index insurance product, as revealed through an auction: (a) a reduction in basis risk, and (b) an experiential game that teaches farmers how index insurance works, with an emphasis on basis risk. We show all farmers demonstrate strong sensitivity to basis risk. The experiential game modestly increased knowledge, and experiential game participants indicate higher levels of preferred insurance coverage. Although offering a lower basis risk insurance product and playing an experiential game both increase preferred coverage in isolation, there is no additional impact of doing both. We adapt a theoretical model of misattribution bias to demonstrate how reference‐dependent learning with loss aversion could lead to this unexpected result.
La protein contributes to cells proliferation and migration and serves as a potential therapeutic target for hepatocellular carcinoma
Authors: Pan Jiaqian , Tong Shuangmei , Kong Lingjun , Zhu Jialei , Tang Jing
Published: August 2020

Aim

La protein is a multifunctional RNA‐binding protein involved in RNA metabolism that has been reported to promote the growth of some solid tumors. However, potential role of La in hepatocellular carcinoma (HCC) has not been fully elucidated. This study aimed to investigate the expression of La and its function in HCC.

Methods

Quantitative real‐time polymerase chain reaction (qRT‐PCR) and western blot analysis were conducted to detect the expression levels of La mRNA and protein in HCC cells and tissues. The proliferation capability of cells was clarified by Cell Counting Kit‐8 and clone formation assays. Wound healing assay was carried out to assess cell migration ability. Related protein expressions were also analyzed by western blot.

Results

Analysis of our clinical samples showed that La mRNA and protein expression of HCC tissues was higher than those of corresponding adjacent tissues, consistent with the result of microarray datasets from Oncomine database. La was also significantly overexpressed in eight HCC cells, compared with normal hepatocytes. According to in vitro experiments, we demonstrated that knockdown of La inhibited HCC cell proliferation and migration.

Conclusions

Our results revealed that La expression is elevated both at the RNA and protein levels in HCC. Highly expressed La significantly promotes tumorigenesis of HCC, suggesting that La may be a potential therapeutic target for the treatment of HCC.
Maternal characteristics and neonatal outcomes of emergency repeat caesarean deliveries due to early‐term spontaneous labour onset
Authors: Nitahara Kenta , Fujita Yasuyuki , Magarifuchi Naomi , Taniguchi Shuichi , Shimamoto Tomihiro
Published: August 2020

Background

The optimal timing of elective repeat caesarean delivery has yet to be determined. One of the reasons to schedule an elective repeat caesarean delivery before 39 weeks gestation is to avoid emergency caesarean delivery due to spontaneous onset of labour.

Aims

By ascertaining maternal characteristics and neonatal outcomes associated with early‐term onset of spontaneous labour, we aim to determine the optimal timing for each individual repeat caesarean delivery.

Materials and Methods

We performed a retrospective analysis of women with repeat caesarean deliveries planned at 38 weeks gestation between 2005 and 2019 at a tertiary referral hospital in Japan. A multivariate logistic regression analysis was adopted to identify independent contributing factors for early‐term spontaneous labour onset. We also compared the rate of neonatal adverse events between women who underwent emergency repeat caesarean deliveries due to the onset of early‐term labour and the ones who underwent elective repeat caesarean deliveries at 38 weeks.

Results

We included 1152 women. History of vaginal deliveries (adjusted odds ratio (AOR), 2.12; 95% confidence interval (95% CI), 1.21–3.74), history of preterm deliveries (AOR, 2.28; 95% CI, 1.38–3.77), and inadequate maternal weight gain during pregnancy (AOR, 1.78; 95% CI, 1.15–2.75) significantly increased the risk of early‐term spontaneous labour onset. In terms of occurrence rate of neonatal complications, we found no significant difference between the groups.

Conclusion

These maternal factors are significant predictors for early‐term labour onset of repeat caesarean deliveries. The onset of early‐term labour did not increase the likelihood of neonatal complications.
Rat model and validation of a modified single‐armed suture technique for microsurgical vasoepididymostomy: Guo’s SA‐LIVE
Authors: Yuan Yiming , Fang Dong , Lei Hongen , Li Meng , Cheng Wanjun , Gao Bing , Peng Jing , Zhang Zhichao , Xin Zhongcheng , Guo Yinglu
Published: August 2020

Background

Double‐armed suture longitudinal intussusception vasoepididymostomy (DA‐LIVE) has been widely adopted owing to its simplicity and high success rate; however, specialized double‐armed microsutures are required.

Objective

To provide a novel single‐armed suture longitudinal intussusception vasoepididymostomy (SA‐LIVE) technique using only two single‐armed sutures, named Guo's SA‐LIVE.

Materials and methods

Four weeks after vasectomy in male adult Wistar rats, vasoepididymostomies were performed using DA‐LIVE, SA‐LIVE, or Guo's SA‐LIVE. After 12 weeks, functional patency was functionally assessed by evaluating for motile spermatozoa distal to the anastomosis. If no motile spermatozoa were visible, the mechanical patency of the anastomosis was tested by the ability of methylene blue to pass through the surgical anastomosis. The key procedure in Guo's SA‐LIVE was cutting each needle with over 1cm attaching suture and making a flat overhand bend knot to tie the needle to the other end of the suture, after the needles were passed through the epididymal tubule and then the vasal lumen in an inside‐out fashion, and then, the needles were passed through the vasal lumen in an inside‐out fashion.

Results

The proportions of functional patency were 50.0% (3/6), 33.3% (2/6), and 50% (3/6) for the DA‐LIVE, SA‐LIVE, and Guo's SA‐LIVE groups, respectively (P = .799). The proportions of mechanical plus functional patency for the three methods were 83.3% (5/6), 66.7% (4/6), and 83.3% (5/6), respectively (P = .725). The mean anastomosis times for the three LIVE techniques and the proportions of complications were similar (P = .150 and .758, respectively).

Conclusions

Guo's single‐armed suture technique is a potentially effective alternative to perform vasoepididymostomy when specialized double‐armed microsutures are not available based on the current animal experiment.
Effects of interphase interval during neuromuscular electrical stimulation of the wrist extensors with maximally tolerated current intensity
Authors: Elboim‐Gabyzon Michal , Awad Yara
Published: August 2020

Short interphase intervals (IPIs) within biphasic symmetrical pulses enhance maximal electrically induced isometric contractions (EIC). However, IPI effects have not been previously studied in muscles stimulated at the highest tolerated current intensity. Our aim was to examine IPI effects on the strength of EIC, degree of discomfort, and sensory and motor thresholds on the wrist extensor muscles. Eighteen subjects (mean age 25.5, SD ± 3.97 years) participated in a repeated‐measures trial. Five parameter settings were used to stimulate the wrist extensors: monophasic pulses with phase durations (PD) 200 µs, and biphasic pulses with PDs either 200 or 500 µs, applied with/without an IPI of 200 µs duration. Order of settings was randomized, and current was set at the maximum intensity tolerated by each subject. IPIs applied at the maximally tolerated current intensity did not increase the strength of the EICs and did not reduce the degree of discomfort or the sensory and motor thresholds. These findings were not dependent on the PDs. Insertion of an IPI within the biphasic current during stimulation of the wrist muscle yielded no advantage in term of contraction strength or degree of discomfort. These results contradict previous studies indicating stronger contractions when an IPI is inserted during stimulation at a predetermined submaximal current intensity. As some of the clinical applications of neuromuscular electrical stimulation utilize the highest intensity tolerated by the individual, these findings are clinically relevant. Additional studies involving other muscle groups, electrode size and locations, and phase parameters are warranted.
Fatty acid composition of the erythrocyte membrane and risk of hepatocellular carcinoma in cirrhotic patients
Authors: Mouillot Thomas , Rizk Maud , Pais de Barros Jean‐Paul , Gilloteau Adrien , Busson Amandine , Bernard‐Chabert Brigitte , Thiefin Gérard , Barraud Hélène , Bronowicki Jean‐Pierre , Richou Carine , Di Martino Vincent , Doffoel Michel , Minello Anne , Latournerie Marianne , Jouve Jean‐Louis , Brondel Laurent , Brindisi Marie‐Claude , Petit Jean‐Michel , Hillon Patrick , Cottet Vanessa ,   CIRCE Study Group
Published: August 2020

Background

Disturbances in fatty acid (FA) metabolism have been reported in cirrhosis, but the role of FAs in the development of hepatocellular carcinoma (HCC) is still unclear. Biomarkers are a promising means to explore the associations between exogenous intake or endogenous production of FAs and cancer risk.

Aim

To estimate the relationship between fatty acid content in erythrocyte membranes and HCC risk in cirrhotic patients

Methods

The “CiRCE” case‐control study recruited cirrhotic patients from six French hospitals between 2008 and 2012. Cases were cirrhotic patients with HCC (n = 349); controls were cirrhotic patients without HCC at inclusion (n = 550). FA composition of phospholipids in erythrocyte membranes was determined by high performance gas chromatography. Odds ratios for HCC risk according to FA concentrations were estimated with multivariable logistic regression.

Results

HCC patients were older and more often men (P < 0.001). In both groups, saturated FAs represented more than 39% of all FAs in erythrocyte membranes, mono‐unsaturated FAs around 14%, and polyunsaturated FAs around 46%. High levels of C15:0 + C17:0, C20:1 n‐9, C18:2 n‐6 and C20:2 n‐6 were associated with higher risk of HCC. The levels of C18:0 and C20:4 n‐6 were lower in HCC cases than in controls.

Conclusions

The FA composition of erythrocyte membranes differed according to the presence of HCC with higher levels of saturated FAs, linoleic and eicosadienoic acids, and lower levels of stearic and arachidonic acids. These alterations may reflect particular dietary patterns and/or altered FA metabolism. Further investigations are warranted.
Fiscal Sustainability of Local Governments in Japan†
Authors: Yoshida Motonori
Published: August 2020

The total amount of Japan's local government (LG) expenditures exceeds its central government (CG) expenditures. Japan's LG and CG are responsible for the worst general government's debt situation among the G7 countries. The paper elucidated the fiscal reactions of Japan's prefecture governments (PGs) based on Bohn's (1998a, 2005) method with a panel dataset (44PGs, fiscal years 1974–2016), addressing nonstationary and endogeneity issues. In my model, a positive reaction of the primary surplus/gross regional product (GRP) ratio to the PG debt/GRP ratio (d) constitutes a sufficient condition for sustainability. The results of the study demonstrate the following: (i) the PG in any fiscal condition are assumed to provide sustainable fiscal management; (ii) the PGs in sounder or more dire fiscal conditions probably manage their finances more firmly; (iii) the fiscal transfers from the CG generally ease the PG fiscal conditions; (iv) although primary regressors d and dsq (the square of d) are assumed to be I (1) with some accuracy, they become stationary through cointegration with other regressors.
Tunnel grafting for wound repair in horses: a novel technique in graft production and placement
Authors: Kalamanova A , Anderson BH , Cust AR , Fulton IC
Published: August 2020

There are several skin grafting methods described in the human and animal literature. Currently, there are five types of free grafts used in horses: pinch and punch grafts, split and full‐thickness sheet or mesh grafts and tunnel grafts. Published methods of tunnel grafting describe the use of alligator forceps. The alligator forceps create a poor tunnel and are excessively traumatic to the granulation bed. This technique utilised a 13G Jamshidi needle that was placed across the granulation bed and created a uniform tunnel. The Jamshidi needle was atraumatic to the granulation bed increasing the opportunity for graft survival. A twin bladed scalpel allowed for the quick creation of uniform width grafts. Removal of the overlying tunnel ‘roof’ took place 5–14 days later to allow graft expansion. This case series included five horses with distal limb wounds and one with a wither injury. Four horses required general anaesthesia for graft placement and three required general anaesthesia for the removal of the tunnel roof. The acceptance of the grafts varied from 70% to 100%. Graft expansion to cover the granulation tissue took 2–5 months. This case series demonstrates that this technique of graft production and placement is an easy method for achieving successful skin grafting. Compared to other graft types, tunnel grafts are more readily accepted. Cosmetic and functional results achieved are better than those with pinch and punch grafts. Tunnel grafting does not require expensive equipment or advanced training, and in some cases can be performed under standing sedation.
Does orthographic processing emerge rapidly after learning a new script?
Authors: Fernández‐López María , Marcet Ana , Perea Manuel
Published: August 2020

Orthographic processing is characterized by location‐invariant and location‐specific processing (Grainger, 2018): (1) strings of letters are more vulnerable to transposition effects than the strings of symbols in same‐different tasks (location‐invariant processing); and (2) strings of letters, but not strings of symbols, show an initial position advantage in target‐in‐string identification tasks (location‐specific processing). To examine the emergence of these two markers of orthographic processing, we conducted a same‐different task and a target‐in‐string identification task with two unfamiliar scripts (pre‐training experiments). Across six training sessions, participants learned to fluently read and write one of these scripts. The post‐training experiments were parallel to the pre‐training experiments. Results showed that the magnitude of the transposed‐letter effect in the same‐different task and the serial function in the target‐in‐string identification tasks were remarkably similar for the trained and untrained scripts. Thus, location‐invariant and location‐specific processing does not emerge rapidly after learning a new script; instead, they may require thorough experience with specific orthographic structures.
Development of adoptive immunotherapy with KK‐LC‐1‐specific TCR‐transduced γδT cells against lung cancer cells
Authors: Ichiki Yoshinobu , Shigematsu Yoshiki , Baba Tetsuro , Shiota Hironobu , Fukuyama Takashi , Nagata Yoshika , So Tetsuya , Yasuda Manabu , Takenoyama Mitsuhiro , Yasumoto Kosei
Published: August 2020

The present study analyzed the antitumor effect of γδT cells transduced with the TCR of cancer‐specific CTLs to establish forceful cancer‐specific adoptive immunotherapy. We cloned the TCRαβ genes from CTLs showing HLA‐B15 restricted recognition of Kita‐Kyushu lung cancer antigen‐1 (KK‐LC‐1), a cancer/germline gene antigen, identified in a lung adenocarcinoma case (F1121). The TCRαβ and CD8 genes were transduced into γδT cells induced from PBLs of healthy volunteers stimulated with zoledronate and IL‐2. The KK‐LC‐1‐specific TCRαβ‐CD8 γδT cells showed cytotoxic activity against the KK‐LC‐1 positive lung cancer cell line F1121L and produced IFN‐γ against F1121L and KK‐LC‐1 peptide‐pulsed F1121 EBV‐B cells. These responses were blocked by HLA class I and HLA‐B/C antibodies. An in vivo assay using NOD/SCID mice with xenotransplantation of human lung cancer cells was performed, and the TCRαβ‐CD8 transduced γδT cells (TCRαβ‐CD8 γδT cells) were intravenously injected. Growth inhibition of KK‐LC‐1+, HLA‐B15+ lung cancer cells was confirmed in mice with injection of the TCRαβ‐CD8 γδT cells from 1 wk after xenotransplantation of cancer cells but not in those treated 2 wk after xenotransplantation. The resected specimens of the tumor, 2 wk after xenotransplantation, highly expressed FasL but not programmed death ligand‐1 (PD‐L1) by immunohistochemical staining. FasL highly expressed cancer cells xenotransplanted 2 wk ago were resistant to TCRαβ‐CD8 γδT cells injection. These results suggested that apoptosis of Fas‐positive TCRαβ‐CD8 γδT cells may be induced by a Fas‐mediated signal after interacting with FasL‐positive cancer cells.
Inter‐Relations Between Ethnic‐Racial Discrimination and Ethnic‐Racial Identity Among Early Adolescents
Authors: Del Toro Juan , Hughes Diane , Way Niobe
Published: August 2020

The authors examined whether the longitudinal inter‐relations between ethnic‐racial discrimination and ethnic‐racial identity vary according to the perpetrator of discrimination. The authors used three waves of data from early adolescents (n = 387; ages 11–12 at Wave 1) to assess the strength and direction of relations between perceived discrimination from non‐school adults and peers vis‐à‐vis ethnic‐racial identity exploration, commitment, private regard, and public regard. Cross‐lagged autoregressive path analyses showed that more frequent discrimination, regardless of source, had reciprocal and significant longitudinal inter‐relations with exploration and public regard. Peer discrimination predicted lower commitment and private regard 1 year later, whereas non‐school adult discrimination did not. Implications are discussed in relation to the role of peers and ethnic‐racial identity processes.
Protective loop‐ileostomy in ileal pouch–anal anastomosis for ulcerative colitis – advantages and disadvantages. A retrospective study
Authors: Ellebæk M. B. , Dilling Kjær M. , Spanggaard K. , El‐Faramawi M. , Möller S. , Qvist N.
Published: August 2020

Aim

The aim was to investigate the overall postoperative complication rate within 90 days following ileal pouch–anal anastomosis (IPAA), with or without a diverting stoma, together with complications 30 days after stoma closure and overall pouch failure rate.

Method

This was a retrospective chart review including IPAA patients with or without a diverting loop‐ileostomy for ulcerative colitis (1 January 1983 to 31 December 2015). Demographic data and postoperative complications were retrieved and recorded.

Results

A total of 434 patients were included. A diverting loop‐ileostomy was performed in 348 patients (80%). Baseline data were similar in the two groups except for body mass index (BMI) and the ratio of women, which were significantly higher in the group without a protective ileostomy. Overall 90‐day complication rate after IPAA [Clavien–Dindo (CD) > 2] was similar in the two groups. Clinical anastomotic leaks (CD > 2) were higher in patients without a diverting stoma (9.3% vs 1.7%) (P = 0.002). The odds ratio for leakage after adjustments (age, gender, immune‐modulating medicine and BMI) was 5.0 for omitting a diverting stoma (P = 0.004). Complications (CD > 2) after loop‐ileostomy closure were seen in 61 cases (14.1%). Omitting a diverting stoma at IPAA demonstrated a non‐significant odds ratio of 1.04 (0.46, 2.38) (P = 0.924) for pouch failure after adjustments (age, gender, immune‐modulating medicine, BMI, time from pouch formation and clinical leakage).

Conclusion

The overall postoperative surgical and medical complication rate within 90 days after IPAA was similar in the group with and without diverting stoma. Postoperative complication rate after reversal was 14%. Omitting a diverting stoma at IPAA demonstrated an increased risk of leaks but no significant risk of long‐term pouch failure.
A prospective evaluation of the outcome of submucosal ligation of fistula tract
Authors: Raja Ram N. K. , Chan K. K. , Md Nor S. F. , Sagap I.
Published: August 2020

Aim

Fistula‐in‐ano (FIA) is an anomalous passage between perianal skin and the anal canal or the rectum that presents many management difficulties. Ligation of intersphincteric fistula tract (LIFT) was introduced as a cost‐effective sphincter‐saving procedure with a reported success rate of 94.4%. Unfortunately, this procedure is technically challenging, and recently submucosal ligation of fistula tract (SLOFT), a simplification of LIFT, was proposed. Our aim was to assess the SLOFT technique over a longer follow‐up period to determine its effectiveness.

Method

A prospective observational study was performed in 47 patients with FIA treated by SLOFT from September 2017 to February 2019.

Results

There were 47 patients, of whom 33(70.2%) were men. The median age was 39 years (range 30–50 years). All the patients had primary FIA of cryptoglandular origin. The patients were followed up for 1 year and were postoperatively assessed at 2, 4, 12 and 24 weeks and 1 year. The median body mass index was 27.3 kg/m2 (range 24.3–29.4 kg/m2) and the median duration of surgery was 15 min (range 13–20 min). Most (83.0%) of the fistulas were trans‐sphincteric. The success rates at the end of 24 weeks and 1 year were 87.2% and 80.9%, respectively. No postoperative incontinence was recorded.

Conclusion

In our series the success rate of SLOFT was 80.9%. There were no sphincter‐related complications. Repeat SLOFT was feasible for cases of recurrence. Therefore, SLOFT should be considered an alternative sphincter‐saving procedure to LIFT for the management of FIA.
Utility of computed tomography and 18F‐fluorodeoxyglucose with positron emission tomography/computed tomography for distinguishing appendiceal mucocele caused by mucinous adenocarcinoma from other pathologies
Authors: Kaneko M. , Kawai K. , Nozawa H. , Hata K. , Tanaka T. , Nishikawa T. , Shuno Y. , Sasaki K. , Emoto S. , Murono K. , Ishii H. , Sonoda H. , Watadani T. , Takao H. , Abe O. , Ishihara S.
Published: August 2020

Aim

Differentiating appendiceal mucocele with mucinous adenocarcinoma from other pathologies before surgery is difficult. The objective of this study was to evaluate the utility of CT and 18F‐fluorodeoxyglucose (FDG) with positron emission tomography (PET)/CT for differentiating mucinous adenocarcinoma of appendiceal mucocele from other pathologies.

Method

The study included 25 patients who underwent surgery for clinically diagnosed appendiceal mucoceles detected on CT at the University of Tokyo Hospital. Among these patients, 19 underwent FDG‐PET/CT preoperatively. We compared features of the CT imaging findings and maximum standard uptake values (SUVmax) detected by FDG‐PET/CT between mucocele with mucinous adenocarcinoma and other pathologies.

Results

A total of 13 men (52%) and 12 women (48%) were included in this study, with a median age of 65 years (range 34–83). There were six patients (24%) with pathologically confirmed mucinous adenocarcinoma, 15 patients (60%) with appendiceal mucinous neoplasm and four patients (16%) with simple mucocele caused by chronic inflammation. On the CT findings, wall irregularity was the only significant feature for the two groups in this study (83.3% vs 0.0%, P < 0.01). There was a significant difference in the SUVmax levels on PET/CT between the two groups (100.0% vs 20.0%, P < 0.01).

Conclusion

Distinguishing between mucocele with mucinous adenocarcinoma and other pathologies using imaging modalities is challenging. Our results suggest that wall irregularity on CT and elevated SUVmax on PET/CT are useful factors that can be employed for such discrimination.
Faults diagnosis of a centrifugal pump using multilayer perceptron genetic algorithm back propagation and support vector machine with discrete wavelet transform‐based feature extraction
Authors: Al Tobi Maamar , Bevan Geraint , Wallace Peter , Harrison David , Okedu Kenneth Eloghene
Published: August 2020

This paper presents a comparative study of two artificial intelligent systems, namely; Multilayer Perceptron (MLP) and support vector machine (SVM), to classify six fault conditions and the normal (nonfaulty) condition of a centrifugal pump. A hybrid training method for MLP is proposed for this work based on the combination of Back Propagation (BP) and Genetic Algorithm (GA). The two training algorithms are tested and compared separately as well. Features are extracted using Discrete Wavelet Transform (DWT), both approximations, details, and two mother wavelets were used to investigate their effectiveness on feature extraction. GA is also used to optimize the number of hidden layers and neurons of MLP. In this study, the feature extraction, GA‐based hidden layers, neurons selection, training algorithm, and classification performance, based on the strengths and weaknesses of each method, are discussed. From the results obtained, it is observed that the DWT with both MLP‐BP and SVM produces better classification rates and performances.
Impact of diabetes mellitus on the risk of severe exacerbation in patients with chronic obstructive pulmonary disease
Authors: Figueira Gonçalves Juan Marco , García Bello Miguel Ángel , Golpe Rafael , Alonso Jerez Juan Luis , García‐Talavera Ignacio
Published: August 2020

Introduction

Suffering type 2 diabetes mellitus (T2DM) appears to promote the occurrence of respiratory infections. However, studies to evaluate the risk of hospital admission due to exacerbations in patients with chronic obstructive pulmonary disease (COPD) and concomitant T2DM are scarce.

Materials and methods

Prospective, observational study with a maximum follow‐up of 18 months. Information on lung function, body mass index, degree of dyspnea, number of exacerbations, comorbidities and pneumococcal vaccination was obtained. Patients were classified into the categories COPD with (COPD/+T2DM) and without T2DM (COPD/‐T2DM).

Results

A total of 121 patients with COPD were enrolled. Forty‐seven (38%) of the study participants were diabetic. The presence of T2DM increased the risk of hospital admission due to COPD exacerbation (OR 2.66; P = 0.031), but no significant difference in the total number of exacerbations was detected.

Conclusions

The risk of hospital admission in the course of exacerbation seems to be higher in COPD/+T2DM patients than in COPD/−T2DM subjects.
Medical Cosmopolitanism: The global extension of justice in healthcare practice
Authors: Gantsho Luvuyo , Wareham Christopher S.
Published: August 2020

While there is a shortage of healthcare workers in virtually all countries, there currently exists a pronounced inequality in the distribution of healthcare workers, with a high concentration of healthcare workers in high income countries (HIC) and low concentrations in low‐ and middle‐ income countries (LMIC). This inequality in the distribution of healthcare workers persists, in spite of the fact that HICs enjoy a much lower disease burden than LMICs This inequality raises medical ethical issues related to what obligations health workers from HICs have to correct these imbalances by working in LMICs. While the biomedical principle of Justice, first formulated by Beauchamp and Childress, advocates for healthcare workers to conduct themselves in a manner that is fair and equitable in light of what is due or owed, it does not elaborate on what sort of obligation this places on healthcare workers from HICs to work in LMICs in a bid fairly distribute the availability of healthcare workers. As such, this paper gives a normative argument for why healthcare workers from HICs have a moral obligation to work in LMICs, a concept we call Medical Cosmopolitanism. Following our positive argument, we debunk prominent objections to the concept of Medical Cosmopolitanism and consider ethical, educational and governmental implications of our findings.
Maternal obesity in sheep impairs foetal hepatic mitochondrial respiratory chain capacity
Authors: Serafim Teresa L. , Cunha‐Oliveira Teresa , Deus Claudia M. , Sardão Vilma A. , Cardoso Ines M. , Yang Shanshan , Odhiambo John F. , Ghnenis Adel B. , Smith Ashley M. , Li Junfei , Nathanielsz Peter W. , Ford Stephen P. , Oliveira Paulo J.
Published: August 2020

Background

Changes in the nutritional environment in utero induced by maternal obesity (MO) lead to foetal metabolic dysfunction predisposing offspring to later‐life metabolic diseases. Since mitochondria play a crucial role in hepatic metabolism and function, we hypothesized that MO prior to conception and throughout pregnancy programmes foetal sheep liver mitochondrial phenotype.

Material and methods

Ewes ate an obesogenic diet (150% requirements; MO), or 100% requirements (CTR), from 60 days prior to conception. Foetal livers were removed at 0.9 gestation. We measured foetal liver mitochondrial DNA copy number, activity of superoxide dismutase, cathepsins B and D and selected protein content, total phospholipids and cardiolipin and activity of mitochondrial respiratory chain complexes.

Results

A significant decrease in activities of mitochondrial complexes I, II‐III and IV, but not aconitase, was observed in MO. In the antioxidant machinery, there was a significant increase in activity of total superoxide dismutase (SOD) and SOD2 in MO. However, no differences were found regarding autophagy‐related protein content (p62, beclin‐I, LC3‐I, LC3‐II and Lamp2A) and cathepsin B and D activities. A 21.5% decrease in total mitochondrial phospholipid was observed in MO.

Conclusions

The data indicate that MO impairs foetal hepatic mitochondrial oxidative capacity and affects total mitochondrial phospholipid content. In addition, MO affects the regulation of foetal liver redox pathways, indicating metabolic adaptations to the higher foetal lipid environment. Consequences of in utero programming of foetal hepatic metabolism may persist and compromise mitochondrial bioenergetics in later life, and increase susceptibility to metabolic diseases.
Perceptions of students on a stand‐alone dental materials course in a revised dental curriculum
Authors: Soni Vishani , Kotsane Daisy F , Moeno Sharon , Molepo Julitha
Published: August 2020

Background

The Dental Materials (DM) course was introduced as a stand‐alone course in 2013, at the University. Prior to that, DM was integrated into clinical courses.

Objective

To determine the perceptions of the Bachelor of Dental Science (BDS2 to BDS5) students on a stand‐alone DM course following curricular amendment.

Methods

This was a cross‐sectional study, in which a simple random sampling strategy was used, with forty‐six students participating. The study was conducted in 2017. A self‐administered, structured, validated questionnaire was used to collect data. The obtained data were summarised and analysed using descriptive and inferential statistics (one‐way ANOVA).

Results

The study was conducted on Bachelor of Dental Science (BDS2 to BDS5) students. A response rate of 49% from the administered questionnaires was achieved. The overall perception, total mean percentage score of 71.4% was obtained showing a generally positive view on the relevance of the course by students. A total mean percentage score of 74.1% showed the students’ view that the DM course was well managed whilst a total mean score of 56.7% expressed the overall view on the reintegration of DM into clinical courses.

Conclusion

The students felt that DM was relevant and it could continue as a stand‐alone course. They perceived that the course was run effectively and managed well, but they had conflicting views on reintegration of the course into clinical modules. Studies with larger sample sizes at other Dental Schools are recommended to determine similarity of results.
Treatment and prognosis of primary pulmonary lymphoma: A long‐term follow‐up study
Authors: Santopietro Michelina , Kovalchuk Sofia , Battistini Roberta , Puccini Benedetta , Annibali Ombretta , Romano Ilaria , Zoli Valerio , Avvisati Giuseppe , Bosi Alberto , Rigacci Luigi
Published: August 2020

Primary pulmonary lymphoma (PPL) is a rare disease with not well‐defined optimal treatment. Outcomes and follow‐up are variable in published data.

Objectives

To define the outcome and optimal treatment strategies in PPL.

Methods

We reviewed the medical records of 49 patients with PPL treated in three Italian Hematological Institutions between 2002 and 2018.

Results

Thirty‐eight (77.5%) cases were indolent PPL, and 11 (22.5%) cases were aggressive PPL. The majority of patients were asymptomatic at diagnosis, early stages (stages IE‐IIE), normal serum LDH, no bone marrow involvement, and low or low‐intermediate risks of IPI. Local therapy ± immunotherapy or immuno‐chemotherapy was possible in 18/49 (37%) patients. Twenty‐eight (57%) patients were treated with immuno‐chemotherapy after biopsy. Waiting and watching were reported in 3 (6%) patients. Overall, the CR and ORR were 83.7% and 95.9%. With a median follow‐up of 62.5 months (range 0.8‐199 months), the estimated 5‐ and 10‐year OS rates were 85% and 72.3% for all patients, 89.2% and 80.3% for indolent PPL, and 70.7% and 47.1% for aggressive PPL. Aggressive PPL tended to have a high risk of progression in the first months (P = .056). No advantages were found for indolent PPL who received immuno‐chemotherapy or more conservative approaches.

Conclusion

Our studies confirm the epidemiological and favorable survival of patients with PPL, suggesting a very conservative approach, particularly in indolent subtypes.
Long‐range correlations of soil water content time series under tillage and different cover crops in a semi‐arid vineyard
Authors: San José Martínez Fernando , García‐Gutiérrez Báez Carlos , Caniego Monreal Francisco Javier , Peregrina Fernando
Published: August 2020

We explored the suitability of multifractal detrended fluctuation analysis (MFDFA) to characterize the temporal dynamics of soil water content (SWC), we analysed the origin of the multifractality of time series of the dynamic of SWC and we investigated how this dynamic was affected by different soil treatments and depths, through the characterization of long‐range correlations. Temporal data of SWC from conventional tillage and two different cover crops at three different depths in a Mediterranean vineyard were examined. The dataset spanned 18 months in 30‐min intervals. We investigated if SWC dynamics, as reflected by long‐range dependencies, can be detected and quantified by MFDFA in the form of scaling laws. We analysed the randomly shuffled series associated with temporal data of SWC to investigate if the detected multifractality of the data reflected either a broad density function of the values of the series or different long‐range correlations for small and large fluctuations in the dataset. Finally, the impact of treatment and depth on the variation of long‐range dependencies was studied. Our results suggest that the time records of soil moisture in a Mediterranean vineyard show a multifractal behaviour compatible with complex patterns of long‐range correlations. Moreover, this complex structure is affected by depth, as depicted by the statistically significant variation of the generalized Hurst exponent h(0), which controls the logarithmic mean of the fluctuation of SWC over a period of time. No significant interactions between treatments and depth was found. This suggests that soil properties that influence soil water dynamics at each depth are not affected by cover crop treatments. This could be due to the fact that the experiment lasted less than 2 years and no long‐term interactions were present at this time interval.

Highlights

Multifractal detrended fluctuation analysis (MFDFA) characterizes soil water content dynamics.

MFDFA detects the influence of soil depth on long‐range correlations.

Time series of soil moisture are multifractals compatible with complex patterns of long‐range correlations.

Long‐range dependencies are affected by depth but no interaction has been found between soil treatment and depth.
IL6R is a target of miR‐197 in human keratinocytes
Authors: Masalha Moamen , Gur‐Wahnon Devorah , Meningher Tal , Ben‐Dov Iddo Z. , Kassem Riad , Sidi Yechezkel , Avni Dror
Published: August 2020

Psoriasis is a chronic inflammatory disorder with cutaneous and systemic manifestations and substantial negative effects on patients’ quality of life. MicroRNAs (miRNAs) are post‐transcriptional regulators of gene expression that play a role in the pathogenesis of psoriasis. Previously studies, from others and by us, highlighted specific miRNAs that are dysregulated in psoriatic lesions. MicroRNA‐197‐3p (miR‐197) expression is downregulated in psoriatic lesions compared to normal or uninvolved skin in patients with psoriasis. We have previously reported that miR‐197 could modulate IL‐22 and IL‐17 signalling in psoriasis. Herein, we identify additional biochemical targets of miR‐197 in psoriasis. We applied a transcriptome‐wide biochemical approach, Protein argonaute‐2 photoactivatable ribonucleoside‐enhanced crosslinking and immunoprecipitation (Ago2 PAR‐CLIP), to search for new targets of miR‐197 in live keratinocytes, and validated its results using reporter assay and analysing by Western blot protein levels in cells overexpressing miR‐197. Ago2 PAR‐CLIP identified biochemical targets of miR‐197, including the alpha subunit of the IL‐6 receptor (IL6R). This work provides evidence that IL6R in bona‐fide biochemical target of miR‐197. IL6R is known to be up‐regulated in psoriasis and even was considered as a possible therapeutic target. From the present data and our previous studies, it appears that miR‐197 is a major regulator of the interaction between immune system cells and keratinocytes.
Quantitative analysis of fluorescent ligand binding to dopamine D3 receptors using live‐cell microscopy
Authors: Allikalt Anni , Laasfeld Tõnis , Ilisson Mihkel , Kopanchuk Sergei , Rinken Ago
Published: August 2020

Dopamine receptors are G protein‐coupled receptors that have several essential functions in the central nervous system. A better understanding of the regulatory mechanisms of ligand binding to the receptor may open new possibilities to affect the downstream signal transduction pathways. The majority of the available ligand binding assays use either membrane preparations, cell suspensions, or genetically modified receptors, which may give at least partially incorrect understanding of ligand binding. In this study, we implemented an assay combining fluorescence and bright‐field microscopy to measure ligand binding to dopamine D3 receptors in live mammalian cells. For membrane fluorescence intensity quantification from microscopy images, we developed a machine learning‐based user‐friendly software membrane tools and incorporated it into a data management software aparecium that has been previously developed in our workgroup. For the experiments, a fluorescent ligand NAPS‐Cy3B was synthesized by conjugating a dopaminergic antagonist N‐(p‐aminophenethyl)spiperone with a fluorophore Cy3B. The subnanomolar affinity of NAPS‐Cy3B makes it a suitable ligand for the characterization of D3 receptors in live HEK293 cells. Using a microplate compatible automated widefield fluorescence microscope, together with the membrane tools software, enables the detection and quantification of ligand binding with a high‐throughput. The live cell assay is suitable for the characterization of fluorescent ligand binding and also in the competition experiments for the screening of novel unlabeled dopaminergic ligands. We propose that this simple yet more native‐like approach is feasible in GPCR research, as it enables the detection of ligand binding in an environment containing more components involved in the signal transduction cascade.
Evidence for local carbon‐cycle perturbations superimposed on the Toarcian carbon isotope excursion
Authors: Wang Yunfeng , Ossa Ossa Frantz , Wille Martin , Schurr Simon , Saussele Mario‐Erich , Schmid‐Röhl Annette , Schoenberg Ronny
Published: August 2020

A Jurassic negative carbon isotope excursion (CIE), co‐evolved with Toarcian Oceanic Anoxic Event (OAE) at ~183 Ma, is suggested to be linked to a global carbon‐cycle perturbation and is well documented for Toarcian terrestrial fossil woods and marine sediments around the globe. A theoretically coupled δ13Ccarb‐δ13Corg pattern due to such dubbed global carbon‐cycle event from the negative CIE in Dotternhausen Toarcian stratigraphic profile (southwest Germany) is unexpectedly disturbed by two‐step δ13Ccarb‐δ13Corg decoupling in which the last step, upper in the stratigraphic order, is of higher magnitude. However, the trigger(s) for these sudden decoupling disturbances are still poorly constrained. Here, connecting new carbon and oxygen isotope data with documentary lipid biomarkers shows that the global carbon cycle during the Toarcian OAE was disturbed by enhanced green sulfur bacteria (GSB) metabolisms and early diagenesis at local scales. The first step δ13Ccarb‐δ13Corg decoupling was induced in the initial stage of the GSB bloom. The second step of much larger δ13Ccarb‐δ13Corg decoupling arising from a GSB prosperity was, however, exaggerated by early diagenesis through the respiration of sulfate‐reducing bacteria (SRB). Paleo‐geographically distinct localities of the Tethys region show contrasting decoupled δ13Ccarb‐δ13Corg patterns, which implies that the second‐order carbon‐cycle perturbations have pervasively and independently impacted the global carbon event during the Toarcian OAE.
Stable isotopes demonstrate intraspecific variation in habitat use and trophic level of non‐breeding albatrosses
Authors: Mills William F. , McGill Rona A. R. , Cherel Yves , Votier Stephen C. , Phillips Richard A.
Published: August 2020

The non‐breeding period is critical for restoration of body condition and self‐maintenance in albatrosses, yet detailed information on diet and distribution during this stage of the annual cycle is lacking for many species. Here, we use stable isotope values of body feathers (δ13C, δ15N) to infer habitat use and trophic level of non‐breeding adult Grey‐headed Albatrosses Thalassarche chrysostoma (n = 194) from South Georgia. Specifically, we: (1) investigate intrinsic drivers (sex, age, previous breeding outcome) of variation in habitat use and trophic level; (2) quantify variation among feathers of the same birds; and (3) examine potential carry‐over effects of habitat use and trophic level during the non‐breeding period on subsequent breeding outcome. In agreement with previous tracking studies, δ13C values of individual feathers indicate that non‐breeding Grey‐headed Albatrosses from South Georgia foraged across a range of oceanic habitats, but mostly in subantarctic waters, between the Antarctic Polar Front and Subtropical Front. Sex differences were subtle but statistically significant, and overlap in the core isotopic niche areas was high (62%); however, males exhibited slightly lower δ13C and higher δ15N values than females, indicating that males forage at higher latitudes and at a higher trophic level. Neither age nor previous breeding outcome influenced stable isotope values, and we found no evidence of carry‐over effects of non‐breeding habitat use or trophic level on subsequent breeding outcome. Repeatability among feathers of the same individual was moderate in δ13C and low in δ15N. This cross‐sectional study demonstrates high variability in the foraging and migration strategies of this albatross population.
Phylogeographical history of the Olive Woodpecker Dendropicos griseocephalus, a species widely distributed across Africa
Authors: Fuchs Jérôme , Bowie Rauri C. K. , Melo Martim , Boano Giovanni , Pavia Marco , Fjeldså Jon
Published: August 2020

Few studies have quantified the extent of genetic differentiation within widely distributed polytypic African bird species with disjunct ranges. Current knowledge indicates that high levels of genetic differentiation are found for such lineages but generalization of the pattern requires further comparisons with other co‐distributed taxa. We assessed the extent of phylogeographical structure across the range of the Olive Woodpecker Dendropicos griseocephalus using mitochondrial and nuclear intron data. The Olive Woodpecker occupies the forests of Central (Dendropicos griseocephalus ruwenzori) and Eastern (Dendropicos g. kilimensis) Africa, with a disjunct morphological lineage (Dendropicos g. griseocephalus) occurring in southern Africa. Each of the subspecies lineages can be diagnosed using morphology. Phylogenetic analyses of our sequence data recovered three monophyletic lineages with kilimensis sister to ruwenzori, and griseocephalus as sister to the clade uniting these two taxa. Molecular species delimitation methods and estimates of gene flow under the isolation‐with‐migration model suggest that the clade uniting the central and eastern subspecies may be recognized as distinct at the species level from the nominate subspecies, which is restricted to southern Africa. We conclude that D. griseocephalus (Boddaert, 1783) and D. ruwenzori (Sharpe, 1902) (including subspecies kilimensis) should be considered full species. The biogeographical pattern we uncover for the Olive Woodpecker differs from that of other co‐distributed widespread species both in terms of the order of sequence divergence of lineages occupying different areas of endemism in Africa, and in the timing of divergence, being younger (0.5–0.7 mya BP) than that recovered for the co‐distributed Square‐tailed Drongo Dicrurus ludwigii (0.9–1.6 mya BP).
White‐faced darter distribution is associated with coniferous forests in Great Britain
Authors: Geary Matthew , von Hardenberg Achaz
Published: August 2020

Understanding of dragonfly distributions is often geographically comprehensive but less so in ecological terms.

White‐faced darter (Leucorhinnia dubia) is a lowland peatbog specialist dragonfly which has experienced population declines in Great Britain. White‐faced darter is thought to rely on peat‐rich pool complexes within woodland, but this has not yet been empirically tested.

We used dragonfly recording data collected by volunteers of the British Dragonfly Society from 2005 to 2018 to model habitat preference for white‐faced darter using species distribution models across Great Britain and, with a more detailed landcover data set, specifically in the North of Scotland.

Across the whole of Great Britain, our models used the proportion of coniferous forest within 1 km as the most important predictor of habitat suitability but were not able to predict all current populations in England.

In the North of Scotland, our models were more successful and suggest that habitats characterised by native coniferous forest and areas with high potential evapotranspiration represent the most suitable habitat for white‐faced darter.

We recommend that future white‐faced darter monitoring should be expanded to include areas currently poorly surveyed but with high suitability in the North of Scotland.

Our results also suggest that white‐faced darter management should concentrate on maintaining Sphagnum rich‐pool complexes and the maintenance and restoration of native forests in which these pool complexes occur.