bluuebunny/crossref_metadata_2025 huggingface dataset:
Bone Mass, Bone Microstructure and Biomechanics in Patients with Hand Osteoarthritis
Authors: Simon David , Tascilar Koray , Unbehend Sara , Bayat Sara , Berlin Andreas , Liphardt Anna-Maria , Meinderink Timo , Rech Juergen , Hueber Axel J , Schett Georg , Kleyer Arnd
Published: May 2020

The impact of primary hand osteoarthritis (HOA) on bone mass, microstructure, and biomechanics in the affected skeletal regions is largely unknown. HOA patients and healthy controls (HCs) underwent high-resolution peripheral quantitative computed tomography (HR-pQCT). We measured total, trabecular, and cortical volumetric bone mineral densities (vBMDs), microstructural attributes, and performed micro–finite element analysis for bone strength. Failure load and scaled multivariate outcome matrices from distal radius and second metacarpal (MCP2) head measurements were analyzed using multiple linear regression adjusting for age, sex, and functional status and reported as adjusted Z-score differences for total and direct effects. A total of 105 subjects were included (76 HC: 46 women, 30 men; 29 HOA: 23 women, six men). After adjustment, HOA was associated with significant changes in the multivariate outcome matrix from the MCP2 head (p < .001) (explained by an increase in cortical vBMD (Δz = 1.07, p = .02) and reduction in the trabecular vBMD (Δz = −0.07, p = .09). Distal radius analysis did not show an overall effect of HOA; however, there was a gender-study group interaction (p = .044) explained by reduced trabecular vBMD in males (Δz = −1.23, p = .02). HOA was associated with lower failure load (−514 N; 95%CI, −1018 to −9; p = 0.05) apparent in males after adjustment for functional status. HOA is associated with reduced trabecular and increased cortical vBMD in the MCP2 head and a reduction in radial trabecular vBMD and bone strength in males. Further investigations of gender-specific changes of bone architecture in HOA are warranted. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
Chondrocyte suppression is mediated by miR‐129‐5p via GDF11/SMAD3 signaling in developmental dysplasia of the hip
Authors: Liu Xijuan , Deng Xueqiang , Ding Rui , Cheng Xigao , Jia Jingyu
Published: May 2020

Recent studies have shown that developmental dysplasia of the hip (DDH) during childhood and in animal models is associated with impaired endochondral ossification of the roof of the acetabulum, yet the molecular mechanism of this pathology remains unknown. To address this, an animal model of DDH was established in 4‐week‐old New Zealand white rabbits by cast immobilization of knee extension. Fifty‐six rabbits of DDH were involved in this study, including 21 male rabbits and 25 female rabbits. High‐throughput RNA sequencing identified 18 differentially expressed microRNAs; miR‐129‐5p downregulation was further confirmed by quantitative polymerase chain reaction. Bioinformatics and luciferase reporter assay identified growth differentiation factor 11 (GDF11) as the target gene of miR‐129‐5p in vitro. miR‐129‐5p downregulation increased GDF11 expression, which induced the phosphorylation of SMAD family member 3. As a result, the expression of runt‐related transcription factor 2, Indian hedgehog homolog, and collagen type X was inhibited in vitro. Meanwhile, Alizarin Red S and Von Kossa staining revealed reduced formation of mineralized nodules by chondrocytes after miR‐129‐5P downregulation compared with the control. Additionally, proliferation assays and flow cytometry confirmed the suppression of chondrocyte proliferation and G1 cell cycle arrest following miR‐129‐5p downregulation. These findings indicate that miR‐129‐5p is able to suppress chondrocyte proliferation and hypertrophic differentiation and decrease mineralization via the miR‐129‐5p/GDF11/SMAD3 axis. This could present the underlying cause for the observed DDH‐associated ossification impairment of the acetabular roof.
Cellular fibroepithelial lesions diagnosed on core needle biopsy: Is there any role of clinical‐sonography features helping to differentiate fibroadenomas and phyllodes tumor?
Authors: Al‐Arnawoot Basma , Scaranelo Anabel , Fleming Rachel , Kulkarni Supriya , Menezes Ravi J. , McCready David , Done Susan , Freitas Vivianne
Published: May 2020

Objective

The purpose of this study is to determine the role of clinico‐sonographic features of breast cellular fibroepithelial lesions (CFELs) diagnosed on core needle biopsy (CNB) in the differentiation between fibroadenoma (FA) and phyllodes.

Materials and Methods

Results of consecutive women with a CNB showing CFEL from 2005 to 2010 were retrospectively reviewed. Clinical and sonographic findings were compared with surgical outcomes. Chi‐square and Fisher's exact tests were used followed by a regression model for statistical analysis.

Results

A total of 131 women with 134 CFEL were included in the study; 89 (66%) were FAs and 45 (34%) were phyllodes (32 benign; 13 malignant). Significant predictors of increased risk of phyllodes tumor were patient age equal to or greater than 50 years (P = .021) and lesion size less than 2 cm at sonography (P = .043). No other imaging or clinical features were able to differentiate FA from phyllodes tumors.

Conclusion

CFEL with a larger size in older women is associated with the surgical pathological result of phyllodes tumor and management should be tailored accordingly. Younger patients with small size nodules might be approached less aggressively, depending on a personalized discussion with the surgeons, taking into account the results obtained in this study.
Extracapsular Dissection in Pleomorphic Adenomas of the Parotid Gland: Results After 13 Years of Follow‐up
Authors: Schapher Mirco , Koch Michael , Goncalves Miguel , Mantsopoulos Konstantinos , Iro Heinrich
Published: May 2020

Objectives/Hypothesis

To assess long‐term results after the treatment of parotid pleomorphic adenomas (PPAs) using different surgical techniques and focusing on recurrence rates and the risk of adverse effects.

Study Design

Retrospective analysis.

Methods

Retrospective analysis of 182 patients treated exclusively for PPAs at a tertiary referral center between 2000 and 2004. Thorough follow‐up examinations over a mean period of 13 years were possible in 53.8% (n = 98/182). Tumors were categorized according to the European Salivary Gland Society (ESGS) system to improve the comparison of outcomes. After different surgical resection strategies, recurrence rates, postoperative facial nerve paresis (FNP), and incidence of Frey's syndrome were assessed. The follow‐up period included clinical examinations and imaging of every patient in the treating department.

Results

Of 182 patients, extracapsular dissection (ED) was performed in 29.7%, and other surgical modalities (OSMs), including facial nerve dissection, in 70.3%. After the long‐term follow‐up, 98% of all the patients (n = 96/98) were recurrence free. When recurrence rates were compared, no significant differences were noted (P < .331). ED resulted in significantly lower FNP rates compared to OSMs (P < .001). FNP rates significantly increased with size and location of the tumors according to ESGS categories (temporary and permanent FNP, P = .04). Surgical invasiveness corresponded to a significant increase in the incidence of Frey's syndrome (P < .001).

Conclusions

ED was associated with the lowest complication rates, but not with a higher risk of recurrence, when compared with OSM in the long‐term course. As ED can be performed in the majority of PPAs, it can be regarded as the treatment of choice whenever possible.

Level of Evidence

4 Laryngoscope, 131:E445–E451, 2021
Analysis of Phytochemical Composition of Camellia oleifera Oil and Evaluation of its Anti‐Inflammatory Effect in Lipopolysaccharide‐Stimulated RAW 264.7 Macrophages
Authors: Chang Ming , Qiu Fangcheng , Lan Niannian , Zhang Tao , Guo Xin , Jin Qingzhe , Liu Ruijie , Wang Xingguo
Published: May 2020

In China, Camellia oleifera oil (COO) is not only a common edible oil but also a traditional remedy widely applied to ameliorate a variety of illnesses associated with inflammation, such as mouth ulcers, thrush, eczema, etc. However, there has been a lack of relevant biological research on the anti‐inflammatory capacity of COO, and the specific bioactive lipid phytochemicals contributing to the anti‐inflammatory effect need further research. In this study, the RAW 264.7 macrophages model was used to investigate the anti‐inflammatory capacity of COO. Our data showed that 33–200 μg/mL COO markedly inhibited the lipopolysaccharide lipopolysaccharide (LPS)‐stimulated nitric oxide (NO.) secretion via the suppression of Nos2 and Cox‐2 expression. The enzyme immunoassay confirmed that COO also exhibited a strong suppressive effect on the expression of proinflammatory cytokines such as Tnf‐α and Il‐6. To further explore the correlation between the anti‐inflammatory effects and the lipid phytochemicals in COO, 10 samples were collected and screened for their chemical compositions. It was interestingly demonstrated that the polyphenol extracts of COO play a vital role in its anti‐inflammatory properties. In addition, an oil‐in‐water (O/W) emulsion‐based system was also developed to deliver the liposoluble COO into the cells, and the feasibility of this system was confirmed. Our research confirms the anti‐inflammatory potential of COO and highlights that the main functional ingredient is polyphenol extracts. This may provide a scientific basis for the comprehensive utilization and development of COO and related functional foods.
In situ recovery of bivalve shell characteristics after temporary exposure to elevated pCO2
Authors: Grear Jason , Pimenta Adam , Booth Harriet , Horowitz Doranne Borsay , Mendoza Wilson , Liebman Matthew
Published: May 2020

Ocean uptake of carbon dioxide (CO2) is causing changes in carbonate chemistry that affects calcification in marine organisms. In coastal areas, this CO2‐enriched seawater mixes with waters affected by seasonal degradation of organic material loaded externally from watersheds or produced as a response to nutrient enrichment. As a result, coastal bivalves often experience strong seasonal changes in carbonate chemistry. In some cases, these changes may resemble those experienced by aquacultured bivalves during translocation activities. We mimicked these changes by exposing juvenile hard clams (500 μm, Mercenaria mercenaria) to pCO2 in laboratory upwellers at levels resembling those already reported for northeastern U.S. estuaries (mean upweller pCO2 = 773, 1274, and 1838 μatm) and then transplanting to three grow‐out sites along an expected nutrient gradient in Narragansett Bay, Rhode Island (154 bags of 100 clams). Prior to the field grow‐out, clams exposed to elevated pCO2 exhibited larger shells but lower dry weight per unit volume (dw/V). However, percent increase in dw/V was highest for this group during the 27‐day field grow‐out, suggesting that individuals with low dw/V after the laboratory treatment accelerated accumulation of dw/V when they were transferred to the bay. Treatments also appeared to affect shell mineral structure and condition of digestive diverticula. Although treatment effects diminished during the field grow‐out, clams that were preexposed for several weeks to high pCO2 would likely have been temporarily vulnerable to predation or other factors that interact with shell integrity. This would be expected to reduce population recovery from short‐term exposures to high pCO2.
Can sales leaders with humility create adaptive retail salespersons?
Authors: Luu Tuan Trong
Published: May 2020

Although humility in leadership has been recognized as vital in leading salespeople to cope with unpredictability and unknowability in customers, the role of sales leader humility in promoting sales behaviors has remained underexplored. Our research aims to unfold how and when sales managers’ leadership humility nurtures retail salespersons’ adaptive selling behavior. Grounded on the dataset from managers and employees working in retail shops of a large telecommunication and computer company in Vietnam, the results reveal the role of retail salespersons’ customer knowledge, adaptive self‐efficacy, and customer‐oriented harmonious passion as the mediation paths for the linkage between sales leader humility and retail salespeople's adaptive selling behavior. The findings further provide evidence for the role of sales managers’ adaptive selling as an enhancer for the impacts of sales leader humility on these mediators.
Study on performance and continuous durability test of single input multi output power take‐off (PTO) gear box
Authors: Lee Y.B. , Lee G.C. , Park J.W. , Sung B.J. , Yang J.D.
Published: May 2020

The power take‐off (PTO) gearbox is widely used for special vehicles, large construction machinery, industrial machinery and ships, to distribute the power of a single input shaft from an engine or a motor to several shafts or to collect several shafts by single shaft power (Torque × rotation speed). The super large hydraulic excavator is equipped with a power take‐off (PTO) gearbox between the main engine and a number of pumps for the purpose of improving the fuel efficiency and improving the system efficiency. The power take‐off (PTO) gearbox of a large hydraulic excavator with a body weight of 100 ton ( = 105 kg) is connected with two large hydraulic pumps and one small hydraulic pump on three output shafts and different axial loads are generated depending on the working characteristics of the excavator. In this paper, we evaluated the performance and durability of a power take‐off (PTO) gearbox of a large hydraulic excavator with a 100‐ton body weight. The test evaluation criteria for non‐fault life time calculation, performance and accelerated life test were established, and the types and characteristics of acceleration test equipment were analyzed. The torque distribution with the use of the gear phase difference to maintain the gearbox output condition was investigated, and energy was saved by circulating experimental power while controlling speed and load with two electric dynamometers. We analyzed the life of the gearbox by analyzing the metal particles generated in the lubricating oil of the gearbox.
Impact of host intraspecies genetic variation, diet, and age on bacterial and fungal intestinal microbiota in tigers
Authors: Jiang Haiying , Chen Wu , Su Li , Huang Mingwei , Lin Libo , Su Qiao , Li Guanyu , Ahmad Hafiz Ishfaq , Li Linmiao , Zhang Xiujuan , Li Huiming , Chen Jinping
Published: May 2020

The bacterial microbiota in the gut varies among species, as well as with habitat, diet, age, and other factors. Intestinal microbiota homeostasis allows a host to adjust metabolic and immune performances in response to environmental changes. Therefore, potential implications of the gut microbiota in sustaining the health of the host have gained increasing attention in the field of endangered animal conservation. However, the effect of host intraspecies genetic variation on the gut microbiota is unknown. Moreover, little is known about the complexity of the gut mycobiota. Tigers are listed as endangered species, raising worldwide concern. Potential influences of subspecies, diet, and age on the gut microbiota in tigers were investigated in this study to provide a better understanding of the response of the tiger gut microbiota to external changes. The results revealed that the impacts of the factors listed above on gut bacterial and fungal communities are versatile. Host intraspecies genetic variation significantly impacted only fungal alpha diversity of the gut microbiota. Differences in diet, on the other hand, had a significant impact on alpha diversity of the gut microbiota, but exerted different effects on beta diversity of gut bacterial and fungal communities. Host age had no significant impact on the diversity of the gut fungal communities, but significantly impacted beta diversity of gut bacterial communities. This comprehensive study of tiger gut microbiota is an essential reference for tiger conservation when considering feeding and management strategies, and will contribute to a better understanding of the mycobiota in wildlife.
Determining the optimal capacity and occupancy rate in a hospital: A theoretical model using queuing theory and marginal cost analysis
Authors: Maaz Muhammad , Papanastasiou Anastasios
Published: May 2020

We model the hospital as seeking to balance the costs to itself in providing care, as well as the societal cost of people waiting for care. We use queuing theory to show that the optimal capacity and the corresponding optimal occupancy rate are dependent on the marginal cost of expanding capacity, the marginal cost of waiting, and the rates of patient arrival and discharge. Therefore, a universal occupancy target is unfounded. As well, the model shows that increasing capacity to respond to increased patient influxes is inadequate, suggesting that the health care system must explore alternate responses to burgeoning patient populations.
Genetic analysis resolves differential diagnosis of a familial syndromic dilated cardiomyopathy: A new case of Alström syndrome
Authors: Lombardo Barbara , D'Argenio Valeria , Monda Emanuele , Vitale Andrea , Caiazza Martina , Sacchetti Lucia , Pastore Lucio , Limongelli Giuseppe , Frisso Giulia , Mazzaccara Cristina
Published: May 2020

Background

Syndromic dilated cardiomyopathy (DCM) includes a group of complex disorders with a very heterogeneous genetic etiology, leading to delay in definitive diagnosis. Conversely, an early genetic diagnosis is very important in determining the disease course, the prognosis, and may guide personalized treatments and family counseling.

Methods

We analyzed two brothers with a multisystemic disorder, including dilated cardiomyopathy, diabetes, bilateral neurosensorial hearing loss, and optic atrophy, using different genetic approaches, namely mitochondrial DNA sequencing, comparative genomic hybridization‐array (a‐CGH) and whole exome sequencing (WES).

Results

Sequencing of the wide mitochondrial genome revealed, in both brothers, the known homoplasmic variant rs2853826 in the subunit 3 of the NADH dehydrogenase gene (MT‐ND3), whose pathogenicity was conflicting. Comparative genomic hybridization‐array analysis revealed in both patients and their father two heterozygous deletions in Phosphodiesterase 4d‐Interacting Protein (PDE4DIP) and Protocadherin‐related 15 (PCDH15) genes, respectively. The use of WES detected a pathogenetic mutation in ALMS1, enabling the definitive diagnosis of Alström syndrome.

Conclusion

We demonstrated how the diagnosis of a complex heterogeneous disease may be difficult, due to several overlapping manifestations and the possible interaction of more genetic variants that could lead to a more severe and complex phenotype.

This paper strongly evidences how genomics is revolutionizing the diagnosis of rare complex disease, representing one of the most essential steps to enable a definitive diagnosis and to establish the etiology for diseases, such as syndromic DCM.
The first concurrent detection of mitochondrial DNA m.3243A>G mutation, deletion, and depletion in a family with mitochondrial diabetes
Authors: Tabebi Mouna , Safi Wajdi , Felhi Rahma , Alila Fersi Olfa , Keskes Leila , Abid Mohamed , Mnif Mouna , Fakhfakh Faiza
Published: May 2020

Background

Mitochondrial diabetes (MD) is a rare monogenic form of diabetes and divided into type l and type 2. It is characterized by a strong familial clustering of diabetes with the presence of maternal transmission in conjunction with bilateral hearing impairment in most of the carriers. The most common form of MD is associated with the m.3243A>G mutation in the mitochondrial MT‐TL1, but there are also association with a range of other point mutations, deletion, and depletion in mtDNA.

Methods

The mitochondrial genome anomalies were investigated in a family with clinical features of MD, which includes a proband presenting severe MD conditions including cardiomyopathy, retinopathy, and psychomotor retardation.

Results

By investigating the patient's blood leukocytes and skeletal muscle, we identified the m.3243A>G mutation in heteroplasmic state. This mutation was absent in the rest of the family members. In addition, our analysis revealed in the proband a large mtDNA heteroplasmic deletion (~1 kb) and a reduction in mtDNA copy number.

Conclusion

Our study points out, for the first time, a severe phenotypic expression of the m.3243A>G point mutation in association with mtDNA deletion and depletion in MD.
β‐Thalassemia pathogenic variants in a cohort of children from the East African coast
Authors: Macharia Alexander W. , Mochamah George , Uyoga Sophie , Ndila Carolyne M. , Nyutu Gideon , Tendwa Metrine , Nyatichi Emily , Makale Johnstone , Ware Russell E. , Williams Thomas N.
Published: May 2020

Background

β‐Thalassemia is rare in sub‐Saharan Africa. Previous studies have suggested that it is limited to specific parts of West Africa. Based on hemoglobin A2 (HbA2) concentrations measured by HPLC, we recently speculated that β‐thalassemia might also be present on the East African coast of Kenya. Here, we follow this up using molecular methods.

Methods

We used raised hemoglobin A2 (HbA2) values (> 4.0% of total Hb) to target all HbAA members of a cohort study in Kilifi, Kenya, for HBB sequencing for β‐thalassemia (n = 99) together with a sample of HbAA subjects with lower HbA2 levels. Because HbA2 values are artifactually raised in subjects carrying sickle hemoglobin (HbS) we sequenced all participants with an HPLC pattern showing HbS without HbA (n = 116) and a sample with a pattern showing both HbA and HbS.

Results

Overall, we identified 83 carriers of four separate β‐thalassemia pathogenic variants: three β0‐thalassemia [CD22 (GAA→TAA), initiation codon (ATG→ACG), and IVS1‐3ʹ end del 25bp] and one β+‐thalassemia pathogenic variants (IVS‐I‐110 (G→A)). We estimated the minimum allele frequency of all variants combined within the study population at 0.3%.

Conclusions

β‐Thalassemia is present in Kilifi, Kenya, an observation that has implications for the diagnosis and clinical care of children from the East Africa region.
Does size matter? Perineometer and digital examination of a model levator hiatus
Authors: Tailor Visha K. , Bhide Alka A. , Fernando Ruwan , Digesu Giuseppe A. , Khullar Vik
Published: May 2020

Introduction

Evaluation of the female pelvic floor muscles is commonly carried out with digital examination and assigning a modified Oxford scale score or vaginal manometry. Racial differences can influence the size of the levator hiatus (LH) with “black” or African nulliparous women having a significantly larger LH compared to Caucasian women. The aim of this study was to assess the impact of LH size on manometry readings of simulated pelvic floor muscle contractions (PFMCs) using a small and large model LH.

Methods

Small and large LH models were created using published data for size. Inflation of a pressure cuff placed circumferentially in the LH model represented a simulated PFMC. The models were examined in a supine position by three examiners and a perineometer twice each at varying simulated PFMC strength.

Results

Positive correlation was found between increasing simulated PFMC strength with a higher Oxford score following digital examination and manometry readings for both the small (rs = .87, rs = .98) and large (rs = .95, rs = .87) models. There was good to excellent inter and intraobserver correlation for digital assessment of both models. The manometry measurements showed a much larger incremental rise from baseline in the small model compared with the large model (P < .05).

Conclusion

This study demonstrates that perineometer readings are affected by natural variations in LH size and PFMC strength. Therefore improvement to pelvic floor strength cannot be interpreted and measurements cannot be compared with others unless the LH size is known or digital examination is carried out.
Abnormalities in metabolic pathways in celiac disease investigated by the metabolic profiling of small intestinal mucosa, blood plasma and urine by NMR spectroscopy
Authors: Upadhyay Deepti , Singh Alka , Das Prasenjit , Mehtab Jiya , Dattagupta Siddhartha , Ahuja Vineet , Makharia Govind K. , Jagannathan Naranamangalam R. , Sharma Uma
Published: May 2020

Celiac disease (CeD) is an autoimmune enteropathy caused by gluten intake in genetically predisposed individuals. We investigated the metabolism of CeD by metabolic profiling of intestinal mucosa, blood plasma and urine using NMR spectroscopy and multivariate analysis. The metabolic profile of the small intestinal mucosa was compared between patients with CeD (n = 64) and disease controls (DCs, n = 30). The blood plasma and urinary metabolomes of CeD patients were compared with healthy controls (HCs, n = 39). Twelve metabolites (proline (Pro), arginine (Arg), glycine (Gly), histidine (His), glutamate (Glu), aspartate, tryptophan (Trp), fumarate, formate, succinate (Succ), glycerophosphocholine (GPC) and allantoin (Alln)) of intestinal mucosa differentiated CeD from controls. The metabolome of blood plasma with 18 metabolites (Pro, Arg, Gly, alanine, Glu, glutamine, glucose (Glc), lactate (Lac), acetate (Ace), acetoacetate (AcAc), β‐hydroxybutyrate (β‐OHB), pyruvate (Pyr), Succ, citrate (Cit), choline (Cho), creatine (Cr), phosphocreatine (PCr) and creatinine) and 9 metabolites of urine (Pro, Trp, β‐OHB, Pyr, Succ, N‐methylnicotinamide (NMN), aminohippurate (AHA), indoxyl sulfate (IS) and Alln) distinguished CeD from HCs. Our data demonstrated changes in nine metabolic pathways. The altered metabolites were associated with increased oxidative stress (Alln), impaired healing and repair mechanisms (Pro, Arg), compromised anti‐inflammatory and cytoprotective processes (Gly, His, NMN), altered energy metabolism (Glc, Lac, β‐OHB, Ace, AcAc, Pyr, Succ, Cit, Cho, Cr and PCr), impaired membrane metabolism (GPC and Cho) and intestinal dysbiosis (AHA and IS). An orthogonal partial least square discriminant analysis model provided clear differentiation between patients with CeD and controls in all three specimens. A classification model built by combining the distinguishing metabolites of blood plasma and urine samples gave an AUC of 0.99 with 97.7% sensitivity, 93.3% specificity and a predictive accuracy of 95.1%, which was higher than for the models built separately using small intestinal mucosa, blood plasma and urine. In conclusion, a panel of metabolic biomarkers in intestinal biopsies, plasma and urine samples has potential to differentiate CeD from controls and may complement traditional tests to improve the diagnosis of CeD.
Deep learning‐based fully automatic segmentation of wrist cartilage in MR images
Authors: Brui Ekaterina , Efimtcev Aleksandr Y. , Fokin Vladimir A. , Fernandez Remi , Levchuk Anatoliy G. , Ogier Augustin C. , Samsonov Alexey A. , Mattei Jean P. , Melchakova Irina V. , Bendahan David , Andreychenko Anna
Published: May 2020

The study objective was to investigate the performance of a dedicated convolutional neural network (CNN) optimized for wrist cartilage segmentation from 2D MR images. CNN utilized a planar architecture and patch‐based (PB) training approach that ensured optimal performance in the presence of a limited amount of training data. The CNN was trained and validated in 20 multi‐slice MRI datasets acquired with two different coils in 11 subjects (healthy volunteers and patients). The validation included a comparison with the alternative state‐of‐the‐art CNN methods for the segmentation of joints from MR images and the ground‐truth manual segmentation. When trained on the limited training data, the CNN outperformed significantly image‐based and PB‐U‐Net networks. Our PB‐CNN also demonstrated a good agreement with manual segmentation (Sørensen–Dice similarity coefficient [DSC] = 0.81) in the representative (central coronal) slices with a large amount of cartilage tissue. Reduced performance of the network for slices with a very limited amount of cartilage tissue suggests the need for fully 3D convolutional networks to provide uniform performance across the joint. The study also assessed inter‐ and intra‐observer variability of the manual wrist cartilage segmentation (DSC = 0.78‐0.88 and 0.9, respectively). The proposed deep learning‐based segmentation of the wrist cartilage from MRI could facilitate research of novel imaging markers of wrist osteoarthritis to characterize its progression and response to therapy.
Can nurses help improve self‐care of patients living with atrial fibrillation? A focus group study exploring patients' disease knowledge gaps
Authors: Toscos Tammy R. , Coupe Amanda , Wagner Shauna , Drouin Michelle , Roebuck Amelia E. , Daley Carly N. , Carpenter Maria D. , Mirro Michael J.
Published: May 2020

Aims

To identify knowledge gaps and preferences for educational material to improve nurse–patient communication and self‐care.

Design

Using a mixed‐methods design, we conducted focus groups and quantitative surveys.

Methods

We conducted three focus groups with atrial fibrillation (AF) patients and support persons (N = 17 participants; 66 ± 16 years) at critical treatment junctures (recent diagnosis or medication switch). Patients and support persons were also surveyed on patient activation (self‐management skills and knowledge), medication adherence, AF knowledge and health literacy. Iterative thematic analysis was performed using focus group transcripts.

Results

Although most participants had adequate health literacy, most reported gaps in AF knowledge. Participants lacked disease‐related knowledge and were unsure how to manage health behaviours (e.g. diet and exercise). Few felt they received adequate education from their healthcare provider. Results emphasize the need for consistent information from nursing staff, in lay language, via both electronic and printed means.
Enabling coexistence: Navigating predator‐induced regime shifts in human‐ocean systems
Authors: Burt Jenn M. , Wilson Ḵii'iljuus Barbara J. , Malchoff Tim , Mack Wii‐tsts‐koom Anne , Davidson Skil Hiilans Allan , Gitkinjuaas  , Salomon Anne K.
Published: May 2020

Rapid system‐wide changes triggered by predators can pose considerable challenges to people. In the Northeast Pacific, the recovery of sea otters Enhydra lutris following their extirpation due to the 18th and 19th century fur trade is driving a social‐ecological regime shift with profound implications. While the ecological consequences of this shift are well documented, very little research has examined the conditions that enable or constrain people's ability to adapt to the social, economic and cultural changes that transpire.

Through a collaborative partnership and workshops with Indigenous knowledge holders spanning Alaska to British Columbia, along with quantitative and qualitative interviews in two Indigenous communities among the first to experience sea otter recovery, we examined people's perceptions of the social‐ecological conditions that affect their ability to adapt to these changes.

We found that communities differed in their relative rankings of adaptation‐enabling conditions; however, the following four broad strategies were perceived as critical to improving coexistence with sea otters: (a) strengthening Indigenous governance and decision‐making authority; (b) promoting adaptive co‐management; (c) weaving Indigenous knowledge and Western science into management plans and (d) establishing learning platforms. Both communities also identified that increased livelihood options and financial assistance would not compensate for lost food security.

Differences in enabling conditions and attitudes towards sea otters within and between communities can be attributed to the social‐ecological and political context in which sea otter recovery occurs.

Our study suggests that enhancing Indigenous peoples' ability to adapt to predator‐induced regime shifts will require a transformation in current resource governance systems if we are to navigate towards an ecologically sustainable and socially just operating space. Overall, this work highlights the need for more Indigenous authority, knowledge and leadership in addressing predator‐induced regime shifts in coupled human‐ocean systems.

A free Plain Language Summary can be found within the Supporting Information of this article.
The impact of statin discontinuation and restarting rates on the optimal time to initiate statins and on the number of cardiovascular events prevented
Authors: Pate Alexander , Elliott Rachel A. , Gkountouras Georgios , Thompson Alexander , Emsley Richard , van Staa Tjeerd
Published: May 2020

Introduction

A patient is eligible for statins in England if they have a 10‐year risk of cardiovascular disease >10%. We hypothesize that if statin discontinuation rates are high it may be better to delay statin initiation until patients are at a higher risk, to maximize the benefit of the drug.

Methods

A four‐state health state transition model was used to assess the optimal time to initiate statins after a risk assessment, in order to prevent the highest number of cardiovascular events, for a given risk profile (age, gender, risk) and adherence rate. A Clinical Practice Research Datalink dataset linked to Hospital Episodes Statistics and Office for National Statistics was used to inform the transition probabilities in this model, taking into account observed statin discontinuation and re‐continuation patterns.

Results

Our results suggest, if statins are initiated in a cohort of 50‐year old men with a 10% 10‐year risk, we prevent 4.78 events per 100 individuals. If we wait 10 years to prescribe, at which point 10‐year risk scores are at 20%, we prevent 5.45 events per 100 individuals. If the observed discontinuation rate was reduced by a sixth, third or half in the same cohort, we would prevent 7.29, 9.01 or 10.22 events per 100 individuals.

Conclusions

In certain scenarios, extra cardiovascular disease events could be prevented by delaying statin initiation beyond a risk of 10% until reaching a age (59 for men, 63 for women), based on statin discontinuation rates in England. The optimal time to initiate statins was driven by age, not by cardiovascular risk.
Proteomic analysis of “Oriental Beauty” oolong tea leaves with different degrees of leafhopper infestation
Authors: Chien Han‐Ju , Yang Man‐Miao , Wang Wei‐Chen , Hong Xiang‐Gui , Zheng Yi‐Feng , Toh Jie‐Teng , Wu Chia‐Chang , Lai Chien‐Chen
Published: May 2020

Rationale

Oriental Beauty, a type of oolong tea native to Taiwan, is highly prized by connoisseurs for its unique fruity aroma and sweet taste. Leaves of Oriental Beauty vary in appearance, aroma, and taste, depending on the degree of tea green leafhopper (Jacobiasca formosana) infestation. In this study, the aim is to investigate the differential expression of proteins in leaves with low, medium, and high degrees of leafhopper infestation.

Methods

Proteomic techniques 2DE (two‐dimensional electrophoresis) and nanoscale liquid chromatography/tandem mass spectrometry (LC/MS/MS) were used to investigate the differential expression of proteins in tea leaves with different degrees of leafhopper infestation.

Results

A total of 89 proteins were found to exhibit significant differences in expression. In a gene ontology analysis, most of these proteins participated in biosynthesis, carbohydrate metabolism, transport, responses to stress, and amino acid metabolism.

Conclusions

These results indicated that the unique aroma and taste of the leaves might be influenced by their protein expression profiles, as well as related factors such as defensive responses to tea green leafhopper saliva.
Two‐color symmetry breaking in laser‐based secondary neutral mass spectrometry
Authors: Jerigova Monika , Lorenc Dusan , Velic Dusan
Published: May 2020

Rationale

An alternative method of analysis for laser‐based secondary neutral mass spectrometry is introduced.

Methods

By mixing a fundamental 1240 nm wavelength of the near‐infrared laser field with an intensity of 1 × 1015 W/cm2 with its second harmonic generation wavelength of 620 nm, control is attained over the ion yield in secondary neutral mass spectrometry for a native silver surface and a surface covered with silver nanoparticles.

Results

The ion yields of selected species in the mass spectra, such as a C2H4O2 surfactant fragment ion and the Ag ion, are enhanced or suppressed by a factor of 8 or 23, respectively, in comparison with single color post‐ionization. In addition, a significant suppression of ion fragmentation is demonstrated for both the silver sample and silver nanoparticles. Periodic variation of the ion yield with a modulation depth of 4% is observed depending upon the relative phase between the fundamental and second harmonic generated fields. These variations are explained in terms of tunneling ionization with symmetry‐broken fields.

Conclusions

An additional degree of freedom in a form of additional second color is introduced in laser‐based secondary neutral mass spectrometry. Ion yield control is extended in a form of symmetry‐broken fields.
An extremely rare case of nivolumab‐associated macroscopic duodenitis with spontaneous regression
Authors: Akizawa Takatora , Saraya Takeshi , Takakura Hiroki , Fujiwara Masachika , Ishii Haruyuki , Takizawa Hajime
Published: May 2020

An 82‐year‐old man was presented to our hospital due to epigastric and right hypochondrial pain 17 weeks after the initiation of intravenous treatment with nivolumab for recurrent lung adenocarcinoma as multiple lung and sternal metastases. Urgent gastroscopy revealed macroscopic duodenitis such as severe erythema, oedema, black‐coloured erosions, and ulcers located throughout the second portion of the duodenum, which was confirmed by abdominal computed tomography as circumferential thickening of the duodenal wall. Those lesions were pathologically considered as non‐specific inflammation and spontaneously disappeared within a month, suggesting nivolumab‐induced immune‐related adverse events.
Mapping complex coastal wetland mosaics in Gabon for informed ecosystem management: use of object‐based classification
Authors: Aldous Allison , Schill Steve , Raber George , Paiz Marie‐Claire , Mambela Emmanuel , Stévart Tariq
Published: May 2020

Wetlands of coastal Gabon provide many ecosystems services including flood protection, water purification and wildlife habitat. Effective sustainable management of this coastal zone is hindered by a lack of accurate wetland maps. Here we describe a novel method used to map the wetland ecosystems of nearly 100 000 km2 of wetland and upland habitat mosaic in the delta of the Ogooué River using an object‐based classification of optical and radar satellite imagery based on training data collected from unmanned aerial vehicle and a post‐classification accuracy assessment using helicopter‐based video. We identified 15 land cover classes, of which nine were wetland. A stratified random sample accuracy assessment of the final classification yielded an overall accuracy of 0.80. Despite the important role that wetland habitats play for wildlife and ecosystem functioning across the region, our results indicate these wetlands cover only 22% of the project area. As expected, most of the wetland habitats are found close to major water bodies, including the Ogooué River, estuaries near the cities of Libreville and Port Gentil and coastal lagoons to the south of these cities. When considering the six Wetlands of International Importance designated under the Ramsar Convention within the project area, only 33% of mapped wetlands fall within the Ramsar site boundaries and only 10% of mapped wetlands fall within protected areas. Furthermore, within the Ramsar sites, only 31% of the land cover was classified as wetland. In order to better manage these wetland resources, more effective Ramsar boundaries would include the extensive wetland habitats found along the coast from Port Gentil south to Loango National Park. These data are now available for managers to improve wetland management within designated Ramsar sites and improving protection designations for vulnerable habitats, for example by protecting wetland connectivity and other ecosystem processes.
A test for differential ascertainment in case‐control studies with application to child maltreatment
Authors: Sordello Matteo , Small Dylan S.
Published: May 2020

We propose a method to test for the presence of differential ascertainment in case‐control studies, when data are collected by multiple sources. We show that, when differential ascertainment is present, the use of only the observed cases leads to severe bias in the computation of the odds ratio. We can alleviate the effect of such bias using the estimates that our method of testing for differential ascertainment naturally provides. We apply it to a dataset obtained from the National Violent Death Reporting System, with the goal of checking for the presence of differential ascertainment by race in the count of deaths caused by child maltreatment.
Removal of Chromate and Nitrate Ions from Aqueous Solutions by CoxFe3‐xO4@silica Hybrid Nanoparticles Decorated with Cross‐Linked Tragacanth Gum: Experiment, Modeling and Optimization
Authors: Moghaddam Ali Zeraatkar , Jazi Mehdi Erfani , Allahrasani Ali , Khazaei Mohammad , Ganjali Mohammad Reza , Saeb Mohammad Reza , Vatanpour Vahid
Published: May 2020

A hybrid nanocomposite cobalt ferrite and Tragacanth gum, denoted as CoxFe3‐xO4@silica@TG was developed and applied in concurrent removal of chromate and nitrate ions from wastewater. The results showed that the presence of Tragacanth gum considerably improved the capability of cobalt ferrite for removing the pollutants. The adsorption properties and surface morphology of the sorbent were compared with those of bare cobalt ferrite, Tragacanth gum, and Tragacanth gum cross‐linked copolymer. The properties of the proposed nanocomposite were studied using FT‐IR, transmission electron microscopy (TEM), and vibrating‐sample magnetometer (VSM) techniques. The effect of different factors including the amount of the adsorbent, sample pH, contact time and initial concentration was also evaluated and optimized through response surface methodology using central composite design. The optimal conditions for the adsorption of both chromate and nitrate ions (30 mg L−1 as the concentration of both of them) were pH=3, an adsorbent dose of 1 mg mL−1 and 22.4 min contact time. The adsorption process was found to follow the pseudo‐second order and intra‐particle diffusion kinetic models. The equilibrium adsorption data followed the Langmuir isotherm and the highest adsorption capacity was determined to be 44.1 and 30.7 mg g−1 for chromate and nitrate, respectively.
DFT Study of the Reaction Mechanism of N2O Decomposition on Au3+/0/− Clusters
Authors: Wu Lin‐Yu , Chen Cheng , Luo Lan , Wang Yong‐Cheng , Yin Bing
Published: May 2020

In this paper, the reaction mechanism of Au3+/0/− clusters with N2O was studied by density functional theory (DFT) calculations. The analysis of the potential energy surfaces showed that the Au3 neutral cluster exhibited highest catalytic activity on the decomposition of N2O, energy barrier is only 11.60 kcal/mol. The corresponding energy barriers for Au3− and Au3+ are 28.51 and 58.79 kcal/mol, respectively. The effects of Au3+/0/− clusters assistance analyzed using the activation strain model indicated that the dissociation of the N−O bond depends on the interaction energy of Au3 clusters and N2O. The electron transfer from the Au3+/0/− cluster to the N2O facilitates the dissociation of N−O bond. The analysis of frontier molecular orbitals (FMO) indicated that only the interaction of HOMO‐LUMO interactions is strongly enough and there is sufficient orbital overlap between the Au3+/0/− clusters and N2O, electron transfer can occur and activation of N2O can be achieved. The study of thermodynamic processes showed that there is evident correlation between the binding energy of the Au3O+/0/− cluster oxides and the barrier energy of the reaction. Therefore, the orbital interactions between Au3+/0/− and N2O and thermodynamic driving force have a great influence on the reaction. These results enrich our understanding of the catalytic dissociation of N2O by Au‐cluster‐based catalysts.
Recording the Electrochemical Profile of Pueraria Leaves for Polyphyly Analysis
Authors: Zhang Mingjun , Pan Bo , Wang Yangyang , Du Xinpeng , Fu Li , Zheng Yuhong , Chen Fei , Wu Weihong , Zhou Qinwei , Ding Su , Zhao Shichao
Published: May 2020

Electrochemical profiles of Pueraria bouffordii, P. montana var. lobata, P. montana var. montana, P. montana var. thomsonii, Haymondia wallichii, Teyleria stricta and Toxicopueraria yunnanensis were recorded from leaf tissue after different solvent extractions. The voltammetric data recorded after different solvent extractions can be derived as patterns for species identification. The electrochemical behavior of plant tissue contains its electrochemical active compounds profile. As the distribution of chemical compounds in plants is controlled by genes, these profiles can reflect differences at the genetic level between species. The dendrogram deduced from the electrochemical profile has been used for polyphyly analysis. The result suggests the Teyleria stricta showed very distant relationships with other species. P. montana var. lobata, P. montana var. montana and P. montana var. thomsonii showed a close relationship because they were varietas. Interestingly, H. wallichii showed a close infrageneric relationship within these species, which disagrees with other morphological studies. In addition, the result also provides insight into phylogenetic status of the regionally Toxicopueraria yunnanensis.
Physicochemical and Structural Properties of Starch from Cassava Roots Differing in Growing Duration and Ploidy Level
Authors: Gourilekshmi Subrahmanyan S. , Jyothi Alummoottil N. , Sreekumar Janardanan
Published: May 2020

Wide variability exists in starch properties even among the same botanical source depending on climatic factors, genotypic differences, harvesting period, etc. The present study is an attempt to understand changes in structure, composition and physicochemical properties of cassava starch with root development. Starch is isolated from five cultivars of cassava at different root harvesting periods starting from root initiation stage, that is, 2–12 months after planting. The cultivars are selected in such a way that they represent different growing duration (short and normal), ploidy level (diploid and triploid), and end use (industrial and edible). Amylose/amylopectin ratio varies in a narrow range (0.24–0.28) for the starch from different varieties. Starch granule morphology does not show any significant variation with root growth and cultivar, but the average granule size varies significantly. All the starches show A‐type X‐ray diffraction pattern and the percentage crystallinity ranges from 37% to 48%. Average chain length and molecular weight of the starch show varietal differences. Even though the swelling power, solubility, water binding capacity and paste clarity are not significantly affected by the root harvesting period, the cultivar differences are evident for these parameters. Significant differences in the physicochemical and functional properties of starch with ploidy of the plant are not observed.