bluuebunny/crossref_metadata_2025 huggingface dataset:
Survival assessment of the extended‐wear insulin infusion set featuring lantern technology in adults with type 1 diabetes by the glucose clamp technique
Authors: Simic Amra , Schøndorff Pernelle K. , Stumpe Tobias , Heschel Matthias , Regittnig Werner , Pöttler Tina , Ninaus Daniela , Augustin Thomas , Groselj‐Strele Andrea , Pieber Thomas R. , Mader Julia K.
Published: February 2021

Maintaining good glycaemic control with the same infusion set for longer than 3 days may improve the quality of life of insulin pump users. The aim of the current study was to assess the efficacy and safety of the novel, extended‐wear infusion set over 7 days of wear in adults with type 1 diabetes. Sixteen participants completed three identical 8‐hour euglycaemic clamp experiments on Days 1, 4 and 7 of infusion set wear. Between the experiments, the participants were discharged home for routine diabetes management while wearing the same extended‐wear infusion set throughout the study. Time to reach the maximum glucose infusion rate (TGIRmax) on Day 7 was reduced by 67% compared with Day 1 (p < .001). The corresponding area under the glucose infusion rate curve (AUCGIR) was comparable for the first 2 h of the clamp (p = .891) but decreased by 28% over time (p < .008). While the extent of insulin absorption decreased with prolonged wear, it was accompanied by an increase in insulin absorption rate. The infusion set survival rate was 100% without leakages, occlusion alarms, severe hypoglycaemia or ketoacidosis. The extended‐wear infusion set proved safe and effective during prolonged wear in real‐life conditions.
Functional dyspepsia in depression: A population‐based cohort study
Authors: Kao Kai‐Liang , Sung Fung‐Chang , Huang Hui‐Chun , Lin Chen‐Ju , Chen Shu‐Chin , Lin Cheng‐Li , Huang Yo‐Ping , Wu Shu‐I , Chen Yi‐Shin , Stewart Robert
Published: February 2021

Background

Patients with functional dyspepsia (FD) are more likely to have persistent depression, yet whether depression and antidepressant treatments are associated with subsequent risk of FD remain unclear.

Methods

Using population‐based insurance administrative data of Taiwan, an 11‐year historic cohort study was assembled, comparing cases aged 18 and above with the diagnosis of depressive disorder, to a propensity score‐matched sample of adults without depression. Incident FD as a primary diagnosis was ascertained. Hazard ratios of FD were calculated using Cox regression models by age, gender, other comorbidities, nonsteroidal anti‐inflammatory medications, antidepressants and antidiabetic agents.

Results

A total of 20,197 people with depressive disorder and 20,197 propensity score‐matched comparisons without depression were followed up. The incidence of FD was 1.7‐fold greater in the depressive cohort than in comparisons (12.9 versus 7.57 per 1000 person‐years), with an adjusted hazard ratio (aHR) of 2.16 (95% confidence interval (CI) 1.93~2.41). Increased risks were significant regardless of comorbidities or medication uses, the highest in the untreated depression group compared to the group without depression, with an aHR of 2.51(95% CI 2.15~2.93).

Conclusions

This population‐based study showed that patients with depressive disorder are at elevated risk of FD. Antidepressant treatment could reduce the risk of FD.
The relationship between serum uric acid levels and development of obesity in living kidney donors after donor nephrectomy
Authors: Karatas Murat , Tatar Erhan , Simsek Cenk , Yıldırım Ali Murat , Uslu Adam
Published: February 2021

Background

Hyperuricaemia plays a role in the pathogenesis of obesity and related metabolic disorders. The aim of this study to investigate the relationship between pre‐donation serum uric acid (SUA) level and obesity development after nephrectomy in living kidney donors.

Methods

Living donors of kidney transplants between 1998 and 2019 were evaluated. Donors with less than 1 year of follow‐up were excluded from the study. The participants were divided into two groups according to last control body mass index (BMI) (obese; ≥ 30 kg/m2 and nonobese; <30 kg/m2) and median baseline SUA level (<4.6 mg/dL and ≥4.6 mg/dL).

Results

In the included 240 donors, the mean follow‐up was 50 ± 44 (12‐216) months. The mean age was 47 ± 11 (19‐82) years, and 46.6% of donors were male. At last control, the percentage of obese donors had increased significantly compared to pre‐donation time (22.5% vs 33.8%; P < .001) and last control obese donors had both higher baseline SUA (5.1 ± 1.4 vs 4.5 ± 1.2; P < .01) and BMI (30.7 ± 2.6 vs 24.8 ± 3.0; P < .001). Cox regression analysis showed that there is an independent relationship between the baseline SUA level and development of obesity (odds ratio: 1.30 [CI; 1.12‐1.50]; P < .001). In Kaplan‐Meier analysis, the development of obesity was significantly higher in kidney donors with high SUA level.

Conclusion

Living kidney donors (LKD) have a tendency to obesity after nephrectomy. Preoperative serum uric acid level gives important information in LKDs that it could foresee the development of obesity after donation.
The incidence of thrombocytopenia in adult patients receiving chemotherapy for solid tumors or hematologic malignancies
Authors: Shaw Jaime L. , Nielson Carrie M. , Park Joseph K. , Marongiu Andrea , Soff Gerald A.
Published: February 2021

Objectives

To estimate the risk of thrombocytopenia in various cancers and chemotherapy regimens.

Methods

Structured patient‐level data from the Flatiron Health Electronic Health Record database were used to identify adult patients who received chemotherapy for a solid tumor or hematologic malignancy from 2012 to 2017. Three‐month cumulative incidence of thrombocytopenia was assessed based on platelet counts, overall and by grade of thrombocytopenia. Co‐occurrence of anemia, neutropenia, and leukopenia was evaluated.

Results

Of 15,521 patients with solid tumors, 13% had thrombocytopenia within 3 months (platelet count < 100 × 109/L); 4% had grade 3 (25 to < 50 × 109/L), and 2% grade 4 (<25 × 109/L) thrombocytopenia. Of 2537 patients with hematologic malignancies, 28% had any thrombocytopenia, 16% with grade 3, and 12% with grade 4. Among patients with thrombocytopenia, it occurred without another cytopenia in 18% of solid tumors and 7% of hematologic malignancies.

Conclusions

In a large, US‐representative sample of patients undergoing chemotherapy in clinical practice, thrombocytopenia incidence varied across tumor and regimen types. Despite recommendations to alter chemotherapy to avoid severe thrombocytopenia, 4% of patients with solid tumors and 16% with hematologic malignancies experienced grade 3 thrombocytopenia. Prediction and prevention of thrombocytopenia may help oncologists avoid dose modifications and their adverse effects on survival.
The long‐term outcome of MOGAD: An observational national cohort study of 61 patients
Authors: Deschamps Romain , Pique Julie , Ayrignac Xavier , Collongues Nicolas , Audoin Bertrand , Zéphir Hélène , Ciron Jonathan , Cohen Mikael , Aboab Jennifer , Mathey Guillaume , Derache Nathalie , Laplaud David , Thouvenot Eric , Bourre Bertrand , Ruet Aurélie , Durand‐Dubief Françoise , Touitou Valérie , Vignal‐Clermont Catherine , Papeix Caroline , Gout Olivier , Marignier Romain , Maillart Elisabeth ,   the NOMADMUS study group
Published: February 2021

Background and objective

The prognosis in myelin oligodendrocyte glycoprotein (MOG) antibody‐associated disease (MOGAD) is a matter of debate. Our aim was to assess the long‐term outcomes of patients with MOGAD.

Methods

We retrospectively analysed the clinical and paraclinical data of patients from the French nationwide observatory study NOMADMUS who tested positive for MOG antibodies (MOG‐IgG) and who had clinical follow‐up of at least 8 years from their first episode.

Results

Sixty‐one patients (median [range] age at onset 27 [3–69] years), with a median (mean; range) follow‐up of 177 (212.8; 98–657) months, were included. Among 58 patients with a relapsing course, 26.3% relapsed in the first year after onset. Of the 61 patients, 90.2% experienced at least one episode of optic neuritis. At last visit, the median (mean; range) Expanded Disability Status Scale (EDSS) score was 1 (2.12; 0–7.5), 12.5% had an EDSS score ≥6 and 37.5% had an EDSS score ≥3. Of 51 patients with final visual acuity (VA) data available, 15.7% had VA ≤0.1 in at least one eye and 25.5% had VA ≤0.5 in at least one eye. Bilateral blindness (VA ≤0.1) was present in 5.9% of patients. Finally, 12.5% of patients presented bladder dysfunction requiring long‐term urinary catheterization. No factor associated significantly with a final EDSS score ≥3 or with final VA ≤0.1 was found.

Conclusion

Overall long‐term favourable outcomes were achieved in a majority of our patients, but severe impairment, in particular visual damage, was not uncommon.
The rule of law as the lodestar of the European Convention on Human Rights: The Strasbourg Court and the independence of the judiciary
Authors: Spano Robert
Published: February 2021

The rule of law is a constitutional principle under the European Convention on Human Rights. Throughout its history, the rule of law has been the lodestar guiding the development of the case‐law of the European Court of Human Rights. In recent years, the normative impact of this principle has been increasing in the case‐law of the Court, in particular in cases dealing with the independence of the judiciary. The article discusses the conceptual core of the rule of law under the Convention system as a fundamental component of “European public order”. Subsequently, the three‐dimensional normative status of the rule of law is explored as well as the Court's statement that the principle is “inherent in all the Articles of the Convention”. On this basis, an in‐depth analysis is undertaken of the application in recent Strasbourg case‐law of the independence of the judiciary as a fundamental organic component of the rule of law. Finally, the author reflects on the “symbiotic” relationship in the field of judicial independence between the Strasbourg Court and the Court of Justice of the European Union.
Targeting DNA damage response pathways to activate the STING innate immune signaling pathway in human cancer cells
Authors: Wayne Joanne , Brooks Teresa , Landras Alexandra , Massey Andrew J.
Published: February 2021

Activating stimulator of interferon genes to turn immunologically refractive cold tumor hot is an exciting therapeutic approach to increase the clinical responsiveness of some human cancers to immune checkpoint inhibitors. DNA damaging drugs and PARP inhibitors are two types of agents that have demonstrated this potential. Inhibitors of Chk1 or Wee1 induce DNA damage in cancer cells in predominantly the S‐phase population. Increased cytoplasmic single‐stranded and double‐stranded DNA (dsDNA) from this DNA damage resulted in increased tank‐binding kinase 1 (TBK1) phosphorylation in a range of cancer cell lines. However, despite robust increases in pTBK1, no downstream consequences of TBK1 phosphorylation were observed (namely no increase in pIRF3/7, interferon regulatory factor (IRF)‐dependent gene expression or a type I IFN response). In combination with cytotoxic chemotherapy such as gemcitabine or camptothecin (CPT), Chk1 inhibition increased cytoplasmic dsDNA compared with the cytotoxic alone but attenuated the cytotoxic chemotherapy‐induced increase in IRF1 protein and STAT1 phosphorylation through inhibition of nuclear RelB translocation. Despite increased cytoplasmic DNA and TBK1 activation, inhibition of Chk1, ataxia telangiectasia and Rad3‐related protein, or Wee1 failed to activate a type I IFN response. We discuss the potential underlying mechanisms for this lack of IRF‐dependent gene response and how this might influence the clinical strategies of combining Chk1 or Wee1 inhibitors with immune checkpoint inhibitors.
Female taxi drivers in Mexico City: Facing patriarchal structures as a force of oppression
Authors: Hiramatsu Anri
Published: February 2021

An increased need for safety has led to a demand in Mexican cities for female drivers for taxis and ride‐hailing services. However, little attention has been paid to female drivers' vulnerability to gender‐based violence and the challenges of working under patriarchal structures. This article draws on the empirical application of Walby's patriarchy framework (1990, 1997) to assess the interrelationship between patriarchal relations in households, paid work, and male violence, on the one hand, and the entry, working conditions, and survival strategies of female drivers in the Mexican taxi industry, on the other. The accounts of the dozen female drivers in Mexico City highlight key challenges faced by these women: Interaction with co‐workers, mistrust of their professional capabilities, sexual harassment, occupational hazards, and lack of political power in the taxi organizations. The findings show that the female drivers are heterogeneous in their working patterns and safety strategies, depending on their different social class and age. The article concludes with recommendations for the city government to provide an effective support scheme for female taxi drivers following an assessment of their demographics and labor force participation patterns.
Successful hybridization between non‐congeneric parrots in a small introduced population
Authors: Hernández‐Brito Dailos , Tella José L. , Carrete Martina , Blanco Guillermo
Published: February 2021

Introduced organisms have to overcome several obstacles, including the scarcity of conspecific mates, before becoming successfully established. We recorded interspecific mating in non‐native areas (Spain) that involved Orange‐winged Amazons Amazona amazonica with three non‐congeneric parrot species: Scaly‐headed Parrot Pionus maximiliani, Rose‐ringed Parakeet Psittacula krameri and Monk Parakeet Myiopsitta monachus. Rather than mating with parakeets, a male Orange‐winged Amazon successfully bred with a female Scaly‐headed Parrot, raising hybrid offspring during five consecutive years and thus increasing the initial population size from five to 12 individuals in 9 years. Non‐congeneric hybridization seems to be extremely rare in wild parrots and, in this case, it may facilitate the successful establishment of a small introduced population in Tenerife, Spain.
Water dispersibility of the β‐carotene source and its effect on the physical, thermal, and in vitro release properties of an inclusion complex
Authors: Flores Floirendo P. , Kong Fanbin
Published: February 2021

There is a need to understand the effect of in vitro digestion on the release of β‐carotene (BC) from inclusion complexes (IC) prepared with water‐dispersible (WDBC) or hexane‐soluble (HSBC) sources. IC were prepared by co‐precipitating WDBC or HSBC with β‐cyclodextrin and characterised using imaging, spectral (FTIR) and thermal techniques. Two solvent systems (absolute ethanol, AE and 4:3 ethanol–hexane, EH) were employed to compare extractability of BC during simulated co‐digestion with rice as food matrix. WDBC‐IC had greater yield (89% vs. 44%) but lower encapsulation efficiency (30% vs. 89%) than HSBC‐IC. Imaging, FTIR and thermal data confirm inclusion complex formation. In vitro WDBC release extracted with AE decreased uniformly and was unaffected by rice, whereas HSBC extracted with EH exhibited gradual release towards intestinal digestion but decreased with rice. Fabricated microcapsules with suitable forms of BC may be applied for food fortification purposes.
Impact of pressure on structure and properties of hot‐compressed Na2O–Al2O3–SiO2 glass by molecular dynamics simulations
Authors: Deng Binghui , Tandia Adama , Shi Ying
Published: February 2021

We conduct systematic studies to investigate the impact of pressure on structure and properties of Na2O–Al2O3–SiO2 glass system using molecular dynamics simulations. Glass compositions range from peralkaline, to charge‐balancing, to peraluminous. Hot‐compression operation is applied to as‐prepared glasses with pressure up to 4 GPa. Several key learnings are obtained from the study: (a) Density and elastic moduli increase with increasing Al/Na ratio (RAl/Na) and pressure, which are mainly driven by average internetwork bond angle reduction and void size reduction upon compression. (b) Population of three bonded oxygen (TBO) show some presence in the peralkaline composition space, while gain significantly in the peraluminous regime. Pressure essentially encourages conversion of bridging oxygen to nonbridging and three bonded oxygens. Local nearest neighbor environment of TBO is predominately Al atoms rather than Si atoms regardless of RAl/Na and applied pressure. (c) Analysis of first sharp diffraction peak (FSDP) from neutron scattering suggests that medium‐range structure is compacted and small size rings are noticeably distorted over the hot‐compression process. (d) Ring size distribution analysis shows that pressure has a more pronounced effect on altering medium‐range structure for peralkaline glasses as compared to peraluminous glasses.
Structure, crystallization, and performances of alkaline‐earth boroaluminosilicate sealing glasses for SOFCs
Authors: Yan Jiajia , Zhang Teng , Tao Haizheng , Zhan Hongbing , Yue Yuanzheng
Published: February 2021

We study the structure, crystallization, and performances of the sealing glasses with the composition (mol.%) of 12Al2O3·8B2O3·40SiO2·40RO (R = Mg, Ca, Sr) for solid oxide fuel cells (SOFCs) before and after isothermal treatment at 700°C, which is within the operation temperature range (600‐800°C) of SOFCs. The crystallization behavior has been investigated by differential scanning calorimetry and X‐ray diffraction under both dynamic and isothermal conditions. The structural evolution is probed using the Raman and nuclear magnetic resonance spectroscopies. The performances of the sealing glasses are characterized in terms of the coefficient of thermal expansion, the crystallization‐induced stress at glass–steel interface. We find that strong crystallization occurs at the operation temperature (700°C) far below the crystallization onset temperature measured by DSC. The structure origin of this anomalous crystallization is discussed in terms of structural heterogeneity of the three studied glasses. We determine the residual stress at the interface between the Ca‐containing glass and the steel after isothermal treatment at 700°C for 48 h, but this stress does not lead to falling off the glass layer from the steel. This indicates that this glass is a good candidate to be applied in SOFCs.
Intracardiac echocardiography‐guided implantation of the Watchman FLX left atrial appendage closure device
Authors: Turagam Mohit K. , Neuzil Petr , Petru Jan , Hala Pavel , Mraz Tomas , Baroch Jiri , Lekesova Veronika , Prokopova Milena , Dukkipati Srinivas R. , Reddy Vivek Y.
Published: February 2021

Background

The next‐generation Watchman FLX left atrial appendage closure (LAAC) device has: (1) an atraumatic closed distal end, (2) reduced height, (3) a recessed screw hub to decrease device‐related thrombus (DRT), (4) two rows of J‐shape anchors so redeployment is possible after full recapture, and (5) ability to treat a greater size range of LAA ostia.

Objective

To report, for the first time, the feasibility and safety of intracardiac echocardiography (ICE)‐guided Watchman FLX implantation.

Methods

A single‐center prospective registry of atrial fibrillation patients planned for LAAC with the FLX device underwent ICE‐guided implantation with conscious sedation. Transesophageal echocardiography (TEE) imaging was done preprocedure (to assess LAA size and exclude thrombus) and at clinical follow‐up at 6–12 weeks. Clinical outcomes were LAA closure success, complications, leak, or DRT on follow‐up TEE and major safety events.

Results

The study included 30 patients: age 75 ± 8 years, 53% men, CHA2DS2‐VASc 4.6 ± 1.6, and HAS‐BLED 3.4 ± 1.1. The primary indication was prior bleeding in 60% (72% GI bleeding). The LAA orifice width and length were 22.7 ± 3.1 and 25.7 ± 5.7 mm, respectively. Technical success was 100% (the first‐choice device was used in 28 of 30). Procedure time was less than 30 min in 27 of 30 cases, with 36 ± 15 ml contrast used. The final device size was 29.2 ± 4.7 mm with 21.6 ± 4.5% compression. There were no procedure‐related complications. Follow‐up TEE at a median 47 days follow‐up showed 100% device success with no DRT or peridevice leak ≥5 mm. Major safety events occurred in 6.6% (2/30).

Conclusion

The Watchman FLX device can be safely implanted with intraprocedural ICE imaging instead of TEE.
Differences in growth between offspring of anadromous and freshwater brown troutSalmo trutta
Authors: Jonsson Bror , Jonsson Nina
Published: February 2021

In this study, individual growth of juvenile offspring of anadromous and freshwater resident brown troutSalmo truttaand crosses between the two from the River Imsa, Norway, was estimated. The juveniles were incubated until hatching at two temperatures (±S.D.), either 4.4 ± 1.5°C or 7.1 ± 0.6°C. Growth rate was estimated for 22 days in August–September when the fish on average werec. 8 g in wet mass, and the estimates were standardized to 1 g fish dry mass. Offspring of anadromousS. truttagrew better at both 15 and 18°C than offspring of freshwater residentS. truttaor offspring of crosses between the twoS. truttatypes. This difference appears not to result from a maternal effect because anadromousS. truttagrew better than the hybrids with anadromous mothers. Instead, this appears to be an inherited difference between the anadromous and the freshwater resident fish lending support to the hypothesis that anadromous and freshwater residentS. truttain this river differ in genetic expression. Egg incubation temperature ofS. truttaappeared not to influence the later growth as reported earlier from the studies of Atlantic salmonSalmo salar.
Predicting the risk of postinflammatory hyperpigmentation: The palmar creases pigmentation scale
Authors: Leal‐Silva Hector
Published: February 2021

Background

Postinflammatory hyperpigmentation (PIH) may affect any skin type but has been linked more often to darker skin. While propensity to hyperpigmentation has not been fully elucidated, there may be a direct correlation to one's palmar crease pigmentation.

Objective

The aim of this study is to validate the reliable use of a palmar creases pigmentation (PCP) scale, and its accuracy in predicting the risk of PIH.

Methods

A prospective, comparative, and blinded study was conducted through photo‐numeric analysis of 126 photographs of pairs of palms. We utilized a 4‐point visual scale based on the level of contrast between palmar crease pigment and that of the surrounding skin. Score 0 indicated no difference, score 1 referred to a low difference, score 2 meant a moderate difference, and score 3 related to a high difference. Scores were subdivided based on the risk of PIH. Scores 0‐1 are low risk and scores 2‐3 are high risk. A panel of 8 medical experts independently evaluated and re‐evaluated the photographs that were shown in a random order.

Results

A significant degree of inter‐rater reliability was found at both evaluation visits, with an intra‐class correlation coefficient (ICC) = 0.908, P <.001, at the first evaluation and an ICC = 0.924, P <.001, at the second evaluation, demonstrating a validity of the scale. Global Fleiss kappa for intra‐rater reliability for all physicians was 0.514.

Conclusion

The PCP scale can be effectively used by any physician to predict hyperpigmentation risk.
Effect of a new cryotherapy device on an itchy sensation in patients with mild atopic dermatitis
Authors: Lee Eun Hye , Lee Hyun Ji , Park Kyung Duck , Lee Weon Ju
Published: February 2021

Background

The existence of an itchy sensation is a common complaint in patients with atopic dermatitis. More therapeutic modalities to address the itchy sensation in atopic dermatitis are still required.

Objective

We sought to assess the effect of a new cryotherapy device on the itchy sensation experienced by patients with atopic dermatitis.

Methods

A total of 28 patients with mild to moderate atopic dermatitis participated in this study. A split‐body clinical trial was conducted for 2 months, where one side of each participant was treated with the novel cryotherapy device, and the other side of each participant was observed as a control. The cryotherapy device was set to −5°C and applied for five seconds. We evaluated the visual analog scale (VAS) score for itch at 10, 30, and 60 minutes and at 1, 2 and 8 weeks after cryotherapy application. In addition, the level of patient satisfaction and adverse events were evaluated every visit.

Results

On the day immediately after treatment, the VAS score for itch in the treated‐side group was lower following cryotherapy application than as compared within the control‐side group. Further, the VAS score for itch in the treated‐side group at baseline (before treatment) was higher than at 1, 2 and 8 weeks after treatment. The proportion of patients reporting good or excellent satisfaction was 14.3%. No serious adverse events were recorded.

Conclusions

The novel cryotherapy tested herein may be a valuable antipruritic therapeutic remedy in patients with atopic dermatitis.
Assessment of serum interleukin‐19 in acne vulgaris patients of different clinical severities
Authors: Saleh Hanan M. , Deif Moustafa A. , El‐Husseiny Rania M.
Published: February 2021

Background

Acne vulgaris (AV) is a common chronic inflammatory disorder of the pilosebaceous unit among adolescents and young adults. Inflammation does have a central role in formation of both inflammatory and noninflammatory acne lesions with production of proinflammatory cytokines.

Aims

To measure serum levels of interleukin 19 (IL‐19) in acne vulgaris patients with different severities, and compare it with healthy controls, to evaluate its role in pathogenesis of acne vulgaris and correlate it with acne severity.

Materials and Methods

This study included 120 subjects, aged 18‐30 years, divided into four groups, 30 in each; mild, moderate, and severe AV patients groups according to acne severity as well as apparently healthy controls group of matched age and sex with no previous history of acne or active acne. Each patient was subjected to history taking, general and dermatological examination with assessment of acne severity. Serum IL‐19 levels of both patients and controls were also measured using quantitative enzyme‐linked immunosorbent assay (ELISA).

Results

Results revealed significant difference in serum IL‐19 levels between acne patients and controls, being higher in the former group (P value is < 0.001). Moreover, the rise in serum IL‐19 levels was significantly proportional to the increased acne severity (P value < 0.001).

Conclusion

IL‐19 is related to the etiopathological inflammatory process of acne vulgaris and correlates with acne severity. It could be proposed as a prognostic inflammatory marker for acne vulgaris.
An evaluation of a prenatal individualised mixed management intervention addressing breastfeeding outcomes and postpartum depression: A randomised controlled trial
Authors: Zhao Ying , Lin Qiping , Wang Jing
Published: February 2021

Aims and objectives

To determine the effects of an individualised mixed management combined lactation education and psychoeducation intervention on breastfeeding outcomes and postpartum depression (PPD) at 3 and 42 days postpartum.

Background

Pregnant women with antenatal depression are prone to postpartum depression and failure in breastfeeding.

Design

Eligible women participated in a randomised single‐blind controlled trial. Results are reported as per the CONSORT 2010 statement.

Methods

Participants were recruited from December 2017–August 2018 at a major teaching hospital located in Shanghai. Primiparous women (n = 182) with an Edinburgh Postnatal Depression Scale score ≥9 were randomly enrolled in the intervention group (n = 91) or the control group (n = 91). The intervention group participated in a 4‐session face‐to‐face mixed management intervention targeting perinatal depression and breastfeeding. The control group received usual care. Breastfeeding and psychological outcomes were measured during the third trimester (≥28 weeks and <35 weeks), and at 3 and 42 days postpartum.

Results

There were statistically significant differences in rates of overall and exclusive breastfeeding, initial breastfeeding experience, breastfeeding behaviour and self‐efficacy between the two groups at 3 and 42 days postpartum (p < .05). Intention‐to‐treat linear mixed model analysis showed that EPDS scores were statistically significantly different between groups over time (F = 20.42, p < .001). Intervention group were more satisfied with their husbands’ care and care received during the first month postpartum (p < .05).

Conclusions

The results demonstrate the effectiveness and feasibility of delivering an individualised mixed management intervention combining lactation guidance with psychological support during pregnancy.

Relevance to clinical practice

This study supports the need to identify pregnant women at risk of perinatal depression and indicates that the prenatal individualised mixed management intervention has the potential to reduce PPD and help achieve better breastfeeding outcomes.
Pathways from pain to physical and mental health‐related quality of life during the third trimester of pregnancy: an exploratory mediation analysis
Authors: Vignato Julie , Perkhounkova Yelena , Saeidzadeh Seyedehtanaz , Patsais Micayla , Inman Michaela , Marie McCarthy Ann , Segre Lisa S.
Published: February 2021

Aims and objectives

To understand how pain affects physical and mental health‐related quality of life during the third trimester of pregnancy.

Background

Poor health‐related quality of life during pregnancy is associated with adverse maternal foetal health outcomes such as increased risk of low‐birth‐weight neonates. Poor health‐related quality of life is linked to pain, pain interference and anxiety in the general adult population. However, we do not know how pain, pain interference (i.e., interference of pain with patient function), and anxiety are interrelated during the third trimester of pregnancy.

Methods

This exploratory cross‐sectional study followed STROBE guidelines. A mobile educational and tracking pregnancy application was used to obtain a racially/ethnically diverse convenience sample of 141 third trimester pregnant women from the U. S. In this sample, 58.2% of women had commercial health insurance, 68.8% were Caucasian, 86.5% were younger than 35 years, and 85.1% had a partner. Women completed demographics, Edinburgh Postnatal Depression Scale and the Brief Pain Inventory on REDCap. Path analysis was used to investigate a model for the relationships among pain intensity, pain interference, anxiety and physical and mental health‐related quality of life.

Results

Pain intensity affected health‐related quality of life indirectly by increasing pain interference, which in turn, decreased both physical and mental health‐related quality of life. In addition, pain interference also increased anxiety, which in turn worsened mental health‐related quality of life, but not physical health‐related quality of life.

Conclusions

Treating perinatal pain may improve health‐related quality of life by decreasing pain interference and anxiety.

Relevance to clinical practice

Nurses should assess for pain interference and anxiety in women experiencing moderate to severe pain during the third trimester of pregnancy. With this knowledge, nurses may advocate for women in receiving effective treatment for their conditions and improvements in their physical and mental health‐related quality of life.
Postural orthostatic tachycardia syndrome – an ‘invisible condition’ with far‐reaching consequences
Authors: Gall Nicholas
Published: February 2021

Click here to view the Original article by K. M. Bourne et al.
Thallus Growth Stage and Geographic Origin Shape Microalgal Diversity in Ramalina farinacea Lichen Holobionts
Authors: Molins Arantzazu , Moya Patricia , Muggia Lucia , Barreno Eva
Published: February 2021

Lichen symbioses are microecosystems hosting many other living organisms besides the two major lichen symbionts (i.e., lichenized fungi [the mycobiont] and green microalgae or cyanobacteria [the photobiont]). Recent investigations evidenced that other fungi, non‐photosynthetic bacteria, and microalgae co‐inhabit within the lichen thalli, but their diversity and their roles are still underinvestigated. Here we present an ad hoc stratified sampling design and in‐depth Illumina paired‐end metabarcoding approach to explore microalgal diversity in lichen thalli of the model species Ramalina farinacea from different ecologies. Lichen thalli were surveyed according to three different sizes, and different thallus parts were considered for molecular, bioinformatics, and community diversity analyses. The results revealed that microalgal diversity strongly depends on the growth stage of the thalli, the geographic area, and the habitat type. The results also show that microalgal diversity does not vary along the thallus branches (lacinias)—that is, it does not correlate with the apical growth and founder effects—and that there is no balanced co‐presence of two main photobionts as previously established in R. farinacea. The sampling design performed here minimizes bias in the assessment of photobiont diversity in lichens and is proposed to be reliable and applicable to further study microalgal diversity in lichen symbioses.
On the Estimation of Periodicity or Almost Periodicity in Inhomogeneous Gamma Point‐Process Data
Authors: Saul Gaitan Rodrigo , Lii Keh‐Shin
Published: February 2021

The non‐homogeneous Poisson process (NHPP) and the renewal process (RP) are two stochastic point process models that are commonly used to describe the pattern of repeated occurrence data. An inhomogeneous Gamma process (IGP) is a point process model that generalizes both the NHPP and a particular RP, commonly referred to as a Gamma renewal process, which has interarrival times that are i.i.d. gamma random variables with unit scale parameter and shape parameter . This article focuses on a particular class of the IGP which has a periodic or almost periodic baseline intensity function and a shape parameter . This model deals with point events that show a pattern of periodicity or almost periodicity. Consistent estimators of unknown parameters are constructed mainly by the Bartlett periodogram. Simulation results that support theoretical findings are provided.
Maternal high‐fat diet disrupted one‐carbon metabolism in offspring, contributing to nonalcoholic fatty liver disease
Authors: Peng Hui , Xu Huiting , Wu Jie , Li Jiangyuan , Zhou Yi , Ding Zehuan , Siwko Stefan K. , Yuan Xianglin , Schalinske Kevin L. , Alpini Gianfranco , Zhang Ke K. , Xie Linglin
Published: February 2021

Background & Aims

Pregnant women may transmit their metabolic phenotypes to their offspring, enhancing the risk for nonalcoholic fatty liver disease (NAFLD); however, the molecular mechanisms remain unclear.

Methods

Prior to pregnancy female mice were fed either a maternal normal‐fat diet (NF‐group, “no effectors”), or a maternal high‐fat diet (HF‐group, “persistent effectors”), or were transitioned from a HF to a NF diet before pregnancy (H9N‐group, “effectors removal”), followed by pregnancy and lactation, and then offspring were fed high‐fat diets after weaning. Offspring livers were analysed by functional studies, as well as next‐generation sequencing for gene expression profiles and DNA methylation changes.

Results

The HF, but not the H9N offspring, displayed glucose intolerance and hepatic steatosis. The HF offspring also displayed a disruption of lipid homeostasis associated with an altered methionine cycle and abnormal one‐carbon metabolism that caused DNA hypermethylation and L‐carnitine depletion associated with deactivated AMPK signalling and decreased expression of PPAR‐α and genes for fatty acid oxidation. These changes were not present in H9N offspring. In addition, we identified maternal HF diet‐induced genes involved in one‐carbon metabolism that were associated with DNA methylation modifications in HF offspring. Importantly, the DNA methylation modifications and their associated gene expression changes were reversed in H9N offspring livers.

Conclusions

Our results demonstrate for the first time that maternal HF diet disrupted the methionine cycle and one‐carbon metabolism in offspring livers which further altered lipid homeostasis. CpG islands of specific genes involved in one‐carbon metabolism modified by different maternal diets were identified.
Infant malnutrition treatment in Kenya: Health worker and breastfeeding peer supporter experiences
Authors: Chabeda Sophie , Oluoch Dorothy , Mwangome Martha , Jones Caroline
Published: February 2021

Acute malnutrition in infants under 6 months (u6m) is increasingly recognised as a global public health problem. The World Health Organisation (WHO) guidelines for inpatient nutritional rehabilitation of infants u6m is re‐lactation: the re‐establishment of exclusive breastfeeding. Evidence suggests these guidelines are rarely followed in many low‐income settings. Two studies of infant nutritional rehabilitation undertaken in three public hospitals in coastal Kenya employed breastfeeding peer supporters (BFPSs) to facilitate WHO guideline implementation. To explore the acceptability of the strategy to health workers (HWs) and the BFPSs, in‐depth interviews were conducted with 20 HWs and five BFPSs in the three study hospitals. The HWs reported that the presence of the BFPSs changed the way infant nutritional rehabilitation was managed, increasing efforts at relactation and decreasing reliance on supplemental milk. BFPSs were said to help address staff shortages and had dedicated time to support and assist the mothers. Key to the success of the BFPSs was the social relationships they were able to establish with the mothers due to the similarity in their experiences and backgrounds. Despite the success of the BFPSs, human resource management and infrastructure challenges remained. BFPSs can successfully be employed to facilitate the implementation of the WHO guidelines for the nutritional rehabilitation of acutely malnourished infants u6m in hospitals in Kenya, establishing supportive social relationships and trust with the mothers of the acutely malnourished infants and helping to address the issue of human resource shortages.
Development and description of New Nordic Diet scores across infancy and childhood in the Norwegian Mother, Father and Child Cohort Study (MoBa)
Authors: Agnihotri Neha , Rudjord Hillesund Elisabet , Bere Elling , Wills Andrew Keith , Brantsæter Anne Lise , Øverby Nina Cecilie
Published: February 2021

In recent years, examining dietary patterns has become a more common way of investigating potential associations between diet and adverse health outcomes. The New Nordic Diet (NND) is a potentially healthy and sustainable dietary pattern characterized by foods that are locally available and traditionally consumed in the Nordic countries. The diet has been typically examined in adult populations, and less is known about compliance to the NND from infancy throughout childhood. In the current study, we therefore aimed to develop and describe child age‐specific NND scores. This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and uses data from the Medical Birth Registry of Norway (MBRN). We have previously developed a NND score for the maternal diet during pregnancy, and the development of the child diet scores was based on the rationale of this score. Food frequency data from n = 89 715 at child age 6 months, n = 76 432 at 18 months, n = 58 884 at 3 years, and n = 35 978 at 7 years were used to construct subscales in accordance with the maternal diet score. Subscales were composed of responses to a selection of food and drink items or other questions and were dichotomized by the median, yielding four age‐specific diet scores where the possible scoring ranged from 0 to 6 at 6 months and 3 years and from 0 to 9 at 18 months and 7 years. The developed scores will be used to examine associations with childhood overweight and cognitive and mental development in future studies.
Can the arts and humanities bring the patient's voice centre stage in medical education?
Authors: Laughey William F. , Finn Gabrielle M.
Published: February 2021

Read this commentary to understand why arts and humanities deserve to move centre stage in the arena of health professional education.
Truly, there is no such thing as a bad teacher
Authors: Giamto Kristian Wongso
Published: February 2021

Finding light in the darkness of interactions with poor clinical role models, Giamto argues most of us have missed opportunities to learn invaluable lessons from such encounters.
Consequences of producing DNA gyrase from a syntheticgyrBAoperon inSalmonella entericaserovar Typhimurium
Authors: Pozdeev German , Mogre Aalap , Dorman Charles J.
Published: February 2021

DNA gyrase is an essential type II topoisomerase that is composed of two subunits, GyrA and GyrB, and has an A2B2structure. Although the A and B subunits are required in equal proportions to form DNA gyrase, thegyrAandgyrBgenes that encode them inSalmonella(and in many other bacteria) are at separate locations on the chromosome, are under separate transcriptional control, and are present in different copy numbers in rapidly growing bacteria. In wild‐typeSalmonella,gyrAis near the chromosome's replication terminus, whilegyrBis near the origin. We generated a syntheticgyrBAoperon at theoriC‐proximal location ofgyrBto test the significance of the gyrase gene position forSalmonellaphysiology. Although the strain producing gyrase from an operon had a modest alteration to its DNA supercoiling set points, most housekeeping functions were unaffected. However, its SPI‐2 virulence genes were expressed at a reduced level and its survival was reduced in macrophage. Our data reveal that the horizontally acquired SPI‐2 genes have a greater sensitivity to disturbance of DNA topology than the core genome and we discuss its significance in the context ofSalmonellagenome evolution and thegyrAandgyrBgene arrangements found in other bacteria.
Functional interaction between ELL transcription elongation factor and Epe1 reveals the role of Epe1 in the regulation of transcription outside heterochromatin
Authors: Sweta Kumari , Sharma Nimisha
Published: February 2021

Eleven‐nineteen lysine‐rich leukemia (ELL) is a eukaryotic RNA polymerase II transcription elongation factor. In Schizosaccharomyces pombe, it is important for survival under genotoxic stress conditions. However, the molecular basis underlying this function of ELL in S. pombe is yet to be deciphered. Here, we carried out a genetic screen to identify multicopy suppressor(s) that could restore normal growth of ell1 deletion mutant in the presence of DNA damaging agent. Sequence analysis of the identified suppressors revealed the anti‐silencing protein, Epe1, as one of the suppressors of ell1 deletion associated genotoxic stress sensitivity. Our results further demonstrate that the overexpression of Epe1 could suppress all other phenotypes associated with the absence of Ell1. Moreover, transcriptional defect of ell1Δ strain could also be alleviated by the overexpression of Epe1. Epe1 also showed a physical interaction with Ell1. Interestingly, we also observed that the region of Epe1 encompassing 403–948 amino acids was indispensable for all the above functions. Furthermore, our results show that the overexpression of Epe1 causes increased H3K9 acetylation and RNA polymerase II recruitment. Taken together, our results show a functional interaction between Epe1 and Ell1, and this function is independent of the well‐known JmjC and N‐terminal transcriptional activation domains of Epe1 in S. pombe.
Non‐self recognition‐based self‐incompatibility can alternatively promote or prevent introgression
Authors: Harkness Alexander , Brandvain Yaniv
Published: February 2021

Self‐incompatibility alleles (S‐alleles), which prevent self‐fertilisation in plants, have historically been expected to benefit from negative frequency‐dependent selection and invade when introduced to a new population through gene flow. However, the most taxonomically widespread form of self‐incompatibility, the ribonuclease‐based system ancestral to the core eudicots, functions through collaborative non‐self recognition, which can affect both short‐term patterns of gene flow and the long‐term process of S‐allele diversification.

We analysed a model of S‐allele evolution in two populations connected by migration, focussing on comparisons among the fates of S‐alleles initially unique to each population and those shared among populations.

We found that both shared and unique S‐alleles from the population with more unique S‐alleles were usually fitter compared with S‐alleles from the population with fewer S‐alleles. Resident S‐alleles often became extinct and were replaced by migrant S‐alleles, although this outcome could be averted by pollen limitation or biased migration.

Collaborative non‐self recognition will usually either result in the whole‐sale replacement of S‐alleles from one population with those from another or else disfavour introgression of S‐alleles altogether.
Trichoderma atroviride‐emitted volatiles improve growth of Arabidopsis seedlings through modulation of sucrose transport and metabolism
Authors: Esparza‐Reynoso Saraí , Ruíz‐Herrera León Francisco , Pelagio‐Flores Ramón , Macías‐Rodríguez Lourdes Iveth , Martínez‐Trujillo Miguel , López‐Coria Montserrat , Sánchez‐Nieto Sobeida , Herrera‐Estrella Alfredo , López‐Bucio José
Published: February 2021

Plants host a diverse microbiome and differentially react to the fungal species living as endophytes or around their roots through emission of volatiles. Here, using divided Petri plates for Arabidopsis‐T. atroviride co‐cultivation, we show that fungal volatiles increase endogenous sugar levels in shoots, roots and root exudates, which improve Arabidopsis root growth and branching and strengthen the symbiosis. Tissue‐specific expression of three sucrose phosphate synthase‐encoding genes (AtSPS1F, AtSPS2F and AtSPS3F), and AtSUC2 and SWEET transporters revealed that the gene expression signatures differ from those of the fungal pathogens Fusarium oxysporum and Alternaria alternata and that AtSUC2 is largely repressed either by increasing carbon availability or by perception of the fungal volatile 6‐pentyl‐2H‐pyran‐2‐one. Our data point to Trichoderma volatiles as chemical signatures for sugar biosynthesis and exudation and unveil specific modulation of a critical, long‐distance sucrose transporter in the plant.
Financial Network and Systemic Risk—A Dynamic Model
Authors: Chen Hong , Wang Tan , Yao David D.
Published: February 2021

We develop a dynamic model to study the systemic risk of the banking network, so as to study the dynamics of bank defaults. In contrast to the existing literature, we show that while the possibility of contagion is determined by interconnectedness of the financial network, whether a financial crisis can occur depends on the profile of the liquid assets of the banks in the system. Based on the dynamic model, we introduce a time to crisis index that allows us to predict the occurrence of a financial crisis. We then provide an intuitive measure of systemic risk. To illustrate the potential usefulness of our model, we provide an analysis of the system of twenty‐two German banks. We show how many of the banks are fundamentally weak, where the contagion effect may arise from, how strong the contagion effect is, and how significant the systemic risk is.