bluuebunny/crossref_metadata_2025_split huggingface dataset:
Objective measures of adenomyosis on MRI and their diagnostic accuracy—a systematic review & meta‐analysis
Authors: Rees Connie O. , Nederend Joost , Mischi Massimo , van Vliet Huib A. A. M. , Schoot Benedictus C. 
Published: March 2021

AbstractIntroductionMagnetic resonance imaging (MRI) diagnosis of adenomyosis is considered the most accurate non‐invasive technique, but remains subjective, with no consensus on which diagnostic parameters are most accurate. We aimed to systematically review the literature on how adenomyosis can be objectively quantified on MRI in a scoping manner, to review the diagnostic performance of these characteristics compared with histopathological diagnosis, and to summarize correlations between measures of adenomyosis on MRI and clinical outcomes.Material and methodsWe searched databases Pubmed, Embase, and Cochrane for relevant literature up to April 2020 according to PRISMA guidelines. We included studies that objectively assessed adenomyosis on MRI, and separately assessed studies investigating the diagnostic performance of MRI vs histopathology for inclusion in a meta‐analysis. The QUADAS‐2 tool was used for risk of bias, with many studies showing an unclear or high risk of bias.ResultsEighty studies were included, of which 14 assessed the diagnostic performance of individual MRI parameters, with four included in the meta‐analysis of diagnostic accuracy. Common MRI parameters were: junctional zone (JZ) characteristics, such as maximum JZ thickness—pooled sensitivity 71.6% (95% CI 46.0%–88.2%), specificity 85.5% (52.3%–97.0%); JZ differential—pooled sensitivity 58.9% (95% CI 44.3%–72.1%), specificity 83.2% (95% CI 71.3%–90.8%); and JZ to myometrial ratio—pooled sensitivity 63.3% (95% CI 51.9%–73.4%), specificity 79.4% (95% CI 42.0%–95.4%); adenomyosis lesion size, uterine morphology (pooled sensitivity 42.9% (95% CI 15.9%–74.9%), specificity 87.7%, (95% CI 37.9–98.8) and changes in signal intensity—eg, presence of myometrium cysts; pooled 59.6% (95% CI 41.6%–75.4%) and specificity of 96.1% (95% CI 80.7%–99.3%). Other MRI parameters have been used for adenomyosis diagnosis, but their diagnostic performance is unknown. Few studies attempted to correlate adenomyosis MRI phenotype to clinical outcomes.ConclusionsA wide range of objective parameters for adenomyosis exist on MRI; however, in many cases their individual diagnostic performance remains uncertain. JZ characteristics remain the most widely used and investigated with acceptable diagnostic accuracy. Specific research is needed into how these objective measures of adenomyosis can be correlated to clinical outcomes.
Local cyclic adenosine monophosphate signalling cascades—Roles and targets in chronic kidney disease
Authors: Sholokh Anastasiia , Klussmann Enno 
Published: March 2021

AbstractThe molecular mechanisms underlying chronic kidney disease (CKD) are poorly understood and treatment options are limited, a situation underpinning the need for elucidating the causative molecular mechanisms and for identifying innovative treatment options. It is emerging that cyclic 3′,5′‐adenosine monophosphate (cAMP) signalling occurs in defined cellular compartments within nanometre dimensions in processes whose dysregulation is associated with CKD. cAMP compartmentalization is tightly controlled by a specific set of proteins, including A‐kinase anchoring proteins (AKAPs) and phosphodiesterases (PDEs). AKAPs such as AKAP18, AKAP220, AKAP‐Lbc and STUB1, and PDE4 coordinate arginine‐vasopressin (AVP)‐induced water reabsorption by collecting duct principal cells. However, hyperactivation of the AVP system is associated with kidney damage and CKD. Podocyte injury involves aberrant AKAP signalling. cAMP signalling in immune cells can be local and slow the progression of inflammatory processes typical for CKD. A major risk factor of CKD is hypertension. cAMP directs the release of the blood pressure regulator, renin, from juxtaglomerular cells, and plays a role in Na+ reabsorption through ENaC, NKCC2 and NCC in the kidney. Mutations in the cAMP hydrolysing PDE3A that cause lowering of cAMP lead to hypertension. Another major risk factor of CKD is diabetes mellitus. AKAP18 and AKAP150 and several PDEs are involved in insulin release. Despite the increasing amount of data, an understanding of functions of compartmentalized cAMP signalling with relevance for CKD is fragmentary. Uncovering functions will improve the understanding of physiological processes and identification of disease‐relevant aberrations may guide towards new therapeutic concepts for the treatment of CKD.
Tectorigenin alleviates intrahepatic cholestasis by inhibiting hepatic inflammation and bile accumulation via activation of PPARγ
Authors: Xiang Jiaqing , Yang Guangyan , Ma Chuanrui , Wei Lingling , Wu Han , Zhang Wei , Tao Xiuhua , Jiang Lingyun , Liang Zhen , Kang Lin , Yang Shu 
Published: March 2021

Background and PurposeIncreasing evidence suggests that human cholestasis is closely associated with the accumulation and activation of hepatic macrophages. Research indicates that activation of PPARγ exerts liver protective effects in cholestatic liver disease (CLD), particularly by ameliorating inflammation and fibrosis, thus limiting disease progression. However, existing PPARγ agonists, such as troglitazone and rosiglitazone, have significant side effects that prevent their clinical application in the treatment of CLD. In this study, we found that tectorigenin alleviates intrahepatic cholestasis in mice by activating PPARγ.Experimental ApproachWild‐type mice were intragastrically administered α‐naphthylisothiocyanate (ANIT) or fed a diet containing 0.1% 3,5‐diethoxycarbonyl‐1,4‐dihydrocollidine (DDC) to simultaneously establish an experimental model of intrahepatic cholestasis and tectorigenin intervention, followed by determination of intrahepatic cholestasis and the mechanisms involved. In addition, PPARγ‐deficient mice were administered ANIT and/or tectorigenin to determine whether tectorigenin exerts its liver protective effect by activating PPARγ.Key ResultsTreatment with tectorigenin alleviated intrahepatic cholestasis by inhibiting the recruitment and activation of hepatic macrophages and by promoting the expression of bile transporters via activation of PPARγ. Furthermore, tectorigenin increased expression of the bile salt export pump (BSEP) through enhanced PPARγ binding to the BSEP promoter. In PPARγ‐deficient mice, the hepatoprotective effect of tectorigenin during cholestasis was blocked.Conclusion and ImplicationsIn conclusion, tectorigenin reduced the recruitment and activation of hepatic macrophages and enhanced the export of bile acids by activating PPARγ. Taken together, our results suggest that tectorigenin is a candidate compound for cholestasis treatment.
UK Head and neck cancer surgical capacity during the second wave of the COVID—19 pandemic: Have we learned the lessons? COVIDSurg collaborative
Authors: Shaw Richard ,   COVIDSurg Collaborative
Published: March 2021

AbstractObjectivesThe aim of this study was to evaluate the differences in surgical capacity for head and neck cancer in the UK between the first wave (March‐June 2020) and the current wave (Jan‐Feb 2021) of the COVID‐19 pandemic.DesignREDcap online‐based survey of hospital capacity.SettingUK secondary and tertiary hospitals providing head and neck cancer surgery.ParticipantsOne representative per hospital was asked to report the capacity for head and neck cancer surgery in that institution.Main outcome measuresThe principal measures of interests were new patient referrals, capacity in outpatients, theatres and critical care; therapeutic compromises constituting delay to surgery, de‐escalated surgery and therapeutic migration to non‐surgical primary modality.ResultsData were returned from approximately 95% of UK hospitals with a head and neck cancer surgery specialist service. 50% of UK head and neck cancer patients requiring surgery have significantly compromised treatments during the second wave: 28% delayed, 10% have received radiotherapy‐based treatment instead of surgery, and 12% have received de‐escalated surgery. Surgical capacity has been more severely constrained in the second wave (58% of pre‐pandemic level) compared with the first wave (62%) despite the time to prepare.ConclusionsSome hospitals are overwhelmed by COVID‐19 and unable to offer essential cancer surgery, but all have neighbouring hospitals in their region retaining good (or even normal) capacity. It is noteworthy that very few patients have been appropriately redirected away from the hospitals most constrained by their burden of COVID‐19. The paucity of an effective central or regional strategic response to this evident mismatch between demand and surgical capacity is to the detriment of our head and neck cancer patients.
Validation of the Alternative International Prognostic Score‐E (AIPS‐E): Analysis of Binet stage A chronic lymphocytic leukemia patients enrolled into the O‐CLL1‐GISL protocol
Authors: Morabito Fortunato , Tripepi Giovanni , Vigna Ernesto , Bossio Sabrina , D’Arrigo Graziella , Martino Enrica Antonia , Storino Francesca , Recchia Anna Grazia , Fronza Gilberto , Di Raimondo Francesco , Colombo Monica , Fais Franco , Neri Antonino , Cutrona Giovanna , Ferrarini Manlio , Gentile Massimo 
Published: March 2021

AbstractObjectivesTo validate the predictive value on time to first treatment (TTFT) of AIPS‐E and IPS‐E evaluated in an independent cohort of newly diagnosed and non‐referred Binet stage A CLL patients enrolled in the O‐CLL1‐GISL protocol (clinicaltrial.gov identifier: NCT00917540).MethodsA cohort of 292 newly diagnosed Binet A CLL cases has been enrolled in the study. Patients from several Italian Institutions were prospectively enrolled within 12 months of diagnosis into the O‐CLL1‐GISL protocol.ResultsThe majority of patients were male (62%); median age was 60.4 years, 102 cases (34.9%) showed unmutated IGHV genes, 8 cases (2.8) the presence of del(11q)/del(17p), 142 cases (48.6%) the presence of palpable lymph nodes and 146 cases (50%) and ALC > 15 × 109/l. After a median follow‐up of 7.2 years, 130 patients underwent treatment. According to the AIPS‐E, 96 patients were classified as low‐risk, 128 as intermediate‐risk, and 68 as high‐risk. These groups showed significant differences in terms of TTFT. The C‐statistic was 0.71 (P < .0001) for predicting TTFT. According to IPS‐E, 77 patients were classified as low‐risk, 135 as intermediate‐risk, and 80 as high‐risk. These groups showed significant differences in terms of TTFT. The C‐statistic was 0.705 (P < .0001) for predicting TTFT.ConclusionsOur data confirm an accurate prognostic utility of both AIPS‐E and IPS‐E at the individual patient level. These data may be useful for a precise stratification of early‐stage patients.
Genetic load has potential in large populations but is realized in small inbred populations
Authors: Mathur Samarth , DeWoody J. Andrew 
Published: March 2021

AbstractPopulations with higher genetic diversity and larger effective sizes have greater evolutionary capacity (i.e., adaptive potential) to respond to ecological stressors. We are interested in how the variation captured in protein‐coding genes fluctuates relative to overall genomic diversity and whether smaller populations suffer greater costs due to their genetic load of deleterious mutations compared with larger populations. We analyzed individual whole‐genome sequences (N = 74) from three different populations of Montezuma quail (Cyrtonyx montezumae), a small ground‐dwelling bird that is sustainably harvested in some portions of its range but is of conservation concern elsewhere. Our historical demographic results indicate that Montezuma quail populations in the United States exhibit low levels of genomic diversity due in large part to long‐term declines in effective population sizes over nearly a million years. The smaller and more isolated Texas population is significantly more inbred than the large Arizona and the intermediate‐sized New Mexico populations we surveyed. The Texas gene pool has a significantly smaller proportion of strongly deleterious variants segregating in the population compared with the larger Arizona gene pool. Our results demonstrate that even in small populations, highly deleterious mutations are effectively purged and/or lost due to drift. However, we find that in small populations the realized genetic load is elevated because of inbreeding coupled with a higher frequency of slightly deleterious mutations that are manifested in homozygotes. Overall, our study illustrates how population genomics can be used to proactively assess both neutral and functional aspects of contemporary genetic diversity in a conservation framework while simultaneously considering deeper demographic histories.
Anoxygenic photosynthesis linked to Neoarchean iron formations in Carajás (Brazil)
Authors: Rego Eric Siciliano , Busigny Vincent , Lalonde Stefan V. , Philippot Pascal , Bouyon Amaury , Rossignol Camille , Babinski Marly , de Cássia Zapparoli Adriana 
Published: March 2021

AbstractMicrobial activity is often invoked as a direct or indirect contributor to the precipitation of ancient chemical sedimentary rocks such as Precambrian iron formations (IFs). Determining a specific metabolic pathway from the geological record remains a challenge, however, due to a lack of constraints on the initial conditions and microbially induced redox reactions involved in the formation of iron oxides. Thus, there is ongoing debate concerning the role of photoferrotrophy, that is the process by which inorganic carbon is fixed into organic matter using light as an energy source and Fe(II) as an electron donor, in the deposition of IFs. Here, we examine ~2.74‐Ga‐old Neoarchean IFs and associated carbonates from the Carajás Mineral Province, Brazil, to reconstruct redox conditions and to infer the oxidizing mechanism that allowed one of the world's largest iron deposits to form. The absence of cerium (Ce) anomalies reveals that conditions were pervasively anoxic during IF deposition, while unprecedented europium (Eu) anomalies imply that Fe was supplied by intense hydrothermal activity. A positive and homogeneous Fe isotopic signal in space and time in these IFs indicates a low degree of partial oxidation of Fe(II), which, combined with the presence of13C‐depleted organic matter, points to a photoautotrophic metabolic driver. Collectively, our results argue in favor of reducing conditions during IF deposition and suggest anoxygenic photosynthesis as the most plausible mechanism responsible for Fe oxidation in the Carajás Basin.
Mountains act as museums and cradles for hemipteran insects in China: Evidence from patterns of richness and phylogenetic structure
Authors: Li Junjie , Li Qiang , Wu Yangxue , Ye Longqin , Liu Huanhuan , Wei Jiufeng , Huang Xiaolei 
Published: March 2021

AbstractAimThis study aims to test whether the diversity centres of hemipteran insects are mainly concentrated in mountains and whether spatial variation exists in the relationship between species richness and environmental factors, and investigate the spatio‐temporal divergence patterns of hemipteran insects in China to infer underlying mechanisms and the role of different regions as museums and/or cradles.LocationChina.Time periodPresent day.Major taxa studiedHemipteran insects.MethodsA comprehensive species distribution dataset consisting of 7,822 hemipteran species was compiled, and a dated molecular phylogeny of hemipteran insects was reconstructed. We analysed the richness and spatio‐temporal divergence patterns of hemipteran insects based on grid cells with a resolution of 1° × 1°. The relative effects of environmental factors on species richness were analysed by general linear models, multivariate spatial autoregressive models and a spatial random forest model. Phylogenetic diversity, phylogenetic structure, and mean divergence times were calculated and evaluated.ResultsThe mountains of central to southern China have the highest hemipteran diversity. Multiple environmental factors together determine the diversity patterns, but relative effects of different factors vary across China's terrain. Central and southern China primarily preserve older lineages and present phylogenetic overdispersion, while northern China shows more recent divergence and phylogenetic clustering. The eastern Himalayas and Hengduan Mountains have high diversity of both ancient and young lineages.Main conclusionsThe diversity patterns of hemipteran insects in China obviously tend to concentrate in mountains and result from combined effects of multiple environmental factors, but the effects vary in different areas. The mountains of central and southern China act as museums, and the mountains of northern China represent evolutionary cradles for Hemiptera diversity, while the eastern Himalayas and Hengduan Mountains are probably being both cradles and museums. Our results identify areas of high richness and phylogenetic diversity, which provide a foundation for insect conservation in China.
‘It's not magic’: A qualitative analysis of geriatric physicians' explanations of cardio‐pulmonary resuscitation in hospital admissions
Authors: Sterie Anca‐Cristina , Jones Laura , Jox Ralf J. , Rubli Truchard Eve 
Published: March 2021

AbstractBackgroundDiscussing patient preferences for cardio‐pulmonary resuscitation (CPR) is routine in hospital admission for older people. The way the conversation is conducted plays an important role for patient comprehension and the ethics of decision making.ObjectiveThe objective was to examine how CPR is explained in geriatric rehabilitation hospital admission interviews, focussing on circumstances in which physicians explain CPR and the content of these explanations.MethodWe recorded forty‐three physician‐patient admission interviews taking place in a hospital in French‐speaking Switzerland, during which CPR was discussed. Data were analysed in French with thematic and conversation analysis, and the extracts used for publication were translated into English.ResultsMean patient age was 83.7 years; 53.5% were admitted for rehabilitation after surgery or traumatism. CPR was explained in 53.8% of the conversations. Most explanations were brief and concerned the technical procedures, mentioning only rarely potential outcome. With one exception, medical indication and prognosis of CPR did not feature in these explanations. Explanations occurred either before the patient's answer (as part of the question about CPR preferences) or after the patient's answer, generated by patients' indecision, misunderstanding and by the need to clarify answers.Discussion and conclusionsThe scarcity and simplicity of CPR explanations highlight a reluctance to have in‐depth discussions and reflect the assumption that CPR does not need explaining. Providing patients with accurate information about the outcomes and risks of CPR is incremental for reaching informed decisions and patient‐centred care.Patient contributionPatients were involved in the data collection stage of the study.
Endodontic management of traumatized permanent teeth: a comprehensive review
Authors: Krastl G. , Weiger R. , Filippi A. , Van Waes H. , Ebeleseder K. , Ree M. , Connert T. , Widbiller M. , Tjäderhane L. , Dummer P. M. H. , Galler K. 
Published: March 2021

AbstractThe pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine–pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.
Runx proteins and transcriptional mechanisms that govern memory CD8 T cell development
Authors: Pipkin Matthew E. 
Published: March 2021

AbstractAdaptive immunity to intracellular pathogens and tumors is mediated by antigen‐experienced CD8 T cells. Individual naive CD8 T cells have the potential to differentiate into a diverse array of antigen‐experienced subsets that exhibit distinct effector functions, life spans, anatomic positioning, and potential for regenerating an entirely new immune response during iterative pathogenic exposures. The developmental process by which activated naive cells undergo diversification involves regulation of chromatin structure and transcription but is not entirely understood. This review examines how alterations in chromatin structure, transcription factor binding, extracellular signals, and single‐cell gene expression explain the differential development of distinct effector (TEFF) and memory (TMEM) CD8 T cell subsets. Special emphasis is placed on how Runx proteins function with additional transcription factors to pioneer changes in chromatin accessibility and drive transcriptional programs that establish the core attributes of cytotoxic T lymphocytes, subdivide circulating and non‐circulating TMEM cell subsets, and govern terminal differentiation. The discussion integrates the roles of specific cytokine signals, transcriptional circuits and how regulation of individual nucleosomes and RNA polymerase II activity can contribute to the process of differentiation. A model that integrates many of these features is discussed to conceptualize how activated CD8 T cells arrive at their fates.
Exploring the relationships among professional quality of life, personal quality of life and resignation in the nursing profession
Authors: Chen Yen‐Chin , Li Tsai‐Chung , Chang Ya‐Wen , Liao Hui‐Chuan , Huang Hsiang‐Ming , Huang Li‐Chi 
Published: March 2021

AbstractAimTo explore the relationships between nurses' quality of life, personal quality of life, intention to stay (ITS) and resign and factors related to resignation.DesignProspective cohort design.MethodsThe participants were recruited from three different levels of hospital in central Taiwan. The survey instruments were structured questionnaires including demographics, Professional Quality of Life Scale, Short Form Health Survey (SF‐36) and the Scale of ITS. The survey data were collected from December 2017–August 2018. Data on nurses’ resignation were collected from the hospital systems 3 months after the survey. Descriptive analysis and multiple logistic regression were used to analyse the factors predicting participants’ resignation.ResultsFive hundred and fifty‐three participants were recruited. Forty‐nine out of 553 participants resigned (8.9%). Higher scores in compassion satisfaction were related to a greater ITS (p < .05). Employment units, burnout and ITS were the predictors for resignation (p < .05). We also found that compassion satisfaction moderated the relationship between ITS and resignation.ConclusionCompassion satisfaction of nursing professionals strengthened the effect of ITS on resignation. Programmes to reinforce satisfaction and stress management could be strategies for increasing nurses’ professional quality of life and retention in clinical practice.ImpactThe study was the first to explore the relationships between professionals’ quality of life, personal quality of life, ITS and resign. The study showed that compassion satisfaction increased the effect between ITS and resignation. Sense of achievement and satisfaction were the most important factors influencing nurses to stay in clinical practice. It is important to enhance nurse compassion satisfaction in nursing career, their job identity and gratification. The effective supportive environment and self‐reflection may enhance compassion satisfaction, ameliorate nurse retention and improve the quality of care.