bluuebunny/crossref_metadata_2025 huggingface dataset:
Ketone therapy for heart failure: current evidence for clinical use
Authors: Takahara Shingo , Soni Shubham , Maayah Zaid H , Ferdaoussi Mourad , Dyck Jason R B
Published: March 2021

During conditions that result in depleted circulating glucose levels, ketone bodies synthesized in the liver are necessary fuel substrates for the brain. In other organs, such as the heart, the reliance on ketones for generating energy in the absence of glucose is less important as the heart can utilize alternative fuel sources, such as fatty acids. However, during pathophysiological conditions, such as heart failure, cardiac defects in metabolic processes that normally allow for sufficient energy production from fatty acids and carbohydrates contribute to a decline in contractile function. As such, it has been proposed that the failing heart relies more on ketone bodies as an energy source than previously appreciated. Furthermore, it has been shown that ketone bodies function as signaling molecules that can suppress systemic and cardiac inflammation. Thus, it is possible that intentionally elevating circulating ketones may be beneficial as an adjunct treatment for heart failure. Although many approaches can be used for ‘ketone therapy’, each of these has their own advantages and disadvantages in the treatment of heart failure. Thus, we summarize current preclinical and clinical studies involving various types of ketone therapy in cardiac disease and discuss the advantages and disadvantages of each modality as possible treatments for heart failure.
Inhibiting cardiac myeloperoxidase alleviates the relaxation defect in hypertrophic cardiomyocytes
Authors: Ramachandra Chrishan J A , Kp Myu Mai Ja , Chua Jasper , Hernandez-Resendiz Sauri , Liehn Elisa A , Knöll Ralph , Gan Li-Ming , Michaëlsson Erik , Jonsson Malin K B , Ryden-Markinhuhta Katarina , Bhat Ratan V , Fritsche-Danielson Regina , Lin Ying-Hsi , Sadayappan Sakthivel , Tang Hak Chiaw , Wong Philip , Shim Winston , Hausenloy Derek J
Published: March 2021

Aims

Hypertrophic cardiomyopathy (HCM) is characterized by cardiomyocyte hypertrophy and disarray, and myocardial stiffness due to interstitial fibrosis, which result in impaired left ventricular filling and diastolic dysfunction. The latter manifests as exercise intolerance, angina, and dyspnoea. There is currently no specific treatment for improving diastolic function in HCM. Here, we investigated whether myeloperoxidase (MPO) is expressed in cardiomyocytes and provides a novel therapeutic target for alleviating diastolic dysfunction in HCM.

Methods and results

Human cardiomyocytes derived from control-induced pluripotent stem cells (iPSC-CMs) were shown to express MPO, with MPO levels being increased in iPSC-CMs generated from two HCM patients harbouring sarcomeric mutations in the MYBPC3 and MYH7 genes. The presence of cardiomyocyte MPO was associated with higher chlorination and peroxidation activity, increased levels of 3-chlorotyrosine-modified cardiac myosin binding protein-C (MYBPC3), attenuated phosphorylation of MYBPC3 at Ser-282, perturbed calcium signalling, and impaired cardiomyocyte relaxation. Interestingly, treatment with the MPO inhibitor, AZD5904, reduced 3-chlorotyrosine-modified MYBPC3 levels, restored MYBPC3 phosphorylation, and alleviated the calcium signalling and relaxation defects. Finally, we found that MPO protein was expressed in healthy adult murine and human cardiomyocytes, and MPO levels were increased in diseased hearts with left ventricular hypertrophy.

Conclusion

This study demonstrates that MPO inhibition alleviates the relaxation defect in hypertrophic iPSC-CMs through MYBPC3 phosphorylation. These findings highlight cardiomyocyte MPO as a novel therapeutic target for improving myocardial relaxation associated with HCM, a treatment strategy which can be readily investigated in the clinical setting, given that MPO inhibitors are already available for clinical testing.
Rosuvastatin for the prevention of venous thromboembolism: a pooled analysis of the HOPE-3 and JUPITER randomized controlled trials
Authors: Joseph Philip , Glynn Robert , Lonn Eva , Ramasundarahettige Chinthanie , Eikelboom John , MacFadyen Jean , Ridker Paul , Yusuf Salim
Published: March 2021

Aims

To examine the association between rosuvastatin and VTE risk, and whether effects vary in different subpopulations stratified by key demographic, cardiovascular disease (CVD) risk factors, and other risk factors associated with VTE.

Methods and results

An individual participant data meta-analysis was conducted across two randomized controlled trials in 30 507 participants over a mean follow-up of 3.62 years, individuals had no prior history of vascular disease but were at intermediate CV risk. In both trials, participants were randomized to receive rosuvastatin or matching placebo. The primary outcome was VTE during follow-up, defined as either deep vein thrombosis or pulmonary embolism. Associations between rosuvastatin and VTE were examined in the overall pooled cohort, and subpopulations stratified by demographic risk factors (i.e. age and sex), CVD risk factors (i.e. obesity, smoking, lipid levels, blood pressure levels, and C-reactive protein level), and a history of cancer. Mean age was 65.96 (SD 7.19) years of age, and 17 832 (58.45%) were male and 5434 (17.82%) were smokers, median BMI was 27.6 [interquartile range (IQR) 24.7–31.1] kg/m2, and median CRP level was 3.4 (IQR 2.1–6.0) mg/L. There were 139 VTE events. In the pooled cohort, rosuvastatin was associated with a large proportional reduction in the risk of VTE (hazard ratio 0.53, 95% CI 0.37–0.75). No significant interactions were observed between treatment with rosuvastatin and the risk of VTE across subpopulations stratified by demographic, CVD risk factors, or a history of cancer (P-values for interactions >0.05 for all subgroups).

Conclusion

Rosuvastatin is associated with a 47% proportional reduction in the risk of VTE, and its effect is consistent both in the presence or absence of VTE-related clinical risk factors.
Metabolic alterations in a rat model of takotsubo syndrome
Authors: Godsman Nadine , Kohlhaas Michael , Nickel Alexander , Cheyne Lesley , Mingarelli Marco , Schweiger Lutz , Hepburn Claire , Munts Chantal , Welch Andy , Delibegovic Mirela , Van Bilsen Marc , Maack Christoph , Dawson Dana K
Published: March 2021

Aims

Cardiac energetic impairment is a major finding in takotsubo patients. We investigate specific metabolic adaptations to direct future therapies.

Methods and results

An isoprenaline-injection female rat model (vs. sham) was studied at Day 3; recovery assessed at Day 7. Substrate uptake, metabolism, inflammation, and remodelling were investigated by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography, metabolomics, quantitative PCR, and western blot (WB). Isolated cardiomyocytes were patch-clamped during stress protocols for redox states of NAD(P)H/FAD or [Ca2+]c, [Ca2+]m, and sarcomere length. Mitochondrial respiration was assessed by seahorse/Clark electrode (glycolytic and β-oxidation substrates). Cardiac 18F-FDG metabolic rate was increased in takotsubo (P = 0.006), as was the expression of GLUT4-RNA/GLUT1/HK2-RNA and HK activity (all P < 0.05), with concomitant accumulation of glucose- and fructose-6-phosphates (P > 0.0001). Both lactate and pyruvate were lower (P < 0.05) despite increases in LDH-RNA and PDH (P < 0.05 both). β-Oxidation enzymes CPT1b-RNA and 3-ketoacyl-CoA thiolase were increased (P < 0.01) but malonyl-CoA (CPT-1 regulator) was upregulated (P = 0.01) with decreased fatty acids and acyl-carnitines levels (P = 0.0001–0.02). Krebs cycle intermediates α-ketoglutarate and succinyl-carnitine were reduced (P < 0.05) as was cellular ATP reporter dihydroorotate (P = 0.003). Mitochondrial Ca2+ uptake during high workload was impaired on Day 3 (P < 0.0001), inducing the oxidation of NAD(P)H and FAD (P = 0.03) but resolved by Day 7. There were no differences in mitochondrial respiratory function, sarcomere shortening, or [Ca2+] transients of isolated cardiomyocytes, implying preserved integrity of both mitochondria and cardiomyocyte. Inflammation and remodelling were upregulated—increased CD68-RNA, collagen RNA/protein, and skeletal actin RNA (all P < 0.05).

Conclusion

Dysregulation of glucose and lipid metabolic pathways with decreases in final glycolytic and β-oxidation metabolites and reduced availability of Krebs intermediates characterizes takotsubo myocardium. The energetic deficit accompanies defective Ca2+ handling, inflammation, and upregulation of remodelling pathways, with the preservation of sarcomeric and mitochondrial integrity.
Behavioral Responses of Asian Citrus Psyllid (Hemiptera: Liviidae) to Salinity-Stressed Citrus
Authors: dos Santos Maria Ângela Cruz Macêdo , Coelho Filho Mauricio Antônio , Modesto Francisco José Nunes , Patt Joseph M , Fancelli Marilene
Published: March 2021

Most commercial citrus varieties are intolerant of salinity stress, but some rootstocks, such as Rangpur lime, tolerate moderately saline irrigation water. Development of salinity-tolerant citrus may allow for citriculture in semiarid and arid regions where salinity stress is problematic. Because salinity stress influences shoot growth in citrus, we compared the behavioral responses of Asian citrus psyllid, Diaphorina citri Kuwayama, to salinity-stressed versus nonstressed Rangpur lime seedlings. The effects of salinity stress on key physiological processes in the seedlings were also examined. Seedlings in the control group were fertilized with a solution having a salinity of 1.7 dS m−1 while seedlings in the salinity-stressed group were fertilized with a solution having a salinity of 10 dS m−1. The seedlings were exposed to salinity stress for increasing durations (15, 20, or 60 d). Seedlings presented differential physiological responses 15 d after the imposition of salinity stress, and differences in psyllid settling rate on control versus salinity-stressed seedlings were discernable within 1 h following the imposition of salinity stress. The levels of settling, oviposition, and egg survivorship were significantly lower on salinity-stressed versus control seedlings. Olfactometer tests showed that female psyllids preferred the odor from control seedlings, suggesting that the odors of control and salinity-stressed seedlings were different. The results showed that D. citri avoids salinity-stressed seedlings; this suggests the possibility of using moderate salinity stress as a management strategy to minimize psyllid settlement and reproduction and to reduce the spread of huanglongbing, especially in citrus grown in semiarid and arid areas.
Critical language pedagogy: an introduction to principles and values
Authors: Crookes Graham V
Published: March 2021

Critical language pedagogy, teaching languages for social justice, is considered in terms of its history and principles. Several sets of principles, from different periods of the development of this literature, are juxtaposed. A connection is drawn from the possible values held by language teachers to the values espoused by critical language pedagogy. These are specified as democratic values, associated with equality, freedom, and solidarity. Values are identified as a means by which language teachers considering this perspective could approach it.
Cross-national time trends in adolescent alcohol use from 2002 to 2014
Authors: Leal-López Eva , Sánchez-Queija Inmaculada , Vieno Alessio , Currie Dorothy , Torsheim , Torbjorn , Pavlova Daria , Moreno-Maldonado Concepción , De Clercq , Bart , Kalman Michal , Inchley Joanna
Published: March 2021

Background

Adolescent alcohol consumption is a major public health concern that should be continuously monitored. This study aims (i) to analyze country-level trends in weekly alcohol consumption, drunkenness and early initiation in alcohol consumption and drunkenness among 15-year-old adolescents from 39 countries and regions across Europe and North America between 2002 and 2014 and (ii) to examine the geographical patterns in adolescent alcohol-related behaviours.

Methods

The sample was composed of 250 161 adolescents aged 15 from 39 countries and regions from Europe and North America. Survey years were 2002, 2006, 2010 and 2014. The alcohol consumption and drunkenness items of the HBSC questionnaire were employed. Prevalence ratios and 95% confidence intervals were estimated using Poisson regression models with robust variance.

Results

Data show a general decrease in all four alcohol variables between 2002 and 2014 except for some countries. However, there is variability both within a country (depending on the alcohol-related behaviour under study) and across countries (in the beginning and shape of trends). Some countries have not reduced or even increased their levels in some variables. Although some particularities have persisted over time, there are no robust patterns by regions.

Conclusions

Despite an overall decrease in adolescent alcohol consumption, special attention should be paid to those countries where declines are not present, or despite decreasing, rates are still high. Further research is needed to clarify factors associated with adolescent drinking, to better understand country specificities and to implement effective policies.
Evolution of inequalities in the coronavirus pandemics in Portugal: an ecological study
Authors: Alves Joana , Soares Patrícia , Rocha João Victor , Santana Rui , Nunes Carla
Published: March 2021

Background

Previous literature shows systematic differences in health according to socioeconomic status (SES). However, there is no clear evidence that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection might be different across SES in Portugal. This work identifies the coronavirus disease 2019 (COVID-19) worst-affected municipalities at four different time points in Portugal measured by prevalence of cases, and seeks to determine if these worst-affected areas are associated with SES.

Methods

The worst-affected areas were defined using the spatial scan statistic for the cumulative number of cases per municipality. The likelihood of being in a worst-affected area was then modelled using logistic regressions, as a function of area-based SES and health services supply. The analyses were repeated at four different time points of the COVID-19 pandemic: 1 April, 1 May, 1 June, and 1 July, corresponding to two moments before and during the confinement period and two moments thereafter.

Results

Twenty municipalities were identified as worst-affected areas in all four time points, most in the coastal area in the Northern part of the country. The areas of lower unemployment were less likely to be a worst-affected area on the 1 April [adjusted odds ratio (AOR) = 0.36 (0.14–0.91)], 1 May [AOR = 0.03 (0.00–0.41)] and 1 July [AOR = 0.40 (0.16–1.05)].

Conclusion

This study shows a relationship between being in a worst-affected area and unemployment. Governments and public health authorities should formulate measures and be prepared to protect the most vulnerable groups.
Gill microbiome structure and function in the chemosymbiotic coastal lucinidStewartia floridana
Authors: Lim Shen Jean , Davis Brenton , Gill Danielle , Swetenburg John , Anderson Laurie C , Engel Annette Summers , Campbell Barbara J
Published: March 2021

Lucinid bivalves harbor environmentally acquired, chemosynthetic, gammaproteobacterial gill endosymbionts. Lucinid gill microbiomes, which may contain other gammaproteobacterial and/or spirochete taxa, remain under-sampled. To understand inter-host variability of the lucinid gill microbiome, specifically in the bacterial communities, we analyzed the microbiome content of Stewartia floridana collected from Florida. Sampled gills contained a monospecific gammaproteobacterial endosymbiont expressing lithoautotrophic, mixotrophic, diazotrophic and C1 compound oxidation-related functions previously characterized in similar lucinid species. Another low-abundance Spirochaeta-like species in ∼72% of the sampled gills was most closely related to Spirochaeta-like species in another lucinid Phacoides pectinatus and formed a clade with known marine Spirochaeta symbionts. The spirochete expressed genes were involved in heterotrophy and the transport of sugars, amino acids, peptides and other substrates. Few muscular and neurofilament genes from the host and none from the gammaproteobacterial and spirochete symbionts were differentially expressed among quadrats predominantly covered with seagrass species or 80% bare sand. Our results suggest that spirochetes are facultatively associated with S. floridana, with potential scavenging and nutrient cycling roles. Expressed stress- and defense-related functions in the host and symbionts also suggest species–species communications, which highlight the need for further study of the interactions among lucinid hosts, their microbiomes and their environment.
Gut bacteria formation and influencing factors
Authors: Yang Jing , Wu Jin'en , Li Yating , Zhang Yong'e , Cho William C , Ju Xianghong , van Schothorst Evert M , Zheng Yadong
Published: March 2021

The gut microbiota plays an important role in human health. In modern life, with the improvement of living conditions, the intake of high-sugar and high-fat diets as well as the large-scale use of antibacterial drugs have an extensive impact on the gut microbiota, even leading to gut microbiota-orchestrating disorders. This review discusses the effects of various factors, including geographic location, age, diet, antibacterial drugs, psychological situation and exercise on gut bacteria, which helps us profoundly to understand the significance of gut bacteria to human health and to find effective solutions to prevent or treat related diseases.
The Association Between Physical Activity Intensity, Cognition, and Brain Structure in People With Type 2 Diabetes
Authors: Zabetian-Targhi Fateme , Srikanth Velandai K , Beare Richard , Breslin Monique , Moran Chris , Wang Wei , Wu Feitong , Smith Kylie J , Callisaya Michele L
Published: March 2021

Background

Physical inactivity is a risk factor for type 2 diabetes (T2D) and dementia. However, it is unknown if physical activity (PA) intensity is associated with brain health in people with T2D. Therefore, this study aimed to determine (i) associations between PA intensity and step count with both cognition and brain structure and (ii) if apolipoprotein E-ε4 or insulin therapy modifies any associations.

Methods

Participants were people with T2D (n = 220; aged 55–86 years). An accelerometer worn over the right hip was used to obtain step count and moderate-to-vigorous PA (MVPA) averaged over 7 days. Cognition in 7 domains was obtained using a battery of neuropsychological tests. Brain structure was measured by Magnetic Resonance Imaging. Linear regression models were used to examine associations between step count, MVPA and each cognitive and Magnetic Resonance Imaging measure. Apolipoprotein E-ε4 × PA and insulin therapy × PA product terms were added to the models to examine effect modification.

Results

The mean age of participants was 67.9 (SD = 6.3). Higher step count was associated with greater hippocampal volume (β = 0.028, 95% CI = 0.005, 0.051). Insulin therapy modified the association between MVPA and attention–processing speed, such that associations were significant in people receiving insulin therapy (p for interaction = .019). There were no other significant associations.

Conclusions

Higher step count and greater time spent in MVPA may be associated with better hippocampal volume and attention–processing speed, respectively, in people with T2D. People with greater diabetes severity (receiving insulin therapy) may get more cognitive benefit from MVPA.
Interventions to Improve the Transition From Home to a Nursing Home: A Scoping Review
Authors: Groenvynck Lindsay , Fakha Amal , de Boer Bram , Hamers Jan P H , van Achterberg Theo , van Rossum Erik , Verbeek Hilde
Published: March 2021

Background and Objectives

The transition from home to a nursing home is a stressful event for both older persons and informal caregivers. Currently, this transition process is often fragmented, which can create a vicious cycle of health care-related events. Knowledge of existing care interventions can prevent or break this cycle. This project aims to summarize existing interventions for improving transitional care, identifying their effectiveness and key components.

Research Design and Methods

A scoping review was performed within the European TRANS-SENIOR consortium. The databases PubMed, EMBASE (Excerpta Medica Database), PsycINFO, Medline, and CINAHL (Cumulated Index to Nursing and Allied Health Literature) were searched. Studies were included if they described interventions designed to improve the transition from home to a nursing home.

Results

17 studies were identified, describing 13 interventions. The majority of these interventions focused on nursing home adjustment with 1 study including the entire transition pathway. The study identified 8 multicomponent and 5 single-component interventions. From the multicomponent interventions, 7 main components were identified: education, relationships/communication, improving emotional well-being, personalized care, continuity of care, support provision, and ad hoc counseling. The study outcomes were heterogeneous, making them difficult to compare. The study outcomes varied, with studies often reporting nonsignificant changes for the main outcome measures.

Discussion and Implications

There is a mismatch between the theory on optimal transitional care and current transitional care interventions, as they often lack a comprehensive approach. This research is the first step toward a uniform definition of optimal transitional care and a tool to improve/develop (future) transitional care initiatives on the pathway from home to a nursing home.
Present-day orogenic processes in the western Kalpin nappe explored by interseismic GNSS measurements and coseismic InSAR observations of the 2020Mw 6.1 Kalpin event
Authors: He Ping , Wen Yangmao , Li Shuiping , Ding Kaihua , Li Zhicai , Xu Caijun
Published: March 2021

As the largest and most active intracontinental orogenic belt on Earth, the Tien Shan (TS) is a natural laboratory for understanding the Cenozoic orogenic processes driven by the India–Asia collision. On 19 January 2020, a Mw 6.1 event stuck the Kalpin region, where the southern frontal TS interacts with the Tarim basin. To probe the local ongoing orogenic processes and potential seismic hazard in the Kalpin region, both interseismic and instantaneous deformation derived from geodetic observations are used in this study. With the constraint of interseismic global navigation satellite system (GNSS) velocities, we estimate the décollement plane parameters of the western Kalpin nappe based on a 2-D dislocation model, and the results suggest that the décollement plane is nearly subhorizontal with a dip of ∼3° at a depth of 24 km. Then, we collect both Sentinel-1 and ALOS-2 satellite images to capture the coseismic displacements caused by the 2020 Kalpin event, and the interferometric synthetic aperture radar (InSAR) images show a maximum displacement of 7 cm in the line of sight near the epicentral region. With these coseismic displacement measurements, we invert the source parameters of this event using a finite-fault model. We determine the optimal source mechanism in which the fault geometry is dominated by thrust faulting with an E–W strike of 275° and a northward dip of 11.2°, and the main rupture slip is concentrated within an area 28.0 km in length and 10.3 km in width, with a maximum slip of 0.3 m at a depth of 6–8 km. The total released moment of our preferred distributed slip model yields a geodetic moment of 1.59 × 1018 N$ \cdot $m, equivalent to Mw 6.1. The contrast of the décollement plane depth from interseismic GNSS and the rupture depth from coseismic InSAR suggests that a compression still exists in the Kalpin nappe forefront, which is prone to frequent moderate events and may be at risk of a much more dangerous earthquake.
“More than just another physical activity program”: exploring the GUM program for at-risk adolescent girls
Authors: Hargreaves Nicole , Forneris Tanya , Sabiston Catherine , Berg Stephen , Kowalski Kent , Ferguson Leah , Caperchione Cristina
Published: March 2021

Physical activity (PA) levels among adolescent girls continue to steadily decline, especially for those classified as ‘at-risk’. To mitigate these trends, Girls United and on the Move (GUM) was created as a dual-component PA and psychosocial program. The primary purpose of this study was to explore participant experiences within GUM, with a secondary purpose of qualitatively informing future PA programs for ‘at-risk’ adolescent girls. Semi-structured interviews (N = 30) were conducted with a purposeful sample of girls from the GUM program. An inductive thematic analysis was utilized to analyze verbatim transcripts. Two themes were generated from the data: 1) Girls uplifting girls, outlining the importance of a girls-only environment and introducing opportunities for alternative PAs, and 2) finding balance between the physical and psychological, detailing the importance of the dual-component program. These findings provide support for the acceptability of an integrated psychosocial and PA program for at-risk adolescent girls.
Frozen elephant trunk technique with different proximal landing zone for aortic dissection
Authors: Panfilov Dmitri S , Kozlov Boris N , Pryakhin Andrey S , Kopeva Kristina V
Published: March 2021

OBJECTIVES

The objective of the study was to evaluate early and midterm outcomes after the frozen elephant trunk (FET) procedure with different proximal landing zones in patients with aortic dissection.

METHODS

Forty-four patients with type A and type B aortic dissection that extended down to the abdominal aorta were enrolled in the study. All of the patients had the FET procedure. The patients were divided in 2 groups according to the level of the proximal landing zone: the zone 2 (Z2) group and zone 3 (Z3) group. Early and midterm outcomes including the false lumen (FL) thrombosis rate were monitored in both groups.

RESULTS

The incidence of stroke, delirium and spinal cord ischaemia was 5.9% vs 3.7% (P = 0.533), 5.9% vs 7.4% (P = 0.903) and 5.9% vs 0 (P = 0.533) in the Z2 and Z3 groups, respectively. The 30-day mortality was 9.1% in both groups. The mean distal landing zone was T7.5 (T7; T9) in the Z2 group vs T9 (T8; T10) in the Z3 group (P = 0.668). The 2-year overall survival was 62.2% with no significant difference in the Z2 and Z3 groups (61.6% vs 64.2%; P = 0.940). There were no aortic-related deaths during the follow-up period. Freedom from reintervention at 24 months was 73% and was comparable between Z2 and Z3 (74.1% vs 91.7%; P = 0.123). The rate of early complete FL thrombosis was comparable in the Z2 and Z3 groups. By 24 months of observation in the Z3 group, the rate of complete FL thrombosis was significantly higher (60% vs 77%; P = 0.046).

CONCLUSIONS

No statistically significant differences were observed between landing zones 2 and 3 during the FET procedure with regard to early outcomes. Proximalization of the FET was associated with a shorter FL thrombosis in the midterm follow-up period that affected the distal aortic reintervention rate.
Quantitative Uniqueness Properties forL2 Functions with Fast Decaying, or Sparsely Supported, Fourier Transform
Authors: Jaye Benjamin , Mitkovski Mishko
Published: March 2021

This paper builds upon two key principles behind the Bourgain–Dyatlov quantitative uniqueness theorem for functions with Fourier transform supported in an Ahlfors regular set. We first provide a characterization of when a quantitative uniqueness theorem holds for functions with very quickly decaying Fourier transform, thereby providing an extension of the classical Paneah–Logvinenko–Sereda theorem. Secondly, we derive a transference result which converts a quantitative uniqueness theorem for functions with fast decaying Fourier transform to one for functions with Fourier transform supported on a fractal set. In addition to recovering the result of Bourgain–Dyatlov, we obtain analogous uniqueness results for denser fractals.
Human Immunodeficiency Virus/AIDS in the Era of Coronavirus Disease 2019: A Juxtaposition of 2 Pandemics
Authors: Eisinger Robert W , Lerner Andrea M , Fauci Anthony S
Published: March 2021

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted persons with human immunodeficiency virus (HIV), interfering with critical health services for HIV prevention, treatment, and care. While there are multiple profiles of persons living with HIV and the impact of COVID-19 may differ for each, the severity of COVID-19 in persons with HIV is related strongly to the presence of comorbidities that increase the risk of severe disease in COVID-19 patients in the absence of HIV. An effective response to the juxtaposition of the HIV and COVID-19 pandemics requires a novel coordinated and collaborative global effort of scientists, industry, and community partners to accelerate basic and clinical research, as well as implementation science to operationalize evidence-based interventions expeditiously in real-world settings. Accelerated development and clinical evaluation of prevention and treatment countermeasures are urgently needed to mitigate the juxtaposition of the HIV and COVID-19 pandemics.
Enabling adoption and use of new health information technology during implementation: Roles and strategies for internal and external support personnel
Authors: Umstead Claire N , Unertl Kim M , Lorenzi Nancy M , Novak Laurie Lovett
Published: March 2021

Objective

Successful technological implementations frequently involve individuals who serve as mediators between end users, management, and technology developers. The goal for this project was to evaluate the structure and activities of such mediators in a large-scale electronic health record implementation.

Materials and Methods

Field notes from observations taken during implementation beginning in November 2017 were analyzed qualitatively using a thematic analysis framework to examine the relationship between specific types of mediators and the type and level of support to end users.

Results

We found that support personnel possessing both contextual knowledge of the institution’s workflow and training in the new technology were the most successful in mediation of adoption and use. Those that lacked context of either technology or institutional workflow often displayed barriers in communication, trust, and active problem solving.

Conclusions

These findings suggest that institutional investment in technology training and explicit programs to foster skills in mediation, including roles for professionals with career development opportunities, prior to implementation can be beneficial in easing the pain of system transition.
Effects of cooled floor pads combined with chilled drinking water on behavior and performance of lactating sows under heat stress
Authors: Zhu Y , Johnston L J , Reese M H , Buchanan E S , Tallaksen J E , Hilbrands A H , Li Y Z
Published: March 2021

This study was conducted to evaluate whether cooled floor pads combined with chilled drinking water could alleviate negative impacts of heat stress on lactating sows. Thirty sows (Landrace × Yorkshire, Parity = 1 to 6) were housed in individual farrowing stalls in two rooms with temperatures being controlled at 29.4°C (0700–1900 hours) and 23.9°C (1900–0700 hours). Sows in one room (Cool), but not in the other room (Control) were provided cooled floor pads (21–22°C) and chilled drinking water (13–15°C). Behavior of sows (15 sows/treatment) was video recorded during farrowing, and days 1, 3, 7, 14, and 21 after farrowing. Videos were viewed continuously to register the birth time of each piglet, from which total farrowing duration and birth intervals were calculated. The number of drinking bouts and the duration of each drinking bout were registered for each sow through viewing videos continuously for 2 h (1530–1730 hours) each video-recording day. Postures (lying laterally, lying ventrally, sitting, and standing) were recorded by scanning video recordings at 5-min intervals for 24 h each video-recording day, and time budget for each posture was calculated. Rectal temperature and respiration rate were measured for all sows the day before and after farrowing, and then once weekly. Sow and litter performance was recorded. Data were analyzed using the Glimmix procedure of SAS. The cooling treatment did not affect sow behavior or litter performance. Sows in the Cool room had lower rectal temperature (P = 0.03) and lower respiration rate (P < 0.001), consumed more feed (P = 0.03), tended to have reduced weight loss (P = 0.07), and backfat loss (P = 0.07) during lactation than sows in the Control room. As lactation progressed, sows increased drinking frequency (P < 0.001) and time spent lying ventrally (P < 0.0001), standing (P < 0.001), and sitting (P < 0.0001), and decreased time spent lying laterally (P < 0.0001) in both Cool and Control rooms. While cooled floor pads combined with chilled drinking water did not affect sow behavior, they did alleviate heat stress partially, as indicated by decreased rectal temperature, respiration rate, weight, and backfat loss, and increased feed intake in lactating sows.
Identification of genomic regions that exhibit sexual dimorphism for size and muscularity in cattle
Authors: Doyle Jennifer L , Purfield Deirdre C , Moore Tom , Carthy Tara R , Walsh Siobhan W , Veerkamp Roel F , Evans Ross D , Berry Donagh P
Published: March 2021

Sexual dimorphism, the phenomenon whereby males and females of the same species are distinctive in some aspect of appearance or size, has previously been documented in cattle for traits such as growth rate and carcass merit using a quantitative genetics approach. No previous study in cattle has attempted to document sexual dimorphism at a genome level; therefore, the objective of the present study was to determine whether genomic regions associated with size and muscularity in cattle exhibited signs of sexual dimorphism. Analyses were undertaken on 10 linear-type traits that describe the muscular and skeletal characteristics of both males and females of five beef cattle breeds: 1,444 Angus (AA), 6,433 Charolais (CH), 1,129 Hereford, 8,745 Limousin (LM), and 1,698 Simmental. Genome-wide association analyses were undertaken using imputed whole-genome sequence data for each sex separately by breed. For each single-nucleotide polymorphism (SNP) that was segregating in both sexes, the difference between the allele substitution effect sizes for each sex, in each breed separately, was calculated. Suggestively (P ≤ 1 × 10−5) sexually dimorphic SNPs that were segregating in both males and females were detected for all traits in all breeds, although the location of these SNPs differed by both trait and breed. Significantly (P ≤ 1 × 10−8) dimorphic SNPs were detected in just three traits in the AA, seven traits in the CH, and three traits in the LM. The vast majority of all segregating autosomal SNPs (86% in AA to 94% in LM) had the same minor allele in both males and females. Differences (P ≤ 0.05) in allele frequencies between the sexes were observed for between 36% (LM) and 66% (AA) of the total autosomal SNPs that were segregating in both sexes. Dimorphic SNPs were located within a number of genes related to muscularity and/or size including the NAB1, COL5A2, and IWS1 genes on BTA2 that are located close to, and thought to be co-inherited with, the MSTN gene. Overall, sexual dimorphism exists in cattle at the genome level, but it is not consistent by either trait or breed.
Effects of iron injection timing on suckling and subsequent nursery and growing-finishing performance and hematological criteria
Authors: Williams Hayden E , Carrender Brittany , Roubicek Cierra D , Maurer Ryan , DeRouchey Joel M , Woodworth Jason C , Dritz Steve S , Tokach Michael D , Coble Kyle F , Goodband Robert D , Gebhardt Jordan T
Published: March 2021

Two experiments were conducted to evaluate the effects of Fe injection timing after birth on suckling and subsequent nursery and growing-finishing pig performance. The injectable Fe source used in both experiments was GleptoForte (Ceva Animal Health, LLC., Lenexa, KS). GleptoForte contains gleptoferron which is a Fe macromolecule complex. In Exp. 1, a total of 324 newborn pigs (DNA 241 × 600, initially 1.6 ± 0.04 kg body weight [BW]) within 27 litters were used. Two days after birth, all piglets were weighed, and six barrows and six gilts per litter were allotted to 1 of 6 treatments consisting of no Fe injection or 200 mg of injectable Fe provided in a single injection on d 2, 4, 6, 8, or 10 of age. Pigs were weaned (~21 d of age) and allotted to nursery pens with all pigs in each pen having received the same Fe treatment. In Exp. 2, a total of 1,892 newborn pigs (PIC 359 × C40; initially 1.5 ± 0.02 kg BW) within 172 litters were used. One day after birth, piglets were weighed, and 11 pigs within each litter were allotted to 1 of 6 treatments consisting of no Fe injection or 200 mg of injectable Fe provided on d 1, 3, 5, or 7 of age, or 200 mg on d 1 plus 200 mg on d 12 of age. Pigs were weaned (19 d of age) and placed in a commercial wean-to-finish facility in a total of 15 pens with equal representation of treatments in each pen. In both experiments, not providing an Fe injection after birth decreased (P < 0.05) preweaning average daily gain (ADG), weaning weight, and hemoglobin and hematocrit values compared with all other treatments. In Exp. 1, increasing the age that piglets received an Fe injection until 4 or 6 d after birth provided marginal evidence for an improvement (quadratic; P = 0.070) in preweaning ADG. For the nursery period, increasing the age that piglets received an Fe injection improved (quadratic; P = 0.013) d 80 BW, but there was no evidence of a difference (P > 0.10) in d 173 BW at the end of the grow-finish period. In Exp. 2, increasing the age that piglets received a 200 mg Fe injection showed no evidence of difference (P > 0.10) for subsequent nursery and growing-finishing ADG. In both experiments, hemoglobin and hematocrit values were decreased (linear; P < 0.05) at weaning with increasing age when pigs received an Fe injection. These experiments suggest that providing a 200 mg Fe injection within 7 d after farrowing is sufficient for optimizing preweaning and subsequent growth performance.
A86 INFLAMMATORY BOWEL DISEASE PATIENTS’ SATISFACTION WITH TELEHEALTH: DURING THE COVID-19 PANDEMIC
Authors: Painchaud M , Singh S , Penner R M
Published: March 2021

Background

Due to the COVID-19 pandemic, clinics were forced to implement telehealth into clinical practice. Inflammatory bowel disease (IBD) patients are a unique population that require long-term care to achieve and maintain deep remission of disease. Thus, they require stable and continuous contact with healthcare providers, often with multiple appointments. We examined an IBD predominant practice, also providing care for general gastrointestinal (GI) conditions in Kelowna, British Columbia. As telehealth has the potential to become a standard of care for clinics, patient satisfaction must be considered. We hypothesize that with the efficacy and ease of remote appointments, there will be an increase in patient satisfaction, quality of care, and quality of communication.

Aims

We aim to compare the level of patient satisfaction between in-person appointments pre-pandemic, and current remote appointment telehealth practices.

Methods

An online survey was sent to the 608 patients who had participated in one or more remote appointment between March 15-June 15, 2020. The survey compared the level of patient satisfaction, quality of care, and quality of communication between patient and doctor before and during the pandemic. It was also determined if patients would elect to continue with remote appointments in the future due to ease of use, and time/financial resources saved.

Results

Of the 273 participants, 80% were IBD patients while 20% were treated for other GI conditions. A total of 78% reported that they would elect to continue with remote appointments as their primary point of care with their doctor. The remaining 22% reported that they prefer in-person visits due to the necessity of a physical exam, yet specified that communication by these remote means was still of good quality. Levels of patient satisfaction before and during the pandemic remained consistent, where 59% of patients assigned a satisfaction rating of 10 (highest) to their pre-pandemic in-person appointments, and 54% of patients assigned a rating of 10 to their remote appointments during the pandemic. Similar consistent results were found for quality of care and quality of communication. A total of 70% of patients reported that if this service had not been available, they would have sought out other forms of care; 18% of the total responses considering emergency care.

Conclusions

IBD patients at Kelowna Gastroenterology perceived similar levels of satisfaction, quality of care, and quality of communication with both in-person and telehealth appointments. This suggests that telehealth practices may be a cost-effective, sustainable appointment style that provides comparable quality to in-person appointments.

Funding Agencies

None
A118 POLYP SIZE CUT-OFF LEVEL TO IMPLEMENT OPTICAL POLYP DIAGNOSIS
Authors: Taghiakbari M , Djinbachian R , von Renteln D
Published: March 2021

Background

Optical polyp diagnosis can be used for real-time pathology prediction of colorectal polyps ≤10 mm. However, the risk of misdiagnosing a polyp with advanced pathology potentially increases with increasing polyp size.

Aims

This study aimed to evaluate different size cut-offs for using optical polyp diagnosis and the associated risk of patients undergoing inadequate follow-up or surveillance.

Methods

In a post-hoc analysis of two prospective studies, the performance of optical diagnosis was evaluated in three polyp size groups: 1–3 mm, 1–5 mm, and 1–10 mm. The primary outcome was the proportion of patients with advanced adenomas and delayed or inappropriate surveillance. Secondary outcomes included percentage of polyps with advanced pathology, agreement between surveillance intervals based on high-confidence optical diagnosis and pathology outcomes, reduction in histopathological examinations, and proportion of patients who could receive an immediate surveillance interval recommendation.

Results

We included 1525 patients with complete colonoscopies (mean age 62.9 years, 50.2% male). The percentage of patients with advanced adenomas and delayed or inappropriate surveillance was 0.7%, 1.7%, and 1.8% when using optical diagnosis for patients with polyps of 1–3, 1–5, and 1–10 mm, respectively. The percentage of polyps with advanced pathology was 0.5%, 1.4%, and 1.9%, respectively. Surveillance interval agreement between pathology and optical diagnosis was 99%, 98%, and 97.8%, respectively. Total reduction in pathology examinations was 33.9%, 53.5%, and 69.0%, respectively.

Conclusions

A 3-mm cut-off for clinical implementation of optical polyp diagnosis yielded high surveillance interval agreement with pathology and a high reduction in pathology examinations while minimizing the risk of inappropriate management for polyps with advanced pathology.

Funding Agencies

None
A189 ELUCIDATING THE MECHANISTIC ROLE OF GLP-1R IN THE INFLAMMATORY RESPONSE OF MACROPHAGES AND B CELLS TO DIETARY FIBRES
Authors: Hanstock S , Rieger A , Dickner R , Jerasi J , Armstrong H , Wine E
Published: March 2021

Background

Both diet and the microbiome have been implicated in the pathogenesis of inflammatory bowel diseases (IBD). Fibre is not digested; it is fermented by microbes in the large bowel. High fibre intake is related to lower risk for the development of IBD, and a high fibre diet is usually recommended for individuals with IBD. However, work in our lab suggests that select dietary fibres may be pro-inflammatory in a pediatric IBD cohort. Importantly, large bowel dysbiosis in IBD could limit the fermentation of dietary fibres, leading to reduced production of beneficial microbiome metabolites as well as an accumulation of intact fibre in the large bowel. These intact fibres may then interact with immune cells residing in the large bowel, through specific receptors, and perpetuate the inflammatory state seen in IBD.

Aims

Based on preliminary findings, we hypothesize that the dietary fibre oligofructose acts through GLP-1R on macrophages and B-cells to regulate the inflammatory environment. We expect to find changes in the expression of cytokines and chemokines, and their receptors.

Methods

Changes in immune cell secretions (ELISA) and the expression of selected inflammatory markers (RT-qPCR) were measured to determine potential pathways involved in response to dietary fibres in vitro. Knockdown of proteins of interest (siRNA) was performed to validate the involvement of these pathways in the inflammatory response to dietary fibres. Cells were treated with oligofructose, oligofructose pre-fermented by bacteria, or no fibre. The involvement of the fibre receptor, GLP-1R, was investigated to understand its connection to pathways identified.

Results

Qiagen RT2 profiler array (human inflammatory cytokines and receptors) and cytokine secretion (ELISA) indicated that in response to oligofructose macrophages have a predominantly pro-inflammatory response while B cells have an anti-inflammatory response. Presence of GLP-1R in large bowel and terminal ileum biopsies collected during endoscopy was higher in IBD (Crohn disease n=7; Ulcerative colitis n=7) than non-IBD patients (n=7), and expression was confirmed on both B-cells and macrophages. Knockdown of GLP-1R (siRNA) significantly reduced the pro-inflammatory response (IL-1β ELISA) with oligofructose application in THP-1 macrophage cells

Conclusions

Improving our understanding of the mechanistic link between dietary fibres and immune response will aid us in developing a model for the interactions of oligofructose with the GLP-1R in B cells and macrophages. Findings from this study may be able to inform dietary interventions, prebiotic/probiotic administration, and drug development for treatment of IBDs.

Funding Agencies

CIHRWeston Foundation