bluuebunny/crossref_metadata_2025 huggingface dataset:
Quality of life in stable and progressive ‘early‐stage’ keratoconus patients
Authors: Steinberg Johannes , Bußmann Nils , Frings Andreas , Katz Toam , Druchkiv Vasyl , Linke Stephan J.
Published: September 2020

Purpose

To analyse the vision‐related quality of life (vr‐QoL) in stable and progressive keratoconus (KC) patients with a still good visual acuity.

Methods

Combined prospective/cross‐sectional study design. The Refractive Status and Vision Profile (RSVP) and the National Eye Institute Visual Functioning – 25 (NEI‐25) questionnaire were used in 16 emmetropic, 32 myopic and 56 KC patients, whereby KC patients with a stable (n = 26) and patients with a progressive stage (n = 30) and some of them before and after corneal cross‐linking (CXL; n = 10) were included. All patients had a DCVA in at least one eye of ≥0.7 (decimal chart).

Results

The analyses revealed a minor decline of the vr‐QoL from emmetropes to myopes to early KC patients with a stable disease. Nonetheless, sociological subscales (i.e. ‘social functioning’, ‘role difficulties’ and ‘dependency’) did not display statistically significant differences comparing these groups. In progressive KC, we could demonstrate a statistically significant decline also of these sociological subscales, which did not improve after CXL.

Conclusion

Due to a still high and almost unaffected vr‐QoL in early KC patients and the distinct decline after progression without rehabilitation after CXL, a reconsideration of current strategies to perform CXL only after a progression is diagnosed should be re‐evaluated.
First large‐scale provenance study of pigments reveals new complex behavioural patterns during the Upper Palaeolithic of south‐western Germany
Authors: Velliky E. C. , MacDonald B. L. , Porr M. , Conard N. J.
Published: September 2020

The use of red iron‐based earth pigments, or ochre, is a key component of early symbolic behaviours for anatomically modern humans and possibly Neanderthals. We present the first ochre provenance study in Central Europe showing long‐term selection strategies by inhabitants of cave sites in south‐western Germany during the Upper Palaeolithic (43–14.5 ka). Ochre artefacts from Hohle Fels, Geißenklösterle and Vogelherd, and local and extra‐local sources, were investigated using neutron activation analysis (NAA), X‐ray diffraction (XRD) and scanning electron microscopy (SEM). The results show that local ochre sources were continuously and systematically accessed forc.29 500 years, with periodic events of long‐distance (about > 300 km) ochre acquisition during the Aurignacian (c.35–43 ka), suggesting higher mobility than previously suspected. The results reveal previously unknown long‐term, complex spatio‐temporal behavioural patterns during the earliest presence ofHomo sapiensin Europe.
Laparoscopic patch repair of a Morgagni hernia in Menkes disease
Authors: Ceccanti Silvia , Mastrangelo Mario , Andreoli Gianmarco , Cozzi Denis A.
Published: September 2020

The association between Morgagni hernia and Menkes disease has not yet been described. Here, we report such a rare association in an 8‐year‐old boy who presented with subocclusive symptoms. He successfully underwent laparoscopic repair with a patch. The patch was fixed to the anterior abdominal wall by using transfascial sutures with extracorporeal knot tying and to the remaining edges of the diaphragmatic defect by using intracorporeal suturing and spiral tacks. At the 2‐year follow‐up, the child remained recurrence‐free and without gastrointestinal symptoms. The potential relationship between the two conditions and the controversial use of spiral tacks to affix the mesh to the diaphragm are also discussed.
Development and validation of the Adverse Inpatient Medication Event model (AIME)
Authors: Falconer Nazanin , Barras Michael , Abdel‐Hafez Ahmad , Radburn Sam , Cottrell Neil
Published: September 2020

Aims

Medication harm has negative clinical and economic consequences, contributing to hospitalisation, morbidity and mortality. The incidence ranges from 4 to 14%, of which up to 50% of events may be preventable. A predictive model for identifying high‐risk inpatients can guide a timely and systematic approach to prioritisation. The aim of this study is to develop and internally validate a risk prediction model for prioritisation of hospitalised patients at risk of medication harm.

Methods

A retrospective cohort study was conducted in general medical and geriatric specialties at an Australian hospital over six months. Medication harm was identified using International Classification of Disease (ICD‐10) codes and the hospital's incident database. Sixty‐eight variables, including medications and laboratory results, were extracted from the hospital's databases. Multivariable logistic regression was used to develop the final risk model. Performance was evaluated using area under the receiver operative characteristic curve (AuROC) and clinical utility was determined using decision curve analysis.

Results

The study cohort included 1982 patients with median age 74 years, of which 136 (7%) experienced at least one adverse medication event(s). The model included: length of stay, hospital re‐admission within 12 months, venous or arterial thrombosis and/or embolism, ≥ 8 medications, serum sodium < 126 mmol/L, INR > 3, anti‐psychotic, antiarrhythmic and immunosuppressant medications, and history of medication allergy. Validation gave an AuROC of 0.70 (95% CI: 0.65–0.74). Decision curve analysis identified that the AIME may be clinically useful to help guide decision making in practice.

Conclusion

We have developed a predictive model with reasonable performance. Future steps include external validation and impact evaluation.
How often are antidepressants prescribed off‐label among older adults in Germany? A claims data analysis
Authors: Schäfer Wiebke , Reinders Tammo , Riedel Oliver , Haug Ulrike
Published: September 2020

Aim

To estimate the extent of off‐label prescribing of antidepressants in older adults and to characterize patients with off‐label vs on‐label prescriptions of antidepressants using a large German health claims database.

Methods

Using data from the German Pharmacoepidemiological Research Database (GePaRD), we conducted a cross‐sectional study in adults aged 65 years or older with a dispensation of an antidepressant between 1 January 2009 and 31 December 2015 after a period of 365 days without such a dispensation. We assessed the overall and annual proportion of off‐label prescriptions of antidepressants by class and individual substance.

Results

Among 263 276 incident users of antidepressants, the proportion of off‐label prescribing was 43.6% (95% CI 43.4‐43.8%) with little variation between 2009 and 2015 (42.2‐44.4%). The proportion of off‐label use was higher in men (49%) than women (41%). While the proportion of off‐label prescriptions was highest for tri‐ and tetracyclic antidepressants with 56.2% (amitriptyline 54.6%, maximum 65.9% for trimipramine), it amounted to 41.8% for selective serotonin reuptake inhibitors (citalopram 41.6%, maximum 46.0% for escitalopram) and was 51.2% for mirtazapine. Indicators of overall morbidity were similar in both groups, eg, pain was coded in 72% of off‐label users vs 77% of on‐label users (insomnia 20% vs 24%).

Conclusion

Our study suggests a high prevalence of off‐label antidepressant use among older adults in Germany, which was not restricted to certain classes of antidepressants or individual antidepressants. Given the unclear risk‐benefit ratio, studies investigating the safety of off‐label use among older adults for individual antidepressants are urgently needed.
Impact of spironolactone exposure on prostate cancer incidence amongst men with heart failure: A Pharmacoepidemiological study
Authors: Hiebert Brett M. , Janzen Bryan W. , Sanjanwala Rohan M. , Ong Aldrich D. , Feldman Ross D. , Kim Julian O.
Published: September 2020

Aims

Aldosterone has been found to influence cancer cell growth, cell cycle regulation and cell migration, including in prostate cancer cells. Spironolactone is an aldosterone antagonist used for managing chronic heart failure (HF) with known antiandrogenic effects. We examined the effect of spironolactone exposure amongst men with HF on the incidence of prostate cancer.

Methods

This retrospective cohort study utilized provincial clinical and administrative databases from the Manitoba Centre for Health Policy. Incident cases of prostate cancer were identified from the provincial cancer registry, and spironolactone exposure was quantified from pharmacare databases. A multivariable proportional hazards model was used to assess the time‐dependent impact of spironolactone exposure on prostate cancer incidence.

Results

A total of 18 562 men with newly diagnosed HF from 2007 to 2015 with a median age of 72 years (interquartile range: 61–81) and a median follow‐up from HF diagnosis to prostate cancer incidence of 2.7 years (interquartile range: 1.1–4.9) were included. A time‐dependent multivariable analysis of spironolactone exposure following HF diagnosis found a reduced the risk of prostate cancer hazard ratio 0.55 (95% confidence interval 0.31–0.98, P = .043).

Conclusion

Spironolactone exposure significantly reduced the incidence of prostate cancer amongst men with HF. These findings support the plausibility of aldosterone as a promoter of prostate cancer growth and development. Prospective clinical trials are warranted to further assess the role of spironolactone or other mineralocorticoid receptor antagonists as a means to prevent prostate cancer development or as an adjunctive measure to prostate cancer treatments.
A sufficiency threshold is not a harm principle: A better alternative to best interests for overriding parental decisions
Authors: Saunders Ben
Published: September 2020

Douglas Diekema influentially argues that interference with parental decisions is not in fact guided by the child’s best interests, but rather by a more permissive standard, which he calls the harm principle. This article first seeks to clarify this alternative position and defend it against certain existing criticisms, before offering a new criticism and alternative. This ‘harm principle’ has been criticized for (i) lack of adequate moral grounding, and (ii) being as indeterminate as the best interest standard that it seeks to replace. I argue that these are not serious problems. I take Diekema’s negative point to be right—our actual standard for intervention is not literally the best interests of the child—but I disagree with his proposed replacement. First, Diekema’s proposed harm threshold should be more carefully distinguished from Mill’s harm principle. Second, there is no reason to assume that the standard for permissible intervention coincides with the threshold for harm (or serious harm). Thus, I propose that the best alternative to the best interests standard is not a harm principle, but rather a sufficiency threshold between adequate (or ‘good enough’) and inadequate (or ‘substandard’) parenting.
Women’s agenda for the improvement of childbirth care: Evaluation of the Babies Born Better survey data set in Spain
Authors: Benet Marta , Escuriet Ramon , Palomar‐Ruiz Laura , Ruiz‐Berdún Dolores , Leon‐Larios Fatima
Published: September 2020

Background

Public patient involvement (PPI) generates knowledge about the health‐illness process through the incorporation of people's experiences and priorities. The Babies Born Better (BBB) survey is a pan‐European online questionnaire that can be used as a PPI tool for preliminary and consultative forms of citizens' involvement. The purpose of this research was to identify which practices support positive birth experiences and which ones women want changed.

Methods

The BBB survey was distributed in virtual communities of practice and through social networks. The version launched in Spain was used to collect data in 2014 and 2015 from women who had given birth in the previous 5 years. A descriptive, quantitative analysis was applied to the sociodemographic data. Two open‐ended questions were analyzed by qualitative content analysis using a deductive and inductive codification process.

Results

A total of 2841 women participated. 41.1% of the responses concerned the category “Care received and experienced,” followed by “Specific interventions and procedures” (26.6%), “Involved members of care team” (14.2%), and “Environmental conditions” (9%). Best practices were related to how care is provided and received, and the main areas for improvement referred to specific interventions and procedures.

Conclusions

This survey proved a useful tool to map the best and poorest practices reported. The results suggest a need for improvement in some areas of childbirth care. Women's reports on negative experiences included a wide range of routine clinical interventions, avoidable procedures, and the influence exerted by professionals on their decision‐making.
Headache, Heartache and Other Illogical Disorders
Authors: Molnar Michael
Published: September 2020

This exercise in biography centres on multiple meanings of ‘nerves’ during the years of Freud’s gradual transition from neuro‐anatomist to specialist in nervous diseases. Thanks to the ongoing publication of the correspondence with Martha Bernays from 1882 to 1886, his early life is now exposed in unprecedented detail. I focus on a mild attack of chickenpox reported in 1885 as an illustration of parallels between his day‐to‐day experience and the disputed relationship of nerves to mind. His illness reveals both anxieties about the state of his own nerves and about his relationship with Martha. At the same time, a questioning of ‘normal’ states of mind underlies his work on cocaine during that period. The blurred distinction between organic and functional disorders, revealed in his experience of chickenpox in 1885, is repeated during an episode of heart problems and migraine in 1894. Both instances, in confusing ‘nervous’ with ‘logical’ disorder, reflect contemporary efforts to reconcile physiology and psychology. Finally some of the paradoxes of illness and mental disorder are recapitulated in a passage from On Narcissism.
Cabozantinib plus docetaxel and prednisone in metastatic castration‐resistant prostate cancer
Authors: Madan Ravi A. , Karzai Fatima H. , Al Harthy Munjid , Petrylak Daniel P. , Kim Joseph W. , Arlen Philip M. , Rosner Inger , Theoret Marc R. , Cordes Lisa , Bilusic Marijo , Peer Cody J. , Dawson Nancy A. , Couvillon Anna , Hankin Amy , Williams Moniquea , Chun Guin , Owens Helen , Marte Jennifer L. , Lee Min‐Jung , Tomita Yusuke , Yuno Akira , Trepel Jane B. , Lee Sunmin , Steinberg Seth M. , Gulley James L. , Figg William D. , Dahut William L.
Published: September 2020

Objective

To evaluate the safety and efficacy of cabozantinib combined with docetaxel.

Patients and Methods

This was a phase 1/2 multicentre study in patients with metastatic castration‐resistant prostate cancer (mCRPC). Docetaxel (75 mg/m2 every 3 weeks with daily prednisone 10 mg) was combined with escalating doses of daily cabozantinib (20, 40 and 60 mg). Based on the results of the phase 1 study, the investigation was expanded into a randomized study of docetaxel with prednisone (hereafter 'docetaxel/prednisone') plus the maximum tolerated dose (MTD) of cabozantinib compared with docetaxel/prednisone alone.

Results

A total of 44 men with mCRPC were enrolled in this phase 1/2 trial. An MTD of 40 mg cabozantinib plus docetaxel/prednisone was determined. Dose‐limiting toxicities were neutropenic fever and palmar‐plantar erythrodysesthesia, and there was one death attributable to a thromboembolic event. In addition, grade 3 or 4 myelosuppression, hypophosphataemia and neuropathy were seen in three or more patients. In the phase 1 study, the median time to progression (TTP) and overall survival (OS) time were 13.6 and 16.3 months, respectively. In the phase 2 study, which was terminated early because of poor accrual, the median TTP and OS favoured the combination (n = 13) compared to docetaxel/prednisone alone (n = 12; 21.0 vs 6.6 months; P = 0.035 and 23.8 vs 15.6 months; P = 0.072, respectively).

Conclusion

Despite the limited number of patients in this study, preliminary data suggest that cabozantinib can be safely added to docetaxel/prednisone with possible enhanced efficacy.
LDL receptors, caveolae and cholesterol in endothelial dysfunction: oxLDLs accomplices or victims?
Authors: Luchetti Francesca , Crinelli Rita , Nasoni Maria Gemma , Benedetti Serena , Palma Francesco , Fraternale Alessandra , Iuliano Luigi
Published: September 2020

Oxidized LDLs (oxLDLs) and oxysterols play a key role in endothelial dysfunction and the development of atherosclerosis. The loss of vascular endothelium function negatively impacts vasomotion, cell growth, adhesiveness and barrier functions. While for some of these disturbances, a reasonable explanation can be provided from a mechanistic standpoint, for many others, the molecular mediators that are involved are unknown. Caveolae, specific plasma membrane domains, have recently emerged as targets and mediators of oxLDL‐induced endothelial dysfunction. Caveolae and their associated protein caveolin‐1 (Cav‐1) are involved in oxLDLs/LDLs transcytosis, mainly through the scavenger receptor class B type 1 (SR‐B1 or SCARB1). In contrast, oxLDLs endocytosis is mediated by the lectin‐like oxidized LDL receptor 1 (LOX‐1), whose activity depends on an intact caveolae system. In addition, LOX‐1 regulates the expression of Cav‐1 and vice versa. On the other hand, oxLDLs may affect cholesterol plasma membrane content/distribution thus influencing caveolae architecture, Cav‐1 localization and the associated signalling. Overall, the evidence indicate that caveolae have both active and passive roles in oxLDL‐induced endothelial cell dysfunction. First, as mediators of lipid uptake and transfer in the subendothelial space and, later, as targets of changes in composition/dynamics of plasma membrane lipids resulting from increased levels of circulating oxLDLs. Gaining a better understanding of how oxLDLs interact with endothelial cells and modulate caveolae‐mediated signalling pathways, leading to endothelial dysfunction, is crucial to find new targets for intervention to tackle atherosclerosis and the related clinical entities.

LINKED ARTICLES

This article is part of a themed issue on Oxysterols, Lifelong Health and Therapeutics. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v178.16/issuetoc
Clinical and radiographic outcomes of reentry lateral sinus floor elevation after a complete membrane perforation
Authors: Wang Da , Tian Jiehua , Wang Ying , Wei Donghao , Lin Ye
Published: September 2020

Background

Although small perforation of the maxillary sinus schneiderian membrane is a well‐documented complication during lateral sinus floor elevation (LSFE), complete perforations larger than 10 mm often result in discontinuation of surgery. Reports on reentry LSFE and its long‐term outcomes are sparse.

Purpose

To evaluate the long‐term outcomes of reentry LSFE following complete membrane perforation to elucidate the technical details of the reentry procedure.

Materials and methods

We assessed the medical records of all patients receiving LSFE from 2008 to 2017 in the Department of Oral Implantology, Peking University Hospital of Stomatology. Twenty‐two patients receiving reentry LSFE after complete membrane perforation were enrolled. Data were recorded using cone beam computer tomography: including the residual bone height, membrane thickness of the sinus prior to surgery (MT1), and before reentry (MT2), and height of the bone graft during the reentry procedure (HBG). Cumulative survival rate of implants (CSR), marginal bone loss (MBL), and subsequent complications were also recorded.

Results

From 2008 to 2017, 2023 consecutive patients (2262 sinuses) who underwent LSFE were screened. Complete membrane perforation occurred in 28 patients and resulted in discontinuation of surgery (1.2%). Twenty two patients were enrolled and received reentry LSFE within 3‐6 months. Two patients undergoing the reentry procedure were suspended due to excessive membrane perforation, while the other 20 finished reentry sinus bone graft. In the reentry procedure, the HBG was 9.73 ± 2.67 mm with 34 implant placements. The MT1 and MT2 were 1.03 ± 0.43 and 1.91 ± 1.45 mm, respectively, showing a statistically significant difference (P < .05). After a follow‐up of 2‐10 years, CSR was 97.1%, and MBL was 0.64 ± 0.50 mm.

Conclusions

The long‐term outcome of reentry LSFE is predictable and reentry LSFE offers a reliable alternative following complete membrane perforation. However, the procedure is relatively sensitive and should be performed by experienced surgeons.
Michael Soulé (1936–2020) on spirituality, ethics, and conservation biology
Authors: Taylor Bron
Published: September 2020

Michael Soulé is best known for his scientific contributions and central role in founding the Society for Conservation Biology and its flagship journal. Less well known are his childhood experiences, his affinity for Zen Buddhism and Arne Naess’ deep ecology philosophy, and his contributions as an environmental activist to efforts to protect biodiversity and rewild ecosystems. Also less well known is the extent to which he was an interdisciplinary environmental studies scholar, struggling to understand what promotes and hinders proenvironmental behaviors. In this regard, his life and that of many other conservation scientists provide important clues, but no easy answers. By attempting to integrate the humanities, with its quest for a meaningful and fulfilling human existence, with naturalistic nature spirituality and ecocentric values, as well as the social and natural sciences, Soulé sought to solve the riddle as to why human beings seemed unable to understand, slow, and halt negative anthropogenic environmental change. He thus modeled what interdisciplinary environmental studies is at its best. Those advocating the conservation of biological diversity have much to learn from Michael Soulé, not only from his scientific findings but also from his way of seeing, the questions he asked, and his love of the living world.
Laparoscopic rectal dissection preserves erectile function after ileal pouch–anal anastomosis: a two‐centre study
Authors: Picaud Olivier , Beyer‐Berjot Laura , Parc Yann , Karsenty Gilles , Creavin Ben , Berdah Stéphane , Lefevre Jérémie H.
Published: September 2020

Aim

Few studies have been published on erectile function after ileal pouch–anal anastomosis (IPAA) and, unlike in women, male fertility after IPAA has never been assessed. The primary objective was to assess the impact of IPAA on erectile function. The secondary objective was to assess the impact of IPAA on male fertility.

Methods

All of the male patients who underwent IPAA in two university care centres between 2003 and 2017, aged 70 years or less at the time of operation, were included. Forty‐eight per cent of the patients responded to the international index of erectile function, the Jorge–Wexner score and a fertility questionnaire. All demographic and perioperative data were prospectively collected. Fertility results were compared with those of a control group undergoing appendectomy, matched for age at the time of operation, desire for paternity and length of follow‐up.

Results

One hundred and thirty‐nine patients were included, among which 46 (33%) presented with erectile dysfunction and 14 (10%) with severe erectile dysfunction. Age older than 50 years (OR 0.27, 95% CI 0.12–0.62, P = 0.002) and rectal dissection performed by open surgery (OR 4.16, 95% CI 1.62–10.65, P = 0.003) were independent risk factors for erectile dysfunction. There was no infertility after IPAA compared with controls: indeed, 23 (16%) IPAA patients presented with pregnancy in their couple versus 27 (22%) controls (P = 0.29), whereas 36 (26%) IPAA patients and 34 (28%) controls (P = 0.80) expressed paternity desire.

Conclusion

A total laparoscopic approach, including rectal dissection, should be preferred to preserve erectile function. Male fertility is not impaired after IPAA.
Accuracy improvement in air‐quality forecasting using regressor combination with missing data imputation
Authors: Ozturk Ali
Published: September 2020

This article proposes a hybrid model based on regressor combination to improve the accuracy of air‐quality forecasting. The expectation‐maximization algorithm was used to impute the missing values of the dataset. The optimal hyperparameter values for the regressors were found by the grid search approach, depending on the mean absolute error (MAE), in the training session. The regressors having the minimum MAE were then globally combined for prediction. The output of the regressor with the minimum absolute error between the actual and predicted values was chosen as the prediction result of the hybrid model. The performance of the proposed model was compared with that of sequential deep learning methods, namely long short‐term memory and gated recurrent unit, in terms of MAE, mean relative error (MRE), and squared correlation coefficient (SCC) metrics. The imputed dataset was divided into training and testing subsets of different durations. According to the experimental results, our hybrid model performed better than the deep learning methods in terms of MAE, MRE, and SCC metrics, irrespective of the training data length. Furthermore, the Akaike's information criterion and the Bayesian information criterion values suggested that the quality of the hybrid model was better than that of the deep learning models.
Avian cultural services peak in tropical wet forests
Authors: Echeverri Alejandra , Karp Daniel S. , Frishkoff Luke O. , Krishnan Jaya , Naidoo Robin , Zhao Jiaying , Zook Jim , Chan Kai M. A.
Published: September 2020

The current biodiversity crisis involves major shifts in biological communities at local and regional scales. The consequences for Earth's life‐support systems are increasingly well‐studied, but knowledge of how community shifts affect cultural services associated with wildlife lags behind. We integrated bird census data (3 years across 150 point‐count locations) with questionnaire surveys (>400 people) to evaluate changes in culturally important species across climate and land‐use gradients in Costa Rica. For farmers, urbanites, and birdwatchers alike, species valued for identity, bequest, birdwatching, acoustic aesthetics, and education were more likely to occupy wetter regions and forested sites, whereas disliked species tended to occupy drier and deforested sites. These results suggest that regional climate drying and habitat conversion in the Neotropics are likely to threaten the most culturally important bird species. This study provides a novel and generalizable pathway for assessing the effects of environmental changes on cultural services and integrating the sociocultural and ecological dimensions of biodiversity.
RpS13 controls the homeostasis of germline stem cell niche through Rho1‐mediated signals in the Drosophila testis
Authors: Wang Min , Chen Xia , Wu Yibo , Zheng Qianwen , Chen Wanyin , Yan Yidan , Luan Xiaojin , Shen Cong , Fang Jie , Zheng Bo , Yu Jun
Published: September 2020

Objectives

Stem cell niche regulated the renewal and differentiation of germline stem cells (GSCs) in Drosophila. Previously, we and others identified a series of genes encoding ribosomal proteins that may contribute to the self‐renewal and differentiation of GSCs. However, the mechanisms that maintain and differentiate GSCs in their niches were not well understood.

Materials and Methods

Flies were used to generate tissue‐specific gene knockdown. Small interfering RNAs were used to knockdown genes in S2 cells. qRT‐PCR was used to examine the relative mRNA expression level. TUNEL staining or flow cytometry assays were used to detect cell survival. Immunofluorescence was used to determine protein localization and expression pattern.

Results

Herein, using a genetic manipulation approach, we investigated the role of ribosomal protein S13 (RpS13) in testes and S2 cells. We reported that RpS13 was required for the self‐renewal and differentiation of GSCs. We also demonstrated that RpS13 regulated cell proliferation and apoptosis. Mechanistically, we showed that RpS13 regulated the expression of ribosome subunits and could moderate the expression of the Rho1, DE‐cad and Arm proteins. Notably, Rho1 imitated the phenotype of RpS13 in both Drosophila testes and S2 cells, and recruited cell adhesions, which was mediated by the DE‐cad and Arm proteins.

Conclusion

These findings uncover a novel mechanism of RpS13 that mediates Rho1 signals in the stem cell niche of the Drosophila testis.
Quality of life as a predictor of time to heroin relapse among male residents following release from compulsory rehabilitation centres in Vietnam
Authors: Vuong Thu , Ritter Alison , Shanahan Marian , Ali Robert , Nguyen Nhu , Minh Khue Pham
Published: September 2020

Introduction and Aims

Quality of life (QOL) is a relevant and quantifiable outcome of drug dependence treatment. We assessed health‐related QOL for people released from three centre‐based compulsory treatment (CCT) centres in Vietnam, using the EQ‐5D. The study aimed to examine the prognostic value of health‐related QOL in relation to time to relapse to heroin use among the participants.

Design and Methods

Two hundred and eight CCT participants with heroin dependence were interviewed at release, and at 3, 6 and 12 months post‐release. Health‐related QOL was measured with the EQ‐5D. Kaplan–Meier survival models were fitted using Cox modelling to examine the rate, timing and prediction of the number of days to heroin relapse and to examine the predictability of the health‐related QOL measures for days to relapse. Relapse was defined as first time of heroin use.

Results

The study found a substantial relapse rate (85.6%) among participants within 12 months following release from CCT centres; the mean number of days to relapse was 57.7 (SD = 31.6). There was no statistically significant change over time in the mean values of health‐related QOL (P = 0.11). While the total index score (across the five pre‐specified EQ‐5D domains) did not have a significant effect in predicting cumulative relapse, lower scores on the Visual Analogue Scale of the EQ‐5D were significantly (P < 0.05) predictive of cumulative relapse, with adjusted hazard ratios for relapse of 0.987 (P = 0.013).

Discussion and Conclusions

EQ‐5D Visual Analogue Scale score is a useful predictor of cumulative heroin relapse among participants released from CCT centres.
Adulte Form der Dermatomyositis ‐ ein Update
Authors: Schlecht Nora , Sunderkötter Cord , Niehaus Sabine , Nashan Dorothée
Published: September 2020

Die adulte Form der Dermatomyositis (DM) wird mit einer Prävalenz von 6–7 auf 100 000 Einwohner pro Jahr angegeben. Auf Grund der nachweislich steigenden Inzidenz, der häufig unterschätzen Systembeteiligung und neuer Entwicklungen zu den Myositis‐spezifischen Antikörpern (MSA) wurde diese kompakte Übersicht zur Dermatomyositis erarbeitet. Des Weiteren wird das klinische Spektrum nicht nur dermatologischer Parameter, sondern auch organischer Symptome erläutert. Die diagnostische Aufarbeitung wie auch therapeutische Regime, basierend auf der S2k‐Leitlinie und aktueller Literatur, werden präsentiert.

Die Dringlichkeit einer frühen Diagnosestellung wird deutlich, zum einen da circa 30 % der DM‐Fälle assoziiert Tumoren aufweisen, Verläufe oft mit Lungenfibrose vergesellschaftet sind und die Myositis zu irreversiblen Muskelschäden führt. Die klinischen Zeichen und eine korrekte Interpretation der serologischen Befunde geben wertvolle Hinweise für die Ausprägung der DM, die Indikationsstellung für weitergehende diagnostische Maßnahmen, die Prognose und Therapiewahl.
Dyskeratosis congenita: a literature review
Authors: AlSabbagh Manahel Mahmood
Published: September 2020

Dyskeratosis congenita is a rare hereditary disease that occurs predominantly in males and manifests clinically as the classic triad of reticulate hyperpigmentation, nail dystrophy and leukoplakia. It increases the risk of malignancy and other potentially lethal complications such as bone marrow failure, lung and liver diseases. Mutations in 19 genes are associated with dyskeratosis congenita, and a fifth of the pathogenic mutations are found in DKC1, the gene coding for dyskerin. This review aims to address the clinical and genetic aspects of the disease.
Association between glycaemic outcome and BMI in Danish children with type 1 diabetes in 2000–2018: a nationwide population‐based study
Authors: Ibfelt E. H. , Vistisen D. , Falberg Rønn P. , Pørksen S. , Madsen M. , Kremke B. , Svensson J.
Published: September 2020

Aim

To describe the development of HbA1c and BMI over time in Danish children with type 1 diabetes; and to investigate the association between HbA1c and BMI including influence of age, gender, diabetes duration, severe hypoglycaemia and treatment method.

Methods

We used the nationwide Danish Registry of Childhood and Adolescent Diabetes, DanDiabKids, including annual registrations of all children with diabetes treated at Danish hospitals. With linear mixed‐effects models and splines we analyzed the HbA1c and BMI development over time as well as the association between HbA1c and BMI including effects of gender, age, disease duration, hypoglycaemia and treatment method. BMI z‐scores were calculated for these analyses.

Results

For the period from 2000 to 2018, 6097 children with type 1 diabetes were identified from the DanDiabKids database. The median (interquartile range) HbA1c level was 65 (57–74) mmol/mol (8.1%) and the median BMI z‐score was 0.85 in girls and 0.67 in boys. A non‐linear association was found between HbA1c and BMI z‐score, with the highest BMI z‐score observed for HbA1c values in the range of approximately 60–70 mmol/mol (7.6–6.8%). The association was modified by gender, age and diabetes duration. Severe hypoglycaemia and insulin pump treatment had a small positive impact on BMI z‐score.

Conclusion

The association between HbA1c and BMI z‐score was non‐linear, with the highest BMI z‐score being observed for intermediate HbA1c levels; however, specific patterns depended on gender, age and diabetes duration.
Peripartum cardiomyopathy in a COVID‐19‐infected woman: differential diagnosis with acute myocarditis—A case report from a Hub Institution during the COVID‐19 outbreak
Authors: De Vita Stefano , Ippolito Sonia , Caracciolo Maria Michela , Barosi Alberto
Published: September 2020

We report the case of a healthy 35‐year‐old woman who had experienced a flu‐like syndrome during the week before childbirth and heart failure symptoms 10 days before the current hospitalization and presented to our emergency department with clinical signs of congestive heart failure, echocardiographic evidence of a severely dilated and hypokinetic heart, laboratory evidence of SARS‐CoV‐2 disease, and radiologic findings consistent with both virus‐related pneumonia and heart failure. Early cardiac magnetic resonance was crucial for the diagnosis of postpartum cardiomyopathy and for the exclusion of virus‐related myocarditis, allowing us to decide on a prudent and supportive clinical approach.
The impact of chronic obstructive pulmonary disease on hospitalization and mortality in patients with heart failure
Authors: Xu Shuo , Ye Zi , Ma Jianyong , Yuan Taiwen
Published: September 2020

Background

Several studies have suggested that chronic obstructive pulmonary disease (COPD) could be predictive of the prognosis in patients with heart failure (HF), but yield conflicting findings. Therefore, we conducted a meta‐analysis to examine the impact of COPD on adverse outcomes in patients with HF.

Methods

We systematically searched the databases of PubMed, EMBASE, Google Scholar, Cochrane library from inception to August 2020 for the relevant studies. Adjusted risk ratios (RRs) and confidence intervals (CIs) were collected and then pooled by the Review Manager version 5.30 software with a random‐effects model.

Results

A total of 18 studies (6 post hoc analyses of trials and 12 observational studies) were included in this meta‐analysis. COPD was associated with an increased risk of all‐cause mortality (hospitalized HF: RR 1.43, 95% CI: 1.20‐1.70; chronic HF: RR 1.24, 95% CI: 1.16‐1.33), but not cardiovascular mortality, in patients with hospitalized HF or chronic HF. In addition, COPD was associated with increased risks of all‐cause hospitalization (RR 1.31, 95% CI: 1.21‐1.42) and HF hospitalization (RR 1.31, 95% CI: 1.21‐1.42) in the chronic HF patients.

Conclusions

COPD comorbidity could increase the risk of all‐cause mortality of HF patients. Future research should confirm the findings on hospitalization because of the limited studies included for this outcome.
Impaired frontal‐parietal control network in chronic prostatitis/chronic pelvic pain syndrome revealed by graph theoretical analysis: A DTI study
Authors: Huang Xinfei , Chen Jianhuai , Liu Shaowei , Gong Qingkuo , Liu Tao , Lu Chao , Qin Zhan , Cui Hongliang , Chen Yun , Zhu Yongkang
Published: September 2020

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by chronic pain in pelvic area and lower urinary tract symptoms (LUTS). Previous neuroimaging studies demonstrated that chronic pain was associated with the altered brain activity. However, the pathological mechanisms associated with altered brain control of CP/CPPS are not well‐understood. Therefore, we sought to investigate the topological properties of white matter brain networks in patients with CP/CPPS and whether the topological configuration of frontal‐parietal control network was disrupted. We collected 19 patients with CP/CPPS and 32 matched healthy controls (HCs). Diffusion tensor imaging data of all participates were used to map the white matter structural networks. Graph theoretical method was applied to investigate the alterations of topological properties of brain network in patients. Moreover, we also investigated whether the alerted brain regions might be correlated with any clinical features of patients by the method of Pearson correlation analysis. Both CP/CPPS patients and HCs exhibited a ‘small‐world’ behavior or economical small‐world architecture of the white matter brain networks. In addition, CP/CPPS had a lower global efficiency in the right middle frontal gyrus (orbital part) and a higher global efficiency in the left middle cingulate and paracingulate gyri. CP/CPPS also showed increased local efficiency in the left middle cingulate and paracingulate gyri and paracentral lobule. Moreover, the local efficiency of the left middle cingulate gyrus was positively correlated with the scores of the influence of symptoms on the quality of life. The local efficiency of the left precuneus and right supplementary motor area were positively correlated with the total scores of NIH‐CPSI and the scores of pain and discomfort symptoms, respectively. Together, we found that patients with CP/CPPS had alterations of connections within the frontal‐parietal control network, which suggested that the altered connectivity involved in the executive control processing procedures might contribute to the pathogenesis of the pelvic pain and LUTS in CP/CPPS. Thus these results provided new insights into the understanding of CP/CPPS.
Speech metrics, general disability, brain imaging and quality of life in multiple sclerosis
Authors: Noffs G. , Boonstra F. M. C. , Perera T. , Butzkueven H. , Kolbe S. C. , Maldonado F. , Cofre Lizama L. Euardo , Galea M. P. , Stankovich J. , Evans A. , van der Walt A. , Vogel A. P.
Published: September 2020

Background and purpose

Objective measurement of speech has shown promising results to monitor disease state in multiple sclerosis. In this study, we characterize the relationship between disease severity and speech metrics through perceptual (listener based) and objective acoustic analysis. We further look at deviations of acoustic metrics in people with no perceivable dysarthria.

Methods

Correlations and regression were calculated between speech measurements and disability scores, brain volume, lesion load and quality of life. Speech measurements were further compared between three subgroups of increasing overall neurological disability: mild (as rated by the Expanded Disability Status Scale ≤2.5), moderate (≥3 and ≤5.5) and severe (≥6).

Results

Clinical speech impairment occurred majorly in people with severe disability. An experimental acoustic composite score differentiated mild from moderate (P < 0.001) and moderate from severe subgroups (P = 0.003), and correlated with overall neurological disability (r = 0.6, P < 0.001), quality of life (r = 0.5, P < 0.001), white matter volume (r = 0.3, P = 0.007) and lesion load (r = 0.3, P = 0.008). Acoustic metrics also correlated with disability scores in people with no perceivable dysarthria.

Conclusions

Acoustic analysis offers a valuable insight into the development of speech impairment in multiple sclerosis. These results highlight the potential of automated analysis of speech to assist in monitoring disease progression and treatment response.
Advanced imaging of a histologically confirmed bone infarction of the distal tibia in a Warmblood mare
Authors: Hann M. J. , Rocchigiani G. , Verin R. , Milner P. , Robinson C. , Castro Martins M.
Published: September 2020

An 8‐year‐old Warmblood‐cross mare presented for investigation of acute onset left hindlimb lameness. Nuclear scintigraphy identified a marked, focal, increase in radiopharmaceutical uptake in the distal aspect of the left tibia. Radiography revealed a large, oval, multi‐loculated radiolucent area within the medulla of the distal metaphysis of the left tibia. The mare was treated conservatively for 6 months but showed little improvement in the lameness so the owner elected for euthanasia. Post‐mortem computed tomographic imaging revealed a large, oval, hypoattenuating area within the distal tibia, surrounded by a thick, irregular, sclerotic border. The lesion occupied the majority of the medullary cavity but the cortical bone was unaffected. Gross and histopathological examination confirmed a diagnosis of a bone infarction in the medullary cavity of the distal tibia.
To what extent do governance, government funding and chief executive officer characteristics influence executive compensation in U.K. charities? Insights from the social theory of agency
Authors: Nguyen Tam Huy , Soobaroyen Teerooven
Published: September 2020

This paper draws on agency theory, as extended by the social theory of agency (STA) (Wiseman, Cuevas‐Rodríguez & Gomez‐Mejia, 2012), to examine the association between governance arrangements, reliance on government funding, chief executive officer (CEO) non‐profit experience, and CEO compensation in the UK charity sector. We rely on a hand‐collected data for the largest 240 charities and find that greater trustee board diversity (specifically gender and education diversity) and the existence of a remuneration or nomination committee are positively associated to CEO compensation. The results also show that a reliance on government funding and CEO's non‐profit work experience, together with the presence of a finance/accounting expert on the audit committee are negatively associated to CEO compensation. The existence of an audit committee, internal audit function, use of specialist external auditor and CEO characteristics (gender, ethnicity and managerial experience) are not significant factors. Our findings are largely consistent with the STA's propositions. Specifically, executive compensation levels reflect the CEO's ability to work with a diverse board while a higher reliance on government funding signals the role of the State's pressures in moderating CEO compensation. Finally, in a context characterised by altruism and public benefit, financial rewards are not seen as the dominant ‘value metric’, resulting in lower compensation for CEOs previously working in the sector. Our findings have policy implications, specifically in relation to the role, composition and effectiveness of governance structures (e.g., trustee boards, audit and remuneration committees) in overseeing the design of executive compensation schemes within the charity sector.
Nutrient addition effects on chlorophyll a, phytoplankton biomass, and heterocyte formation in Lake Erie’s central basin during 2014–2017: Insights into diazotrophic blooms in high nitrogen water
Authors: Chaffin Justin D. , Stanislawczyk Keara , Kane Douglas D. , Lambrix Madeline M.
Published: September 2020

Phosphorus (P) usually is the primary limiting nutrient of phytoplankton biomass, but attention towards nitrogen (N) and trace nutrients, such as iron (Fe), has surfaced. Additionally, N‐fixing cyanobacterial blooms have been documented to occur in N‐rich, P‐poor waters, which is counterintuitive from the paradigm that low N and high P promotes blooms. For example, Lake Erie's central basin has Dolichospermum blooms when nitrate concentrations are high, which raises questions about which nutrient(s) are selecting for Dolichospermum over other phytoplankton and why an N‐fixer is present in high N waters?

We conducted a 4‐year (2014–2017) study in Lake Erie's central basin to determine which nutrient (P, N, or trace nutrients such as Fe, molybdenum [Mo], and boron [B]) constrained chlorophyll concentration, phytoplankton biovolume, and nitrate assimilation using nutrient enrichment bioassays. The enriched lake water was incubated in 1‐L bottles in a growth chamber programmed at light and temperatures of in situ conditions for 4–7 days. We also quantified heterocytes when N‐fixing cyanobacteria were present.

Compared to the non‐enriched control, the P‐enriched (+P) treatment had significantly higher chlorophyll and phytoplankton biovolume in c. 75% of experiments. Combination enrichments of P with ammonium‐N, nitrate‐N, Fe, Mo, and B were compared to the +P treatment to determine secondary limitations. +P and ammonium‐N and +P nitrate‐N resulted in higher chlorophyll in 50% of experiments but higher phytoplankton biovolume in only 25% of experiments. These results show that P was the primary limiting nutrient, but there were times when N was secondarily limiting.

Chlorophyll concentration indicated N secondary limitation in half of the experiments, but biovolume indicated only N secondary limitation in 25% of the experiments. To make robust conclusions from nutrient enrichment bioassays, both chlorophyll and phytoplankton biovolume should be measured.

The secondary effects of Fe, Mo, and B on chlorophyll were low (<26% of experiments), and no secondary effects were observed on phytoplankton biovolume and nitrate assimilation. However, +P and Fe resulted in more chlorophyll than +P in experiments conducted during Dolichospermum blooms, and +P and B significantly increased the number of heterocytes in Dolichospermum. These results indicate that low Fe availability might select for Dolichospermum, and low B constrains heterocyte formation in the central basin of Lake Erie. Furthermore, these results could apply to other lakes with high N and low P where diazotrophic cyanobacterial blooms occur.