bluuebunny/crossref_metadata_2025 huggingface dataset:
Axial and transverse deep‐water sediment supply to syn‐rift fault terraces: Insights from the West Xylokastro Fault Block, Gulf of Corinth, Greece
Authors: Cullen Timothy M. , Collier Richard E. Ll. , Gawthorpe Robert L. , Hodgson David M. , Barrett Bonita J.
Published: October 2019

Deep‐water syn‐rift systems develop in partially‐ or transiently‐linked depocentres to form complicated depositional architectures, which are characterised by short transport distances, coarse grain sizes and a wide range of sedimentary processes. Exhumed systems that can help to constrain the tectono‐stratigraphic evolution of such systems are rare or complicated by inversion tectonics. Here, we document a mid‐Pleistocene deep‐water syn‐rift system fed by Gilbert‐type fan deltas in the hangingwall of a rift margin fault bounding the West Xylokastro Horst block, on the southern margin of the Gulf of Corinth, Greece. Structural and stratigraphic mapping combined with digital outcrop models permit observations along this syn‐rift depositional system from hinterland source to deep‐water sink. The West Xylokastro Fault hangingwall is filled by two distinct sediment systems; an axial system fed by coarse‐grained sediment gravity flows derived from fault‐tip Gilbert‐type fan deltas and a lateral system dominated by mass transport deposits fed from an evolving fault‐scarp apron. Abrupt changes in stratigraphic architecture across the axial system are interpreted to record changes in relative base level, sediment supply and tectonics. Locally, depositional topography and intra‐basinal structures controlled sediment dispersal patterns, from bed‐scale infilling of local rugose topography above mass transport complexes, to basin‐scale confinement from the fault scarp apron. These acted to generate a temporally and spatially variable, heterogeneous stratigraphic architecture throughout the basin‐fill. The transition of the locus of sedimentation from a rift margin to a fault terrace through the syn‐sedimentary growth of a basinward fault produced regressive surfaces updip, which manifest themselves as channels in the deep‐water realm and acted to prograde the system. We present a new conceptual model that recognises coeval axial and transverse systems based on the stratigraphic architecture around the West Xylokastro fault block that emphasizes the lateral and vertical heterogeneity of rift basin‐fills with multiple entry points.
Birth of a Father: Fathering in the First 1,000 Days
Authors: Bakermans‐Kranenburg Marian J. , Lotz Anna , Alyousefi‐van Dijk Kim , van IJzendoorn Marinus
Published: October 2019

As a result of societal changes, fathers participate more actively in child care than they used to. In this article, we propose a context‐dependent biobehavioral model of emergent fatherhood in which sociocultural, behavioral, hormonal, and neural factors develop and interact during the first 1,000 days of fatherhood. Sociocultural factors, including different expectations of fathers and varying opportunities for paternal caregiving through paid paternal leave, influence paternal involvement. Levels of hormones (e.g., testosterone, vasopressin, oxytocin, cortisol) predict fathers’ parenting behaviors, and involvement in caregiving in turn affects their hormones and brain responses to infant stimuli. The birth of the first child marks the transition to fatherhood and may be a critical period in men’s lives, with a smoother transition to fatherhood predicting more optimal involvement by fathers in subsequent years. A focus on prenatal and early postnatal fathering may pave the way for developing interventions that effectively support fathering during pregnancy and in the first years of their children’s lives.
Aetiopathogenesis of severe cutaneous adverse reactions (SCARs) in children: A 9‐year experience in a tertiary care paediatric hospital setting
Authors: Liccioli Giulia , Mori Francesca , Parronchi Paola , Capone Manuela , Fili Lucia , Barni Simona , Sarti Lucrezia , Giovannini Mattia , Resti Massimo , Novembre Elio M.
Published: October 2019

Background

Severe cutaneous adverse reactions (SCARs) are delayed‐type hypersensitivity reactions to drugs including as follows: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), Stevens‐Johnson syndrome (SJS), Toxic Epidermal Necrolysis (TEN) and Acute Generalized Exanthematous Pustulosis (AGEP). Incidence, triggers and management of SCARs have not been investigated in large‐scale epidemiological studies on children.

Objective

The aim of our study was to collect epidemiological, clinical and aetiological data from children with SCARs referred to our tertiary care paediatric hospital of Florence.

Methods

From 2010 to 2018 charts of children with diagnosis of SCAR were reviewed, and data collected during the acute phase and/or the subsequent allergy evaluation. Patients underwent patch tests, intradermal tests and lymphocyte transformation tests. All children were investigated for infectious diseases.

Results

Incidence of SCARs in hospitalized children was 0.32% over a 9‐year period. Fifty‐four children were enrolled (31 M; 23 F; median age 6.5 years): 17 cases of DRESS, 30 SJS, 3 TEN, 2 AGEP, 1 linear immunoglobulin A bullous disease (LABD) and 1 pemphigus. Twenty‐eight out of 54 patients underwent drug allergy investigations, and 50% of them resulted positive. Combining clinical history and results of allergy work‐up, 74% SCARs seem to be caused by drugs, 18.6% by both drugs and infections, 3.7% by infections, and 3.7% remained idiopathic. No deaths occurred.

Conclusions

In this study, SCARs incidence is in line with literature data. Drugs were most commonly the leading cause. Management of SCARs requires cooperation among professional figures for an early diagnosis and a prompt treatment. Mortality rate seems to be lower in children.
Effects of different types of intraoral scanners and scanning ranges on the precision of digital implant impressions in edentulous maxilla: An in vitro study
Authors: Miyoshi Keita , Tanaka Shinpei , Yokoyama Sawako , Sanda Minoru , Baba Kazuyoshi
Published: October 2019

Objective

This study aimed to evaluate the precision of digital implant impressions in comparison with conventional impressions and assess the impact of the scanning range on precision.

Materials and Methods

An edentulous maxilla model with six implants was scanned with four intraoral scanners (IOSs) and a dental laboratory scanner five times each, and stereolithography (STL) data were generated. A conventional silicone impression was made, and a model was fabricated, which was scanned using the laboratory scanner. This procedure was also repeated five times. Nine different ranges of interest (ROIs) were defined, and the average discrepancies of the measurement points between each pair of STL images out of five for each ROI were calculated. The effects of “impression method” and “ROI” on precision, as evaluated by the averaged discrepancy, were tested by two‐way analysis of variance (p < .05).

Results

The effects of “impression methods” and “ROI” and their interactions were statistically significant. The discrepancies in the scanned datasets of the dental laboratory scanner were significantly lower than those in the other impression methods. The discrepancies of the IOSs were comparable with those of the laboratory scanner when the ROI was limited, however; the discrepancies deteriorated when the ROI expanded across the arch, while those of the laboratory scanner remained stable irrespective of the ROI.

Conclusions

Within the limitation of this in vitro study, digital implant impressions by IOSs may show clinically acceptable precision when the scan range is limited, such as in 3‐unit superstructure supported by two implants.
Biatrial and right ventricular deformation imaging: Implications of the recent EACVI consensus document in the clinics and beyond
Authors: Saha Samir K. , Kiotsekoglou Anatoli , Gopal Aasha S , Lindqvist Per
Published: October 2019

In this review, right ventricular (RV), right atrial (RA), and left atrial (LA) strain in some selected clinical situations has been discussed in light of the current literature. To exemplify the significance of the use of multichamber strain, we have provided some illustrations of common cardiac problems. The recently published European Association of Cardiovascular Imaging (EACVI) consensus document for standardization of RV, RA, and LA strain, using the currently available software, has fulfilled the aspirations of investigators world over who have been studying atrial strain using a bailed‐out algorithm designed principally to quantify left ventricular deformation. The purpose of this review was to reiterate the value of the application of RV and biatrial strain imaging in research and day‐to‐day clinical practice, using the 2‐dimensional speckle tracking echocardiography (2D‐STE). Also, we present a short report on how RA strain may remain coupled to pulmonary hemodynamics. Besides, we have highlighted the technical challenges of atrial strain quantification. We have not used the nomenclature of chamber deformation proposed by the EACVI document as the publications cited in this review have used different sets of nomenclature.
Lipoprotein receptor‐related protein 6 is required to maintain intercalated disk integrity
Authors: Wang Xiang , Zou Yan , Li Yang , Chen Zhidan , Yin Chao , Wang Ying , Zhang Lei , Wu Jian , Yang Chunjie , Zhang Guoping , Zou Yunzeng , Gong Hui
Published: October 2019

The intercalated disk (ID), a highly organized adhesion structure connecting neighboring cardiomyocytes, fulfills mechanical and electrical signaling communication to ensure normal heart function. Lipoprotein receptor‐related protein 6 (LRP6) is a co‐receptor inducing canonical Wnt/β‐catenin signaling. It was recently reported that LRP6 deficiency in cardiomyocytes predisposes to arrhythmia independent of Wnt signaling. However, whether LRP6 directly regulates the structure of IDs requires further investigation. The aim of the present study was to explore the role of LRP6 in IDs and the potential underlying mechanisms by inducible cardiac‐specific LRP6 knockout mice. The results revealed that LRP6 was predominately expressed in the cell membrane, including the IDs of cardiomyocytes. Tamoxifen‐inducible cardiac‐specific LRP6 knockout mice displayed overt cardiac dysfunction and disruption of ID structure. Further analysis revealed that cardiac LRP6 deficiency induced the imbalance of ID component proteins, characterized by the sharply decreased expression of connexin 43 (Cx43) and the significantly increased expression of N‐cadherin, desmoplakin and γ‐catenin in tissue lysates or membrane fraction from the left ventricle. STRING database analysis indicated that β‐catenin, but no other ID‐associated proteins, interacted with LRP6. Our immunoprecipitation analysis demonstrated that LRP6 strongly interacted with Cx43, N‐cadherin and γ‐catenin, and weakly interacted with β‐catenin, whereas there was no association with desmoplakin. In response to LRP6 deficiency, the recruitment of β‐ or γ‐catenin to N‐cadherin was increased, but they displayed little interaction with Cx43. In conclusion, LRP6 is required to maintain the integrity of ID structure and the balance of ID proteins, and the interaction between LRP6 and Cx43, N‐cadherin and γ‐catenin may be involved in this process.
“Providing a complete episode of care”: A survey of registered nurse and registered midwife prescribing behaviours and practices
Authors: Casey Mary , Rohde Daniela , Higgins Agnes , Buckley Tom , Cashin Andrew , Fong Jacqueline , Hughes Mary , McHugh Aine
Published: October 2019

Aims and objectives

To describe the prescribing behaviours and practices of registered nurse and midwife prescribers and to explore experiences of enablers and barriers to prescribing practices.

Background

The extension of prescriptive authority to nurses and midwives internationally has created new opportunities for them to expand their scope of practice and is of significant benefit to effective and efficient health service provision.

Design

Cross‐sectional national survey of registered nurse and midwife prescribers.

Methods

Data were collected through an online survey between April–July 2018. A total of 84 nurse and midwife prescribers participated. The STROBE checklist was applied as the reporting guideline for this study.

Results

Respondents estimated that two‐fifths of their consultations involved an episode of prescribing. Nurse and midwife prescribers engaged in similar prescribing behaviours spanning the range of activities from initiating new medications to ceasing medicines. The most frequently selected criterion for prescribing was clinical effectiveness. Prescribing was viewed as essential to respondents' clinical practice, allowing them to provide a complete episode of care and leading to a reduction in medication errors and reduced delays and waiting times for patients. Enablers of prescribing included knowledge, experience, education and access to continuous professional development, as well as support from colleagues and organisations.

Conclusion

Little is known about the prescribing behaviours and practices of registered nurse and midwife prescribers. While prescribing authority enables nurse and midwife practitioners to deliver holistic care, there remain significant barriers and challenges including increased workloads, lack of continuous professional development, lack of support and overly restrictive rules and policies governing prescribing.

Relevance to clinical practice

Addressing the barriers identified in this study could enable more nurse and midwife prescribers to work to their full scope of practice, enabling populations to fully capitalise on the contributions of registered nurse and midwife prescribing services.
Antifungal prophylaxis with posaconazole tablet and oral suspension in patients with haematologic malignancy: Therapeutic drug monitoring, efficacy and risk factors for the suboptimal level
Authors: Oh Jihyu , Kang Cheol‐In , Kim Si‐Ho , Huh Kyungmin , Cho Sun Young , Chung Doo Ryeon , Lee Soo‐Youn , Jung Chul Won , Peck Kyong Ran
Published: October 2019

Background

Posaconazole is used to prevent invasive fungal infections (IFIs) in patients with haematologic malignancy. In this study, we compared plasma posaconazole concentrations (PPCs) and the incidence of breakthrough IFIs between patients with haematologic malignancy receiving posaconazole oral suspension vs tablet.

Methods

We retrospectively collected data on adult patients with haematologic malignancies who received posaconazole prophylaxis during chemotherapy from April 2014 through May 2018. A total of 242 cases with PPCs, 88 in the oral suspension group and 154 in the tablet group, were included in this study.

Results

Patients receiving tablets achieved a significantly higher mean PPC than did those on oral suspension (1.631 ± 0.878 μg/mL in the tablet group vs. 0.879 ± 0.585 μg/mL in the oral suspension group). One hundred and thirty‐seven of 154 patients (89.0%) receiving tablets had PPCs of 0.7 μg/mL or more, while only 41 of 88 patients (46.6%) receiving oral suspension attained an optimal level (P < .001). The incidence of breakthrough IFIs was significantly higher in the oral suspension group compared with in the tablet group (14.8% of oral suspension vs. 4.5% of tablet; P = .005). In the analysis including patients receiving posaconazole tablets, hypoalbuminemia (< 3.5 g/dL) was found to be a risk factor associated with suboptimal levels (odds ratio: 8.872; 95% confidence interval: 3.011 ‐ 26.141; P < .001).

Conclusions

Suboptimal PPCs in the tablet group were less common than those in the oral suspension group. Therapeutic drug monitoring may be still necessary even in patients receiving posaconazole tablets, especially in those with hypoalbuminemia.
Dental anomalies in craniofacial microsomia: A systematic review
Authors: Elsten Eline E. C. M. , Caron Cornelia J. J. M. , Dunaway David J. , Padwa Bonnie L. , Forrest Chris , Koudstaal Maarten J.
Published: October 2019

Objective: To provide an overview on the prevalence and types of dental anomalies in patients with craniofacial microsomia (CFM). Eligibility criteria: Inclusion criteria were CFM and dental anomalies. The following data were extracted: number of patients, methodology, mean age, sex, affected side, severity of mandibular hypoplasia, dentition stage and dental anomalies. Information sources: Cochrane, EMBASE, PubMed, MEDLINE Ovid, Web of Science, CINAHL EBSCOhost and Google Scholar, searched until the 30 August 2019. Risk of bias: The quality was examined with the OCEBM Levels of Evidence. Included studies: In total, 13 papers were included: four retrospective cohort studies, four prospective cohort studies, four case‐control studies and one case series. Synthesis of results: The studies reported information on dental agenesis, delayed dental development, tooth size anomalies, tooth morphology and other dental anomalies. Description of the effect: Dental anomalies are more often diagnosed in patients with CFM than in healthy controls and occur more often on the affected than on the non‐affected side. Strengths and limitations of evidence: This is the first systematic review study on dental anomalies in CFM. However, most articles were of low quality. Interpretation: Dental anomalies are common in CFM, which might be linked to the development of CFM. The pathophysiology of CFM is not entirely clear, and further research is needed.
Feasibility of early outplanting of sexually propagated Acropora verweyi for coral reef restoration demonstrated in the Philippines
Authors: Ligson Charlon A. , Tabalanza Tracy D. , Villanueva Ronald D. , Cabaitan Patrick C.
Published: October 2019

Over the last 20 years, coral sexual propagation techniques for reef restoration have been steadily developed and improved. However, these techniques involve considerable time and costs to grow coral propagules. There is a need to examine the optimal size of juvenile corals for outplantation. Here, we outplanted sexually propagated small (3–5 mm diameter) and large (10–15 mm diameter) Acropora verweyi corals at 4 months after fertilization at two sites in northwestern Philippines, and compared their survival and radial growth rate after a year. A. verweyi coral juveniles (n = 240) exhibited an overall mean survival of 29.5% and growth rate of 11.12 ± 6.2 mm/year (mean ± SD). Large colonies had a significantly higher growth rate than smaller colonies. Although survivorship of large juveniles was significantly better than that of the smaller ones at one site, it did not differ significantly at the other. Each 4‐month‐old coral cost US$1.52 to produce, while the cost of each of the outplanted juveniles (n = 240) was about US$2.67, whereas the cost of each survivor about a year after outplantation was US$11.47. Results suggest that A. verweyi reared in ex situ nurseries for only 4 months can survive reasonably well when outplanted onto coral reefs.
Migratory effects of arsenic as a hydrogeological pollutant on the quality of wastewater treatment sludge
Authors: Gligor Gellért , Cvijanović Gorica , Miščević Branislav , Hojka Zdravko , Kezić Vjekoslav , Bošković Jelena , Žuža Milena
Published: October 2019

The results of ICP‐OES analysis with (EPA 200.7) method serve as a proof of the negative influence of inorganic (As) from the processing of drinking water on the quality of anaerobic digested sludge. Detection of these proportions has for the first time confirmed the migratory flow of arsenic from the source point technological wastewater at Water intake 1 through the city sewage network to the wastewater treatment plant (WWTP) in Subotica. Arsenic (As) with low concentration at the input of the WWTP has ranged from 0.029 to 0.05 mg/L, but after anaerobic digestion, arsenic concentration in the sludge still showed a limiting character, which has caused a decrease in its quality and the possibility of wider utilisation. In order to preserve the quality of the potential biological product at WWTP, the impact of migratory arsenic must be prevented, and inertness of waste has to be achieved by the introduction of stabilisation/solidification technologies.
Data-Driven Modeling of the Modal Properties of a Six-Degrees-of-Freedom Industrial Robot and Its Application to Robotic Milling
Authors: Nguyen Vinh , Cvitanic Toni , Melkote Shreyes
Published: October 2019

This paper presents a Gaussian process regression (GPR)-based approach to model the dynamic properties of a six-degree-of-freedom (6-DOF) industrial robot within its workspace. Discretely sampled modal parameters (modal frequency, modal stiffness, modal damping coefficient) of the robot structure determined through experimental modal analysis are used to develop the GPR model, which is then evaluated for its ability to accurately predict the modal parameters at different points in the workspace. The validation results show that the model captures the significant trends in the modal parameters within the sampling space but exhibits greater errors in regions further from the robot base. The results of the GPR model are also compared with those derived from an analytical model of the robot tool tip dynamics. The analytical model is found to overestimate the robot’s stiffness, especially in extended arm configurations, and to underestimate the natural frequency. The average peak-to-valley vibrations predicted by the GPR model during robotic end milling are compared with experimental results. The model-predicted peak-to-valley vibrations follow the measured values with a maximum error of 0.028 mm in the wall and floor surface directions. The results show that the GPR model presented in this paper can serve as a useful tool for understanding and optimizing the tool tip vibrations produced in robotic milling.
Identification of Cavitation Instabilities on a Three-Bladed Inducer by Means of Strain Gages
Authors: Hadavandi Ruzbeh , Pace Giovanni , Valentini Dario , Pasini Angelo , d'Agostino Luca
Published: October 2019

This paper reports the experimental characterization of the cavitation-induced flow instabilities of a high head three-bladed inducer at design condition detected simultaneously by means of piezoelectric pressure transducers located at different axial and azimuthal stations on the casing of the pump and strain gages mounted on the pressure side of each blade. The simultaneous analysis performed in the stationary and rotating frames, supported by high-speed movies, suggests that the mechanism of formation of the detected subsynchronous rotating cavitation resembles that of modal stall in compressors, being the cavitation region the source of compliance. In fact, at decreasing cavitation number, a strong attached cavitation, developed preferentially on one blade and capable of completely surrounding and unloading the following blade, starts to be destabilized as consequence of the progressive intensification of a modal oscillation. The developed complex instability, consisting in a strong oscillation of the attached cavitation, is detected in both the frames as the simultaneous presence of a subsynchronous rotating cavitation and a cavitation surge.
Rapid Phenotypic and Metabolomic Domestication of Wild
Penicillium
Molds on Cheese
Authors: Bodinaku Ina , Shaffer Jason , Connors Allison B. , Steenwyk Jacob L. , Biango-Daniels Megan N. , Kastman Erik K. , Rokas Antonis , Robbat Albert , Wolfe Benjamin E.
Published: October 2019

Industrial cultures of filamentous fungi are used to add unique aesthetics and flavors to cheeses and other microbial foods. How these microbes adapted to live in food environments is generally unknown as most microbial domestication is unintentional. Our work demonstrates that wild molds closely related to the starter culture
Penicillium camemberti
can readily lose traits and quickly shift toward producing desirable aroma compounds. In addition to experimentally demonstrating a putative domestication pathway for
P. camemberti
, our work suggests that wild
Penicillium
isolates could be rapidly domesticated to produce new flavors and aesthetics in fermented foods.
Postpartum depression screening: are we doing a competent job?
Authors: Sudhanthar Sathyanarayan , Sheikh Zile-e-huma , Thakur Kripa
Published: October 2019

Postpartum depression (PPD) is one of the most common and severe postpartum morbidity, affecting 10%–20% of mothers within the first year of childbirth. The adverse effects of PPD, namely, prevention of mother-baby bonding and early cessation of breastfeeding, adversely affects infant growth and brain development. Studies have found that up to 50% of women with PPD go undiagnosed. Despite the American Academy of Pediatrics (AAP) recommendations, only a small percentage of paediatricians are currently screening for PPD. This project aimed to improve PPD screening using a validated tool to 75% in a primary care inner-city clinic serving a predominantly underserved population as per AAP recommendations. Baseline data for 40 charts of 2-month-old and 4-month-old well-child visits showed no documentation of PPD screening. The screening tool used for this project was the Edinburgh Postpartum Depression Scale (EPDS), which is a validated 10-item screening questionnaire for PPD. Three Plan-Do-Study-Act (PDSA) cycles were implemented involving educational strategies, system-based practice improvement and stakeholder participation. Improvement seen after PDSA cycle 1 was minimal. At the end of cycle 2, 16/50 (33%) charts had documentation of screening using EPDS. At the end of cycle 3, 33/40 (82%) charts had EPDS documentation, an increase of 49% from cycle 2. There were eight in total positive PPD screenings between cycles 2 and 3. These patients were provided counselling support through a social worker and referral services through the local community mental health organisation. We achieved more than our 75% target goal for PPD screening implementation at the residency clinic, thereby increasing residents’ awareness of PPD and the importance of PPD screening. Poststudy follow-up shows that screening was maintained at a higher rate but never reached 100%.
Gut microbiota of obese subjects with Prader-Willi syndrome is linked to metabolic health
Authors: Olsson Lisa M , Poitou Christine , Tremaroli Valentina , Coupaye Muriel , Aron-Wisnewsky Judith , Bäckhed Fredrik , Clément Karine , Caesar Robert
Published: October 2019

Objective

The gut microbiota has been implicated in the aetiology of obesity and associated comorbidities. Patients with Prader-Willi syndrome (PWS) are obese but partly protected against insulin resistance. We hypothesised that the gut microbiota of PWS patients differs from that of non-genetically obese controls and correlate to metabolic health. Therefore, here we used PWS as a model to study the role of gut microbiota in the prevention of metabolic complications linked to obesity.

Design

We conducted a case-control study with 17 adult PWS patients and 17 obese subjects matched for body fat mass index, gender and age. The subjects were metabolically characterised and faecal microbiota was profiled by 16S ribosomal RNA gene sequencing. The patients’ parents were used as a non-obese control group. Stool samples from two PWS patients and two obese controls were used for faecal microbiota transplantations in germ-free mice to examine the impact of the microbiota on glucose metabolism.

Results

The composition of the faecal microbiota in patients with PWS differed from that of obese controls, and was characterised by higher phylogenetic diversity and increased abundance of several taxa such asAkkermansia,Desulfovibrioand Archaea, and decreased abundance ofDorea. Microbial taxa prevalent in the PWS microbiota were associated with markers of insulin sensitivity. Improved insulin resistance of PWS was partly transmitted by faecal microbiota transplantations into germ-free mice.

Conclusion

The gut microbiota of PWS patients is similar to that of their non-obese parents and might play a role for the protection of PWS patients from metabolic complications.
Scientific frontiers in faecal microbiota transplantation: joint document of Asia-Pacific Association of Gastroenterology (APAGE) and Asia-Pacific Society for Digestive Endoscopy (APSDE)
Authors: Ng Siew C , Kamm Michael A , Yeoh Yun Kit , Chan Paul K S , Zuo Tao , Tang Whitney , Sood Ajit , Andoh Akira , Ohmiya Naoki , Zhou Yongjian , Ooi Choon Jin , Mahachai Varocha , Wu Chun-Ying , Zhang Faming , Sugano Kentaro , Chan Francis K L
Published: October 2019

Objective

The underlying microbial basis, predictors of therapeutic outcome and active constituent(s) of faecal microbiota transplantation (FMT) mediating benefit remain unknown. An international panel of experts presented key elements that will shape forthcoming FMT research and practice.

Design

Systematic search was performed, FMT literature was critically appraised and a 1-day round-table discussion was conducted to derive expert consensus on key issues in FMT research.

Results

16 experts convened and discussed five questions regarding (1) the role of donor and recipient microbial (bacteria, viruses, fungi) parameters in FMT; (2) methods to assess microbiota alterations; (3) concept of keystone species and microbial predictors of FMT, (4) influence of recipient profile and antibiotics pretreatment on FMT engraftment and maintenance and (5) new developments in FMT formulations and delivery. The panel considered that variable outcomes of FMT relate to compositional and functional differences in recipient’s microbiota, and likely donor-associated and recipient-associated physiological and genetic factors. Taxonomic composition of donor intestinal microbiota may influence the efficacy of FMT in recurrentClostridioides difficileinfections and UC. FMT not only alters bacteria composition but also establishes trans-kingdom equilibrium between gut fungi, viruses and bacteria to promote the recovery of microbial homeostasis. FMT is not a one size fits all and studies are required to identify microbial components that have specific effects in patients with different diseases.

Conclusion

FMT requires optimisation before their therapeutic promise can be evaluated for different diseases. This summary will guide future directions and priorities in advancement of the science and practice of FMT.
Psychosis and longitudinal outcomes in Huntington disease: the COHORT Study
Authors: Connors Michael H , Teixeira-Pinto Armando , Loy Clement T
Published: October 2019

Objective

Huntington disease (HD) is an autosomal dominant neurodegenerative disease involving motor disturbances, cognitive decline and psychiatric symptoms. Psychotic symptoms occur in a significant proportion of patients. We sought to characterise the clinical outcomes of this group of patients.

Methods

Data were drawn from the Cooperative Huntington Observational Research Trial, a prospective, multi-centre observational study. 1082 patients with HD were recruited. Measures of cognition, function, behavioural disturbance and motor function were completed annually over 5 years.

Results

Overall, 190 patients (17.6%) displayed psychotic symptoms. These patients demonstrated worse cognition, function and behavioural disturbances than patients without psychosis over time. Patients with psychosis also demonstrated lower levels of chorea than patients without psychosis, despite adjusting for concurrent antipsychotic and tetrabenazine use.

Conclusions

Psychosis in HD is associated with poorer outcomes in cognition, function and behavioural symptoms. Patients with psychotic symptoms may also have less chorea. Altogether, the findings suggest patients with psychosis have a distinct clinical course.
Dimethyl fumarate decreases neurofilament light chain in CSF and blood of treatment naïve relapsing MS patients
Authors: Sejbaek Tobias , Nielsen Helle Hvilsted , Penner Natasha , Plavina Tatiana , Mendoza Jason P , Martin Nellie Anne , Elkjaer Maria Louise , Ravnborg Mads Henrik , Illes Zsolt
Published: October 2019

Objectives

In a prospective phase IV trial of the first-line oral treatment dimethyl fumarate (DMF), we examined dynamics of neurofilament light (NFL) chain in serum, plasma and cerebrospinal fluid (CSF) samples collected over 12 months from relapsing-remitting multiple sclerosis (RRMS) patients. NFL changes were related to disease activity.

Methods

We examined NFL levels by single-molecule array in 88 CSF, 348 plasma and 131 sera from treatment-naïve RRMS patients (n=52), healthy controls (n=23) and a placebo group matched by age, sex and NFL (n=52). Plasma/sera were collected at baseline, and 1, 3, 6 and 12 months after DMF. CSF samples were collected at baseline and 12 months after DMF.

Results

NFL concentration in CSF, plasma and serum correlated highly (p<0.0001 for all), but plasma levels were only 76.9% of paired serum concentration. After 12 months of DMF treatment, NFL concentration decreased by 73%, 69% and 55% in the CSF, serum and plasma (p<0.0001, respectively). Significant reduction in blood was observed after 6 and 12 months treatment compared with baseline (p<0.01 and p<0.0001, respectively) and to placebo (p<0.0001). Patients with NFL above the 807.5 pg/mL cut-off in CSF had 5.0-times relative risk of disease activity (p<0.001).

Conclusions

This study provides Class II evidence that first-line DMF reduces NFL in both blood and CSF after 6 months and normalises CSF levels in 73% of patients. High NFL concentration in CSF after a year reflected disease activity. NFL levels were higher in serum than in plasma, which should be considered when NFL is used as a biomarker.
Ethnography of texts: a literature review of health and female homosexuality in Brazil
Authors: Rau Steuernagel Carolina , Engebretsen Eivind , Kristiansen Hans Wiggo , Moen Kåre
Published: October 2019

This paper reviews the literature on health and female homosexuality in Brazil and, along the way, outlines an alternative approach to reviewing academic literature. Rather than summarising the contents of previously published papers, we relate to these publications primarily as partakers in the creation of knowledge. Inspired by Actor-Network Theory (ANT), we apply ethnographic methods to understand the papers as study participants endowed with action. We also draw on the notions of inscription and intertextuality to trace the complex relationship between the findings in the articles and the realities outside of them. We claim that ‘evidence’ is the product of translational processes in which original events, such as experiments, blood tests and interviews, are changed into textual entities. In addition, text production is seen as an absorption of everything else surrounding its creation. When events are turned into articles, the text incorporates the political environment to which original events once belonged. We thus observe a political text inscribed into the written evidence of sexually transmitted infections, and the practice of publishing about scientific vulnerabilities emerges as political action. In contrast with traditional ways of reviewing literature in medical scholarship, this article offers a reminder that although there is a connection between textual evidence and the reality outside publications, these dimensions are not neutrally interchangeable.
Is baseline routine renal ultrasound indicated for all MS patients?
Authors: Títoff Igor B , Titoff Victoria , Scott Thomas F
Published: October 2019

Background

Most patients with multiple sclerosis (MS) develop multiple urological complaints due to hyperactive or hypoactive bladder, and may have detrusor-sphincter dyssynergia. Routine renal ultrasound (RUS) screening has been recommended for both symptomatic and asymptomatic MS patients; however, there is little data to support this practice.

Methods

Prospectively screened consecutive MS clinic patients in 2016–2017 with functional systems scores (FSS) indicating moderate to severe neurogenic bladder symptoms (FSS bladder ≥2) were sent for RUS. We also screened for history of urinary tract infections.

Results

872 patients were screened between 3 September 2016 and 13 April 2017. 58 patients met inclusion criteria for RUS. 6 were excluded due to non-compliance with testing or unavailability of results; 52 patients were imaged. Only 3/52 patients were found to have renal pathology requiring follow-up. Of those three, one had known symptomatic nephrolithiasis, and one had subsequently normal findings, leaving one patient newly found to have valid abnormal upper urinary tract (UUT) findings. Multiple incidental findings were also discovered.

Conclusion

The minimal yield for significant UUT pathology found in this enriched group of symptomatic MS patients indicates that RUS screening for asymptomatic MS patients without clear risk factors is not indicated. Red flags for high risk of UUT complications should be used as triggers for baseline RUS screening in MS patients.
Relationship between triglyceride levels and ischaemic stroke in elderly hypertensive patients
Authors: Huang Yu-Qing , Huang Jia-Yi , Liu Lin , Chen Chao-Lei , Yu Yu-Ling , Tang Song-tao , Zhang Bin , Feng Ying Qing
Published: October 2019

Background

Although hyperlipidaemia was a well-known risk factor for ischaemic stroke, the association between triglyceride and first ischaemic stroke remains uncertain.

Objectives

The present study attempted to explore the relationship between triglyceride and first ischaemic stroke in a Chinese community elderly patients with hypertension.

Methods and results

This was a retrospective cohort study. We enrolled 3249 consecutive elderly patients with hypertension from a community in China between January 2010 and December 2011. Patients were divided into four groups based on the quartiles of triglyceride. Multivariate Cox regression analysis, subgroup and interaction test were performed to evaluate the relationship between triglyceride and first ischaemic stroke. There were a total of 3249 participants including 1455 male and 1794 female, with a mean age of 71.36±7.18 years. At an average follow-up of 5.5 years, 205 patients were identified to have first ischaemic stroke. After adjustment for potential confounders, using the lowest quartiles of triglyceride as the reference, multivariable HR (95% CI) for first ischaemic stroke increased in parallel with the quartiles of triglyceride (HRs were 1.56 (95% CI 1.07 to 2.51), 1.74 (95% CI 1.07 to 2.84) and 1.85 (95% CI 1.05 to 2.89)) from the second to the fourth quartiles, respectively (p=0.002 for trend). Subgroup and interaction analysis showed that there was no interactive effect on triglyceride and first ischaemic stroke.

Conclusion

Triglyceride was an independent risk factor for first ischaemic stroke among Chinese elderly patients with hypertension.
Biomarkers of iron metabolism facilitate clinical diagnosis in Mycobacterium tuberculosis infection
Authors: Dai Youchao , Shan Wanshui , Yang Qianting , Guo Jiubiao , Zhai Rihong , Tang Xiaoping , Tang Lu , Tan Yaoju , Cai Yi , Chen Xinchun
Published: October 2019

Background

Perturbed iron homeostasis is a risk factor for tuberculosis (TB) progression and an indicator of TB treatment failure and mortality. Few studies have evaluated iron homeostasis as a TB diagnostic biomarker.

Methods

We recruited participants with TB, latent TB infection (LTBI), cured TB (RxTB), pneumonia (PN) and healthy controls (HCs). We measured serum levels of three iron biomarkers including serum iron, ferritin and transferrin, then established and validated our prediction model.

Results

We observed and verified that the three iron biomarker levels correlated with patient status (TB, HC, LTBI, RxTB or PN) and with the degree of lung damage and bacillary load in patients with TB. We then built a TB prediction model, neural network (NNET), incorporating the data of the three iron biomarkers. The model showed good performance for diagnosis of TB, with 83% (95% CI 77 to 87) sensitivity and 86% (95% CI 83 to 89) specificity in the training data set (n=663) and 70% (95% CI 58 to 79) sensitivity and 92% (95% CI 86 to 96) specificity in the test data set (n=220). The area under the curves (AUCs) of the NNET model to discriminate TB from HC, LTBI, RxTB and PN were all >0.83. Independent validation of the NNET model in a separate cohort (n=967) produced an AUC of 0.88 (95% CI 0.85 to 0.91) with 74% (95% CI 71 to 77) sensitivity and 92% (95% CI 87 to 96) specificity.

Conclusions

The established NNET TB prediction model discriminated TB from HC, LTBI, RxTB and PN in a large cohort of patients. This diagnostic assay may augment current TB diagnostics.
Evaluating tobacco retailer experience and compliance with a flavoured tobacco product restriction in Boston, Massachusetts: impact on product availability, advertisement and consumer demand
Authors: Kephart Lindsay , Setodji Claude , Pane Joseph , Shadel William , Song Glory , Robertson Jennifer , Harding Nikysha , Henley Patricia , Ursprung Wannakuwatte Waduge Sanouri
Published: October 2019

Background

Flavoured tobacco products are widely available in youth-accessible retailers and are associated with increased youth initiation and use. The city of Boston, Massachusetts restricted the sale of flavoured tobacco products, including cigars, smokeless tobacco and e-cigarettes, to adult-only retailers. This paper describes the impact of the restriction on product availability, advertisement and consumer demand.

Methods

Between January and December 2016, data were collected in 488 retailers in Boston at baseline and 469 retailers at 8-month follow-up, measuring the type, brand and flavour of tobacco products being sold. Process measures detailing the educational enforcement process, and retailer experience were also captured. McNemar tests and t-tests were used to assess the impact of the restriction on product availability.

Results

After policy implementation, only 14.4% of youth-accessible retailers sold flavoured products compared with 100% of retailers at baseline (p<0.001). Flavoured tobacco product advertisements decreased from being present at 58.9% of retailers to 28.0% at follow-up (p<0.001). Postimplementation, retailers sold fewer total flavoured products, with remaining products often considered as concept flavours (eg, jazz, blue). At follow-up, 64.0% of retailers reported that customers only asked for flavoured products a few times a week or did not ask at all. Retailers reported that educational visits and the flavoured product guidance list aided with compliance.

Conclusion

Tobacco retailers across Boston were largely in compliance with the regulation. Availability of flavoured tobacco products in youth-accessible retailers declined city-wide after policy implementation. Strong educational and enforcement infrastructure may greatly enhance retailer compliance.
Skew Poincaré–Birkhoff–Witt extensions over weak compatible rings
Authors: Reyes Armando , Suárez Héctor
Published: October 2019

In this paper, we introduce weak [Formula: see text]-compatible rings and study skew Poincaré–Birkhoff–Witt extensions over these rings. We characterize the weak notion of compatibility for several noncommutative rings appearing in noncommutative algebraic geometry and some quantum algebras of theoretical physics. As a consequence of our treatment, we unify and extend results in the literature about Ore extensions and skew PBW extensions over compatible rings.
Pesticide-Induced Planthopper Population Resurgence in Rice Cropping Systems
Authors: Wu Jincai , Ge Linquan , Liu Fang , Song Qisheng , Stanley David
Published: October 2019

Planthoppers are serious rice pests in Asia. Their population resurgence was first reported in the early 1960s, caused mainly by insecticides that indiscriminately killed beneficial arthropods and target pests. The subsequent resurgence involved two mechanisms, the loss of beneficial insects and insecticide-enhanced planthopper reproduction. In this review, we identify two forms of resurgence, acute and chronic. Acute resurgence is caused by traditional insecticides with rapid resurgence in the F1 generation. Chronic resurgence follows application of modern pesticides, including fungicides and herbicides, with low natural enemy toxicity, coupled with stimulated planthopper reproduction. The chemical-driven syndrome of changes leads to later resurgence in the F2 or later generations. Chronic resurgence poses new threats to global rice production. We review findings on the physiological and molecular mechanisms of chronic planthopper resurgence and suggest research directions that may help manage these new threats.
Global Trends in Bumble Bee Health
Authors: Cameron Sydney A. , Sadd Ben M.
Published: October 2019

Bumble bees ( Bombus) are unusually important pollinators, with approximately 260 wild species native to all biogeographic regions except sub-Saharan Africa, Australia, and New Zealand. As they are vitally important in natural ecosystems and to agricultural food production globally, the increase in reports of declining distribution and abundance over the past decade has led to an explosion of interest in bumble bee population decline. We summarize data on the threat status of wild bumble bee species across biogeographic regions, underscoring regions lacking assessment data. Focusing on data-rich studies, we also synthesize recent research on potential causes of population declines. There is evidence that habitat loss, changing climate, pathogen transmission, invasion of nonnative species, and pesticides, operating individually and in combination, negatively impact bumble bee health, and that effects may depend on species and locality. We distinguish between correlational and causal results, underscoring the importance of expanding experimental research beyond the study of two commercially available species to identify causal factors affecting the diversity of wild species.
The Prominent Role of HMGA Proteins in the Early Management of Gastrointestinal Cancers
Authors: Meireles Da Costa Nathalia , Ribeiro Pinto Luis Felipe , Nasciutti Luiz Eurico , Palumbo Jr. Antonio
Published: October 2019

GI tumors represent a heterogeneous group of neoplasms concerning their natural history and molecular alterations harbored. Nevertheless, these tumors share very high incidence and mortality rates worldwide and patients’ poor prognosis. Therefore, the identification of specific biomarkers could increase the development of personalized medicine, in order to improve GI cancer management. In this sense, HMGA family members (HMGA1 and HMGA2) comprise an important group of genes involved in the genesis and progression of malignant tumors. Additionally, it has also been reported that HMGA1 and HMGA2 display an important role in the detection and progression of GI tumors. In this way, HMGA family members could be used as reliable biomarkers able to efficiently track not only the tumor per se but also the main risk conditions related with their development of GI cancers in the future. Finally, it shall be a promising option to revert the current scenario, once HMGA genes and proteins could represent a convergence point in the complex landscape of GI tumors.