bluuebunny/crossref_metadata_2025 huggingface dataset:
Accuracy of serological testing for SARS‐CoV‐2 antibodies: First results of a large mixed‐method evaluation study
Authors: Brigger Daniel , Horn Michael P. , Pennington Luke F. , Powell Abigail E. , Siegrist Denise , Weber Benjamin , Engler Olivier , Piezzi Vanja , Damonti Lauro , Iseli Patricia , Hauser Christoph , Froehlich Tanja K. , Villiger Peter M. , Bachmann Martin F. , Leib Stephen L. , Bittel Pascal , Fiedler Martin , Largiadèr Carlo R. , Marschall Jonas , Stalder Hanspeter , Kim Peter S. , Jardetzky Theodore S. , Eggel Alexander , Nagler Michael
Published: September 2020

Background

Serological immunoassays that can identify protective immunity against SARS‐CoV‐2 are needed to adapt quarantine measures, assess vaccination responses, and evaluate donor plasma. To date, however, the utility of such immunoassays remains unclear. In a mixed‐design evaluation study, we compared the diagnostic accuracy of serological immunoassays that are based on various SARS‐CoV‐2 proteins and assessed the neutralizing activity of antibodies in patient sera.

Methods

Consecutive patients admitted with confirmed SARS‐CoV‐2 infection were prospectively followed alongside medical staff and biobank samples from winter 2018/2019. An in‐house enzyme‐linked immunosorbent assay utilizing recombinant receptor‐binding domain (RBD) of the SARS‐CoV‐2 spike protein was developed and compared to three commercially available enzyme‐linked immunosorbent assays (ELISAs) targeting the nucleoprotein (N), the S1 domain of the spike protein (S1), and a lateral flow immunoassay (LFI) based on full‐length spike protein. Neutralization assays with live SARS‐CoV‐2 were performed.

Results

One thousand four hundred and seventy‐seven individuals were included comprising 112 SARS‐CoV‐2 positives (defined as a positive real‐time PCR result; prevalence 7.6%). IgG seroconversion occurred between day 0 and day 21. While the ELISAs showed sensitivities of 88.4% for RBD, 89.3% for S1, and 72.9% for N protein, the specificity was above 94% for all tests. Out of 54 SARS‐CoV‐2 positive individuals, 96.3% showed full neutralization of live SARS‐CoV‐2 at serum dilutions ≥ 1:16, while none of the 6 SARS‐CoV‐2‐negative sera revealed neutralizing activity.

Conclusions

ELISAs targeting RBD and S1 protein of SARS‐CoV‐2 are promising immunoassays which shall be further evaluated in studies verifying diagnostic accuracy and protective immunity against SARS‐CoV‐2.
Social Dimensions of Health: Ritual Practice, Moral Orders, and Worlds of Meaning in Brazilian Candomblé and Umbanda Temples
Authors: Markus Wiencke
Published: September 2020

In Western medicine the interpretation prevails that mental illness is a psychological and/or biological disorder. Most important concepts in health psychology, such as sense of coherence, self‐efficacy, hope, or dispositional optimism are all very cognition and individual centered. In this individualized perspective, mental illness is constructed in such a way that it can be treated in a dyadic doctor–patient or therapist–patient relationship with the help of drugs or therapeutic techniques. In this article, I would like to develop a contrasting social construction of mental illness. In Umbanda and Candomblé temples in Brazil, what is interpreted in the Western model as illness is understood as a “spiritual problem.” Here, the individual is constructed in relationship to the community, and individual health and healing is footed in moral‐spiritual orders. In presenting the details of my investigation, I will apply Grawe’s common factors as a foil for developing the link between mental illness and its social context.
Ocular complications of oak processionary caterpillar setae in the Netherlands; case series, literature overview, national survey and treatment advice
Authors: Tan Matthew K. H. , Jalink Maarten B. , Sint Jago Naïlah F. M. , Ho Lintje , Arnold van Vliet J. H. , Das Tridib , de Faber Jan Tjeerd H. N. , Wisse Robert P. L.
Published: September 2020

During early summer 2019, the Netherlands experienced an outbreak of the exotic oak processionary caterpillar. The vast number of caterpillars, which live in large nests on oak trees before they turn into moths, possess thousands of small, barbed hairs (setae) that are disseminated with the wind. The hairs cause a range of primarily dermatologic problems. However, Dutch ophthalmologists started reporting patients with ophthalmologic complaints caused by the penetrating hairs of the oak processionary caterpillar. This paper focuses on the ophthalmologic complications caused by the caterpillar hairs. We collected a series of four cases with reports ranging from a corneal erosion with hairs lodged into the cornea, to a sterile endophthalmitis in which hairs were found in the vitreous. A literature review for similar cases was performed using the PubMed and Embase database. Together with the Dutch Ophthalmic Society (Nederlands Oogheelkundig Gezelschap, NOG), a national survey was issued to determine the scale of this new problem. This showed that oak processionary caterpillar related complaints are primarily limited to the south of the Netherlands. Suggested ophthalmic treatment guidelines are presented. With the next summer at the doorstep, and limited preventative measures against the caterpillar hairs, we expect a new wave of ophthalmologic complaints coming year as well.
Fitness‐associated substitutions following failure of direct‐acting antivirals assessed by deep sequencing of full‐length hepatitis C virus genomes
Authors: Fourati Slim , Rodriguez Christophe , Soulier Alexandre , Donati Flora , Hamadat Sabah , Poiteau Lila , Demontant Vanessa , Brillet Rozenn , Ahnou Nazim , Gricourt Guillaume , Chevaliez Stéphane , Ahmed‐Belkacem Abdelhakim , Pawlotsky Jean‐Michel
Published: September 2020

Background

In hepatitis C virus (HCV) infection, treatment failure is generally associated with the selection of resistance‐associated substitutions (RAS) conferring reduced susceptibility to direct‐acting antiviral (DAA) drugs. Resistant variants continue to replicate after the end of treatment with potential for transmission. This may result from the selection of “fitness‐associated substitutions”.

Aim

To characterise potential “fitness‐associated substitutions” in patients infected with genotype 3a failing DAA drugs

Methods

By means of shotgun metagenomics, we sequenced full‐length HCV genomes at treatment initiation and at virological relapse in eight patients infected with genotype 3a with cirrhosis failing sofosbuvir and an NS5A inhibitor. The impact of amino acid changes occurring outside of DAA target regions selected in at least two patients were assessed on the in vitro susceptibility to an NS5A inhibitor and replication capacity.

Results

At treatment failure, besides selection of known NS5A RASs, especially Y93H, a large number of amino acid changes was observed outside of DAA target regions. We identified four amino acid positions at which observed changes substantially improved in vitro replication capacity without affecting NS5A inhibitor susceptibility.

Conclusions

This is the first in vivo observation combined with in vitro confirmation of selection of phenotypically characterised “fitness‐associated substitutions” together with RASs at the time of sofosbuvir‐NS5A inhibitor treatment failure in patients infected with genotype 3a with cirrhosis. Our findings may explain the persistence of resistant HCV variants after treatment in patients who did not achieve sustained virological remission.
Does the time from symptom onset to surgery affect the outcomes of patients with acute appendicitis? A prospective cohort study of 255 patients
Authors: Jiang Li , Liu Zhonghui , Tong Xiaojun , Deng Yang , Liu Jianwen , Yang Xuefei , Chan Fion S.Y. , Fan Joe K.M.
Published: September 2020

Introduction

The objective of this study was to evaluate the impact of operative timing on outcomes of acute appendicitis.

Methods

This study examined adult patients who had presented to the hospital with acute appendicitis and had undergone appendectomy from December 2017 to February 2019. Time delay and outcomes of perforated and non‐perforated appendicitis were compared. Patients were classified into five groups based on the period from symptom onset to operation: group 1, <24 hours; group 2, ≥24 and <48 hours; group 3, ≥48 and <72 hours; group 4, ≥72 and <96 hours; and group 5, ≥96 hours. The five groups were compared, with risk of perforation assessed in particular.

Results

A total of 255 patients were included in the analysis. Symptom duration, operative time, and length of postoperative hospital stay (P < .001) were significantly longer in the perforated group (n = 49) than in the non‐perforated group (n = 206). The perforated group also had a higher conversion rate to open procedures (P = .002) and a higher rate of wound infection (P = .034). Group 1 had 53 patients, group 2 had 95 patients, group 3 had 57 patients, group 4 had 32 patients, and group 5 had 18 patients. The incidence of appendiceal perforation and median operative time progressively increased along with symptom duration in the five groups. In multivariate analyses, independent risk factors for appendiceal perforation were male gender (odds ratio = 2.33, 95% confidence interval [CI]: 1.07‐5.08) and symptom duration ≥48 hours (relative to ≥24 and <48 hours) (odds ratio = 4.64, 95%CI: 1.76‐12.27). Patients with symptom duration ≥72 hours had a significantly longer operative time than those with symptom duration ≥48 and <72 hours (β = 21.38, 95%CI: 5.66‐37.11, P = .008).

Conclusion

The risk of perforation increased significantly 48 hours after the onset of appendicitis. Symptoms duration ≥72 hours was associated with a longer operative time.
Anaphylaxis Refractory to intramuscular adrenaline during in‐hospital food challenges: A case series and proposed management
Authors: Alviani Cherry , Burrell Sarah , Macleod Abigail , Edees Susan , Roberts Graham , Turner Paul J , Erlewyn‐Lajeunesse Michel
Published: September 2020

Background

Anaphylaxis is a severe, systemic hypersensitivity reaction that can be potentially life‐threatening. Anaphylaxis during oral food challenge is not uncommon and can usually be effectively managed with intramuscular adrenaline as first line treatment. Although very rare, fatal anaphylaxis during in‐hospital food challenge has been reported.

Objective

We describe our experience of cases of refractory anaphylaxis at in‐hospital challenge and propose a framework for escalation of treatment in such cases using intravenous infusion of adrenaline which has been adopted for widespread use elsewhere.

Methods

We present four patients who all experienced severe life‐threatening anaphylaxis, refractory to intramuscular adrenaline treatment, during supervised oral food challenges. Patient data were collected from contemporaneous notes, and patient consent was obtained.

Results

In all four cases, the anaphylaxis reactions were amenable to treatment with low‐dose intravenous adrenaline, with no reported adverse effects.

Conclusion and clinical relevance

These cases demonstrate the need for clinicians undertaking higher risk allergen challenges to be able to manage cases of severe anaphylaxis refractory to intramuscular adrenaline, and to consider a framework for managing these reactions. While peripheral intravenous adrenaline infusions should always be initiated only in conjunction with expert input, the protocol suggested is simple enough to be undertaken within the hospital environment while more experienced support is obtained.
A prospective multicentre external validation study of the Liverpool Peritonsillar abscess Score (LPS) with a no‐examination COVID‐19 modification
Authors: Selwyn David , Yang Ding , Heward Elliot , Kerai Ashwin , Thompson Elinor , Shommakhi Abulgasem , Faulkner Scott , Siau Richard , Walijee Hussein , Hampton Tom , Chudek Dorota , Singhera Supriya , Din Waqas , Lau Andrew S.
Published: September 2020

Objectives

Our primary aim was to validate the Liverpool Peritonsillar abscess Score (LPS) externally in a new patient cohort. Our secondary aim was to modify the LPS in the light of the COVID‐19 pandemic to produce a no‐examination variant for use in this instance.

Design

Prospective multicentre external validation study.

Setting

Six different secondary care institutions across the United Kingdom.

Participants

Patients over 16 years old who were referred to ENT with any uncomplicated sore throat such a tonsillitis or peritonsillar abscess (PTA).

Main outcome measures

Sensitivity, specificity, positive predictive value and negative predictive value for both the original LPS model and the modified model for COVID‐19.

Results

The LPS model had sensitivity and specificity calculated at 98% and 79%, respectively. The LPS has a high negative predictive value (NPV) of 99%. The positive predictive value (PPV) was slightly lower at 63%. Receiver operating characteristic (ROC) curve, including the area under the curve (AUROC), was 0.888 which indicates very good accuracy.

Conclusions

External validation of the LPS against an independent geographically diverse population yields high NPV. This may support non‐specialist colleagues who may have concerns about mis‐diagnosing a PTA. The COVID‐19 modification of the LPS has a similar NPV, which may be of use where routine oral examination is to be avoided during the COVID‐19 pandemic.
How the diversity of human concepts of nature affects conservation of biodiversity
Authors: Ducarme Frédéric , Flipo Fabrice , Couvet Denis
Published: September 2020

Protecting nature has become a global concern. However, the very idea of nature is problematic. We examined the etymological and semantic diversity of the word used to translate nature in a conservation context in 76 of the primary languages of the world to identify the different relationships between humankind and nature. Surprisingly, the number of morphemes (distinct etymological roots) used by 7 billion people was low. Different linguistic superfamilies shared the same etymon across large cultural areas that correlate with the distribution of major religions. However, we found large differences in etymological meanings among these words, echoing the semantic differences and historical ambiguity of the contemporary European concept of nature. The principal current Western meaning of nature in environmental public policy, conservation science, and environmental ethics–that which is not a human artifact–appears to be relatively rare and recent and to contradict the vision of nature in most other cultures, including those of pre‐Christian Europe. To avoid implicit cultural bias and hegemony–and thus to be globally intelligible and effective–it behooves nature conservationists to take into account this semantic diversity when proposing conservation policies and implementing conservation practices.
Inferring Behavior From Partial Social Information Plays Little or No Role in the Cultural Transmission of Adaptive Traits
Authors: Atkinson Mark , Blakey Kirsten H. , Caldwell Christine A.
Published: September 2020

Many human cultural traits become increasingly beneficial as they are repeatedly transmitted, thanks to an accumulation of modifications made by successive generations. But how do later generations typically avoid modifications which revert traits to less beneficial forms already sampled and rejected by earlier generations? And how can later generations do so without direct exposure to their predecessors' behavior? One possibility is that learners are sensitive to cues of non‐random production in others' behavior, and that particular variants (e.g., those containing structural regularities unlikely to occur spontaneously) have been produced deliberately and with some effort. If this non‐random behavior is attributed to an informed strategy, then the learner may infer that apparent avoidance of certain possibilities indicates that these have already been sampled and rejected. This could potentially prevent performance plateaus resulting from learners modifying inherited behaviors randomly. We test this hypothesis in four experiments in which participants, either individually or in interacting dyads, attempt to locate rewards in a search grid, guided by partial information about another individual's experience of the task. We find that in some contexts, valid inferences about another's behavior can be made from partial information, and these inferences can be used in a way which facilitates trait adaptation. However, the benefit of these inferences appears to be limited, and in many contexts—including some which have the potential to make inferring the experience of another individual easier—there appears to be no benefit at all. We suggest that inferring previous behavior from partial social information plays a minimal role in the adaptation of cultural traits.
Usefulness of S‐O clip in endoscopic submucosal dissection of a colorectal tumor which progressed to the ileum
Authors: Ohnita Ken , Nakashiki Suguru , Nakashima Masahiro
Published: September 2020

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Wire‐loop technique as an effective method for endoscopic removal of a post‐operative dislocated stent
Authors: Tanisaka Yuki , Ryozawa Shomei , Mizuide Masafumi
Published: September 2020

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Quality of life in primary aldosteronism: A prospective observational study
Authors: Buffolo Fabrizio , Cavaglià Giovanni , Burrello Jacopo , Amongero Martina , Tetti Martina , Pecori Alessio , Sconfienza Elisa , Veglio Franco , Mulatero Paolo , Monticone Silvia
Published: September 2020

Background

Previous studies suggested that patients affected by primary aldosteronism (PA) have impaired quality of life (QOL) compared to the general population, but a direct comparison with patients affected by essential hypertension (EH) has never been performed. The aim of the study was to compare the QOL of patients affected by PA to the QOL of patients affected by EH.

Material and methods

We designed a prospective observational study comparing the QOL of patients with PA and carefully matched patients with EH before and after treatment. We recruited 70 patients with PA and 70 patients with EH, matched for age, sex, blood pressure levels and intensity of antihypertensive treatment. We assessed QOL at baseline and after specific treatment for PA or after optimization of medical therapy for patients with EH.

Results

Patients with PA displayed impaired QOL compared with the general healthy population, but similar to patients with EH. Both laparoscopic adrenalectomy and treatment with mineralocorticoid receptor antagonist allowed an improvement of QOL in patients with PA, that was more pronounced after surgical treatment. Optimization of blood pressure control by implementation of antihypertensive treatment (without MR antagonists) allowed a minimal improvement in only one of eight domains in patients with EH.

Conclusions

Patients with PA have impaired QOL, which is likely caused by uncontrolled hypertension and the effects of intensive antihypertensive treatment. Surgical and medical treatment of PA allows a significant improvement of QOL, by amelioration of blood pressure control and, after surgical treatment, by reduction of antihypertensive treatment.
VEGFR2 and VEGFA polymorphisms are not associated with an inferior prognosis in Caucasian patients with aggressive B‐cell lymphoma
Authors: Kaddu‐Mulindwa Dominic , Rosolowski Maciej , Ziepert Marita , Regitz Evi , Assmann Gunter , Bewarder Moritz , Held Gerhard , Pfreundschuh Michael , Bittenbring Jörg Thomas
Published: September 2020

Purpose

Previous published data showed an impact of single‐nucleotide polymorphisms in the VEGF A and VEGFR2 genes on the survival of patients with various malignancies, among others diffuse large B‐cell lymphoma (DLBCL).

Patients and Methods

We investigated the role of four VEGF‐A and two VEGFR‐2 gene polymorphisms on the outcome of 273 patients with diffuse large B‐cell lymphoma who were treated with R‐CHOP within a prospective, randomized trial of the German High‐Grade Non‐Hodgkin Lymphoma Study Group (DSHNHL). The genomic DNA samples were analyzed using commercial DNA Probes (Applied Biosystems, USA) to detect single‐nucleotide polymorphisms in the VEGF A rs699947, rs1570360, rs2010963, rs3025039 and rs1870377, and rs2305948 in the VEGFR2 receptor. Hundred healthy blood donors served as a control.

Results

There was no difference between the SNP allele frequencies in lymphoma patients compared to the control group for all investigated SNPs. None of the investigated SNPs was significantly associated with EFS or OS. After adjusting for the International Prognostic Index risk factors in a multivariate analysis, these results could be confirmed.

Conclusion

Single‐nucleotide polymorphisms of the VEGF and VEGFR2 were not associated with a worse outcome in Caucasian patients with DLBCL.
Outcomes of relapsed or refractory acute myeloid leukemia patients failing venetoclax‐based salvage therapies
Authors: Zucenka Andrius , Pileckyte Regina , Trociukas Igoris , Peceliunas Valdas , Vaitekenaite Vilmante , Maneikis Kazimieras , Davainis Linas , Zvirblis Tadas , Stoskus Mindaugas , Gineikiene Egle , Norvilas Rimvydas , Dirse Vaidas , Surauciute Agne , Zucenkiene Emile , Griskevicius Laimonas
Published: September 2020

Objectives and methods

We conducted a retrospective analysis to evaluate the outcomes of 28 heavily pretreated (median 3 (2‐6) treatment lines, sixteen (57%) allotransplanted) relapsed/refractory acute myeloid leukemia patients who had failed salvage venetoclax‐based therapies.

Results

The median age was 59 years (20‐80), 20 patients (71%) had ECOG 2‐4 status, and 18 patients (64%) were stratified to European Leukemia Network 2017 adverse risk group. The most common mutations were ASXL1 (21%), RUNX1 (18%), FLT3 ITD/TKD (18%), PTPN11 (15%), NRAS/KRAS (15%), and WT1 (15%). Twenty‐two patients (79%) received different post‐venetoclax salvage therapies with the overall response rate of 23% (complete remission + morphological leukemia‐free state). Three of six (50%) patients achieved complete remissions after therapy with venetoclax + actinomycin D ± low‐dose cytarabine. The remaining 6 patients did not receive any further salvage treatment mainly due to poor general condition. The median overall survival was 3.9 months for all patients (4.3 for those receiving post‐venetoclax salvage vs 1.3 months receiving palliative care alone, P < .001).

Conclusions

Though the remission rate and survival of patients failing venetoclax are poor, a small proportion of these R/R AML patients may still respond to cautious intensification of chemotherapy with venetoclax.
Muscle involvement in SARS‐CoV‐2 infection
Authors: Pitscheider Lea , Karolyi Mario , Burkert Francesco R. , Helbok Raimund , Wanschitz Julia V. , Horlings Corinne , Pawelka Erich , Omid Sara , Traugott Marianna , Seitz Tamara , Zoufaly Alexander , Lindeck‐Pozza Elisabeth , Wöll Ewald , Beer Ronny , Seiwald Stefanie , Bellmann‐Weiler Rosa , Hegen Harald , Löscher Wolfgang N.
Published: September 2020

Background and Purpose

Since the outbreak of the severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) pandemic, several reports indicated neurological involvement in COVID‐19 disease. Muscle involvement has also been reported as evidenced by creatine kinase (CK) elevations and reports of myalgia.

Methods

Creatine kinase, markers of inflammation, pre‐existing diseases and statin use were extracted from records of Austrian hospitalised COVID‐19 patients. Disease severity was classified as severe in case of intensive care unit (ICU) admission or mortality. COVID‐19 patients were additionally compared to an historical group of hospitalised influenza patients.

Results

Three hundred fifty‐one patients with SARS‐CoV‐2 and 258 with influenza were included in the final analysis. CK was elevated in 27% of COVID‐19 and in 28% of influenza patients. CK was higher in severe COVID‐19 as were markers of inflammation. CK correlated significantly with inflammation markers, which had an independent impact on CK when adjusted for demographic variables and disease severity. Compared to influenza patients, COVID‐19 patients were older, more frequently male, had more comorbidities, and more frequently had a severe disease course. Nevertheless, influenza patients had higher baseline CK than COVID‐19, and 35.7% of intensive care unit (ICU)‐admitted patients had CK levels >1,000 U/L compared to only 4.7% of ICU‐admitted COVID‐19 patients.

Conclusions

HyperCKemia occurs in a similar frequency in COVID‐19 and influenza infection. CK levels were lower in COVID‐19 than in influenza in mild and severe disease. CK levels strongly correlate with disease severity and markers of inflammation. To date, it remains unclear whether hyperCKemia is due to a virus‐triggered inflammatory response or direct muscle toxicity.
Retrofitting coal‐fired power plants with biomass co‐firing and carbon capture and storage for net zero carbon emission: A plant‐by‐plant assessment framework
Authors: Wang Rui , Chang Shiyan , Cui Xueqin , Li Jin , Ma Linwei , Kumar Amit , Nie Yaoyu , Cai Wenjia
Published: September 2020

The targets of limiting global warming levels below 2°C or even 1.5°C set by Paris Agreement heavily rely on bioenergy with carbon capture and storage (BECCS), which can remove carbon dioxide in the atmosphere and achieve net zero greenhouse gas (GHG) emission. Biomass and coal co‐firing with CCS is one of BECCS technologies, as well as a pathway to achieve low carbon transformation and upgrading through retrofitting coal power plants. However, few studies have considered co‐firing ratio of biomass to coal based on each specific coal power plant's characteristic information such as location, installed capacity, resources allocation, and logistic transportation. Therefore, there is a need to understand whether it is worth retrofitting any individual coal power plant for the benefit of GHG emission reduction. It is also important to understand which power plant is suitable for retrofit and the associated co‐firing ratio. In order to fulfill this gap, this paper develops a framework to solve these questions, which mainly include three steps. First, biomass resources are assessed at 1 km spatial resolution with the help of the Geography Information Science method. Second, by setting biomass collection points and linear program model, resource allocation and supply chain for each power plants are complete. Third, is by assessing the life‐cycle emission for each power plant. In this study, Hubei Province in China is taken as the research area and study case. The main conclusions are as follows: (a) biomass co‐firing ratio for each CCS coal power plant to achieve carbon neutral is between 40% and 50%; (b) lower co‐firing ratio sometimes may obtain better carbon emission reduction benefits; (c) even the same installed capacity power plants should consider differentiated retrofit strategy according to their own characteristic. Based on the results and analysis above, retrofit suggestions for each power plant are made in the discussion.
Association between cognitive reserve dimensions and frailty among older adults: A structured narrative review
Authors: Sardella Alberto , Catalano Antonino , Lenzo Vittorio , Bellone Federica , Corica Francesco , Quattropani Maria C , Basile Giorgio
Published: September 2020

Frailty is a broadly investigated geriatric condition, which is characterized by an increased vulnerability to stressors. It represents an extremely relevant public health issue, increasingly conceptualized in a multidimensional perspective. The concept of cognitive reserve (CR), as originally conceptualized by Stern, has been developed in the past decades as a potential factor able to determine individual differences in cognitive vulnerability and trajectories occurring with aging. Our purpose was to provide a comprehensive review of the literature exploring the relationship between CR dimensions, selected according to the Stern model, and frailty status. A review of the literature on the association between potential CR dimensions and frailty was carried out through PubMed, Web of Knowledge and Scopus. CR expressed in terms of education, occupation, premorbid intelligence quotient and leisure time activities was associated with frailty in both cross‐sectional and longitudinal observations. The majority of reviewed evidence suggests a potential protective role of CR factors against the onset and the worsening of frailty among older adults. To the best of our knowledge, this is the first attempt to provide a comprehensive overview regarding the association between CR dimensions and frailty. Education, occupation, premorbid intelligence quotient and leisure time activities are able to interact with the general concept of frailty, rather than simply affecting the cognitive trajectory towards dementia. The lack of a unique and operationalized approach to the assessment of CR, as well as the wide heterogeneity of frailty evaluation tools and criteria, denote some methodological critical issues that need to be overcome. Geriatr Gerontol Int 2020; 20: 1005–1023..
Pruritus: Is there a grain of salty truth?
Authors: Penny Jarrin D. , Salerno Fabio R. , Akbari Alireza , McIntyre Christopher W.
Published: September 2020

Hemodialysis patients characteristically suffer from a range of unpleasant symptoms. Uremic pruritus effects close to half of the chronic kidney disease population, reducing quality of life and associated with increased mortality. Its pathophysiology though is poorly understood; currently deployed therapeutic approaches are ineffective. Excessive levels of skin and soft tissue sodium accumulate in dialysis patients, producing a range of biological consequences, including inflammation. We report an index case of a hemodialysis patient with debilitating pruritus and extreme levels of tissue sodium, measured with Sodium‐23 magnetic resonance imaging. Both the tissue sodium loading and pruritus responded fully to initiation of expanded hemodialysis therapy with a recently introduced medium cutoff dialysis membrane‐based dialyzer.
Immigrant Men’s Labour Market Incorporation in South Africa: Regional and National Origin Differences
Authors: Souza Emmanuel F. , Flippen Chenoa A.
Published: September 2020

This study explores the process of labour market incorporation among migrant men in South Africa, which has become a magnet for regional immigration in recent decades. Using 2011 Census data, we compare the employment rates, class of worker, occupation and income of black African immigrants, by region of origin, to black South African‐born internal migrants, and examine how these outcomes are associated with various forms of human capital. Results show that, overall, immigrant men enjoy higher employment levels compared to internal migrants. However, this immigrant employment advantage does not extend into other labour market outcomes. Immigrant men are over‐represented in the informal sector, which contributes to generally lower income relative to South Africans. The returns to education are also markedly lower for immigrants than for their internal migrant counterparts. Results also highlight variations across regional and national origin groups, with better‐resourced groups exhibiting more favourable outcomes than longer‐established but lower‐skilled co‐ethnic communities.
Cellular expression of DNA damage/repair and reactive oxygen/nitrogen species in human periodontitis and peri‐implantitis lesions
Authors: Dionigi Carlotta , Larsson Lena , Carcuac Olivier , Berglundh Tord
Published: September 2020

Aim of the study

To evaluate differences in the cellular expression of DNA damage/repair and reactive oxygen/nitrogen species between human periodontitis and peri‐implantitis lesions.

Material and methods

40 patients presenting with generalized severe periodontitis and 40 patients with severe peri‐implantitis were included. Soft tissue biopsies were collected from diseased sites in conjunction with surgical therapy and prepared for histological analysis. Four regions of interest were identified: the pocket epithelium (PE), the infiltrated connective tissue (ICT), which was divided into one inner area facing the PE (ICT‐1) and one outer area (ICT‐2). A non‐infiltrated connective tissue area (NCT) lateral of the ICT was also selected.

Results

It was demonstrated that the ICT of peri‐implantitis specimens was considerably larger and contained significantly larger area proportions and densities of CD68‐, MPO‐ and iNOS‐positive cells than that of periodontitis samples. Cellular densities were overall higher in the inner ICT zone lateral of the PE (ICT‐1) than in the outer ICT compartment (ICT‐2). While the NCT area lateral of the ICT comprised significantly larger proportions and densities of y‐H2AX‐, iNOS‐, NOX2‐, MPO‐ and PAD4/MPO‐positive cells in peri‐implantitis than in periodontitis sites, a reverse difference was noted for the area proportion and density of 8‐OHdG‐positive cells in the PE.

Conclusions

It is suggested that peri‐implantitis lesions are associated with an enhanced and upregulated host response and contain larger numbers of neutrophils, macrophages and iNOS‐positive cells than periodontitis lesions.
Periodontitis and risk of prevalent and incident coronary heart disease events
Authors: Winning Lewis , Patterson Christopher C. , Linden Katie , Evans Alun , Yarnel John , McKeown Pascal P. , Kee Frank , Linden Gerard J.
Published: September 2020

Objective

To investigate periodontitis as a risk factor for prevalent and incident coronary heart disease (CHD) in a group of middle‐aged men from Northern Ireland.

Methods

A representative sample of 1400 dentate men had a comprehensive periodontal examination between 2001 and 2003. Prevalent and incident CHD events were validated by independent cardiologists. Logistic regression was used to assess the cross‐sectional relationship between periodontitis and prevalent CHD and Cox's proportional hazards analysis to assess the longitudinal relationship between periodontitis and incident CHD.

Results

The mean age of the men at baseline was 63.7 (SD 3.0) years. Of the 1400 men examined, 126 (9%) had prevalent CHD. After adjusting for confounding variables, men with highest mean CAL (Q4) had an odds ratio of 2.15 (95% CI 1.15–4.02), p = 0.02 for prevalent CHD in comparison to men with the lowest CAL (Q1). During a median follow‐up of 12.7 years, 137 (10.8%) of the 1274 men free of CHD at baseline had an incident CHD event. After adjusting for confounding variables, the hazard ratio for incident CHD in men in Q4 versus Q1 CAL categories was 1.36 (95% CI 0.81–2.29), p = 0.24.

Conclusions

In this group of dentate men, periodontitis was associated with prevalent CHD. However, there was no association with incident CHD.
Primary cutaneous peripheral T‐cell lymphoma, not otherwise specified: results of a multicentre European Organization for Research and Treatment of Cancer (EORTC) cutaneous lymphoma taskforce study on the clinico‐pathological and prognostic features
Authors: Kempf W. , Mitteldorf C. , Battistella M. , Willemze R. , Cerroni L. , Santucci M. , Geissinger E. , Jansen P. , Vermeer M.H. , Marschalko M. , Papadavid E. , Piris M.A. , Ortiz‐Romero P.L. , Novelli M. , Paulli M. , Quaglino P. , Ranki A. , Rodríguez Peralto J.L. , Wobser M. , Auschra B. , Robson A.
Published: September 2020

Background

Cutaneous peripheral T‐cell lymphoma, not otherwise specified (PTL NOS) is an aggressive, but poorly characterized neoplasm.

Objectives

The European Organization for Research and Treatment of Cancer cutaneous lymphoma taskforce (EORTC CLTF) investigated 33 biopsies of 30 patients with primary cutaneous PTL NOS to analyse their clinical, histological, immunophenotypic features and outcome.

Methods

Retrospective analysis of clinical data and histopathological features by an expert panel.

Results

Cutaneous PTL NOS manifested clinically either with solitary or disseminated rapidly grown ulcerated tumours or disseminated papulo‐nodular lesions. Histologically, a mostly diffuse or nodular infiltrate in the dermis and often extending into the subcutis was found. Epidermotropism was rarely present and only mild and focal. Unusual phenotypes were frequent, e.g. CD3+/CD4−/CD8− and CD3+/CD4+/CD8+. Moreover, 18% of the cases exhibited an aberrant expression of the B‐cell marker CD20 by the tumour cells. All solitary tumours were located on the limbs and presented a high expression of GATA‐3 but this did not correlate with outcome and therefore could not serve as a prognostic factor. The prognosis was shown to be generally poor with 10 of 30 patients (33%) dying of lymphoma within the follow‐up of 36 months (mean value; range 3–144). The survival rates were 61% after 3 years (CI, 43–85%) and 54% after 5 years (CI, 36–81%). Small to medium‐sized morphology of tumour cells was associated with a better outcome than medium to large or large tumour cells. Age, gender, clinical stage, CD4/CD8 phenotype and GATA‐3 expression were not associated with prognosis. Chemotherapy was the most common treatment modality, but surgical excision and/or radiotherapy may represent an appropriate first‐line treatment for solitary lesions.

Conclusions

Cutaneous PTL NOS shows an aggressive course in most patients independent of initial presentation, age and phenotype. Cytomorphology was identified as a prognostic factor. The data indicate a need for more effective treatment modalities in PTL NOS.
Impact of Wnt/β‐catenin signaling on ethanol‐induced changes in brain endothelial cell permeability
Authors: Laksitorini Marlyn D. , Yathindranath Vinith , Xiong Wei , Parkinson Fiona E. , Thliveris James A. , Miller Donald W.
Published: September 2020

Chronic exposure to ethanol is associated with enhanced leakiness in the brain microvessel endothelial cells that form the blood–brain barrier (BBB). As previous studies suggested Wnt/β‐catenin signaling could improve the BBB phenotype of brain endothelial cells, we examined the extent to which Wnt signaling is altered following ethanol exposure, using both a cell culture model of the BBB and mice exposed to ethanol, and the ability of Wnt activation to reverse the permeability effects of ethanol. The human brain endothelial cells, hCMEC/D3, were exposed to ethanol (17–200 mM) for various periods of time (0–96 hr) and Wnt signaling, as well as expression of downstream genes influencing BBB integrity in the cell monolayers were monitored. Determination of Wnt signaling in both brain homogenates and brain microvessels from mice exposed to ethanol was also performed. The effects of ethanol on the permeability of the hCMEC/D3 monolayers were examined using both small molecular weight (sodium fluorescein) and large molecular weight (IRdye 800CW PEG) fluorescent markers. Exposure of hCMEC/D3 to ethanol (50 mM) caused a down‐regulation of Wnt/β‐catenin signaling, a reduction of tight junction protein expression and up‐regulation of plasmalemma vesicle associated protein (PLVAP). A similar reduction in Wnt/β‐catenin activity in both cortical brain homogenates and isolated cortical cerebral microvessels were observed in mice. Other areas such as cerebellum and striatum displayed as much as 3–6 fold increases in Dkk‐1, an endogenous Wnt inhibitor. Ethanol exposure caused significant changes in both sodium fluorescein and IRdye 800CW PEG permeability (2‐fold compared to control). The ethanol‐induced increases in permeability were attenuated by treatment with known Wnt activators (i.e. LiCl or Wnt3a). Additional screens of CNS active agents with possible Wnt activity indicated fluoxetine could also prevent the permeability effects of ethanol. These studies suggest that ethanol‐induced changes in brain microvessel permeability can be reversed through activation of Wnt signaling.

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The European Portuguese version of the insomnia severity index
Authors: Clemente Vanda , Ruivo Marques Daniel , Miller‐Mendes Mariana , Morin Charles M. , Serra Joana , Allen Gomes Ana
Published: September 2020

Insomnia is the most prevalent sleep complaint, but remains largely an unidentified public health issue. The Insomnia Severity Index (ISI) is a brief self‐report questionnaire to assess insomnia, long‐established both in clinical and research settings. The present study aimed to analyse the reliability, validity, and accuracy of the ISI European Portuguese version. After the translation protocol, 1,274 participants (65.54% female), with a mean (SD, range) age of 37.52 (16.82, 18–95) years, completed the ISI. This sample included 250 patients with insomnia from a Sleep Medicine Centre, presenting a diagnosis of insomnia disorder (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; International Classification of Sleep Disorders, Third Edition), and 1,024 individuals from the community. A group of 30 patients with obstructive sleep apnea (OSA) was also recruited. Cronbach’s α was 0.88 (internal consistency), and corrected item‐total correlations ranged from 0.56 to 0.83. An exploratory factor analysis (oblique rotation) revealed a two‐factor solution for both clinical and community samples. The ISI total score significantly differentiated insomnia disorder, no insomnia, and OSA subgroups with a large effect size (η 2 = 0.42). The correlation between ISI and Pittsburgh Sleep Quality Index supported concurrent validity (0.82), and discriminant validity was confirmed by a moderate correlation between ISI and Beck Depression Inventory Second Edition (0.32). The area under the curve was 0.88, and the optimal cut‐off to detect clinical insomnia was 14 (82.1% sensitivity, 79.5% specificity). In conclusion, the Portuguese version of the ISI is a reliable and valid measure of insomnia in clinical and non‐clinical populations. Our present study also contributes to relevant data for the international literature regarding the cut‐off score of the scale for the detection of clinical insomnia.
MAFLD identifies patients with significant hepatic fibrosis better than NAFLD
Authors: Yamamura Sakura , Eslam Mohammed , Kawaguchi Takumi , Tsutsumi Tsubasa , Nakano Dan , Yoshinaga Shinobu , Takahashi Hirokazu , Anzai Keizo , George Jacob , Torimura Takuji
Published: September 2020

Background & Aims

Diagnostic criteria for metabolic associated fatty liver disease (MAFLD) have been proposed, but not validated. We aimed to compare the diagnostic accuracy of the MAFLD definition vs the existing NAFLD criteria to identify patients with significant fibrosis and to characterize the impact of mild alcohol intake.

Methods

We enrolled 765 Japanese patients with fatty liver (median age 54 years). MAFLD and NAFLD were diagnosed in 79.6% and 70.7% of patients respectively. Significant fibrosis was defined by FIB‐4 index ≥1.3 and liver stiffness ≥6.6 kPa using shear wave elastography. Mild alcohol intake was defined as <20 g/day. Factors associated with significant fibrosis were analysed by logistic regression and decision‐tree analyses.

Results

Liver stiffness was higher in MAFLD compared to NAFLD (7.7 vs 6.8 kPa, P = .0010). In logistic regression, MAFLD (OR 4.401; 95% CI 2.144‐10.629; P < .0001), alcohol intake (OR 1.761; 95% CI 1.081‐2.853; P = .0234), and NAFLD (OR 1.721; 95%CI 1.009‐2.951; P = .0463) were independently associated with significant fibrosis. By decision‐tree analysis, MAFLD, but not NAFLD or alcohol consumption was the initial classifier for significant fibrosis. The sensitivity for detecting significant fibrosis was higher for MAFLD than NAFLD (93.9% vs 73.0%). In patients with MAFLD, even mild alcohol intake was associated with an increase in the prevalence of significant fibrosis (25.0% vs 15.5%; P = .0181).

Conclusions

The MAFLD definition better identifies a group with fatty liver and significant fibrosis evaluated by non‐invasive tests. Moreover, in patients with MAFLD, even mild alcohol consumption is associated with worsening of hepatic fibrosis measures.
The nature of the CM parent asteroid regolith based on cosmic ray exposure ages
Authors: Zolensky Michael E. , Takenouchi Atsushi , Mikouchi Takashi , Gregory Timothy , Nishiizumi Kunihiko , Caffee Marc W. , Velbel Michael A. , Ross Daniel K. , Zolensky Andrew , Le Loan , Imae Naoya , Yamaguchi Akira
Published: September 2020

Cosmic ray exposure (CRE) ages of CM chondrites have been found to have multiple peaks (as many as four), in stark contrast to other groups of chondrites (Nishiizumi and Caffee 2012; Herzog and Caffee 2014). In this study, we sought correlations between the CRE ages and petrography of CM chondrites, and we conclude that the degree of aqueous alteration does appear to vary with the CRE ages—the CMs displaying the most aqueous alteration all have relatively short exposure ages. However, some CMs with low degrees of alteration also have short exposure ages—thus, this apparent correlation is not exclusive. We also found a definite inverse relation between the number of distinctive lithologies in a CM and its exposure age, which could indicate different responses of homogeneous and heterogeneous meteoroids to the space environment between their onset of exposure (exhumation and ejection from the parent body) and arrival at Earth. Breccias have more internal surfaces of lithologic discontinuity, possibly resulting in weaker meteoroids that disintegrate more readily than their more homogeneous counterparts. Our results suggest that CM chondrite regoliths consist of numerous genomict lithologies in a breccia with millimeter‐ to decimeter‐scale clasts, with varying degree of heating/metamorphism.
Hf‐W chronology of a macrochondrule from the L5/6 chondrite Northwest Africa 8192
Authors: Hellmann Jan L. , Kruijer Thomas S. , Metzler Knut , Patzek Markus , Pack Andreas , Berndt Jasper , Kleine Thorsten
Published: September 2020

A large, igneous‐textured, and 2 cm‐sized spherical object from the L5/6 chondrite NWA 8192 was investigated for its chemical composition, petrography, O isotopic composition, and Hf‐W chronology. The petrography and chemical data indicate that this object closely resembles commonly found chondrules in ordinary chondrites and is therefore classified as a “macrochondrule.* As a result of metal loss during its formation, the macrochondrule exhibits elevated Hf/W, which makes it possible to date this object using the short‐lived 182Hf‐182W system. The Hf‐W data provide a two‐stage model age for metal–silicate fractionation of 1.4 ± 0.6 Ma after Ca‐Al‐rich inclusion (CAI) formation, indicating that the macrochondrule formed coevally to normal‐sized chondrules from ordinary chondrites. By contrast, Hf‐W data for metal from the host chondrite yield a younger model age of ~11 Ma after CAIs. This younger age agrees with Hf‐W ages of other type 5–6 ordinary chondrites, and corresponds to the time of cooling below the Hf‐W closure temperature during thermal metamorphism on the parent body. The Hf‐W model age difference between the macrochondrule and the host metal demonstrates that the Hf‐W systematics of the bulk macrochondrule were not disturbed during thermal metamorphism, and therefore, that the formation age of such objects can still be determined even in strongly metamorphosed samples. Collectively, this study illustrates that chondrule formation was not limited to mm‐size objects, implying that the rarity of macrochondrules reflects either that this process was very inefficient, that subsequent nebular size‐sorting decimated large chondrules, or that large precursors were rare.
A two‐sector neo‐Kaleckian model of growth and distribution: Investment allocation and evolutionary dynamics
Authors: Azevedo Araujo Ricardo , Drumond Carlos Eduardo
Published: September 2020

This paper focuses on the two‐sector neo‐Kaleckian model of growth and distribution that was developed by Dutt (1990) and challenged by Park (1995). We develop a variant of this model, focusing on the supply‐side to solve the overdetermination problem that was raised by Park. Finally, we introduce evolutionary dynamics to model the investment flows between the capital and consumer goods sectors. In this setup, the sectoral profit rates and the size of capital stocks wield an essential role upon the entrepreneur’s decision on which sector to invest in. This model is perfectly determined and it generates a stable evolutionary equilibrium over the long term.