bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Carbohydrate Mouth Rinsing on Upper Body Resistance Exercise Performance
Authors: Krings Ben M. , Shepherd Brandon D. , Waldman Hunter S. , McAllister Matthew J. , Smith JohnEric W.
Published: September 2019

Carbohydrate mouth rinsing has been shown to enhance aerobic exercise performance, but there is limited research with resistance exercise (RE). Therefore, the purpose of this investigation was to examine the effects of carbohydrate mouth rinsing during a high-volume upper body RE protocol on performance, heart rate responses, ratings of perceived exertion, and felt arousal. Recreationally experienced resistance-trained males (N = 17, age: 21 ± 1 years, height: 177.3 ± 5.2 cm, mass: 83.5 ± 9.3 kg) completed three experimental sessions, with the first serving as familiarization to the RE protocol. During the final two trials, the participants rinsed a 25-ml solution containing either a 6% carbohydrate solution or an artificially flavored placebo in a randomized, counterbalanced, and double-blinded fashion. The participants rinsed a total of nine times immediately before beginning the protocol and 20 s before repetitions to failure with the exercises bench press, bent-over row, incline bench press, close-grip row, hammer curls, skull crushers (all completed at 70% one-repetition maximum), push-ups, and pull-ups. Heart rate, ratings of perceived exertion, and felt arousal were measured at the baseline and immediately after each set of repetitions to failure. There were no differences for the total repetitions completed (carbohydrate = 203 ± 25 repetitions vs. placebo = 201 ± 23 repetitions, p = .46, Cohen’s d = 0.10). No treatment differences were observed for heart rate, ratings of perceived exertion, or felt arousal (p > .05). Although carbohydrate mouth rinsing has been shown to be effective in increasing aerobic performance, the results from this investigation show no benefit in RE performance in resistance-trained males.
Predicting Fan Behavior Through Egocentric Network Analysis: Examining Season-Ticket Holder Renewal
Authors: Katz Matthew , Heere Bob , Melton E. Nicole
Published: September 2019

The purpose of this study is to utilize egocentric network analysis to predict repurchase behaviors for college football season-ticket holders. Using a research approach grounded in network theory, we included the relational and behavioral characteristics of sport fans in a binomial regression model to predict renewal decisions among college football season-ticket holders. More specifically, we developed a model that incorporates the egocentric network variables, past behavior, and behavioral intentions to empirically test which consumer characteristics predict future behavior. Building on previous research emphasizing the role of socializing agents and social connections in sport fan consumption, through the use of egocentric network analysis, we examined the effects of social structure and social context on repurchasing decisions. Moreover, the present study is positioned within the larger discourse on season-ticket holders, as we aimed to add a network theory perspective to the existing research on season-ticket holder churn and renewal.
The Impact of a Foot-Toe Orthosis on Dynamic Balance: An Exploratory Randomized Control Trial
Authors: Kelly Adam , Stanek Justin
Published: October 2019

Context:The influence of custom and over-the-counter foot orthoses on dynamic balance has been investigated in the past. However, there has not been an exploration of the use of a foot-toe orthosis for improving balance. The ability of clinicians to influence balance could have important implications for injury prevention and rehabilitation.Objective:To determine the impact of a foot-toe orthosis on dynamic balance in healthy, young adults.Design:Randomized control trial.Setting:Athletic training laboratory.Participants:In total, 64 healthy, recreationally active participants aged 18–29 years were randomly allocated to one of the following groups: the foot-toe orthosis and laboratory-issued shoe group, the laboratory-issued shoe only (SO) group, or the control group.Interventions:Subjects in the intervention group wore the foot-toe orthosis and laboratory-issued shoe with activities of daily living for 4 weeks. Subjects in the SO intervention group wore the laboratory-issued shoe with activities of daily living for 4 weeks. Participants in the control group did not receive any intervention.Main Outcome Measures:The instrumented version of the Star Excursion Balance Test, known as the Lower Quarter Y-Balance Test, was used to quantify the dynamic balance at baseline and follow-up. Reaches were normalized for leg length.Results:There were statistically significant differences in postintervention scores on the Lower Quarter Y-Balance Test for both the dominant (P = .03, effect size = 0.84; 95% confidence interval, 0.25 to 1.43) and nondominant (P = .002, effect size = 0.74; 95% confidence interval, 0.15 to 1.32) legs when comparing dynamic balance scores of the foot-toe orthosis and laboratory-issued shoe group with the SO and control groups. No significant differences were observed when comparing dynamic balance between the SO and control groups.Conclusions:A 4-week intervention with a foot-toe orthosis and laboratory-issued shoe resulted in improved dynamic balance in a healthy young adult population. These findings suggest a novel intervention for increasing balance.
Quantizing single-molecule surface-enhanced Raman scattering with DNA origami metamolecules
Authors: Fang Weina , Jia Sisi , Chao Jie , Wang Liqian , Duan Xiaoyang , Liu Huajie , Li Qian , Zuo Xiaolei , Wang Lihua , Wang Lianhui , Liu Na , Fan Chunhai
Published: September 2019

Plasmonic nanostructures supporting strong spatially confined field enhancement are developed to probe single-molecule SERS.
Stiff isotropic lattices beyond the Maxwell criterion
Authors: Chen Wen , Watts Seth , Jackson Julie A. , Smith William L. , Tortorelli Daniel A. , Spadaccini Christopher M.
Published: September 2019

We validate the predicted performance of new lattice materials that are stiff despite appearing to violate the Maxwell criterion.
Photoswitchable single-walled carbon nanotubes for super-resolution microscopy in the near-infrared
Authors: Godin Antoine G. , Setaro Antonio , Gandil Morgane , Haag Rainer , Adeli Mohsen , Reich Stephanie , Cognet Laurent
Published: September 2019

Single-molecule photoswitchable emitters are demonstrated in the near-infrared based on single-wall carbon nanotube hybrids.
How do phonons relax molecular spins?
Authors: Lunghi Alessandro , Sanvito Stefano
Published: September 2019

The intramolecular components of acoustic phonons and the Zeeman interaction make electronic spins relax in an external field.
Spin-orbit torque–driven propagating spin waves
Authors: Fulara H. , Zahedinejad M. , Khymyn R. , Awad A. A. , Muralidhar S. , Dvornik M. , Åkerman J.
Published: September 2019

Propagating spin waves generated by a metal-based spin Hall nano-oscillator for highly energy-efficient spin wave technology.
Safety, Pharmacokinetics, and Antiviral Activity of AT-527, a Novel Purine Nucleotide Prodrug, in Hepatitis C Virus-Infected Subjects with or without Cirrhosis
Authors: Berliba Elina , Bogus Maxim , Vanhoutte Frédéric , Berghmans Pieter-Jan , Good Steven S. , Moussa Adel , Pietropaolo Keith , Murphy Robert L. , Zhou Xiao-Jian , Sommadossi Jean-Pierre
Published: October 2019

AT-527 is a novel modified guanosine nucleotide prodrug inhibitor of the hepatitis C virus (HCV) NS5B polymerase, with increased
in vitro
antiviral activity compared to sofosbuvir and a highly differentiated favorable preclinical profile compared to other anti-HCV nucleoside/nucleotide analogs.
The Polyamine Spermidine Modulates the Production of the Bacterial Genotoxin Colibactin
Authors: Chagneau Camille V. , Garcie Christophe , Bossuet-Greif Nadège , Tronnet Sophie , Brachmann Alexander O. , Piel Jörn , Nougayrède Jean-Philippe , Martin Patricia , Oswald Eric
Published: October 2019

Colibactin-producing
Escherichia coli
strains are associated with cancerous and precancerous colorectal tissues and are suspected of promoting colorectal carcinogenesis. In this study, we describe a new interplay between the synthesis of the genotoxin colibactin and the polyamine spermidine. Polyamines are highly abundant in cancer tissue and are associated with cell proliferation. The need for spermidine in genotoxic activity provides a new perspective on the role of these metabolites in the pathogenicity of colibactin-producing
E. coli
strains in colorectal cancer.
Geology of the Driftless Area
Authors: Knox* James C.
Published: September 2019

The Driftless Area is a region of roughly 22,000 km2 almost entirely in southwestern Wisconsin and adjacent northwestern Illinois that contains no evidence for glaciation during the Quaternary. Both in terms of topography and geomorphic process, it stands in stark contrast to the surrounding glaciated landscapes of the Midwestern United States. The nearly flat-lying Paleozoic sedimentary rocks in the region are deeply incised by the dendritic drainage system of the upper Mississippi and lower Wisconsin Rivers and numerous of their tributaries. Records of geologic processes that predate the Quaternary glaciations are exposed at the near-surface. The landscape is blanketed by loess of the Kieler Formation and was affected by mass wasting and a range of periglacial processes that were pervasive during permafrost conditions that existed between 33 and 14 ka. Post-glacial fluvial systems preserve myriad examples of channel adjustment to changes in sediment supply from the transition of glacial to interglacial conditions, changes in discharge across periods of Holocene climate change, and responses to Euro-American settlement of the landscape.
Late Pleistocene vegetation in the Driftless Area
Authors: Baker* Richard G.
Published: September 2019

The physical and fluvial development of the Driftless Area, largely in Wisconsin, has been investigated by James C. Knox and was the subject of a 1982 field trip. This chapter reviews and expands current understanding of the geomorphic history in and adjacent to the Driftless Area in northeast Iowa and southeast Minnesota, and the paleoecology and paleoclimates that were important in the late glacial and Holocene landform development. This information was largely obtained using fossil pollen, plant macrofossils, fossil mammals and insects, and cave speleothem records.
An overview of Driftless Area prehistory
Authors: Stoltman James B. , Boszhardt Robert F.
Published: September 2019

This paper presents an overview of the human prehistory of the Driftless Area of the Upper Mississippi Valley as revealed through archaeological research. Discussion begins with the earliest evidence of human occupation over 13,000 yr ago and concludes just prior to the arrival of European traders and missionaries in the seventeenth century.
Historic changes to floodplain systems in the Driftless Area
Authors: Belby Colin S. , Spigel Lindsay J. , Fitzpatrick* Faith A.
Published: September 2019

Floodplain systems in the Driftless Area have experienced widespread historical transformations in hydrologic and sediment characteristics as well as rates of hydrogeomorphic processes. These changes exceed natural variability experienced during the Holocene and are driven by nearly two centuries of major land-cover alterations coupled with shifting precipitation patterns. On the pre–Euro-American landscape, tributaries to the Upper Mississippi River had clear, constant base flow and low sedimentation rates due to a protective cover of prairie, oak savanna, and woodland. The Upper Mississippi River was sandy and braided, with geomorphologically diverse backwaters, side channels, and vegetated islands. Soil erosion and gullying caused by agriculture-related land clearance have had the largest historical effects on Upper Mississippi River tributary stream morphology and floodplain sedimentation. Floodplain sedimentation rates for tributaries and the Upper Mississippi River were 0.2 and 0.9 mm/yr, respectively, before Euro-American settlement, compared to 2–20 and 5–20 mm/yr after Euro-American settlement, respectively. The soil conservation movement had its birthplace in the Driftless Area in the 1920s because of the region’s widespread landscape degradation. As soil erosion decreased and gullies were stabilized in the middle to late twentieth century, land management efforts turned toward the lingering problem of fine-grained, phosphorus-rich sediment stored in tributary floodplains and channels. This trend has been complicated by a climatic shift in the late twentieth century toward increased annual precipitation, increased flood variability, and more floods in late fall and winter months, when bare fields are vulnerable to runoff. Floods are major contributors to channel erosion and deposition, and variability in magnitudes and frequency will likely continue in the early twenty-first century. Restoration efforts in tributaries have included reducing bank erosion, reconnecting floodplains, and adding trout habitat features. Lock and dam structures have altered sediment transport and erosion processes within the Upper Mississippi River, and restoration efforts there have focused on creation and rehabilitation of islands and protection of remnant off-channel backwater habitats.
Lead and zinc mining in the Driftless Area
Authors: Knox* James C.
Published: September 2019

Lead and zinc ore minerals occur in the middle Ordovician Sinnipee Group dolomites in southwest Wisconsin and adjacent areas of northwest Illinois and northeast Iowa. Europeans began mining lead deposits as early as the mid-1600s; production of lead ore and smelting of lead reached a peak ca. 1850. Mining and production from the stratigraphically lower zinc deposits reached a peak in 1917, with a lesser resurgence of zinc production ca. 1950–1970. The mining detritus and sediment from mine waste piles is relatively stable. However, cations of lead and zinc freely adsorb to clay and silt particles and have been incorporated into the downstream fluvial systems. The temporal coincidence of lead-zinc mining and active aggradation of many fluvial systems in the Driftless Area has resulted in these “legacy sediments” being preserved in overbank fluvial deposits throughout the Lead-Zinc District.
Dip, layer spacing, and incision rate controls on the formation of strike valleys, cuestas, and cliffbands in heterogeneous stratigraphy
Authors: Ward Dylan J.
Published: September 2019

Landscapes developed over heterogeneous stratigraphy exhibit a spectrum of landforms from dramatic cliffbands to hogbacks, depending on the dip and spacing of the layers. In deeply incised landscapes, a single cliffband may consist of multiple resistant layers, whereas similar stratigraphy elsewhere is separated by strike valleys into individual cuesta benches or hogbacks. This paper presents a geometric analysis, informed by a numerical landscape model, to explain the conditions for development of a strike valley floored by erodible rocks. The results define a threshold incision rate below which strike valleys are more likely to form; this threshold incision rate is proportional to the stratigraphic spacing of cliff-forming layers and a trigonometric function of dip angle. The analysis also yields a time scale for the adjustment of structural landforms to changes in regional incision rate, which is a function of dip angle and the coupling between cliff retreat rate and escarpment height. In example landscapes of the Colorado Plateau, this time scale is likely much longer than that of documented variations of incision rates due to late Quaternary climate and land-use changes. The transitional state of escarpments in layered rock may therefore contain information about regional downcutting rates over time scales different from those recorded by the fluvial network. The utility of such features will require better understanding of the coupling between incision of a foot slope and the retreat rate of the cliff above in different kinds of rocks.
Visual benefit versus visual gain: what is the effect of baseline covariants in the treatment arm relative to the control arm? A pooled analysis of ANCHOR and MARINA
Authors: Tufail Adnan , Margaron Philippe , Guerin Tadhg , Larsen Michael
Published: September 2019

Background

This study aimed to elucidate visual benefits of ranibizumab in patients with neovascular age-related macular degeneration (nAMD) compared with control arms and identify factors affecting response.

Methods

This is a post-hoc pooled analysis of two phase III studies, ANCHOR and MARINA, of ranibizumab for the treatment of nAMD. ANCHOR included 83 international sites. MARINA included 96 sites in the USA. Analysis included patients (control, n=323; ranibizumab, n=332) with nAMD and a baseline best-corrected visual acuity (BCVA) of ≥35–<85 letters.

Results

Patients receiving ranibizumab achieved an adjusted mean BCVA superiority of 18.9 and 21.2 letters over 12 and 24 months, respectively, compared with control. Ranibizumab treatment, higher baseline BCVA, lower age and smaller lesion size were positively associated with the ability to achieve BCVA >69 letters. Patients with the highest baseline BCVA had lowest BCVA gains. Ranibizumab treatment, lower baseline BCVA, lower age and smaller lesion size were identified as significant predictors of BCVA gain from baseline at month 24 (all p<0.0001). However, the difference in mean BCVA gains at month 24 between treatment and control groups was similar for all baseline BCVA subgroups (≥35–<55 letters, 21.9 letters; ≥55–<70 letters, 25.2 letters; ≥70–<85 letters, 19.3 letters).

Conclusions

Higher baseline BCVA is associated with lower BCVA gains but a greater likelihood of achieving good final BCVA >69 letters due to smaller gains needed to achieve response. Visual benefits, including maintenance of visual acuity (VA), final VA achieved and relative gain compared with natural disease progression, should be considered when assessing treatment response in nAMD.
Impact of a pharmacist intervention at an intensive care rehabilitation clinic
Authors: MacTavish Pamela , Quasim Tara , Shaw Martin , Devine Helen , Daniel Malcolm , Kinsella John , Fenelon Carl , Kishore Rakesh , Iwashyna Theodore J , McPeake Joanne
Published: September 2019

Objective

While disruptions in medications are common among patients who survive critical illness, there is limited information about specific medication-related problems among survivors of critical care. This study sought to determine the prevalence of specific medication-related problems detected in patients, seen after critical care discharge.

Design

Consecutive patients attending an intensive care unit (ICU) follow-up programme were included in this single-centre service evaluation.

Setting

Tertiary care regional centre in Scotland (UK).

Participants

47 patients reviewed after critical care discharge at an ICU follow-up programme.

Interventions

Pharmacists conducted a full medication review, including: medicines reconciliation, assessing the appropriateness of each prescribed medication, identification of any medication-related problems and checking adherence.

Measurements

Medication-related problems in patients following critical care discharge. Interventions and medication-related problems were systematically graded and risk factors were identified using an adapted version of the National Patient Safety Agency Risk Matrix.

Main results

69 medication-related problems were identified in 38 (81%) of the 47 patients. The most common documented problem was drug omission (29%). 64% of the medication-related problems identified were classified as either moderate or major. The number of pain medications prescribed at discharge from intensive care was predictive of medication-related problems (OR 2.02, 95% CI 1.14 to 4.26, p=0.03).

Conclusions

Medication problems are common following critical care. Better communication of medication changes both to patients and their ongoing care providers may be beneficial following a critical care admission. In the absence of highly effective communication, a pharmacy intervention may contribute substantially to an intensive care rehabilitation or recovery programme.
Developing the role of midwives as ‘contraceptive champions’ to support early access to effective postnatal contraception for women
Authors: Gallimore Annette , Craig Alison , Cameron Sharon , Milne Dona , Lakha Fatim
Published: September 2019

Objective

To evaluate the acceptability of the new contraceptive champion role to the first hospital and community midwives in NHS Lothian trained in this role.

Design

Health service evaluation.

Population

Hospital and community midwives trained as contraceptive champions, NHS Lothian, Scotland, UK.

Methods

Qualitative research: 1:1 semi-structured interviews (baseline and follow-up) with five contraceptive champions.

Main outcome measure

Qualitative data on views of the new contraceptive champions on the first 6 months of the role.

Results

All contraceptive champions stated increased confidence in their knowledge of postnatal contraception. They reported that women had not questioned the role of midwives in inserting contraceptive implants postnatally in hospital and at home. Midwife colleagues and hospital doctors had been supportive.

Conclusion

The new role of contraceptive champion is reported by midwives to have been well received in its first year by women, the midwives themselves and their healthcare colleagues.
Value of monitoring negative emotional bias in primary care in England for personalised antidepressant treatment: a modelling study
Authors: Simon Judit , Harmer Catherine J , Kingslake Jonathan , Dawson Gerard R , Dourish Colin T , Goodwin Guy M
Published: September 2019

Background

Depressed patients often focus on negative life events. Effective antidepressant therapy reverses this negative emotional bias (NEB) within 1 week. Clinical therapeutic effect usually requires 4–6 weeks. The value of implementing NEB monitoring for the personalisation of antidepressant therapy is unknown.

Objective

To estimate the likely outcome and cost consequences of adopting the P1vital Oxford Emotional Test Battery (ETB) for this purpose in routine primary care in England.

Methods

A hybrid decision analytic model (decision tree plus Markov model) was developed to estimate the cost-effectiveness of ETB monitoring versus no ETB over 52 weeks using quality-adjusted life years (QALYs). Differences in depression severity, episode type and analytical perspectives were considered. Input data were derived from relevant guidelines, literature, national databases, expert opinion and the developers for the year 2013. Multiple sensitivity analyses addressed uncertainty.

Findings

The mean number of ETB tests is 2.162 per newly diagnosed patient and 2.166 per patient with recurrent depression. The incremental cost-effectiveness of ETB versus ‘no ETB’ is £4355/QALY from the healthcare perspective. From the broader societal perspective, ETB is more effective and cost saving.

Conclusions

Monitoring negative emotional bias in primary care in England for personalised antidepressant treatment using ETB seems as an effective and cost-effective option under all considered scenarios (including worst case). Its main economic value seems to lie in reduced productivity loss as opposed to healthcare savings.

Clinical implications

The test supports accelerated application of evidence-based depression care. Further optimisation and implementation in the ongoing European PReDicT trial is ongoing.
Gastroparesis: a turning point in understanding and treatment
Authors: Grover Madhusudan , Farrugia Gianrico , Stanghellini Vincenzo
Published: September 2019

Gastroparesis is defined by delayed gastric emptying (GE) and symptoms of nausea, vomiting, bloating, postprandial fullness, early satiety and abdominal pain. Most common aetiologies include diabetes, postsurgical and postinfectious, but in many cases it is idiopathic. Clinical presentation and natural history vary by the aetiology. There is significant morbidity and healthcare utilisation associated with gastroparesis. Mechanistic studies from diabetic animal models of delayed GE as well as human full-thickness biopsies have significantly advanced our understanding of this disorder. An innate immune dysregulation and injury to the interstitial cells of Cajal and other components of the enteric nervous system through paracrine and oxidative stress mediators is likely central to the pathogenesis of gastroparesis. Scintigraphy and13C breath testing provide the most validated assessment of GE. The stagnant gastroparesis therapeutic landscape is likely to soon see significant changes. Relatively newer treatment strategies include antiemetics (aprepitant), prokinetics (prucalopride, relamorelin) and fundic relaxants (acotiamide, buspirone). Endoscopic pyloromyotomy appears promising over the short term, especially for symptoms of nausea and vomiting. Further controlled trials and identification of the appropriate subgroup with pyloric dysfunction and assessment of long-term outcomes are essential. This review highlights the clinical presentation, diagnosis, mechanisms and treatment advancements for gastroparesis.
Quantifying and monitoring fibrosis in non-alcoholic fatty liver disease using dual-photon microscopy
Authors: Wang Yan , Wong Grace Lai-Hung , He Fang-Ping , Sun Jian , Chan Anthony Wing-Hung , Yang Jinlian , Shu Sally She-Ting , Liang Xieer , Tse Yee Kit , Fan Xiao-Tang , Hou Jinlin , Chan Henry Lik-Yuen , Wong Vincent Wai-Sun
Published: September 2019

Objective

Fibrosis stage is strongly associated with liver-related outcomes and is a key surrogate endpoint in drug trials for non-alcoholic steatohepatitis. Dual-photon microscopy allows automated quantification of fibrosis-related parameters (q-FPs) and may facilitate large-scale histological studies. We aim to validate the performance of q-FPs in a large histological cohort.

Design

344 patients with non-alcoholic fatty liver disease (NAFLD) underwent 428 liver biopsies (240 had paired transient elastography examination). Fibrosis stage was scored using the NASH Clinical Research Network system, and q-FPs were measured by dual-photon microscopy using unstained slides. Patients were randomly assigned to the training and validation cohorts to test the performance of individual q-FPs and derive optimal cut-offs.

Results

Over 25 q-FPs had area under the receiver-operating characteristics curves >0.90 for different fibrosis stages. Among them, the perimeter of collagen fibres and number of long collagen fibres had the highest accuracy. At the best cut-offs, the two q-FPs had 88.3%–96.2% sensitivity and 78.1%–91.1% specificity for different fibrosis stages in the validation cohort. q-FPs and histological scoring had nearly identical correlations with liver stiffness measurement, suggesting that the accuracy of q-FPs approached that of histological assessment. Among patients with paired liver biopsies, changes in the same q-FPs were associated with changes in fibrosis stage. At a median follow-up of 5.6 years, baseline q-FPs predicted liver-related events.

Conclusion

q-FP is highly accurate in the assessment of fibrosis in NAFLD patients. This automated platform can be used in future studies as objective and reliable evaluation of histological fibrosis.
International consensus conference on stool banking for faecal microbiota transplantation in clinical practice
Authors: Cammarota Giovanni , Ianiro Gianluca , Kelly Colleen R , Mullish Benjamin H , Allegretti Jessica R , Kassam Zain , Putignani Lorenza , Fischer Monika , Keller Josbert J , Costello Samuel Paul , Sokol Harry , Kump Patrizia , Satokari Reetta , Kahn Stacy A , Kao Dina , Arkkila Perttu , Kuijper Ed J , Vehreschild Maria J GT , Pintus Cristina , Lopetuso Loris , Masucci Luca , Scaldaferri Franco , Terveer E M , Nieuwdorp Max , López-Sanromán Antonio , Kupcinskas Juozas , Hart Ailsa , Tilg Herbert , Gasbarrini Antonio
Published: September 2019

Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrentClostridioides difficileinfection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.

Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,

Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.
Trends in school-age pedestrian and pedalcyclist crashes in the USA: 26 states, 2000–2014
Authors: Wheeler-Martin Katherine C , Curry Allison E , Metzger Kristina B , DiMaggio Charles J
Published: September 2019

Background

Despite substantial progress, motor vehicle crashes remain a leading killer of US children. Previously, we documented significant positive impacts of Safe Routes to School interventions on school-age pedestrian and pedalcyclist crashes.

Objective

To expand our analysis of US trends in motor vehicle crashes involving school-age pedestrians and pedalcyclists, exploring heterogeneity by age and geography.

Methods

We obtained recent police-reported crash data from 26 states, calculating population rates of pedestrian and pedalcyclist crashes, crash fatality rates and pedestrian commuter-adjusted crash rates (‘pedestrian danger index’) for school-age children as compared with other age groups. We estimated national and statewide trends by age, injury status, day and travel hour using hierarchical linear modeling.

Results

School-age children accounted for nearly one in three pedestrians and one in two pedalcyclists struck in motor vehicle crashes from 2000 to 2014. Yet, the rates of these crashes declined 40% and 53%, respectively, over that time, on average, even as adult rates rose. Average crash rates varied geographically from 24.4 to 100.8 pedestrians and 15.6 to 56.7 pedalcyclists struck per 100 000 youth. Crash rates and fatality rates were inversely correlated.

Conclusions

Despite recent increases in adult pedestrian crashes, school-age and younger pedestrians experienced ongoing declines in motor vehicle crashes through 2014 across the USA. There was no evidence of displacement in crash severity; declines were observed in all outcomes. The growing body of state crash data resources can present analytic challenges but also provides unique insights into national and local pedestrian crash trends for all crash outcomes.
Characteristics, behaviour and role of biomarkers in metastatic triple-negative breast cancer
Authors: Goto Yutaro , Thike Aye Aye , Ong Clara Chong Hui , Lim Johnathan Xiande , Md Nasir Nur Diyana , Li Huihua , Koh Valerie Cui Yun , Chen Xiao-Yang , Yeong Joe Poh Sheng , Sasano Hironobu , Tan Puay Hoon
Published: September 2019

Aims

Characterising the factors responsible for metastatic triple-negative breast cancer (TNBC) is of significant importance, considering its high mortality rate and scant data. In this study, we evaluated the characteristics, clinical behaviour and role of biomarkers (androgen receptor (AR), oestrogen receptor beta (ERβ) and p53) in metastatic TNBC.

Methods

Immunohistochemistry was performed for AR, ERβ and p53 on 125 primary TNBCs with known metastasis and correlated with clinicopathological parameters and outcome.ARandp53mRNA profiling was also carried out on 34 tumours from the same series and correlated with outcomes.

Results

In this cohort, grade 3 and pT2 tumours predominated. The most common site for metastasis was the lung and pleura (41, 32.8%), and 15 (12.0%) cases demonstrated metastasis in multiple sites. Among these, 92% of tumours metastasised without preceding local recurrences. Five- and ten-year overall survival (OS) rates were 27% and 7.2%, while 5- and 10- year survival rates after metastasis were 9.6% and 3.2% respectively. AR, ERβ and p53 protein expressions were observed in 16%, 96.8% and 58.1% of tumours, respectively. A combinational phenotype of AR-ERβ+p53+ tumours was associated with poorer OS (HR 1.543, 95%CI 1.030 to 2.310, p=0.035). HigherARmRNA levels were significantly associated with favourable OS (p=0.015) and survival after metastasis (p=0.027).

Conclusions

Metastatic TNBC harboured aggressive behaviour and displayed predominantly visceral metastasis with most metastatic events occurring without intervening local recurrences. A combinational phenotype of AR-ERβ+p53+ was significantly associated with poorer OS.
Cigarette smoking and oral microbiota in low-income and African-American populations
Authors: Yang Yaohua , Zheng Wei , Cai Qiu-Yin , Shrubsole Martha J , Pei Zhiheng , Brucker Robert , Steinwandel Mark D , Bordenstein Seth R , Li Zhigang , Blot William J , Shu Xiao-Ou , Long Jirong
Published: September 2019

Background

Cigarette smoking is a common risk factor for diseases and cancers. Oral microbiota is also associated with diseases and cancers. However, little is known about the impact of cigarette smoking on the oral microbiota, especially among ethnic minority populations.

Methods

We investigated cigarette smoking in relationship with the oral microbiota in a large population of predominately low-income and African-American participants. Mouth rinse samples were collected from 1616 participants within the Southern Community Cohort Study, including 592 current-smokers, 477 former-smokers and 547 never-smokers. Oral microbiota was profiled by 16S ribosomal RNA gene deep sequencing.

Results

Current-smokers showed a different overall microbial composition from former-smokers (p=6.62×10−7) and never-smokers (p=6.00×10−8). The two probiotic genera,BifidobacteriumandLactobacillus, were enriched among current-smokers when compared with never-smokers, with Bonferroni-corrected p values (PBonferroni) of 1.28×10−4 and 5.89×10−7, respectively. The phylumActinobacteriawas also enriched in current-smokers when compared with never-smokers, with a median relative abundance of 12.35% versus 9.36%, respectively, and with aPBonferroni=9.11×10−11. In contrast, the phylumProteobacteriawas depleted in current smokers (PBonferroni=5.57×10−13), with the relative abundance being almost three times that of never-smokers (7.22%) when compared with that of current-smokers (2.47%). Multiple taxa within these two phyla showed differences in abundance/prevalence between current-smokers and never-smokers atPBonferroni<0.05. The differences in the overall microbial composition and abundance/prevalence of most taxa were observed among both African-Americans and European-Americans. Meanwhile, such differences were not observed between former-smokers and never-smokers.

Conclusion

Smoking has strong impacts on oral microbial community, which was recovered after smoking cessation.
Relationship between childhood socioeconomic position and adverse childhood experiences (ACEs): a systematic review
Authors: Walsh David , McCartney Gerry , Smith Michael , Armour Gillian
Published: September 2019

Background

‘Adverse childhood experiences’ (ACEs) are associated with increased risk of negative outcomes in later life: ACEs have consequently become a policy priority in many countries. Despite ACEs being highly socially patterned, there has been very little discussion in the political discourse regarding the role of childhood socioeconomic position (SEP) in understanding and addressing them. The aim here was to undertake a systematic review of the literature on the relationship between childhood SEP and ACEs.

Methods

MEDLINE, PsycINFO, ProQuest and Cochrane Library databases were searched. Inclusion criteria were: (1) measurement of SEP in childhood; (2) measurement of multiple ACEs; (3) ACEs were the outcome; and (4) statistical quantification of the relationship between childhood SEP and ACEs. Search terms included ACEs, SEP and synonyms; a second search additionally included ‘maltreatment’. Overall study quality/risk of bias was calculated using a modified version of the Hamilton Tool.

Results

In the ACEs-based search, only 6 out of 2825 screened papers were eligible for qualitative synthesis. The second search (including maltreatment) increased numbers to: 4562 papers screened and 35 included for synthesis. Eighteen papers were deemed ‘high’ quality, five ‘medium’ and the rest ‘low’. Meaningful statistical associations were observed between childhood SEP and ACEs/maltreatment in the vast majority of studies, including all except one of those deemed to be high quality.

Conclusion

Lower childhood SEP is associated with a greater risk of ACEs/maltreatment. With UK child poverty levels predicted to increase markedly, any policy approach that ignores the socioeconomic context to ACEs is therefore flawed.

PROSPERO registration number

CRD42017064781.
Effect of mode of anesthesia on radiation exposure in patients undergoing endovascular recanalization of anterior circulation embolic stroke
Authors: Hemmerich Felix , Weyland Charlotte S , Schönenberger Silvia , Ringleb Peter A , Möhlenbruch Markus A , Bendszus Martin , Pfaff Johannes AR
Published: September 2019

Purpose

To determine the effect of general anesthesia (GA) versus conscious sedation (CS) on radiation exposure (RE), procedure time (PT), and fluoroscopy time (FT) in patients receiving endovascular stroke treatment (EST) for large vessel occlusions (LVOs) in the anterior circulation.

Methods

Retrospective analysis of an institutional review board−approved prospective stroke database of a comprehensive stroke center focusing on RE (as dose area product (DAP) in Gy.cm², median (IQR)), PT, and FT (in minutes, median (IQR)) in patients receiving EST for LVOs of the anterior circulation according to the mode of anesthesia during the intervention.

Results

Overall 544 patients were included in this analysis (GA: n=143, CS: n=401). For all included LVOs in the anterior circulation PTs (GA: 69 (44–100); CS: 59 (37–99); p=0.235), FTs (GA: 33 (20–56); CS: 29 (16–51); p=0.286), and RE (DAP, GA: 116.23 (73.47–173.41); CS: 110.5 (68.35–184.65); p=0.929) were comparable. In a subgroup analysis of occlusions of the middle cerebral artery (M1-segment; GA: n=80/544, 14.7%; CS: n=211/544, 38.8%), PTs (GA: 69 (37–101); CS: 54 (35 – 89); p=0.223), FTs (GA: 33 (19–55); CS: 25 (14–48); p=0.264), and RE (DAP, GA: 110.91 (66.8–169.12); CS: 103.8 (63.17–181); p=0.893) were similar.

Conclusion

In this retrospective analysis, no effect of the mode of anesthesia on the radiation exposure during EST was detected as GA and CS showed comparable PT, FT, and DAPs.
Functional, inflammatory and interstitial impairment due to artificial stone dust ultrafine particles exposure
Authors: Ophir Noa , Bar Shai Amir , Korenstein Rafi , Kramer Mordechai R , Fireman Elizabeth
Published: September 2019

Objective

Artificial stone dust (ASD) contains high levels of ultrafine particles (UFP <1 µm) which penetrate deeply into the lungs. This study aimed to demonstrate the direct effect of UFP in the lungs of ASD-exposed workers on functional inflammatory and imaging parameters.

Methods

68 workers with up to 20 years of ASD exposure at the workplace were recruited from small enterprises throughout the country and compared with 48 non-exposed individuals. Pulmonary function test (PFT), CT, induced sputum (IS) and cytokine analyses were performed by conventional methods. The CT scans were evaluated for features indicative of silicosis in three zones of each lung. UFP were quantitated by the NanoSight LM20 system (NanoSight, Salisbury) using the Nanoparticle Tracking Analysis. Interleukin (IL)-6, IL-8 and tumour necrosis factor alpha (TNF-α) levels were measured by Luminex (R&D Systems).

Results

Thirty-four patients had CT scores between 0 and 42, and 29 of them were diagnosed with silicosis. Content of the UFP retrieved from IS supernatants correlated negatively with the PFT results (total lung capacity r=−0.347, p=0.011; forced expiratory volume in 1 s r=−0.299, p=0.046; diffusion lung carbon monoxide in a single breath r=−0.425, p=0.004) and with the CT score (r=0.378, p=0.023), and with the inflammatory cytokines IL-8 (r=0.336, p=0.024), IL-6 (r=0.294, p=0.065) and TNF-α (r=0.409, p=0.007). Raw material of ASD was left to sedimentate in water for <15 min, and 50% of the floating particles were UFP. A cut-off of 8×106 UFP/mL in IS samples had a sensitivity of 77% to predict pulmonary disease.

Conclusions

This is the first demonstration of an association between UFP-related decreased PFT results, worsening of CT findings and elevation of inflammatory cytokines, which may be attributed to high-dose inhalation of UFP of ASD at the workplace.
Addition of dexamethasone to local infiltration analgesia in elective total hip arthroplasty: a double-blind, randomized control trial
Authors: El-Boghdadly Kariem , Short Anthony James , Gandhi Rajiv , Chan Vincent W S
Published: September 2019

Background and objectives

Pain following total hip arthroplasty is significant, and effective analgesia is associated with an improvement in functional outcomes. Dexamethasone may facilitate the action of local anesthesia, but its role as an additive to a local infiltration analgesia (LIA) mixture in hip arthroplasty settings has not been investigated. We hypothesized that the addition of dexamethasone to local anesthetic infiltration improves analgesic outcomes following total hip arthroplasty.

Methods

We performed a double-blind, randomized control trial of 170 patients undergoing total hip arthroplasty. Patients were randomized to receive LIA mixed with either 2 mL of saline 0.9% or 2 mL of dexamethasone 4 mg/mL. The primary outcome was 24 hours oral morphine consumption. Secondary outcomes included short-term and long-term analgesic and functional outcomes and adverse events.

Results

85 patients were included in each arm. 24 hours morphine consumption was similar between saline and dexamethasone groups, with a median (IQR (range)) of 75 (45–105 (0–240)) and 62.5 (37.5–102.5 (0–210)) mg, respectively (p=0.145). However, patients receiving dexamethasone had significantly reduced opioid consumption for their total in-hospital stay, but not at any other time points examined. Functional outcomes were similar between groups. The incidence of postoperative nausea and vomiting was reduced in patients receiving dexamethasone.

Conclusions

The addition of 8 mg dexamethasone to LIA did not reduce 24 hours morphine consumption but was associated with limited improvement in short-term analgesic outcomes and a reduction in postoperative nausea and vomiting. Dexamethasone had no effect on functional outcomes or long-term analgesia.

Trial registration number

NCT02760043
Mechanical nociceptive thresholds in endurance horses
Authors: Schambourg Morgane , Taylor Polly M
Published: September 2019

Background

Alteration of limb sensitivity is forbidden in equine sports but difficult to enforce. We aimed to develop an objective field method to assess mechanical nociceptive threshold (MNT) in endurance horses.

Methods

A remotely controlled pneumatic actuator (1 mm tip) was used to measure forelimb pastern MNT in 108 endurance horses.

Results

Median (IQR) MNT at rest was 1.9 N (0.9–3.5). Icing had no significant effect on limb sensitivity. MNT measured at weekly intervals increased from week 1 (1.2 N (0.6–1.8)) to week 3 (1.9 N (1.2–2.8)) (P<0.05). In 17 horses without impaired sensitivity, MNT increased from 1.2 N (0.6–2.3) before to 2.4 N (1.2–5.2) after racing (P=0.0017). In desensitised horses, MNT after racing was higher (8 limbs—23.1 N (21.4 to >25)) than in horses without impaired sensitivity (42 limbs—2.2 N (1.2–4.3)) (P<0.0001). Desensitisation with mepivacaine increased MNT to above the safety cut‐off (25 N) at 10 minutes; sensitivity return to baseline varied between individuals but was restored by 330 minutes. None of the horses became averse to the technique.

Conclusion

MNT was practical, non‐traumatic, repeatable and well tolerated under field conditions in endurance horses. The technique differentiated postracing MNT in horses with normal sensitivity from those with impaired sensitivity.
Timothy David Hirst
Authors: Oxtoby Tom , Baird Fran
Published: September 2019

A ‘friend to all’, as well as an inspirational vet who was fully committed to the future of British farming
The changes in growth performance and lipid metabolism of pigs with yellow fat induced by high dietary fish oil
Authors: Guo Qiuping , Li Fengna , Wen Chaoyue , Zhang Lingyu , Duan Yehui , Wang Wenlong , Huang Ruilin , Yin Yulong
Published: September 2019

The aim of this study was to investigate the alteration in growth performance and lipid metabolism during the development of yellow fat in pigs. A total of 30 pigs (9.23 ± 0.21 kg) were assigned to three treatments: (1) low fish oil (LFO), basal diet + 2% fresh fish oil; (2) high fish oil (HFO), basal diet + 8% fresh fish oil; and (3) oxidized fish oil (OFO), basal diet + 8% OFO (peroxide value = 250 meqO2kg−1). Pigs fed HFO and OFO diets showed yellow staining of fat and decreased growth performance, including average daily gain, average daily feed intake, and final body weight (P < 0.01). The oxidized lipid markers malondialdehyde, yellowness b* of backfat, perirenal fat, and abdominal fat were markedly increased in the pigs fed with HFO and OFO (P < 0.05). Furthermore, following HFO feeding, pigs showed significant decreases in n-6 polyunsaturated fatty acid, n-6/n-3 polyunsaturated fatty acid ratio and mRNA expression levels of CCAAT-/enhancer-binding protein alpha, fatty acid synthase, lipoprotein lipase, and hormone-sensitive lipase in backfat (P < 0.01). Overall, pigs with yellow-fat trait showed decreased growth performance and altered lipid metabolism by the high fish oil feeding.
Homogeneously Modified Special relativity (HMSR)
Authors: Torri Marco Danilo Claudio , Antonelli Vito , Miramonti Lino
Published: September 2019

This work explores a Standard Model extension possibility, that violates Lorentz invariance, preserving the space-time isotropy and homogeneity. In this sense HMSR represents an attempt to introduce an isotropic Lorentz Invariance Violation in the elementary particle SM. The theory is constructed starting from a modified kinematics, that takes into account supposed quantum effects due to interaction with the space-time background. The space-time structure itself is modified, resulting in a pseudo-Finsler manifold. The SM extension here provided is inspired by the effective fields theories, but it preserves covariance, with respect to newly introduced modified Lorentz transformations. Geometry perturbations are not considered as universal, but particle species dependent. Non universal character of the amended Lorentz transformations allows to obtain visible physical effects, detectable in experiments by comparing different perturbations related to different interacting particles species.
Black hole shadow of a rotating polytropic black hole by the Newman–Janis algorithm without complexification
Authors: Contreras Ernesto , Ramirez–Velasquez J. M. , Rincón Ángel , Panotopoulos Grigoris , Bargueño Pedro
Published: September 2019

In this work, starting from a spherically symmetric polytropic black hole, a rotating solution is obtained by following the Newman–Janis algorithm without complexification. Besides studying the horizon, the static conditions and causality issues of the rotating solution, we obtain and discuss the shape of its shadow. Some other physical features as the Hawking temperature and emission rate of the rotating polytropic black hole solution are also discussed.