bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological Flora of the British Isles: Crassula helmsii
Authors: Smith Tim , Buckley Phil
Published: February 2020

This account presents information on all aspects of the biology of Crassula helmsii (Kirk) Cockayne (New Zealand Pygmyweed, Australian Swamp Stonecrop) that are relevant to understanding its ecological characteristics and behaviour. The main topics are presented within the standard framework of the Biological Flora of the British Isles: distribution, habitat, communities, responses to biotic factors, responses to environment, structure and physiology, phenology, floral and seed characters, herbivores and disease, history, and conservation.

Crassula helmsii is an invasive aquatic macrophyte originating from Australia and New Zealand. The first naturalized population was recorded in Britain in 1956. All British specimens appear to represent a single lineage. DNA analysis indicates that British specimens originate from Australia.

Crassula helmsii is capable of growing in a wide range of lentic freshwater and riparian habitats. It may grow as free floating, submerged, emergent or terrestrial forms. Morphology can differ markedly on the same stem.

Flowers are produced, but with no known pollinators outside of its native range. Reproduction is thought to be predominantly by asexual methods outside Australia and New Zealand, through stem fragmentation and dispersal. Seed germination outside the native range appears to be very rare and poorly understood.

Crassula helmsii has been and still is controlled by active management because of fears that its capacity to produce monocultures will lead to loss of biodiversity in the plant communities it invades. Evidence for species losses due to colonization by C.  helmsii is rather anecdotal, although suppression of native biomass through competition has been reported. No consistently effective control procedures have been identified.
Transcriptomic and physiological responses of Skeletonema costatum to ATP utilization
Authors: Zhang Xiaohua , Lin Senjie , Liu Dongyan
Published: February 2020

The capacity of phytoplankton to utilize dissolved organic phosphorus (DOP) plays an important role in their competition for resources when the availability of dissolved inorganic phosphorus (DIP) is low in the aquatic systems. Here, we explored the physiological and molecular responses of a globally distributed marine diatom, Skeletonema costatum, in utilizing adenosine‐5′‐triphosphate (ATP) based on incubation experiments under ATP, DIP‐replete, and DIP‐depleted conditions. The results show that ATP supports the growth of S. costatum as efficiently as DIP. The pathway of S. costatum involved in utilizing ATP is not related to alkaline phosphatase (AP), an important DOP hydrolase, although extracellular hydrolysis is involved. The transcriptome analysis revealed several transcripts related to the hydrolase activity (e.g. NAD+ diphosphatase), which were significantly upregulated in the ATP culture group, indicating their possible involvement in ATP hydrolysis. Meanwhile, ATP‐grown S. costatum exhibited downregulation of the genes related to a series of metabolic activities (e.g. purine metabolism), apparently to adapt to ATP condition.
Why was apparent evidence ignored? The delayed relaxation of China's birth control
Authors: Jing Yijia , Hu Zhan
Published: February 2020

The ideal of evidence‐based policy making (EBPM) may be hindered by delayed policy response to disclosed evidence. This article adopts Allison's three‐lens decision‐making framework to highlight technical, organizational, and political causes of delayed policy responses to apparent evidence. The study uses China's birth control policy as a case to examine the lag of policy adjustments. Although ample supply of evidence suggested earlier relaxation of China's one‐child policy, major adjustments only happened after 2013 and failed to achieve significant results. The study indicates that a politics‐informed EBPM approach may better position the role of evidence in policy processes by taking into consideration the unavoidable influences of institutions and politics.
Automated delineation of hospital service areas as a new tool for health care planning
Authors: Haynes Alan G. , Wertli Maria M. , Aujesky Drahomir
Published: February 2020

Objective

To develop an automated, reproducible method for delineating hospital service areas (HSAs).

Data Sources/Setting

Discharge data from all Swiss acute care hospitals for the years 2013 to 2016.

Study Design

We derived HSAs and hospital referral regions for Switzerland using a newly developed flow‐based, automated, objective, and reproducible method using all discharge data. We compared our method to the classical, partially subjective approach used to delineate the Swiss Health Care Atlas by delineating four sets of intervention‐specific HSAs.

Principal Findings

Based on 4 105 885 discharges, the fully automated method delineated 63 HSAs. Comparison with existing HSAs reveals good overlap and comparable measures of health utilization between the methods and shows that in the Swiss setting, our method outperforms a cluster‐based approach to defining HSAs. While the classical method potentially takes an entire day to delineate the regions, our method took approximately 10 minutes.

Conclusions

Hospital service areas are used to analyze differences in use of health care that may indicate underuse and overuse. Our new, fully automated, objective, and reproducible method provides a useful tool for hospital services researchers that will enable them to delineate and update patient‐flow‐based HSAs.
Isoflavone profiles and antioxidant properties in different parts of soybean sprout
Authors: Kim Min‐Ah , Kim Mi‐Ja
Published: February 2020

Sprouting is one of the processing methods to enhance bioavailability of some nutrients of agricultural products. Soybeans were germinated for 6 days and soybean (SB), soybean sprout (SBS), cotyledon of soybean sprout (CSS), and hypocotyl and root of soybean sprout (HRSS) were collected. Isoflavone profiles and in vitro antioxidant activities of 80% ethanol extracts of samples were analyzed. In addition, oxidative stability of the extract was evaluated in corn oils heated at 100 °C. The hypocotyl and root part of soybean sprout contained significantly (P < 0.05) higher content of isoflavone aglycones than the cotyledon part of soybean sprout. Diphenyl‐1‐picrylhydrazyl radial and 2,2’‐azinobis(3‐ethylbenzothiazoline‐6‐sul‐fonic acid cation radical scavenging activities of SBS were 1.6 and 1.3 times higher than those of SB, respectively (P < 0.05), whereas those of CSS were 1.1 and 1.8 times higher than those of HRSS, respectively (P < 0.05). CSS had higher ORAC and FRAP values than others. High correlations between contents of total flavonoids and antioxidant activities were observed in all in vitro antioxidant assays. SBS, CSS, and HRSS had significantly higher oxidative stability than SB in 100 °C heated corn oil after 9 hr treatment (P < 0.05). Generally, 80% ethanol extract of CSS had high in vitro antioxidant properties whereas HRSS had high aglycone forms of isoflavones. Isoflavone aglycones may not be major ingredients providing antioxidant activities of soybean sprout.

Practical Application

Soybeans are important crops for the preparation of tofu, soymilk, and protein sources. Soybean sprout prepared by germinating soybean and growing for several days is one of important food materials used as daily diet in some countries. In this study, antioxidant activities of different parts of soybean sprouts were evaluated using in vitro methods and bulk oil model systems. In addition, isoflavone profiles of soybean sprouts were determined. Enhanced antioxidant activities of soybean sprouts may help consumers choose healthier foods and extend business areas of the soybean food industry.
Influence of heat treatment and egg matrix on the physicochemical and allergenic properties of egg custard
Authors: Tong Ping , Xiong Liji , Gao Jinyan , Li Xin , Wu Zhihua , Yang Anshu , Yuan Juanli , Wu Yong , Chen Hongbing
Published: February 2020

To investigate the influence of heat treatment and egg matrix on egg custard (EC) proteins, 12 different kinds of ECs with different egg/water ratios (1:1, 1:1.5, 1:2, or 1:3, v/v) and different heating temperatures (80, 90, or 100 °C) and times (10, 15, or 20 min) were prepared and evaluated for the digestibility, structure, eliciting capacity and sensitizing capacity using SDS‐PAGE, fluorescence spectra, ELISA, and a BALB/c mouse model, respectively. The physicochemical properties of EC proteins were significantly affected by heat treatment and egg matrix, which showed the increased digestibility and partially unfolded structure. The eliciting capacity of EC evaluated by IgE binding to sera from egg‐allergic patients was reduced after heat treatment, and the EC made by heating at 100 °C for 20 min with a whole egg/water ratio of 1:2 (v/v) was the weakest. The sensitizing capacity of EC was also reduced in the BALB/c mouse model, which showed the significantly decreased levels of specific IgE, IgG, IgG1 and IgG2a, mMCP‐1 and histamine in the mouse sera, as well as cytokine secretions of IL‐4, IL‐5, and IL‐13, compared with the raw egg (RE) group. Results demonstrate that heat treatment and egg matrix significantly reduced the eliciting and sensitizing capacity of EC by changing the tertiary structure and increasing the digestibility of EC proteins.

Practical Application

Egg custard (EC) is one kind of savory food suitable for all ages, and is also a traditional supplementary food for infants and young children in China. However, limited information is available on the allergenicity of egg custard. In this work, we evaluated how the structure, digestibility, and allergenic potential of egg allergens in EC were altered by the degree of thermal treatment and egg matrix, and elucidated the links between the physicochemical properties and allergenic potential of EC affected by heat treatment and egg matrix. Our results demonstrate that heat treatment and egg matrix significantly reduced the eliciting and sensitizing capacity of EC by changing the tertiary structure and increasing the digestibility of EC proteins.
Protective effects of phenolic acid extract from ginseng on vascular endothelial cell injury induced by palmitate via activation of PI3K/Akt/eNOS pathway
Authors: Chen Xuenan , Yao Fan , Song Jia , Fu Baoyu , Sun Guang , Song Xinying , Fu Chunge , Jiang Rui , Sun Liwei
Published: February 2020

Elevated free fatty acids may impair insulin‐mediated signaling to eNOS that contributes to the pathophysiology of endothelial dysfunction. Previous studies have indicated the protective effect of ginseng and the regulatory potential of phenolic acid components from other plants on endothelial function. Therefore, this study investigated the protective effects of phenolic acid extract from ginseng (PG2) on endothelial cells against palmitate‐induced damage. We found that PG2 increases cell viability, inhibits the palmitate‐induced intracellular accumulation of lipids, and the overexpression of endothelin‐1 (ET‐1) through enhancing the phosphorylation of the phosphatidylinositol 3‐kinase/Akt/endothelial nitric oxide synthase (PI3K/Akt/eNOS) signaling pathway. The results of this study may be valuable for the development of PG2 to combat the endothelial cell damage caused by hyperlipidemia.

Practical Application

We proved that phenolic acid extract from ginseng has a protective effect on free fatty acid‐induced endothelial dysfunction in vitro. This study provides experimental data for the application of ginseng‐derived phenolic acids in treating cardiovascular disease.
Peripheral nerve blocks for analgesia after elective total hip arthroplasty
Authors: Nielsen Niels Dalsgaard
Published: February 2020

A significant subgroup of patients suffer from moderate or severe pain after total hip arthroplasty (THA). Regional analgesia has the potential to reduce post‐operative pain and thereby spare patients from opioids, but regional analgesia of the hip is complicated as the area is innervated by multiple nerves. However, the nociceptors of the hip joint are primarily innervated by the obturator and femoral nerves. The effect of an obturator nerve block (ONB) on pain following THA has never been investigated. A femoral nerve block is known to reduce pain after THA, but is unfortunately accompanied by an increased risk of fall. We have developed a novel nerve block—the iliopsoas plane block (IPB)—that has the potential to anaesthetize the hip articular sensory branches of the femoral nerve without causing motor blockade.
Transcriptome analysis reveals the difference between “healthy” and “common” aging and their connection with age‐related diseases
Authors: Zeng Lu , Yang Jialiang , Peng Shouneng , Zhu Jun , Zhang Bin , Suh Yousin , Tu Zhidong
Published: February 2020

A key goal of aging research was to understand mechanisms underlying healthy aging and develop methods to promote the human healthspan. One approach is to identify gene regulations unique to healthy aging compared with aging in the general population (i.e., “common” aging). Here, we leveraged Genotype‐Tissue Expression (GTEx) project data to investigate “healthy” and “common” aging gene expression regulations at a tissue level in humans and their interconnection with diseases. Using GTEx donors' disease annotations, we defined a “healthy” aging cohort for each tissue. We then compared the age‐associated genes derived from this cohort with age‐associated genes from the “common” aging cohort which included all GTEx donors; we also compared the “healthy” and “common” aging gene expressions with various disease‐associated gene expressions to elucidate the relationships among “healthy,” “common” aging and disease. Our analyses showed that 1. GTEx “healthy” and “common” aging shared a large number of gene regulations; 2. Despite the substantial commonality, “healthy” and “common” aging genes also showed distinct function enrichment, and “common” aging genes had a higher enrichment for disease genes; 3. Disease‐associated gene regulations were overall different from aging gene regulations. However, for genes regulated by both, their regulation directions were largely consistent, implying some aging processes could increase the susceptibility to disease development; and 4. Possible protective mechanisms were associated with some “healthy” aging gene regulations. In summary, our work highlights several unique features of GTEx “healthy” aging program. This new knowledge could potentially be used to develop interventions to promote the human healthspan.
Randomized Clinical Trial of Intravenous (IV) Acetaminophen as an Adjunct to IV Hydromorphone for Acute Severe Pain in Emergency Department Patients
Authors: Bijur Polly E. , Friedman Benjamin W. , White Deborah , Wollowitz Andrew , Campbell Caron , Jones Michael P. , Chang Andrew K. , Gallagher E. John
Published: February 2020

Background

A fundamental challenge for emergency department (ED) clinicians is to relieve severe, acute pain while simultaneously avoiding adverse events associated with opioid analgesics. Because there is evidence that intravenous (IV) acetaminophen is an effective adjuvant analgesic in postoperative settings, we examined whether it also has a role in the ED.

Methods

This was a two‐arm, double‐blind randomized clinical trial. All patients received 1 mg of IV hydromorphone. Patients were then randomized to receive 1 g of IV acetaminophen or placebo. The primary outcome was the between‐group difference in change in pain from baseline (before treatment) to 60 minutes after administration of study drugs, measured on an 11‐point numeric rating scale (NRS).

Results

Of 828 patients screened, 162 were enrolled and 159 had the primary outcome. Patients allocated to acetaminophen + hydromorphone had a mean decline in pain from baseline to 60 minutes of 6.2 NRS units; those receiving placebo + hydromorphone had a mean decline of 5.4, a difference of 0.8 NRS units (95% confidence interval [CI] = −0.01 to 1.8). Two patients in each group received additional analgesics in the first 60 minutes of the study. At 120 minutes the NRS pain difference was 0.6 (95% CI = –0.4 to 1.6). A total of 26.9% of patients who received acetaminophen wanted more analgesia versus 37.7% of those given placebo (difference = –10.8%, 95% CI = −24.3% to 4.4%). The incidence of adverse effects was similar in both groups.

Conclusions

The addition of 1 g of IV acetaminophen to 1 mg of IV hydromorphone provided neither clinically meaningful nor statistically superior analgesia than hydromorphone alone.
Comparison of S‐1 plus oxaliplatin (SOX) and capecitabine plus oxaliplatin (XELOX) as adjuvant chemotherapies for stage II and III gastric cancer after D2 resection: A single‐center retrospective study
Authors: Jiang Zhichao , Sun Yongkun , Zhang Wen , Cui Chengxu , Yang Lin , Zhou Aiping
Published: February 2020

Background

Capecitabine plus oxaliplatin (XELOX) as adjuvant therapy for gastric cancer (GC) reduces cancer recurrence and improves survival. S‐1 plus oxaliplatin (SOX) is well‐tolerated and effective against advanced GC, and also be used widely in adjuvant treatment. However, data comparing SOX and XELOX as adjuvant treatments are lacking.

Method

Data on treatment modalities, adverse events, recurrence and metastasis were collected from 180 patients with stage II and III GC, who received SOX or XELOX after D2 gastrectomy between January 2012 and December 2015, and analyzed retrospectively. The primary endpoint was 3‐year disease‐free survival (DFS) rate.

Results

Median follow was 52.9 months; 3‐year DFS rate and overall survival (OS) rate were 75.2% and 67.6% (P = 0.359) and 81.2% and 83.3% (P = 0.77) in the SOX and XELOX groups, respectively. There was no significant difference in peritoneal metastasis rates in the SOX and XELOX groups (8.6% vs 15%, respectively; P = 0.232). Compound recurrent disease was associated with significantly shorter OS. Multivariate analysis identified metastatic lymph node ratio (LNR) as an independent prognostic factor for OS (P = 0.036; hazard ratio = 2.875; 95% confidence interval, 1.069–7.729); the LNR ≥17% group had inferior 3‐year OS rate to the LNR <17% group (P = 0.001). The incidence of grades 3 and 4 adverse events was similar in both groups; however, grade ≥2 hand–foot syndrome was significantly less frequent in the SOX group (P = 0.01).

Conclusion

SOX has similar survival benefits to XELOX and is well‐tolerated in Chinese patients with GC following D2 gastrectomy.
Modelling of neutrophil dynamics in children receiving busulfan or treosulfan for haematopoietic stem cell transplant conditioning
Authors: Solans Belén P. , Chiesa Robert , Doncheva Bilyana , Prunty Helen , Veys Paul , Trocóniz Iñaki F. , Standing Joseph F.
Published: February 2020

Aims

Busulfan and treosulfan are cytotoxic agents used in the conditioning regime prior to paediatric haematopoietic stem cell transplantation (HSCT). These agents cause suppression of myeloid cells leaving patients severely immunocompromised in the early post‐HSCT period. The main objectives were: (i) to establish a mechanistic pharmacokinetic–pharmacodynamic (PKPD) model for the treatment and engraftment effects on neutrophil counts comparing busulfan and treosulfan‐based conditioning, and (ii) to explore current dosing schedules with respect to time to HSCT.

Methods

Data on 126 patients, 72 receiving busulfan (7 months–18 years, 5.1–47.0 kg) and 54 treosulfan (4 months–17 years, 3.8–35.8 kg), were collected. In total, 8935 neutrophil count observations were recorded during the study period in addition to drug concentrations to develop a mechanistic PKPD model. Absolute neutrophil count profiles were modelled semimechanistically, accounting for transplant effects and differing set points pre‐ and post‐transplant.

Results

PK were best described by 2‐compartment models for both drugs. The Friberg semimechanistic neutropenia model was applied with a linear model for busulfan and a maximum efficacy model for treosulfan describing drug effects at various stages of neutrophil maturation. System parameters were consistent across both drugs. The HSCT was represented by an amount of progenitor cells enhancing the neutrophils' proliferation and maturation compartments. Alemtuzumab was found to enhance the proliferative rate under which the absolute neutrophil count begin to grow after HSCT.

Conclusion

A semimechanistic PKPD model linking exposure to either busulfan or treosulfan to the neutrophil reconstitution dynamics was successfully built. Alemtuzumab coadministration enhanced the neutrophil proliferative rate after HSCT. Treosulfan administration was suggested to be delayed with respect to time to HSCT, leaving less time between the end of the administration and stem cell infusion.
Approaching the Transference Relation in Cognitive‐Behaviourism: Applying a Lacanian Logic
Authors: Craig Angus G.
Published: February 2020

Authors aiming to conceptualize a ‘cognitive countertransference’ continue to search for the most effective way to integrate psychoanalytic theory, and a coherent definition for such a concept. This paper first argues that authentic attempts at integration of the concept of transference into cognitive‐behaviourism require a return to seminal work onÜbertragung(transference) andGegenübertragung(countertransference). References to these terms throughout the work of Sigmund Freud and Jacques Lacan are discussed in the context of the overall progression in the work of both theorists. With regard to two fundamental psychoanalytic concepts that underlie a Freudo‐Lacanian understanding of transference – the unconscious and repetition – this paper subsequently explores how a Lacanian logic may inform the emerging ‘cognitive countertransference’ literature. This paper contextualizes such thinking within the ongoing psychoanalytic debate regarding the utility of the analyst's participation in the transference relation. Ultimately, this paper argues that a cognitive countertransference may be redundant in favour of an understanding of shared cotransference, or transference relation, which begets simple theoretical conclusions, and technical recommendations. Implications for cognitive‐behavioural theory and practice are examined.
Late bedtime and dental caries incidence in Kuwaiti children: A longitudinal multilevel analysis
Authors: Alqaderi Hend , Tavares Mary , Al‐Mulla Fahd , Al‐Ozairi Ebaa , Goodson Jo Max
Published: February 2020

Objective

Inadequate sleep contributes to several adverse systemic health outcomes due to hormonal and metabolic disorders. The purpose of this study was to determine the effect of bedtime on the development of dental caries and the relationship with salivary ghrelin and leptin in a prospective cohort study of Kuwaiti children.

Methods

Data were collected from 5456 10‐year‐old children in 2012 and repeated in 2014. We selected children from 138 middle schools representing the six governorates of Kuwait. We derived data from oral examinations, self‐reported sleep interviews, body and weight measurements, and chemical analysis of whole saliva samples. Leptin and ghrelin were determined by salivary assay in a subset of 744. Two separate analyses were performed. a) Using the entire longitudinal data set (n = 5456), multilevel random intercept analysis was conducted to assess the relationship between reported bedtime and dental caries. b) Using data from a subset of the original sample (n = 744), multiple linear regression analysis was conducted to determine the relationship between dental caries and salivary ghrelin and leptin. The outcome variable was the development of dental caries in children. The independent explanatory variables and confounders were bedtime, sleep duration, salivary ghrelin and leptin; confounders assessed were gingivitis, sex, age and governorate (school location).

Results

With every additional hour past 8 pm for bedtime, there was a 20% increase in dental caries incidence over two years (B = 0.2, P = .01), adjusting for age, gender, gingivitis and governorate. There was a significant difference in the magnitude of dental caries between the six governorates of Kuwait. Lower levels of salivary leptin and higher levels of salivary ghrelin were associated with increased dental caries, and sleep duration was an effect modifier that negatively affected the relationship between leptin and dental caries (B = −0.09, P < .05) and positively affects the relationship between ghrelin and dental caries (B = 0.07, P < .05). Additionally, there was a significant clustering effect within schools in this cohort.

Conclusion

In a cohort study of Kuwaiti children, late bedtime was associated with increased dental caries incidence. Additionally, dental caries experience increased with higher levels of salivary ghrelin and lower levels of salivary leptin, and sleep duration mediates the relationship between these two biomarkers and dental caries.
Molecular approaches to allergen‐specific immunotherapy: Are we so far from clinical implementation?
Authors: Pechsrichuang Phornsiri , Jacquet Alain
Published: February 2020

Conventional allergen‐specific immunotherapy (AIT), based on administrations of allergen extracts, represents up to now the unique protocol for the desensitization of allergic patients. Whereas the effectiveness of AIT was evidenced for the treatment of allergic rhinitis and allergic asthma, such strategy remains experimental for food allergies up to now. However, important issues are commonly associated with AIT as the quality of natural allergen extracts, the long duration and adverse side‐effects which negatively affect successful desensitization together with the patient compliance. The rapid progression of molecular allergology made possible the quest of safer, shorter and more effective immunotherapeutic approaches. The aim of this review was to provide an update on these different innovative recombinant derivatives including their efficacy but also their limitations. Despite promising preclinical and early clinical studies, the absence of convincing data in large phase III trials precludes so far the translation of these immunotherapeutic candidates into the clinic.
Oxidative stress‐induced retinal damage is prevented by mild hypothermia in an ex vivo model of cultivated porcine retinas
Authors: Mueller‐Buehl Ana M. , Doepper Hannah , Grauthoff Sven , Kiebler Tobias , Peters Laura , Hurst José , Kuehn Sandra , Bartz‐Schmidt Karl U. , Dick H. Burkard , Joachim Stephanie C. , Schnichels Sven
Published: February 2020

Background

Hydrogen peroxide (H2O2) can be used in vitro to simulate oxidative stress. In retinal organ cultures, H2O2 induces strong neurodegeneration of the retina. It is known that oxidative stress plays a role in the development of several retinal diseases including glaucoma and ischemia. Thus, we investigated whether processes underlying oxidative stress can be prevented by hypothermia using an ex vivo organ culture model of porcine retinas.

Methods

Porcine retinal explants were cultivated for 5 and 8 days. Oxidative stress was induced via 300 μM H2O2 on day 1 for 3 hours. Hypothermia treatment at 30°C was applied simultaneously with H2O2, for 3 hours. Retinal ganglion cells (RGCs), apoptosis, bipolar and cholinergic amacrine cells, microglia and macroglia were evaluated immunohistologically. Apoptosis rate was additionally analysed via western blot.

Results

Reduced apoptosis rates through hypothermia led to a preservation of RGCs (P < .001). Amacrine cells were rescued after hypothermia treatment (P = .17), whereas bipolar cells were only protected partly. Additionally, at 8 days, microglial response due to oxidative stress was completely counteracted via hypothermia (P < .001).

Conclusions

H2O2 induced strong degenerative processes in porcine retinas. The role of oxidative stress in the progression of retinal diseases makes this ex vivo organ culture model suitable to investigate new therapeutic approaches. In the present study, the damaging effect of H2O2 to several retinal cell types was counteracted or strongly alleviated through hypothermia treatment. Especially RGCs, which are affected in glaucoma disease, were protected due to a reduced apoptosis rate through hypothermia.
How to ask about the use of new psychoactive substances to increase the validity of results in self‐report prevalence surveys
Authors: Drapalova Eva , Belackova Vendula , Cadet‐Taïrou Agnès
Published: February 2020

Introduction and Aims

New psychoactive substances (NPS) represent hundreds of novel compounds. However, the general public might not be familiar with the overarching term NPS. This can result in both under‐ and over‐reporting of NPS use.

Design and Methods

The study analysed the last‐year prevalence of NPS use in an online survey conducted across I‐TREND project countries (the Czech Republic, the Netherlands and Poland). Self‐reported NPS use was assessed within two types of questions—a generic and a checklist question. We analysed prevalence for each question separately, incorporated the free‐text probe ‘other’ that followed them, and combined the two questions into a conservative and an inclusive estimate.

Results

Including free‐text responses to the ‘other’ categories increased prevalence of NPS use (from 51% to 56% for the checklist question and 25% to 32% for the generic question). Taking an inclusive approach to estimating prevalence (i.e. indicating NPS use in either a generic list or from the checklist) yielded a higher prevalence estimate (60%, 95% confidence interval 58–62%), compared to a more conservative approach in which NPS use had to be affirmed by both questions (27%, 95% confidence interval 26–29%).

Discussion and Conclusions

Generic questions might lead to notably lower estimates of self‐reported NPS use in comparison to checklists. However, creating relevant checklists is challenging and lengthy survey instruments have limitations. Further surveys might benefit from featuring a combination of the strategies used in this study—a single (generic) question involving a number of locally specific NPSs and a free‐text ‘other’ probe.
Combined total skin radiotherapy and immune checkpoint inhibitors: A promising potential treatment for mycosis fungoides and Sezary syndrome
Authors: Elsayad Khaled , Stadler Rudolf , Steinbrink Kerstin , Eich Hans Theodor
Published: February 2020

Radiotherapy, particularly total skin electron beam therapy (TSEB), is one of the main pillars in the strategy for treatment of cutaneous T‐cell lymphoma (CTCL). Low‐dose TSEB has gained considerable attention since it has a minimal toxicity profile. Low‐dose TSEB has been shown to yield an overall response rate up to 95 %, although the response duration is usually short. Few studies have been published on treatment outcomes after combined treatment of CTCL with TSEB and systemic therapy. Remission rates of patients who received immune checkpoint inhibitors alone ranged from 15–38 % with a two‐year progression‐free survival of 69 %. Given that TSEB results in rapid reduction of the disease burden in almost all patients, we hypothesized that TSEB followed by immune checkpoint inhibitors might be a reasonable treatment with a sustained effect for treatment‐experienced patients with mycosis fungoides and Sezary syndrome.
Efficacy and tolerability of sodium‐glucose co‐transporter‐2 inhibitors and glucagon‐like peptide‐1 receptor agonists: A systematic review and network meta‐analysis
Authors: Hussein Humaira , Zaccardi Francesco , Khunti Kamlesh , Davies Melanie J. , Patsko Emily , Dhalwani Nafeesa N. , Kloecker David E. , Ioannidou Ekaterini , Gray Laura J.
Published: February 2020

Aim

To compare the efficacy and tolerability of sodium‐glucose co‐transporter 2 inhibitors (SGLT‐2is) and glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) in adults with type 2 diabetes.

Materials and methods

Electronic databases were searched from inception to 24 April 2019 for randomized controlled trials reporting change in glycated haemoglobin (HbA1c) at approximately 24 and/or 52 weeks for SGLT‐2is and/or GLP‐1RAs (classified as short‐ and long‐acting). Bayesian network meta‐analyses were conducted to compare within and between SGLT‐2i and GLP‐1RA classes for cardiometabolic efficacy and adverse events (PROSPERO registration number: CRD42018091306).

Results

Sixty‐four trials (53 trials of 24 weeks; seven trials of 52 weeks; four trials of both 24 and 52 weeks), comprising 31 384 participants were identified. Compared with placebo, all treatments improved HbA1c. Long‐acting GLP‐1RAs reduced HbA1c compared with short‐acting GLP‐1RAs and SGLT‐2is, with semaglutide showing greater reduction compared with placebo [24 weeks: −1.49% (95% credible interval: −1.76, −1.22); 52 weeks: −1.38% (−2.05, −0.71)] and all other treatments. Long‐acting GLP‐1RAs showed benefits in body weight and waist circumference reduction, while SGLT‐2is reduced blood pressure. SGLT‐2is showed increased risk of genital infection in comparison with long‐acting GLP‐1RAs [odds ratio (95% credible interval): 5.26 (1.45, 25.00)], while GLP‐1RAs showed increased risk of diarrhoea in comparison with SGLT‐2is [short‐acting GLP‐1RAs: 1.65 (1.09, 2.49); long‐acting GLP‐1RAs: 2.23 (1.51, 3.28)]. No other differences were found between SGLT‐2is and GLP‐1RAs in adverse events.

Conclusion

Long‐acting GLP‐1RAs showed superiority in reducing HbA1c levels, body weight and waist circumference. SGLT‐2is showed reductions in blood pressure levels. This review provides essential evidence to guide treatment recommendations in the management of type 2 diabetes.
Myocardial longitudinal strain, fitness, and heart failure risk factors in young adults
Authors: Arenas Ivan A. , Podesta Carlos A. , Issa Omar , Lin Jeffrey , Brenes Juan C.
Published: February 2020

Aims

To investigate the relationship between fitness, heart failure (HF) risk factors (age, blood pressure, and obesity), and global/regional myocardial longitudinal strain in young adults undergoing stress testing.

Methods

Individuals 25–55 years old without any significant medical history, not taking medications, and with a normal maximal stress echocardiogram were eligible. Global and regional longitudinal strain (LS) was evaluated by 2D speckle tracking echocardiography.

Results

One hundred and seventy patients were included, of which 60% were males. The mean age was 43 years old, 49% had optimal blood pressure, and 30% were obese. On average, patients achieved 10.5 (3) METS, and the global LS was −19.9 (3.1) %. Reduced fitness was associated with decreased global longitudinal strain (GLS). Those in the top GLS quartile walked on average 1 minute and 21 seconds longer compared with the lowest quartile (P < .001). The effect of fitness on LS was preferential to the mid and apex, such that there was an apex‐to‐base gradient. Obesity was also independently associated with reduced GLS. However, the reduction in LS in obese individuals was more prominent at the base and mid‐walls with relative sparing of the apex. Similar to fitness, aging was also associated with an increase in the apex‐to‐base gradient of LS. Furthermore, diastolic filling parameters correlated distinctively with regional LS.

Conclusions

In young adults without cardiovascular disease, low fitness and obesity are independently associated with reduced left ventricular longitudinal strain. There is a differential effect of HF risk factors on regional longitudinal function.
Unusual place… unusual number
Authors: Vieira Maria João , Craveiro Nuno , Alves Miguel , Pitta Luz
Published: February 2020

Cardiac papillary fibroelastoma is a rare, benign cardiac tumor. It often arises from the valvular endocardium and is usually solitary. Nonvalvular location is rare and even more rare is the presentation as multiple masses. A 71‐year‐old female patient was referred for echocardiographic evaluation due to progressive fatigue. The presence of multiple left atrial masses was observed on echocardiographic evaluation. The patient was treated surgically for the prevention of embolic complications, and the histologic diagnosis of multiple nonvalvular papillary fibroelastoma was made. This case highlights the need to consider this unusual location and presentation for this type of tumor.
A core curriculum in the biological and biomedical sciences for dentistry
Authors: Bennett Jon H. , Beeley Josie A. , Anderson Paul , Belfield Louise , Brand Henk S. , Didilescu Andreea C. , Dymock David , Guven Yegane , Hector Mark P. , Holbrook Peter , Jayasinghe Jaya A. P. , O'Sullivan Jeff , Riggio Marcello , Roger‐Leroi Valerie , Scheven Ben , Sloan Alastair J. , Vandamme Katleen , Manzanares Maria‐Cristina
Published: February 2020

Introduction

The biomedical sciences (BMS) are a central part of the dental curriculum that underpins teaching and clinical practice in all areas of dentistry. Although some specialist groups have proposed curricula in their particular topic areas, there is currently no overarching view of what should be included in a BMS curriculum for undergraduate dental programmes. To address this, the Association for Dental Education in Europe (ADEE) convened a Special Interest Group (SIG) with representatives from across Europe to develop a consensus BMS curriculum for dental programmes.

Curriculum

This paper summarises the outcome of the deliberations of this SIG and details a consensus view from the SIG of what a BMS curriculum should include.

Conclusions

Given the broad nature of BMS applied to dentistry, this curriculum framework is advisory and seeks to provide programme planners with an indicative list of topics which can be mapped to specific learning objectives within their own curricula. As dentistry becomes increasingly specialised, these will change, or some elements of the undergraduate curriculum may move to the post‐graduate setting. So, this document should be seen as a beginning and it will need regular review as BMS curricula in dentistry evolve.
Non‐memory cognitive symptom development in Alzheimer's disease
Authors: Blenkinsop A. , van der Flier W. M. , Wolk D. , Lehmann M. , Howard R. , Frost C. , Barnes J.
Published: February 2020

Background and purpose

Memory is known to be the most common first symptom in Alzheimer’s disease (AD). Assessing non‐memory cognitive symptom development in AD is important for understanding disease progression and the potential identification of treatment‐responsive subtypes.

Methods

Data from the National Alzheimer’s Coordinating Center were examined. Logistic regression models were fitted evaluating the development of judgement, language, visuospatial and attention symptoms at first and second visits to Alzheimer’s Disease Centers. Predictors were age and prior symptoms, adjusting for symptom length and sex. The models were then refitted assessing apolipoprotein E ε4 (APOE‐ε4) effects.

Results

Each decade reduction in presentation age increased the odds of language, visuospatial and attention symptom development at both visits by 8%–18% (P < 0.05, all tests), and judgement symptoms at the second visit by 13% (P < 0.05). Prior symptoms were not equally predictive of symptom development. For example, having first predominant language symptoms carried the lowest risk of developing other first‐visit symptoms and having memory symptoms was a stronger predictor of developing judgement than other symptoms. The APOE‐ε4 gene showed little impact on symptom development when included as a predictor.

Conclusions

Our findings provide support for the concept that younger‐onset AD is associated with the progressive development of more non‐memory symptoms beyond the first time point. Associations between symptoms were evident, which may reflect that pathology can remain isolated in a network for some time. APOE‐ε4 status had little influence on cognitive symptom development which may indicate that the effect it has occurs very early in the disease course.
Pro‐islet amyloid polypeptide in micelles contains a helical prohormone segment
Authors: DeLisle Charles F. , Malooley Alexander L. , Banerjee Indrani , Lorieau Justin L.
Published: February 2020

Pro‐islet amyloid polypeptide (proIAPP) is the prohormone precursor molecule to IAPP, also known as amylin. IAPP is a calcitonin family peptide hormone that is cosecreted with insulin, and largely responsible for hunger satiation and metabolic homeostasis. Amyloid plaques containing mixtures of mature IAPP and misprocessed proIAPP deposit on, and destroy pancreatic β‐cell membranes, and they are recognized as a clinical hallmark of type 2 diabetes mellitus. In order to better understand the interaction with cellular membranes, we solved the solution NMR structure of proIAPP bound to dodecylphosphocholine micelles at pH 4.5. We show that proIAPP is a dynamic molecule with four α‐helices. The first two helices are contained within the mature IAPP sequence, while the second two helices are part of the C‐terminal prohormone segment (Cpro). We mapped the membrane topology of the amphipathic helices by paramagnetic relaxation enhancement, and we used CD and diffusion‐ordered spectroscopy to identify environmental factors that impact proIAPP membrane affinity. We discuss how our structural results relate to prohormone processing based on the varied pH environments and lipid compositions of organelle membranes within the regulated secretory pathway, and the likelihood of Cpro survival for cosecretion with IAPP.

Database

The assigned resonances have been deposited in the Biological Magnetic Resonance Bank (BMRB) with accession numbers 50007 and 50019 for proIAPP and Cpro, respectively. The lowest energy structures have been deposited in the Protein Data Bank (PDB) with access codes 6UCJ and 6UCK.
Assessing the influence of wildfire on leaf decomposition and macroinvertebrate communities in boreal streams using mixed‐species leaf packs
Authors: Musetta‐Lambert Jordan L. , Kreutzweiser David P. , Sibley Paul K.
Published: February 2020

We investigated how compositional differences in riparian leaf litter derived from burned and undisturbed forests influenced leaf breakdown and macroinvertebrate communities using experimental mixed‐species leaf packs in boreal headwater streams. Leaf pack mixtures simulating leaf litter from dominant riparian woody‐stem species in burned and undisturbed riparian zones were incubated in two references and two fire‐disturbed streams for 5 weeks prior to measuring temperature‐corrected breakdown rates and macroinvertebrate community composition, richness, and functional metrics associated with decomposers such as shredder abundance and % shredders.

Leaf litter breakdown rates were higher and had greater variability in streams bordered by reference riparian forests than in streams where riparian forests had been burned during a wildfire. Streams bordered by fire disturbance showed significant effects of litter mixture on decomposition rates, observed as significantly higher decomposition rates of a fire‐simulated leaf mixture compared to all other mixtures.

Variation among sites was higher than variation among litter mixtures, especially for macroinvertebrate community composition. In general, fire‐simulated leaf mixtures had greater shredder abundances and proportions, but lower overall macroinvertebrate abundance; however, the shredder abundance trend was not consistent across all leaf mixtures at each stream.

These results show that disturbance‐driven riparian forest condition and resulting composition of leaf subsidies to streams can influence aquatic invertebrate community composition and their function as decomposers. Therefore, if one of the primary goals of modern forest management is to emulate natural disturbance patterns, boreal forest managers should adapt silvicultural practices to promote leaf litter input that would arise post‐fire, thereby supporting stream invertebrate communities and their function.
The case for research integration, from genomics to remote sensing, to understand biodiversity change and functional dynamics in the world's lakes
Authors: Thackeray Stephen J. , Hampton Stephanie E.
Published: February 2020

Freshwater ecosystems are heavily impacted by multiple stressors, and a freshwater biodiversity crisis is underway. This realization has prompted calls to integrate global freshwater ecosystem data, including traditional taxonomic and newer types of data (e.g., eDNA, remote sensing), to more comprehensively assess change among systems, regions, and organism groups. We argue that data integration should be done, not only with the important purpose of filling gaps in spatial, temporal, and organismal representation, but also with a more ambitious goal: to study fundamental cross‐scale biological phenomena. Such knowledge is critical for discerning and projecting ecosystem functional dynamics, a realm of study where generalizations may be more tractable than those relying on taxonomic specificity. Integration could take us beyond cataloging biodiversity losses, and toward predicting ecosystem change more broadly. Fundamental biology questions should be central to integrative, interdisciplinary research on causal ecological mechanisms, combining traditional measures and more novel methods at the leading edge of the biological sciences. We propose a conceptual framework supporting this vision, identifying key questions and uncertainties associated with realizing this research potential. Our framework includes five interdisciplinary “complementarities.” First, research approaches may provide comparative complementarity when they offer separate realizations of the same focal phenomenon. Second, for translational complementarity, data from one research approach is used to translate that from another, facilitating new inferences. Thirdly, causal complementarity arises when combining approaches allows us to “fill in” cause–effect relationships. Fourth, contextual complementarity is realized when together research methodologies establish the wider ecological and spatiotemporal context within which focal biological responses occur. Finally, integration may allow us to cross inferential scales through scaling complementarity. Explicitly identifying the modes and purposes of integrating research approaches, and reaching across disciplines to establish appropriate collaboration will allow researchers to address major biological questions that are more than the sum of the parts.
The Effect of Reflexology on Lactation and Postpartum Comfort in Caesarean‐Delivery Primiparous Mothers: A Randomized Controlled Study
Authors: Çankaya Seyhan , Ratwisch Gülay
Published: February 2020

Aim

This study aimed to investigate the effect of reflexology on lactation and postpartum comfort in primiparas giving births through caesarean section.

Methods

This randomized controlled trial was conducted in 100 women with first birth through caesarean section between May 2016 and May 2017. Expectant mothers were randomly included into an intervention and a control group. The intervention group consisted of mothers in whom reflexology was performed three times per day at every eight hours for 30 min for 3 days.

Results

The mean scores of the breastfeeding chart system and breastfeeding satisfaction scores of the mothers in the intervention group were significantly higher than those of the controls, and the first lactation period of the mothers in the intervention group was shorter than that of the controls. Mean breast‐tension, breast‐heat, and breast‐pain scores were similar in both groups on day 1; however, a significant increase was seen the intervention group on days 2 and 3, compared to those in the controls. The mean scores of the Postpartum Comfort Questionnaire in the intervention group were significantly better than those of the controls.

Conclusions

Reflexology starts lactation earlier in mothers giving birth via caesarean section, supports the breastfeeding period, and increases mothers' postpartum comfort.