bluuebunny/crossref_metadata_2025 huggingface dataset:
Postural Stability Under Dual-Task Conditions: Development of a Post-Concussion Assessment for Lower-Extremity Injury Risk
Authors: Westwood Caroline , Killelea Carolyn , Faherty Mallory , Sell Timothy
Published: April 2019

Context: Concussions are consequence of sports participation. Recent reports indicate there is an increased risk of lower-extremity musculoskeletal injury when returning to sport after concussion suggesting that achieving “normal” balance may not fully indicate the athlete is ready for competition. The increased risk of injury may indicate the need to refine a screening tool for clearance.
Objective: Assess the between-session reliability and the effects of adding a cognitive task to static and dynamic postural stability testing in a healthy population.
Setting: Clinical laboratory.
Participants: Twelve healthy subjects (6 women; age 22.3 [2.9] y, height 174.4 [7.5] cm, weight 70.1 [12.7] kg) participated in this study.
Design: Subjects underwent static and dynamic postural stability testing with and without the addition of a cognitive task (Stroop test). Test battery was repeated 10 days later. Dynamic postural stability testing consisted of a forward jump over a hurdle with a 1-legged landing. A stability index was calculated. Static postural stability was also assessed with and without the cognitive task during single-leg balance. Variability of each ground reaction force component was averaged.
Main Outcome Measures: Interclass correlation coefficients (ICC2,1) were computed to determine the reliability. Standard error of measure, mean standard error, mean detectable change, and 95% confidence interval were all calculated.
Results: Mean differences between sessions were low, with the majority of variables having moderate to excellent reliability (static .583–.877, dynamic .581–.939). The addition of the dual task did not have any significant effect on reliability of the task; however, generally, the ICC values improved (eyes open .583–.770, dual task .741–.808).
Conclusions: The addition of a cognitive load to postural stability assessments had moderate to excellent reliability in a healthy population. These results provide initial evidence on the feasibility of dual-task postural stability testing when examining risk of lower-extremity musculoskeletal injury following return to sport in a concussed population.
Spontaneous behaviors drive multidimensional, brainwide activity
Authors: Stringer Carsen , Pachitariu Marius , Steinmetz Nicholas , Reddy Charu Bai , Carandini Matteo , Harris Kenneth D.
Published: April 2019

Neuron activity across the brain

How is it that groups of neurons dispersed through the brain interact to generate complex behaviors? Three papers in this issue present brain-scale studies of neuronal activity and dynamics (see the Perspective by Huk and Hart). Allen
et al.
found that in thirsty mice, there is widespread neural activity related to stimuli that elicit licking and drinking. Individual neurons encoded task-specific responses, but every brain area contained neurons with different types of response. Optogenetic stimulation of thirst-sensing neurons in one area of the brain reinstated drinking and neuronal activity across the brain that previously signaled thirst. Gründemann
et al.
investigated the activity of mouse basal amygdala neurons in relation to behavior during different tasks. Two ensembles of neurons showed orthogonal activity during exploratory and nonexploratory behaviors, possibly reflecting different levels of anxiety experienced in these areas. Stringer
et al.
analyzed spontaneous neuronal firing, finding that neurons in the primary visual cortex encoded both visual information and motor activity related to facial movements. The variability of neuronal responses to visual stimuli in the primary visual area is mainly related to arousal and reflects the encoding of latent behavioral states.

Science
, this issue p.
eaav3932
, p.
eaav8736
, p.
eaav7893
; see also p.
236
Isolation and Characterization of Live Yeast Cells from Ancient Vessels as a Tool in Bio-Archaeology
Authors: Aouizerat Tzemach , Gutman Itai , Paz Yitzhak , Maeir Aren M. , Gadot Yuval , Gelman Daniel , Szitenberg Amir , Drori Elyashiv , Pinkus Ania , Schoemann Miriam , Kaplan Rachel , Ben-Gedalya Tziona , Coppenhagen-Glazer Shunit , Reich Eli , Saragovi Amijai , Lipschits Oded , Klutstein Michael , Hazan Ronen
Published: April 2019

So far, most of the study of ancient organisms has been based mainly on the analysis of ancient DNA. Here we show that it is possible to isolate and study microorganisms—yeast in this case—from ancient pottery vessels used for fermentation. We demonstrate that it is highly likely that these cells are descendants of the original yeast strains that participated in the fermentation process and were absorbed into the clay matrix of the pottery vessels. Moreover, we characterized the isolated yeast strains, their genomes, and the beer they produced. These results open new and exciting avenues in the study of domesticated microorganisms and contribute significantly to the fields of bio- and experimental archaeology that aim to reconstruct ancient artifacts and products.
Enrichment and Proteomic Characterization of the Cyst Wall from
In Vitro
Toxoplasma gondii Cysts
Authors: Tu Vincent , Mayoral Joshua , Sugi Tatsuki , Tomita Tadakimi , Han Bing , Ma Yan Fen , Weiss Louis M.
Published: April 2019

Toxoplasma gondii
is a highly prevalent parasite worldwide that presents life-threatening risks to immunocompromised and pregnant individuals. Whereas the life stage responsible for acute infection can be treated, the life stage responsible for chronic infection is refractory to currently available therapeutics. Little is known about the protein composition of the cyst wall, an amorphous structure formed by parasites that is suspected to facilitate persistence within muscle and nervous tissue during chronic (latent) infection. By implementing a refined approach to selectively purify cyst wall fragments, we identified several known and novel cyst wall proteins from our sample preparations. We confirmed the localizations of several proteins from this data set and identified one that is involved in parasite virulence. These data will propel further studies on cyst wall structure and function, leading to therapeutic strategies that can eliminate the chronic infection stage.
Global Spread of Mutant PfCRT and Its Pleiotropic Impact on Plasmodium falciparum Multidrug Resistance and Fitness
Authors: Dhingra Satish K. , Gabryszewski Stanislaw J. , Small-Saunders Jennifer L. , Yeo Tomas , Henrich Philipp P. , Mok Sachel , Fidock David A.
Published: April 2019

Our study defines the allelic distribution of
pfcrt
, an important mediator of multidrug resistance in
Plasmodium falciparum
, in Africa and Asia. We leveraged whole-genome sequence analysis and gene editing to demonstrate how current drug combinations can select different allelic variants of this gene and shape region-specific parasite population structures. We document the ability of PfCRT mutations to modulate parasite susceptibility to current antimalarials in dissimilar,
pfcrt
allele-specific ways. This study underscores the importance of actively monitoring
pfcrt
genotypes to identify emerging patterns of multidrug resistance and help guide region-specific treatment options.
Impact of breast milk intake on body composition at term in very preterm babies: secondary analysis of the Nutritional Evaluation and Optimisation in Neonates randomised controlled trial
Authors: Li Yangmei , Liu Xinxue , Modi Neena , Uthaya Sabita
Published: April 2019

Objective

To investigate the impact of breast milk (BM) intake on body composition at term in very preterm infants.

Design

Preplanned secondary analysis of the Nutritional Evaluation and Optimisation in Neonates Study, a 2-by-2 factorial randomised controlled trial of preterm parenteral nutrition (PN).

Setting

Four National Health Service hospitals in London and South-East England.

Patients

Infants born at <31 weeks of gestation; infants with life-threatening congenital abnormalities and those unable to receive trial PN within 24 hours of birth were ineligible. 133 infants survived and underwent whole-body MRI at term (37–44 weeks postmenstrual age).

Main outcome measures

Non-adipose tissue mass (non-ATM), ATM and ATM as a percentage of body weight (% ATM) at term.

Results

Compared with the exclusively BM group (proportion of BM=100% milk, n=56), predominantly formula-fed infants (BM ≤50%, n=38) weighed 283.6 g (95% CI 121.6 to 445.6) more, had 257.4 g (139.1–375.7) more non-ATM and a greater positive weight Z-score change between birth and term. There were no significant differences in weight, non-ATM and weight Z-score change between the exclusively and predominantly BM (BM 51%–99%, n=39) groups. Compared with the exclusively BM group no significant differences were observed in ATM and %ATM in the predominantly BM and predominantly formula-fed groups.

Conclusions

The slower weight gain of preterm infants fed BM appears to be due to a deficit in non-ATM and may reflect lower protein intake. Whether this pattern persists into childhood, is altered by BM fortification or later diet, or relates to functional outcomes, are important research questions.

Clinical trial registration

ISRCTN29665319, post results.
School-age outcomes of children without cerebral palsy cooled for neonatal hypoxic–ischaemic encephalopathy in 2008–2010
Authors: Lee-Kelland Richard , Jary Sally , Tonks James , Cowan Frances M , Thoresen Marianne , Chakkarapani Ela
Published: April 2019

Objective

Since therapeutic hypothermia became standard care for neonatal hypoxic–ischaemic encephalopathy (HIE), even fewer infants die or have disability at 18-month assessment than in the clinical trials. However, longer term follow-up of apparently unimpaired children is lacking. We investigated the cognitive, motor and behavioural performances of survivors without cerebral palsy (CP) cooled for HIE, in comparison with matched non-HIE control children at 6–8 years.

Design

Case–control study.

Participants

29 case children without CP, cooled in 2008–2010 and 20 age-matched, sex-matched and social class-matched term-born controls.

Measures

Wechsler Intelligence Scales for Children, Fourth UK Edition, Movement Assessment Battery for Children, Second Edition (MABC-2) and Strengths and Difficulties Questionnaire.

Results

Cases compared with controls had significantly lower mean (SD) full-scale IQ (91 [10.37]vs105[13.41]; mean difference (MD): −13.62, 95% CI −20.53 to –6.71) and total MABC-2 scores (7.9 [3.26]vs10.2[2.86]; MD: −2.12, 95% CI −3.93 to –0.3). Mean differences were significant between cases and controls for verbal comprehension (−8.8, 95% CI –14.25 to –3.34), perceptual reasoning (−13.9, 95% CI–20.78 to –7.09), working memory (−8.2, 95% CI–16.29 to –0.17), processing speed (−11.6, 95% CI–20.69 to –2.47), aiming and catching (−1.6, 95% CI–3.26 to –0.10) and manual dexterity (−2.8, 95% CI–4.64 to –0.85). The case group reported significantly higher median (IQR) total (12 [6.5–13.5] vs 6 [2.25–10], p=0.005) and emotional behavioural difficulties (2 [1–4.5] vs 0.5 [0–2.75], p=0.03) and more case children needed extra support in school (34%vs5%, p=0.02) than the control group.

Conclusions

School-age children without CP cooled for HIE still have reduced cognitive and motor performance and more emotional difficulties than their peers, strongly supporting the need for school-age assessments.
Volumetric parameters-based differentiation of narrow angle from open angle and classification of angle configurations: an SS-OCT study
Authors: Li Fei , Zhou Rouxi , Gao Kai , Jin Ling , Zhang Xiulan
Published: April 2019

Background

To evaluate the diagnostic ability of volumetric parameters to differentiate narrow angle from open angle and distinguish different configurations of narrow angle.

Methods

The current study was composed of two parts. In the first part, with gonioscopy as reference standard, we tested power of each parameter to differentiate narrow angle from open angle. In the second part, we evaluated the efficacy of different parameters to distinguish angle configurations which were subclassified into type 1 (pupillary block) and type 2 (non-pupillary block and multiple mechanisms) based on ultrasound biomicroscopy (UBM) images.

Results

In part 1, the training set was composed of 117 narrow-angle eyes and 60 open-angle eyes, and the validation set included 38 narrow-angle eyes and 37 open-angle eyes. Anterior chamber volume (ACV) outperformed all the other parameters with an area under the curve (AUC) of 0.988. The sensitivity and specificity of the cut-off value 98.1 mm3 in the validation set were 90.0% and 97.1%, respectively. In part 2, training set was composed of 96 eyes of 88 patients with primary angle-closure disease, with 49 diagnosed as type 1 and 47 as type 2 configuration. 32 eyes were used for validation. A model comprised of iris volume (IV), iris thickness (IT) 2000 µm from the scleral spur and angle open distance (AOD) 750 µm from the scleral spur was found to have an AUC of 0.793 (95% CI, 0.695 to 0.870). Sensitivity and specificity of the model were 82.6% and 77.8% respectively in the validation set.

Conclusions

With ACV, we can detect patients with narrow angle from open angle faster and more easily than AOD and anterior chamber depth. Then, for patients with narrow angle, the combination of IV, IT and AOD750 measured by swept-source optical coherence tomography could further classify configurations of angle closure compared with UBM.
Effect of segmentation error correction on optical coherence tomography angiography measurements in healthy subjects and diabetic macular oedema
Authors: Ghasemi Falavarjani Khalil , Habibi Abbas , Anvari Pasha , Ghasemizadeh Shahriar , Ashraf Khorasani Maryam , Shenazandi Hamideh , Sarraf David
Published: April 2019

Purpose

To evaluate the impact of segmentation error on vessel density measurements in healthy eyes and eyes with diabetic macular oedema (DMO).

Methods

In this prospective, comparative, non-interventional study, enface optical coherence tomography angiography (OCTA) images of the macula from healthy eyes and eyes with DMO were acquired. Two expert graders assessed and corrected the segmentation error. The rate of segmentation error and the changes in vessel density and inner retinal thickness after correction of the segmentation error were recorded and compared between the two groups.

Results

20 eyes with DMO and 24 healthy eyes were evaluated. Intergrader agreement was excellent (intraclass correlation coefficient ≥0.9) for all parameters in both groups. The rate of segmentation error was 33% and 100% in healthy and diabetic eyes, respectively (p<0.001). Nine healthy eyes (37.5%) and all eyes with DMO (100%) were noted to exhibit a change in at least one of the foveal or parafoveal vessel density measurements. The rate of any change in foveal and parafoveal vessel densities in both the superficial and deep capillary plexus was statistically significantly higher in the diabetic group (all p<0.001). No statistically significant change was observed in mean vessel density (superficial and deep capillary plexuses) after correction of the segmentation error in healthy and DMO eyes (All p>0.05). However, the mean absolute change in the vessel density measurements was statistically significantly higher in the diabetic group (all p<0.05). The mean absolute change in superficial and deep inner retinal thickness was statistically significantly higher in DMO (p=0.02 and p=0.002, respectively).

Conclusions

In this study, misidentification of retinal layers and consequent vessel density measurement error occurred in all eyes with DMO and in one-third of healthy eyes. The segmentation error should be checked and manually corrected in the OCTA vessel density measurements, especially in the presence of macular oedema.
Distinct effects of acute exercise and breaks in sitting on working memory and executive function in older adults: a three-arm, randomised cross-over trial to evaluate the effects of exercise with and without breaks in sitting on cognition
Authors: Wheeler Michael J , Green Daniel J , Ellis Kathryn A , Cerin Ester , Heinonen Ilkka , Naylor Louise H , Larsen Robyn , Wennberg Patrik , Boraxbekk Carl-Johan , Lewis Jaye , Eikelis Nina , Lautenschlager Nicola T , Kingwell Bronwyn A , Lambert Gavin , Owen Neville , Dunstan David W
Published: April 2019

Background

Sedentary behaviour is associated with impaired cognition, whereas exercise can acutely improve cognition.

Objective

We compared the effects of a morning bout of moderate-intensity exercise, with and without subsequent light-intensity walking breaks from sitting, on cognition in older adults.

Methods

Sedentary overweight/obese older adults with normal cognitive function (n=67, 67±7 years, 31.2±4.1 kg/m2) completed three conditions (6-day washout): SIT (sitting): uninterrupted sitting (8 hours, control); EX+SIT (exercise + sitting): sitting (1 hour), moderate-intensity walking (30 min), uninterrupted sitting (6.5 hours); and EX+BR (exercise + breaks): sitting (1 hour), moderate-intensity walking (30 min), sitting interrupted every 30 min with 3 min of light-intensity walking (6.5 hours). Cognitive testing (Cogstate) was completed at four time points assessing psychomotor function, attention, executive function, visual learning and working memory. Serum brain-derived neurotrophic growth factor (BDNF) was assessed at six time points. The 8-hour net area under the curve (AUC) was calculated for each outcome.

Results

Working memory net AUC z-score·hour (95% CI) was improved in EX+BR with a z-score of +28 (−26 to +81), relative to SIT, −25 (−79 to +29, p=0.04 vs EX+BR). Executive function net AUC was improved in EX+SIT, −8 (− 71 to +55), relative to SIT, −80 (−142 to −17, p=0.03 vs EX+SIT). Serum BDNF net AUC ng/mL·hour (95% CI) was increased in both EX+SIT, +171 (−449 to +791, p=0.03 vs SIT), and EX+BR, +139 (−481 to +759, p=0.045 vs SIT), relative to SIT, −227 (−851 to +396).

Conclusion

A morning bout of moderate-intensity exercise improves serum BDNF and working memory or executive function in older adults, depending on whether or not subsequent sitting is also interrupted with intermittent light-intensity walking.

Trial registration number

ACTRN12614000737639.
Return to play and risk of repeat concussion in collegiate football players: comparative analysis from the NCAA Concussion Study (1999–2001) and CARE Consortium (2014–2017)
Authors: McCrea Michael , Broglio Steven , McAllister Thomas , Zhou Wenxian , Zhao Shi , Katz Barry , Kudela Maria , Harezlak Jaroslaw , Nelson Lindsay , Meier Timothy , Marshall Stephen William , Guskiewicz Kevin M
Published: April 2019

Objective

We compared data from the National Collegiate Athletic Association (NCAA) Concussion Study (1999–2001) and the NCAA-Department of Defense Concussion Assessment, Research and Education (CARE) Consortium (2014–2017) to examine how clinical management, return to play (RTP) and risk of repeat concussion in collegiate football players have changed over the past 15 years.

Methods

We analysed data on reported duration of symptoms, symptom-free waiting period (SFWP), RTP and occurrence of within-season repeat concussion in collegiate football players with diagnosed concussion from the NCAA Study (n=184) and CARE (n=701).

Results

CARE athletes had significantly longer symptom duration (CARE median=5.92 days, IQR=3.02–9.98 days; NCAA median=2.00 days, IQR=1.00–4.00 days), SFWP (CARE median=6.00 days, IQR=3.49–9.00 days; NCAA median=0.98 days, IQR=0.00–4.00 days) and RTP (CARE median=12.23 days, IQR=8.04–18.92 days; NCAA median=3.00 days, IQR=1.00–8.00 days) than NCAA Study athletes (all p<0.0001). In CARE, there was only one case of repeat concussion within 10 days of initial injury (3.7% of within-season repeat concussions), whereas 92% of repeat concussions occurred within 10 days in the NCAA Study (p<0.001). The average interval between first and repeat concussion in CARE was 56.41 days, compared with 5.59 days in the NCAA Study (M difference=50.82 days; 95% CI 38.37 to 63.27; p<0.0001).

Conclusion

Our findings indicate that concussion in collegiate football is managed more conservatively than 15 years ago. These changes in clinical management appear to have reduced the risk of repetitive concussion during the critical period of cerebral vulnerability after sport-related concussion (SRC). These data support international guidelines recommending additional time for brain recovery before athletes RTP after SRC.
Descriptive, observational study of pharmaceutical and non-pharmaceutical arrests, use, and overdoses in Maine
Authors: Simpson Kevin J , Moran Matthew T , Foster Michelle L , Shah Dipam T , Chung Daniel Y , Nichols Stephanie D , McCall Kenneth L , Piper Brian J
Published: April 2019

Objectives

The Maine Diversion Alert Program grants healthcare providers access to law enforcement data on drug charges. The objectives of this report were to analyse variations in drug charges by demographics and examine recent trends in arrests, prescriptions of controlled substances and overdoses.

Design

Observational.

Setting

Arrests, controlled prescription medication distribution and overdoses in Maine.

Participants

Drug arrestees (n=1272) and decedents (n=2432).

Primary outcome measures

Arrestees were analysed by sex and age. Substances involved in arrests were reported by schedule (I–V or non-controlled prescription) and into opioids, stimulants or other classes. Controlled substances reported to the Drug Enforcement Administration (2007–2017) were evaluated. Drug-induced deaths (2007–2017) reported to the medical examiner were examined by the substance(s) identified.

Results

Males were more commonly arrested for stimulants and schedule II substances. More than two-thirds of arrests involved individuals under the age of 40. Individuals age>60 were elevated for oxycodone arrests. Over three-fifths (63.38%) of arrests involved schedule II–IV substances. Opioids accounted for almost half (44.6%) of arrests followed by stimulants (32.5%) and sedatives (9.1%). Arrests involving buprenorphine exceeded those for oxycodone, hydrocodone, methadone, tramadol and morphine, combined. Prescriptions for hydrocodone (−56.0%) and oxycodone (−46.9%) declined while buprenorphine increased (+58.1%) between 2012 and 2017. Deaths from 2007 to 2017 tripled. Acetylfentanyl and furanylfentanyl were the most common fentanyl analogues identified.

Conclusions

Although the overall profile of those arrested for drug crimes in 2017 involve males, age <40 and heroin, exceptions (oxycodone for older adults) were observed. Most prescription opioids are decreasing while deaths involving opioids continue to increase in Maine.
Recognising eosinophilic oesophagitis as a cause of food bolus obstruction
Authors: Ntuli Yevedzo , Bough Isabelle , Wilson Michael
Published: April 2019

Background

Eosinophilic oesophagitis (EoE) is a chronic, inflammatory condition of the oesophagus, characterised by intermittent dysphagia, food bolus obstruction (FBO) and histologically proven, eosinophil-mediated inflammation. EoE is identified in up to 50% of FBO presentations.

Objective

To evaluate the management of patients presenting with FBO to our centre against current clinical guidelines.

Design

A retrospective analysis of acute FBO was performed between January 2008 and August 2014. Patients were identified using the ICD 10 code T18.1, ‘foreign body in oesophagus’ in their electronic discharge document. Data were collected on admitting specialty, previous FBO, endoscopy findings, biopsy sites and findings, eosinophil count and diagnosis of EoE.

Results

310 acute episodes of FBO were included in the final study cohort. 202 (65.2%) flexible oesophagogastroduodenoscopies (OGDs) were performed, with 50 (34.5%) of those occurring in those admitted under ENT (n=145), versus 28 (93.3%) and 124 (91.9%) in general medicine (n=30) and surgery (n=135), respectively. 80 (39.6%) had oesophageal biopsies taken, and 21 novel diagnoses of EoE were made (26.3% biopsy-proven rate). Five (23.8%) of the novel diagnoses had a formal eosinophil count included in the histopathology report, and eight (38.1%) had up to three previous OGDs that had not diagnosed their condition of EoE.

Conclusion

Our study highlights wide variation in adherence to the guidelines for the management of FBO depending on admitting specialty. We advocate an FBO protocol involving single specialty management, flexible OGD, ≥6 biopsies from the upper and lower oesophagus, and standardisation of oesophageal biopsy reports with a formal eosinophil count.
Infants born to mothers with IBD present with altered gut microbiome that transfers abnormalities of the adaptive immune system to germ-free mice
Authors: Torres Joana , Hu Jianzhong , Seki Akihiro , Eisele Caroline , Nair Nilendra , Huang Ruiqi , Tarassishin Leonid , Jharap Bindia , Cote-Daigneault Justin , Mao Qixing , Mogno Ilaria , Britton Graham J , Uzzan Mathieu , Chen Ching-Lynn , Kornbluth Asher , George James , Legnani Peter , Maser Elana , Loudon Holly , Stone Joanne , Dubinsky Marla , Faith Jeremiah J , Clemente Jose C , Mehandru Saurabh , Colombel Jean-Frederic , Peter Inga
Published: April 2019

Background and aims

Prenatal and early life bacterial colonisation is thought to play a major role in shaping the immune system. Furthermore, accumulating evidence links early life exposures to the risk of developing IBD later in life. We aimed to assess the effect of maternal IBD on the composition of the microbiome during pregnancy and on the offspring’s microbiome.

Methods

We prospectively examined the diversity and taxonomy of the microbiome of pregnant women with and without IBD and their babies at multiple time points. We evaluated the role of maternal IBD diagnosis, the mode of delivery, antibiotic use and feeding behaviour on the microbiome composition during early life. To assess the effects of IBD-associated maternal and infant microbiota on the enteric immune system, we inoculated germ-free mice (GFM) with the respective stool and profiled adaptive and innate immune cell populations in the murine intestines.

Results

Pregnant women with IBD and their offspring presented with lower bacterial diversity and altered bacterial composition compared with control women and their babies. Maternal IBD was the main predictor of the microbiota diversity in the infant gut at 7, 14, 30, 60 and 90 days of life. Babies born to mothers with IBD demonstrated enrichment in Gammaproteobacteria and depletion in Bifidobacteria. Finally, GFM inoculated with third trimester IBD mother and 90-day infant stools showed significantly reduced microbial diversity and fewer class-switched memory B cells and regulatory T cells in the colon.

Conclusion

Aberrant gut microbiota composition persists during pregnancy with IBD and alters the bacterial diversity and abundance in the infant stool. The dysbiotic microbiota triggered abnormal imprinting of the intestinal immune system in GFM.
Comparison between optical microscopy and automation for cytometric analysis of pericardial fluids in a cohort of adult subjects undergoing cardiac surgery
Authors: Buoro Sabrina , Seghezzi Michela , Baigorria Vaca Maria del Carmen , Manenti Barbara , Moioli Valentina , Previtali Giulia , Simon Caterina , Cugola Diego , Brucato Antonio , Ottomano Cosimo , Lippi Giuseppe
Published: April 2019

Aims

Limited information is available on number and type of cells present in the pericardial fluid (PF). Current evidence and has been garnered with inaccurate application of guidelines for analysis of body fluids. This study was aimed at investigating the performance of automate cytometric analysis of PF in adult subjects.

Methods

Seventy-four consecutive PF samples were analysed with Sysmex XN with a module for body fluid analysis (XN-BF) and optical microscopy (OM). The study also encompassed the assessment of limit of blank, limit of detection and limit of quantitation (LoQ), imprecision, carryover and linearity of XN-BF module.

Results

XN-BF parameters were compared with OM for the following cell classes: total cells (TC), leucocytes (white blood cell [WBC]), polymorphonuclear (PMN) and mononuclear (MN) cells. The relative bias were −4.5%, 71.2%, 108.2% and −47.7%, respectively. Passing and Bablok regression yielded slope comprised between 0.06 for MN and 5.8 for PMN, and intercept between 0.7 for PMN and 220.3 for MN. LoQ was comprised between 3.8×106and 6.0×106cells/L for WBC and PMN. Linearity was acceptable and carryover negligible.

Conclusions

PF has a specific cellular composition. Overall, automated cell counting can only be suggested for total number of cells, whereas OM seems still the most reliable option for cell differentiation.
Too sick to work, too healthy to qualify: a cross-country analysis of the effect of changes to disability benefits
Authors: Jensen Natasja Koitzsch , Brønnum-Hansen Henrik , Andersen Ingelise , Thielen Karsten , McAllister Ashley , Burström Bo , Barr Ben , Whitehead Margaret , Diderichsen Finn
Published: April 2019

Background

Denmark and Sweden have implemented reforms that narrowed disability benefit eligibility criteria. Such reforms in combination with increasing work demands create a pincer movement where in particular those with moderate health problems might be unable to comply with work demands, but still not qualify for permanent disability benefits, ending up with temporary means-tested or no benefits. This paper examines whether this actually happened before and after the reforms.

Methods

The Survey of Health, Ageing and Retirement in Europe (SHARE) study waves 1–2 and 4–6 in Denmark and Sweden for the age group 50–59 years (N=5384) was used to analyse changes in employment rates and benefits among people with different levels of health before, during and after disability benefit reforms. Interaction between time and health in relation to employment versus permanent or temporary benefits was used as a criterion for whether our hypotheses was confirmed.

Results

Overall, employment rates have increased in the age group, but only among the healthy. The OR for receiving temporary or no benefits increased from 1.25 (95% CI: 0.81 to 1.90) before to 1.73 (95% CI: 1.14 to 2.61) after policy reforms for the 29% with moderate health problems and from 2.89 (95% CI: 1.66 to 5.03) to 6.71 (95% CI: 3.94 to 11.42) among the 11% with severe health problems. The interaction between time and health was statistically significant (p<0.001).

Conclusion

People with impaired health and workability are forced into a life with temporary means-tested or no benefits when pressed by rising work demands and stricter disability benefit eligibility criteria.
Recommended medical and non-medical factors to assess military preventable deaths: subject matter experts provide valuable insights
Authors: Harrison Whitney Y , Wardian J L , Sosnov J A , Kotwal R S , Butler F K , Stockinger Z T , Shackelford S A , Gurney J M , Spott M A , Finelli L N , Mazuchowski E L , Smith D J , Janak J C
Published: April 2019

Introduction

Historically, there has been variability in the methods for determining preventable death within the US Department of Defense. Differences in methodologies partially explain variable preventable death rates ranging from 3% to 51%. The lack of standard review process likely misses opportunities for improvement in combat casualty care. This project identified recommended medical and non-medical factors necessary to (1) establish a comprehensive preventable death review process and (2) identify opportunities for improvement throughout the entire continuum of care.

Methods

This qualitative study used a modified rapid assessment process that includes the following steps: (1) identification and recruitment of US government subject matter experts (SMEs); (2) multiple cycles of data collection via key informant interviews and focus groups; (3) consolidation of information collected in these interviews; and (4) iterative analysis of data collected from interviews into common themes. Common themes identified from SME feedback were grouped into the following subject areas: (1) prehospital, (2) in-hospital and (3) forensic pathology.

Results

Medical recommendations for military preventable death reviews included the development, training, documentation, collection, analysis and reporting of the implementation of the Tactical Combat Casualty Care Guidelines, Joint Trauma System Clinical Practice Guidelines and National Association of Medical Examiners autopsy standards. Non-medical recommendations included training, improved documentation, data collection and analysis of non-medical factors needed to understand how these factors impact optimal medical care.

Conclusions

In the operational environment, medical care must be considered in the context of non-medical factors. For a comprehensive preventable death review process to be sustainable in the military health system, the process must be based on an appropriate conceptual framework implemented consistently across all military services.
Facial Colorings of Plane Graphs
Authors: CZAP JÚLIUS , JENDROL’ STANISLAV
Published: April 2019

This paper extends and updates the survey [J. Czap, S. Jendrol’, Facially-constrained colorings of plane graphs: A survey, Discrete Math. 340 (2017) 2691–2703] on facial colorings. Different types of colorings of plane graphs are discussed in their vertex, edge, total, and list versions.
The Effect of Delay to Surgery on Major Complications after Primary Flexor Tendon Repair
Authors: Reito Aleksi , Manninen Mari , Karjalainen Teemu
Published: April 2019

Background: Flexor tendon repair carries a significant risk for complications, which often leads to revision surgery. The purpose of this study was to assess the effect of different factors on the risk for major complications patients undergoing a primary end-to-end flexor tendon repair and early passive mobilization regimen (Kleinert protocol).

Methods: Between January 2000 and September 2009, a total of 312 patients underwent a flexor tendon repair at out institution. We excluded patients whose injury was self-inflicted or secondary to a rheumatic disease or a fall leaving 187 patients with 325 injured tendons for the study.

Results: 152 (81.7%) patients were male and 34 (18.3%) females. Mean age of the patients was 32.7 years (SD 14.4, range 11 to 73). The fifth ray was most commonly affected. The majority of the injuries were located in zone II. Median delay to surgery was 3 days. Complications were observed in 34 patients (18.2%). Univariable analysis showed that patient age, mechanism of injury, injured ray, delay to surgery between three and seven days, and greater suture thickness were associated with increased risk of complications. In the subsequent multivariable analysis, only the mechanism of injury and delay to surgery remained as significant risk factors for major complications.

Conclusions: We conclude that complications after flexor tendon repair may be reduced by appropriate timing of the surgery. Delay to surgery lasting between three and seven days seems to be associated with increased risk for major complications.
Efficient Data Supply for Parallel Heterogeneous Architectures
Authors: Ham Tae Jun , Aragón Juan L. , Martonosi Margaret
Published: April 2019

Decoupling techniques have been proposed to reduce the amount of memory latency exposed to high-performance accelerators as they fetch data. Although decoupled access-execute (DAE) and more recent decoupled data supply approaches offer promising single-threaded performance improvements, little work has considered how to extend them into parallel scenarios. This article explores the opportunities and challenges of designing parallel, high-performance, resource-efficient decoupled data supply systems. We propose M
ercury
, a parallel decoupled data supply system that utilizes thread-level parallelism for high-throughput data supply with good portability attributes. Additionally, we introduce some microarchitectural improvements for data supply units to efficiently handle long-latency indirect loads.
Self-Collected Samples in Cervical Cancer Screening: Results of HPV and Pap Self-Collected Samples Compared to Physician-Obtained Specimens
Authors: Mangold Bernhard Reinhold
Published: April 2019

Objective: In order to increase overall participation in cervical cancer screening, several investigators propose a concept of introducing self-tests. The study presented here compared test results of the Pap test and 4 different HPV test systems of self-collected and physician-collected vaginal specimens. Study Design: 208 patients of a colposcopy clinic had physician-taken and self-taken vaginal samples. All cell samples enabled a liquid-based Pap test and testing for carcinogenic HPV genotypes. In addition, all patients had a colposcopy with or without cervical biopsy and/or conisation. Results: 99 patients had the histological diagnosis of CIN2+. The HPV test sensitivity of self-collected samples differed significantly in this patient group depending on the test system performed. The sensitivity of the self-collected Pap test was significantly lower than HPV testing, but the positive predictive value of the Pap self-test was very high. Conclusion: The results of this study indicate that under the circumstances of self-testing HPV test systems differ in test sensitivity and specificity. Self-collected Pap tests can provide a test result with a very high positive predictive value and introduce therapeutic strategies. In order to improve screening strategies, it could be an opportunity to combine HPV and Pap tests in self-taken vaginal samples, especially in countries with a low income level. In countries with a good medical infrastructure, self-testing has to be introduced with caution.
Neurotensin Enhances Locomotor Activity and Arousal and Inhibits Melanin-Concentrating Hormone Signaling
Authors: Levitas-Djerbi Talia , Sagi Dana , Lebenthal-Loinger Ilana , Lerer-Goldshtein Tali , Appelbaum Lior
Published: April 2019

Background: Hypothalamic neurotensin (Nts)-secreting neurons regulate fundamental physiological processes including metabolism and feeding. However, the role of Nts in modulation of locomotor activity, sleep, and arousal is unclear. We previously identified and characterized Nts neurons in the zebrafish hypothalamus. Materials and Methods: In order to study the role of Nts, nts mutant (nts–/–), and overexpressing zebrafish were generated. Results: The expression of both nts mRNA and Nts protein was reduced during the night in wild-type zebrafish. Behavioral assays revealed that locomotor activity was decreased during both day and night, while sleep was increased exclusively during the nighttime in nts–/– larvae. Likewise, inducible overexpression of Nts increased arousal in hsp70:Gal4/uas:Nts larvae. Furthermore, the behavioral response to light-to-dark transitions was reduced in nts–/– larvae. In order to elucidate potential contenders that may mediate Nts action on these behaviors, we profiled the transcriptome of 6 dpf nts–/– larvae. Among other genes, the expression levels of melanin-concentrating hormone receptor 1b were increased in nts–/– larvae. Furthermore, a portion of promelanin-concentrating hormone 1 (pmch1) and pmch2 neurons expressed the nts receptor. In addition, expression of the the two zebrafish melanin-concentrating hormone (Mch) orthologs, Mch1 and Mch2, was increased in nts–/– larvae. Conclusion: These results show that the Nts and Mch systems interact and modulate locomotor activity and arousal.
A Geography of Agrotoxins use in Brazil and its Relations to the European Union
Authors:   Universidade de São Paulo. Faculdade de Filosofia, Letras e Ciências Humanas, Bombardi Larissa Mies
Published: April 2019

"Larissa’s work is, therefore, not merely a Brazilian concern. Just as Brazil’s history and transatlantic trade cannot be disassociated from early European industrialisation and early days of empire, its massive role in international food and agroenergy trade mean that the moral, ethical and political questions raised by her research are a global concern. The seepage from laboratory to crop, field to factory and back on to the plates of our families makes the evidence more difficult to ignore. The extent that decision makers may attempt to do so remains to be seen, but the Atlas of Agrotoxins means that the excuse that ‘we did not know’ collapses under the weight of this book." - Brian Garvey - Department of Work, Employment & Organisation University of Strathclyde, Glasgow.
A noite e a cidade: uma revisão temática para a geografia
Authors: Góis Marcos Paulo Ferreira de
Published: April 2019

A ideia presente neste artigo é a de apresentar um balanço bibliográfico sobre o debate em torno da noite como uma categoria analítica para a pesquisa na área da geografia humana e ciências correlatas. Apresentamos as principais linhas de estudos sobre a noite em sua relação com a dinâmica urbana, realçando os aspectos centrais das análises realizadas nos últimos quarenta anos de pesquisa: os agentes, os processos e as espacialidades derivadas das práticas associadas ao período noturno. O objetivo é apontar algumas tendências e situar algumas problemáticas relativas ao uso da categoria noite em sua relação com o espaço urbano presentes na ideia de fronteira, na noção de transgressão da ordem e nos conflitos relacionados ao uso por atividades de lazer.
Editorial
Authors: Lencioni Sandra
Published: April 2019

Este número da Geousp – Espaço e Tempo registra ideias que tiveram lugar no Seminário 40 Anos de Geografia Crítica: sua atualidade na Geografia Humana da FFLCH-USP, promovido pelo Programa de Pós-Graduação em Geografia Humana, do Departamento de Geografia da Faculdade de Filosofia, Letras e Ciências Humanas da Universidade de São Paulo, no dia 15 de outubro de 2018. O objetivo desse Seminário foi discutir e problematizar o legado e a potência do movimento da Geografia Crítica no referido Departamento, bem como sua importância no desvendamento do mundo moderno e a atualidade científica de seu pensamento crítico.
Combination Antiplatelet and Oral Anticoagulant Therapy in Patients With Coronary and Peripheral Artery Disease
Authors: Gurbel Paul A. , Fox Keith A.A. , Tantry Udaya S. , ten Cate Hugo , Weitz Jeffrey I.
Published: April 2019

Antiplatelet therapy is the mainstay for the treatment of acute and chronic arterial disease involving the coronary and peripheral beds. However, questions remain about optimal antithrombotic therapy for long-term treatment of chronic vascular disease. The observation that dual antiplatelet therapy with acetylsalicylic acid and clopidogrel was associated with lower thrombotic event rates than acetylsalicylic acid monotherapy in patients with acute coronary syndromes and those undergoing percutaneous coronary intervention changed the treatment paradigm. Moreover, the demonstration that more pharmacodynamically potent P2Y
12
inhibitors than clopidogrel were associated with fewer thrombotic event occurrences further solidified the dual antiplatelet therapy approach. However, recurrent thrombotic events occur in ≈1 in 10 patients in the first year following an acute coronary syndrome event, despite treatment with the most potent P2Y
12
inhibitors, a limitation that has stimulated interest in exploring the efficacy and safety of approaches using anticoagulants on top of antiplatelet therapy. These investigations have included treatment with very-low-dose oral anticoagulation, and even its replacement of acetylsalicylic acid in the presence of a P2Y
12
inhibitor, in patients stabilized after an acute coronary syndrome event. Recent basic and translational studies have suggested noncanonical effects of coagulation factor inhibition that may further modulate clinical benefits. This in-depth review will discuss developments in our understanding of the roles that platelets and coagulation factors play in atherothrombosis and review the rationale and clinical evidence for combining antiplatelet and oral anticoagulant therapy in patients with coronary and peripheral artery disease.
Effects of Blood Pressure Lowering on Clinical Outcomes According to Baseline Blood Pressure and Cardiovascular Risk in Patients With Type 2 Diabetes Mellitus
Authors: Rahman Faisal , McEvoy John W. , Ohkuma Toshiaki , Marre Michel , Hamet Pavel , Harrap Stephen , Mancia Giuseppe , Rodgers Anthony , Selvin Elizabeth , Williams Bryan , Muntner Paul , Chalmers John , Woodward Mark ,   on behalf of the ADVANCE Collaborative Group
Published: April 2019

The optimal blood pressure (BP) goal in patients with diabetes mellitus remains controversial. We examined whether benefits and risks of intensified antihypertensive therapy in diabetes mellitus are influenced by either baseline BP or cardiovascular disease (CVD) risk. We studied 10 948 people with diabetes mellitus, at moderate-to-high risk, in the ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation). Cox models were used to determine whether baseline BP category or CVD risk modified the outcomes of combination perindopril-indapamide treatment, compared with placebo. During 4.3 years of follow-up, treatment with perindopril-indapamide versus placebo reduced mortality and major vascular (macrovascular or microvascular) events. There was no evidence of differences in these effects, regardless of baseline systolic BP (evaluated down to <120 mm Hg;
P
for heterogeneity, 0.85), diastolic BP (evaluated down to <70 mm Hg;
P
=0.49), or whether 10-year CVD risk was ≥20% or <20% (
P
=0.08). The effects of randomized treatment on discontinuation of treatment because of cough or hypotension/dizziness were also statistically consistent across subgroups defined by baseline BP and CVD risk (all
P
≥0.08). Adults with diabetes mellitus appear to benefit from more intensive BP treatment even at levels of BP and CVD risk that some guidelines do not currently recommend for intervention.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00751972.