bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of point‐of‐care ROTEM® into a trauma major haemorrhage protocol: A before and after study
Authors: Campbell Don , Wake Elizabeth , Walters Kerin , Ho Debbie , Keijzers Gerben , Wullschleger Martin , Winearls James
Published: September 2020

Objective

The aim of the present study was to assess transfusion practices with the implementation of a targeted viscoelastic haemostatic assay (VHA) (ROTEM®) guided coagulation management programme into a major haemorrhage protocol for trauma patients requiring ICU admission, starting from time of arrival in the ED.

Methods

This retrospective observational study was conducted in a major trauma centre in Australia. One hundred and sixty‐two trauma patients admitted to the ICU between January 2013 and December 2015 with an Injury Severity Score ≥12 and who received blood products were included: 37 in the pre‐group, 48 during implementation and 77 in post‐group. The primary outcome was blood and blood product administration amounts.

Results

Packed red blood cell transfusion amounts did not significantly change post introduction of the ROTEM®. There was a significant increase in fibrinogen replacement between the pre‐ and post‐groups (P < 0.001), accompanied by a reduction in the use of fresh frozen plasma (P < 0.001) and prothrombinex (P < 0.001). Platelet usage in the post‐group was higher but not reaching statistical significance (P  = 0.051). Post‐implementation point‐of‐care ROTEM® testing was able to be performed in the ED in 94.8% of cases.

Conclusion

Although there was no overall reduction of packed red blood cell usage, a change in the pattern of administration of other blood products was observed with the implementation of a targeted VHA (ROTEM®) guided coagulation management programme. Larger studies are needed to further define the role of early VHA testing to guide correction of trauma‐induced coagulopathy and the effect on clinical outcomes.
Laparoscopic treatment of diffuse peritonitis for ileocolic anastomotic leak following totally laparoscopic right hemicolectomy
Authors: Mari Giulio , Achilli Pietro , Crippa Jacopo , Cordaro Giuseppe , Berardi Valter , Di Fratta Emanuele , Maggioni Dario
Published: September 2020

Anastomotic leakage with local or diffuse peritonitis represents one of the severe complications that may occur after right hemicolectomy. Abdominal exploration through laparotomy is associated with an increased risk of surgical site infection, pain, incisional hernias, and prolonged recovery. Laparoscopic surgery is feasible for many emergency surgical conditions, but when it comes to a diffuse peritonitis due to an ileocolic anastomotic failure, surgical re‐intervention with a minimally invasive approach is rarely adopted. We report a case series of diffuse peritonitis caused by ile‐ocolic anastomotic failure after totally laparoscopic right hemicolectomy that were successfully managed by laparoscopic re‐interventions. In all the cases the anastomosis was resected and extracted, then peritoneal lavage with saline solution was performed and terminal ileostomy was fashioned in the right iliac fossa. Peritoneal lavage was repeated every 24 hours until the peritonitis was completely resolved. All the patients were successfully discharged after a median hospital stay of 13 days. Laparoscopic surgery for the treatment of anastomotic leak after right hemicolectomy was feasible and effective in our series of patients.
Differences in Sociodemographic and Alcohol‐Related Clinical Characteristics Between Treatment Seekers and Nontreatment Seekers and Their Role in Predicting Outcomes in the COMBINE Study for Alcohol Use Disorder
Authors: Haass‐Koffler Carolina L. , Piacentino Daria , Li Xiaobai , Long Victoria M. , Lee Mary R. , Swift Robert M. , Kenna George A. , Leggio Lorenzo
Published: September 2020

Background

One of the challenges in early‐stage clinical research aimed at developing novel treatments for alcohol use disorder (AUD) is that the enrolled participants are heavy drinkers, but do not seek treatment for AUD.

Aims

To compare nontreatment seekers with alcohol dependence (AD) from 4 human laboratory studies conducted at Brown University (N = 240; 65.4% male) to treatment seekers with AD from the multisite COMBINE study (N = 1,383; 69.1% male) across sociodemographic and alcohol‐related clinical variables and to evaluate whether the variables that significantly differentiate the 2 samples predict the 3 main COMBINE clinical outcomes: time to relapse, percent days abstinent (PDA), and good clinical outcome.

Methods

Sample characteristics were assessed by parametric and nonparametric testing. Three regression models measured the association between the differing variables and the 3 main COMBINE clinical outcomes.

Results

The nontreatment seekers, compared to the treatment seekers, were more ethnically diverse, less educated, single, and working part‐time or unemployed (p’s < 0.05); they met fewer DSM‐IV AD criteria and had significantly lower scores on alcohol‐related scales (p’s < 0.05); they were less likely to have a father with alcohol problems (p < 0.0001) and had a significantly earlier age of onset and longer duration of AD (p’s < 0.05); they also had significantly more total drinks, drinks per drinking day, heavy drinking days (HDD), and lower PDA in the 30 days prior to baseline (p’s < 0.0001 to <0.05). Having more HDD in the 30 days prior to baseline predicted all of the 3 COMBINE clinical outcomes. All the other characteristics mentioned above that differed significantly between the 2 groups predicted at least 1 of the 3 COMBINE clinical outcomes, except for level of education, age of onset, and duration of AD.

Conclusions

The observed differences between groups should be considered in efforts across participant recruitment at different stages of the development of new treatments for AUD.
Dreaming “the Unspeakable”?How the Auschwitz Concentration Camp Prisoners Experienced and Understood Their Dreams
Authors: Owczarski Wojciech
Published: September 2020

This article explores the dream descriptions submitted in 1973–1974 by former Polish prisoners of the Auschwitz concentration camp in response to a questionnaire sent out by Polish psychiatrists. These descriptions are being investigated as testimonies that represent the Auschwitz inmates’ experiences commonly regarded as “unspeakable.” Not only the dream experience itself, but also the respondents’ attitudes toward and beliefs about dreams are taken into consideration in an attempt to understand the impact of the Holocaust on the survivors. Their general inability of comprehending the Auschwitz and post‐Auschwitz dreams seems to be the most important and significant aspect of their testimonies. The experience of dreams as completely strange and astonishing phenomena is being explained in this article in connection with the respondents’ ability and inability to recover from their Holocaust trauma.
Two‐year outcomes of minimally invasive XEN Gel Stent implantation in primary open‐angle and pseudoexfoliation glaucoma
Authors: Rauchegger Teresa , Angermann Reinhard , Willeit Peter , Schmid Eduard , Teuchner Barbara
Published: September 2020

Purpose

The aim of this study was to evaluate the efficacy of XEN® Gel Stent implantation in the treatment of primary open‐angle glaucoma (POAG) and pseudoexfoliation glaucoma (XFG) regarding the reduction of intraocular pressure (IOP) and number of IOP‐lowering medications over 2 years.

Methods

In this retrospective, observational, single‐centre study, patients with POAG or XFG underwent implantation of the XEN® Gel Stent with or without combined phacoemulsification. Changes in mean IOP, mean number of IOP‐lowering medications, number of postoperative interventions, complete or qualified surgical success rate (defined as IOP < 18 mmHg without or with IOP‐lowering medication, respectively) and complete surgical failure rate (defined as the necessity of a glaucoma‐related secondary surgical intervention or loss of light perception) were assessed 12 months (12M) and 24 months (24M) postoperatively.

Results

Seventy‐nine eyes of 63 patients with open‐angle glaucoma were included in the study (71% POAG, 29% XFG). Before surgery, mean IOP was 23.4 ± 7.9 mmHg. IOP was 14.6 ± 3.6 mmHg 12 months postoperatively (−31% from baseline, 95% CI −42% to −20%, n = 30, p < 0.001) and 14.8 ± 4.4 mmHg 24 months postoperatively (−29% from baseline, 95% CI −30% to −41%, n = 28, p < 0.001). Mean number of IOP‐lowering medications was significantly reduced from 2.7 ± 1.1 before surgery to 1.0 ± 1.2 (−69%, 95% CI −89% to 46%, p < 0.001) 12 months after surgery and 1.0 ± 1.2 (−64%, 95% CI −91% to −36%, p < 0.001) at 24 months after surgery. Complete surgical success was achieved in 39% (12M) and 34% (24M) of patients and qualified success in 29% (12M) and 27% (24M). 13 (16%) eyes were classified as complete surgical failure. In 62% of the patients needling procedures had to be performed.

Conclusion

The XEN® Gel Stent is an efficacious minimal invasive glaucoma surgery for primary open‐angle and pseudoexfoliation glaucoma, resulting in significant reduction of IOP and a reduction in glaucoma medications from baseline in two‐third of treated patients with 2‐year follow‐up. Frequent follow‐up examinations were mandatory to identify early and late bleb failure and additional needling procedures were necessary to reestablish aqueous flow.
Effects of free compulsory education on rural well‐being in China
Authors: Chen Yongwei , Zhang Ying
Published: September 2020

We use a regression discontinuity design to estimate the effects of free compulsory education on rural family well‐being and explore the potential mechanisms. Using data from the Chinese Family Panel Studies, we observe a decline in the well‐being of rural families that were fully exposed to this policy. Our findings are robust to various checks, including changing the window widths, functional forms, estimating methods, selected samples, and indicators of family well‐being. Analysis indicates that the education cost burden did not decline significantly as expected by the treated families, contributing to a decline in their well‐being. These findings suggest that the government should introduce the policy at the pre‐school stage. At the same time, it is urgent that the educational expenditure burden on residents be reduced.
Effect of pineapple stem starch feeding on rumen microbial fermentation, blood lipid profile, and growth performance of fattening cattle
Authors: Khongpradit Anchalee , Boonsaen Phoompong , Homwong Nitipong , Suzuki Yutaka , Koike Satoshi , Sawanon Suriya , Kobayashi Yasuo
Published: September 2020

Pineapple stem starch (PS) was evaluated for its suitability as a new starch source in concentrate for fattening cattle, based on the growth performance, blood profile, and rumen parameters of 36 steers in a 206‐day feeding study. PS was formulated as a 40% concentrate and fed with forage in comparison with ground corn (GC) and ground cassava (CA) formulated at the same level. PS feeding improved weight gain and feed conversion ratio without affecting feed intake. PS did not obviously influence blood lipid profiles throughout the experiment. Ruminal concentration of total short‐chain fatty acids (SCFA) increased with PS without affecting SCFA composition throughout the feeding study. Rumen amylolytic group, especially Ruminococcus bromii, was dominant in the rumen microbial community, and showed increased abundance by PS feeding throughout the experiment. These results clearly indicate the potential of PS as a useful starch source for fattening cattle in terms of rumen fermentation and growth performance.
Use of an anti‐CD200‐blocking antibody improves immune responses to AML in vitro and in vivo
Authors: Rastogi Namrata , Baker Sarah , Man Stephen , Uger Robert A. , Wong Mark , Coles Steven J. , Hodges Marie , Gilkes Amanda F. , Knapper Steven , Darley Richard L. , Tonks Alex
Published: September 2020

Treatment of relapsed/resistant acute myeloid leukaemia (AML) remains a significant area of unmet patient need, the outlook for most patients remaining extremely poor. A promising approach is to augment the anti‐tumour immune response in these patients; most cancers do not activate immune effector cells because they express immunosuppressive ligands. We have previously shown that CD200 (an immunosuppressive ligand) is overexpressed in AML and confers an inferior overall survival compared to CD200low/neg patients. Here we show that a fully human anti‐CD200 antibody (TTI‐CD200) can block the interaction of CD200 with its receptor and restore AML immune responses in vitro and in vivo.
Surgeon heterogeneity significantly affects functional and oncological outcomes after radical prostatectomy in the Swedish LAPPRO trial
Authors: Nyberg Martin , Sjoberg Daniel D. , Carlsson Sigrid V. , Wilderäng Ulrica , Carlsson Stefan , Stranne Johan , Wiklund Peter , Steineck Gunnar , Haglind Eva , Hugosson Jonas , Bjartell Anders
Published: September 2020

Objectives

To evaluate how surgeon heterogeneity – the variation in outcomes between individual surgeons – influences functional and oncological outcomes after robot‐assisted laparoscopic prostatectomy (RALP) and retropubic radical prostatectomy (RRP), and to assess whether surgeon heterogeneity affects the comparison between RALP and RRP.

Patients and Methods

Laparoscopic Prostatectomy Robot Open (LAPPRO) is a prospective, controlled, non‐randomized trial performed at 14 Swedish centres with 68 operating surgeons. A total of 4003 men with localized prostate cancer were enrolled between 2008 and 2011. The endpoints were urinary incontinence, erectile dysfunction (ED) and recurrence at 24 months after surgery. Logistic regression models were built to evaluate surgeon heterogeneity and, secondarily, surgeon‐specific factors were added to the models to investigate their influence on heterogeneity and the comparison between RALP and RRP.

Results

Among surgeons who performed at least 20 surgeries during the study period (n=25), we observed statistically significant heterogeneity for incontinence (P = 0.001), ED (P < 0.001) and rate of recurrent disease (P < 0.001). The significant heterogeneity remained when analysing only experienced surgeons with a stated experience of at least 250 radical prostatectomies (n=12). Among all participating surgeons (n=68), differences in surgeon volume explained 42% of the observed heterogeneity for incontinence (P = 0.003), 11% for ED (P = 0.03) and 19% for recurrence (P = 0.01). Taking surgeon volume into account when comparing RALP and RRP had a significant impact on the results. The effect was greatest for functional outcomes, and the additional adjustments for the surgeons' previous experience changed whether the difference between techniques was statistically significant or not. The surgeons’ annual volume had the greatest effect on the recurrence rate.

Conclusions

There was a large degree of heterogeneity among surgeons regarding both functional and oncological outcomes and this had a significant impact on the results when comparing RALP and RRP. Some of the observed heterogeneity was explained by differences in surgeon volume. Efforts to decrease heterogeneity are warranted and variation among surgeons must be accounted for when conducting comparative analyses between surgical techniques.
Association between childhood asthma and attention deficit hyperactivity or autism spectrum disorders: A systematic review with meta‐analysis
Authors: Kaas Trine H. , Vinding Rebecca K. , Stokholm Jakob , Bønnelykke Klaus , Bisgaard Hans , Chawes Bo L.
Published: September 2020

Background

Children with asthma are at risk of depression and anxiety and growing evidence suggest they may also be at risk of attention deficit hyperreactivity disorder (ADHD) and autism spectrum disorder (ASD). Here, we conducted a systematic review with meta‐analysis of studies investigating association between asthma and ADHD or ASD in children.

Methods

A comprehensive search using PubMed, EMBASE and Cochrane Library databases was completed in March 2019. Observational human studies published in English, clinic‐based or population‐based with a healthy comparator group, evaluating asthma‐ADHD or asthma‐ASD overlap in children 18 years or younger using categorical diagnoses (yes/no) were considered for inclusion. Random effects meta‐analysis models were used to analyse data. The Newcastle Ottawa Scale was used to evaluate risk of bias.

Results

A total of 25 asthma‐ADHD studies were included of which 17 showed significant positive associations and one a negative association: 17/25 studies were population‐based, 19/25 were cross‐sectional or cohort studies and 7/25 had a low risk of bias. We performed a meta‐analysis of 23 of the studies, which showed a significant association between asthma and ADHD: odds ratio (OR) 1.52 (1.42‐1.63), P < .001, I2 = 60%. All studies were adjusted for age and sex and a large proportion; that is, 19/23 were further adjusted for relevant confounders. Seventeen asthma‐ASD studies were included, whereof 7 showed a positive association and 3 a negative association; 8/17 were population‐based with a cross‐sectional study design and 4/17 had a low risk of bias. We performed a meta‐analysis of 14 of the studies, which did not show a significant association between asthma and ASD: OR 1.12 (0.93‐1.34), P = .24, I2 = 89%. All studies were adjusted for age and sex and 10/14 were further adjusted for relevant confounders.

Conclusions

This systematic review with meta‐analyses shows a significant overlap between asthma and ADHD, but not between asthma and ASD in children. Clinicians taking care of children with asthma or ADHD should be aware of such association to aid an early diagnosis and treatment of such comorbidity.
Using long‐term data for a reintroduced population to empirically estimate future consequences of inbreeding
Authors: Armstrong Doug P. , Parlato Elizabeth H. , Egli Barbara , Dimond Wendy J. , Kwikkel Renske , Berggren Åsa , McCready Mhairi , Parker Kevin A. , Ewen John G.
Published: September 2020

Inbreeding depression is an important long‐term threat to reintroduced populations. However, the strength of inbreeding depression is difficult to estimate in wild populations because pedigree data are inevitably incomplete and because good data are needed on survival and reproduction. Predicting future population consequences is especially difficult because this also requires projecting future inbreeding levels and their impacts on long‐term population dynamics, which are subject to many uncertainties. We illustrate how such projections can be derived through Bayesian state‐space modeling methods based on a 26‐year data set for North Island Robins (Petroica longipes) reintroduced to Tiritiri Matangi Island in 1992. We used pedigree data to model increases in the average inbreeding level (F) over time based on kinship of possible breeding pairs and to estimate empirically Ne/N (effective/census population size). We used multiple imputation to model the unknown components of inbreeding coefficients, which allowed us to estimate effects of inbreeding on survival for all 1458 birds in the data set while modeling density dependence and environmental stochasticity. This modeling indicated that inbreeding reduced juvenile survival (1.83 lethal equivalents [SE 0.81]) and may have reduced subsequent adult survival (0.44 lethal equivalents [0.81]) but had no apparent effect on numbers of fledglings produced. Average inbreeding level increased to 0.10 (SE 0.001) as the population grew from 33 (0.3) to 160 (6) individuals over the 25 years, giving a ratio of 0.56 (0.01). Based on a model that also incorporated habitat regeneration, the population was projected to reach a maximum of 331–1144 birds (median 726) in 2130, then to begin a slow decline. Without inbreeding, the population would be expected stabilize at 887–1465 birds (median 1131). Such analysis, therefore, makes it possible to empirically derive the information needed for rational decisions about inbreeding management while accounting for multiple sources of uncertainty.
Testing Huston's dynamic equilibrium model along fire and forest productivity gradients using avian monitoring data
Authors: Janousek William M. , Dreitz Victoria J.
Published: September 2020

Aim

Many studies investigating the response of wildlife to disturbance focus predominantly on the effects of the disturbance alone but fail to account for the influence of ecosystem productivity in moderating the response of species and thus the resulting biodiversity patterns. We use Huston's dynamic equilibrium model (DEM) to explore the relationship between avian diversity and fire across the greater Rocky Mountain region of the western United States. This model provides the theoretical foundation to understand the distinct and interactive effects disturbance and productivity have on regulating species richness.

Location

We used avian monitoring data collected at 120 sites across Colorado, Idaho, Montana and Wyoming in the western United States from 2008 to 2016.

Methods

We used a Bayesian hierarchical multispecies occupancy model to predict species richness across fire and productivity gradients. Hierarchical models enable inference at the community and species level, accounting for imperfect detection, and providing a more accurate assessment of the ecological relationships.

Results

We found support of the hypotheses described by the DEM Avian species richness changed little across the fire severity gradient alone, though this relationship varies considerably when including the interaction of fire and ecosystem productivity. At lower latitudes, richness is greatest at intermediate levels of fire severity and productivity following the DEM. However, as latitude increases, the productivity at which richness is greatest also increases. Mean productivity increases with latitude across the study area, and we argue the changing regional levels of ecosystem productivity alters the relationships predicted by the DEM.

Main conclusions

Our results provide an important example of how relationships between richness and disturbance may be missed if viewed outside the context of other environmental factors, mainly ecosystem productivity. This highlights the importance of accounting for changing ecological context across broad spatial scales to ensure accurate assessments of disturbance–diversity relationships.
New method for fixing an endoscopic nasobiliary drainage tube in the treatment of postoperative bile leakage
Authors: Maruyama Hirotsugu , Nagami Yasuaki , Fujiwara Yasuhiro
Published: September 2020

Watch a video of this article
Targeting both BET and CBP/EP300 proteins with the novel dual inhibitors NEO2734 and NEO1132 leads to anti‐tumor activity in multiple myeloma
Authors: Ryan Katie R. , Giles Francis , Morgan Gareth J.
Published: September 2020

Objectives

Two promising epigenetic therapeutic targets have emerged for the treatment of hematologic malignancies, BET and CBP/EP300 proteins. Several studies have shown that targeting these individual classes of proteins has anti‐tumor activity in multiple myeloma (MM), as well as other cancers. Here, we present the first data exploring the anti‐tumor activity of two novel dual inhibitors, NEO2734 and NEO1132, of both BET and CBP/EP300 proteins in MM.

Methods

Sixteen MM cell lines (MMCLs) were treated with the dual inhibitors NEO2734 and NEO1132, the single BET inhibitors JQ1, OTX015, IBET‐762, and IBET‐151, and a single CBP/EP300 inhibitor CPI‐637.

Results

The dual inhibitor NEO2734 showed strong anti‐tumor activity and was consistently highly active against all MMCLs, being as potent as JQ1 and more so than other single inhibitors. NEO2734 and NEO11132 induced a significant G1 cell cycle arrest and decreased c‐MYC and IRF4 protein levels in MMCLs compared to the other single inhibitors. Sensitivity to the dual inhibitors was not dependent on a specific MM molecular subgroup but correlated with c‐MYC protein expression levels.

Conclusions

The dual inhibition of BET and CBP/EP300 has potential therapeutic benefits for patients with MM.
Authigenic anatase within 1 billion‐year‐old cells
Authors: Sirantoine Eva , Wacey David , Bischoff Karl , Saunders Martin
Published: September 2020

The siliciclastic ~1 Ga‐old strata of the Torridon Group, Scotland, contain some of the most exquisitely preserved three‐dimensional organic‐walled microfossils (OWMs) of the Precambrian. A very diverse microfossil assemblage is hosted in a dominantly phosphatic and clay mineral matrix, within the Diabaig and the Cailleach Head (CH) Formations. In this study, we report on several microfossil taxa within the CH Formation (Leiosphaeridia minutissima, Leiosphaeridia crassa, Synsphaeridium spp. and Myxococcoides spp.) that include populations of cells containing an optically transparent and highly refringent mineral, here identified using electron microscopy as anatase (TiO2). Most anatase crystals occur entirely within individual cells, surrounded by unbroken carbonaceous walls. Rarely, an anatase crystal may protrude outside a cell, interpreted to correspond to zones where the cell wall had broken down prior to anatase precipitation. Where an anatase crystal entombs an organic intracellular inclusion (ICI), the ICI is large and well preserved. These combined observations indicate that the intracellular anatase is an authigenic sedimentary phase, making this the first report of in situ precipitated anatase intimately associated with microfossils. The ability of anatase to preserve relatively large volumes of intracellular and cell wall organic material in these cells suggests that the crystallisation of anatase entombed cellular contents particularly quickly, soon after the death of the cell. This is consistent with the strong affinity of Ti for organic material, the low solubility of TiO2, and reports of Ti occurring in living organisms. With the data currently available, we propose a mineralisation pathway for anatase involving Ti complexation with organic ligands within specific cells, leading to localised post‐mortem anatase nucleation inside these cells as the complexes broke down. Further overgrowth of the anatase crystals was likely fuelled by very early diagenetic mobilisation of Ti that had been bound to more labile organic material nearby in the sediments.
Global variation in diurnal asymmetry in temperature, cloud cover, specific humidity and precipitation and its association with leaf area index
Authors: Cox Daniel T. C. , Maclean Ilya M. D. , Gardner Alexandra S. , Gaston Kevin J.
Published: September 2020

The impacts of the changing climate on the biological world vary across latitudes, habitats and spatial scales. By contrast, the time of day at which these changes are occurring has received relatively little attention. As biologically significant organismal activities often occur at particular times of day, any asymmetry in the rate of change between the daytime and night‐time will skew the climatic pressures placed on them, and this could have profound impacts on the natural world. Here we determine global spatial variation in the difference in the mean annual rate at which near‐surface daytime maximum and night‐time minimum temperatures and mean daytime and mean night‐time cloud cover, specific humidity and precipitation have changed over land. For the years 1983–2017, we derived hourly climate data and assigned each hour as occurring during daylight or darkness. In regions that showed warming asymmetry of >0.5°C (equivalent to mean surface temperature warming during the 20th century) we investigated corresponding changes in cloud cover, specific humidity and precipitation. We then examined the proportional change in leaf area index (LAI) as one potential biological response to diel warming asymmetry. We demonstrate that where night‐time temperatures increased by >0.5°C more than daytime temperatures, cloud cover, specific humidity and precipitation increased. Conversely, where daytime temperatures increased by >0.5°C more than night‐time temperatures, cloud cover, specific humidity and precipitation decreased. Driven primarily by increased cloud cover resulting in a dampening of daytime temperatures, over twice the area of land has experienced night‐time warming by >0.25°C more than daytime warming, and has become wetter, with important consequences for plant phenology and species interactions. Conversely, greater daytime relative to night‐time warming is associated with hotter, drier conditions, increasing species vulnerability to heat stress and water budgets. This was demonstrated by a divergent response of LAI to warming asymmetry.
Associations of aging trajectories for an index of frailty score with mortality and medical and long‐term care costs among older Japanese undergoing health checkups
Authors: Taniguchi Yu , Kitamura Akihiko , Abe Takumi , Kojima Gotaro , Shinozaki Tomohiro , Seino Satoshi , Yokoyama Yuri , Nofuji Yu , Ikeuchi Tomoko , Matsuyama Yutaka , Fujiwara Yoshinori , Shinkai Shoji
Published: September 2020

Aim

Using up to 13 years of repeated‐measures data, we identified aging trajectories for an index in frailty score among older Japanese undergoing health checkups. In addition, we examined whether these trajectories were associated with all‐cause and cause‐specific mortality and healthcare costs.

Methods

In total, 1698 adults aged ≥65 years completed annual assessments during 2002–2014. During follow‐up, the average number of follow‐up assessments was 3.9, and the total number of observations was 6373. Frailty was defined by using the following criteria from Fried's phenotype: slowness, weakness, exhaustion, low physical activity and weight loss.

Results

We identified four aging trajectories for frailty. Specifically, 6.5%, 47.3%, 30.3% and 16.0% of participants were in the high, second, third and low trajectory groups, respectively. As compared with the low trajectory group, the high trajectory group had greater risks of cardiovascular disease (adjusted hazard ratios of 3.42) and other‐cause death (adjusted hazard ratios of 3.04). The high trajectory group had the highest medical costs until late in the eighth decade of life, costs decreased after age 70 years and were lowest at age 90 years (estimated at $116.7); however, medical and long‐term care costs greatly increased after age 80 years in the second and third trajectory groups.

Conclusions

Higher aging trajectories in frailty score were associated with elevated risks for cardiovascular, other‐cause and all‐cause death among older Japanese receiving health checkups. Medical and care needs greatly increased for the second and third trajectory groups when their frailty level was progressed in later life. Geriatr Gerontol Int 2020; 20: 1072–1078..
Acupuncture as a therapeutic resource for treatment of chronic pain in people with haemophilia
Authors: Oliveira Karen Cristina Pires , Ricciardi Janaina Bosso da Silva , Grillo Cassia Maria , Montebello Maria Imaculada de Lima , Sato Jorge Eji , de Sousa Maria da Luz Rosário
Published: September 2020

Introduction

Chronic pain is common in individuals with severe and moderate haemophilia who did not receive prophylaxis during childhood.

Objective

To verify the effectiveness of acupuncture in reducing intensity in chronic pain, changes in quality of life, joint function and impact on treatment satisfaction of haemophilia patients.

Methods

Single‐blinded randomized clinical trial with 28 participants divided into two groups: Acupuncture (G1) treated with traditional unilateral acupuncture (side of greatest referred pain) and Control (G2) treated with transcutaneous electrical nerve stimulation (TENS), with electrodes on the joint of most intense pain. Both groups had a 20‐minute session per week, total of 05 consecutive sessions. Before starting treatment, participants underwent sociodemographic assessment, physical assessment (HJHS), quality of life questionnaire (Haem‐a‐Qol) and treatment expectation (Likert scale). After the end of the fifth session, Haem‐a‐Qol, HJHS and degree of satisfaction (Likert) were performed. The assessment of pain intensity using the visual analogue scale (VAS) was performed before the beginning and after the end of all sessions in both groups. Statistical analysis was performed using ANOVA, Bonferroni, t test and chi‐square test (P < .05).

Results

There was a statistical difference within and between groups G1 and G2 in reduction of VAS. In Haem‐a‐Qol, the groups showed similarity in quality of life. Both groups had high expectations for treatment. G1 presented a better degree of treatment satisfaction than G2. Total HJHS showed no difference within and between groups. Conclusion: Acupuncture was effective in reducing pain intensity in haemophilia patients with chronic joint disease when compared to TENS.
Telehealth for delivery of haemophilia comprehensive care during the COVID‐19 pandemic
Authors: O’Donovan Mairead , Buckley Catherine , Benson Julie , Roche Sheila , McGowan Mark , Parkinson Laura , Byrne Patricia , Rooney Gloria , Bergin Catherine , Walsh Deirdre , Bird Rachel , McGroarty Feargal , Fogarty Helen , Smyth Elizabeth , Ahmed Saad , O’Donnell James S. , Ryan Kevin , O'Mahony Brian , Dougall Alison , O’Connell Niamh M.
Published: September 2020

Introduction

The COVID‐19 pandemic caused an unprecedented impact to haemophilia healthcare delivery. In particular, rapid implementation of telehealth solutions was required to ensure continued access to comprehensive care.

Aims

To explore patient and healthcare provider (HCP) experience of telehealth in a European Haemophilia Comprehensive Care Centre.

Method

A systematic evaluation was performed to survey patient and HCP experience and compare clinical activity levels with telehealth to in‐person attendances.

Results

Public health measures implemented in March 2020 to reduce COVID‐19 spread resulted in a 63% decrease in medical/nursing clinic consultation activity compared to the same period in 2019. Implementation of digital care pathways resulted in marked increase in activity (52% greater than 2019). Importantly, enhanced patient engagement was noted, with a 60% reduction in non‐attendance rates. Survey of patients who had participated in medical/nursing teleconsultations demonstrated that teleconsultations improved access (79%), reduced inconvenience (82%), was easy to use (94%) and facilitated good communication with the HCP (97%). A survey exploring the telemedicine experience of HCPs, illustrated that HCPs were satisfied with teleconsultation and the majority (79%) would like to continue to offer teleconsultation as part of routine patient care. In addition to medical/nursing reviews, continued access to physiotherapy with virtual exercise classes for people with haemophilia and teleconsultation for acute dental issues was equally successful.

Conclusion

During an unprecedented public health emergency, telehealth has enabled continued access to specialized haemophilia comprehensive care. Our novel findings show that this alternative is acceptable to both patients and HCPs and offers future novel opportunities.
The effect of chewing gum on dry mouth, interdialytic weight gain, and intradialytic symptoms: A prospective, randomized controlled trial
Authors: Ozen Nurten , Aydin Sayilan Aylin , Mut Dilek , Sayilan Samet , Avcioglu Zeynep , Kulakac Nursen , Ecder Tevfik , Akyolcu Neriman
Published: September 2020

Introduction

The major salivary glands can be stimulated by chewing gum to increase saliva flow and decrease xerostomia. The aim of this study was to investigate the effect of chewing gum on dry mouth, interdialytic weight gain, and intradialytic symptoms in hemodialysis (HD) patients.

Methods

This prospective randomized controlled single‐blind study was conducted with patients who had been treated for at least 6 months with sessions 3 days a week for 4 hours at two HD units. Patients were randomly allocated to chewing gum group or the control group. In the chewing gum group, gum was chewed for 10 minutes six times a day, and when the patients felt mouth dryness or were thirsty. In the nonchewing gum group, gum was not chewed. The patients were followed‐up for 3 months. A total of three saliva samples were taken before starting treatment at the first, 12th, and 36th HD session. Data were collected with the “Visual Analogue Scale (VAS),” “Hemodialysis Patients Fluid Control Scale,” “Dialysis Symptom Index,” and “Hospital Anxiety and Depression Scale” at baseline, week 4, week 8, and week 12.

Findings

The study was completed with a total of 44 patients consisting of 22 patients in the each group. The second and third month VAS values (xerostomia) of the patients in the chewing gum groups were statistically significantly lower than those in the control group (P = 0.014, P < 0.001, respectively). The third month salivary flow rate in the chewing gum group was higher than the values in the control group patients (P < 0.001).

Discussion

It is anticipated that this study will raise nurses' awareness of dry mouth and encourage future studies on interventions to increase the salivary flow rate to prevent or treat dry mouth.
Hidden or unnoticed? Multiple lines of evidence support the recognition of a new species of Pseudocorynopoma (Characidae: Corynopomini)
Authors: Malabarba Luiz R. , Chuctaya Junior , Hirschmann Alice , de Oliveira Eduardo Bitencourt , Thomaz Andréa T.
Published: September 2020

Species delimitation is a permanent issue in systematics. The increasing recognition of geographically isolated populations as independent lineages allowed by new methods of analysis has inflated the species‐populations dilemma, which involves deciding whether to consider separate lineages as different species or structured genetic populations. This is commonly observed between fishes of adjacent river basins, with some lineages being considered allopatric sister species and others considered isolated populations or variants of the same species. Pseudocorynopoma doriae is a characid diagnosed from its single congener by the number of anal‐fin rays and sexually dimorphic characters of males, including distinct fin colouration. The authors found variation in the colour pattern between isolated populations previously identified as P. doriae but no variation in scale or fin‐ray counts. They analysed molecular evidence at the population level and morphological differences related to life history (e.g., colour dimorphism related to inseminating behaviour). The results provide compelling evidence for the recognition of a new species of Pseudocorynopoma despite the lack of discrete differences in meristic data. The recognition of the new species is consistent with biogeographical evidence for the long‐term isolation of the respective river drainages and with differences between the ichthyofaunal communities of these rivers.
Purpose in Life and Motoric Cognitive Risk Syndrome: Replicable Evidence from Two National Samples
Authors: Sutin Angelina R. , Luchetti Martina , Stephan Yannick , Terracciano Antonio
Published: September 2020

BACKGROUND/OBJECTIVES

Motoric cognitive risk (MCR) syndrome is characterized by cognitive complaints and slow gait speed in the absence of dementia. Consistent evidence indicates that it predicts dementia and premature mortality. Less is known about its antecedents, particularly the role of psychological function. Purpose in life is an aspect of well‐being that reflects a goal‐oriented and ‐driven life that has been implicated in cognitive aging. We aimed to examine the cross‐sectional association between purpose in life and MCR and to test the hypothesis that purpose is associated with a lower risk of new cases of MCR over an up to 12‐year follow‐up.

DESIGN

Cross‐sectional and longitudinal multi‐cohort design.

SETTING

Health and Retirement Study (HRS) and the National Health and Aging Trends Study (NHATS).

PARTICIPANTS

A total of 6,785 individuals from the HRS and 5,665 from the NHATS.

MEASUREMENTS

Participants reported on their purpose in life and cognitive complaints and completed a walking speed assessment. Cognitive complaints and walking speed were assessed again up to 12 years later in HRS and up to 7 years later in NHATS.

RESULTS

Higher purpose in life was associated with a 33% lower risk of MCR concurrently (meta‐analytic odds ratio = .75; 95% confidence interval [CI] = .62–.90; P = .002) and an about 26% lower risk of incident MCR longitudinally (meta‐analytic hazard ratio = .77; 95% CI = .70–.84; P < .001). These associations were significant in each sample, were independent of sociodemographic covariates, and persisted after controlling for personality and health‐related factors (depressive symptoms, physical activity, disease burden).

CONCLUSION

Purpose in life is associated with a lower risk of incident MCR, an association that was replicated in two independent samples. Purpose is a malleable aspect of psychological function that is a promising target of intervention for healthier cognitive aging.
Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8‐12 years
Authors: Katsikogianni Eleni , Schweigert‐Gabler Susette , Krisam Johannes , Orhan Gül , Bissar Abdul , Lux Christopher J. , Schmitter Marc , Giannakopoulos Nikolaos Nikitas
Published: September 2020

Background and Objective

Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among schoolchildren aged 8‐12 years.

Methods

This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8‐12 years, with and without TMD symptoms, selected randomly from the Rhein‐Neckar district. Self‐reporting of non‐dental facial pain was used as the reference standard, against which we calculated the following for the pain‐related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver‐operating characteristic (AUROC) curve displaying sensitivity and specificity.

Results

Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs).

Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jaw‐opening limitations, as they occurred too rarely in our sample.

Conclusion

In this study, the diagnostic accuracy of the DC/TMD for TMD‐related pain in children was lower than that recorded for adults in previous studies.
Probiotics in poultry feed: A comprehensive review
Authors: Abd El‐Hack Mohamed E. , El‐Saadony Mohamed T. , Shafi Manal E. , Qattan Shaza Y. A. , Batiha Gaber E. , Khafaga Asmaa F. , Abdel‐Moneim Abdel‐Moneim E. , Alagawany Mahmoud
Published: September 2020

The use of antibiotics to maintain animal well‐being, promote growth and improve efficiency has been practised for more than 50 years. However, as early as the 1950s, researchers identified concern on the development of resistant bacteria for the antibiotics streptomycin and tetracycline used in turkeys and broilers respectively. These findings laid the groundwork for agricultural officials to impose stricter regulatory parameters on the use of antibiotics in poultry feeds. Probiotics are live micro‐organisms included in the diet of animals as feed additives or supplements. Commonly known as a direct‐fed microbial, probiotics provide beneficial properties to the host, primarily through action in the gastrointestinal tract (GIT) of the animal. Supplementation of probiotics in the diet can improve animal health and performance, through contributions to gut health and nutrient use. For instance, supplementation of probiotics has been demonstrated to benefit farm animals in immune modulation, structural modulation and increased cytokine production, which positively affect the intestinal mucosal lining against pathogens. Bacillus subtilis has been a popular bacterium used within the industry and was shown to improve intestinal villus height. Increasing the villus height and structure of the crypts in the GIT allows for the improvement of nutrient digestion and absorption. Tight junctions maintain important defences against pathogenic bacteria and cellular homeostasis. Heat stress can be a major environmental challenge in the poultry industry. Heat stress causes the bird to fluctuate its internal core temperature beyond their comfort zone. To overcome such challenges, poultry will attempt to balance its heat production and dissipation through behavioural and physiological adaptation mechanisms.
Difference in Healthcare Usage, Pharmacy Prescriptions, and Healthcare Cost for Special Olympic Athletes Compared to Non‐athletes with Intellectual Disabilities
Authors: Al‐Heizan Muhammad O. , St. John Brittany , DuBois Lindsay , Niemeier Brandi , Ausderau Karla K.
Published: September 2020

Objectives

Examine healthcare usage, pharmacy prescriptions and healthcare cost among people with Intellectual Disability (ID) who participate in Special Olympics (SO) compared to people with ID who do not participate in SO. In addition, a subanalysis was completed to compare SO athletes who participated in the Healthy Athlete program to those who had not.

Methods

Ten years of data were extracted based on active claim and identification. Final analyses included non‐SO participants and SOWI athletes for healthcare and pharmacy.

Results

SOWI athletes who participated in the Healthy Athlete program had significantly lower healthcare and pharmacy usage, and cost than SOWI athletes who did not participate controlling for race, ethnicity, and age.

Conclusions

Public health programs may have variable levels of effectiveness when addressing health disparities for people with ID.