bluuebunny/crossref_metadata_2025 huggingface dataset:
SEC is an anti-angiogenic virulence factor that promotesStaphylococcus aureusInfective Endocarditis Independent of Superantigen Activity
Authors: Kinney Kyle J. , Tang Sharon S. , Wu Xiao-Jun , Tran Phuong M. , Bharadwaj Nikhila S. , Gibson-Corley Katherine N. , Forsythe Ana N. , Kulhankova Katarina , Gumperz Jenny E. , Salgado-Pabón Wilmara
Published: December 2019

The superantigen staphylococcal enterotoxin C (SEC) is critical forStaphylococcus aureusinfective endocarditis (SAIE) in rabbits. Superantigenicity, its hallmark function, was proposed to be a major underlying mechanism driving SAIE but was not directly tested. With the use ofS. aureusMW2 expressing SEC toxoids, we show that superantigenicity does not sufficiently account for vegetation growth, myocardial inflammation, and acute kidney injury in the rabbit model of native valve SAIE. These results highlight the critical contribution of an alternative function of superantigens to SAIE. In support of this, we provide evidence that SEC exerts anti-angiogenic effects by inhibiting branching microvessel formation in anex vivorabbit aortic ring model and by inhibiting endothelial cell expression of one of the most potent mediators of angiogenesis, VEGF-A. SEC’s ability to interfere with tissue re-vascularization and remodeling after injury serves as a mechanism to promote SAIE and its life-threatening systemic pathologies.
Ecological drivers of African swine fever virus persistence in wild boar populations: insight for control
Authors: Pepin Kim M. , Golnar Andrew J. , Abdo Zaid , Podgórski Tomasz
Published: December 2019

Environmental sources of infection can play a primary role in shaping epidemiological dynamics, however the relative impact of environmental transmission on host-pathogen systems is rarely estimated. We developed and fit a spatially-explicit model of African swine fever virus (ASFV) in wild boar to estimate what proportion of carcass-based transmission is contributing to the low-level persistence of ASFV in Eastern European wild boar. Our model was developed based on ecological insight and data from field studies of ASFV and wild boar in Eastern Poland. We predicted that carcass-based transmission would play a substantial role in persistence, especially in low-density host populations where contact rates are low. By fitting the model to outbreak data using Approximate Bayesian Computation, we inferred that between 53 to 66% of transmission events were carcass-based – i.e., transmitted through contact of a live host with a contaminated carcass. Model fitting and sensitivity analyses showed that the frequency of carcass-based transmission increased with decreasing host density, suggesting that management policies should emphasize the removal of carcasses and consider how reductions in host densities may drive carcass-based transmission. Sensitivity analyses also demonstrated that carcass-based transmission is necessary for the autonomous persistence of ASFV under realistic parameters. Autonomous persistence through direct transmission alone required high host densities; otherwise re-introduction of virus periodically was required for persistence when direct transmission probabilities were moderately high. We quantify the relative role of different persistence mechanisms for a low-prevalence disease using readily collected ecological data and viral surveillance data. Understanding how the frequency of different transmission mechanisms vary across host densities can help identify optimal management strategies across changing ecological conditions.
Unexpected diversity of CRISPR unveils some evolutionary patterns of repeated sequences inMycobacterium tuberculosis
Authors: Refrégier Guislaine , Sola Christophe , Guyeux Christophe
Published: December 2019

Diversity of the CRISPR locus ofMycobacterium tuberculosiscomplex has been studied since 1997 for molecular epidemiology purposes. By targeting solely the 43 spacers present in the two first sequenced genomes (H37Rv and BCG), it gave a biased idea of CRISPR diversity and ignored diversity in the neighbouringcas-genes.

We set up tailored pipelines to explore the diversity of CRISPR-cas locus in Short Reads. We analyzed data from a representative set of 198 clinical isolates as evidenced by well-characterized SNPs.

We found a relatively low diversity in terms of spacers: we recovered only the 68 spacers that had been described in 2000. We found no partial or global inversions in the sequences, letting always the Direct Variant Repeats (DVR) in the same order. In contrast, we found an unexpected diversity in the form of: SNPs in spacers and in Direct Repeats, duplications of various length, and insertions at various locations of the IS6110insertion sequence, as well as blocks of DVR deletions. The diversity was in part specific to lineages. When reconstructing evolutionary steps of the locus, we found no evidence for SNP reversal. DVR deletions were linked to recombination between IS6110insertions or between Direct Repeats.

This work definitively shows that CRISPR locus ofM. tuberculosisdid not evolve by classical CRISPR adaptation (incorporation of new spacers) since the last most recent common ancestor of virulent lineages. The evolutionary mechanisms that we discovered could be involved in bacterial adaptation but in a way that remains to be identified.
Comparison of mechanical sorting and DNA metabarcoding for diet analysis with degraded wolf scats
Authors: Massey Aimee , Roffler Gretchen , Vermeul Tessa , Allen Jennifer , Levi Taal
Published: December 2019

DNA metabarcoding has become a powerful technique for identifying species and profiling biodiversity with the potential to improve efficiency, reveal rare prey species, and correct mistaken identification error in diet studies. However, the extent to which molecular approaches agree with traditional approaches is unknown for many species. Here, we compare diets from wolf scats profiled using both mechanical sorting and metabarcoding of amplified vertebrate DNA sequences. Our objectives were: (1) compare findings from mechanical sorting and metabarcoding as a method of diet profiling and (2) use results to better understand diets of wolves on Prince of Wales Island, a population of conservation concern. We predicted metabarcoding would reveal both higher diversity of prey and identify rare species that are overlooked with mechanical sorting. We also posited that the relative contribution of Sitka black-tailed deer (Odocoileus hemionus sitkensis) and beaver (Castor canadensis) would be overestimated with mechanical sorting methods because of the failure to account for the full diet diversity of these wolves. We found that there was substantial overlap in the diets revealed using both methods, indicating that deer, beaver, and black bear (Ursus americanus) were the primary prey species. However, there was a large discrepancy in the occurrence of beaver in scats (54% and 24% from mechanical sorting and metabarcoding, respectively) explained by the high rate of false positives with mechanical sorting methods. Metabarcoding revealed more diet diversity than mechanical sorting, thus supporting our initial predictions. Prince of Wales Island wolves appear to have a more diverse diet with greater occurrence of rare species than previously described including 14 prey species that contribute to wolf diet. Metabarcoding is an effective method for profiling carnivore diet and enhances our knowledge concerning the full diversity of wolf diets, even in the extremely wet conditions of southeast Alaska, which can lead to DNA degradation. Given the increasingly efficient and cost-effective nature of collecting eDNA, we recommend incorporating these molecular methods into field-based projects to further examine questions related to increased use of alternate prey coinciding with changes in abundance of primary prey and habitat alteration.
Tuning shape and internal structure of protein droplets via biopolymer filaments
Authors: Scheff Danielle R. , Weirich Kimberly L. , Dasbiswas Kinjal , Patel Avinash , Vaikuntanathan Suriyanarayanan , Gardel Margaret L.
Published: December 2019

Macromolecules can phase separate to form liquid condensates, which are emerging as critical compartments in fields as diverse as intracellular organization and soft materials design. A myriad of macromolecules, including the protein FUS, form condensates which behave as isotropic liquids. Here, we investigate the influence of filament dopants on the material properties of protein liquids. We find that the short, biopolymer filaments of actin spontaneously partition into FUS droplets to form composite liquid droplets. As the concentration of the filament dopants increases, the coalescence time decreases, indicating that the dopants control the relative surface tension to viscosity. The droplet shape is tunable ranging from spherical to tactoid as the filament length or concentration is increased. We find that the tactoids are well described by a model of a bipolar liquid crystal droplet, where nematic order from the anisotropic actin filaments competes with isotropic interfacial energy from the FUS, controlling droplet shape in a size-dependent manner. Our results demonstrate a versatile approach to construct tunable, anisotropic macromolecular liquids.
UniPath: A uniform approach for pathway and gene-set based analysis of heterogeneity in single-cell epigenome and transcriptome profiles
Authors: Chawla Smriti , Samydurai Sudhagar , Kong Say Li , Wang Zhenxun , Tam Wai Leong , Sengupta Debarka , Kumar Vibhor
Published: December 2019

Here, we introduce UniPath, for representing single-cells using pathway and gene-set enrichment scores by a transformation of their open-chromatin or gene-expression profiles. Besides being robust to variability in dropout, UniPath provides consistency and scalability in estimating gene-set enrichment scores for every cell. UniPath’s approach of predicting temporal-order of single-cells using their gene-set activity score enables suppression of known covariates. UniPath based analysis of mouse cell atlas yielded surprising, albeit biologically-meaningful co-clustering of cell-types from distant organs and helped in annotating many unlabeled cells. By enabling unconventional analysis, UniPath also proves to be useful in inferring context-specific regulation in cancer cells.
Effects of nitrogen deposition on the spatial pattern of biocrusts and soil microbial activity in a semi‐arid Mediterranean shrubland
Authors: Benvenutto‐Vargas Verónica P. , Ochoa‐Hueso Raúl
Published: December 2019

Human activities have doubled, or even tripled, the amount of nitrogen (N) fixed globally, which alters the functioning and reduces the biodiversity of terrestrial ecosystems.

In this study, we used a 10‐year N addition experiment in a semi‐arid Mediterranean shrubland in central Spain to evaluate the effects of increased N deposition on biocrust cover, soil microbial enzymatic activity and their spatial patterns. We collected highly replicated, spatially explicit data to carry out Moran's I correlograms at the plot level and used linear mixed models to evaluate the effects of N addition on cover, microbial activity and Moran's I values for each distance class of correlograms.

High N deposition (50 kg N ha−1 year−1) reduced the cover of the foliose lichen Cladonia foliacea, an important component of biocrusts, and generated significant alterations and losses of the spatial pattern of biocrusts and soil microbial enzymatic activity. Furthermore, we found indication that N addition altered the relationship between biocrust cover and microbial enzymatic activity, suggesting that the presence of well‐developed biocrust communities modulates the effects of high N deposition on soil microbial activity.

Synthesis. Overall, our study suggests that an increase in N deposition may have important consequences for the structure and functioning of Mediterranean ecosystems and that some of these consequences may be due to alterations in the way in which different soil communities (e.g. moss‐lichen biocrusts and soil microorganisms) interact with one another.

A free Plain Language Summary can be found within the Supporting Information of this article.
Neuropharmacological effects of Aconiti Lateralis Radix Praeparata
Authors: Zhao Lihong , Sun Zhihui , Yang Limin , Cui Ranji , Yang Wei , Li Bingjin
Published: December 2019

Aconiti Lateralis Radix Praeparata (Fuzi in Chinese), which are the lateral roots of Aconitum Carmichaelii Debx, is widely used in China to treat many neurological diseases. Fuzi, in its various forms, has many neuropharmacological effects. It can act as an analgesic and help with depression, epilepsy, and dementia. However, the neuropharmacological effects of Aconiti Lateralis Radix Praeparata are seldom comprehensively reviewed. In this review, the neuropharmacological activities of some components contained in Aconiti Lateralis Radix Praeparata are considered. These include aconitine, mesaconitine, hypaconitine, total alkaloid, polysaccharide‐1, benzoylmesaconine, fuziline, songorine, and napelline. We also specifically discuss the antidepressant effects of total alkaloids and polysaccharide‐1. This review may provide a theoretical basis for further utilization of Aconiti Lateralis Radix Praeparata for diseases that affect the central nervous system.
Agricultural and rural development in China during the past four decades: an introduction
Authors: Huang Jikun , Rozelle Scott , Zhu Xinkai , Zhao Shiji , Sheng Yu
Published: December 2019

The past four decades have witnessed unprecedented economic growth and rapidly rising food demand in China. This paper provides an introduction to readers with useful information summarising the development of China’s agricultural sector and the transformation of its rural economy over the 40 years of economic reform. It is, however, impossible to cover all aspects of this recent and rich history in a single journal special issue. Nevertheless, we are of the view that these papers address the most fundamentally important and insightful topics including: land reform and rural development; technology progress and productivity growth; changing food consumption patterns; rural education and human capital accumulation; and poverty alleviation.
Effects of opting‐out from federal nurse anesthetists' supervision requirements on anesthesiologist work patterns
Authors: Baird Matthew , O'Donnell John M. , Martsolf Grant R.
Published: December 2019

Objective

To estimate the impact of opting‐out from Medicare supervision requirements for certified registered nurse anesthetists (CRNAs) on anesthesiologists' work patterns.

Data Sources/Study Setting

Secondary data from two national surveys of anesthesiologists and the Area Health Resource File.

Study Design

We use a matching difference‐in‐difference regression which contrasts the change in work patterns for anesthesiologists in California, which dropped supervision requirements, to the change for similar anesthesiologists. Key outcome variables include the number of weekly hours worked, the type of work done, and type of care delivery teams.

Data Collection/Extraction Methods

Self‐reported national survey data drawn from members of the American Society of Anesthesiologists.

Principal Findings

Anesthesiologists in California saw no change in time spent working or time spent supervising CRNAs. There was a decrease in direct care clinical work hours along with a shift in working more in intraoperative care, a decrease in postoperative care, and an increase in the percentage of cases supervising residents.

Conclusions

Anesthesiologists had small but real responses to California’s decisions to opt‐out of the physician supervision requirement for CRNAs, doing more work in intraoperative care and less outside of the operating room. Total hours worked saw no change.
Emergency presentation of new onset versus recurrent undiagnosed seizures: A retrospective review
Authors: Holper Sarah , Foster Emma , Chen Zhibin , Kwan Patrick
Published: December 2019

Objectives

To identify clinical factors that may assist emergency physicians to delineate between patients with new onset seizures (NOS) versus patients with recurrent undiagnosed seizures (RUS) among those presenting with apparent ‘first seizures’ to EDs. In addition, to provide a summary of current evidence‐based guidelines regarding the workup of seizure presentations to ED.

Methods

This retrospective cohort study included patients aged over 17 years who presented to a tertiary hospital ED between 1 January 2008 and 30 November 2016 with seizure‐related ICD‐10‐AM discharge codes. Exclusion criteria included pre‐existing epilepsy and non‐seizure diagnoses. Medical records were reviewed and relevant data extracted.

Results

Seventy‐five patients had NOS (54.7% [41/75] female, median age 71 years) and 22 patients had RUS (59.1% [13/22] female, median age 64 years). Non‐motor index seizures were more than four times as common among RUS patients (27.3% [6/22] RUS vs 6.7% [5/75] NOS; P = 0.015). 95.5% (21/22) of RUS patients met epilepsy diagnostic criteria compared to 44.0% (33/75) of NOS patients (P < 0.001). No differences in patient demographics, seizure aetiology or seizure risk factors were identified.

Conclusions

Emergency physicians should be wary of patients presenting with non‐motor ‘first seizures’: they are more likely to have experienced prior seizures (the ‘recurrent untreated seizure’ group), and thus meet epilepsy diagnostic criteria. Almost half of those with actual NOS may also meet epilepsy criteria, largely driven by abnormal neuroimaging. Distinguishing RUS from NOS patients in the ED allows accurate prognostication and timely initiation of appropriate therapy.
Gastric duplication cyst fistulized with the colon in an adult: A case report
Authors: Berri Toufik , Mazouzi Slimane
Published: December 2019

Gastric duplication cyst is uncommon congenital malformation rarely seen in the adult population. Although complications related to duplication such as infection, haemorrhage, obstruction, and fistula formation with neighbouring structures had been previously reported, fistulization into the colon in adult has been previously never described to our knowledge. In this study, we present the case of a 36‐year‐old male patient with moderate mental retardation who presented with 10 months history of progressive abdominal pain, nausea, vomiting, and important weight loss. Clinical assessment and radiological investigations demonstrated the presence of non‐communicating gastric duplication cyst inserted on the greater curvature of the antrum and fistulized into the transverse colon. At laparotomy, the cyst was completely excised and the colon containing the fistula was resected with colo‐colonic anastomosis. Pathology confirmed gastric duplication and demonstrated that the inner surface of the cyst was lined by gastric type mucosa. The patient had an uneventful recovery and after 3 months of follow‐up, all symptoms disappeared. Also, he gained 11 kg in weight. This case highlights, therefore, the fact that all gastric duplication cysts should be removed in order to avoid the risk of serious complications.
Comparison of the circulatory effects of continuous renal replacement therapy using AN69ST and polysulfone membranes in septic shock patients: A retrospective observational study
Authors: Shibata Mami , Miyamoto Kyohei , Kato Seiya
Published: December 2019

The acrylonitrile‐co‐methallyl sulfonate surface‐treated (AN69ST) membrane is expected to improve hemodynamics in patients with sepsis through cytokine adsorption. However, the clinical literature on AN69ST membranes is very limited. We aimed to compare the circulatory effects of continuous renal replacement therapy (CRRT) between patients using the AN69ST membrane and polysulfone (PS) membrane (a nonadsorbing membrane). This retrospective observational study enrolled 38 patients with septic shock, as defined by Sepsis‐3 criteria, who required CRRT from April 2013 to March 2018. Those who died within 24 hours after CRRT initiation and received polymyxin B‐immobilized fiber column direct hemoperfusion, extracorporeal membrane oxygenation, and CRRT using other membranes were excluded. The primary outcome was the vasopressor dependency index during the 12 hours after CRRT initiation, which was calculated as (inotropic score)/(mean arterial pressure). Of 38 patients analyzed, 16 underwent CRRT with an AN69ST membrane and 22 with a PS membrane. The median patient age was 68 years, and the median Acute Physiology and Chronic Health Evaluation (APACHE) II score at intensive care unit admission was 29.5. The vasopressor dependency index decreased significantly during the 12 hours after CRRT initiation in both groups (AN69ST: from 0.50 ± 0.43 to 0.33 ± 0.27 [P < .05], PS: from 0.34 ± 0.30 to 0.21 ± 0.22 [P < .05]). The time course of the vasopressor dependency index during the 12 hours did not differ between the two groups (P = .11). The vasopressor dependency index decreased significantly after CRRT initiation in both groups. The time course of the vasopressor dependency index did not differ between the groups.
Development of a validated Chinese version of the inflammatory bowel disease disability index
Authors: Zhang Jing Jing , Lou Dan Na , Ma Han , Yu Chao Hui , Chen Li Hua , Li You Ming
Published: December 2019

Objective

The inflammatory bowel disease disability index (IBD‐DI) has been used to evaluate functional status for patients with inflammatory bowel diseases (IBD). The study aimed to develop a reliable Chinese version of IBD‐DI (C‐IBD‐DI).

Methods

Consecutive patients with IBD and healthy controls were recruited from June 2016 to July 2017 in the First Affiliated Hospital, College of Medicine, Zhejiang University (Hangzhou, Zhejiang Province, China) to complete an inflammatory bowel disease questionnaire‐32 (IBDQ‐32), Hamilton's anxiety rating scale (HAMA) and Hamilton's depression rating scale‐24 items (HAMD‐24). The validation process included item reduction, reliability and validity tests.

Results

Altogether 122 patients with IBD completed the validation process. Factor analysis reduced the C‐IBD‐DI to 13 items. Cronbach's α coefficient was 0.90. The C‐IBD‐DI scores were correlated with IBDQ‐32 score (r = −0.79, P < 0.001), HAMA (r = 0.78, P < 0.001) and HAMD‐24 (r = 0.81, P < 0.001). The total score of C‐IBD‐DI was significantly higher in patients with active IBD than in those in remission. The intraclass correlation coefficient was 0.83 in the stable IBD group, representing a good test–retest reliability. Those with improved disease activity had a significantly lower C‐IBD‐DI score at the follow‐up visit than at baseline. Patients with IBD had worse disability levels and quality of life than the controls, and were more likely to be anxious and depressed, especially those with active IBD.

Conclusions

The validated C‐IBD‐DI comprising 13 questions has highly acceptable reliability and validity. Multicenter studies including large sample sizes are needed to further confirm our results.
Prognostic value of a new score using serum alkaline phosphatase and pleural effusion lactate dehydrogenase for patients with malignant pleural effusion
Authors: Shi Xin‐Yu , Yi Feng‐Shuang , Wang Zheng , Qiao Xin , Zhai Kan
Published: December 2019

Background

The objective of our study was to analyze the prognostic value of the combination of serum ALP and pleural effusion LDH (AL score) for malignant pleural effusion (MPE) patients.

Methods

This study includes retrospective, descriptive and observational research from 1 June 2006 to 1 December 2017, which aimed to identify prognostic factors related to MPE patients. We analyzed the association of various clinical features, routinely tested markers from peripheral blood and MPE at diagnosis and overall survival (OS). All MPE patients were assigned to three groups according to their AL score. The impact of the AL score and other prognostic factors were evaluated with multivariable regression.

Results

According to their AL score, 193 patients were assigned to three groups with 25 in group 0 (sALP < 65 U/L and pLDH < 155 U/L), 121 in group 1 (sALP > 65 U/L or pLDH > 155 U/L) and 47 (sALP > 65 U/L and pLDH > 155 U/L) in group 2. For groups 0, 1 and 2, median survival times (MST) were 23, 15 and 7 months, respectively. Among the three groups, MST, serum albumin level, C reactive protein, erythrocyte sedimentation rate, the ratios of platelet‐to‐lymphocyte, neutrophil‐to‐lymphocyte showed significant differences. The counts of neutrophils, monocytes, platelets and AL score (0 vs. 1, P = 0.038, hazard ratio [HR]: 1.858, 95% confidence interval [CI]: [1.034, 3.339]; 0 vs. 2, P = 0.001, HR: 2.993, 95% CI: [1.556, 5.531]) were independent prognostic indicators for OS of MPE patients.

Conclusion

AL score is a promising indicator which can be used to predict the prognosis of MPE patients. It can assist physicians in the selection of patients for appropriate palliative treatment.

Key points

To our knowledge, this paper is the first study that combined two enzymes (sALP and pLDH) from serum and pleural effusion and studied the prognostic value for MPE patients. It has been proved to be a promising indicator to assist physicians select patients for appropriate palliative treatment.
Tracheal intubation in patients at risk for cervical spinal cord injury: A systematic review
Authors: Cabrini Luca , Baiardo Redaelli Martina , Filippini Martina , Fominskiy Evgeny , Pasin Laura , Pintaudi Margherita , Plumari Valentina P. , Putzu Alessandro , Votta Carmine D. , Pallanch Ottavia , Ball Lorenzo , Landoni Giovanni , Pelosi Paolo , Zangrillo Alberto
Published: December 2019

Background

Tracheal intubation in patients at risk for secondary spinal cord injury is potentially difficult and risky.

Objectives

To compare tracheal intubation techniques in adult patients at risk for secondary cervical spinal cord injury undergoing surgery. Primary outcome was first‐attempt failure rate. Secondary outcomes were time to successful intubation and procedure complications.

Design

Systematic review and meta‐analysis of randomized controlled trials (RCTs) with trial sequential analysis (TSA).

Data Sources

Databases searched up to July 2019.

Eligibility

Randomized controlled trials comparing different intubation techniques.

Results

We included 18 trials enrolling 1972 patients. Four studies used the “awake” approach, but no study compared awake versus non‐awake techniques. In remaining 14 RCTs, intubation was performed under general anesthesia. First‐attempt failure rate was similar when comparing direct laryngoscopy or fiberoptic bronchoscopy versus other techniques. A better first‐attempt failure rate was found with videolaryngoscopy and when pooling all the fiberoptic techniques together. All these results appeared not significant at TSA, suggesting inconclusive evidence. Intubating lighted stylet allowed faster intubation. Postoperative neurological complications were 0.34% (no significant difference among techniques). No life‐threatening adverse event was reported; mild local complications were common (19.5%). The certainty of evidence was low to very low mainly due to high imprecision and indirectness.

Conclusions

Videolaryngoscopy and fiberoptic‐assisted techniques might be associated with higher first‐attempt failure rate over controls. However, low to very low certainty of evidence does not allow firm conclusions on the best tracheal intubation in patients at risk for cervical spinal cord injury.
Twenty‐four‐hour subjective and pharmacological effects of ad‐libitum electronic and combustible cigarette use among dual users
Authors: Harvanko Arit M. , St Helen Gideon , Nardone Natalie , Addo Newton , Benowitz Neal L.
Published: December 2019

Background and Aims

Relative pharmacological effects of e‐cigarettes and cigarettes during 24 hours of ad‐libitum use have not been described. In this study, 24‐hour blood plasma nicotine concentrations and 48‐hour subjective effects with use of cigarettes and e‐cigarettes were measured among dual users.

Design

Two‐arm within‐subject cross‐over design with preferred e‐cigarette or cigarette ad‐libitum use over 48 hours.

Setting

Hospital research ward in San Francisco, California, USA.

Participants

Thirty‐six healthy dual users of e‐cigarettes and cigarettes (n = 8, 25% females).

Measurements

Twenty‐four‐hour blood plasma nicotine and cotinine concentrations and 48‐hour self‐reported nicotine withdrawal symptoms and rewarding effects.

Findings

Analyses used analysis of variance (ANOVA)‐based mixed models with order of product (e‐cigarette or cigarette) and product type (combustible cigarette or type of e‐cigarette) as fixed effects, and subject as a repeated effect. During a 24‐hour period, e‐cigarettes produced lower nicotine exposure than cigarettes for the majority of users, although 25% received more nicotine from e‐cigarettes, which was predicted by more frequent e‐cigarette use or greater dependence. Compared to cigarette smoking, nicotine exposure for variable‐power tank users was similar, while cig‐a‐like (t(30) = 2.71, P = 0.011, d = 0.745) and fixed‐power tank users (t(30) = 3.37, P = 0.002, d = 0.993) were exposed to less nicotine. Cigarettes were rated higher than e‐cigarettes on some desirable subjective effects (e.g. psychological reward, t(322) = 7.24 P < 0.001, d = 0.432), but withdrawal symptom reduction was comparable. No differences were found between e‐cigarette types, but Bayes factors indicate that these measures were insensitive.

Conclusions

During a 24‐hour period in a hospital setting in the United States, nicotine exposure for dual users of e‐cigarettes and cigarettes was similar when using cigarettes or variable‐power tank devices only but was lower for those using cig‐a‐like or fixed‐power devices only. Despite lower nicotine levels, all types of e‐cigarette were effective in preventing withdrawal symptoms. E‐cigarettes were rated less rewarding than cigarettes.
Effect of alcohol use disorders and alcohol intake on the risk of subsequent depressive symptoms: a systematic review and meta‐analysis of cohort studies
Authors: Li Jiande , Wang Hongxuan , Li Mei , Shen Qingyu , Li Xiangpen , Zhang Yuanpei , Peng Jialing , Rong Xiaoming , Peng Ying
Published: December 2019

Background and Aims

Alcohol use disorders (AUD) are often comorbid with depressive symptoms. Cohort studies on the association between AUD and subsequent depressive symptoms have produced inconsistent results. Moreover, regarding alcohol intake, the risk of developing depressive symptoms might vary with alcohol intake level. We aimed to investigate the association between AUD, alcohol intake and subsequent depressive symptoms.

Design and Setting

We conducted a systematic search in PubMed, Embase and PsycINFO for cohort studies on the association between AUD or alcohol intake and subsequent depressive symptoms.

Participants

We included 338 426 participants from 42 studies. Six and four studies analyzed only females and males, respectively.

Measurements

We combined risk estimates for developing depressive symptoms using a random‐effects model. We divided alcohol intake into abstinence, light (0–84 g/week), moderate (85–168 g/week) and heavy drinking (> 168 g/week or > 48 g/day at least weekly). We conducted a categorical analysis to compare the risk of depressive symptoms between abstinence and different intake categories. Further, we conducted a dose–response analysis to investigate the alcohol–depression association.

Findings

We analyzed 42 studies (follow‐up time: 1–40 years). AUD was associated with significantly increased risk of subsequent depressive symptoms [relative risk (RR) = 1.57, 95% confidence interval (CI) = 1.41–1.76]. Regarding alcohol intake, heavy drinking had an increased risk of depressive symptoms; however, the association was only significant when controls were limited to non‐heavy drinkers (RR = 1.13, 95% CI = 1.05–1.22). Taking into consideration the possibility of publication bias and confounding factors made the association non‐significant. We observed J‐shaped associations in both categorical and dose–response analyses where light‐moderate drinking had a significantly decreased risk of depression, while heavy drinking did not show a significant association with depressive symptoms compared with non‐drinkers.

Conclusion

Alcohol use disorders are associated with increased the risk of subsequent depressive symptoms. Heavy drinking does not significantly predict occurrence of depressive symptoms after adjusting for potential confounders.
Trained Identities: Exploring Emergent Identities Aboard One Slow‐Moving Train
Authors: Leggett William H.
Published: December 2019

This article explores processes of identity negotiation through talk and body language among a small community of travelers aboard a cross‐country train. I explore the emergent and contingent nature of narrative as well as the role of body language and silence in the construction of self and other in a space separate from the usual social networks that inform our senses of self. I argue that aboard the train we were able to invent ourselves anew, making of ourselves what we wanted with the understanding that we would never meet again and that our stories could go largely unchecked. At the same time, I note the importance of structural identity markers in our storytelling and place‐making actions.
Forbidden Fieldwork: The Affair as Research Method
Authors: Rice Kathleen
Published: December 2019

This creative nonfiction essay is both a reflection about a complex intimate relationship that developed during doctoral fieldwork and a commentary on what anthropologists are socialized to compartmentalize, silence, and refuse for the sake of academic credibility. Grounded in the author’s personal experience of having an affair in the field, it explains that pursing a course of action that the author was trained and socialized to eschew had the unexpected outcome of advancing the author’s anthropological research.
Comparison of biosynthetic versus synthetic mesh in clean and contaminated ventral hernia repairs
Authors: Keogh Kandice , Slater Kellee
Published: December 2019

Background

Abdominal hernias are an increasingly common presentation due to obesity, ageing and prevalence of prior abdominal surgery. Mesh repair is the mainstay of treatment; however, mesh selection remains largely subjective. There are little data available to assess the performance of biosynthetic meshes against synthetic meshes across all wound types. This study assessed the 6‐month outcomes of a single surgeon's cohort of ventral hernia repairs performed with either GORE BIO‐A (BioA) or Parietex ProGrip (ProGrip).

Methods

Retrospective case cohort study across two centres with patients undergoing repair by a single surgeon (KS) between January 2014 and April 2018 was conducted. All hernia repairs were performed with either BioA (n = 55) or ProGrip mesh (n = 60). Outcomes were monitored for 6 months post repair. Wounds were classified according to the Centre for Disease Control Wound Status. Outcomes measured were length of stay, general complications, wound complications and hernia recurrence.

Results

The overall complication rate and length of stay were similar for both groups. In clean wounds, the complication rate was equivalent for BioA and ProGrip (34% versus 22%, P = 0.22). There was a significant difference in complication rates in contaminated wounds – BioA 17% versus ProGrip 100% (P = 0.004). BioA performed equivocally in clean and contaminated wounds (34% versus 17%, P = 0.178), whereas ProGrip performed worse in contaminated wounds (22% versus 100%, P = 0.016).

Conclusion

Our results suggest that BioA is a suitable, if not preferable, choice for contaminated hernia repair. In this cohort, BioA was also demonstrated as safe and equivalent to ProGrip mesh in clean hernia wounds.
Relationship between age, comorbidities and complications in head and neck cancer patients undergoing curative surgery
Authors: Shepherd Sally J. , Creber Nathan , Mansour Kristy , Wiesenfeld David , Iseli Tim A. , Amott Deborah
Published: December 2019

Background

Both age and comorbidity are accepted as significant prognostic factors for adverse perioperative outcomes in major surgery. Elderly patients may be overlooked for radical treatment for fear of poor perioperative outcome. We aim to assess the relationship between age, comorbidities and post‐operative outcomes in a tertiary head and neck unit.

Methods

A retrospective analysis was undertaken on 651 patients who underwent surgery for head and neck cancer at a tertiary hospital between 2007 and 2014.

Results

A total of 253 (38.9%) patients were aged ≥70 years and 398 (61.1%) patients were ≤69 years. Age alone did not predict prolonged post‐operative stay, perioperative complications nor perioperative mortality. Congestive cardiac failure and/or complicated diabetes were significantly associated with poor outcomes, as was male sex.

Conclusion

Patients of any age with cardiac failure or complicated diabetes have a higher rate of post‐operative complications in head and neck surgery.
Expression and prognostic utility of SSX2IP in patients with nasopharyngeal carcinoma
Authors: Chang Shih‐Lun , Lee Sung‐Wei , Yang Sheau‐Fang , Chien Chu‐Chun , Chan Ti‐Chun , Chen Tzu‐Ju , Yang Ching‐Chieh , Li Chien‐Feng , Wei Yu‐Ching
Published: December 2019

Cell adhesion affects carcinogenesis, tumor progression, and metastasis. We datamined a published transcriptome (GSE12452) of nasopharyngeal carcinoma (NPC) and identified SSX2IP as a significantly upregulated gene in NPC carcinogenesis among genes associated with cell adhesion (GO:0007155). Consequently, we assessed SSX2IP protein expression and its prognostic significance in 124 patients with NPC using immunohistochemistry and the H‐score method. The status of SSX2IP immunoexpression correlated with clinical and pathological characteristics, as well as oncological outcomes. High levels of SSX2IP expression were significantly associated with more advanced primary tumor and TNM stages. Kaplan–Meier and log‐rank analyses revealed that high levels of SSX2IP expression, and advanced tumor stage and lymph node metastasis were significantly associated with lower rates of local recurrence‐free survival (LRFS), distant metastasis‐free survival (DMeFS), and disease‐specific (DSS) survival. Multivariate analysis showed that high levels of SSX2IP expression significantly predicted DSS (hazard ratio [HR], 4.290; 95% confidence interval [CI], 2.271–8.102; p < 0.001), DMeFS (HR, 4.159’ 95% CI, 2.072–8.345; p < 0.001), and LRFS (HR, 3.007’ 95% CI,: 1.418–6.378; p = 0.004). We associated high levels of SSX2IP immunoexpression with aggressive pathological features and worse oncological outcomes, suggesting its potential therapeutic value for patients with NPC.
The role of executive functions in kindergarteners’ persistent and non‐persistent behaviour
Authors: Oeri Niamh , Kälin Sonja , Buttelmann David
Published: December 2019

The aim of the study was to examine whether cognitive skills are related to persistence. Thus, children’s (N = 157, mean age: 5.9 years) persistent and non‐persistent behaviours (i.e., cheating and off‐task) were assessed in an unsolvable task. Additionally, we assessed children’s executive functions and temperament. Analysis for persistence showed that cognitive inhibition and cognitive flexibility predicted children’s persistent behaviour, beyond age and temperament. Analyses for non‐persistent behaviours revealed that temperament and weak executive functions predicted cheating, while age predicted off‐task behaviour.

Statement of contribution

What is already known on this subject?

So far, persistence has been conceptualized as a temperamental sub‐dimension of self‐regulation.

What does this study add?

A child’s persistence depends not only on temperament but also on cognitive inhibition and cognitive flexibility.

There are qualitative differences between the two non‐persistent behaviours cheating and off‐task.

While cheating is related to weaker cognitive skills, off‐task behaviour seems mainly age‐related.
Long‐term outcome evaluation of medium/high risk acute lymphoblastic leukaemia children treated with or without cranial radiotherapy in the EORTC 58832 randomized study
Authors: Piette Caroline , Suciu Stefan , Bertrand Yves , Uyttebroeck Anne , Vandecruys Els , Plat Geneviève , Paillard Catherine , Pluchart Claire , Sirvent Nicolas , Maurus Renée , Poirée Maryline , Simon Pauline , Ferster Alina , Hoyoux Claire , Mazingue Françoise , Paulus Robert , Freycon Claire , Thomas Caroline , Philippet Pierre , Gilotay Caroline , van der Werff Ten Bosch Jutte , Rohrlich Pierre S. , Benoit Yves
Published: December 2019

We investigated the long‐term outcome, the incidence of second neoplasms (SN) and the rate of late adverse effects (LAE) in children with central nervous system (CNS) negative medium/high‐risk de novo acute lymphoblastic leukaemia (ALL), in first complete remission (CR1) at end of late intensification, randomized to receive no cranial radiotherapy (No CRT, n = 92) versus CRT (standard arm, n = 84) in the non‐inferiority EORTC 58832 study (1983–1989). Median follow‐up was 20 years (range 4–32 years). The 25‐year disease‐free survival rate (±SE) was 67·4 ± 4·9% without CRT and 70·2 ± 5·0% with CRT. The 25‐year incidence of isolated (6·5 ± 2·6% vs. 4·8 ± 2·3%) and any CNS relapse {8·7 ± 2·9% vs. 11·9 ± 3·5%; hazard ratio (HR) 0·71 [95% confidence interval (CI) 0·28–1·79]; test of non‐inferiority: P = 0·01} was not increased without CRT. The 25‐year SN incidence in CR1 was 7·9 ± 4·6% vs. 11·0 ± 4·2%. The 25‐year event‐free and overall survival rates were quite similar in both arms [59·5 ± 6·3% vs. 60·5 ± 5·9%, HR 0·94 (95% CI 0·57–1·52), and 78·1 ± 4·3% vs. 78·5 ± 4·5%, HR 1·00 (95% CI 0·53–1·88)]. Omission of CRT was associated with dramatic decrease in CNS and endocrine LAE rates. In conclusion, our data suggest that, with proper systemic and intrathecal CNS prophylaxis, CRT could totally be omitted in CR1 without jeopardizing survival, while decreasing LAE in childhood ALL.
The effect of the urinary and faecal microbiota on lower urinary tract symptoms measured by the International Prostate Symptom Score: analysis utilising next‐generation sequencing
Authors: Holland Bradley , Karr Mallory , Delfino Kristin , Dynda Danuta , El‐Zawahry Ahmed , Braundmeier‐Fleming Andrea , McVary Kevin , Alanee Shaheen
Published: December 2019

Objective

To examine the correlation between urinary and faecal microbial profiles and the different aspects of lower urinary tract symptoms (LUTS) in men, as there is accumulating evidence that variations in the human microbiota may promote different benign disease conditions.

Patients and Methods

We extracted total DNA from urine and faecal samples of a group of men, under an Institutional Review Board‐approved protocol. At the same time, International Prostate Symptom Score (IPSS) data were collected. We then amplified the extracted DNA and sequenced it using bacterial 16S ribosomal RNA gene high‐throughput next‐generation sequencing platform, and analysed the microbial profiles for taxonomy to examine the correlation between the different operational taxonomy units (OTUs) and LUTS represented by the total IPSS, the different symptom levels of the IPSS (mild, moderate, and severe) and its subcomponents of storage, nocturia, voiding, and bother.

Results

We included 30 patients (60 samples; one urine and one faecal per patient). In all, 48 faecal OTUs showed a significant correlation with one or more of the IPSS components; 27 with nocturia, 19 with bother, 16 with storage symptoms, and nine with voiding symptoms. The most substantial negative (protective) correlation was between Lachnospiraceae Blautia, a bacteria that increases the availability of gut anxiolytic and antidepressant short‐chain fatty acids, and bother (correlation coefficient 0.702; P = 0.001). The abundance of L. Blautia continued to have a protective correlation against LUTS when looking at the different levels of IPSS severity (moderate and severe vs mild, correlation coefficient 0.6132; P = 0.002). Ten unique urinary OTUs showed significant correlation with LUTS; eight with nocturia, one with bother, three with storage, and one with voiding, but no faecal OUT had more than a low correlation with the outcomes of interest in this study.

Conclusions

Our prospective work finds a plausible correlation between L. Blautia and LUTS. Additional studies are needed to determine if the correlations found in the present research are applicable to the general population of patients affected by LUTS.
Can point‐of‐care testing improve access to diagnostic screening and testing for people with learning disabilities? Exploring perspectives to improve access and equity
Authors: Giles Karen , Ling Jonathan , Gordon Isabel
Published: December 2019

Accessible summary

People with learning disabilities, like everyone else, need to have their health checked, but this can sometimes be difficult.

We asked people with learning disabilities and the people who look after them what they thought about how they have blood tests done or their hearing checked.

We found out the things that make it a positive experience.

We learnt that people with learning disabilities and the people who look after them thought point‐of‐care testing would be a good idea.

We learnt what things they thought should be put in place to make this type of testing work well for them.

Background

People with learning disabilities have an increased risk of diabetes, cardiovascular disease and hearing loss. This study explored service users' and health professionals' perspectives and experiences of adopting minimally invasive diagnostic and screening devices, known as point‐of‐care testing (POCT) as a means of improving access and engagement.

Materials and Methods

Focus groups and semi‐structured interviews were undertaken with attendees at a nonhealthcare day centre, specialist learning disability clinical network and national leads as well as researchers into learning disability and point‐of‐care issues. Thematic analysis of the data was undertaken.

Results

There was a lack of awareness and experience of POCT across the users and health professionals. Despite this, on seeing the devices and discussing application there was strong support and acceptability across all participants for their use so long as individual needs were addressed. There was no consistent sense of where this testing should be done but support for the flexibility this could provide in terms of nonmedicalised locations and individual needs. Strategies for success included the use of specific adjustments such as the presence of a known carer, pre‐testing information in an appropriate format and taking into account each individual's preferences.

Conclusions

POCT is considered a viable and useful method for improving access to testing for people with learning disabilities. Adoption barriers in implementation identified as specific to the field of learning disabilities included lack of POCT awareness and diagnostic overshadowing concerns, and adjusting for individualised needs is essential.