bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and safety of iloprost in trauma patients with haemorrhagic shock‐induced endotheliopathy—Protocol for the multicentre randomized, placebo‐controlled, blinded, investigator‐initiated shine‐trauma trial
Authors: Johansson Pär I. , Eriksen Christian Fenger , Schmal Hagen , Gaarder Christine , Pall Marlene , Henriksen Hanne Hee , Bovbjerg Pernille , Lange Theis , Næss Pål Aksel , Nielsen Christian , Kirkegaard Hans , Stensballe Jakob
Published: January 2021

Background

Traumatic injury accounts for 800 000 deaths in the European Union annually. The main causes of deaths in trauma patients are exsanguination and multiple organ failure (MOF). We have studied >1000 trauma patients and identified shock‐induced endotheliopathy (SHINE), the pathophysiological mechanism responsible for MOF and high mortality. Pilot studies indicate that low‐dose iloprost (1 ng/kg/min) improves endothelial functionality in critically ill patients suggesting this intervention may improve patient outcome in traumatic SHINE.

Material and Methods

This is a multicentre, randomized, blinded clinical investigator‐initiated phase 2B trial in trauma patients with haemorrhagic shock‐induced endotheliopathy. Patients are randomized 1:1 to 72 hours infusion of iloprost 1 ng/kg/min or Placebo (equal volume of saline). A total of 220 trauma patients will be included. The primary endpoint is the number of intensive care unit (ICU)‐free days, within 28 days of admission. Secondary endpoints include 28‐ and 90‐day all‐cause mortality, hospital length of stay, vasopressor‐free days in the intensive care unit (ICU) within 28 days, ventilator‐free days in the ICU within 28 days, renal replacement‐free days in the ICU within 28 days, number of serious adverse reactions and serious adverse events within the first 4 days of admission.

Discussion

This trial will test the safety and efficacy of administration of iloprost vs placebo for 72 hours in trauma patients with haemorrhagic shock‐induced endotheliopathy. Trial endpoints focus on the potential effect of iloprost to reduce the need for ICU stay secondary to mitigation of organ failure.

Trial registration

SHINE‐TRAUMA trial—EudraCT no. 2019‐000936‐24—Clinicaltrials.gov: NCT03903939 Ethics Committee no. H‐19014482.
Real‐world effectiveness of pharmacological treatments of alcohol use disorders in a Swedish nation‐wide cohort of 125 556 patients
Authors: Heikkinen Milja , Taipale Heidi , Tanskanen Antti , Mittendorfer‐Rutz Ellenor , Lähteenvuo Markku , Tiihonen Jari
Published: January 2021

Background and aim

Pharmacotherapy for alcohol use disorder (AUD) is recommendable, but under‐used, possibly due to deficient knowledge of medications. This study aimed to investigate the real‐world effectiveness of approved pharmacological treatments (disulfiram, acamprosate, naltrexone and nalmefene) of AUD.

Design

A nation‐wide, register‐based cohort study.

Setting

Sweden.

Participants

All residents aged 16–64 years living in Sweden with registered first‐time treatment contact due to AUD from July 2006 to December 2016 (n = 125 556, 62.5% men) were identified from nation‐wide registers.

Measurements

The main outcome was hospitalization due to AUD. The secondary outcomes were hospitalization due to any cause, alcohol‐related somatic causes, as well as work disability (sickness absence or disability pension), and death. Mortality was analysed with between‐individual analysis using a traditional multivariate‐adjusted Cox hazards regression model. Recurrent outcomes, such as hospitalization‐based events and work disability, were analysed with within‐individual analyses to eliminate selection bias.

Findings

Naltrexone combined with acamprosate [hazard ratio (HR) = 0.74; 95% confidence interval (CI) = 0.61–0.89], combined with disulfiram (HR = 0.76, 95% CI = 0.60–0.96) and as monotherapy (HR = 0.89, 95% CI = 0.81–0.97) was associated with a significantly lower risk of AUD‐hospitalization compared with no use of AUD medication. Similar results were found for risk of hospitalization due to any cause. Benzodiazepine use and acamprosate monotherapy were associated with an increased risk of AUD‐hospitalization (HR = 1.18, 95% CI = 1.14–1.22 and HR = 1.10, 95% CI = 1.04–1.17, respectively). No statistically significant effects were found for work disability or mortality.

Conclusions

Naltrexone as monotherapy and when combined with disulfiram and acamprosate appears to be associated with lower risk of hospitalization due to any and alcohol‐related causes, compared with no use of alcohol use disorder (AUD) medication. Acamprosate monotherapy and benzodiazepine use appear to be associated with increased risk of AUD‐associated hospitalization.
Association between age at first reported e‐cigarette use and subsequent regular e‐cigarette, ever cigarette and regular cigarette use
Authors: Conner Mark , Grogan Sarah , Simms‐Ellis Ruth , Cowap Lisa , Armitage Christopher J. , West Robert , Marshall Anna‐Marie , Siddiqi Kamran
Published: January 2021

Background and aims

Association of electronic cigarette use and subsequent smoking has received considerable attention, although age of first use has not. This study tested differences in regular (e‐cigarettes, cigarettes) and ever (cigarettes) use between e‐cigarette user groups: early versus never users, late versus never users, early versus late users and effects of controlling for covariates.

Design

Prospective study with 12‐ and 24‐month follow‐up of e‐cigarette/cigarette ever/regular use with data from an intervention.

Setting

Forty‐five schools in England (Staffordshire and Yorkshire).

Participants

Never smokers (3289 13–14‐year‐olds) who were part of a cluster randomized controlled trial.

Measurements

The sample was divided into groups of e‐cigarette users: early users (at 13–14 years), late users (at 14–15 years) and never users (at 13–14 and 14–15 years). Dependent variables were self‐reported regular e‐cigarette and cigarette use and ever cigarette use at 15–16 years. Covariates were assessed.

Findings

Early and late users compared with never users were significantly more likely to be regular e‐cigarette users [early: odds ratio (OR) = 9.42, 95% confidence interval (CI) = 5.38, 16.49, P < 0.001; late: OR = 6.89, 95% CI = 4.11, 11.54, P < 0.001], ever cigarette users (early: OR = 7.96, 95% CI = 6.02, 10.53, P < 0.001; late: OR = 5.13, 95% CI = 3.85, 6.84, P < 0.001) and regular cigarette users (early: OR = 7.80, 95% CI = 3.99, 15.27, P < 0.001; late: OR = 4.34, 95% CI = 1.93, 9.77, P < 0.001) at age 15–16 years. Late users compared with early users had significantly lower rates of ever use of cigarettes at 15–16 years (OR = 0.48, 95% CI = 0.35, 0.66, P < 0.001), although this difference was non‐significant at 12 months after first use of e‐cigarettes (OR = 0.89, 95% CI = 0.64, 1.25, P = 0.498). Controlling for covariates did not change the findings.

Conclusions

Adolescents in England who report using e‐cigarettes at age 13–14 years have higher rates of subsequently initiating cigarette use than adolescents who report using e‐cigarettes at age 14–15 years, a difference that may be attributable to a longer period of time to initiate cigarette use in former group.
What on‐line searches tell us about public interest and potential impact on behaviour in response to minimum unit pricing of alcohol in Scotland
Authors: Leon David A. , Yom‐Tov Elad , Johnson Anne M. , Petticrew Mark , Williamson Elizabeth , Lampos Vasileios , Cox Ingemar
Published: January 2021

Aims

To investigate whether the introduction of minimum unit pricing (MUP) in Scotland on 1 May 2018 was reflected in changes in the likelihood of alcohol‐related queries submitted to an internet search engine, and in particular whether there was any evidence of increased interest in purchasing of alcohol from outside Scotland.

Design

Observational study in which individual queries to the internet Bing search engine for 2018 in Scotland and England were captured and analysed. Fluctuations over time in the likelihood of specific topic searches were examined. The patterns seen in Scotland were contrasted with those in England.

Setting

Scotland and England.

Participants

People who used the Bing search engine during 2018.

Measurements

Numbers of daily queries submitted to Bing in 2018 on eight alcohol‐related topics expressed as a proportion of queries on that day on any topic. These daily likelihoods were smoothed using a 14‐day moving average for Scotland and England separately.

Findings

There were substantial peaks in queries about MUP itself, cheap sources of alcohol and online alcohol outlets at the time of introduction of MUP in May 2018 in Scotland, but not England. These were relatively short‐lived. Queries related to intoxication and alcohol problems did not show a MUP peak, but were appreciably higher in Scotland than in England throughout 2018.

Conclusions

Analysis of internet search engine queries appears to show that a fraction of people in Scotland may have considered circumventing minimum unit pricing in 2018 by looking for on‐line alcohol retailers. The overall higher levels of queries related to alcohol problems in Scotland compared with England mirrors the corresponding differences in alcohol consumption and harms between the countries.
Education tracking and adolescent smoking: a counterfactual and prospective cohort study
Authors: Lin Wen‐Hsu , Gebel Michael
Published: January 2021

Background and Aims

Adolescent smoking is a health issue and a potential health inequality issue. Education tracking, which is the placement of students into different school types and curricula based on their learning needs or abilities, is an indicator of inequality and risk factor of adolescent smoking. We examined the effect of educational tracking, dividing students into vocational and academic high school tracks, on adolescent smoking in Taiwan.

Design and Setting

Longitudinal panel data, collected annually from 2000 over a period of 6 years as part of the Taiwan Youth project, were used.

Participants

Adolescents (aged 13–18 years) from the first six waves of the Taiwan Youth Project were included in the project, of whom 2147 had clear information on track attendance in 10th grade, control variables in 7th/8th grades and smoking behavior in 8th grade (before track placement). Post‐track smoking behavior was measured at 10th, 11th and 12th grades.

Measurements

The outcome variable was the self‐reported smoking status in the 8th grade and between 10th and 12th grades. The treatment variable of interest was education tracking (vocational versus academic), which was conducted when the student was in 10th grade. Several important confounders were used for the difference‐in‐differences propensity score matching (e.g. parents’ education and same classroom peer smoking).

Findings

Placement of a student in the vocational track increased the proportion of smokers by 3.3 percentage points in 10th grade (P = 0.039). The effect was even more pronounced in 11th grade (6.2 percentage points; P = 0.000) and 12th grade (5.9 percentage points; P = 0.003).

Conclusions

Education tracking (placement of students into different school curricula based on learning needs or abilities) appears to be a risk factor for adolescent smoking among Taiwanese adolescents.
Radiographic assessment of carpal conformation in the horse, part 2: Finding acceptable limits to postural and rotational variations during radiography
Authors: Olusa Timothy A. O. , Davies Helen M. S.
Published: January 2021

Finding an appropriate location for perpendicular positioning of the X‐ray machine to produce zero lateromedial (ZLM) and zero dorsopalmar (ZDP) carpal images (views) and finding an acceptable range of rotational variations for measurement of carpal conformational parameters were two major challenges identified during field radiography of equine forelimbs. 16 cadaver forelimbs transacted at antebrachial midshaft from 10 horses (aged 9.13 ± 4.59 years) were axially mounted into a custom‐built frame, and the radiographic machine and plate were perpendicularly aligned with the limb. Each limb was then radiographed at 2.5° interval of vertical rotation of the machine until ZLM and ZDP images were acquired, and at 24 other postural and rotational positions from ZLM and ZDP at 5° interval for comparison of measurements with the standardized ZLM and ZDP images. ZLM radiographs were produced at a mean vertical projection angle (VPA) of 9.84 ± 3.47° palmarolateral–dorsomedial oblique (PaL‐DMO), while ZDP was acquired at VPA of 6.41 ± 2.73° dorsolateral–palmaromedial oblique (DL‐PaMO). Changes in limbs’ postural tilts, vertical plate rotations (VPR) and horizontal beam rotations (HBR) had no effect on the quality of the radiographs and on carpal measurements, while vertical beam rotation (VBR) of X‐ray beam produced significant changes on the quality of radiographs and on measurements of carpal parameters. It is recommended that field radiographs of equine forelimbs intended for carpal measurement be obtained within a proposed range of VPA of 2.5° to 12.5° PaL‐DMO for ZLM and 2.5° to 10° DL‐PaMO for ZDP in order to minimize potential errors attributable to vertical rotational movements.
Preoperative prediction of difficult laparoscopic cholecystectomy based on diffusion‐weighted magnetic resonance imaging
Authors: Kurata Yoshihiro , Hayano Koichi , Ichinose Masanori , Sasaki Takuma , Kainuma Shunsuke , Fukasawa Kimiaki , Shimao Hitoshi , Ohira Gaku , Matsubara Hisahiro
Published: January 2021

Introduction

Laparoscopic cholecystectomy is a common surgery with a varying difficulty level. Difficult laparoscopic cholecystectomy may be experienced by many surgeons. If difficult procedures are predicted preoperatively, surgeons may be able to plan the surgical approach and treatment accordingly. Studies have reported using blood and clinical imaging data to predict difficult cholecystectomy. However, to our knowledge, no studies have reported using MRI. The purpose of this study was to evaluate the usefulness of MRI as a predictor of difficult laparoscopic cholecystectomy.

Methods

We retrospectively evaluated 25 patients with cholecystitis or biliary colic who had undergone diffusion‐weighted whole‐body imaging before laparoscopic cholecystectomy. The apparent diffusion coefficient value of the cystic duct was measured and its relationship with operative time and blood loss was examined to assess the capacity of diffuse‐weighted whole‐body imaging to predict difficult cholecystectomy. Further, we collected blood data and compared its usefulness as a predictor.

Results

The apparent diffusion coefficient value of the cystic duct was significantly lower in patients with difficult laparoscopic cholecystectomy than in those with non‐difficult procedures (P = .00007). White blood cell count and serum C‐reactive protein level were significantly higher in patients with difficult cholecystectomy than in those with non‐difficult procedures (P = .035, .030). In the receiver operating characteristic analysis, the apparent diffusion coefficient value was the best predictor.

Conclusion

Our results suggest that the apparent diffusion coefficient value of the cystic duct is a predictor of difficult laparoscopic cholecystectomy. In the future, it may be useful to study changes in coefficient values over time to determine optimal surgical timing.
Proton pump inhibitors and risk of all‐cause and cause‐specific mortality: A cohort study
Authors: Brown Jeremy P. , Tazare John R. , Williamson Elizabeth , Mansfield Kathryn E. , Evans Stephen J. , Tomlinson Laurie A. , Bhaskaran Krishnan , Smeeth Liam , Wing Kevin , Douglas Ian J.
Published: January 2021

Aim

To investigate the association between proton pump inhibitors (PPIs) and both all‐cause and cause‐specific mortality.

Methods

We conducted a cohort study using the UK Clinical Practice Research Datalink GOLD database. We compared 733 885 new users of PPIs to 124 410 new users of H2 receptor antagonists (H2Ras). In a secondary analysis we compared 689 602 PPI new users to 1 361 245 nonusers of acid suppression therapy matched on age, sex and calendar year. Hazard ratios for all‐cause and cause‐specific mortality were estimated using propensity score (PS) weighted Cox models.

Results

PPI prescription was associated with increased risk of all‐cause mortality, with hazard ratios decreasing considerably by increasing adjustment (unadjusted hazard ratio [HR] 1.65, 95% confidence interval [CI] 1.62‐1.69; PS‐weighted HR 1.38, 95% CI 1.33‐1.44; high‐dimensional PS‐weighted HR 1.31, 95% CI 1.26‐1.37). Short‐term associations were observed with mortality from causes where a causal short‐term association is unexpected (eg, lung cancer mortality: PS‐weighted HR at 6 months 1.77, 95% CI 1.39‐2.25). Adjusted hazard ratios were substantially higher when compared to nonusers (PS‐weighted HR all‐cause mortality 1.96, 95% CI 1.94‐1.99) rather than H2RA users.

Conclusions

PPI prescription was strongly associated with all‐cause and cause‐specific mortality. However, the change in hazard ratios (a) by increasing adjustment and (b) between comparator groups indicates that residual confounding is likely to explain the association between poor health outcomes and PPI use, and fully accounting for this using observational data may not be possible.
Imprinting of founders' entrepreneurial motivations on enterprises' practices and processes: The context of creative industries
Authors: Abecassis‐Moedas Céline , BenMahmoud‐Jouini Sihem , Manceau Delphine , Pereira Joana
Published: January 2021

This paper explores the imprinting of entrepreneurs' motivations on the practices and processes of enterprises. We investigate the question in the context of creative industries (CIs) as an extreme case of entrepreneurial motivations (EMs) prevalence. We analyse the EM of 14 founders of design consultancies. Three EMs emerge:self‐fulfilment,freedomandfinancialmotivation. The qualitative analysis reveals that the founders' EMs at the time of a venture's founding has a lasting impact on the characteristics of the venture (name, processes formalization, decision‐making processes, performance measures and growth strategies). Specifically, founders driven byself‐fulfilmenttend to build ventures named after them. In these ventures, processes are informal, decision‐making is centralized, performance measures are based on personal satisfaction and recognition and enterprise growth is restrained. Founders who seekfreedomtend to run enterprises with semiformal processes, semicentralized decision‐making, a client satisfaction focus, and slow growth strategies. In contrast, founders withfinancialmotivations tend to create enterprises with formal processes, decentralized decision‐making, financial performance metrics and growth ambitions. By focusing on EM and adopting a holistic approach beyond some characteristics of the venture, we complement the imprinting literature.
The treatment landscape of advanced angiosarcoma in Asia—A multi‐national collaboration from the Asian Sarcoma Consortium
Authors: Chen Tom Wei‐Wu , Pang Angela , Puhaindran Mark E. , Maw Myo Myint , Loong Herbert H. , Sriuranpong Virote , Chang Chih‐Chi , Mingmalairak Siyamol , Hirose Takeshi , Endo Makoto , Kawai Akira , Farid Mohamad , Tan Sze Huey , Goh Wei Lin , Quek Richard , Chan Jeffrey C. H. , Leung Alex K. C. , Ngan Roger K. C.
Published: January 2021

Angiosarcoma (AS) is a rare disease with a dismal prognosis. The treatment landscape and prognostic factors for advanced AS, including locally advanced, unresectable, and metastatic disease remain elusive. The Asian Sarcoma Consortium is an international collaborative effort to understand the sarcoma treatment landscape in Asia. We undertook a retrospective chart review of AS patients seen in 8 sarcoma academic centers across Asia. Patients with complete clinical, treatment, and follow‐up data were enrolled. Overall, 276 advanced AS patients were included into this study; 84 (30%) of the patients had metachronous metastatic AS. The median age was 67 y; primary sites of AS was cutaneous in 55% and visceral in 45% of patients. In total, 143 (52%) patients received at least 1 line of systemic chemotherapy. The most common first‐line chemotherapy regimen used was paclitaxel (47.6%) followed by liposomal doxorubicin (19.6%). The median overall survival (OS) was 7.8 mo. Significant prognostic factors for OS included age > 65 (hazard ratio (HR) 1.54, P = .006), male gender (HR 1.39, P = .02), and a cutaneous primary AS site (HR 0.63, P = .004). The median progression‐free survival (PFS) for first‐line chemotherapy was 3.4 mo. PFS for single vs combination or paclitaxel vs liposomal doxorubicin chemotherapy regimens were comparable. This study provides an insight into the treatment patterns and prognostic factors of advanced AS patients in Asia. Prognosis of advanced AS remains poor. Data from this study serve as a benchmark for future clinical study design.
Pathological response post neoadjuvant therapy for locally advanced rectal cancer is an independent predictor of survival
Authors: On Jason , Shim Joanna , Mackay Craig , Murray Graeme , Samuel Leslie , Parnaby Craig , Ramsay George
Published: January 2021

Aim

Neoadjuvant treatment (NaT) for locally advanced rectal cancer prior to surgery has led to improved outcomes. However, the relationship between pathological response to NaT and survival is not entirely clear. The aim of this study was to assess the degree of pathological response to NaT on survival outcomes.

Methods

Clinical and pathological data were collected from a prospectively maintained pathology database between 2005 and 2017. The primary outcome was the overall survival based on pathological response categorized as complete, good partial, partial and minimal. Univariate and multivariate analyses were conducted to identify variables predictive of survival. Cox proportional hazard ratios were used for survival.

Results

A total of 596 patients had surgery following NaT for locally advanced rectal cancer. The median follow‐up was 4.57 years (interquartile range 2.21–8.15 years). The overall survival for complete pathological response was 75.6% vs. 37.3% for minimal response (P < 0.001). The overall survival at the end of the study in the good partial vs. partial response groups was 58.9% vs. 39% (P < 0.001). On multivariate analysis, the degree of pathological response remains an independent variable for overall and disease‐specific survival across all categories.

Discussion

In addition to other pathological variables, the degree of pathological response to NaT is an independent predictor for survival outcomes. Future verification of these findings elsewhere could support NaT response being used for adjuvant therapy decision making.
Hip pain in adolescents with cerebral palsy: a population‐based longitudinal study
Authors: Larsen Selma Mujezinović , Ramstad Kjersti , Terjesen Terje
Published: January 2021

Aim

To investigate the prevalence, characteristics, and risk factors of hip pain in adolescents with cerebral palsy (CP) and compare the findings with those of the same individuals 5 years earlier.

Method

Sixty‐seven adolescents (28 females, 39 males; mean age 14y 7mo; SD 1y 5mo; range 12–17y) with bilateral CP, in Gross Motor Function Classification System (GMFCS) levels III to V enrolled in a CP surveillance programme were assessed for hip pain. Their caregivers responded to the questions on the intensity and frequency of hip pain from the Child Health Questionnaire (CHQ) (transformed to CHQ hip pain score; 100 indicates no pain). Interference of hip pain with daily activities and sleep was recorded on numeric rating scales. Hip displacement was measured radiographically by the migration percentage.

Results

Twenty‐eight participants had 44 painful hips. Their mean CHQ hip pain score was 40 (SD 21.4; range 10–80). Independent risk factors for hip pain, low CHQ hip pain score, and interference with sleep were severe hip subluxation (migration percentage 50–89%) and GMFCS level V. A migration percentage of 50% to 89% was the only independent risk factor for interference with daily activities. Over 5 years, the number of participants with hip pain increased from 18 to 28, while the mean migration percentage of the most displaced hip was unchanged.

Interpretation

Our CP hip surveillance programme did not protect the participants against increasing prevalence of hip pain during adolescence. We suggest that surveillance programmes for CP should include guidelines on the characteristics and management of hip pain.

What this paper adds

Hip pain prevalence increased in adolescents over a 5‐year period in a cerebral palsy surveillance programme.

Risk factors for hip pain were Gross Motor Function Classification System level V and severe hip subluxation.
Interaction of diabetes genetic risk and successful lifestyle modification in the Diabetes Prevention Programme
Authors: Raghavan Sridharan , Jablonski Kathleen , Delahanty Linda M. , Maruthur Nisa M. , Leong Aaron , Franks Paul W. , Knowler William C. , Florez Jose C. , Dabelea Dana ,   the Diabetes Prevention Program Research Group
Published: January 2021

Aim

To test whether diabetes genetic risk modifies the association of successful lifestyle changes with incident diabetes.

Materials and methods

We studied 823 individuals randomized to the intensive lifestyle intervention (ILS) arm of the Diabetes Prevention Programme who were diabetes‐free 1 year after enrolment. We tested additive and multiplicative interactions of a 67‐variant diabetes genetic risk score (GRS) with achievement of three ILS goals at 1 year (≥7% weight loss, ≥150 min/wk of moderate leisure‐time physical activity, and/or a goal for self‐reported total fat intake) on the primary outcome of incident diabetes over 3 years of follow‐up.

Results

A lower GRS and achieving each or all three ILS goals were each associated with lower incidence of diabetes (all P < 0.05). Additive interactions were significant between the GRS and achievement of the weight loss goal (P < 0.001), physical activity goal (P = 0.02), and all three ILS goals (P < 0.001) for diabetes risk. Achievement of all three ILS goals was associated with 1.8 (95% CI 0.3, 3.4), 3.1 (95% CI 1.5, 4.7), and 3.9 (95% CI 1.6, 6.2) fewer diabetes cases/100‐person‐years in the first, second and third GRS tertiles (P < 0.001 for trend). Multiplicative interactions between the GRS and ILS goal achievement were significant for the diet goal (P < 0.001), but not for weight loss (P = 0.18) or physical activity (P = 0.62) goals.

Conclusions

Genetic risk may identify high‐risk subgroups for whom successful lifestyle modification is associated with greater absolute reduction in the risk of incident diabetes.
Spectral characteristics of subthalamic nucleus local field potentials in Parkinson's disease: Phenotype and movement matter
Authors: Godinho Fabio , Fim Neto Arnaldo , Bianqueti Bruno Leonardo , de Luccas Julia Baldi , Varjão Eduardo , Terzian Filho Paulo Roberto , Figueiredo Eberval Gadelha , Almeida Tiago Paggi , Yoneyama Takashi , Takahata André Kazuo , Rocha Maria Sheila , Soriano Diogo Coutinho
Published: January 2021

Parkinson's disease (PD) is clinically heterogeneous across patients and may be classified in three motor phenotypes: tremor dominant (TD), postural instability and gait disorder (PIGD), and undetermined. Despite the significant clinical characterization of motor phenotypes, little is known about how electrophysiological data, particularly subthalamic nucleus local field potentials (STN‐LFP), differ between TD and PIGD patients. This is relevant since increased STN‐LFP bandpower at α–β range (8–35 Hz) is considered a potential PD biomarker and, therefore, a critical setpoint to drive adaptive deep brain stimulation. Acknowledging STN‐LFP differences between phenotypes, mainly in rest and movement states, would better fit DBS to clinical and motor demands. We studied this issue through spectral analyses on 35 STN‐LFP in TD and PIGD patients during rest and movement. We demonstrated that higher β2 activity (22–35 Hz) was observed in PIGD only during rest. Additionally, bandpower differences between rest and movement occurred at the α–β range, but with different patterns as per phenotypes: movement‐induced desynchronization concerned lower frequencies in TD (10–20 Hz) and higher frequencies in PIGD patients (21–28 Hz). Finally, when supervised learning algorithms were employed aiming to discriminate PD phenotypes based on STN‐LFP bandpower features, movement information had improved the classification accuracy, achieving peak performances when TD and PIGD movement‐induced desynchronization ranges were considered. These results suggest that STN‐LFP β‐band encodes phenotype‐movement dependent information in PD patients.
The FEBS Journal in 2021: a sharp reminder that science really matters
Authors: Martin Seamus J.
Published: January 2021

The FEBS Journal, a leading multidisciplinary journal in the life sciences, continues to grow in visibility and impact. Here, the Editor‐in‐Chief Seamus Martin discusses developments at the journal over the past year and the impact of the COVID‐19 crisis on research activities.
Measuring and Visualizing Patterns of Ethnic Concentration: The Role of Distortion Coefficients
Authors: de Bézenac Cécile , Clark William A. V. , Olteanu Madalina , Randon‐Furling Julien
Published: January 2021

The paper provides numerical measures and visualizations of urban segregation based on a new index, the Distortion coefficient. Distortion coefficients are derived from trajectories of contact with the city’s population as an individual will encounter an increasing number of persons in a growing distance from their original location. They can be interpreted as measures of how different, or in technical terms, how distorted the view of the city is from any one location. In this paper, we present the theoretical rationale and the procedure leading to the computation of the Distortion coefficients. Through a detailed illustration using Chicago as a case study, we provide the general framework for analyzing and visualizing Distortion. We show that these measures are able to capture complex demographic changes over time and paint a more complete picture of segregation than indices based on imposed scales.
Morphologically high‐grade trichoblastic carcinoma: a clinicopathological study with long‐term clinical follow‐up
Authors: Mehta Arjun , Davey Jonathan , Wiedemeyer Katharina , Brenn Thomas
Published: January 2021

Aims

Trichoblastic carcinomas (malignant trichoblastomas) are rare and poorly documented neoplasms characterised by malignant transformation of a pre‐existing benign trichoblastoma, and are subdivided histologically into low‐grade and high‐grade tumours. Whereas morphologically low‐grade trichoblastic carcinomas show indolent behaviour, morphologically high‐grade trichoblastic carcinomas have been associated with a poor prognosis, but little is known about their true biological potential. The aim of this study was to better define the clinicopathological features and outcomes of morphologically high‐grade trichoblastic carcinomas.

Methods and results

Four high‐grade trichoblastic carcinomas were retrieved from departmental files, and the clinical and histopathological features and follow‐up were recorded. The tumours presented as nodules on the scalps, necks and shoulders of adults (median age, 40 years; range, 30–55 years) with a female predominance of 3:1. Three patients had a longstanding history with recent change. Histologically, three tumours were characterised by an expansile cellular nodule composed of sheets of pleomorphic epithelioid cells with brisk mitotic activity and necrosis arising in a background of a benign trichoblastoma. One tumour showed a more gradual transition from a benign trichoepithelioma to an undifferentiated carcinoma with infiltrative growth and perineural infiltration. All patients were alive with no evidence of recurrence or metastasis following complete excision after a median follow‐up of 96 months (range, 30–180 months).

Conclusions

The correct diagnosis of high‐grade trichoblastic carcinoma relies on adequate sampling and recognition of the benign trichoblastic precursor lesion, i.e. trichoblastoma or trichoepithelioma. Despite the concerning histological features of the malignant component, the tumours appear to be less aggressive than previously thought.
Elastic and thermodynamic properties of cerium‐doped yttrium aluminum garnets
Authors: Goncharov Vitaliy G. , Wei Nian , Lau Miu Lun , Ennaceur Sue M. , Migliori Albert , Xu Hongwu , Long Min , Guo Xiaofeng
Published: January 2021

Cerium‐doped yttrium aluminum garnets (Y3‐xCexAl5O12, Ce:YAGs) are promising yellow light‐emitting components of solid‐state white light‐emitting diodes. Although there have been numerous studies examining the effects of Ce concentrations on the luminescent properties of Y3‐xCexAl5O12, the impacts of Ce dopant on the elastic and thermodynamic properties are not well understood. In this work, we used resonant ultrasound spectroscopy (RUS) to determine the effects of Ce doping (0.025, 0.1, 1 at. %) on the elastic and thermodynamic properties of Y3‐xCexAl5O12. The elastic moduli calculated via the Voigt–Reuss–Hill (VRH) method demonstrated that low Ce dopant concentrations (≤0.1 at. %) induced negligible effects on the elasticity of the YAG host matrix, while a high Ce concentration (1 at. %) yielded significant softening. RUS spectral analysis and SEM images suggested that the elastic softening originated from microstructural differences induced at higher Ce dopant concentrations. In addition, we demonstrated an increase in elastic anisotropy at higher Ce concentrations, which further elucidated the correlations between structure and elasticity of Y3‐xCexAl5O12. Debye temperatures (θD), heat capacities (Cp), and thermal conductivities (κ) were calculated for Ce:YAGs through the relations of RUS‐derived parameters (sound velocities, elastic moduli) and previously determined thermal expansion coefficients. Ce:YAG was found to have a significant reduction in θD, Cp, and κ at Ce concentrations ≥1 at. %. Lastly, extrapolation of Cp and κ to higher temperatures allowed the modeling of thermal stress experienced by Y3‐xCexAl5O12 disks up to 1073.15 K.
Piezoelectric glass‐ceramics: Crystal chemistry, orientation mechanisms, and emerging applications
Authors: Gerace Katy S. , Mauro John C. , Randall Clive A.
Published: January 2021

Piezoelectric materials have coupled mechanical and electrical energies and have long been used in devices for actuators, sensors, energy harvesters, frequency filters, and various additional applications. Piezoelectricity requires a non‐centrosymmetric crystal structure and is therefore confined to materials that possess a periodic crystalline structure. Due to the non‐crystalline nature of glass, piezoelectricity is fundamentally forbidden. However, one way to exploit piezoelectric properties in a glassy matrix is by developing glass‐ceramics that possess controlled growth of a crystalline phase. Growth and orientation of piezoelectric crystals in a glassy matrix is a non‐trivial process that has long been explored to combine the formability of glass with the thermal and mechanical resilience of glass‐ceramics. While extensive work has been done in the field of functional glass‐ceramics, the results are presented in isolated articles and a comprehensive review pertaining to symmetry breaking methods to exploit anisotropic properties in glass‐ceramics has been absent from the literature. Here, we present a global review of the fundamental symmetry requirements for piezoelectricity, the development of polar, piezoelectric glass‐ceramic compositions (specifically those with LiNbO3 and fresnoite‐based crystal phases), and various crystal growth and orientation mechanisms, including relevant kinetic and thermodynamic driving forces. Lastly, we discuss the challenges associated with implementing gradients to drive oriented crystal growth to develop non‐centrosymmetry, and the need for future modeling work to produce adequate time‐temperature‐transformation (TTT) diagrams that take into account kinetic and thermodynamic driving forces for oriented crystal growth. Going beyond technical challenges, we conclude with an examination of current and potential applications for piezoelectric glass‐ceramics that combine the formability of glass with the symmetry‐dependent properties of ceramics.
Nurse and patient factors: Predicting seclusion in adolescent psychiatric units
Authors: Yurtbasi Miriam K. , Melvin Glenn , Pavlou Christine , Gordon Michael
Published: January 2021

Problem

Seclusion is considered a necessity when alternatives have failed. There is a consensus that seclusion has no therapeutic benefit, which justifies efforts to reduce the practice. This study aimed to identify nurse and patient variables that are predictive of seclusion on a large adolescent inpatient unit.

Methods

Nested case controls were used to compare 72 afternoon shifts on which seclusion occurred to 216 afternoon shifts on which no seclusion occurred, between 2010 and 2013, at an Adolescent Psychiatric Inpatient Unit.

Findings

Increased seclusion was predicted by a lower nurse to patient ratio, more male nurses on shift, fewer female nurses on shift, the presence of agency/temporary nurses on shift, greater combined years of mental health experience, and lower total HoNOSCA behavior subscale score. Unique predictors that increased risk of seclusion included greater number of male nurses and the presence of agency/temporary nurses, while a greater number of female nurses decreased risk of seclusion.

Conclusions

Nurses play a unique role in seclusion outcomes that are separate to patient‐factors and act as both protective and risk factors for seclusion. Changes can be made to staffing to reduce seclusion and future research should investigate why these nurse‐factors contribute to seclusion.
Prevalence of psychotropic medication and factors associated with antipsychotic treatment in adults with intellectual disabilities: a cross‐sectional, epidemiological study in Germany
Authors: Koch A. D. , Dobrindt J. , Schützwohl M.
Published: January 2021

Background

Mental health services in people with intellectual disabilities (ID) are frequently limited to psychotropic medication (PM), especially antipsychotics. The objectives of this study were to assess the prevalence rates of PM treatment in adults with ID in Germany and to identify factors associated with antipsychotic treatment.

Methods

This study is an epidemiological, cross‐sectional study. Sampling was realised by a random selection of service‐providing institutions, followed by a random selection of adults with ID within these participating institutions. Interviews were conducted with formal and informal carers of n = 197 adults with ID. Data were analysed using descriptive statistics and risk ratios.

Results

The 4‐week prevalence rate of PM was 53.8%. Antipsychotics were the most frequent PM (43.7%). Polypharmacy and off‐label use were common. Antipsychotic treatment is associated with living in a residential home [relative risk (RR) = 2.99], not working in a sheltered workshop (RR = 1.46), autism spectrum disorder (RR = 1.89), a documented psychiatric diagnosis (RR = 1.61), psychiatric symptomatology (RR = 1.44) and (mild) challenging behaviours (RR = 4.58).

Conclusions

Further efforts are needed to provide adequate mental health care, specifically to improve PM treatment regarding amount, indication and the consideration of non‐psychopharmacological treatment options.
Mechanisms and Effects of Health Coaching in Patients With Early‐Stage Chronic Kidney Disease: A Randomized Controlled Trial
Authors: Lin Mei‐Yu , Cheng Su‐Fen , Hou Wen‐Hsuan , Lin Pi‐Chu , Chen Ching‐Min , Tsai Pei‐Shan
Published: January 2021

Purpose

To examine the effects of health coaching on self‐management and quality of life (QOL) in patients with chronic kidney disease (CKD) and to evaluate whether self‐efficacy and patient activation mediate the effect of health coaching on self‐management and QOL.

Design and Methods

A single‐center, parallel‐group, randomized controlled trial. A total of 108 patients with stages 1 to 3a CKD participated in the study. Participants were randomly assigned to a health‐coaching intervention group or a usual care control group. Participants’ QOL (World Health Organization Quality of Life Scale), self‐management (CKD Self‐Management instrument), patient activation (Patient Activation Measure), and self‐efficacy (CKD Self‐Efficacy instrument) were measured at baseline, immediately after, and 6 weeks after the intervention.

Findings

Health coaching improved QOL, self‐management, patient activation, and self‐efficacy at postintervention and at 12 weeks’ follow‐up. Health coaching had a significant indirect effect on QOL through improvements in patient activation. Health coaching exerted a significant indirect effect on self‐management through improvements in self‐efficacy and patient activation.

Conclusions

The findings demonstrated that health coaching can effectively improve QOL and self‐management. A health‐coaching intervention can raise self‐efficacy and activation levels through which self‐management and QOL further improve.

Clinical Relevance

Health‐coaching strategies can be used to assist patients with early‐stage CKD in reaching their health goals and becoming activated in self‐management of their diseases.
Bioecological aspects of triatomines and marsupials as wildTrypanosoma cruzireservoirs in urban, peri‐urban and rural areas in the Western Brazilian Amazon
Authors: Magalhães L. , Silveira H. , Prestes S. , Costa Magalhães L. K. , Santana R. A. , Ramasawmy R. , Oliveira J. , Roque C. C. R. , Silva Junior R. C. A. , Fé N. , Duarte R. , Maciel M. , Ortiz J. , Morais R. , Monteiro W. M. , Guerra J. A. , Barbosa Guerra M. G. V.
Published: January 2021

In the Amazon region,Trypanosoma cruzitransmission cycles involve a great diversity of Triatominae vectors and mammal reservoirs. SomeRhodniusspp. mainly inhabit palm trees that act as microhabitats for hosts and vectors. The current study aimed to describe aspects of the bio‐ecology of the vectors and reservoirs ofT. cruziin relation to human populations resident near areas with large quantities of palm trees, in rural, peri‐urban and urban collection environments, located in the Western Brazilian Amazon.Rhodnius pictipesandDidelphis marsupialiswere respectively the most predominant vector and reservoir, with rates of 71% forR. pictipesand 96.5% forD. marsupialis.The vast majority ofT. cruziisolates clustered with TcI. The most prevalent haplotype was TcI COII1 (69.7%).Mauritia flexuosaandAttalea phaleratawere the main ecological indicators of infestation by triatomines. Birds were the most common food source (27,71%).T. cruziisolated fromR. robustushas the haplotype HUM‐13, previously detected in a chronic Chagas patient living in the same area. Our results demonstrate the relevance of this study, with the occurrence of elevated infection rates in animals, and suggest the importance of the Amazon zones where there is a risk of infection in humans.
Gastrointestinal medication burden among persons with the Ehlers‐Danlos syndromes
Authors: Dhingra Radha , Bascom Rebecca , Thompson Elizabeth , Francomano Clair A. , Schubart Jane R.
Published: January 2021

Background

The Ehlers‐Danlos syndromes (EDSs) are a group of heritable disorders of connective tissue associated with an increased prevalence of both structural and functional GI conditions.

Methods

We used 10 years (2005–2014) of administrative claims data comprised of 4294 people with clinician‐diagnosed EDS, aged 5–62 years, and compared their frequency of GI drug prescription claims to their age‐, sex‐, state of residence‐, and earliest claim date‐matched controls. We categorized the GI medications into the following groups: acid suppressants, anti‐emetics, irritable bowel syndrome drugs, and visceral hypersensitivity (VHS) medications.

Key Results

Compared to controls, a significantly higher proportion of persons with EDS had prescription claims for at least one GI drug group, as well as for drugs in each of the four GI drug groups included in our study. By age‐group, 25.7% children and 45.1% adults with EDS had prescription claims for at least one GI drug group compared with only 7.4% and 21.0% of controls, respectively (p < 0.0001). By gender, 44.0% of women and 25.3% of men with EDS had prescription claims for at least one class of GI drugs compared with 19.2% and 9.6% of controls, respectively (p < 0.0001).

Conclusions and Key Inferences

Predominant medication burden occurs among women with EDS, beginning peri‐pubertally for anti‐emetics and VHS drugs. High GI medication burden underscores previous evidence that GI dysmotility is common among persons with EDS.
Error traps in anesthesia for fetal interventions
Authors: Ferschl Marla B. , Rollins Mark D. , Chatterjee Debnath
Published: January 2021

A wide range of fetal interventions are being performed worldwide to save the fetus's life, prevent permanent fetal organ damage, and allow a successful transition to extrauterine life. However, these are invasive procedures and can be associated with serious complications. This article focuses on promoting a culture of safety by highlighting five common error traps while anesthetizing patients for fetal interventions. They include failure to preserve uteroplacental perfusion and gas exchange, failure to achieve adequate uterine relaxation prior to hysterotomy, failure to monitor the fetus and prepare for fetal/neonatal resuscitation, failure to prepare for maternal hemorrhage, and failure to promptly treat uterine atony. Practical tips for avoiding these serious complications will also be discussed.
Energy thresholds of blow‐up for the Hartree equation with a focusing subcritical perturbation
Authors: Tian Shuai , Yang Ying , Zhou Rui , Zhu Shihui
Published: January 2021

This paper studies the blow‐up solutions for the Schrödinger equation with a Hartree‐type nonlinearity together with a power‐type subcritical perturbation. The precisely sharp energy thresholds for blow‐up and global existence are obtained by analyzing potential well structures for associated functionals.
Auto-Ignition of Gas Turbine Lubricating Oils in a Shock Tube Using Spray Injection
Authors: Cooper Sean P. , Browne Zachary K. , Alturaifi Sulaiman A. , Mathieu Olivier , Petersen Eric L.
Published: January 2021

In choosing the lubricating oil for a gas turbine system, properties such as viscosity, viscosity index, corrosion prevention, and thermal stability are chosen to optimize turbine longevity and efficiency. Another property that needs to be considered is the lubricant's reactivity, as the lubricant's ability to resist combustion during turbine operation is highly desirable. In evaluating a method to define reactivity, the extremely low vapor pressure of these lubricants makes conventional vaporization by heating impractical. To this end, a new experiment was designed and tested to evaluate the reactivity of lubricating oils using an existing shock-tube facility at Texas A&M University equipped with an automotive fuel injector. This experiment disperses a premeasured amount of lubricant into a region of high-temperature air to study auto-ignition. To ensure proper dispersal, a laser extinction diagnostic was used to detect the lubricant particles behind the reflected shock as they are dispersed and vaporized. An OH* chemiluminescence diagnostic was used to determine ignition delay time. Using this method, various 32-, 36-, and 46-weight lubricants identified as widely used in the gas turbine industry were tested. Experiments were conducted in postreflected shock conditions around 1370 K (2006 °F) and 1.2 atm, where ignition delay time, peak OH* emission, and time-to-peak values were recorded and compared. Ignition was observed for all but one of the lubricants at these conditions, and mild to strong ignition was observed for the other lubricants with varying ignition delay times.