bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Literacy Moderate the Relationship between Age of Migration and Cognitive Change: Results from the Washington Heights-Inwood Community Aging Project (WHICAP)
Authors: Carrión C I , Arias F , Diaz-Santos M , Levy S-A , Hill-Jarrett T G , Avila J , Jones R , Rivera Mindt M , Arce M , Schupf N , Mayeux R , Manly J
Published: August 2019

Objective

The “healthy immigrant effect” pertains to findings that Hispanics/Latinos born outside of the US tend to be physically and emotionally healthier than individuals born in the US. However, immigrant Latino groups residing in the US have higher incidences of dementia (Tang et al., 2001). Sex/gender and years of education have been found to moderate the relationship between age of migration and cognitive functioning among immigrants born in Mexico (Garcia et al., 2017; Hill et al., 2012). While years of education has been the focus of many studies, literacy (ability to read/write) has been less frequently explored as a moderator of age of migration and cognitive change. We investigated the effect of age of migration on cognitive trajectory in a diverse Latino population and explored whether literacy influences the association between age of immigration and cognitive change. We hypothesize that literacy (ability to read/write) will buffer the effects of age of migration on cognitive (memory, language, motor speed, visuospatial) trajectory.

Participants and Method

Age at baseline, English fluency, country of birth, sex/gender, and years of education were included as time-invariant covariates and literacy was tested as a moderator via multiple group modeling.

Results

Results show that age of migration is marginally and inversely associated with baseline cognitive performance (p < .01). Thus, individuals who immigrated at an older age had lower baseline cognitive scores than their counterparts. Age of migration was not associated with cognitive change. Independent of covariates, literacy did not buffer the negative effects of later age at migration on cognitive function.

Conclusions

Results suggest that literacy confers a small advantage in premorbid cognition, but does not protect against cognitive decline over time. These findings also suggest that adults who immigrate at an older age present with lower cognitive scores at baseline, but do not experience faster rates of cognitive change.

References

Tang, M. X., Cross, P., Andrews, H., Jacobs, D. M., Small, S., Bell, K., ... & Mayeux, R. (2001). Incidence of AD in African-Americans, Caribbean Hispanics, and Caucasians in northern Manhattan. Neurology, 56, 49-56. Garcia, M. A., Reyes, A. M., Downer, B., Saenz, J. L., Samper-Ternent, R. A., & Raji, M. (2018). Age of migration and the incidence of cognitive impairment: A cohort study of elder Mexican-Americans. Innovation in aging, 1, igx037. https://doi.org/10.1093/geroni/igx037. Hill, T. D., Angel, J. L., Balistreri, K. S., & Herrera, A. P. (2012). Immigrant Status and Cognitive Functioning in Late Life: An Examination of Gender Variations in the Healthy Immigrant Effect. Social Science & Medicine (1982), 75, 2076–2084. http://doi.org/10.1016/j.socscimed.2012.04.005.
Review of Emotional Intelligence: A Preliminary Map Across Latin America
Authors: Patino-Carvajal H , Tibiriçá L , Garcia Y , Maresco A , Tourgeman I
Published: August 2019

Objective

The purpose of this study was to investigate the prevalence of Emotional Intelligence (EI) research among 19 Latin American countries.

Participants and Method

Respective to each country, Total Life Science publications and Psychology publications were gathered from “UNESCO Science Report Towards 2030.” Population and GDP statistics pertaining to each country were derived from CIA Factbook. Mean education and percentage of GDP allocated for education were gathered from UNESCO Institute for Statistics. The databases SciELO and Redalyc were used to exhume the number of published Emotional Intelligence articles. The term “inteligencia emocional” was used. Findings were filtered to meet inclusion criteria: peer-reviewed, published between 2008-2018, corresponding to a Psychology related subject. Duplicate articles, those that did not contain the term “inteligencia emocional” in the abstract and articles that were not listed under the Psychology category were excluded.

Results

Data analysis of 19 countries from 2008-2014 revealed the mean number of Emotional Intelligence published articles to be 2.65 (SD = 5.54) articles per country - with a maximum of 22 and a minimum of 0. The percent of articles featuring EI in relation to Total Psychology articles published had a mean of 7% - with Minimum of 0% and Maximum of 60%. Bolivia has the highest percentage of articles on EI (60%), whereas Colombia the highest total number of articles published (n = 41). Population was significantly correlated with Total Articles Published and Total Psychology Articles Published.

Conclusions

Emotional Intelligence in Latin American countries is not widely investigated. Findings revealed 12 out of 19 Latin American countries had one or more publications related to Emotional Intelligence. While population was shown to be related to the number of articles published in Life Sciences and Psychology, it did not reveal a correlation with the publication of studies regarding EI. Furthermore, education and GDP were not related to the overall publication of articles.
Consideration of Bilingual Language Proficiency When Testing Pediatric Cancer Survivors: A Case Study
Authors: Saez-Flores E , Tawfik S H , Mora V R
Published: August 2019

Objective

This case study illustrates the importance of considering English-language proficiency (ELP) when testing linguistically diverse individuals with medical conditions.

Case Description

Julia is a 10-year-old girl born to immigrant parents. She was primarily exposed to Spanish at home. At 4 years, she was diagnosed with medulloblastoma, had a craniotomy (gross total resection), craniospinal radiation, and 1 year of chemotherapy. Although in remission, lasting effects included ataxia, fine-and gross- motor impairment, hand-dominance switch, and mild hearing loss. Moreover, Julia’s schooling was delayed until she was 6 years old. Julia has struggled academically with vocabulary, phonemic awareness, reading fluency/comprehension, and listening comprehension. At 9 years, Julia was evaluated in English only and was reported to be in the Extremely Low range of cognitive function, attributed to her medical history. Despite her history of bilingual language acquisition, Julia’s ELP was not assessed and her abilities were likely underestimated. When Julia was 10 years old, a bilingual clinician conducted an evaluation to better assess Julia’s cognitive ability. Her performance greatly improved when tested in Spanish (increase in scores of >1 standard deviation).

Diagnostic Impressions and Outcomes

Julia was diagnosed with mild neurocognitive disorder due to another medical illness. However, her performance was likely impacted by her ELP as well, which was not being addressed.

Discussion

In order to accurately assess bilingual children with neurocognitive deficits resulting from medical complications, ELP and acquisition should be considered. In Julia’s case, her brain tumor, radiation, and chemotherapy likely disrupted her cognitive development during a critical time for language development.
It's Not All Tests and Norms! The Reach of Culture in Behavioral Research
Authors: Bernstein J H , Youssef F
Published: August 2019

Five major challenges experienced while conducting a study regarding the neurobehavioral developmental trajectories of primary school children in Trinidad and Tobago are reviewed. 1. Governing Principles. Institutional review of the scientific rationale for the work and safety of participants is required for research activities in any/all settings. 2. Design/Methodology. Cultural beliefs/values/goals shape the research endeavor from recruitment strategies, informed consent, research design, and data collection to outcome monitoring. 3. Participants. Research studies involving children are closely scrutinized. Children need additional protections because they cannot give informed consent. Who speaks for children and how? Children must be recruited via guardians - who may not be parents but societal institutions functioning as “proxy guardians”. The relationships between parents and different “proxy guardians” respond to cultural beliefs/values. 4. Behavioral Measurement-Tests. American psychology has been severely critiqued as focusing on a circumscribed sector of the population while neglecting 95% of the global community. A core concern is the use, in non-United States settings, of behavioral measures developed and normed in the U.S. No measure can be truly culture free: all brains are sculpted by interactions not only with the physical world but also with the psychological world of their own cultural heritage. 5. Behavioral Measurement-Rating Scales. In transferring research across cultures, language/dialect differences are frequently highlighted. Differences in literacy can be even more challenging. Lack of literacy cannot be used to exclude persons from potential research benefits, nor for the failure to conduct effective informed consent processes. Cultural variations in the value/use of the written word have direct impact on research design/methodology, data collection/quality, the training/conduct of research personnel, and on funding. Implications for the mounting research in international settings are discussed.
Applied electric fields suppress osimertinib-induced cytotoxicity via inhibiting FOXO3a nuclear translocation through AKT activation
Authors: Li Li , Hu Chen , Lu Conghua , Zhang Kejun , Han Rui , Lin Caiyu , Zhao Sanjun , A Chunxian , Cheng Chunyan , Zhao Min , He Yong
Published: August 2019

Osimertinib is a third-generation epidermal growth factor receptor tyrosine kinase inhibitor against T790M-mutant non-small cell lung cancer (NSCLC). Acquired resistance to osimertinib is a growing clinical challenge that is not fully understood. Endogenous electric fields (EFs), components of the tumor microenvironment, are associated with cancer cell migration and proliferation. However, the impact of EFs on drug efficiency has not been studied. In this study, we observed that EFs counteracted the effects of osimertinib. EFs of 100 mV/mm suppressed osimertinib-induced cell death and promoted cell proliferation. Transcriptional analysis revealed that the expression pattern induced by osimertinib was altered by EFs stimulation. KEGG analysis showed that differential expression genes were mostly enriched in PI3K-AKT pathway. Then, we found that osimertinib inhibited AKT phosphorylation, while EFs stimulation resulted in significant activation of AKT, which could override the effects generated by osimertinib. Importantly, pharmacological inhibition of PI3K/AKT by LY294002 diminished EF-induced activation of AKT and restored the cytotoxicity of osimertinib suppressed by EFs, which proved that AKT activation was essential for EFs to attenuate the efficacy of osimertinib. Furthermore, activation of AKT by EFs led to phosphorylation of forkhead box O3a (FOXO3a), and reduction in nuclear translocation of FOXO3a induced by osimertinib, resulting in decreased expression of Bim and attenuated cytotoxicity of osimertinib. Taken together, we demonstrated that EFs suppressed the antitumor activity of osimertinib through AKT/FOXO3a/Bim pathway, and combination of PI3K/AKT inhibitor with osimertinib counteracted the effects of EFs. Our findings provided preliminary data for therapeutic strategies to enhance osimertinib efficacy in NSCLC patients.
Genetic diversity in introduced Douglas-fir and its natural regeneration in Central Europe
Authors: Neophytou Charalambos , van Loo Marcela , Hasenauer Hubert
Published: August 2019

Since its first introduction in the 19th century, Douglas-fir has become the economically most important non-native forest tree species in Central European countries. Many of these planted forests are important seed sources and/or exhibit natural regeneration. Thus, it is important to assess (1) the genetic diversity of the mature stands and (2) if the genetic diversity can be passed on to the next generations. In order to address these issues, we genotyped mature Douglas-fir individuals and natural regeneration from >100 native and non-native populations using nuclear microsatellite markers. We compared the genetic diversity of native North American populations with mature Douglas-fir populations in Central Europe. The results show that genetic diversity did not differ significantly between European populations and the assigned native origin. Using a subset of 36 sites from Central Europe, we detected a significant reduction in the genetic diversity of adult versus naturally regenerated juvenile trees, indicating a bottleneck effect in the next generation of European Douglas-fir stands. The main reason may be that the mature European Douglas-fir stands are highly fragmented and thus the stand size is not adequate for transmitting the genetic diversity to the next generation. This should be taken into account for the commercial harvesting of seed stands. Seed orchards may offer a potential alternative in providing high quality and genetically diverse reproductive material.
A combined 2-D/1-D magma ascent model of explosive volcanic eruptions
Authors: Massol Hélène
Published: August 2019

Explosive eruptions involve the fragmentation of magma that changes the flow regime from laminar to turbulent within the volcanic conduit during ascent. If the gas volume fraction is high, magma fragments and the eruption style is explosive, but if not, the magma flows effusively out of the vent. Gas escape processes depend on how the magma can rupture, and recent experimental studies measured rupture stress thresholds of the order of a few megapascals. It is thus critical to model the gas content and state of stress evolution in the flowing magma within the conduit. We present a new self-consistent model of an explosive eruption from the magma chamber to the surface, based on a critical gas volume fraction. Our model allows to explore irregular geometries below the fragmentation level (2-D). We first compare our model with classical 1-D models of explosive eruptions and find that in the case of straight conduits and fragmented flows, 1-D models are accurate enough to model the gas pressure and vertical velocity distribution in the conduit. However, in the case of an irregular conduit shape at depth, 2-D models are necessary. Despite a certain conduit radius visible at the surface, very different stress fields within the flow could be present depending upon the position and shape of any conduit irregularities. Stresses of the order of more than 1 MPa can be attained in some locations. High tensile stresses are located at the centre of the conduit, while high shear stresses are located at the conduit walls leading to several potential rupture locations. Due to the interplay between the velocity field and decompression rate, similar conduit radius visible at the surface might also lead to very different fragmentation depths with a difference of more than 1500 m between an enlarged conduit shape at some depth and a straight conduit. At depth, different conduit sizes might lead to the same order of magnitude for the mass flux, depending on the conduit geometry.
Corticosteroid-Free Remission vs Overall Remission in Clinical Trials of Moderate–Severe Ulcerative Colitis and Crohn’s Disease
Authors: George John , Singh Siddharth , Dulai Parambir S , Ma Christopher , Nguyen Tran , Feagan Brian G , Sandborn William J , Jairath Vipul
Published: August 2019

Background

We summarized the protocol-specified corticosteroid tapering regimens in clinical trials of moderate–severe ulcerative colitis (UC) and Crohn’s disease (CD) and calculated differences in rates of clinical remission vs corticosteroid-free clinical remission (CSF-CR).

Methods

Through a systematic literature review through February 28, 2019, we identified 16 randomized controlled trials (RCTs) of biologics or small molecules in patients with moderate–severe UC or CD who reported CSF-CR as an outcome. We estimated the relative risk and 95% confidence interval of achieving CSF-CR vs overall clinical remission in patients treated with active intervention or placebo through random-effects meta-analysis.

Results

Across trials of UC (11 trials) and CD (5 trials), a median of 53% and 49% of participants were on corticosteroids at the time of trial entry, respectively. Participants were allowed to enter trials at a median corticosteroid dose (range) of 35 (20–40) mg/d. Doses were kept stable for a median (range) of 8 (5–10) weeks during induction therapy, after which a mandatory and structured taper was implemented, albeit with the investigators’ discretion depending on clinical status. Pooled rates of CSF-CR in patients with UC and CD treated with placebo were 9.7% and 19.1%, respectively. In UC and CD trials, the rate of CSF-CR was 24% and 18% lower than the rate of overall clinical remission, respectively.

Conclusions

Protocol-specified corticosteroid tapering regimens vary across trials. These findings will help to inform the design and interpretation of future clinical trials and highlight the need for standardization.
Secular and rotational light curves of 6478 Gault
Authors: Ferrín Ignacio , Fornari Cesar , Acosta Agustín
Published: August 2019

We obtained 877 images of active asteroid 6478 Gault on 41 nights from 2019 January 10 to June 8, using several telescopes. We created the phase, secular, and rotational light curves of Gault, from which several physical parameters can be derived. From the phase plot, we find that no phase effect was evident. This implies that an optically thick cloud of dust surrounded the nucleus hiding the surface. The secular light curve (SLC) shows several zones of activity, the origin of which is speculative. From the SLC plots, a robust absolute magnitude can be derived and we find mV (1,1,α) = 16.11 ± 0.05. We also found a rotational period Prot = 3.360 ± 0.005 h and show evidence that 6478 might be a binary. The parameters of the pair are derived. Previous works have concluded that 6478 is in a state of rotational disruption and the above rotational period supports this result. Our conclusion is that 6478 Gault is a suffocated comet getting rid of its suffocation by expelling surface dust into space using the centrifugal force. This is an evolutionary stage in the lifetime of some comets. Besides being a main-belt comet (MBC), the object is classified as a dormant Methuselah Lazarus, meaning Gault is both highly evolved and has a decaying perihelion distance.
Search for neutron star binaries in the Local Group galaxies using LISA
Authors: Seto Naoki
Published: August 2019

We discuss the prospects of LISA for detecting neutron star binaries (NSBs) in the Local Group galaxies such as LMC and M31. Using the recently estimated merger rate ${\rm 1540 \, Gpc^{-3}\, yr^{-1}}$ and inversely applying the conventional arguments based on the B-band galaxy luminosities, we estimate the frequency distributions of NSBs in the local galaxies. We find that, after 10 yr observation with its current design sensitivity, LISA might detect ∼5 NSBs both in LMC and M31 with signal-to-noise ratios larger than 10. Some of the NSBs might be three-dimensionally localized well within LMC. These binaries will be useful for studying various topics including the origin of r-process elements.
Differences in blastomere totipotency in 2-cell mouse embryos are a maternal trait mediated by asymmetric mRNA distribution
Authors: Casser E , Wdowik S , Israel S , Witten A , Schlatt S , Nordhoff V , Boiani M
Published: August 2019

It is widely held that the first two blastomeres of mammalian embryos are equally totipotent and that this totipotency belongs to the group of regulative properties. However, this interpretation neglects an important aspect: evidence only came from successful monozygotic twins which can speak only for those pairs of half-embryos that are able to regulate in the first place. Are the frequently occurring incomplete pairs simply an artefact, or do they represent a real difference, be it in the imperfect blastomere’s ability to regulate growth or in the distribution of any compound X that constrains regulation? Using the model system of mouse embryos bisected at the 2-cell stage after fertilization, we present evidence that the interblastomere differences evade regulation by external factors and are already latent in oocytes. Specifically, an interblastomere imbalance of epiblast production persists under the most diverse culture conditions and applies to the same extent in parthenogenetic counterparts. As a result, cases in which twin blastocysts continued to develop in only one member account for 65 and 57% of zygotic and parthenogenetic pairs, respectively. The interblastomere imbalance is related to the subcellular distribution of gene products, as documented for the epiblast-related gene Cops3, using mRNA FISH in super-resolution mode confocal microscopy. Blastomere patterns of Cops3 mRNA distribution are α-amanitin-resistant. Thus, the imbalance originates not from de novo transcription, but from influences which are effective before fertilisation. These data expose previously unrecognized limits of regulative capacities of 2-cell stage blastomeres and point to aspects of cytoplasmic organization of the mouse oocyte that segregate unequally to blastomeres during cleavage.
Predicting the Occurrence of Postoperative Distal Junctional Kyphosis in Cervical Deformity Patients
Authors: Passias Peter G , Horn Samantha R , Oh Cheongeun , Lafage Renaud , Lafage Virginie , Smith Justin S , Line Breton , Protopsaltis Themistocles S , Yagi Mitsuru , Bortz Cole A , Segreto Frank A , Alas Haddy , Diebo Bassel G , Sciubba Daniel M , Kelly Michael P , Daniels Alan H , Klineberg Eric O , Burton Douglas C , Hart Robert A , Schwab Frank J , Bess Shay , Shaffrey Christopher I , Ames Christopher P ,   On behalf of The International Spine Study Group
Published: August 2019

BACKGROUND

Distal junctional kyphosis (DJK) development after cervical deformity (CD)-corrective surgery is a growing concern for surgeons and patients. Few studies have investigated risk factors that predict the occurrence of DJK.

OBJECTIVE

To predict DJK development after CD surgery using predictive modeling.

METHODS

CD criteria was at least one of the following: C2-C7 Coronal/Cobb > 10°, C2-7 sagittal vertical axis (cSVA) > 4 cm, chin-brow vertical angle > 25°. DJK was defined as the development of an angle <−10° from the end of fusion construct to the second distal vertebra, and change in this angle by <−10° from baseline to postoperative. Baseline demographic, clinical, and surgical information were used to predict the occurrence of DJK using generalized linear modeling both as one overall model and as submodels using baseline demographic and clinical predictors or surgical predictors.

RESULTS

One hundred seventeen CD patients were included. At any postoperative visit up to 1 yr, 23.1% of CD patients developed DJK. DJK was predicted with high accuracy using a combination of baseline demographic, clinical, and surgical factors by the following factors: preoperative neurological deficit, use of transition rod, C2-C7 lordosis (CL)<−12°, T1 slope minus CL > 31°, and cSVA > 54 mm. In the model using only baseline demographic/clinical predictors of DJK, presence of comorbidities, presence of baseline neurological deficit, and high preoperative C2-T3 angle were included in the final model (area under the curve = 87%). The final model using only surgical predictors for DJK included combined approach, posterior upper instrumented vertebrae below C4, use of transition rod, lack of anterior corpectomy, more than 3 posterior osteotomies, and performance of a 3-column osteotomy.

CONCLUSION

Preoperative assessment and consideration should be given to these factors that are predictive of DJK to mitigate poor outcomes.
Practice Patterns of Infectious Diseases Physicians in Transitioning From Intravenous to Oral Therapy in Patients With Bacteremia
Authors: Hospenthal Duane R , Waters C Dustin , Beekmann Susan E , Polgreen Philip M
Published: August 2019

Background

Bacteremia in adult patients has traditionally been treated with extended courses of intravenous antibiotics. Data on the use of (or rapid transition to) oral therapy are limited.

Methods

Adult infectious disease physicians participating in the Infectious Diseases Society of America Emerging Infections Network (EIN) were surveyed regarding their use of oral antibiotics in patients with bacteremia. Respondents were asked to assume that patients were hemodynamically stable, recovered bacteria were susceptible to potential antibiotics, adequate source control had been achieved, and patients had adequate gastrointestinal absorption. Variables of specific bacteria, oral agent, and associated infection were included.

Results

A total of 655 (50%) of 1321 EIN participants responded. Under certain conditions, 88% would transition patients with Gram-negative bacteremia to complete a course of therapy with oral antibiotics; 71% would transition patients with Gram-positive bacteremia to oral agents. Only 78 (12%) respondents would not treat any bacteremic patient with oral agents. Most respondents (≥75%) were comfortable treating infections secondary to Enterobacteriaceae, Salmonella, Pseudomonas, Stenotrophomonas, Streptococcus pneumoniae, and β-hemolytic streptococci with oral agents. Fewer than 20% endorsed use of oral antibiotics for Staphylococcus aureus or in cases of endocarditis. Fluoroquinolones and trimethoprim-sulfamethoxazole were the preferred agents in Gram-negative bacteremia; linezolid and β-lactams were the preferred agents in Gram-positive bacteremia.

Conclusions

In select circumstances, the majority of respondents would transition patients to oral antibiotics, in both Gram-negative and Gram-positive bacteremia. Most agreed with the use of oral agents in Gram-negative bacteremia caused by Enterobacteriaceae, but they would not use oral agents for Gram-positive bacteremia caused by S aureus or in endocarditis.
Revenge of the Steamroller: ABCP as a Window on Risk Choices*
Authors: Arteta Carlos , Carey Mark , Correa Ricardo , Kotter Jason
Published: August 2019

We use credit-arbitrage asset-backed commercial paper vehicles as a laboratory to empirically examine financial institutions’ motivations to take bad-tail systematic risk. By comparing the characteristics of global banks that sponsored credit-arbitrage vehicles prior to the global financial crisis to those that did not, we show that owner–manager agency problems, government safety nets, and government ownership of banks are associated with bad-tail systematic risk-taking. Although good governance is associated with less risk-taking on average, well-governed banks that also have a high ex ante expectation of being bailed out by the government take more risk. Lastly, we find mixed evidence that tougher bank capital regulation deters bad-tail risk-taking.
Alternative Oxidase Is Involved in the Pathogenicity, Development, and Oxygen Stress Response ofBotrytis cinerea
Authors: Lin Zesong , Wu Jianyan , Jamieson Pierce A. , Zhang Chuanqing
Published: September 2019

Alternative oxidase (AOX) is a ubiquinol terminal oxidase that is involved in fungal mitochondrial oxidative phosphorylation. In this study, we analyzed the roles of AOX in Botrytis cinerea by generating BcAOX deletion mutants. The mutants exhibited defects in mycelial growth, sporulation, spore germination, and virulence. Furthermore, the sensitivity of the mutants to quinone outside inhibitor fungicides and oxidative stress were increased. All phenotypic variations could be restored in the complemented strain. In summary, these results showed that BcAOX is involved in the regulation for vegetative development, adaptation to environmental stress, and virulence of B. cinerea.
Resolvin E3 attenuates allergic airway inflammation via the interleukin‐23‐interleukin‐17A pathway
Authors: Sato Makiko , Aoki‐Saito Haruka , Fukuda Hayato , Ikeda Hiroyuki , Koga Yasuhiko , Yatomi Masakiyo , Tsurumaki Hiroaki , Maeno Toshitaka , Saito Tsugumichi , Nakakura Takashi , Mori Tetsuya , Yanagawa Masataka , Abe Mitsuhiro , Sako Yasushi , Dobashi Kunio , Ishizuka Tamotsu , Yamada Masanobu , Shuto Satoshi , Hisada Takeshi
Published: August 2019

We investigated the effects of resolvin E (RvE) 1, RvE2, and RvE3 on IL‐4‐ and IL‐33‐stimulated bone marrow‐derived dendritic cells (BMDCs) from house dust mite (HDM)‐sensitized mice. We also investigated the role of RvE3 in a murine model of HDM‐induced airway inflammation. In vitro, BMDCs from HDM‐sensitized mice were stimulated with IL‐4 and IL‐33 and then treated with RvE1, RvE2, RvE3, or vehicle. RvE1, RvE2, and RvE3 suppressed IL‐23 release from BMDCs. In vivo, RvE3 administrated to HDM‐sensitized and challenged mice in the resolution phase promoted a decline in total numbers of inflammatory cells and eosinophils, reduced levels of IL‐23 and IL‐17 in lavage fluid, and suppressed IL‐23 and IL‐17A mRNA expression in lung and peribronchial lymph nodes. RvE3 also reduced resistance in the lungs of HDM‐sensitized mice. A NanoBiT β‐arrestin recruitment assay using human embryonic kidney 293 cells revealed that pretreatment with RvE3 suppressed the leukotriene B4 (LTB4)‐induced β‐arrestin 2 binding to LTB4 receptor 1 (BLT1R), indicating that RvE3 antagonistically interacts with BLT1R. Collectively, these findings indicate that RvE3 facilitates the resolution of allergic airway inflammation, partly by regulating BLT1R activity and selective cytokine release by dendritic cells. Our results accordingly identify RvE3 as a potential therapeutic target for the management of asthma.—Sato, M., Aoki‐Saito, H., Fukuda, H., Ikeda, H., Koga, Y., Yatomi, M., Tsurumaki, H., Maeno, T., Saito, T., Nakakura, T., Mori, T., Yanagawa, M., Abe, M., Sako, Y., Dobashi, K., Ishizuka, T., Yamada, M., Shuto, S., Hisada, T. Resolvin E3 attenuates allergic airway inflammation via the interleukin‐23‐interleukin‐17A pathway. FASEB J. 33, 12750–12759 (2019). www.fasebj.org
Perivascular adipose tissue–derived extracellular vesicle miR‐221‐3p mediates vascular remodeling
Authors: Li Xinzhi , Ballantyne Laurel L. , Yu Ying , Funk Colin D.
Published: August 2019

Adipose tissue–secreted extracellular vesicles (EVs) containing microRNAs (miRNAs) convey intercellular message signaling. The biogenesis of EV‐miRNAs from perivascular adipose tissue (PVAT) and their roles in intercellular communication in response to obesity‐associated inflammation have not yet been fully explored. By feeding mice a high‐fat diet for 16 wk, we established obesity‐associated, chronic low‐grade inflammation in PVAT, characterized as hypertrophy of perivascular adipocytes, decreased adipogenesis, and proinflammatory macrophage infiltration. We show that PVAT‐derived EVs and their encapsulated miRNAs can be taken up into vascular smooth muscle cells (VSMCs) in vivo and in vitro. miR‐221‐3p is one of the highly enriched miRNAs in obese PVAT and PVAT‐derived EVs. Transfer and direct overexpression of miR‐221‐3p dramatically enhances VSMC proliferation and migration. Peroxisome proliferator–activated receptor γ coactivator 1α is identified as a miR‐221‐3p target in VSMC phenotypic modulation. Obese mice secrete abundant miRNA‐containing EVs, evoking inflammatory responses in PVAT and vascular phenotypic switching in abdominal aorta of lean mice. Local delivery of miR‐221‐3p mimic in femoral artery causes vascular dysfunction by suppressing the contractile genes in the arterial wall. Our findings provide an EV–miR‐221‐3p–mediated mechanism by which PVAT triggers an early‐stage vascular remodeling in the context of obesity‐associated inflammation.—Li, X., Ballantyne, L. L., Yu, Y., Funk, C. D. Perivascular adipose tissue–derived extracellular vesicle miR‐221‐3p mediates vascular remodeling. FASEB J. 33, 12704–12722 (2019). www.fasebj.org
Fascia Iliaca Block Decreases Hip Fracture Postoperative Opioid Consumption: A Prospective Randomized Controlled Trial
Authors: Thompson Jeffrey , Long Mitchell , Rogers Eloise , Pesso Raymond , Galos David , Dengenis Rhyne Champ , Ruotolo Charles
Published: August 2019

Objectives:

To determine the efficacy of a preoperative fascia iliaca compartment block in decreasing postoperative pain and improving functional recovery after hip fracture surgery.

Design:

Randomized prospective Level 1 therapeutic.

Setting:

Academic Level 1 trauma center.

Patients:

Geriatric patients with fractures of the proximal femur (neck, intertrochanteric, or subtrochanteric regions) were prospectively randomized into an experimental (A) or control (B) groups. Forty-seven patients met inclusion criteria, 23 randomized to the experimental group and 24 to the control group.

Intervention:

Patients randomized to the experimental group received an ultrasound-guided fascia iliaca compartment block administered by a board-certified anesthesiologist immediately before the initiation of anesthesia.

Main Outcome Measurements:

Primary outcome measure was postoperative pain medication consumption until postoperative day 3. Secondary outcomes included functional recovery and a study-specific patient-reported satisfaction survey assessed on postoperative day 3.

Results:

There was no significant difference in consumption of acetaminophen for mild pain, tramadol for moderate pain, or functional recovery between the 2 groups. There was a statistically significant decrease in morphine consumption (0.4 mg vs. 19.4 mg, P = 0.05) and increase in patient-reported satisfaction (31%, P = 0.01).

Conclusions:

Preoperative fascia iliaca compartment block significantly decreases postoperative opioid consumption while improving patient satisfaction. We recommend the integration of this safe and efficacious modality into institutional geriatric hip fracture protocols as an adjunctive pain control strategy.

Level of Evidence:

Therapeutic Level II See Instructions for Authors for a complete description of levels of evidence.
The Effects of Diabetes and Diabetic Medications on Bone Health
Authors: Elamir Yasmine , Gianakos Arianna L. , Lane Joseph M. , Sharma Anupa , Grist William P. , Liporace Frank A. , Yoon Richard S.
Published: August 2019

The incidence and prevalence of diabetes continues to increase, and proper understanding of the adverse effects on bone metabolism is important. This review attempts to discuss the pathophysiology of the effects of diabetes and diabetic medications on bone metabolism and bone health. In addition, this review will address the mechanisms resulting in increased fracture risk and delayed bone healing to better treat and manage diabetic patients in the orthopedic clinical setting.
Decreased vitamin D serum levels at melanoma diagnosis are associated with tumor ulceration and high tumor mitotic rate
Authors: Moreno-Arrones Oscar M. , Zegeer Josh , Gerbo Michael , Manrique-Silva Esperanza , Requena Celia , Traves Víctor , Nagore Eduardo
Published: August 2019

The aim of this study is to evaluate the relation between 25-hydroxyvitamin D levels at diagnosis and pathological characteristics in primary invasive melanoma. A cross-sectional study was designed based on a series of 204 consecutive patients diagnosed of invasive melanomas in the 2013–2017 period at a single institution. 25-hydroxyvitamin D serum levels at diagnosis were assessed, and three groups were defined by vitamin D status: deficiency, insufficiency, and sufficiency. Clinical and pathological characteristics were compared between the groups by Chi-square test. Logistic regression models were performed to evaluate the association between vitamin D status and Breslow thickness, ulceration, and tumor mitotic rate. A significant association between vitamin D levels at diagnosis and location, tumor mitotic rate, and ulceration was found; and a borderline association with Breslow thickness and BMI. Deficient levels were found in 7.8% of patients and increased the risk of presenting ulcerated tumors [odds ratio: 6.8 (95% confidence interval: 1.5–29.7; P = 0.012)] and with a tumor mitotic rate greater than 1 mitosis/mm2 [odds ratio: 6.0 (95% confidence interval: 1.4–25.1; P = 0.014)]. A marginal increased risk of tumor thickness greater than 1 mm was also observed [odds ratio: 3.7 (95% confidence interval: 1.0–13.9; P = 0.057)]. Our study suggests a role of vitamin D levels in melanoma aggressiveness and raises the question as to whether vitamin D levels should be monitored, or even supplemented, in people with low yearly sun exposure.
Source-Apportioned PM2.5 and Cardiorespiratory Emergency Department Visits
Authors: Pennington Audrey Flak , Strickland Matthew J. , Gass Katherine , Klein Mitchel , Sarnat Stefanie Ebelt , Tolbert Paige E. , Balachandran Sivaraman , Chang Howard H. , Russell Armistead G. , Mulholland James A. , Darrow Lyndsey A.
Published: August 2019

Background:

Despite evidence suggesting that air pollution-related health effects differ by emissions source, epidemiologic studies on fine particulate matter (PM2.5) infrequently differentiate between particles from different sources. Those that do rarely account for the uncertainty of source apportionment methods.

Methods:

For each day in a 12-year period (1998–2010) in Atlanta, GA, we estimated daily PM2.5 source contributions from a Bayesian ensemble model that combined four source apportionment methods including chemical transport and receptor-based models. We fit Poisson generalized linear models to estimate associations between source-specific PM2.5 concentrations and cardiorespiratory emergency department visits (n = 1,598,117). We propagated uncertainty in the source contribution estimates through analyses using multiple imputation.

Results:

Respiratory emergency department visits were positively associated with biomass burning and secondary organic carbon. For a 1 µg/m3 increase in PM2.5 from biomass burning during the past 3 days, the rate of visits for all respiratory outcomes increased by 0.4% (95% CI 0.0%, 0.7%). There was less evidence for associations between PM2.5 sources and cardiovascular outcomes, with the exception of ischemic stroke, which was positively associated with most PM2.5 sources. Accounting for the uncertainty of source apportionment estimates resulted, on average, in an 18% increase in the standard error for rate ratio estimates for all respiratory and cardiovascular emergency department visits, but inflation varied across specific sources and outcomes, ranging from 2% to 39%.

Conclusions:

This study provides evidence of associations between PM2.5 sources and some cardiorespiratory outcomes and quantifies the impact of accounting for variability in source apportionment approaches.
Cardiac Rehabilitation in a Rural Setting
Authors: Frechette Kristen M. , Conley Sheila M. , Tang Austin , Welch Terrence D.
Published: August 2019

Purpose:

The cardiac rehabilitation (CR) program at Dartmouth-Hitchcock Medical Center (DHMC) devotes a nurse to the inpatient units in an attempt to optimize the referral process. This report defines the rates of referral and participation at DHMC and explores potential factors that affect participation.

Methods:

Seven hundred ten consecutive patients who underwent percutaneous coronary intervention, coronary artery bypass grafting, or valve surgery from January 1, 2015 to June 30, 2015 were reviewed to determine whether the patient was referred for CR. Participation rates and the effect of time delay and patient-specific factors on participation were examined.

Results:

Six hundred ninety-eight (98%) of the 710 post-procedural patients were evaluated by the inpatient rehabilitation nurse. One hundred sixty-seven patients were ineligible for outpatient therapy on the basis of established criteria; the remaining 543 patients were referred to DHMC or regional rehabilitation programs. Of those referred to the on-site program at DHMC, 84% participated. Of those referred to regional programs, 60% participated. There was an inverse correlation (r = −0.82; P = .003) between wait times and participation rates for the various programs.

Conclusions:

Despite its rural location with a large geographic catchment area, DHMC achieves high rates of CR referral and participation. The approach used at DHMC, which includes a CR nurse working with the inpatient cardiac services, a strong level of integration with the physician community, and well-developed relationships with regional rehabilitation programs, may be helpful for those programs wishing to improve referral and participation rates. Shorter wait times between hospital discharge and initiation of rehabilitation may improve participation rates.
Expression and function of lncRNA ANRIL in a mouse model of acute myocardial infarction combined with type 2 diabetes mellitus
Authors: Zhang Lin , Wang Yan-Min
Published: August 2019

Background:

This study intends to explore whether lncRNA ANRIL has an influence on type 2 diabetes mellitus (T2DM) complicated with acute myocardial infarction (MI) and to further investigate the underlying mechanism.

Methods:

The ANRIL level in peripheral blood from patients was detected by qRT-PCR. A T2DM mouse model was established by intraperitoneal injection of streptozocin (STZ). MI was induced by ligation of the left anterior descending coronary artery. Cardiac function parameters were measured using echocardiography. Triphenyltetrazolium chloride (TTC) staining was performed to determine the infarct size, and Masson staining was conducted to delineate the area of fibrosis in the myocardium. TUNEL staining was used to detect myocardial cell apoptosis. The expression of the myocardial fibrosis-related proteins TGF-β1, collagen I and collagen III was analysed using Western blot.

Results:

ANRIL was upregulated in peripheral venous blood from patients with T2DM-MI and in myocardial tissues from the established T2DM-MI model mice. Furthermore, ANRIL overexpression caused cardiac dysfunction and increased the heart/body weight rate and infarct size in the T2DM-MI mice. Moreover, ANRIL overexpression caused myocardial fibrosis and myocardial cell apoptosis, and it increased the expression of the myocardial fibrosis-related proteins TGF-β1, collagen I and collagen III in the T2DM-MI mice. However, ANRIL knockdown exerted the opposite effects.

Conclusion:

ANRIL may be involved in the progression and development of T2DM-MI, which might provide novel ideas for the prevention and treatment of cardiovascular diseases.
Perception of Provision of Futile Care Among Clinicians in the Neuroscience Intensive Care Unit
Authors: Amoroso Shanna , Chalela Julio A.
Published: August 2019

BACKGROUND: Futile care in the neuroscience intensive care unit (NSICU) can create moral distress for clinicians who may differ in their interpretation of the value of such care. We sought to compare the perception of provision of futile care in the NSICU among physicians, advanced practice providers, and intensive care unit registered nurses (ICURNs). METHODS: This is a cross-sectional study of 77 patients. A standardized questionnaire was used to ask clinicians whether care being provided to NSICU patients admitted for more than 48 hours was futile and whether they would want that treatment for their loved one. Demographics, diagnosis, and reason for treatment futility were collected. Futility was analyzed independently and in an aggregate manner (yes/probable combined and no/probable combined). RESULTS: The sample median age was 61 (SD, 17.179) years, men comprised 53% of the sample, and 68% were white. Collectively, there were 77 futile responses (33%), 136 nonfutile (59%), and 18 probable futile (8%). Physicians and nurse practitioners deemed futility in 36% of patients; ICURNs, in 27% (P < .05). Age, race, or diagnosis did not impact futility perception. The treatment was acceptable for a loved one in 53% of cases for physicians, 43% for advanced practice providers, and 48% for ICURNs (P < .05). Interobserver agreement for futility was 0.469 (CK), and pairwise agreement was 71%. Interobserver agreement for treatment acceptable for a loved one was 0.568 (CK), and pairwise agreement was 78%. CONCLUSIONS: Clinicians consider NSICU care futile in one-third of patients, but correlation among them is moderate; no specific variable is associated with such perception.
Electrophysiologic Characteristics of Various Degrees of Selective Outer Hair Cell Loss in Rats
Authors: Huang Wenqin , Chen Shulin , Dong Chang , Li Changwu , Sun Liang , Wang Xianren , Jiang Hongyan
Published: August 2019

Hypothesis:

The characteristics of auditory brainstem response (ABR), electrocochleogram (ECochG), and distortion product otoacoustic emissions (DPOAE) of different degrees of selective outer hair cells (OHCs) loss may be helpful for clinicians to evaluate the pathogeny, diagnosis, and rehabilitation of individuals’ hearing loss.

Background:

How many OHCs are necessary to maintain cochlear amplifier function remains unknown. The electrophysiologic characteristics may indicate different degrees of OHCs loss.

Methods:

Electrophysiological characteristics were tested using 8-kHz pure-tone stimulus and OHCs counted specifically in the region of the cochlea corresponding to 8-kHz. Rat models of selective OHCs loss were established by injecting kanamycin (KM) at various dosages, and the region of 8-kHz was obtained by 8-kHz pure-tone exposure.

Results:

The ABR thresholds were affected slightly with OHCs loss < 30%, and were increased dramatically with OHCs loss ranging from 30 to 70%, but the thresholds did not increase further when OHCs loss exceeded 70%. As OHCs loss increased, the compound action potential (CAP) amplitude decreased. The CAP amplitude and OHCs loss were negatively correlated. Moreover, the summating potential (SP)/action potential (AP) increased as OHCs loss increased. DPOAE and cochlear microphonics (CM) exhibited reduced amplitudes when OHCs loss < 30%.

Conclusions:

Electrophysiologic characteristics may indicate different degrees of OHCs loss. While OHCs loss > 70%, the cochlear amplification may lose completely, but it is difficult to detect OHCs loss < 30%, because the ABR or DPOAE may reveal “normal” at this level. Moreover, the decreased CAP amplitude or increased SP/AP may be indicators for OHCs loss.
A Prospective Evaluation of Postoperative Opioid Use in Otologic Surgery
Authors: Qian Z. Jason , Alyono Jennifer C. , Woods Ong-Dee , Ali Noor , Blevins Nikolas H.
Published: August 2019

Objective:

To prospectively evaluate opioid consumption following adult outpatient otologic surgery.

Study Design:

Prospective observational.

Setting:

Single-tertiary referral center.

Patients:

Patients scheduled for otologic surgery who did not have a history of chronic opioid use were recruited between February 2018 and February 2019.

Interventions and Main Outcome Measures:

Opioid consumption was queried using telephone or in-person surveys administered between postoperative days 5 and 15. Patient demographics, surgical details, and opioid prescription patterns were abstracted from medical records. Opioid distribution was determined by querying records maintained by the California Department of Justice through a state-wide prescription drug monitoring program mandated since 2016.

Results:

Seventy patients were prescribed an average of 68.9 ± 31.8 mg of morphine equivalents (MME) and consumed 47.3 ± 42.9 MME over 2.4 ± 2.3 days postoperatively. Patients who received a postauricular incision were prescribed significantly more than those who underwent transcanal procedures (86.2 vs 55.9 MME; t test, p < 0.001), consumed significantly more (72.2 vs 28.6 MME; t test, p < 0.001), and for a significantly longer duration (3.4 vs 1.6 days; t test, p = 0.001). In the postauricular group, there was no significant difference in consumption between mastoidectomy and nonmastoidectomy subgroups (64.9 vs 89.2 MME; t test, p = 0.151). Eighty percent of transcanal patients consumed 50 MME (10 pills) or less, while 80% of postauricular patients consumed 80 MME (16 pills) or less.

Conclusions:

Patients in our cohort consumed approximately 3/4 of the prescribed opioids. Those with postauricular incisions used significantly more than those with transcanal incisions. Postoperative opioid prescription recommendations should be tailored according to the extent of surgery.