bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare utilization and costs of psychiatric and somatic comorbidities associated with newly diagnosed adult ADHD
Authors: Garcia‐Argibay Miguel , Pandya Ekta , Ahnemark Ewa , Werner‐Kiechle Tamara , Andersson Lars Magnus , Larsson Henrik , Du Rietz Ebba
Published: March 2021

Background

Psychiatric and somatic problems in young adulthood have been found to be main drivers of costs in individuals with childhood ADHD. However, knowledge of the patterns of healthcare utilization and costs of comorbidities in middle‐aged adults with newly diagnosed ADHD is very limited.

Method

We studied individuals born 1966–1978 (from the Swedish Total Population Register) with newly diagnosed ADHD between the ages of 30–45 years and individuals without ADHD matched on birthdate, birth county, and sex. Healthcare utilization and expenditure for psychiatric and somatic disorders were obtained over four years (two years pre‐ and post‐initial ADHD diagnosis).

Results

Middle‐aged adults with newly diagnosed ADHD showed higher levels of healthcare utilization and costs (outpatient, inpatient, medications) for psychiatric and somatic comorbidities relative to adults without ADHD, both before and after the initial diagnosis. Females showed greater average group differences across the study period for medication prescriptions than males. Total incremental annual costs per capita were €2478.76 in adults with ADHD relative to those without, and costs were mainly driven by inpatient care. Psychiatric outpatient visits were statistically significantly higher the year before the ADHD diagnosis compared with two years before and after the diagnosis.

Conclusion

This study demonstrates the substantial burden of psychiatric and somatic comorbidities in middle‐aged adults newly diagnosed with ADHD. Psychiatric outpatient visits peaked in the year leading up to the ADHD diagnosis. Findings further suggested that females with ADHD may seek more treatment for comorbidities than males, which may reflect a general female tendency.
Urban Neighbourhood Forums in Ankara as a Commoning Practice
Authors: Ergenç Ceren , Çelik Özlem
Published: March 2021

The neighbourhood forums in Ankara began to convene during the Gezi protests in 2013 and lasted about three years. The activities of Ankara Gezi forums are urban commoning practices in terms of a new set of demands and methods. This paper conceptualises urban commoning practices as method, content, and demand. This framework offers an understanding of urban commoning that is not based on monetary transaction, but focuses on seeing commoning as a social process. Commoning is not ahistorical, rather it is engaged with the historical political potential of urban spaces. Commoning as method discusses organising in commons, commoning as content focuses on the form and meaning of political action, and commoning as demand emphasises the discursive use of right to the city. The case selection of this research enables us to reflect on how urban commoning is experienced in a city under less financial investment pressure, but at the centre of national‐level politics.
Trans‐perineal transection through “Neo‐Anus” for recto‐bulbar urethral fistula using a 5‐mm stapler in laparoscopically assisted anorectoplasty ‐ A novel and secure technique
Authors: Ieiri Satoshi , Ikoma Shinichiro , Harumatsu Toshio , Onishi Shun , Murakami Masakazu , Muto Mitsuru , Kaji Tatsuru
Published: March 2021

Laparoscopically assisted anorectoplasty (LAARP) for recto‐bulbar urethral fistula (RBUF) is not now a standard operation due to urethra injury risk and incomplete removal of fistula. Our approach is a novel and secure technique of trans‐perineal transection using a 5‐mm stapler for RBUF. Before performing LAARP, the orifice of RBUF was confirmed under flexible cystoscope inspection. Before transection of RBUF, the center of the muscle complex was detected at perineal skin. The muscle complex and the pubo‐rectal sling were then also confirmed with electrical nerve stimulator under laparoscopic approach. A 5‐mm trocar was inserted to pass through the center of the muscle complex from perineal incision of the neo‐anus. RBUF was stapled and transected using a 5‐mm stapler inserted from the neo‐anus. The operator successfully confirmed complete adequate closure of RBUF under flexible cystoscope inspection. A 5‐mm stapler was effective and useful for the transection of RBUF.
Glucocorticoid use and risk of first and recurrent venous thromboembolism: self‐controlled case‐series and cohort study
Authors: Orsi Fernanda A. , Lijfering Willem M. , Geersing Geert‐Jan , Rosendaal Frits R. , Dekkers Olaf M. , le Cessie Saskia , Cannegieter Suzanne C.
Published: March 2021

Glucocorticoid treatment increases venous thromboembolism (VTE) risk. Whether this is due to the medication or the underlying disease, or affects the risk of VTE recurrence, has been difficult to determine. The aim of our present study was to quantify the risk for first and recurrent VTE associated with oral glucocorticoids use, considering the underlying disease. A total of 2547 patients with VTE from the Multiple Environmental and Genetic Assessment of Risk Factors for Venous Thrombosis (MEGA) study were linked to the Dutch Pharmaceutical Statistics register. The risk of first VTE during periods of exposure with oral glucocorticoids was estimated by the self‐controlled case series method and that of recurrent VTE was examined in a cohort design. The incidence rate ratio (IRR) of first VTE in the period of glucocorticoid treatment was 3·51 [95% confidence interval (CI) 2·55–4·80]. This IRR was 2·53 (95% CI 1·10–5·72) in the week before treatment started, 5·28 (95% CI 2·89–9·53) in the first 7 days of treatment, remained elevated afterwards and decreased to 1·55 (95% CI 0·85–3·12) after 6 months, as compared to unexposed periods. The hazard ratio for recurrence was 2·72 (95% CI 1·64–4·78) in treatment periods as compared with no treatment. The increased risk of VTE associated with oral glucocorticoid treatment is due to a combined effect of the treatment and the underlying disease, remaining high during the first months of prescription.
Developmental and Intervention‐Related Change in Autobiographical Memory Specificity in Maltreated Children: Indirect Effects of Maternal Reminiscing
Authors: Valentino Kristin , Speidel Ruth , Lawson Monica
Published: March 2021

This study examined the development of autobiographical memory specificity (AMS) in a longitudinal randomized controlled trial of 242 maltreated and nonmaltreated children (aged 36–86 months; 50.4% male; 39.7% Black, 25.9% White, 34.5% Latinx/other) and their mothers. Half of the maltreated families were randomized to receive an intervention to improve maternal reminiscing. The effects of maltreatment and the intervention on children’s AMS via two indices of maternal reminiscing, sensitive guidance, and elaboration, were evaluated. Bidirectional associations between AMS and child maladjustment were also examined. Intervention‐related improvement in maternal sensitive guidance 6‐month postintervention (b* = .36) related to greater AMS among maltreated children 1 year later (b* = .19). These findings underscore the role of maternal sensitive guidance in facilitating AMS.
An analysis of weight loss efforts and expectations in a Canadian Cohort: A retrospective medical chart review
Authors: Kuk Jennifer L. , Dehlehhosseinzadeh Maral , Kamran Elham , Wharton Sean
Published: March 2021

The weight loss history and weight loss goals were examined in 4108 patients referred to a publicly funded evidence‐based clinical weight management program using a retrospective chart review. The majority of patients were white females, aged of 50.1 ± 13.7 years and a BMI of 39.0 ± 7.5 kg/m2. Pregnancy was the most common reason for weight gain in women (17.7%) and while the reasons in men are more varied (injury, stress and medication: all ~5%). Over 50% of patients cited no specific reason for their weight gain. Self‐directed diet and exercise were the most commonly used self‐reported weight loss methods. Women were more likely to report using medication and bariatric surgical weight loss methods than men (P < .05), and only 5% of women and 12.8% men report never having tried to lose weight in the past. Patients had an ideal weight loss goal of 28.9% to 34.4%, which was similar to the patient's lowest reported adult weight. Approximately 70% of patients enrolling at the clinic had previously lost at least 4.5 kg (10 lb) one or more times and 16.7% lost weight at least 5 times in their life, but patient weight at enrolment was similar to their highest adult reported weight. Thus, most patients referred to this clinical weight management program have previously attempted self‐directed diet and exercise weight loss. Patients were close to their highest adult weight and had very large weight loss goals, similar to what is typically achieved only by surgical intervention, despite having already had several bouts of weight loss.
Using culturomics and social media data to characterize wildlife consumption
Authors: Li Juan , Hu Qi
Published: March 2021

Wildlife provides food, medicine, clothing, and other necessities for humans, but overexploitation can disrupt the sustainability of wildlife resources and severely threaten global biodiversity. Understanding the characteristics of consumer behavior is helpful for wildlife managers and policy makers, but the traditional survey methods are laborious and time‐consuming. In contrast, culturomics may more efficiently identify the features of wildlife consumption. As a case study of the culturomics approach, we examined tiger bone wine consumption in China based on social media and Baidu search engine data. Tiger bone wine is one of the most purchased tiger products; its consumption is closely related to tiger poaching, which greatly threatens wild tiger survival. We searched a popular social media website for the term “tiger bone wine” and focused on posts that were originally created from 1 January 2012 to 31 December 2018. We filtered and classified posts related to the purchase, sale, or consumption of tiger bone wine and extracted information on providers, consumption motivations, year of production, and place of origin of the tiger bone wines based on the texts and photos of these posts. We found 756 posts related to tiger bone wine consumption, 113 of which mentioned providers of tiger bone wine, including friends (53%), elder relatives (37%), peer relatives (7%), and others (3%). Out of the 756 posts, 266 indicated the motivations of tiger bone wine consumption. Tiger bone wines were consumed as a tonic (34%), medicine (23%), game product (30%), and a symbol of wealth (28%). Some posts indicated ≥2 consumption motivations. These findings were consistent with the search queries from Baidu index. Such information could help develop targeted strategies for tiger conservation. The culturomics approach illustrated by our study is a rapid and cost‐efficient way to characterize wildlife consumption.
Exploring human–nature interactions in national parks with social media photographs and computer vision
Authors: Väisänen Tuomas , Heikinheimo Vuokko , Hiippala Tuomo , Toivonen Tuuli
Published: March 2021

Understanding the activities and preferences of visitors is crucial for managing protected areas and planning conservation strategies. Conservation culturomics promotes the use of user‐generated online content in conservation science. Geotagged social media content is a unique source of in situ information on human presence and activities in nature. Photographs posted on social media platforms are a promising source of information, but analyzing large volumes of photographs manually remains laborious. We examined the application of state‐of‐the‐art computer‐vision methods to studying human–nature interactions. We used semantic clustering, scene classification, and object detection to automatically analyze photographs taken in Finnish national parks by domestic and international visitors. Our results showed that human–nature interactions can be extracted from user‐generated photographs with computer vision. The different methods complemented each other by revealing broad visual themes related to level of the data set, landscape photogeneity, and human activities. Geotagged photographs revealed distinct regional profiles for national parks (e.g., preferences in landscapes and activities), which are potentially useful in park management. Photographic content differed between domestic and international visitors, which indicates differences in activities and preferences. Information extracted automatically from photographs can help identify preferences among diverse visitor groups, which can be used to create profiles of national parks for conservation marketing and to support conservation strategies that rely on public acceptance. The application of computer‐vision methods to automatic content analysis of photographs should be explored further in conservation culturomics, particularly in combination with rich metadata available on social media platforms.
Conservation planning on China's borders with Myanmar, Laos, and Vietnam
Authors: Wang Lin , Yang Bin , Bai Yang , Lu Xiaoqiang , Corlett Richard T. , Tan Yunhong , Chen Xiao‐Yong , Zhu Jianguo , Liu Yan , Quan Rui‐Chang
Published: March 2021

Transboundary conservation is playing an increasingly important role in maintaining ecosystem integrity and halting biodiversity loss caused by anthropogenic activities. However, lack of information on species distributions in transboundary regions and understanding of the threats in these areas impairs conservation. We developed a spatial conservation plan for the transboundary areas between Yunnan province, southwestern China, and neighboring Myanmar, Laos, and Vietnam in the Indo‐Burma biodiversity hotspot. To identify priority areas for conservation and restoration, we determined species distribution patterns and recent land‐use changes and examined the spatiotemporal dynamics of the connected natural forest, which supports most species. We assessed connectivity with equivalent connected area (ECA), which is the amount of reachable habitat for a species. An ECA incorporates the presence of habitat in a patch and the amount of habitat in other patches within dispersal distance. We analyzed 197,845 locality records from specimen collections and monographs for 21,004 plant and vertebrate species. The region of Yunnan immediately adjacent to the international borders had the highest species richness, with 61% of recorded species and 56% of threatened vertebrates, which suggests high conservation value. Satellite imagery showed the area of natural forest in the border zone declined by 5.2% (13,255 km2) from 1995 to 2018 and monoculture plantations increased 92.4%, shrubland 10.1%, and other cropland 6.2%. The resulting decline in connected natural forest reduced the amount of habitat, especially for forest specialists with limited dispersal abilities. The most severe decline in connectivity was along the Sino‐Vietnamese border. Many priority areas straddle international boundaries, indicating demand and potential for establishing transboundary protected areas. Our results illustrate the importance of bi‐ and multilateral cooperation to protect biodiversity in this region and provide guidance for future conservation planning and practice.
Myroxylon pereirae (balsam of Peru): Still worth testing?
Authors: Guarneri Fabrizio , Corazza Monica , Stingeni Luca , Patruno Cataldo , Napolitano Maddalena , Pigatto Paolo D. M. , Gallo Rosella , Cristaudo Antonio , Romita Paolo , Offidani Annamaria , Schena Donatella , Milanesi Nicola , Micali Giuseppe , Zucca Myriam , Foti Caterina ,   SIDAPA Study Group
Published: March 2021

Background

Because Myroxylon pereirae (MP), or balsam of Peru, is nowadays almost not used “as such,” and fragrance mix 1 (FM1) apparently is more sensitive in detecting fragrance allergy, the usefulness of testing MP in baseline series was recently questioned.

Objectives

Identification of the number of clinically relevant patch test reactions to MP not detected by FM1.

Methods

Retrospective analysis of 12 030 patients patch tested with MP and FM1 for contact dermatitis between January 2018 and December 2019 in 13 Italian dermatology clinics.

Results

Four hundred thirty‐nine patients (3.6%) had a positive patch test reaction to MP; 437 (3.6%) had a positive patch test reaction to FM1. Positive reactions to both MP and FM1 were observed in 119 subjects (1.0%), 310 (2.6%) reacted to MP only, 304 (2.5%) to FM1 only, 5 to MP and sorbitan sesquioleate (SSO), 9 to FM1 and SSO, and 5 to MP, FM1, and SSO. Single sensitizations were clinically relevant in 75.2% of cases for MP (62.9% current, 12.3% past) and 76.3% for FM1 (70.1% current, 6.2% past).

Conclusions

Based on our results, MP appears to be still worth testing along with FM1 in baseline series, because it allows detection of a remarkable number of fragrance allergies, often relevant, which would be otherwise missed.
Clinical assessment of endothelial function in heart failure with preserved ejection fraction: A meta‐analysis with meta‐regressions
Authors: Ambrosino Pasquale , Papa Antimo , Buonauro Agostino , Mosella Marco , Calcaterra Ilenia , Spedicato Giorgio Alfredo , Maniscalco Mauro , Di Minno Matteo Nicola Dario
Published: March 2021

Background

Endothelial dysfunction is a key mechanism in the development of cardiac remodelling and diastolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Flow‐mediated (FMD) and nitrate‐mediated dilation (NMD) are noninvasive methods to assess endothelial function. We performed a meta‐analysis evaluating the impact of HFpEF on FMD and NMD.

Methods

PubMed, Web of Science, Scopus and EMBASE databases were systematically searched according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Differences were expressed as mean difference (MD) with 95% confidence intervals (95%CI). The random effects method was used.

Results

A total of seven studies were included in the final analysis, 7 with data on FMD (326 HFpEF patients and 417 controls) and 3 on NMD (185 HFpEF patients and 271 controls). Compared to controls, HFpEF patients showed significantly lower FMD (MD: −1.929; 95%CI: −2.770, −1.088;P < .0001) and NMD values (MD: −2.795; 95%CI: −3.876, −1.715;P < .0001). Sensitivity analyses substantially confirmed results. Meta‐regression models showed that increasing differences in E/A ratio (Z‐score: −2.002;P = .045), E/E’ ratio (Z‐score: −2.181;P = .029) and left atrial diameter (Z‐score: −1.951;P = .050) were linked to higher differences in FMD values between cases and controls.

Conclusions

Impaired endothelial function can be documented in HFpEF, with the possibility of a direct association between the severity of diastolic and endothelial dysfunction. Targeting endothelial dysfunction through pharmacological and rehabilitation strategies may represent an attractive therapeutic option.
Host‐choice by a specialist folivore reflects trade‐offs between foliage quality and parasitism risks
Authors: Stead Lauren , Heard Stephen B. , Johns Robert C.
Published: March 2021

1. The spruce budworm,Choristoneura fumiferanaClem., is an important outbreaking pest of balsam fir,Abies balsamea(L.) Mill, and black spruce,Picea mariana(Mill.) Britton, Sterns & Poggenb., throughout the boreal forests of North America.

2. Despite several studies reporting higher performance for larvae on balsam fir versus those on black spruce, many females still lay eggs on spruce. In this 2‐year study, we explored possible tri‐trophic trade‐offs associated with host selection taking into account both larval overwintering and feeding periods.

3. Based on field surveys, parasitism rates were significantly higher for overwintering larvae on balsam fir than on black spruce in 2017.

4. Field bioassays confirmed past studies showing 21% higher larval survival on balsam fir versus black spruce, especially when larval emergence was synchronized with host budburst.

5. Considering both overwintering and feeding survival, overall spruce budworm performance was nearly equal between hosts, though larvae gained some advantage on balsam fir if larval feeding was synchronized with budburst.

6. These results suggest that female egg lay on both hosts may be a ‘bet‐hedging’ strategy that balances trade‐offs between higher parasitism and higher foliage quality on different potential host species.
Exploring the clinical relevance of a dichotomy between affective and non‐affective psychosis: Results from a first‐episode psychosis cohort study
Authors: Ramain Julie , Conus Philippe , Golay Philippe
Published: March 2021

Aim

Defining diagnosis is complex in early psychosis, which may delay the introduction of an appropriate treatment. The dichotomy of affective and non‐affective psychosis is used in clinical setting but remains questioned on a scientific basis. In this study, we explore the clinical relevance of this dichotomy on the basis of clinical variables in a sample of first‐episode psychosis patients.

Method

We conducted a prospective study in a sample of 330 first‐episode psychosis treated at an early intervention program. Affective and non‐affective psychosis patients were compared on premorbid history, baseline data, outcomes and course of symptoms over the 3 years of treatment.

Results

Affective psychosis patients (22.42%) were more likely to be female, and had a shorter duration of untreated psychosis. The longitudinal analyses revealed that positive symptoms remained higher over the entire follow‐up in the non‐affective sub‐group. A higher degree of variability of manic symptoms and a significantly better insight after 6 months were observed in the affective sub‐group. No difference was observed regarding depressive and negative symptoms. At discharge, only the environmental quality of life and insight recovery were better in affective psychosis.

Conclusions

Our study suggests that despite marginal differences at baseline presentation, these sub‐groups differ regarding outcome, which may require differentiation of treatment and supports the utility of this dichotomy.
Increased angiogenesis and migration of dermal microvascular endothelial cells from patients with psoriasis
Authors: Li Jiao , Hou Hui , Zhou Ling , Wang Juanjuan , Liang Jiannan , Li Junqin , Hou Ruixia , Niu Xuping , Yin Guohua , Li Xinhua , Zhang Kaiming
Published: March 2021

Psoriasis displays both increased angiogenesis and microvascular dilation in the skin, while human dermal microvascular endothelial cells (HDMECs) are involved in angiogenesis and microvascular dilation. Whether the functions of HDMECs are altered in psoriatic skin versus healthy skin remain unknown. Here, we isolated HDMECs from the skin of 10 patients with psoriasis and 10 healthy subjects and compared angiogenesis, proliferation, migration and cell metabolism between psoriatic HDMECs and normal HDMECs. We found that the morphology of primary HDMECs was comparable between psoriatic HDMECs and normal HDMECs. After passage, psoriatic HDMECs displayed larger cell size and wider intercellular space. In addition to DiI‐Ac‐LDL (DiI‐labelled acetylated low‐density lipoprotein) uptake, expression levels of CD31, vWF (von Willebrand factor) and LYVE‐1 were comparable in psoriatic HDMECs versus normal HDMECs. However, psoriatic HDMECs exhibited increased tube formation (numbers of nodes and meshes, p < 0.05) and migration (numbers of migrated cells, p < 0.001) and reductions in proliferation (growth rates, p < 0.05) and energy metabolism (oxygen consumption rate and extracellular acidification rate, p < 0.05) compared with normal HDMECs. Therefore, psoriatic HDMECs display an increased angiogenesis and migration and decreased proliferation and metabolic activity, suggesting a pathogenic role of HDMECs in psoriasis.
What variables are associated with use of and need for dental prosthesis? A cross‐sectional study
Authors: Rosalen Nathália P. , Muniz Francisco Wilker M. G. , Scalco Natália R. , Dezingrini Koriandher da S. , Colussi Eliane L. , Pires Ana Luiza C. , Colussi Paulo R. G.
Published: March 2021

Background

Population‐based studies assessing the factors associated with use of and need for dental prosthesis among older adults are scarce.

Objective

To evaluate the use of and need for dental prosthesis and associated factors in the older adult population of a southern city of Brazil.

Material and methods

A cross‐sectional study, involving community‐dwelling older adults (≥60 years), was performed. A probabilistic per cluster sampling was used, and 282 participants from Veranópolis, Brazil, were included. A clinical oral health examination was performed, and a structured questionnaire was applied. Bivariate and multivariate analyses were performed to verify associations using Poisson regression with robust variance.

Results

The prevalence of use of dental prosthesis was 87.2% (n = 246), while the prevalence of need for dental prosthesis was 27% (n = 76). Older adults with medium/high levels of education had 17.8% (P = .019) lower prevalence ratio (PR) for use of dental prosthesis. Unmarried and retired older adults had, respectively, 11.1% (PR:1.111; 95%CI:1.022‐1.207) and 19.5% (PR:1.195; 95%CI:1.009‐1.415) higher PR for use of prosthesis. Those without access to dental care had 11.8% (P = .012) higher PR for use of dental prosthesis. Older adults living in rural areas had 64.7% (PR:1.647; 95%CI:1.079‐2.514) higher PR of need for dental prosthesis.

Conclusion

High and low prevalence of use of and need for dental prosthesis, respectively, were detected in this sample. Level of education, marital status, retirement status and access to dental care were associated with the use of dental prostheses. However, only residence area was associated with the need for oral rehabilitation.
Challenges of antithrombotic therapy in the management of cardiovascular disease in patients with inherited bleeding disorders: A single‐centre experience
Authors: Cohen Oliver C. , Bertelli Michele , Manmathan Gavin , Little Callum , Riddell Anne , Pollard Debra , Aradom Elsa , Mussara Molly , Harrington Chris , Kanagasabapathy Pamela , De Silva Ravi , Martin Bruce , Peralta Rita , Gomez Keith , Yee Thynn , Chowdary Pratima , Rakhit Roby D.
Published: March 2021

Introduction

Cardiovascular events in patients with inherited bleeding disorders are challenging to manage. The risk of bleeding secondary to antithrombotic treatment must be balanced against the risk of thrombosis secondary to haemostatic therapy.

Methods

Patients with inherited bleeding disorders with coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI) or atrial fibrillation (AF) from a single centre (2010–2018) are included.

Results

A total of 11 patients undergoing CABG (n = 3), PCI (n = 5) or with AF (n = 3) and a diagnosis of haemophilia A (n = 8), haemophilia B (n = 1), factor XI deficiency (n = 1) and von Willebrand disease (n = 1) managed by a multidisciplinary team are reported. In patients undergoing CABG, factor levels were normalized for 7–10 days with trough levels of 70–80% with severe patients continuing high‐dose factor prophylaxis (trough 20–30%) three weeks post‐operatively with daily aspirin. In a patient with mild haemophilia A and an inhibitor, recombinant factor VIIa dosing was monitored with thromboelastometry. For PCI, a 3rd‐generation drug‐eluting stent with one month of dual antiplatelet therapy in addition to high‐dose prophylaxis as needed was preferred. Patients with AF and severe haemophilia did not receive antithrombotic treatment, and a thrombin generation assay was used to guide heparin dosing in mild haemophilia.

Conclusion

Our experience demonstrates the importance of interdisciplinary communication to identify strategies that decrease the risk of bleeding and thrombosis. The use of extended, increased intensity prophylaxis facilitated antiplatelet therapy. Global assays may help balance the intensity of haemostatic and antithrombotic treatment.
Efficacy of ubrogepant based on prior exposure and response to triptans: A post hoc analysis
Authors: Blumenfeld Andrew M. , Goadsby Peter J. , Dodick David W. , Hutchinson Susan , Liu Chengcheng , Finnegan Michelle , Trugman Joel M. , Szegedi Armin
Published: March 2021

Objective

To determine the potential efficacy of ubrogepant for acute treatment of migraine based on historical experience with triptans.

Background

Although triptans have improved migraine treatment, their efficacy and tolerability may limit their utility in some individuals. Ubrogepant is a small‐molecule, oral calcitonin gene–related peptide receptor antagonist approved by the Food and Drug Administration for acute treatment of migraine in adults.

Methods

This post hoc analysis of pooled data from the pivotal trials ACHIEVE I and II, identically designed, randomized, double‐blind, phase 3, single‐attack trials of ubrogepant in adults with a history of migraine with/without aura, examined the efficacy and tolerability of ubrogepant 50 mg versus placebo based on participants’ historical experience with triptans: triptan responder, triptan‐insufficient responder, and triptan naïve. Co‐primary efficacy endpoints were pain freedom and absence of most bothersome migraine‐associated symptom (MBS) 2 h post initial dose. Adverse events (AEs) within historical triptan experience subgroups were evaluated.

Results

In the pooled analysis population (n = 1799), 682 (placebo, n = 350; ubrogepant 50 mg, n = 332), 451 (placebo, n = 223; ubrogepant, n = 228), and 666 (placebo, n = 339; ubrogepant, n = 327) participants were triptan responders, triptan‐insufficient responders, and triptan‐naïve, respectively. Response rates on co‐primary efficacy endpoints were higher for ubrogepant versus placebo across all groups. Treatment‐by‐subgroup interaction p values based on odds ratios for pain freedom (p = 0.290) and absence of MBS (p = 0.705) indicated no significant impact of historical triptan experience on ubrogepant efficacy. AE incidence for ubrogepant did not differ appreciably across historical triptan experience subgroups.

Conclusions

Ubrogepant efficacy and tolerability did not differ for the acute treatment of migraine in participants classified as triptan responders, triptan‐insufficient responders, and triptan‐naïve based on their historical experience with triptans.
'Reluctant pioneer': A qualitative study of doctors' experiences as patients with long COVID
Authors: Taylor Anna K. , Kingstone Tom , Briggs Tracy A. , O'Donnell Catherine A. , Atherton Helen , Blane David N. , Chew‐Graham Carolyn A.
Published: March 2021

Background

The coronavirus disease (COVID‐19) pandemic has had far‐reaching effects upon lives, healthcare systems and society. Some who had an apparently 'mild' COVID‐19 infection continue to suffer from persistent symptoms, including chest pain, breathlessness, fatigue, cognitive impairment, paraesthesia, muscle and joint pains. This has been labelled 'long COVID'. This paper reports the experiences of doctors with long COVID.

Methods

A qualitative study; interviews with doctors experiencing persistent symptoms were conducted by telephone or video call. Interviews were transcribed and analysis conducted using an inductive and thematic approach.

Results

Thirteen doctors participated. The following themes are reported: making sense of symptoms, feeling let down, using medical knowledge and connections, wanting to help and be helped, combining patient and professional identity. Experiencing long COVID can be transformative: many expressed hope that good would come of their experiences. Distress related to feelings of being ‘let down’ and the hard work of trying to access care. Participants highlighted that they felt better able to care for, and empathize with, patients with chronic conditions, particularly where symptoms are unexplained.

Conclusions

The study adds to the literature on the experiences of doctors as patients, in particular where evidence is emerging and the patient has to take the lead in finding solutions to their problems and accessing their own care.

Patient and Public contribution

The study was developed with experts by experience (including co‐authors HA and TAB) who contributed to the protocol and ethics application, and commented on analysis and implications. All participants were given the opportunity to comment on findings.
Multiple sulfur isotope chemostratigraphy across the Permian–Triassic boundary at Chaotian, China: Implications for a shoaling model of toxic deep‐waters
Authors: Saitoh Masafumi , Ueno Yuichiro , Isozaki Yukio , Yoshida Naohiro
Published: March 2021

Previous studies on multiple sulfur isotopes (32S, 33S, and 34S) in sedimentary pyrite at the end‐Permian suggested a shoaling of anoxic/sulfidic deep‐water contributing to the extinction. This scenario is based on an assumption that the sedimentary sulfur cycle was largely controlled by benthos activity, though a stratigraphic correlation between the sulfur records and ichnofabrics of the sediments at the end‐Permian has not yet been examined. We report the multiple sulfur isotopic composition of pyrite in the Permian–Triassic boundary interval at Chaotian, South China. Our data can be generally explained by a mixing of sulfur in sulfide from two different sources: one produced via sulfate reduction in an open system with respect to sulfate and the other produced in a closed system. In particular, the former with the substantially low δ34S (<−40 ‰) and high ∆33S (up to +0.100 ‰) values was likely produced via water‐mass sulfate reduction or via sulfate reduction in oxic sediments with common burrows. The frequent occurrence of small pyrite framboids (mostly <5 μm in diameter) in the Lopingian (Late Permian) Dalong Formation of deep‐water facies supports the enhanced water‐mass sulfate reduction in an anoxic deep‐water mass. The negative ∆33S values are observed only in the oxic limestones, and no substantial ∆33S change is observed across the extinction horizon despite of the disappearance of bioturbation. Our results are apparently inconsistent with the previous shoaling model. We expand the model and infer that, when the deep‐water was sulfidic and its shoaling rate was high, a substantial amount of hydrogen sulfide (H2S) was supplied onto the shelf via the shoaling; that resulted in the positive ∆33S value of the bulk sediments. The observed ∆33S variation on a global scale suggests a substantial variation in H2S concentration and/or in upwelling rate of shoaling deep‐waters during the Permian–Triassic transition.
Incorporation of calcium in glasses: A key to understand the vitrification of sewage sludge
Authors: Tarrago Mariona , Royo Irene , Martínez Salvador , Garcia‐Valles Maite , Neuville Daniel R.
Published: March 2021

The quantity of sewage sludge generated daily by wastewater treatment plants represents a major environmental problem and a financial burden for plant operators. Valorization strategies focusing on reusing sewage sludge as a raw material are currently developed. Vitrification can help us reduce the volume of waste and binds the components in the structure of chemically stable glasses and glass‐ceramics. In this study, the vitrification of sewage sludge inside a basaltic rock has been simulated by producing glasses and a glass‐ceramic from basalt enriched in calcium that lie between the stability fields of pyroxene and melilite in the system CaO–MgO–SiO2–Al2O3. CaO addition causes the oxidation of the melt at above the liquidus, increases the crystallization temperature, decreases the melting temperature, and improves the microhardness of the glasses. Glass‐ceramic processes improves the properties of the Ca‐doped basalt glass. The microhardness of the glass (8.2 GPa) and the glass‐ceramic (8.6 GPa) and leaching tests (in the ppb range) place both the glass and the glass‐ceramics at the high end of the mechanical properties and chemical resistance of ceramic tiles for the building industry.
Growth and thermal inactivation of Listeria monocytogenes and Escherichia coli O157:H7 in four kinds of traditionally non‐fermented soya bean products
Authors: Xie Tianhui , Yuan Xue , Wen Dingyuan , Shi Hui
Published: March 2021

This study evaluated growth and thermal inactivation of Listeria monocytogenes and Escherichia coli O157:H7 inoculated in tofu, dougan, qianzhang and doupi which were stored at 4, 25 and 37 °C and heated at 55, 60, 65 and 70 °C. Growth of the two pathogens in four soya bean products increased with temperature or Aw of soya bean products increasing. At the same temperature, lag time (LT) values of L. monocytogenes (16.32–0.94 h) and E. coli O157:H7 (2.66–0.98 h) in tofu which has the highest Aw were the lowest. When inoculated soya bean products were stored at 4 °C, L. monocytogenes grew slowly, while E. coli O157:H7 did not grow but survived for 14 days. With temperature increasing, δ‐values of L. monocytogenes and E. coli O157:H7 in the four soya bean products were decreased. With Aw of soya bean products increasing, thermal resistance of L. monocytogenes decreased, while that of E. coli O157:H7 increased. This study could assist retail soya bean products processors and food industry to enhance safety of soya bean products and design thermal processing regimes.
The impact of a participatory intervention on the therapeutic relationship in mental health nurses: A multicentre study
Authors: Moreno‐Poyato Antonio R. , Rodríguez‐Nogueira Óscar , Casanova‐Garrigos Georgina , El Abidi Khadija , Roldán‐Merino Juan F. ,   MiRTCIME.CAT working group
Published: March 2021

Aims

To evaluate the effects of an intervention aimed at improving the therapeutic relationship, using the participatory‐action research method, in terms of improving the quality of the nurse–patient therapeutic relationship.

Design

A single‐group pre‐post research design.

Methods

Quantitative data were collected between January 2018 and June 2019 using an online form completed by nurses from 18 mental health units (N = 95). Data were collected before and after the intervention, which consisted of the design, implementation and evaluation of strategies to improve the therapeutic relationship through participatory‐action research involving nurses. The Working Alliance Inventory‐Short, Interpersonal Reactivity Index, Evidence‐Based Practice Questionnaire and Practice Environment Scale of the Nursing Work Index were used. The Wilcoxon rank‐sum test was used together with the Spearman's correlation coefficient. Two multiple linear regressions models were constructed.

Results

Overall, the intervention improved the nurse–patient therapeutic relationship. In addition, the results revealed that, above all, the improvement in evidence‐based practice along with a decrease in nurses’ personal distress were the factors associated with the improvement of the nurse–patient therapeutic relationship.

Conclusion

In mental health units, the therapeutic nurse–patient relationship can be improved through participatory interventions that include the implementation of evidence‐based practices.

Impact

This research examined the effects of an intervention aimed at improving the therapeutic relationship among nurses working at mental health units using participatory action research. The results show that the therapeutic relationship can be improved through participatory methods where evidence‐based practice is implemented and enhanced among nurses, since a better therapeutic relationship along with reduced staff discomfort are determining factors that influence the quality of the therapeutic relationship. Institutional managers should promote participatory group interventions to enable nurses to develop evidence‐based aspects of the therapeutic relationship together with expanding personal aspects and self‐knowledge.
Adaptive immune response and resting metabolism are unaffected by manipulation of flight intensity, but negatively related to each other
Authors: Bryła Amadeusz , Bury Agata , Niedojadło Jowita , Speakman John R. , Sadowska Edyta T. , Cichoń Mariusz , Bauchinger Ulf
Published: March 2021

Activation of an immune response (IR) upon exposure to pathogens is crucial to ensure adequate organismal performance and is directly linked to survival. Fitness benefits of the response may be associated with costs in terms of increased energy expenditure and may compete for resources and compromise such fitness benefits. Trade‐offs between immune function and other traits relevant for fitness are well documented, however, it remains unknown if such trade‐offs are energetically mediated. We manipulated the flight activity of 70 zebra finches Taeniopygia guttata to investigate the energy reallocation to the immune system in rested and exercised birds. Four experimental groups exhibiting different flight intensity were used: trained, untrained and birds that either stopped or started flight training after the immune challenge. If costs associated with the IR and flight activity compete for energy, we predicted the extent of inhibition of IR would be dependent on energy allocated to physical activity. Daytime resting metabolic rate was measured before and after the immune challenge, induced using sheep red blood cells (SRBC). Strength of the response was measured as the concentration of anti‐SRBC antibodies six days post‐challenge. We found no evidence for the predicted inhibition of the immune function between trained and untrained birds, as there was no difference in resting metabolic rate between experimental groups. However, resting metabolic rate following the challenge was negatively correlated with the IR. Surprisingly, individuals with relatively low resting metabolic rates following immune challenge were able to up‐regulate their IR, indicating a trade‐off in the use of the energy resource independent of flight activity levels. Our results suggest that energy allocation to mount the IR may represent a constraint that is possibly linked to the circadian pattern of the energy budget but appears to be independent of energetic challenges brought on by different levels of flight activity.
Dietitian encounters after treatment for ovarian cancer
Authors: Johnston Elizabeth A. , Ibiebele Torukiri I. , van der Pols Jolieke C. , Webb Penelope M. ,   the OPAL Study Group
Published: March 2021

Background

After ovarian cancer treatment, women report health issues that may be amenable to change with dietary support. The present study investigated how many women encounter a dietitian post‐treatment and the factors associated with dietitian service use.

Methods

We used data from a cohort of women with invasive epithelial ovarian cancer to identify socio‐economic, clinical and personal factors associated with dietitian encounter after treatment completion. Data were collected at regular intervals using validated questionnaires up to 4 years post‐treatment completion. Logistic regression (LR) and generalised linear mixed models (GLMM) were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess factors associated with dietitian encounter at any time‐point post‐treatment (LR), as well as in the 3 months prior to a follow‐up questionnaire (GLMM) to assess time‐varying factors.

Results

Of 819 women, 97 (12%) reported seeing a dietitian post‐treatment. Factors associated with dietitian encounter were being overweight (ORLR = 1.7, CI = 1.1–2.8), having poorer self‐rated health (ORLR = 2.5, CI = 1.2–5.2; ORGLMM = 2.3, CI = 1.2–4.4) or poorer diet quality (ORLR = 0.5, CI = 0.2–1.0) pre‐diagnosis, treatment within the public health system (ORGLMM = 1.8, CI = 1.2–2.7), previous support from dietetic (ORLR = 3.1, CI = 1.8–5.4; ORGLMM = 2.8, CI = 1.8–4.2) or other allied health services (ORLR = 2.0, CI = 1.2–3.2; ORGLMM = 3.7, CI = 2.4–5.5), and having progressive disease at follow‐up (ORGLMM = 2.2, CI = 1.4–3.3). Most women (86%) with ≥ 3 moderate‐to‐severe nutrition impact symptoms did not report a dietitian encounter post‐treatment.

Conclusions

Few women encounter a dietitian post‐treatment for ovarian cancer, including those with multiple nutrition impact symptoms. Further work is needed to engage those likely to benefit from dietitian support but less likely to seek or receive it.
High Iron Requirements for Growth in the Nuisance Alga Gonyostomum semen (Raphidophyceae)
Authors: Münzner Karla , Gollnisch Raphael , Rengefors Karin , Koreiviene Judita , Lindström Eva S.
Published: March 2021

The bloom‐forming freshwater alga Gonyostomum semen is associated with acidic, mesotrophic brown water lakes in boreal regions. However, researchers have been unable to conclusively link G. semen abundance and bloom formation to typical brown water lake traits, that is, high water color and DOC (dissolved organic carbon) concentrations. Iron is a main driver of water color in boreal lakes, and a recent study of lake monitoring data indicated a connection between lakes with high G. semen abundance and iron concentrations >200 µg · L−1. Thus, iron may be the missing link in explaining G. semen abundance and growth dynamics. We experimentally assessed the effects of different iron concentrations above or below 200 µg · L−1 on the growth of G. semen batch monocultures. Iron concentrations <200 µg · L−1 limited G. semen growth, while iron concentrations >200 µg · L−1 did not. Moreover, the iron concentration of the medium required for growth was higher than for other common phytoplankton (Microcystis botrys and Chlamydomonas sp.) included in the experiment. These results indicate that G. semen requires high levels of iron in the lake environment. Consequently, this and previous findings using lake monitoring data support the hypothesis that high concentrations of iron favor the formation of high‐density G. semen blooms in boreal brown water lakes. As lakes get browner in a changing climate, monitoring iron levels could be a potential tool to identify lakes at risk for G. semen blooms, especially among lakes that provide ecosystem services to society.
Optimising the use of gene expression data to predict plant metabolic pathway memberships
Authors: Wang Peipei , Moore Bethany M. , Uygun Sahra , Lehti‐Shiu Melissa D. , Barry Cornelius S. , Shiu Shin‐Han
Published: March 2021

Plant metabolites from diverse pathways are important for plant survival, human nutrition and medicine. The pathway memberships of most plant enzyme genes are unknown. While co‐expression is useful for assigning genes to pathways, expression correlation may exist only under specific spatiotemporal and conditional contexts.

Utilising > 600 tomato (Solanum lycopersicum) expression data combinations, three strategies for predicting memberships in 85 pathways were explored.

Optimal predictions for different pathways require distinct data combinations indicative of pathway functions. Naive prediction (i.e. identifying pathways with the most similarly expressed genes) is error prone. In 52 pathways, unsupervised learning performed better than supervised approaches, possibly due to limited training data availability. Using gene‐to‐pathway expression similarities led to prediction models that outperformed those based simply on expression levels. Using 36 experimental validated genes, the pathway‐best model prediction accuracy is 58.3%, significantly better compared with that for predicting annotated genes without experimental evidence (37.0%) or random guess (1.2%), demonstrating the importance of data quality.

Our study highlights the need to extensively explore expression‐based features and prediction strategies to maximise the accuracy of metabolic pathway membership assignment. The prediction framework outlined here can be applied to other species and serves as a baseline model for future comparisons.