bluuebunny/crossref_metadata_2025 huggingface dataset:
Body weight gain in clozapine‐treated patients: Is norclozapine the culprit?
Authors: Jessurun Naomi T. , Derijks Hieronymus J. , van Marum Rob J. , Jongkind Amy , Giraud Eline L. , van Puijenbroek Eugène P. , Grootens Koen P.
Published: July 2021

The antipsychotic drug clozapine is associated with weight gain. The proposed mechanisms include blocking of serotonin (5‐HT2a/2c), dopamine (D2) and histamine (H1) receptors. Clozapine is metabolized by cytochrome P450 1A2 (CYP1A2) to norclozapine, a metabolite with more 5‐HT2c‐receptor and less H1 blocking capacity. We hypothesized that norclozapine serum levels correlate with body mass index (BMI), waist circumference and other parameters of the metabolic syndrome. We performed a retrospective cross‐sectional study in 39 patients (female n = 8 (20.5%), smokers n = 18 (46.2%), average age 45.8 ± 9.9 years) of a clozapine outpatient clinic in the Netherlands between 1 January 2017 and 1 July 2020. Norclozapine concentrations correlated with waist circumference (r = 0.354, P = .03) and hemoglobin A1c (HbA1c) (r = 0.34, P = .03). In smokers (smoking induces CYP1A2), norclozapine concentrations correlated with waist circumference (r = 0.723, P = .001), HbA1c (r = 0.49, P = .04) and BMI (r = 0.63, P = .004). Elucidating the relationship between norclozapine and adverse effects of clozapine use offers perspectives for interventions and treatment options.
MYB mediates downregulation of the colorectal cancer metastasis suppressor heterogeneous nuclear ribonucleoprotein L‐like during epithelial‐mesenchymal transition
Authors: Sakuma Keiichiro , Sasaki Eiichi , Hosoda Waki , Komori Koji , Shimizu Yasuhiro , Yatabe Yasushi , Aoki Masahiro
Published: July 2021

Heterogeneous nuclear ribonucleoprotein L‐like (HNRNPLL), a suppressor of colorectal cancer (CRC) metastasis, is transcriptionally downregulated when CRC cells undergo epithelial‐mesenchymal transition (EMT). Here we show that decrease of MYB mediates the downregulation of HNRNPLL during EMT. The promoter activity was attributed to a region from −273 to −10 base pairs upstream of the transcription start site identified by 5'‐RACE analysis, and the region contained potential binding sites for MYB and SP1. Luciferase reporter gene assays and knockdown or knockout experiments for genes encoding the MYB family proteins, MYB, MYBL1, and MYBL2, revealed that MYB was responsible for approximately half of the promoter activity. On the other hand, treatment with mithramycin A, an inhibitor for SP1 and SP3, suppressed the promoter activity and their additive contribution was confirmed by knockout experiments. The expression level of MYB was reduced on EMT while that of SP1 and SP3 was unchanged, suggesting that the downregulation of HNRNPLL during EMT was mediated by the decrease of MYB expression while SP1 and SP3 determine the basal transcription level of HNRNPLL. Histopathological analysis confirmed the accumulation of MYB‐downregulated cancer cells at the invasion front of clinical CRC tissues. These results provide an insight into the molecular mechanism underlying CRC progression.
Differences in treatment and survival between elderly patients with thoracic esophageal cancer in metropolitan areas and other areas
Authors: Motoyama Satoru , Maeda Eri , Iijima Katsunori , Anbai Akira , Sato Yusuke , Wakita Akiyuki , Nagaki Yushi , Fujita Hiromu , Minamiya Yoshihiro , Higashi Takahiro
Published: July 2021

To address the major issue of regional disparity in the treatment for elderly cancer patients in an aging society, we compared the treatment strategies used for elderly patients with thoracic esophageal cancer and their survival outcomes in metropolitan areas and other regions. Using the national database of hospital‐based cancer registries in 2008‐2011, patients aged 75 years or older who had been diagnosed with thoracic esophageal cancer were enrolled. We divided the patients into two groups: those treated in metropolitan areas (Tokyo, Kanagawa, Osaka, Aichi, Saitama, and Chiba prefectures) with populations of 6 million or more and those treated in other areas (the other 41 prefectures). Compared were patient backgrounds, treatment strategies, and survival curves at each cancer stage. In total, 1236 (24%) patients from metropolitan areas and 3830 (76%) patients from nonmetropolitan areas were enrolled. Patients in metropolitan areas were treated at more advanced stages. There was also a difference in treatment strategy. The 3‐year survival rate among cStage I patients was better in metropolitan areas (71.6% vs. 63.7%), and this finding mainly reflected the survival difference between patients treated with radiotherapy alone. For cStage II‐IV patients, there were no differences. Multivariable Cox proportional hazard analysis including interaction terms between treatment areas, cStage, and the first‐line treatments revealed that treatments in the metropolitan areas were significantly associated with better survival among patients treated with radiotherapy alone for cStage I cancer. Treatment strategies for elderly patients with thoracic esophageal cancer and its survival outcomes differed between metropolitan areas and other regions.
Health experience outcomes of a health promotion project for middle school pupils in Sweden
Authors: Nilsson Lindström Petra , Khalaf Atika , Bringsén Åsa
Published: July 2021

The aim was to examine middle school‐aged pupils’ participation in an action‐oriented school health promotion project and investigate its effects on their health experience, learning and influence. A survey was sent eight times to middle school‐aged pupils (n = 105). A descriptive analysis with group comparisons was followed by a regression analysis. Health differences were found between gender and age. Aspects of pupil influence and learning about health showed positive progression during the project. Satisfaction with school performance was most associated with health experience. Thus, health experience, gender, and age are factors to consider when planning similar health promotion projects in schools.
Prioritizing the vulnerable over the susceptible for COVID‐19 vaccination
Authors: Paloyo Siegfredo R. , Caballes Alvin B. , Hilvano‐Cabungcal Ana Melissa , De Castro Leonardo
Published: July 2021

The COVID‐19 pandemic led to a health crisis with widespread social and economic adverse effects. To address the fallout, vaccine development has been pursued in record time. Several vaccines have already been deployed in countries worldwide, but as the supply is limited, these have been provided selectively. Various allocation schemes, premised on ensuring an equitable distribution, have prioritized the elderly, given their apparent susceptibility. For the Philippines and possibly other countries with extremely limited supplies, the elderly need not always be given primary preference. The level of available supplies can be so low that the immediate focus of allocation should be on mitigating both infection and transmission. The proposed alternative vaccine allocation framework gives priority to groups rendered more vulnerable, such as those who are unable to avoid prolonged exposure to possibly infected people because of medical necessity or occupational conditions. Vulnerable groups include healthcare and other essential workers as well as patients requiring continued healthcare services. The proposed allocation scheme is meant to be complementary to concurrent public health measures, which have to be maintained though made less restrictive as the pandemic is brought under control.
Reconstructing the Cross: Fragile Crucifixion and Immigrant Survivors of Domestic Violence
Authors: Theuring Ashley
Published: July 2021

This article reimagines the significance of Jesus’ crucifixion through the layered lens of suffering experienced by immigrant survivors of domestic violence. Towards this end, the article begins with an overview of the compounding systems of oppression, immigration, and domestic violence. Next, the author outlines and deconstructs several classical theologies of the cross in light of gender, trauma, and suffering. Finally, the author suggests a reconstruction of the cross as a “fragile crucifixion,” which looks at suffering and crucifixion as both upheld by humans through empire and subverted by humans through liberative practices.
Foreign aid, public investment, and the informal economy
Authors: Chatterjee Santanu , Kelly Mark C. , Turnovsky Stephen J.
Published: July 2021

This paper examines the absorption of foreign aid in the presence of formal and informal production. Calibrating a two‐sector open economy model to 67 aid‐recipient countries for 1990–2019, we show that an increase in foreign aid drives resources into the informal sector, and away from the formal sector. With untied aid, the expansion of the informal sector can lead to an economic contraction through the Dutch Disease effect. An economic expansion with an increase in the share of formal production can be attained by re‐allocating existing aid to public investment rather than an increase in the aggregate level of aid.
MadingleyR: An R package for mechanistic ecosystem modelling
Authors: Hoeks Selwyn , Tucker Marlee A. , Huijbregts Mark A. J. , Harfoot Mike B. J. , Bithell Mike , Santini Luca
Published: July 2021

Aim

Mechanistic general ecosystem models are used to explore fundamental ecological dynamics and to assess possible consequences of anthropogenic and natural disturbances on ecosystems. The Madingley model is a mechanistic general ecosystem model (GEM) that simulates a coherent global ecosystem, consisting of photo‐autotrophic and heterotrophic life, based on fundamental ecological processes. The C++ implementation of the Madingley model delivers fast computational performance, but it (a) limits the userbase to researchers that are familiar with the intricacies of C++ programming, (b) has limited possibility to change model settings and provide model outputs required to address specific research questions, and (c) has limited reproducibility of simulation experiments. The aim of this paper is to present an R package of the Madingley model to aid with increasing the accessibility and flexibility of the model.

Innovation

The MadingleyR R package streamlines the installation procedure and supports all major operating systems. MadingleyR enables users to combine multiple consecutive simulations, making case study specific modifications to MadingleyR objects along the way. Default input files are available from the package and study‐specific inputs can be easily loaded from the R environment. MadingleyR also provides functions to plot and summarize MadingleyR outputs. We provide a comprehensive description of the MadingleyR functions and workflow. We also demonstrate the applicability of the MadingleyR package using three case studies: (a) simulating the cascading effects of the loss of mega‐herbivores on food‐web structure, (b) simulating the impacts of increased land‐use intensity on the total biomass of different feeding guilds by restricting the total vegetation biomass available for feeding and (c) simulating the impacts of an intensive land‐use scenario on a continental scale.

Main conclusions

The MadingleyR package provides direct accessibility to simulations with the mechanistic ecosystem model Madingley and is flexible in its application without a loss in performance.
Telehealth model of care for outpatient inflammatory bowel disease care in the setting of the COVID‐19 pandemic
Authors: Shah Rushab , Wright Emily , Tambakis George , Holmes Jacinta , Thompson Alexander , Connell William , Lust Mark , Niewiadomski Ola , Kamm Michael , Basnayake Chamara , Ding John
Published: July 2021

Background

Advances in inflammatory bowel disease (IBD) monitoring, greater number of available treatments and a shift towards tight disease control, IBD care has become more dynamic with regular follow ups.

Aims

We assessed the impacts of the COVID‐19 pandemic on outpatient IBD patient care at a tertiary centre in Melbourne. More specifically, we assessed patient satisfaction with a telehealth model of care, failure to attend rates at IBD clinics and work absenteeism prior to and during the pandemic.

Methods

We conducted a retrospective, qualitative analysis to assess our aims through an online survey. We invited patients who attended an IBD outpatient clinic from April to June 2020 to participate. This study was conducted at a single, tertiary referral hospital in Melbourne. The key data points that we analysed were patient satisfaction with a telehealth model of care and the effect of telehealth clinics on work absenteeism.

Results

One hundred and nineteen (88.1%) patients were ‘satisfied’ or ‘very satisfied’ with the care received in the telehealth clinic. Eighty‐four (60.4%) patients reported needing to take time off work to attend a face‐to‐face appointment, compared to 29 (20.9%) patients who needed to take time off work to attend telehealth appointments (P < 0.001). Clinic non‐attendance rates were similar prior to and during the pandemic with rates of 11.4% and 10.4% respectively (P = 0.840).

Conclusions

Patients report high levels of satisfaction with a telehealth model of care during the COVID‐19 pandemic, with clinic attendance rates not being affected. Telehealth appointments significantly reduced work absenteeism when compared to traditional face‐to‐face clinics.
Supporting cancer care clinicians to ‘hold’ their patients during and beyond the COVID‐19 pandemic: a role for reflective ethics discussions
Authors: Delany Clare , Benhamu Joanne , McDougall Rosalind , Ko Danielle , Jones Hayley , Mileshkin Linda , Largey Geraldine , Clinch Alex , Heynemann Sarah
Published: July 2021

The COVID‐19 pandemic has placed an overwhelming burden on healthcare delivery globally. This paper examines how COVID‐19 has affected cancer care clinicians' capacity to deliver cancer care in the Australian context. We use the lens of ‘holding patients’ (drawing from attachment theory, psychology and from Australian Indigenous knowledge) to conceptualise cancer clinicians' processes of care and therapeutic relationships with patients. These notions of ‘holding’ resonate with the deep responsibility cancer care clinicians feel towards their patients. They enrich ethical language beyond duties to benefit, avoid harm, respect patients' autonomy and provide just treatment. We consider the disruptive effects of COVID‐19 on care delivery and on clinicians themselves. We then show how models of clinical ethics and other similar reflective discussion approaches are a relevant support mechanism to assist clinicians to process and make sense of COVID‐19's disruptions to their professional ethical role of holding patients during and beyond the pandemic.
Dysphagia: clinical evaluation and management
Authors: Selvanderan Shane , Wong Stephanie , Holloway Richard , Kuo Paul
Published: July 2021

Dysphagia is a common problem affecting all ages. It is increasing in frequency particularly among the younger population due to the rising incidence of eosinophilic oesophagitis, a condition which often leads to acute presentation to hospital for the first time with food bolus obstruction requiring endoscopic removal. Careful history taking remains the first and most important step in evaluating dysphagia, and it is especially important to distinguish an oropharyngeal versus oesophageal origin, which helps to guide further investigation and therapy. The three main investigations for dysphagia remain endoscopy, barium study and manometry, with endoscopy also offering therapeutic potential. Management is largely determined by the eventual diagnosis, often in a multi‐disciplinary setting.
Peutz–Jeghers syndrome complicated by gastric‐type cervical mucinous carcinoma and primary peritoneal carcinoma
Authors: Kotaka Saki , Kanno Kiyoshi , Yanai Shiori , Omori Masako , Andou Masaaki
Published: July 2021

A 45‐year‐old multiparous woman with a STK11 mutation and a history of Peutz–Jeghers syndrome underwent radical hysterectomy and bilateral salpingo‐oophorectomy for a gastric‐type cervical mucinous carcinoma. Four and a half years later, blood tests revealed elevations in CEA and CA125 tumor marker levels, and computed tomography showed multiple calcifications in the peritoneum. Peritoneal dissemination was suspected, and a laparoscopic biopsy was performed. Histopathology showed a high‐grade serous carcinoma, and the patient was diagnosed with a metachronous stage IIIC primary peritoneal carcinoma. She had no BRCA1/2 mutation. After chemotherapy with docetaxel, carboplatin, and bevacizumab, she achieved complete remission.
Feed digestibility, digesta passage and faecal microbial biomass in desert‐adapted goats exposed to mild water restriction
Authors: Ramadhan M. R. , Schlecht E. , Dickhoefer U. , Mahgoub O. , Joergensen R. G.
Published: July 2021

In arid and semi‐arid environments, extensively managed ruminants regularly experience drinking water shortage, especially in the dry season. The present study therefore investigated the effects of mild drinking water restriction on feed intake, feed digestibility, solid digesta passage and composition of faeces including faecal microbial biomass. A feeding trial was conducted in Oman, during the dry summer months.

Nine adult male Batinah goats were subjected to three watering regimes in a 3 × 3 Latin Square design. Treatments were (1) water offered ad libitum (100%, W100); (2) water restricted to 85% ad libitum consumption (W85); and (3) water restricted to 70% ad libitum consumption (W70). Animals were offered Rhodes grass hay and whole barley grains (1:1 ratio) at 1.3 times maintenance energy requirements. Each of the three experimental periods comprised 16 days of adaptation and 8 days of measurements. During the latter, feed offered and refused as well as faeces were sampled and quantified. Gastrointestinal digesta passage was determined using ytterbium‐labelled Rhodes grass hay. Ergosterol and amino sugars were used as markers for faecal microbial biomass, that is the sum of fungi and bacteria. Water restriction had no effect on feed intake and digesta passage. However, feed dry matter, organic matter and fibre digestibility increased (p < 0.05) in W70 compared with W85, and the excreted amount of faecal dry matter, organic matter, nitrogen and neutral detergent fibre decreased (p < 0.05) in W70 compared with W85. Even though water restriction did not affect total faecal microbial biomass carbon (C) concentration, that of fungal biomass C increased (p < 0.05) in W70 compared with W85. Therefore, mild water restriction seems unproblematic from a physiological and nutrient utilization perspective as it increases feed digestibility without compromising feed intake.
Why do readers fail to notice word transpositions, omissions, and repetitions? A review of recent evidence and theory
Authors: Huang Kuan‐Jung , Staub Adrian
Published: July 2021

Most readers have had the experience of initially failing to notice an omission or repetition of a function word, or a transposition of two adjacent words. In the present article, we review recent research investigating this phenomenon. We emphasize that failure to notice such errors is of substantial theoretical interest, given what we have learned about how systematically and incrementally readers inspect and process text. We endorse the idea that a process of rational inference may play a critical role, while we cast doubt on the idea that failure to notice errors arises from parallel processing of multiple words. We review a number of recent studies from our own laboratory that have investigated the relationship between eye movements during reading and noticing, or failing to notice, an error. While the conclusions from these studies are broadly consistent with a rational inference account, we find that when readers fail to notice an error, their eye movements generally show no indication that the error was registered at all. On its surface, this finding may be viewed as inconsistent with the idea that the rational inference process that enables readers to overlook errors is genuinely post‐perceptual. We suggest a mechanism by which eye movement control models could account for this finding.
Weak transport for non‐convex costs and model‐independence in a fixed‐income market
Authors: Acciaio Beatrice , Beiglböck Mathias , Pammer Gudmund
Published: July 2021

We consider a model‐independent pricing problem in a fixed‐income market and show that it leads to a weak optimal transport problem as introduced by Gozlan et al. We use this to characterize the extremal models for the pricing of caplets on the spot rate and to establish a first robust super‐replication result that is applicable to fixed‐income markets. Notably, the weak transport problem exhibits a cost function which is non‐convex and thus not covered by the standard assumptions of the theory. In an independent section, we establish that weak transport problems for general costs can be reduced to equivalent problems that do satisfy the convexity assumption, extending the scope of weak transport theory. This part could be of its own interest independent of our financial application, and is accessible to readers who are not familiar with mathematical finance notation.
Constraints on the origins of iron silicide spherules in ultrahigh‐temperature distal impact ejecta
Authors: Batovrin Sergei , Lipovsky Boris , Gulbin Yury , Pushkarev Yury , Shukolyukov Yury A.
Published: July 2021

Terrestrially occurring iron silicide spherules, described in the geological literature for 160 years as cosmogenic and approved as “extraterrestrial” minerals by IMA CNMMN in 1984, so far have escaped any serious examination by meteoriticists. Our isotopic and REE data, obtained for silicide spherules for the first time, disagree with the meteoritic origin of gupeiite (Fe3Si) and xifengite (Fe5Si3) spherules from two continents. Despite departures from terrestrial norms (87Rb/86Sr—0.0174; 87Sr/86Sr—0.700181; 3He/4He—7.57 × 10−6; 40Ar/36Ar—325.9), the compositions of 143Nd/144Nd (0.512034) and 147Sm/144Nd (0.06357), as well as REE abundances, clarify provenance from upper crust sediments for samples with U/Pb age of 121–314 ka from the Ala‐Tau range in the Urals. However, the morphology of flanged button shapes, ring waves, and eccentro‐radiating ridges reliably constrains the origin of silicide spherules to distal meteoritic impact ejecta. Arc jet ablation experiments have previously demonstrated that similar morphologies, observed on australite tektites, reflect aerodynamic ablation rates corresponding to flight velocities well into orbital range. These features are generally accepted as conclusive evidence for hypervelocity atmospheric entry from space. Internal structure, consistent with accretion through the coalescence of 3–5 µm droplets, and composition, closely corresponding to 1893–1154 K span of C‐type condensation sequences, indicate a high probability of processing through recondensation of ejecta vapor.
Identification of the novel HLA‐DRB1*11:271 allele by next‐generation sequencing
Authors: You Xuan , He Yanmin , Tao Sudan , He Ji , Zhu Faming
Published: July 2021

HLA‐DRB1*11:271 differs from HLA‐DRB1*11:01:01:01 by a single nucleotide substitution at position 610G > A.
Seed germination dynamics of silverleaf nightshade (Solanum elaeagnifolium Cav.) and implications for effective weed management
Authors: Turner Nathaniel Jacob , Sanchez Jacobo , Vavra Cody , Dhaliwal Lakhvir K. , Emendack Yves , Coldren Cade , Angeles‐Shim Rosalyn B.
Published: July 2021

Silverleaf nightshade (Solanum elaeagnifolium Cav.) is a noxious weed that threatens agricultural productivity and biodiversity worldwide. The long‐term management of soil seedbanks along with the aboveground populations of silverleaf nightshade has the potential to effectively control the species in its introduced range. Implementation of this strategy requires insights into the germination behavior of the weed in response to various environmental stimuli and endogenous cues. We assessed the morphology and germination of silverleaf nightshade seeds from an agricultural farm, native rangelands, and an urban site in Texas, USA. The effects of growth substrate, phytohormones, and salt treatments on seed germination were also evaluated to identify potential stimulus that can be used to manipulate germination in the species. Results of the study showed that silverleaf nightshade seeds from the agricultural farm were the largest, while those from the Littlefield rangeland were the smallest. Seeds collected from the urban site and agricultural farm have higher germination rates than those sampled from the rangelands. Compared to domesticated crops, silverleaf nightshade seeds require longer imbibition time. Seed germination was better in potting mix than in sand or combined potting mix and sand and was significantly reduced by salt and abscisic acid treatments. Overall, results of the study highlight the crucial role of local environments in conditioning the transgenerational adaptation of species, particularly with respect to germination. Recommendations for silverleaf nightshade control are presented based on the observed variations in the germination behavior of populations within specific ranges.
An Experimental Study of the Effect of Particle Shape on Force Transmission and Mobilized Strength of Granular Materials
Authors: Marteau Eloïse , Andrade José E.
Published: July 2021

Force chains have been regarded as an important hallmark of granular materials. Numerous studies have examined their evolution, properties, and statistics in highly idealized, often circular-shaped, granular assemblies. However, particles found in nature and handled in industries come in a wide variety of shapes. In this article, we experimentally investigate the robustness of force chains with respect to particle shape. We present a detailed analysis on the particle- to continuum-scale response of granular materials affected by particle shape, which includes the force transmission and mobilized shear strength. The effect of shape is studied by comparing experimental results collected from shear tests performed on 2D analog circular- and arbitrarily shaped granular assemblies. Particle shapes are directly discretized from X-ray CT images of a real sand sample. By inferring individual contact forces using the granular element method (GEM), we provide a direct visualization of the force network, a statistical characterization of the force transmission and a quantitative description of the shear strength in terms of rolling, sliding, and interlocking contact mechanisms. We report that force chains are less prevalent in assemblies of arbitrarily-shaped particles than in circular-shaped samples. Furthermore, interlocking is identified as the essential contact mechanism that (1) furnishes a stable structure for force chains to emerge and (2) explains the enhanced shear strength observed in the arbitrarily-shaped samples. These findings highlight the importance of accounting for particle shape to capture and predict the complex mechanical behavior of granular materials across scales.
Si-capping-induced surface roughening on the strip structures of Ge selectively grown on an Si substrate
Authors: Katamawari Riku , Kawashita Kazuki , Hizawa Takeshi , Ishikawa Yasuhiko
Published: July 2021

Si-capping-induced surface roughening, accompanying Si–Ge alloying, is reported for strip structures of Ge selectively grown on Si via ultrahigh vacuum chemical vapor deposition. A 0.7-μm-wide strip structure of Ge running in the [110] direction, as well as a 100-μm-wide mesa structure, is selectively grown on an Si (001) surface exposed in an SiO2-masked Si substrate. In contrast to a wide mesa structure with a Ge thickness of 0.5 μm, composed of a (001) plane at the top and {113} facet planes at the sidewalls, the (001) top plane almost disappears for the narrow strip structure. The strip is mainly surrounded with inclined {113} planes near the top and adjacent {111} planes at the side, while the structure near the bottom edges depends on the growth temperature (600/700 °C). An Si cap layer with a thickness of 10 nm or larger is subsequently grown at 600 °C to protect the fragile Ge surface. The scanning electron microscopy observations reveal a roughened surface on the {113} planes, with depressions specifically induced near the boundary with the {111} planes. The Raman spectra indicate that an SiGe alloy is formed on the strip and the wide mesa sidewalls due to the Si–Ge interdiffusion. There is no such SiGe alloy on the (001) plane of the wide mesa top. The Si cap layer with a misfit strain probably works as a stressor for the underlying Ge, applying stress concentrated around the facet boundaries and inducing a mass transport alongside the Si–Ge interdiffusion for strain relaxation. In terms of the fabrication of practical devices, it is important to suppress the roughening and alloying significantly by decreasing the growth temperature for the Si cap layer from 600 to 530 °C.
Phenyl-Lactic Acid Is an Active Ingredient in Bactericidal Supernatants of Lactobacillus crispatus
Authors: Abdul-Rahim Omar , Wu Qihao , Price Travis K. , Pistone Giuseppe , Diebel Katherine , Bugni Tim S. , Wolfe Alan J.
Published: July 2021

Although
Lactobacillus crispatus
is an established commensal microbe frequently used in probiotics, its protective role in the bladder microbiome has not been clarified. We report here that some urinary isolates of
L. crispatus
exhibit bactericidal activity, primarily due to its ability to excrete phenyl-lactic acid into its environment.
Supplemental Material: Neogene volcanism on the eastside of Mount Diablo, Contra Costa County, California
Authors: Sullivan Raymond , al. et
Published: July 2021

Geochemical and radiometric analyses. Table S1: 40Ar/39Ar analytical data for Marsh Creek and Perkins Canyon intrusions; Table S2: Single-grain plateau and isochron results; Table S3: 40Ar/39Ar analytical data from sample 343.
Educational disparities in hypertension, diabetes, obesity and smoking in Brazil: a trend analysis of 578 977 adults from a national survey, 2007–2018
Authors: Dulgheroff Pedro Toteff , da Silva Luciana Saraiva , Rinaldi Ana Elisa Madalena , Rezende Leandro F. M. , Marques Emanuele Souza , Azeredo Catarina Machado
Published: July 2021

Objectives

Our study aimed to assess social inequality trends for hypertension, diabetes mellitus, smoking and obesity from 2007 to 2018 in adults from Brazilian capitals.

Setting

Data from the Surveillance of Risk and Protection Factors for Chronic Diseases by Telephone Survey study, a cross-sectional telephone survey, conducted annually from 2007 to 2018.

Participants

We used data from 578 977 Brazilian adults (≥18 years).

Design

Cross-sectional surveys conducted annually from 2007 to 2018.

Primary outcome measures

Participants responded to a questionnaire about medical diagnosis of hypertension and diabetes, smoking status, weight and height. Educational inequalities (0–3, 4–8, 9–11 and 12 or more years of study) by sex and skin colour were assessed trough absolute, Slope Index of Inequality (SII) and relative measures of inequality, Concentration Index and trends were tested by Prais-Winsten.

Results

All outcomes were more prevalent in the least educated. The largest absolute educational inequality was observed for hypertension (SIItotal=−37.8 in 2018). During 2007–2018, the total educational disparity remained constant for hypertension, increased for diabetes and smoking, and decreased for obesity. Overall, inequality was higher among women and non-whites, compared with men and whites. We found a reduction in absolute inequality for hypertension among non-whites, an increase for diabetes in all strata, and an increase for smoking in women and non-whites. The relative inequality decreased in women and whites and increased for smoking in all strata, except among men.

Conclusion

The educational inequality reduced for obesity, remained constant for hypertension and increased for diabetes and smoking from 2007 to 2018 in Brazilian adults.
Group Pregnancy Care for refugee background women: a codesigned, multimethod evaluation protocol applying a community engagement framework and an interrupted time series design
Authors: Riggs Elisha , Yelland Jane , Mensah Fiona K , Gold Lisa , Szwarc Josef , Kaplan Ida , Small Rhonda , Middleton Philippa , Krastev Ann , McDonald Ellie , East Christine , Homer Caroline , Nesvadba Natalija , Biggs Laura , Braithwaite Jeffrey , Brown Stephanie J
Published: July 2021

Introduction

Pregnancy and early parenthood are key opportunities for interaction with health services and connecting to other families at the same life stage. Public antenatal care should be accessible to all, however barriers persist for families from refugee communities to access, navigate and optimise healthcare during pregnancy. Group Pregnancy Care is an innovative model of care codesigned with a community from a refugee background and other key stakeholders in Melbourne, Australia. Group Pregnancy Care aims to provide a culturally safe and supportive environment for women to participate in antenatal care in a language they understand, to improve health literacy and promote social connections and inclusion. This paper outlines Froup Pregnancy Care and provides details of the evaluation framework.

Methods and analysis

The evaluation uses community-based participatory research methods to engage stakeholders in codesign of evaluation methods. The study is being conducted across multiple sites and involves multiple phases, use of quantitative and qualitative methods, and an interrupted time series design. Process and cost-effectiveness measures will be incorporated into quality improvement cycles. Evaluation measures will be developed using codesign and participatory principles informed by community and stakeholder engagement and will be piloted prior to implementation.

Ethics and dissemination

Ethics approvals have been provided by all six relevant authorities. Study findings will be shared with communities and stakeholders via agreed pathways including community forums, partnership meetings, conferences, policy and practice briefs and journal articles. Dissemination activities will be developed using codesign and participatory principles.
Cohort profile: a national, population-based cohort of children born after assisted conception in the UK (1992–2009): methodology and birthweight analysis
Authors: Purkayastha Mitana , Roberts Stephen A , Gardiner Julian , Brison Daniel R , Nelson Scott M , Lawlor Deborah , Luke Barbara , Sutcliffe Alastair
Published: July 2021

Purpose

To generate a large cohort of children born after assisted reproductive technology (ART) in the UK between 1992 and 2009, their naturally conceived siblings (NCS) and matched naturally conceived population (NCP) controls and linking this with health outcome data to allow exploration of the effects of ART. The effects of fresh and frozen embryo transfer on birth weight (BW) were analysed to test the validity of the cohort.

Participants

Children recorded on the Human Fertilisation and Embryology Authority (HFEA) register as being born after ART between 1992 and 2009, their NCS and matched NCP controls linked to Office for National Statistics birth registration dataset (HFEA-ONS cohort). This cohort was further linked to the UK Hospital Episode Statistics database to allow monitoring of the child’s post-natal health outcomes up to 2015 (HFEA-ONS-HES subcohort).

Findings to date

The HFEA-ONS cohort consisted of 75 348 children born after non-donor ART carried out in the UK between 1 April 1992 and 31 July 2009 and successfully linked to birth registration records, 14 763 NCS and 164 823 matched NCP controls. The HFEA-ONS-HES subcohort included 63 877 ART, 11 343 NCS and 127 544 matched NCP controls further linked to health outcome data. The exemplar analysis showed that children born after fresh embryo transfers were lighter (BW difference: −131 g, 95% CI: −140 to –123) and those born after frozen embryo transfers were heavier (BW difference: 35 g, 95% CI: 19 to 52) than the NCP controls. The within-sibling analyses were directionally consistent with the population control analyses, but attenuated markedly for the fresh versus natural conception (BW difference: −54 g; 95% CI: −72 to –36) and increased markedly for the frozen versus natural conception (BW difference: 152 g; 95% CI: 113 to 190) analyses.

Future plans

To use this cohort to explore the relationship between ART conception and short-term and long-term health outcomes in offspring.
Three dimensional echocardiography documents haemodynamic improvement by biventricular pacing in patients with severe heart failure
Authors: Kim W Y , Søgaard P , Mortensen P T , Jensen H Kjærulf , Pedersen A Kirstein , Kristensen B Ø , Egeblad H
Published: July 2021

OBJECTIVES

To quantify the short term haemodynamic effects of biventricular pacing in patients with heart failure and left bundle branch block by using three dimensional echocardiography.

DESIGN

Three dimensional echocardiography was performed in 15 consecutive heart failure patients (New York Heart Association functional class III or IV) with an implanted biventricular pacing system. Six minute walk tests were performed to investigate the effect of biventricular pacing on exercise capacity. Data were acquired at sinus rhythm and after short term (2–7 days) biventricular pacing.

RESULTS

Compared with baseline values, biventricular pacing significantly reduced left ventricular end diastolic volume (EDV) by mean (SD) 4.0 (5.1)% (p < 0.01) and end systolic volume (ESV) by 5.6 (6.4)% (p < 0.02). Mitral regurgitant fraction was significantly reduced by 11 (12.1)% (p < 0.003) and forward stroke volume (FSV) increased by 13.9 (18.6)% (p < 0.02). Exercise capacity was significantly improved with biventricular pacing by 48.4 (43.3)% (p < 0.00001). Regression analyses showed that the percentage increase in FSV independently predicted percentage improvement in walking distance (r2 = 0.73, p < 0.0002). Both basal QRS duration and QRS narrowing predicted pacing efficacy, showing a significant correlation with %ΔEDV, %ΔESV, and %ΔFSV.

CONCLUSIONS

In five of 15 consecutive patients with heart failure and left bundle branch block, biventricular pacing induced a more than 15% increase in FSV, which predicted a more than 25% increase in walking distance and was accompanied by an immediate reduction in left ventricular chamber size and mitral regurgitation.
Short early filling deceleration time on day 1 after acute myocardial infarction is associated with short and long term left ventricular remodelling
Authors: Otašević P , Nešković A N , Popović Z , Vlahović A , Bojić D , Bojić M , Popović A D
Published: July 2021

OBJECTIVE

To assess the relations between early filling deceleration time, left ventricular remodelling, and cardiac mortality in an unselected group of postinfarction patients.

DESIGN AND PATIENTS

Prospective evaluation of 131 consecutive patients with first acute myocardial infarction. Echocardiography was performed on day 1, day 2, day 3, day 7, at three and six weeks, and at three, six, and 12 months after infarction. According to deceleration time on day 1, patients were divided into groups with short (< 150 ms) and normal deceleration time (⩾ 150 ms).

SETTING

Tertiary care centre.

RESULTS

Patients with a short deceleration time had higher end systolic and end diastolic volume indices and a higher wall motion score index, but a lower ejection fraction, in the year after infarction. These patients also showed a significant increase in end diastolic (p < 0.001) and end systolic volume indices (p = 0.007) during the follow up period, while ejection fraction and wall motion score index remained unchanged. In the group with normal deceleration time, end diastolic volume index increased (p < 0.001) but end systolic volume index did not change; in addition, the ejection fraction increased (p = 0.002) and the wall motion score index decreased (p < 0.001). One year and five year survival analysis showed greater cardiac mortality in patients with a short deceleration time (p = 0.04 and p = 0.02, respectively). In a Cox model, which included initial ejection fraction, infarct location, and infarct size, deceleration time on day 1 was the only significant predictor of five year mortality.

CONCLUSIONS

A short deceleration time on day 1 after acute myocardial infarction can identify patients who are likely to undergo left ventricular remodelling in the following year. These patients have a higher one year and five year cardiac mortality.
Endovascular stents in the management of coarctation of the aorta in the adolescent and adult: one year follow up
Authors: Harrison D A , McLaughlin P R , Lazzam C , Connelly M , Benson L N
Published: July 2021

OBJECTIVES

To test the hypothesis that endovascular stents used with dilation of coarctation of the aorta (CoA) improve late outcomes. Balloon dilation for CoA has been limited by concerns over the risk for acute dissection, late restenosis, or aneurysm formation.

DESIGN

All patients seen with CoA between November 1994 and September 1997 underwent attempted stent implantation. Follow up was obtained for all patients and a subgroup (n = 18) had repeat catheterisation at a mean (SD) of 1.3 (0.5) years to assess residual gradient and stent-CoA morphology.

RESULTS

Stents were placed in 27 patients (15 male and 12 female patients, mean age 30.1 (13.1) years), of whom seven had prior surgical coarctectomy and one had a prior balloon dilation. Hypertension was present in 26 patients (mean pressure 164 (26)/86 (13) mm Hg), of whom 16 were on antihypertension drugs. CoA gradients were 46 (20) mm Hg (range 18–106 mm Hg) at baseline and 3 (5) mm Hg after the procedure. One patient had a stroke following the procedure; another patient had incomplete dilation and underwent a second procedure. At 1.8 (1) years after the procedure the mean pressure was 130 (14)/74 (11) mm Hg with seven patients on antihypertension treatment. The clinical gradient was 4 (8) mm Hg (range 0–32 mm Hg). At follow up angiography, the mean gradient was 4(6) mm Hg, and two patients had a gradient over 10 mm Hg. Aneurysms formed in three patients at the dilation site; one patient was referred for surgery.

CONCLUSION

In this age group stent management for CoA appears to be an effective technique and results in sustained reduction in CoA gradients at early term follow up, but aortic aneurysm was detected in 17% of patients who had repeat angiography.
β2 Adrenergic receptors mediate important electrophysiological effects in human ventricular myocardium
Authors: Lowe M D , Rowland E , Brown M J , Grace A A
Published: July 2021

OBJECTIVE

To define the effects of β2 adrenergic receptor stimulation on ventricular repolarisation in vivo.

DESIGN

Prospective study.

SETTING

Tertiary referral centre.

PATIENTS

85 patients with coronary artery disease and 22 normal controls.

INTERVENTIONS

Intravenous and intracoronary salbutamol (a β2 adrenergic receptor selective agonist; 10–30 μg/min and 1–10 μg/min), and intravenous isoprenaline (a mixed β1/β2adrenergic receptor agonist; 1–5 μg/min), infused during fixed atrial pacing.

MAIN OUTCOME MEASURES

QT intervals, QT dispersion, monophasic action potential duration.

RESULTS

In patients with coronary artery disease, salbutamol decreased QTonset and QTpeak but increased QTend duration; QTonset–QTpeak and QTpeak–QTend intervals increased, resulting in T wave prolongation (mean (SEM): 201 (2) ms to 233 (2) ms; p < 0.01). There was a large increase in dispersion of QTonset, QTpeak, and QTend which was more pronounced in patients with coronary artery disease—for example, QTend dispersion: 50 (2) ms baselinev 98 (4) ms salbutamol (controls), and 70 (1) ms baseline v 108 (3) ms salbutamol (coronary artery disease); p < 0.001. Similar responses were obtained with isoprenaline. Monophasic action potential duration at 90% repolarisation shortened during intracoronary infusion of salbutamol, from 278 (4.1) ms to 257 (3.8) ms (p < 0.05).

CONCLUSIONS

β2adrenergic receptors mediate important electrophysiological effects in human ventricular myocardium. The increase in dispersion of repolarisation provides a mechanism whereby catecholamines acting through this receptor subtype may trigger ventricular arrhythmias.
Long axis excursion in aortic stenosis
Authors: Takeda S , Rimington H , Smeeton N , Chambers J
Published: July 2021

OBJECTIVES

To examine long axis excursion in patients with all grades of aortic stenosis and preserved transverse systolic function, and to compare long axis excursion in symptomatic with that in asymptomatic severe aortic stenosis.

DESIGN

Prospective comparative study.

SETTING

Regional cardiothoracic centre.

PATIENTS

78 patients with all grades of aortic stenosis and normal fractional shortening and ejection fraction were studied. There were two comparison groups, 10 age matched normal subjects and 14 patients with aortic stenosis and fractional shortening < 26%.

METHODS

Aortic valve function and left ventricular mass were assessed echocardiographically. M mode measurements of long axis excursion at the septal and lateral sides of the mitral annulus were taken.

RESULTS

There were significant differences between the groups in long axis excursion at both the septal (p < 0.0001) and lateral sides of the mitral annulus (p = 0.002 by analysis of variance). Long axis excursion was independently related to both left ventricular mass index (p = 0.001) and the grade of aortic stenosis (p = 0.002). Comparing patients with severe aortic stenosis with and without symptoms, there were significant differences in effective orifice area (p = 0.02 ) and long axis excursion at the lateral side of the mitral annulus (p = 0.04), but not in fractional shortening, ejection fraction, or peak or mean pressure difference.

CONCLUSION

In patients with aortic stenosis, long axis excursion is reduced even in the presence of normal fractional shortening or ejection fraction. It is lower in patients with symptomatic compared with asymptomatic severe aortic stenosis and may be of use in predicting the onset of symptoms.
Left sided arrhythmogenic ventricular dysplasia in siblings
Authors: De Pasquale C G , Heddle W F
Published: July 2021

A 32 year old man with no previous medical history suffered a sudden cardiac death. Post mortem examination revealed circumferential fibro-fatty infiltration of the left ventricular myocardium. Histological appearance was characteristic of arrhythmogenic right ventricular dysplasia but unusual for its localisation only to the left ventricle. As a result of this sudden cardiac death the family of the deceased was screened for cardiac disease. A brother of the index case was 36 years old and free of cardiac history and symptoms. Cardiac investigations revealed a functionally and electrically abnormal left ventricle with apparent sparing of the right ventricle. The brothers may have a left sided form of arrhythmogenic ventricular dysplasia and illustrate the importance of screening family members of young victims of sudden cardiac death.