bluuebunny/crossref_metadata_2025 huggingface dataset:
Linking visual gamma to task‐related brain networks—a simultaneous EEG‐fMRI study
Authors: Beldzik Ewa , Domagalik Aleksandra , Beres Anna , Marek Tadeusz
Published: August 2019

There is a growing interest in human gamma‐band oscillatory activity due to its direct link to neuronal populations, its associations with many cognitive processes, and its positive relationship with fMRI BOLD signal. Visual gamma has been successfully detected using concurrent EEG‐fMRI recordings and linked to activity in the visual cortex using voxel‐wise regression analysis. As gamma‐band oscillations reflect predominantly feedforward projections between brain regions, its inclusion in functional connectivity analysis is highly recommended; however, very few studies have investigated this line of research. In the current study, we aimed to explore this gap by asking which fMRI brain network is related to gamma activity induced by the color discrimination task. Advanced denoising strategies and multitaper spectral decomposition were applied to EEG data to detect gamma oscillations, and group independent component analysis was performed on fMRI data to identify task‐related neural networks. Despite using only trials without motor response (50% of the trials), the two neural measures were successfully coupled. One of the six task‐related networks, the occipito‐parietal network, exhibited significant trial‐by‐trial covariations with gamma oscillations. In addition to the expected extrastriate visual cortex, the network encompasses extensive brain activations in the precuneus, bilateral intraparietal, and anterior insular cortices. We argue that the visual cortex is the source of gamma, whereas the remaining brain regions exhibit feedforward and feedback connections related to this oscillatory activity. Our findings provide evidence for the electrophysiological basis of the connectivity revealed by BOLD signal and impart novel insights into the neural mechanism of color discrimination.
The impact of 0.2% chlorhexidine gel on oral health and the incidence of pneumonia amongst adults with profound complex neurodisability
Authors: Prasad Ria , Daly Blanaid , Manley Graham
Published: August 2019

Aims

Investigate the effect of toothbrushing with 0.2% chlorhexidine gel on oral health and pneumonia amongst patients with a neurodisability who are fed via percutaneous endoscopic gastrostomy.

Method

Forty‐nine patients at the Royal Hospital for Neuro‐disability were recruited to an observational study. Daily toothbrushing with 0.2% chlorhexidine gel was undertaken for 12 months by trained nursing staff. Plaque and gingival health were assessed every six weeks using the Simplified Debris Index and the Basic Periodontal Examination. The annual incidence and prevalence of episodes of pneumonia experienced by patients whilst using the chlorhexidine gel were compared to rates from the previous year.

Results

Plaque levels and the proportion of patients with periodontal pocketing > 3.5 mm significantly reduced, P < .001, with chlorhexidine toothbrushing. Total number of pneumonia episodes (75‐67), antibiotics administered (73‐64), and radiographs taken (19 to 16) were lower in the year wherein chlorhexidine was employed, and hospitalisations dropped by 31% (16‐11), but these reductions were not statistically significant. No adverse events were reported.

Conclusion

Daily toothbrushing with 0.2% chlorhexidine undertaken by a trained and supported nursing staff was effective in improving oral health but did not significantly affect annual rates of pneumonia amongst patients.
Exploring dyadic teacher–child interactions, emotional security, and task engagement in preschool children displaying externalizing behaviors
Authors: Alamos Pilar , Williford Amanda P.
Published: August 2019

Based on attachment theory, we tested whether the link between dyadic teacher–child interactions and task engagement operates through a child's security with the teacher. In a sample of preschoolers (N = 470) rated by their teachers as exhibiting elevated disruptive behaviors, the quality of dyadic teacher–child interactions and children's security were observed using a standardized task. Children's engagement with tasks was both observed in the preschool classroom and rated by the teacher. Results indicated that the quality of teacher–child dyadic interactions was associated directly with teacher‐reported task engagement, and indirectly associated, through a child's security, with observed task engagement. We discussed the contribution of these findings to our understanding of how the quality of dyadic teacher–child interactions may serve to regulate children's behavior in the classroom for children whose teachers perceive them as displaying early externalizing behaviors.
Phylogenetic relationships and phylogeography of the genus Sinocyrtaspis Liu, 2000 (Orthoptera: Tettigoniidae: Meconematinae) reveal speciation processes related to climate change
Authors: Wang Tao , Zhu Qidi , Heller Klaus‐Gerhard , Zhou Zhijun , Shi Fuming
Published: August 2019

Species of Sinocyrtaspis Liu inhabit moist montane environments in south China, and occur allopatrically in restricted regions without overlapping areas. This study presents the first phylogeny of Sinocyrtaspis based on one nuclear DNA sequence [partial ITS1‐5.8S rDNA‐ITS2 (ITS)] as well as two mitochondrial genes [cytochrome oxidase subunit I (COI) and cytochrome b (CYTB)] using Bayesian inference and maximum likelihood. In addition, reconstructing the ancestral geographical range on the basis of the combined genes and distribution information, MaxEnt modelling was used to predict potential distribution areas in the Last Glacial Maximum (LGM), the mid‐Holocene, the present‐day and in the year 2070, in order to understand speciation processes and responses to climate change in this genus. The phylogenetic analyses supported the monophyly of Sinocyrtaspis. The results of species delimitation confirmed seven Sinocyrtaspis species and that the speciation events mainly occurred in the late Miocene to early Pliocene when the climate became colder and drier. The conclusions of the phylogeographical analysis are as follows: (i) the centres of origin of Sinocyrtaspis were Hunan and north‐east Guangxi; (ii) two dispersal routes became obvious with the final destinations of Jiangxi and Zhejiang, respectively; (iii) after the Miocene cooling period, the ancestor species partly remained in Guizhou and partly spread; (iv) as a response to climate change, species altered distribution areas by moving along altitude gradients in mountain regions, whereas the anthropogenic global warming trend has promoted some species moving to high‐latitude areas or caused population differentiation.
Immune dysregulation and osteosarcoma: Staphylococcus aureus downregulates TGF‐β and heightens the inflammatory signature in human and canine macrophages suppressed by osteosarcoma
Authors: Tuohy Joanne L. , Somarelli Jason A. , Borst Luke B. , Eward William C. , Lascelles B. Duncan X. , Fogle Jonathan E.
Published: August 2019

Since William Coley utilized bacterial immunotherapy to treat sarcomas in the late 19th century, an association between infection and improved survival has been reported for human and canine osteosarcoma patients. One of the reasons for this improved survival is likely a reactivation of the host immune system towards an inflammatory anti‐tumour response, and one of the key players is the macrophage. Yet, despite their importance, the response of macrophages to infectious agents in the context of osteosarcoma has not been thoroughly evaluated. The aim of this study was to evaluate how in vitro exposure to a bacterial agent (Staphylococcus aureus) influenced canine and human macrophage differentiation in the presence of osteosarcoma. Our hypothesis was that S. aureus would, in the presence of osteosarcoma, induce a macrophage phenotype with significantly increased inflammatory signatures. Consistent with our hypothesis, human macrophages co‐cultured with osteosarcoma and S. aureus exhibited increased IFN‐γ, TNF‐α and IL‐12p70 cytokine secretion, decreased TGF‐β cytokine secretion and increased mRNA expression of TNF‐α when compared with macrophages co‐cultured with osteosarcoma and to macrophages cultured alone. Canine macrophages similarly exhibited increased IFN‐γ and TNF‐α cytokine secretion, decreased TGF‐β cytokine secretion, increased mRNA expression of TNF‐α and increased surface receptor expression of CD80 when co‐cultured with osteosarcoma and S. aureus. Collectively, the findings of this study suggest that infection upregulates the inflammatory immune response to counteract osteosarcoma‐induced immune suppression. This work informs a potential therapeutic strategy to optimize inflammatory stimuli for triggering an anti‐osteosarcoma macrophage response.
Synthesis of nanosized amorphous and nanocrystalline TiO2 for photochemical oxidation of methomyl insecticide in aqueous media
Authors: Tony Maha A. , Mansour Shehab A.
Published: August 2019

Aqueous solution loaded with methomyl insecticide is photocatalytically treated upon UV radiation and TiO2 in a green sustainable oxidation technique. TiO2 is a highly promising photocatalytic oxidation method, whereas the main findings is increasing the surface area for maximizing the treatment efficiency. Herein, TiO2 was synthesized via sonochemical hydrolysis technique and amorphous TiO2 (TM100) was obtained. Further, annealing of amorphous TiO2 at 500 ºC resulting in anatase phase TiO2 (TN500). The phase structure of the both samples was confirmed by high‐resolution transmission electron microscope (HR‐TEM). The results revealed that the materials exhibited high methomyl removal efficiency due to its nanostructure nature. The optimum TM100 and TN500 for the treatment were 40 and 20 mg/L and resulted in 99.5 and 100% methomyl removal, respectively. Furthermore, pH and H2O2 effect were studied. Additionally, high correlation was attained between empirical and modelled values with a second‐order kinetic model for the two processes.
The contribution of low‐frequency fatigue to the loss of quadriceps contractile function following repeated drop jumps
Authors: Kamandulis Sigitas , Muanjai Pornpimol , Skurvydas Albertas , Brazaitis Marius , Sniečkus Audrius , Venckūnas Tomas , Streckis Vytautas , Mickeviciene Dalia , Jones David A.
Published: August 2019

New Findings

What is the central question of this study?

Why do some subjects recover slowly following a bout of eccentric exercise and why is recovery faster following a repeated bout?

What is the main finding and its importance?

The results are consistent with two major causes of the reduction of quadriceps torque, the onset of low‐frequency fatigue which recovered relatively fast and a second, delayed form of damage. Differences in the delayed damage process largely accounted for the differences in the rate of torque recovery between subjects after a first bout and it was suppression of the delayed damage which accounted for the faster recovery following a repeated bout of eccentric exercise.

The purpose of this study was to determine the extent to which low‐frequency fatigue (LFF) accounts for the loss of quadriceps strength and time course of recovery following a series of drop jumps (DJs). Seventeen female subjects (20.8 ± 1.4 years) undertook 100 DJs, which were repeated 4 weeks later. Maximum isometric torque (MIT) and the ratio of torque generated by 20 and 100 Hz electrical stimulation (20/100), as a measure of LFF, were measured over 7 days following each series of DJs. After the first series the 20/100 ratio fell to a greater extent than MIT (to 35 ± 8.7% and 69 ± 11%, respectively) but recovered over 2–3 days, while MIT showed little recovery over this time. Changes of the 20/100 ratio were similar between subjects with fast or slow MIT recovery. Following the second series of DJs, changes in the 20/100 ratio were similar to those of the first bout and there were no differences between fast and slow recovering subjects. MIT, however, recovered more rapidly than after the first bout; the faster recovery was confined to the subjects who recovered slowly following the first bout. The results are consistent with two major causes of the reduction of quadriceps torque, the onset of low‐frequency fatigue which recovered relatively fast and a second, delayed, form of damage. The latter largely accounted for the differences in MIT recovery between subjects after the first bout, while suppression of the delayed damage accounted for the faster recovery following the repeated bout.
Cranial endocast of a stem platyrrhine primate and ancestral brain conditions in anthropoids
Authors: Ni Xijun , Flynn John J. , Wyss André R. , Zhang Chi
Published: August 2019

A 20-Ma-old monkey skull from the Andes Mountains establishes that large and gyrificated brains evolved repeatedly in anthropoids.
Draft Genome Sequences of 14
Lactobacillus
,
Enterococcus
, and
Staphylococcus
Isolates from the Nasopharynx of Healthy Feedlot Cattle
Authors: Amat Samat , Holman Devin B. , Timsit Edouard , Gzyl Katherine E. , Alexander Trevor W.
Published: August 2019

Here, we present the first draft genome sequences of 14 bacterial strains isolated from the nasopharynx of healthy feedlot cattle. These genomes are from 12
Lactobacillus
isolates (
L. amylovorus
,
L. buchneri
,
L. curvatus
, and
L. paracasei
), 1
Enterococcus hirae
isolate, and 1
Staphylococcus chromogenes
isolate.
Demand for health services and drug prescriptions among overweight or obese preschool children
Authors: Ortiz-Pinto Maira Alejandra , Ortiz-Marrón Honorato , Esteban-Vasallo María D , Quadrado-Mercadal Agueda , Casanova-Pardomo Dayami , González-Alcón Marta , Ordobás-Gavin María , Galán Iñaki
Published: August 2019

Objectives

To evaluate the association between excess weight and the demand of health services in preschool children compared with healthy weight.

Methods

The data come from the Longitudinal Study of Childhood Obesity cohort (1884 4-year-old children, residing in the Madrid region, Spain) who provided information through telephone questionnaire, physical examination and electronic medical records. We defined overweight, general and abdominal obesity based on body mass index, waist circumference and waist-to-height ratio. Using mixed models of multivariable negative binomial regression we calculated the incidence rate ratio (IRR) regarding primary care (PC) doctor visits, drug prescriptions and hospital admissions by weight status at the end of the 2-year follow-up.

Results

Childhood general obesity was associated with a higher demand for PC services related to psychological problems (IRR=1.53; 95% CI 1.02 to 2.28) and childhood abdominal obesity, according to waist-to-height ratio, was related to more frequent problems of the musculoskeletal system (IRR=1.27; 95% CI 1.00 to 1.62). Drugs were prescribed more frequently to children falling under all three definitions of excess weight, compared with healthy weight children. No differences in the number of hospital admissions were observed.

Conclusions

The demand of health services related to early childhood obesity was small. Nevertheless, obesity was associated with a slightly greater demand for drug prescriptions and for PC doctor visits related to psychological and musculoskeletal problems.
Necrotising fasciitis complicating hand, foot and mouth disease
Authors: Smith Clara , Scott John
Published: August 2019

A literature search confirmed no previous cases of necrotising fasciitis (NF) complicating hand,foot and mouth disease (HFMD). This report explores the case of a previously well 55-week-old Caucasian boy who attended accident and emergency with an acutely swollen right hand and atypical viral rash affecting the hands and face. He was admitted under plastic surgery and treated with intravenous antibiotics and fluid resuscitation for sepsis secondary to cellulitis. Following dermatological review of the rash, a clinical diagnosis of atypical HFMD was made. He deteriorated over the first 12 hours with progression of cellulitis despite intervention. Emergency exploration and debridement were performed for suspected NF. NF was subsequently confirmed by laboratory testing. He required 5 days in paediatric intensive care but made a full recovery. Recent reports highlight an increase in atypical cases of HFMD. Clinicians should be aware of the potential for superadded necrotising infection in cases of atypical HFMD.
Ectopic adrenocorticotrophic hormone syndrome (EAS) with phaeochromocytoma: a challenging endocrine case with a happy ending
Authors: Wan Muhamad Hatta Sharifah Faradila , Lekkakou Leoni , Viswananth Ananth , Buch Harit
Published: August 2019

Ectopic adrenocorticotropic hormone (ACTH) syndrome (EAS) is rarely caused by a phaeochromocytoma. We report a case of a 51-year-old woman with an 8-year history of severe constipation who underwent extensive investigations including gastroscopy, colonoscopy, ultrasonography, colonic transit studies and isotope defeacography, which did not reveal any pathology other than slow colonic transit time. The unifying diagnosis of ectopic ACTH and phaeochromocytoma was made after the case was initially investigated for an adrenal incidentaloma. Multiple challenges had to be overcome prior to surgery for the functioning adrenal adenoma including management of refractory hypokalaemia, poor nutritional status, persistent hyperglycaemia, labile blood pressure and florid hypercortisolaemia driving the metabolic derangements. She underwent an uneventful left-sided adrenalectomy and required no medication thereafter with normal blood pressure, blood glucose and serum potassium and resolution of constipation and abdominal symptoms. In conclusion, patients with EAS related to phaeochromocytoma are rare and present with distinctive diagnostic and management challenges but if diagnosed successfully and managed intensively, they are curable.
Long-term outcome of scleral-sutured posterior chamber intraocular lens: a case series
Authors: Bausili Portabella Maria Montserrat , Nadal Jeroni , Alvarez de Toledo Juan , Fideliz de la Paz María , Barraquer Rafael Ignacio
Published: August 2019

Purpose

Purpose: To evaluate the long-term stability of scleral-sutured intraocular lenses (IOLs) and analyse the possible causes of suture breakage.

Setting

Barraquer Institute in Barcelona, Spain.

Design

Retrospective study of consecutive cases.

Methods

Study of patients with scleral-sutured IOL with aphakia, subluxated or luxated IOL were included. Follow-up was longer than 6 months and patients over 18 years of age. Preoperative data (best-corrected visual acuity testing (BCVA), intraocular pressure (IOP), axial length and slit-lamp examination), intraoperative data (characteristics of the scleral flaps, suture material (Prolene or Mersilene) and scleral-sutured IOL) and postoperative data (BCVA, IOP, slit-lamp examination and complications) through 10 years were collected for analysis.

Results

345 consecutive cases of scleral-sutured IOL were included. 25 eyes underwent a second operation after a prior sutured IOL due to suture breakage (mean 40.2±39.6 months after the first surgery) and three of them needed a third surgery. Younger adults (less than 40-year old), the use of a combination of Prolene and Mersilene sutures to perform the surgery and suturing only one flap were found to have higher risk of suture breakage after a follow-up of 10 years. The probability of surviving of the scleral-sutured IOL at 10 years after surgery was 0.79.

Conclusions

Scleral-sutured posterior chamber IOL in eyes with a lack of capsular support is a safe and effective procedure with a low rate of complication and stable visual acuity. Further studies with special focus on young adults or myopic eyes are required to demonstrate long-term safety in those special cases.
Multifactorial interventions for preventing falls in older people living in the community: a systematic review and meta-analysis of 41 trials and almost 20 000 participants
Authors: Hopewell Sally , Copsey Bethan , Nicolson Philippa , Adedire Busola , Boniface Graham , Lamb Sarah
Published: August 2019

Objective

To assess the longer term effects of multifactorial interventions for preventing falls in older people living in the community, and to explore whether prespecific trial-level characteristics are associated with greater fall prevention effects.

Design

Systematic review with meta-analysis and meta-regression.

Data sources

MEDLINE, EMBASE, CINHAL, CENTRAL and trial registries were searched up to 25 July 2018.

Study selection

We included randomised controlled trials (≥12 months’ follow-up) evaluating the effects of multifactorial interventions on falls in older people aged 65 years and over, living in the community, compared with either usual care or usual care plus advice.

Review methods

Two authors independently verified studies for inclusion, assessed risk of bias and extracted data. Rate ratios (RaR) with 95% CIs were calculated for rate of falls, risk ratios (RR) for dichotomous outcomes and standardised mean difference for continuous outcomes. Data were pooled using a random effects model. The Grading of Recommendations, Assessment, Development and Evaluation was used to assess the quality of the evidence.

Results

We included 41 trials totalling 19 369 participants; mean age 72–85 years. Exercise was the most common prespecified component of the multifactorial interventions (85%; n=35/41). Most trials were judged at unclear or high risk of bias in ≥1 domain. Twenty trials provided data on rate of falls and showed multifactorial interventions may reduce the rate at which people fall compared with the comparator (RaR 0.79, 95% CI 0.70 to 0.88; 20 trials; 10 116 participants; I2=90%; low-quality evidence). Multifactorial interventions may also slightly lower the risk of people sustaining one or more falls (RR 0.95, 95% CI 0.90 to 1.00; 30 trials; 13 817 participants; I2=56%; moderate-quality evidence) and recurrent falls (RR 0.88, 95% CI 0.78 to 1.00; 15 trials; 7277 participants; I2=46%; moderate-quality evidence). However, there may be little or no difference in other fall-related outcomes, such as fall-related fractures, falls requiring hospital admission or medical attention and health-related quality of life. Very few trials (n=3) reported on adverse events related to the intervention. Prespecified subgroup analyses showed that the effect on rate of falls may be smaller when compared with usual care plus advice as opposed to usual care only. Overall, heterogeneity remained high and was not explained by the prespecified characteristics included in the meta-regression.

Conclusion

Multifactorial interventions (most of which include exercise prescription) may reduce the rate of falls and slightly reduce risk of older people sustaining one or more falls and recurrent falls (defined as two or more falls within a specified time period).

Trial registration number

CRD42018102549.
Referral transit time between sending and first-line receiving health facilities: a geographical analysis in Tanzania
Authors: Schmitz Michelle M , Serbanescu Florina , Arnott George E , Dynes Michelle , Chaote Paul , Msuya Abdulaziz Ally , Chen Yi No
Published: August 2019

Background

Timely, high-quality obstetric services are vital to reduce maternal and perinatal mortality. We spatially modelled referral pathways between sending and receiving health facilities in Kigoma Region, Tanzania, identifying communication and transportation delays to timely care and inefficient links within the referral system.

Methods

We linked sending and receiving facilities to form facility pairs, based on information from a 2016 Health Facility Assessment. We used an AccessMod cost-friction surface model, incorporating road classifications and speed limits, to estimate direct travel time between facilities in each pair. We adjusted for transportation and communications delays to create a total travel time, simulating the effects of documented barriers in this referral system.

Results

More than half of the facility pairs (57.8%) did not refer patients to facilities with higher levels of emergency obstetric care. The median direct travel time was 25.9 min (range: 4.4–356.6), while the median total time was 106.7 min (22.9–371.6) at the moderate adjustment level. Total travel times for 30.7% of facility pairs exceeded 2 hours. All facility pairs required some adjustments for transportation and communication delays, with 94.0% of facility pairs’ total times increasing.

Conclusion

Half of all referral pairs in Kigoma Region have travel time delays nearly exceeding 1 hour, and facility pairs referring to facilities providing higher levels of care also have large travel time delays. Combining cost-friction surface modelling estimates with documented transportation and communications barriers provides a more realistic assessment of the effects of inter-facility delays on referral networks, and can inform decision-making and potential solutions in referral systems within resource-constrained settings.
Electronic palliative care coordination system (EPaCCS) in practice: A useful tool?
Authors: Millares Martin Pablo
Published: August 2019

Objectives

First, to assess if Electronic Palliative Care Coordination Systems (EPaCCS) was used by different organisations as a tool to share information; second, to assess whether there was a measurable benefit with patients dying at their preferred place of death.

Methods

A retrospective analysis of the 65 decedents from last 12 months in the registered list of a single practice in Leeds was conducted.

Results

EPaCCS was present in 24 patients (36.9%). It was used by more than one organisation in 17 cases (70.9%). It facilitated death at the preferred place in 19 of the 20 cases (95%) were preferences were recorded.

Conclusions

EPaCCS within the organisation was not used as widely as it could have been presumed. Having a patient with an EPaCCS in the electronic medical records did not imply there was sharing of information among the different organisations involved. Although there was a clear impact on individuals dying at their preferred place of death, preferences were not necessarily recorded in EPaCCS.
Psychological knowledge production about abortion: the politics of location and representation
Authors: Macleod Catriona Ida , Mavuso Jabulile Mary-Jane Jace , Chiweshe Malvern , du Toit Ryan
Published: August 2019

Background

Despite considerable psychology research being conducted on abortion, there has been no study of the history of psychological knowledge production on the topic. The aim of our research was to analyse journal articles published in English language psychology journals using a politics of location and of representation analytical lens.

Study design

A systematic search for articles published on abortion in psychology journals from 1960 to 2015 was conducted. A mixed-method approach (content analysis and narrative review) was used to analyse the dataset. Articles were coded according to: decade of publication, region, types of research conducted, and main issues focused on. A narrative review of the dominant issue researched – psychological consequences – in two decades (the 1970s and 2000s) was conducted.

Results

Knowledge production began in the 1970s in most regions featured in the dataset and in the 1990s in South Africa. Research is dominated by quantitative studies conducted in North America and Europe concerning the demarcation of psychological consequences of abortion performed under safe conditions. In the 1970s, abortion was viewed as leading to benign psychological consequences, but by the 2000s traumatology talk was firmly entrenched. Only one article, emanating from South Africa, addressed the question of unsafe abortion.

Conclusions

Knowledge production in psychology needs to move beyond a narrow focus on the psychological consequences of abortion and attitudes to abortion. Nuanced, contextualised research of the psychology of both safe and unsafe abortion is necessary.
Impact of self-administration of misoprostol for early medical abortion: a prospective observational cohort study
Authors: Finch Rebecca Elizabeth , McGeechan Kevin , Johnstone Anne , Cameron Sharon
Published: August 2019

Introduction

In October 2017, Scotland legalised the home use of misoprostol for the purpose of early medical abortion (EMA). Women up to 9+6 weeks’ gestation can now self-administer the drug at home, 24–48 hours after receiving mifepristone in the clinic.

Objective

To evaluate the impact of this change on the uptake and success rate of EMA, and on the provision of effective contraception on discharge.

Methods

A prospective observational study was conducted to compare the outcomes of two cohorts of women in the 6 months before and 6 months after the introduction of home administration of misoprostol. The main outcome measures were uptake of EMA, success of EMA and provision of long-acting reversible contraception (LARC) to women undergoing EMA.

Results

There was a statistically significant increase in the uptake of EMA from 698/1075 (64.9%) women in the first study period to 823/1146 (71.8%) in the second study period. There was no statistically significant difference in the success rate of EMA: 99.3% and 98.9% in clinic and home misoprostol cohorts, respectively. There was also no statistically significant difference in the proportion of women provided with LARC: 37.7% and 33.7% in clinic and home misoprostol cohorts, respectively.

Conclusions

Self-administration of misoprostol at home increased uptake of EMA, with no effect on the high success rate that was previously seen with clinic administration of misoprostol. In addition, the reduced number of visits associated with home use of misoprostol has not affected the provision of effective contraception to women.
Practice pattern variability in the management of acute severe colitis: a UK provider survey
Authors: Sebastian Shaji , Lisle Jessica , Subramanian Sreedhar , Dhar Anjan , Shenoy Achut , Limdi Jimmy , Butterworth Jeffrey , Allen Patrick B , Samuel Sunil , Moran Gordon , Shenderey Richard , Parkes Gareth , Raine Tim , Lobo Alan J , Kennedy Nicholas A
Published: August 2019

Introduction

Lack of comparative trial data on dosing regimens of infliximab in patients with acute severe ulcerative colitis (ASUC) failing intravenous corticosteroids has resulted in variability of rescue regimes in ASUC with potential impact on clinical outcomes. We aimed to evaluate practice variability and physician perspectives in decision-making with rescue therapy.

Methodology

An internet-based survey of members of the inflammatory bowel disease (IBD) section of the British Society of Gastroenterology was conducted. The survey evaluated provider characteristics and general practice in the setting of ASUC, followed by a vignette with linked questions.

Results

The response rate of the survey was 31% (209/682 IBD section members). 134 (78%) reported they would use standard infliximab dose (5 mg/kg) while 37 (22%) favoured a higher front-loading dose of 10 mg/kg citing low albumin, high C-reactive protein as their reason for their preference. IBD specialists chose the higher front-loading dose more often compared with other gastroenterologists (p=0.01) In the specific case vignette, accelerated induction (AI) was favoured by 51% of the respondents while 25% used the standard induction regime and 19% favoured colectomy. IBD specialists more often favoured AI compared with other gastroenterologists (p=0.03) with the main reason being presence of predictors of low infliximab levels (74%). The reasons cited for favouring standard induction (n=57) included lack of evidence for AI (18), their usual practice (11), unlicensed regime (7), and safety concerns (4).

Conclusions

There are significant variations in practice in the use of infliximab rescue therapies with an urgent need for development of care pathways to standardise practice.
Cardiorespiratory fitness and heart rate recovery predict sudden cardiac death independent of ejection fraction
Authors: Hernesniemi Jussi A , Sipilä Kalle , Tikkakoski Antti , Tynkkynen Juho T , Mishra Pashupati P , Lyytikäinen Leo-Pekka , Nikus Kjell , Nieminen Tuomo , Lehtimaki Terho , Kähönen Mika
Published: August 2019

Objective

To evaluate whether cardiorespiratory fitness (CRF) and heart rate recovery (HRR) associate with the risk of sudden cardiac death (SCD) independently of left ventricular ejection fraction (LVEF).

Methods

The Finnish Cardiovascular Study is a prospective clinical study of patients referred to clinical exercise testing in 2001–2008 and follow-up until December 2013. Patients without pacemakers undergoing first maximal or submaximal exercise testing with cycle ergometer were included (n=3776). CRF in metabolic equivalents (METs) was estimated by achieving maximal work level. HRR was defined as the reduction in heart rate 1 min after maximal exertion. Adjudication of SCD was based on death certificates. LVEF was measured for clinical indications in 71.4% of the patients (n=2697).

Results

Population mean age was 55.7 years (SD 13.1; 61% men). 98 SCDs were recorded during a median follow-up of 9.1 years (6.9–10.7). Mean CRF and HRR were 7.7 (SD 2.9) METs and 25 (SD 12) beats/min/min. Both CRF and HRR were associated with the risk of SCD in the entire study population (HRCRF0.47 (0.37–0.59), p<0.001 and HRHRR0.57 (0.48–0.67), p<0.001 with HR estimates corresponding to one SD increase in the exposure variables) and with CRF, HRR and LVEF in the same model (HRCRF0.60 (0.45–0.79), p<0.001, HRHRR0.65 (0.51–0.82), p<0.001) or adjusting additionally for all significant risk factors for SCD (LVEF, sex, creatinine level, history of myocardial infarction and atrial fibrillation, corrected QT interval) (HRCRF0.69 (0.52–0.93), p<0.01, HRHRR0.74 (0.58–0.95) p=0.02).

Conclusions

CRF and HRR are significantly associated with the risk of SCD regardless of LVEF.
Compound heterozygous mutations identified in severe type I protein S deficiency impaired the secretion of protein S
Authors: Zhou Jingyi , Shen Wenyan , Gu Yi , Li Min , Shen Wei
Published: August 2019

Aims

Hereditary protein S (PS) deficiency is one of the natural anticoagulant deficiencies causing thrombophilia. We herein described a young male with recurrent deep venous thrombosis, who was diagnosed as type I PS deficiency with compound heterozygous mutations ofPROS1gene. We aimed to analyse the relationship between the genotype and phenotype detection and investigate the pathological mechanisms ofPROS1mutations causing PS deficiency.

Methods

Genetic analysis ofPROS1gene was carried out by direct sequencing. Thrombin generation potential and the inhibition function of thrombin generation by plasma PS were detected by thrombin generation test (TGT). The mRNA transcription level of mutant PS in vitro was measured by real-time PCR, while the protein level was evaluated by western blot and ELISA. Cellular distribution of the protein was further analysed by immunofluorescence.

Results

Compound heterozygous mutations (PROS1c.1551_1552delinsG, p.Thr518Argfs*39 andPROS1c.1681C>T, p.Arg561Trp) were identified in the propositus, and the former one was a novel small indel mutation. TGT results showed impaired inhibition of thrombin generation with the addition of activated protein C in his parents with certain heterozygous mutations. In vitro expression study, p.Thr518Argfs*39 mutant produced truncated protein retained in the cytoplasm, while p.Arg561Trp mutant partially affected the secretion of PS. Both mutations are located in C-terminal sex hormone-binding globulin (SHBG)-like domain of PS.

Conclusions

Compound heterozygous mutations identified in the study have strong detrimental effect, causing severe type I PS deficiency in the propositus. SHBG-like domain of PS might play an important role in PS secretion system.
Correlation of the quantitative level of MGMT promoter methylation and overall survival in primary diagnosed glioblastomas using the quantitative MethyQESD method
Authors: von Rosenstiel Charlotte , Wiestler Benedikt , Haller Bernhard , Schmidt-Graf Friederike , Gempt Jens , Bettstetter Marcus , Rihani Laura , Wu Wei , Meyer Bernhard , Schlegel Jürgen , Liesche-Starnecker Friederike
Published: August 2019

Aims

O(6)-methylguanine-DNA-methyltransferase (MGMT) promoter methylation is a high predictive factor for therapy results of temozolomide in patients with glioma. The objective of this work was to analyse the impact of MGMT promoter methylation in patients with primary diagnosed glioblastoma (GBM) relating to survival using a quantitative method (methylation quantification of endonuclease-resistant DNA, MethyQESD) by verifying a cut-off point for MGMT methylation provided by the literature (</≥10%) and calculating an optimal cut-off.

Methods

67 patients aged 70 years or younger, operated between January 2013 and December 2015, with newly diagnosed IDH wild-type GBM and clinical follow-up were retrospectively investigated in this study. A known MGMT promoter methylation status was the inclusion criteria.

Results

Median overall survival (OS) was 16.9 months. Patients who had a methylated MGMT promoter region of ≥10% had an improved OS compared with patients with a methylated promoter region of <10% (p=0.002). Optimal cut-off point for MGMT promoter methylation was 11.7% (p=0.012).

Conclusion

The results confirm that the quantitative level of MGMT promoter methylation is a positive prognostic factor in newly diagnosed patients with GBM. The cut-off provided by the literature (</≥10%) and the calculated optimal cut-off value of 11.7% give a statistically significant separation. Hence, MethyQESD is a reliable method to calculate MGMT promoter methylation in GBM.
Effects of bilateral stimulation of the subthalamic nucleus in Parkinson's disease with and without REM sleep behaviour disorder
Authors: Bargiotas Panagiotis , Debove Ines , Bargiotas Ioannis , Lachenmayer Martin Lenard , Ntafouli Maria , Vayatis Nicolas , Schüpbach Michael WM , Krack Paul , Bassetti Claudio L
Published: August 2019

Background

Although rapid eye movement sleep behaviour disorder (RBD) in Parkinson’s disease (PD) is associated with increased non-motor symptoms, its impact on the deep brain stimulation (DBS) outcome remains unclear. This is the first study to compare the post-DBS outcome between PD patients with RBD (PD-RBD+) and without (PD-RBD-).

Methods

We analysed data from PD patients who were treated with bilateral DBS in the nucleus subthalamicus. Assessments included night-polysomnography (only pre-DBS), and motor and non-motor assessments pre-DBS and post-DBS.

Results

Among 50 PD patients (29 males, mean age 62.5 years, 11.8 mean PD years), 24 (48%) had RBD. Pre-DBS, the two groups were equal in respect to sociodemographic features, disease duration and PD medications. A multivariate analysis showed that the clinical profile linked to motor, non-motor and quality of life features differed significantly between PD patients with and without RBD. The most discriminative elements were Unified Parkinson’s Disease Rating Scale (UPDRS)-III, apathy and depression scores. Post-DBS, UPDRS-III, Epworth sleepiness scale and PD questionnaire improved significantly in both groups. UPDRS-II scores significantly improved in the PD-RBD+ group (−45%) but remained unchanged in the PD-RBD- group (−14%). The depression score improved significantly in the PD-RBD+ (−34%) and remained unchanged in the PD-RBD- group. The apathy score remained unchanged in the PD-RBD+ group but increased significantly in the PD-RBD- group (+33%).

Conclusion

While pre-DBS, PD patients with and without RBD showed different clinical profiles, post-DBS, the clinical profiles were comparable between the two groups. In respect to depressive symptoms, apathy and activities of daily living, PD-RBD+ patients show favourable post-DBS outcome. These findings highlight the importance of RBD assessment prior to DBS surgery.
Effect modification of the association between total cigarette smoking and ALS risk by intensity, duration and time-since-quitting: Euro-MOTOR
Authors: Peters Susan , Visser Anne E , D'Ovidio Fabrizio , Vlaanderen Jelle , Portengen Lützen , Beghi Ettore , Chio Adriano , Logroscino Giancarlo , Hardiman Orla , Pupillo Elisabetta , Veldink Jan H , Vermeulen Roel , van den Berg Leonard H
Published: August 2019

Background

We investigated the association between cigarette smoking and risk of amyotrophic lateral sclerosis (ALS) in a pooled analysis of population-based case–control studies and explored the independent effects of intensity, duration and time-since-quitting.

Methods

ALS cases and controls, matched by age, sex and region, were recruited in the Netherlands, Italy and Ireland (*Euro-MOTOR project). Demographics and detailed lifetime smoking histories were collected through questionnaires. Effects of smoking status, intensity (cigarettes/day), duration (years), pack-years and time-since-quitting (years) on ALS risk were estimated using logistic regression models, adjusting for age, sex, alcohol, education and centre. We further investigated effect modification of the linear effects of pack-years by intensity, duration and time-since-quitting using excess OR (eOR) models.

Results

Analyses were performed on 1410 cases and 2616 controls. Pack-years were positively associated with ALS risk; OR=1.26 (95% CI: 1.03 to 1.54) for the highest quartile compared with never smokers. This association appeared to be predominantly driven by smoking duration (ptrend=0.001) rather than intensity (ptrend=0.86), although the trend for duration disappeared after adjustment for time-since-quitting. Time-since-quitting was inversely related to ALS (ptrend<0.0001). The eOR decreased with time-since-quitting smoking, until about 10 years prior to disease onset. High intensity smoking with shorter duration appeared more deleterious than lower intensity for a longer duration.

Conclusions

Our findings provide further support for the association between smoking and ALS. Pack-years alone may be insufficient to capture effects of different smoking patterns. Time-since-quitting appeared to be an important factor, suggesting that smoking may be an early disease trigger.
Variation in anti-predator behaviors of white-tailed deer (Odocoileus virginianus) in a multi-predator system
Authors: Olson E.R. , Van Deelen T.R. , Ventura S.J.
Published: August 2019

Anti-predator responses to perceived predation risk can influence population demography. Understanding the relative effect of predator exposure and intraspecific interactions across a variety of anti-predator behaviors provides important insight into inter- and intra-specific drivers of species-specific behaviors. We merged classical behavioral observation methods with camera trapping techniques to examine anti-predator behaviors of white-tailed deer (Odocoileus virginianus (Zimmermann, 1780)) relative to variation in predator exposure and interspecific interactions. We coded 772 behavioral observations from >180 000 images spanning 605 trap-nights. Seasonal differences in behavioral responses to diminishing returns on foraging effort indicated that deer are risk-averse foragers and are more likely to exhibit risky behaviors in the presence of a concentrated food resource when the nutritional value of food resources are high. However, deer tended to spend less time at a site as resources diminished, supporting marginal value theories of habitat use. Intraspecific interaction predicted vigilance and the amount of time spent at a site. Similar to many other species, deer tended to be less vigilant and spend more time at a site as group size increased. Our research suggests that white-tailed deer in Wisconsin make foraging decisions based on factors associated with individual fitness, presence of conspecifics, and habitat characteristics.
Facial Expression Recognition Method Based on Improved VGG Convolutional Neural Network
Authors: Cheng Shuo , Zhou Guohui
Published: August 2019

Because the shallow neural network has limited ability to represent complex functions with limited samples and calculation units, its generalization ability will be limited when it comes to complex classification problems. The essence of deep learning is to learn a nonlinear network structure, to represent input data distributed representation and demonstrate a powerful ability to learn deeper features of data from a small set of samples. In order to realize the accurate classification of expression images under normal conditions, this paper proposes an expression recognition model of improved Visual Geometry Group (VGG) deep convolutional neural network (CNN). Based on the VGG-19, the model optimizes network structure and network parameters. Most expression databases are unable to train the entire network from the start due to lack of sufficient data. This paper uses migration learning techniques to overcome the shortage of image training samples. Shallow CNN, Alex-Net and improved VGG-19 deep CNN are used to train and analyze the facial expression data on the Extended Cohn–Kanade expression database, and compare the experimental results obtained. The experimental results indicate that the improved VGG-19 network model can achieve 96% accuracy in facial expression recognition, which is obviously superior to the results of other network models.
The canonical frame of purified gravity
Authors: Beltrán Jiménez Jose , Heisenberg Lavinia , Koivisto Tomi S.
Published: August 2019

In the recently introduced gauge theory of translations, dubbed Coincident General Relativity (CGR), gravity is described with neither torsion nor curvature in the spacetime affine geometry. The action of the theory enjoys an enhanced symmetry and avoids the second derivatives that appear in the conventional Einstein–Hilbert action. While it implies the equivalent classical dynamics, the improved action principle can make a difference in considerations of energetics, thermodynamics and quantum theory. This paper reports on possible progress in those three aspects of gravity theory. In the so-called purified gravity, (1) energy–momentum is described locally by a conserved, symmetric tensor, (2) the Euclidean path integral is convergent without the addition of boundary or regulating terms and (3) it is possible to identify a canonical frame for quantization.
MICROSTRUCTURE AND WEAR PROPERTY OF Ti/C MODIFIED LAYERS ON Ti–6Al–4V SUBSTRATE
Authors: MA DANDAN , MA YONG , FAN AILAN , WANG YONGSHENG , YU SHENGWANG , GAO JIE , HEI HONGJUN , TANG BIN
Published: August 2019

The Ti/C modified layers were prepared on Ti–6Al–4V alloy by double glow plasma surface alloying technique. The microstructure and composition of the modified layers were characterized by X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDS) and scanning electron microscopy (SEM). The bonding strength, micro-hardness and friction performance of the modified layers were examined by the scratch tester, micro-hardness tester, reciprocating wear tester, and white light interferometer. The results show that both of the microstructure and properties of the Ti/C modified layer get the remarkable effects when the temperature reaches 910∘C. Belonging to metallurgical bonding with the substrate, the modified layer possesses a continuous, compact and uniform packet-like particle structure. Compared with the Ti–6Al–4V substrate, the surface micro-hardness and wear resistance of Ti/C modified layer are significantly improved.
Classification of operator extensions, monad liftings and distributive laws for differential algebras and Rota–Baxter algebras
Authors: Zhang Shilong , Guo Li , Keigher William
Published: August 2019

Generalizing the algebraic formulation of the First Fundamental Theorem of Calculus (FFTC), a class of constraints involving a pair of operators was considered in [Extensions of operators, liftings of monads, and mixed distributive laws, Appl. Categ. Struct. 26 (2018) 747–765]. For a given constraint, the existences of extensions of differential and Rota–Baxter operators, of liftings of monads and comonads, and of mixed distributive laws are shown to be equivalent. In this paper, we give a classification of the constraints satisfying these equivalent conditions.