bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of renal and hepatic blood value screening before non‐steroidal anti‐inflammatory drug administration in dogs
Authors: Chalifoux N. V. , Kaiman G. , Drobatz K. J. , Thawley V. J.
Published: October 2020

Objectives

To evaluate the potential association between signalment, history and physical examination findings and elevated renal and hepatic blood values before non‐steroidal anti‐inflammatory drug administration in dogs. Secondary objectives were to investigate clinicopathologic differences between dogs that were and were not prescribed a non‐steroidal anti‐inflammatory drug.

Materials and Methods

Medical records of 81 dogs that underwent renal and hepatic blood value screening before drug administration via a non‐steroidal anti‐inflammatory drug blood panel were reviewed retrospectively. Patient signalment, history and physical examination findings were recorded.

Results

Six (7%) dogs had an elevated blood urea nitrogen, 2 (2%) dogs had an elevated creatinine, 24 (30%) dogs had an elevated alanine aminotransferase, 29 (36%) had an elevated aspartate aminotransferase and 14 (17%) had an elevated alkaline phosphatase. Forty‐five (56%) dogs had an elevation in at least 1 renal or hepatic blood value. Dogs less than 8 years of age and with a longer duration of clinical signs were less likely to have an elevated renal or hepatic blood value. Dogs with elevated hepatic blood values were less likely to be prescribed a non‐steroidal anti‐inflammatory drug; however, this was not true for elevated renal parameters alone.

Clinical Significance

The results of this preliminary study suggest that blood value screening before non‐steroidal anti‐inflammatory drug administration may be important for dogs greater than 8 years of age. Hepatic enzyme elevations may play a greater role in clinical decision making in comparison to renal parameters.
Longitudinal relations between sleep and cognitive functioning in children: Self‐esteem as a moderator
Authors: Saini Ekjyot K. , Gillis Brian T. , Elmore‐Staton Lori , Buckhalt Joseph A. , El‐Sheikh Mona
Published: October 2020

Short and poor‐quality sleep disrupt cognitive functioning, yet associations vary across studies, underscoring the importance of examining individual differences and moderators of risk. Utilizing a multi‐method, two‐wave longitudinal design, we examined self‐esteem as a moderator of relations between actigraphy‐derived sleep duration (minutes) and quality (efficiency, long‐wake episodes) and children's cognitive functioning 1 year later. During the first study wave (T1), participants were 243 children (47% female) with a mean age of 10.4 years (SD = 8.0 months). The sample was representative of its community, with 37% identifying as Black/African American and 63% White/European American. Children completed a self‐esteem measure and wore actigraphs for seven consecutive nights. Participants returned to the lab 1 year later and completed a standardized assessment of cognitive functioning. Results indicated that self‐esteem moderated longitudinal associations between sleep quality and cognitive functioning. Specifically, children with both better sleep quality and higher self‐esteem performed better relative to other children in the sample.
More than moving online: Implications of the COVID‐19 pandemic on curriculum development
Authors: Keegan David A. , Bannister Susan L.
Published: October 2020

With the dust settled, but not yet cleared, on initial adjustments to education during COVID‐19, 10 author groups offer reflections on next steps for 10 areas of practice.
Functional characterization of the HMP‐P synthase of Legionella pneumophila (Lpg1565)
Authors: Paxhia Michael D. , Swanson Michele S. , Downs Diana M.
Published: October 2020

The production of the pyrimidine moiety in thiamine synthesis, 2‐methyl‐4‐amino‐5‐hydroxymethylpyrimidine phosphate (HMP‐P), has been described to proceed through the Thi5‐dependent pathway in Saccharomyces cerevisiae and other yeast. Previous work found that ScThi5 functioned poorly in a heterologous context. Here we report a bacterial ortholog to the yeast HMP‐P synthase (Thi5) was necessary for HMP synthesis in Legionella pneumophila. Unlike ScThi5, LpThi5 functioned in vivo in Salmonella enterica under multiple growth conditions. The protein LpThi5 is a dimer that binds pyridoxal‐5′‐phosphate (PLP), apparently without a solvent‐exposed Schiff base. A small percentage of LpThi5 protein co‐purifies with a bound molecule that can be converted to HMP. Analysis of variant proteins both in vivo and in vitro confirmed that residues in sequence motifs conserved across bacterial and eukaryotic orthologs modulate the function of LpThi5.

Importance

Thiamine is an essential vitamin for the vast majority of organisms. There are multiple strategies to synthesize and salvage this vitamin. The predominant pathway for synthesis of the pyrimidine moiety of thiamine involves the Fe‐S cluster protein ThiC. An alternative pathway utilizes Thi5, a novel enzyme that uses PLP as a substrate. The Thi5‐dependent pathway is poorly characterized in yeast and has not been characterized in Bacteria. Here we demonstrate that a Thi5‐dependent pathway is necessary for thiamine biosynthesis in Legionella pneumophila and provide biochemical data to extend knowledge of the Thi5 enzyme, the corresponding biosynthetic pathway, and the role of metabolic network architecture in optimizing its function.
Frequent attenders' experiences of encounters with healthcare personnel: A systematic review of qualitative studies
Authors: Huhtakangas Moona , Tuomikoski Anna‐Maria , Kyngäs Helvi , Kanste Outi
Published: October 2020

Rather than measure demographic factors such as socioeconomics, the aim of this study was to examine the lived experience of frequent attenders by synthesizing findings on their encounters with healthcare personnel. The Scopus, CINAHL, PsycARTICLES, and PubMed (Medline) databases were searched in May 2020 in order to screen studies by title and abstract (n = 1794) and full‐text (n = 20). Findings from the included studies (n = 6) were then pooled using meta‐aggregation, yielding the following results: difficulties in resolving frequent attenders' situations may create “service circles,” frustrating patients with their situation; frequent attenders' own expertise regarding their condition should be recognized and valued alongside that of healthcare professionals when performing collaborative care; a lack of empathy and disparagement may make frequent attenders feel misunderstood and unappreciated; frequent attenders should be recognized as individuals by taking their circumstances into account and providing support accordingly. Frequent attenders' experiences demonstrate the importance of shared decision‐making, continuity of care, and acknowledging these patients' individual circumstances. Identifying the variety of frequent attenders' service needs by synthesizing their experiences is a practical way of organizing patient‐centered healthcare services.
Too noisy to sleep safely?—An observational study of noise levels and distractions during critical phases of pediatric anesthesia
Authors: Monaghan Myles , Abdelaal Ahmed Mahmoud M. Alkhatip Ahmed , Holmes Chris
Published: October 2020

Background

Noise and distraction are recognized as contributing factors in critical incidents associated with surgery and anesthesia. In addition, excessive noise exposure can have negative effects on patients and staff members in these environments.

Aims

We aimed to quantify noise exposure of the anesthesiology team and patients in pediatric operating theaters, comparing them to adult studies, internationally recognized standards, and identifying factors contributing to noise and/or distraction.

Methods

We measured noise levels during three phases of anesthesia (pre‐induction, induction, and postinduction/maintenance) and recorded additional environmental sources of distraction and noise.

Results

We included 49 theater cases. The median and interquartile range (IQR) of mean noise levels during pre‐induction, induction, and maintenance were 61 (59.7‐63.5), 61.9 (60.6‐63.3), and 61.6 (60.4‐63.7) dB, respectively, while the median (IQR) of maximal noise levels was 81.4 (77.3‐86.8), 83.7 (78.5‐87.4), and 86.3 (84.6‐90.4), respectively. There was an average of 8.3 people present in the room during induction. In 23 cases, there were additional unnecessary conversations occurring within the room at induction. We noted the maintenance phase was the noisiest phase of anesthesia. We recorded frequent potential sources of distraction during pre‐induction and induction, though no significant correlations between these distractions and recorded noise levels.

Conclusions

We documented noise levels well above recommended levels during all phases of pediatric anesthesia. We highlighted factors with potential to contribute to noise and distraction but found no statistically significant correlation with noise levels.
Inner bark as a crucial tissue for non‐structural carbohydrate storage across three tropical woody plant communities
Authors: Rosell Julieta A. , Piper Frida I. , Jiménez‐Vera Cipatli , Vergílio Paula C. B. , Marcati Carmen R. , Castorena Matiss , Olson Mark E.
Published: October 2020

Non‐structural carbohydrates (NSC) are crucial for forest resilience, but little is known regarding the role of bark in NSC storage. However, bark's abundance in woody stems and its large living fraction make it potentially key for NSC storage. We quantified total NSC, soluble sugar (SS) and starch concentrations in the most living region of bark (inner bark, IB), and sapwood of twigs, trunks and roots of 45 woody species from three contrasting tropical climates spanning global extremes of bark diversity and wide phylogenetic diversity. NSC concentrations were similar (total NSC, starch) or higher (SS) in IB than wood, with concentrations co‐varying strongly. NSC concentrations varied widely across organs and species within communities and were not significantly affected by climate, leaf habit or the presence of photosynthetic bark. Starch concentration tended to increase with density, but only in wood. IB contributed substantially to NSC storage, accounting for 17–36% of total NSC, 23–47% of SS and 15–33% of starch pools. Further examination of the drivers of variation in IB NSC concentration, and taking into account the substantial contribution of IB to NSC pools, will be crucial to understand the role of storage in plant environmental adaptation.
Five‐year survey uncovers extensive diversity and temporal fluctuations among fusarium head blight pathogens of wheat and barley in Brazil
Authors: Pereira Carolina B. , Ward Todd J. , Del Ponte Emerson M. , Mara Moreira Gláucia , Busman Mark , McCormick Susan P. , Feksa Heraldo R. , De Almeida Juliano L. , Tessmann Dauri J.
Published: October 2020

We conducted a five‐year survey (2011–2015) of barley and wheat fields in Paraná state, Brazil, obtaining 754 Fusarium isolates from spikes with fusarium head blight (FHB)‐symptoms. Multilocus genotyping and TEF‐1α gene sequence analyses confirmed the dominance of the F. graminearum species complex (FGSC, 75.7%), but F. poae (11.5%), as well as F. avenaceum and related members of the F. tricinctum species complex (FTSC, 8.1%) appeared as substantial contributors to FHB. Within the FGSC, F. graminearum of the 15‐ADON genotype was dominant (63%), followed by F. meridionale of the NIV genotype (23.1%), F. cortaderiae of the NIV (7%) or 3‐ADON (2.6%) genotypes, and F. austroamericanum (3.8%) of the 3‐ADON genotype. Substantial variation in pathogen composition was observed across years, with F. poae and F. meridionale frequencies significantly elevated in some years. Most F. poae strains produced DAS, diANIV, and butenolide, but not neosolaniol, T‐2, or HT‐2. All FTSC species produced moniliformin. Enniatin production was widespread among FTSC species, with the single F. acuminatum strain found to be the strongest producer of enniatins. Our findings confirm FGSC as a major contributor to FHB and expand considerably our knowledge of the presence, frequency, and conditions under which other pathogens may emerge, altering the spectrum of toxins that may accumulate in grain.
Brassinosteroids trigger tolerance to iron toxicity in rice
Authors: Tadaiesky Lorene B. A. , da Silva Breno R. S. , Batista Bruno Lemos , Lobato Allan K. da S.
Published: October 2020

Iron (Fe) toxicity is one of the most frequent abiotic stresses in rice, as it affects from 15% to 30% of the total production. Brassinosteroids (BRs), including 24‐epibrassinolide (EBR), regulate ion homeostasis and improve the antioxidant system. The aim of this research was to determine whether EBR can contribute to the tolerance of rice plants exposed to Fe toxicity and to evaluate the possible effect on anatomical characteristics, nutrient concentrations, the antioxidant system, and gas exchange. The experiment was randomized with four treatments, two with different concentrations of Fe (250 and 6250 μM, control and toxicity, respectively) and these were either supplied with EBR or not (0 and 10 nM EBR, described as −EBR and +EBR, respectively). Treating plants grown under Fe toxic conditions with EBR caused an 70% increase in root aerenchyma area, compared to plants without steroid treatment. Our results revealed that EBR treatment could mitigate the deleterious effects of Fe toxicity in rice plants, by modulating the aerenchyma area, which contributes to the formation of an oxidative barrier and reduce the Fe mobilization at the root surface. Plants that were exposed to Fe toxic concentrations and treated with EBR showed (1) an increase in the enzyme activities of superoxide dismutase, catalase, ascorbate peroxidase and peroxidase, (2) mitigation of oxidative damage and (3) increased scavenging of reactive oxygen species. Finally, EBR alleviated the negative impacts induced by excess Fe on the net photosynthetic rate and the instantaneous carboxylation efficiency. These benefits were directly related to higher electron transport and stomatal density and indirectly linked to the protection mechanism exercised by the antioxidant enzymes on photosynthetic machinery. We conclude that EBR is able to confer tolerance to Fe toxicity in rice plants.
Bacillus pumilus improved drought tolerance in Glycyrrhiza uralensis G5 seedlings through enhancing primary and secondary metabolisms
Authors: Zhang Xinhui , Xie Zhicai , Lang Duoyong , Chu Yuankui , Cui Gaochang , Jia Xiaoxia
Published: October 2020

It has been reported that drought stress adversely affects the growth and yield of Glycyrrhiza uralensis, Chinese liquorice, in agricultural production. Bacillus pumilus, an important plant growth‐promoting bacterium, play a significant role in improving plant tolerance to abiotic stress. However, the role of Bacillus pumilus G5 in resisting drought stress is largely unknown. In the present study, we found that drought stress significantly inhibited the growth and reduced the biomass of G. uralensis seedlings by restraining C‐ and N‐metabolism, while this could be effectively reversed by B. pumilus G5 inoculation. Specifically, B. pumilus G5 significantly increased the content of primary metabolites such as soluble sugar, soluble protein, and free amino acids by regulating the C and N metabolic processes in G. uralensis seedlings. Moreover, B. pumilus G5 increased the content of glycyrrhizic acid, one of the important secondary metabolites, likely mediated through the increased content of primary metabolites and by recovering the expression of three key enzymes, HMGR, SQS, and β‐AS, in the biosynthesis of glycyrrhizic acid. Interestingly, the regulating effect of B. pumilus G5 inoculation on promoting the accumulation of glycyrrhizic acid and increasing the expression of synthesis‐related genes is spatially selective. In summary, our findings suggest that B. pumilus G5 could alleviate adverse effects induced by drought stress on the growth of G. uralensis seedlings by regulating C‐ and N‐metabolisms that further triggered the accumulation of secondary metabolites, and this finally improved the drought tolerance of cultivated G. uralensis seedlings.
HbWRKY82, a novel IIc WRKY transcription factor from Hevea brasiliensis associated with abiotic stress tolerance and leaf senescence in Arabidopsis
Authors: Kang Guijuan , Yan Dong , Chen Xiaoli , Yang Lifu , Zeng Rizhong
Published: October 2020

WRKY group transcription factors of model plants and major crops are confirmed to play essential roles in stress responses, senescence, secondary metabolism processes and hormone signal transduction. Previous studies have identified 81 HbWRKY genes from Hevea brasiliensis (the Pará rubber tree), but the functions of HbWRKYs in response to abiotic stresses and leaf senescence are unclear. In this study, one novel group IIc WRKY transcription factor named HbWRKY82 was identified and characterized as a stress‐associated WRKY in rubber tree. Transient expression and transcriptional activation analyses indicated that HbWRKY82 encoded a nuclear protein and functioned as a transcription activator. The transcription levels of HbWRKY82 were induced by exogenous Ethrel (ET) (ethylene releaser) and abscisic acid (ABA) stimulations, down‐regulated in tapping panel dryness rubber trees, and also exhibits significant decrease during the progression of leaf senescence. Overexpression of HbWRKY82 in Arabidopsis improved the tolerance to dehydration and salinity, and decreased the sensitivity to exogenous ABA. Moreover, real‐time quantitative PCR analysis demonstrated that HbWRKY82 regulated the transcriptional expression of several stress‐responsive genes (DREB1A, ERD10, HKT1, P5CS, RD22, RD29B, SKOR), leaf senescence marker genes (EIN3, WRKY53, NAP), ROS‐related genes (RbohD, CSD1, CSD2, FSD3) and hormone signaling genes (EIN3, ABF3, ABF4). Collectively, our findings suggested that HbWRKY82 might function as an important transcriptional regulator in ET‐ and ABA‐mediated leaf senescence and abiotic stress responses, and also be involved in tapping panel dryness, latex flow and regeneration processes of rubber trees via participating in the ET and reactive oxygen species signaling pathways.
Functional characterization and expression profiling of glyoxalase III genes in date palm grown under abiotic stresses
Authors: Jana Gerry A. , Krishnamurthy Pannaga , Kumar Prakash P. , Yaish Mahmoud W.
Published: October 2020

Methylglyoxal (MG), a by‐product of various metabolic processes, including glycolysis, is a highly reactive cytotoxic metabolite. The level of MG in the cell is maintained at a non‐toxic level via MG detoxification pathways such as the universal glyoxalase system, including glyoxalase I/II/III enzymes. Glyoxalase III (DJ‐1) can breakdown MG to d‐lactate in a single step without reducing glutathione (GSH). Elucidating the function of the DJ‐1 gene family may provide further knowledge about its role in plants under abiotic stresses. Here, we characterize four glyoxalase III genes (PdDJ‐1B1, PdDJ‐1B2, PdDJ‐1C, and PdDJ‐1D) encoding the conserved DJ‐1 domain in the genome of the date palm, a crop with high drought and salinity tolerance. The expression level of the PdDJ‐1 genes increased in date palm leaves upon salinity treatment. In addition, overexpression of PdDJ‐1 genes in Escherichia coli and the complementation in yeast hsp31Δ knockout mutant cells enhanced their growth rate and reduced the accumulation of reactive oxygen species (ROS) under MG and oxidative stress conditions as shown by the flow cytometry assay. Subcellular localization using confocal microscopy revealed the accumulation of PdDJ‐1B1, PdDJ‐1C, and PdDJ‐1D in the chloroplast, whereas PdDJ‐1B2 was localized to the cytosol. Remarkably, constitutive expression of the PdDJ‐1C gene in Arabidopsis thaliana Columbia (Col‐0) resulted in the generation of non‐viable albino plants implying that PdDJ‐1C plays a critical function in chloroplast development. These findings suggest that PdDJ‐1 protein has an important function in MG‐detoxification and maintaining the redox balance in date palm plants under abiotic stress conditions.
Differences in stakeholder perceptions about native forest: implications for developing a restoration program
Authors: Castillo Jessica A. , Smith‐Ramírez Cecilia , Claramunt Vivianne
Published: October 2020

Ecological restoration is a global priority. Incorporating stakeholders' perceptions has been established as a critical factor to improve the success of restoration and conservation initiatives and decrease future social conflicts; however, it has barely been incorporated. Our objective was to analyze and compare the differences in the perceptions of Chilean dryland forest restoration of three groups: local community, experts, and government managers. We asked about: (1) what is the knowledge, importance, and uses that they have and give to the native forest and its restoration? (2) What is the willingness to restore the native forest? (3) What are the most valuable goods and services provided by the forest? (4) Where to begin to restore? (5) What criteria must be considered to prioritize areas to restore? To determine if the criteria selected were related to the stakeholder group, a semi‐parametric multivariate analysis of variance (MANOVA) was performed. Semi‐structured interviews were carried out with 61 stakeholders. The community gave greater importance to restoring the ravines and creeks, the experts to restoring areas that increase landscape connectivity, and both experts and government managers to restoring areas of greater biodiversity and ecological value. The experts gave a lower value to both social and economic criteria compared to the local community and government managers. The differences among stakeholder perceptions must necessarily be considered in the restoration programs. Research on perceptions can contribute to decision‐making and will favor the social approval and long‐term success of restoration programs.
Mortgage lending, monetary policy, and prudential measures in small euro‐area economies: Evidence from Ireland and the Netherlands
Authors: Everett Mary , de Haan Jakob , Jansen David‐Jan , McQuade Peter , Samarina Anna
Published: October 2020

This paper examines whether the increased use of macroprudential policies since the global financial crisis has affected the impact of (euro‐area and foreign) monetary policy on mortgage lending in Ireland and the Netherlands, which are both small open economies in the euro area. Using quarterly bank‐level data on domestic lending in both countries for 2003–2018, we find that restrictive euro‐area monetary policy shocks reduce the growth of mortgage lending. We find evidence that stricter domestic prudential regulation mitigates this effect in Ireland, but not so in the Netherlands. There is some weak evidence for an international bank lending channel that can be mitigated by stricter lender‐based domestic prudential regulation.
Decomposing episodes of large growth in international trade
Authors: Malloy Brandon
Published: October 2020

I use bilateral trade data from a variety of countries to decompose the patterns of trade growth across various goods classifications during episodes of rapid growth in bilateral trade. I find that bilateral trade growth during these episodes is fragmented—less than 5% of goods classifications account for over 65% of overall bilateral trade growth. I quantitatively assess whether “Melitz‐style" trade models, with heterogeneous productivity firms, CES demand and fixed and variable costs of exporting, can match the observed fragmentation of bilateral trade growth. I find the standard model generates less than 40% of the observed fragmentation in the data, as measured by the share of total trade growth accounted for by various quantiles of goods classifications. However, by incorporating heterogeneous tariff and productivity changes imputed from US production and export data, I find that the model generates approximately 90% of the magnitude of fragmentation of trade growth across goods as in the data.
Coalitional Architecture of Climate Change Litigation Networks in the United States
Authors: Holm Federico , Berardo Ramiro
Published: October 2020

Understanding how coalitions battle to advance or slow down regulatory efforts to address climate change is critical to assess the likelihood that regulatory approaches can succeed in curbing the emission of greenhouse gases. This requires a thorough examination of how coalitions form and are structured. We focus our analysis on the Obama administration's “Climate Action Plan,” aimed to tackle greenhouse gas emissions from the operation of oil and gas facilities, transportation, and electricity generation. We focus on coalitional behavior when actors litigate either in favor or against each of these rules and reconstruct the comprehensive network of stakeholder relations across court cases by recreating the network of cosigners of documents submitted during the litigation process. We identify two main coalitions of pro‐ and anti‐regulation actors and assess their coalitional strategies. We use descriptive statistics, baseline models, and community detection algorithms to explore participation patterns related to level of participation, cross‐regulation activity, clustering, and homophily based subcoalitions.
Regional citrate anticoagulation vs no‐anticoagulation for CRRT in hyperlactatemia patients with increased bleeding risk: A retrospective cohort study
Authors: Li Lu , Bai Ming , Yu Yan , Li Yangping , Zhao Lijuan , Sun Shiren
Published: October 2020

There are controversial opinions on the use of regional citrate anticoagulation (RCA) continuous renal replacement therapy (CRRT) in hyperlactatemia patients with increased bleeding risk. Patients with hyperlactatemia and increased bleeding risk who accepted RCA or no‐anticoagulation CRRT in our center were retrospectively included. Eighty patients who underwent RCA‐CRRT and 47 patients received no‐anticoagulation CRRT were included. Filter lifespan was significantly longer in the RCA group than the no‐anticoagulation group (44.5 hours [2‐89] vs 24.5 hours [1.5‐70], P < .001). The adjusted results demonstrated that patients in the no‐anticoagulant group had significantly higher risk of filter failure (HR = 4.765, 95% CI 2.703‐8.4, P ＜ .001). Bleeding episodes occurred in 19 (24.1%) and 22 (46.8%) patients in the RCA and no‐anticoagulation group, respectively (P = .012). The overall citrate accumulation (CA) rate was 5% in the RCA group. Patient mortality was associated with the comorbidity of hypertension, increased serum lactate level, and increased SOFA score. After matching, the filter lifespan was significantly longer in the RCA group than the no‐anticoagulation group. With careful monitoring and timely adjustment, RCA most likely was safe and effective for CRRT in hyperlactatemia patients with increased bleeding risk.
Potassium isotope anomalies in meteorites inherited from the protosolar molecular cloud
Authors: Ku Y. , Jacobsen S. B.
Published: October 2020

Potassium, a moderately volatile element, shows presolar isotopic heterogeneity in meteorites.
Pharmacological Characterization of TP0591816, a Novel Macrocyclic Respiratory Syncytial Virus Fusion Inhibitor with Antiviral Activity against F Protein Mutants
Authors: Yoshida Ippei , Arikawa Kaho , Honma Yusuke , Inatani Shoko , Yoshinaga Mitsukane , Sugiyama Hiroyuki
Published: October 2020

Human respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in early childhood. However, no vaccines have yet been approved for prevention of RSV infection, and the treatment options are limited. Therefore, development of effective and safe anti-RSV drugs is needed. In this study, we evaluated the antiviral activity and mechanism of action of a novel macrocyclic anti-RSV compound, TP0591816. TP0591816 showed significant antiviral activities against both subgroup A and subgroup B RSV, while exerting no cytotoxicity.
Petrogenesis of Ordovician granitoids in Western Kunlun, NW Tibetan Plateau: Insights into the evolution of the Proto-Tethys Ocean
Authors: Wang Peng , Zhao Guochun , Han Yigui , Liu Qian , Yao Jinlong , Li Jianhua
Published: October 2020

Granitoid rocks are universal in continental crust and are of special significance in understanding tectonic settings. This paper presents detailed zircon U-Pb dating, Hf isotope, whole-rock geochemistry, and Sr-Nd-Pb isotope analyses, and mineralogy of two Ordovician granitoid intrusions and one quartz diorite intrusion in Western Kunlun, NW Tibetan Plateau. The Yutian Complex is composed of diverse rock suites, including monzogabbros, quartz monzodiorites, monzogranites, and monzodioritic enclaves. These suites have similar rock formation ages (447–440 Ma) and minerals, e.g., amphibole grains from different suites belonging to pargasite. Moreover, they exhibit geochemical similarities, such as broadly parallel trace-element patterns characterized by enrichments in light rare earth elements and large ion lithophile elements, and depletions in high field strength elements, which are typical features of arc rocks. Furthermore, the studied samples display homogeneous zircon Hf values, e.g., εHf(t) = −1 to −3, and whole-rock isotopic compositions, e.g., εNd(t) = −4 to −6. Thus, they were most likely derived from a mantle wedge enriched by subducted sediments and fluids, which then evolved into different suites through fractional crystallization of hornblende and plagioclase. The ca. 440 Ma North Yutian quartz diorite intrusion, with an average of εHf(t) value of −6, was a product of the partial melting of mafic lower crust through slightly fractional crystallization of hornblende. In contrast, the ca. 470 Ma Aqiang granodiorite intrusion has εHf(t) values varying from −5 and −2, but it has heterogeneous petrological and geochemical features. It is considered to be a product of the partial melting of the overriding mantle wedge modified by fluids derived from the subducted Proto-Tethys slab and some mixed crustal materials. The Aqiang samples belong to the slightly fractionated I-type series, but they have variable alumina saturation index (ASI = molar Al2O3/[CaO – 3.33 × P2O5 + Na2O + K2O]) values (0.74–1.03) due to variable peraluminous biotite contents. The different suites in the Yutian Complex display low ASI values (<1) controlled by sources and fractional crystallization. The Yutian Complex and the North Yutian intrusion were emplaced during the southward subduction of the Proto-Tethys oceanic lithosphere, and the Aqiang intrusion was emplaced in response to the northward subduction.
Supplemental Material: Evaporite weathering and deposition as a long-term climate forcing mechanism
Authors: Shields Graham , Mills Benjamin
Published: October 2020

Carbon-alkalinity-calcium deep time box model details.
T and genetic variations between Asian and Caucasian polypoidal choroidal vasculopathy
Authors: Jordan-Yu Janice Marie , Teo Kelvin , Fan Qiao , Gana Jose Carlos , Leopando Anna Karina , Nunes Sandrina , Farinha Cláudia , Barreto Patricia , Melo Joana Barbosa , Carreira Isabel , Murta Joaquim Neto , Silva Rufino , Cheung Chui Ming Gemmy
Published: October 2020

Purpose

To compare phenotypic and genetic variations in polypoidal choroidal vasculopathy (PCV) between Caucasian and Asian patients.

Methods

We analysed phenotypic and genotypic data from two sites, Association for Innovation and Biomedical Research on Light and Image, Portugal and Singapore National Eye Centre, Singapore. Baseline fundus photography, spectral domain-optical coherence tomography, indocyanine green and fluorescein angiography scans were analysed by respective reading centres using a standardised grading protocol. Single nucleotide polymorphisms across 8 PCV loci were compared between cases and controls selected from each population.

Results

One hundred and forty treatment-naïve PCV participants (35 Portuguese and 105 Singaporean) were included. The Portuguese cohort were older (72.33±8.44 vs 68.71±9.40 years, p=0.043) and were comprised of a lower proportion of males (43% vs 71%, p=0.005) compared with the Singaporean cohort. Differences in imaging features include higher prevalence of soft drusen (66% vs 30%, p=0.004), lower prevalence of subretinal haemorrhage (14% vs 67%, p<0.001), smaller polypoidal lesion (PL) area (0.09±0.09 vs 0.76±0.93 mm2, p<0.001), lower ratio of PL to branching vascular network area (3% vs 38%, p<0.001) and lower central retinal thickness (346.48±93.74 vs 493.16±212.92 µm, p<0.001) in the Portuguese cohort. CETP rs3764261 (OR 2.467; 95% CI 1.282 to 4.745, p=0.006) in the Portuguese population was significantly associated with PCV and CFH rs800292 (OR 1.719; 95% CI 1.139 to 2.596, p=0.010) in the Singaporean population, respectively.

Conclusion

Among Asian and Caucasian patients with PCV, there are significant differences in the expression of phenotype. We also identified different polymorphisms associated with PCV in the two populations.
'You’re the best liar in the world’: a grounded theory study of rowing athletes’ experience of low back pain
Authors: Wilson Fiona , Ng Leo , O'Sullivan Kieran , Caneiro J P , O'Sullivan Peter PB , Horgan Alex , Thornton Jane S , Wilkie Kellie , Timonen Virpi
Published: October 2020

Objectives

Low back pain (LBP) is common in rowers and leads to considerable disability and even retirement. The athlete voice can help clinicians to better understand sport-related pain disorders. We aimed to capture the lived experience of LBP in rowers.

Methods

Cross-sectional qualitative study using a grounded theory approach. Adult competitive rowers with a rowing-related LBP history were recruited in Australia and Ireland. Data were collected through interviews that explored: context around the time of onset of their LBP and their subsequent journey, experiences of management/treatment, perspectives around present beliefs, fears, barriers and expectations for the future.

Results

The 25 rowers (12 women/13 men) who participated were aged 18–50 years; they had a mean 12.1 years of rowing experience. They discussed a culture of concealment of pain from coaches and teammates, and fear of being judged as ‘weak’ because of the limitations caused by LBP. They reported fear and isolation as a result of their pain. They felt that the culture within rowing supported this. They reported inconsistent messages regarding management from medical staff. Some rowers reported being in a system where openness was encouraged—they regarded this a leading to better outcomes and influencing their LBP experience.

Conclusions

Rowers’ lived experience of LBP was influenced by a pervasive culture of secrecy around symptoms. Rowers and support staff should be educated regarding the benefits of early disclosure and rowers should be supported to do so without judgement.
Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice
Authors: Maclean Abbie , Ashton James J , Garrick Vikki , Beattie R Mark , Hansen Richard
Published: October 2020

The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.

Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.

Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.

These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.

In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.
Mortality in biopsy-confirmed nonalcoholic fatty liver disease: results from a nationwide cohort
Authors: Simon Tracey G , Roelstraete Bjorn , Khalili Hamed , Hagström Hannes , Ludvigsson Jonas F
Published: October 2020

Objective

Population-based data are lacking regarding the risk of overall and cause-specific mortality across the complete histological spectrum of non-alcoholic fatty liver disease (NAFLD).

Design

This nationwide, matched cohort study included all individuals in Sweden with biopsy-confirmed NAFLD (1966 to 2017; n=10 568). NAFLD was confirmed histologically from all liver biopsies submitted to Sweden’s 28 pathology departments, after excluding other etiologies of liver disease, and further categorised as, simple steatosis, non-fibrotic steatohepatitis (NASH), non-cirrhotic fibrosis and cirrhosis. NAFLD cases were matched to ≤5 general population comparators by age, sex, calendar year and county (n=49 925). Using Cox regression, we estimated multivariable-adjusted HRs (aHRs) and 95% CIs.

Results

Over a median of 14.2 years, 4,338 NAFLD patients died. Compared with controls, NAFLD patients had significantly increased overall mortality (16.9 vs 28.6/1000 PY; difference=11.7/1000 PY; aHR=1.93, 95% CI=1.86 to 2.00). Compared with controls, significant excess mortality risk was observed with simple steatosis (8.3/1000 PY, aHR=1.71, 95% CI=1.64 to 1.79), non-fibrotic NASH (13.4/1000 PY, aHR=2.14, 95% CI=1.93 to 2.38), non-cirrhotic fibrosis (18.4/1000 PY, aHR=2.44, 95% CI=2.22 to 2.69) and cirrhosis (53.6/1000 PY, aHR=3.79, 95% CI=3.34 to 4.30)(ptrend<0.01). This dose-dependent gradient was similar when simple steatosis was the reference (ptrend<0.01). The excess mortality associated with NAFLD was primarily from extrahepatic cancer (4.5/1000 PY, aHR=2.16, 95% CI=2.03 to 2.30), followed by cirrhosis (2.7/1000 PY, aHR=18.15, 95% CI=14.78 to 22.30), cardiovascular disease (1.4/1000 PY, aHR=1.35, 95% CI=1.26 to 1.44) and hepatocellular carcinoma (HCC) (1.2/1000 PY, aHR=11.12, 95% CI=8.65 to 14.30).

Conclusion

All NAFLD histological stages were associated with significantly increased overall mortality, and this risk increased progressively with worsening NAFLD histology. Most of this excess mortality was from extrahepatic cancer and cirrhosis, while in contrast, the contributions of cardiovascular disease and HCC were modest.
Evolving impact of long-term survival results on metastatic melanoma treatment
Authors: Michielin Olivier , Atkins Michael B , Koon Henry B , Dummer Reinhard , Ascierto Paolo Antonio
Published: October 2020

Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.
Pulmonary complications in trauma patients with obstructive sleep apnea undergoing pelvic or lower limb operation
Authors: Fiorentino Michele , Hwang Franchesca , Pentakota Sri Ram , Livingston David H , Mosenthal Anne C
Published: October 2020

Background

Obstructive sleep apnea (OSA) is increasingly prevalent in the range of 2% to 24% in the US population. OSA is a well-described predictor of pulmonary complications after elective operation. Yet, data are lacking on its effect after operations for trauma. We hypothesized that OSA is an independent predictor of pulmonary complications in patients undergoing operations for traumatic pelvic/lower limb injuries (PLLI).

Methods

Nationwide Inpatient Sample (2009–2013) was queried for International Classification of Diseases, Ninth Revision, Clinical Modification codes for PLLI requiring operation. Elective admissions and those with concurrent traumatic brain injury with moderate to prolonged loss of consciousness were excluded. Outcome measures were pulmonary complications including ventilatory support, ventilator-associated pneumonia, pulmonary embolism (PE), acute respiratory distress syndrome (ARDS), and respiratory failure. Multivariable logistic regression analysis was used, adjusting for OSA, age, sex, race/ethnicity, and specific comorbidities (obesity, chronic lung disease, and pulmonary circulatory disease). P<0.01 was considered statistically significant.

Results

Among the 337 333 patients undergoing PLLI operation 3.0% had diagnosed OSA. Patients with OSA had more comorbidities and were more frequently discharged to facilities. Median length of stay was longer in the OSA group (5 vs 4 days, p<0.001). Pulmonary complications were more frequent in those with OSA. Multivariable logistic regression showed that OSA was an independent predictor of ventilatory support (adjusted odds ratio (aOR), 1.37; 95% CI,1.24 to 1.51), PE (aOR 1.40; 95% CI, 1.15 to 1.70), ARDS (aOR 1.36; 95% CI,1.23 to 1.52), and respiratory failure (aOR 1.90; 95% CI, 1.74 to 2.06).

Conclusion

OSA is an independent and underappreciated predictor of pulmonary complications in those undergoing emergency surgery for PLLI. More aggressive screening and identification of OSA in trauma patients undergoing operation are necessary to provide closer perioperative monitoring and interventions to reduce pulmonary complications and improve outcomes.

Level of evidence

Prognostic Level IV.
Lightweight magnesium phosphate cement composites with struvite recovered from wastewater
Authors: Setayesh Gar Parisa , Lobanov Sergey , Pernechele Matteo , Zanotti Cristina
Published: October 2020

A feasibility study was performed to utilize struvite, in combination with magnesium oxide (MgO), to develop magnesium phosphate cement. The struvite was a wastewater by-product from a sewage treatment plant in British Columbia, Canada. To achieve MgO–phosphate reactivity in water, two types of recycled struvite were used: heated struvite and newberyite (i.e., rehydrated struvite). A more common phosphate source, potassium dihydrogen phosphate (KDP) was also adopted and replaced in different proportions by recycled struvite. Perlite was incorporated to produce lightweight composites for building applications at different strength–density ratios. Microstructural and chemical analyses were complemented with compressive strength tests at different ages. Reactivity with MgO was achieved for both heated struvite and newberyite. The main reaction product was cattiite but reactivity of less soluble newberyite was lower. KDP had the fastest reaction leading to the formation of K-struvite. The lightweight composites achieved up to 90% of their strength in 7 days.
Process of AC multichannel gliding arcs discharge in rotational flow
Authors: Wang Wei-Zhen , Jia Min , Song Fei-Long , Zhang Zhi-Bo , Cui Wei
Published: October 2020

In order to solve the problem of small and asymmetrical plasma area of the gliding arc (GA) in the chemical treatment process, a plasma actuator driven by alternating current (AC) with a frequency of 23.2kHz was designed to multichannel gliding arcs (MGAs) in a rotational air flow at atmospheric pressure. The spatiotemporally resolved discharge characteristics of the MGA, including long-length breakdown, long-term extinction and typical breakdown features, were investigated combining optical and electrical diagnostic methods simultaneously at a flow rate of 250 SLM (standard liter per minute). The response characteristics of MGA under different flow rates were analyzed. On average, the MGA exhibit 48.8% more discharge power compared to traditional single-channel GA under flow rates of 50–250 SLM, which is due to the GAs continual existence at long-length state, representing better stability of the MGA plasma actuators. It was observed that the frequency of typical breakdown and long-term extinction increased as the flow rate accelerated, and the maximum height the GA could reach decreased with the number of channels increasing from 1 to 5, which can be attributed to the power decline of separate channels of GAs at 50 SLM. It was also found that MGA showed a broader plasma distribution of low electron temperature than traditional single-channel GA.
INEFFICIENT BUBBLES AND EFFICIENT DRAWDOWNS IN FINANCIAL MARKETS
Authors: SCHATZ MICHAEL , SORNETTE DIDIER
Published: October 2020

At odds with the common “rational expectations” framework for bubbles, economists like Hyman Minsky, Charles Kindleberger and Robert Shiller have documented that irrational behavior, ambiguous information or certain limits to arbitrage are essential drivers for bubble phenomena and financial crises. Following this understanding that asset price bubbles are generated by market failures, we present a framework for explosive semimartingales that is based on the antagonistic combination of (i) an excessive, unstable pre-crash process and (ii) a drawdown starting at some random time. This unifying framework allows one to accommodate and compare many discrete and continuous time bubble models in the literature that feature such market inefficiencies. Moreover, it significantly extends the range of feasible asset price processes during times of financial speculation and frenzy and provides a strong theoretical background for future model design in financial and risk management problem settings. This conception of bubbles also allows us to elucidate the status of rational expectation bubbles, which, by design, suffer from the paradox that a rational market should not allow for misvaluation. While the discrete time case has been extensively discussed in the literature and is most criticized for its failure to comply with rational expectations equilibria, we argue that this carries over to the finite time “strict local martingale”-approach to bubbles.