bluuebunny/crossref_metadata_2025 huggingface dataset:
Isohemagglutinin titering performed on an automated solid‐phase and hemagglutinin‐based analyzer is comparable to results obtained by manual gel testing
Authors: Lally Kimberly , Kruse Robert L. , Smetana Heather , Davis Rivcah , Roots Angela , Marshall Christi , Ness Paul M. , DeZern Amy E. , Gladstone Douglas E. , Brennan Daniel C. , Desai Niraj M. , Tobian Aaron A.R. , Bloch Evan M. , Gehrie Eric A.
Published: January 2020

BACKGROUND

Isohemagglutinins (anti‐A and anti‐B) mediate hemolytic transfusion reactions, antibody‐mediated rejection of solid‐organ transplants, and delayed engraftment after stem cell transplant. However, quantification of isohemagglutinins is often labor intensive and operator dependent, limiting availability and interfacility comparisons. We evaluated an automated, solid‐phase and agglutination‐based antibody titer platform versus manual gel testing.

STUDY DESIGN AND METHODS

Plasma samples were obtained from 54 randomly selected patients. Titers were determined by our laboratoryʼs standard assay (manual dilution followed by manual gel testing) and were compared to results obtained on a fully automated blood bank analyzer (Galileo NEO, Immucor). The analyzer determined immunoglobulin G (IgG) antibodies using solid‐phase and immunoglobulin M (IgM) antibodies by direct hemagglutination.

RESULTS

Isohemagglutinin titers obtained by manual gel versus the automated assay generally (>80%) agreed within one doubling dilution, and always (100%) agreed within two dilutions. Among O samples, the gel titer and the highest titer obtained with the automated assay (either IgG or IgM) were similar in paired, nonparametric analysis (p = 0.06 for anti‐A; p = 0.13 for anti‐B). Gel titers from group A and group B patients were slightly higher than the highest titer obtained using the automated assay (p = 0.04 for group A; p = 0.009 for group B), although these differences were within the accepted error of measurement.

CONCLUSION

Manual and automated methodologies yielded similar isohemagglutinin titers. Separate quantification of IgM and IgG isohemagglutinins via automated titration may yield additional insight into hemolysis, graft survival after ABO‐incompatible transplantation, and red blood cell engraftment after ABO‐incompatible stem cell transplant.
Long‐term arthroscopic assessment of intra‐articular allografts for treatment of spontaneous cranial cruciate ligament rupture in the dog
Authors: Biskup Jeffery J. , Conzemius Michael G.
Published: January 2020

Objective

To assess the 12‐month survival of intra‐articular, decellularized allografts for the treatment of cranial cruciate ligament disease (CCLD) in dogs.

Study design

Prospective case series.

Animals

Twenty client‐owned dogs with spontaneous CCL rupture.

Methods

Affected stifles were treated solely by implantation of an intra‐articular, decellularized, deep digital flexor tendon allograft. Functional outcome was evaluated at baseline and at 6 and 12 months after surgery with the Liverpool Osteoarthritis for Dogs questionnaire and force platform gait analysis. At 12 months after surgery, dogs underwent arthroscopy to visually assess the allografts.

Results

Scores on owner questionnaires (improved 62.5%;P= .005) and ground reaction forces (improved 34.4%;P= .017) were improved in all dogs 12 months after surgery. Dogs with an intact graft (IG) were more likely to have a successful outcome compared with dogs with a torn graft (P= .011). According to arthroscopy, 45% of grafts seemed to survive at 12 months after surgery.

Conclusion

About half of intra‐articular allografts survived 12 months after implantation in CCL‐deficient stifles. Dogs with IG had successful outcomes at 12 months after surgery according to assessment by force platform gait analysis.

Clinical significance

These results preclude immediate clinical application but provide evidence to justify further investigation of intra‐articular grafts as a repair option for CLLD.
Serological investigation of orthohantaviruses in patients with fever of unknown origin in Kazakhstan
Authors: Tukhanova Nur , Shin Anna , Abdiyeva Karlygash , Turebekov Nurkeldi , Yeraliyeva Lyazzat , Yegemberdiyeva Ravilya , Shapiyeva Zhanna , Froeschl Guenter , Hoelscher Michael , Wagner Edith , Rösel Kerstin , Zhalmagambetova Aliya , Musralina Lyazzat , Frey Stefan , Essbauer Sandra
Published: January 2020

Objective

Orthohantaviruses are geographically widely distributed and present various clinical manifestations from mild symptoms to the severe form of haemorrhagic fever with renal syndrome (HFRS) in Eurasia. Official registration of HFRS in Kazakhstan started in the year 2000. However, the true prevalence of human infections by orthohantaviruses within Kazakhstan is unknown. The aim of this study was to investigate of the seroprevalence of orthohantavirus infections in patients with fever of unknown origin (FUO) in two regions, Almaty and Kyzylorda region.

Methods

Paired serum samples from 802 patients with FUO were screened for the presence of orthohantavirus IgG and IgM antibodies by ELISA. Positive samples were further tested by immunoblotting and indirect immunofluorescence tests (IIFT) to determine the respective orthohantavirus serotypes. Suspected acute serum samples were additionally checked by a RT‐PCR to identify viral RNA.

Results

In total 178/802 (22.2%) serum samples reacted with orthohantavirus IgG antibodies and 4/802 (0.5%) with IgM antibodies. All positive samples were tested by immunoblotting which resulted in 2.9% positive samples with IgG antibodies against Puumala (PUUV), Hantaan (HTNV) and Dobrava (DOBV) virus serotypes in Almaty region and 5.4% to PUUV and DOBV serotypes in Kyzylorda region, respectively. In the IFFT, 1.9% positive samples from Almaty and 3.1% from Kyzylorda were confirmed for PUUV and DOBV serotypes. Out of four IgM ELISA positive samples only three were positive against PUUV in the immunoblot and showed weak positive reactivity for the Saaremaa (SAAV), PUUV and HTNV serotypes in the IFFT.

Conclusions

This study demonstrates the presence of orthohantavirus infections among patients with FUO in Kazakh regions that were so far considered as non‐endemic. The healthcare system needs to be prepared accordingly in order to be capable of detecting cases and providing adequate management of patients.
On the -problem for restrictions of complex reflection arrangements
Authors: Amend Nils , Deligne Pierre , Röhrle Gerhard
Published: January 2020

Let $W\subset \operatorname{GL}(V)$ be a complex reflection group and $\mathscr{A}(W)$ the set of the mirrors of the complex reflections in $W$. It is known that the complement $X(\mathscr{A}(W))$ of the reflection arrangement $\mathscr{A}(W)$ is a $K(\unicode[STIX]{x1D70B},1)$ space. For $Y$ an intersection of hyperplanes in $\mathscr{A}(W)$, let $X(\mathscr{A}(W)^{Y})$ be the complement in $Y$ of the hyperplanes in $\mathscr{A}(W)$ not containing $Y$. We hope that $X(\mathscr{A}(W)^{Y})$ is always a $K(\unicode[STIX]{x1D70B},1)$. We prove it in case of the monomial groups $W=G(r,p,\ell )$. Using known results, we then show that there remain only three irreducible complex reflection groups, leading to just eight such induced arrangements for which this $K(\unicode[STIX]{x1D70B},1)$ property remains to be proved.
A 7‐day high‐fat, high‐calorie diet induces fibre‐specific increases in intramuscular triglyceride and perilipin protein expression in human skeletal muscle
Authors: Whytock K. L. , Parry S. A. , Turner M. C. , Woods R. M. , James L. J. , Ferguson R. A. , Ståhlman M. , Borén J. , Strauss J. A. , Cocks M. , Wagenmakers A. J. M. , Hulston C. J. , Shepherd S. O.
Published: January 2020

Key points

We have recently shown that a high‐fat, high‐calorie (HFHC) diet decreases whole body glucose clearance without impairing skeletal muscle insulin signalling, in healthy lean individuals.

These diets are also known to increase skeletal muscle IMTG stores, but the effect on lipid metabolites leading to skeletal muscle insulin resistance has not been investigated.

This study measured the effect of 7 days’ HFHC diet on (1) skeletal muscle concentration of lipid metabolites, and (2) potential changes in the perilipin (PLIN) content of the lipid droplets storing intramuscular triglyceride (IMTG).

The HFHC diet increased PLIN3 protein expression and redistributed PLIN2 to lipid droplet stores in type I fibres.

The HFHC diet increased IMTG content in type I fibres, while lipid metabolite concentrations remained the same. The data suggest that the increases in IMTG stores assists in reducing the accumulation of lipid metabolites known to contribute to skeletal muscle insulin resistance.

A high‐fat, high‐calorie (HFHC) diet reduces whole body glucose clearance without impairing skeletal muscle insulin signalling in healthy lean individuals. HFHC diets also increase skeletal muscle lipid stores. However, unlike certain lipid metabolites, intramuscular triglyceride (IMTG) stored within lipid droplets (LDs) does not directly contribute to skeletal muscle insulin resistance. Increased expression of perilipin (PLIN) proteins and colocalisation to LDs has been shown to assist in IMTG storage. We aimed to test the hypothesis that 7 days on a HFHC diet increases IMTG content while minimising accumulation of lipid metabolites known to disrupt skeletal muscle insulin signalling in sedentary and obese individuals. We also aimed to identify changes in expression and subcellular distribution of proteins involved in IMTG storage. Muscle biopsies were obtained from the m. vastus lateralis of 13 (11 males, 2 females) healthy lean individuals (age: 23 ± 2.5 years; body mass index: 24.5 ± 2.4 kg m−2), following an overnight fast, before and after consuming a high‐fat (64% energy), high‐calorie (+47% kcal) diet for 7 days. After the HFHC diet, IMTG content increased in type I fibres only (+101%; P < 0.001), whereas there was no change in the concentration of either total diacylglycerol (P = 0.123) or total ceramides (P = 0.150). Of the PLINs investigated, only PLIN3 content increased (+50%; P < 0.01) solely in type I fibres. LDs labelled with PLIN2 increased (+80%; P < 0.01), also in type I fibres only. We propose that these adaptations of LDs support IMTG storage and minimise accumulation of lipid metabolites to protect skeletal muscle insulin signalling following 7 days’ HFHC diet.
Investigation of In-Plane Fluid Elastic Instability for a Triangular Tube Bundle Subjected to Two-Phase Flow
Authors: Azuma Seinosuke , Morita Hideyuki , Hirota Kazuo , Kondo Yoshiyuki , Utsumi Seiho , Komuro Yoshiteru , Kawakami Ryoichi , Nariai Toshifumi , Nishikawa Yoshito
Published: January 2020

In recent years, in a newly installed replacement steam generator, in-plane (IP) fluid elastic instability (FEI) for the heat transfer tubes has occurred. The fluid elastic instability is one of the severe vibrations in the heat transfer tube bundle and should be avoided. There have been many studies on the out-of-plane (OOP) fluid elastic instability, and the design evaluation guideline based on Connors' equation and the results of flow tests has been established. On the other hand, no evaluation guideline has been established for in-plane fluid elastic instability, and no critical coefficient has been determined in high-temperature, high-pressure steam–water two-phase conditions. Therefore, in this paper, in order to develop the guideline for evaluating in-plane fluid elastic instability, the critical coefficients were obtained using two types of test equipment for rotate triangular array in two-phase flow (SF6 ethanol) simulating steam–water flow under high-temperature and high-pressure conditions.
Modeling Interfacial Interactions and Turbulence in the Near-Wall Region of a Vertical Bubbly Boundary Layer
Authors: Chahed Jamel , Masbernat Lucien
Published: January 2020

A two-fluid model with second-order turbulence closure is used for the simulation of a turbulent bubbly boundary layer. The turbulence model is based on the decomposition of the Reynolds stress tensor in the liquid phase into two parts: a turbulent part and a pseudo-turbulent part. The reduction in second-order turbulence closure in the near-wall region is interpreted according to a modified wall logarithmic law. Numerical simulations of bubbly boundary layer developing on a vertical flat plate were performed in order to analyze the bubbles effect on the liquid turbulence structure and to evaluate the respective roles of turbulence and of interfacial forces in the near-wall distribution of the void fraction. The two-fluid model with the second-order turbulence closure succeeds in reproducing the diminution of the turbulent intensity observed in the near-wall region of bubbly boundary layer and the increase in turbulence outside the boundary layer. The analysis of the interfacial force in the near-wall zone has led to the development of relatively simple formulation of the lift-wall force in the logarithmic zone that depends on dimensionless distances to the wall. After appropriate adjustment, this formulation makes it possible to reproduce the shape of the near-wall void fraction peaking observed in bubbly boundary layer experiments.
Numerical Investigation on Heat Transfer of Supercritical Water With a Variable Turbulent Prandtl Number Model
Authors: Kong Xiangfei , Sun Dongfeng , Gou Lingtong , Wang Siqi , Yang Nan , Li Huixiong
Published: January 2020

Turbulent Prandtl number (Prt) has a great impact on the performance of turbulence models in predicting heat transfer of supercritical fluids. Unrealistic treatment of Prt may lead to large deviations of the prediction results from experimental data under supercritical conditions. In this study, the effect of Prt on heat transfer of supercritical water was extensively studied by using shear stress transport (SST) k–ω turbulence model, and the results suggested that using the existing Prt models would lead to failures in predicting the heat transfer characteristics of supercritical water under deteriorated heat transfer (dht) conditions. A new variable Prt model was proposed with the Prt varied with pressure, turbulent viscosity ratio, and molecular Prandtl number. The new model was validated by comparing the numerical results with the corresponding experimental data, and it was found that the new variable Prt model exhibited better performance on reproducing the dht of supercritical water in vertical tubes than those of the existing Prt models.
A Century of Cartilage Tribology Research Is Informing Lubrication Therapies
Authors: Bonnevie Edward D. , Bonassar Lawrence J.
Published: January 2020

Articular cartilage is one of the most unique materials found in nature. This tissue's ability to provide low friction and low wear over decades of constant use is not surpassed, as of yet, by any synthetic materials. Lubrication of the body's joints is essential to mammalian locomotion, but breakdown and degeneration of cartilage is the leading cause of severe disability in the industrialized world. In this paper, we review how theories of cartilage lubrication have evolved over the past decades and connect how theories of cartilage lubrication have been translated to lubrication-based therapies. Here, we call upon these historical perspectives and highlight the open questions in cartilage lubrication research. Additionally, these open questions within the field's understanding of natural lubrication mechanisms reveal strategic directions for lubrication therapy.
It's Not Easy Being Green: Integrating Refugees in German Environmentalist Culture
Authors: Jacobs Joela
Published: January 2020

The solidarity crisis has prompted many initiatives for refugees in Germany, among them quite a few local and state-funded environmental education programs. Many of these initiatives are framed as measures of cultural integration and issue bold statements such as “recycling has become a cultural value in Germany.” Media depictions of these programs therefore inadvertently detail the cultural specificity of “environmentalism made in Germany” and reveal institutionalized idiosyncrasies of a long-standing green leader. The news coverage as well as the online self-presentations of these initiatives seem to embody the ideals of Willkommenskultur with glossy images of people of color among their blond neighbors and with captions that feature moments of mutual learning. Yet despite ample evidence of good intentions driving the programs, their feel-good depictions are problematic for many reasons: they are invariably dominated by German voices and specifically German environmental concerns, rendering the (homogenized) refugees and the global dimension of climate change secondary yet somehow responsible. Many of the articles begin with the imagery of trash surrounding refugee housing, seemingly not realizing that these portrayals suggest a linkage between refuse and refuge – between discarded objects and displaced human beings. Largely ignoring pressing issues of asylum housing and employment, it is not always clear whose problems these programs set out to solve, and the more tone-deaf reporting about them brings to light many difficult notions, such as conceiving of German environmentalism as thepath to integration (a problematic concept to begin with) and as a universal good despite its apparent localism. This article analyzes available media representations of a set of environmentalist initiatives for refugees, which tell us as much, if not more, about German perceptions of cultural values and related conversations in the publics sphere as about refugees and the environment.Keywordssolidarity crisis, refugees, German environmental culture, environmental education, recycling, Will
Contribution to the knowledge of African Parakalummidae (Acari, Oribatida)

Authors: Ermilov Sergey G. , Starý Josef
Published: January 2020

Two new species of oribatid mites of the genus Neoribates (Oribatida, Parakalummidae) are described based on adult specimens from leaf litter in the Montagne d'Ambre National Park of North Madagascar. Neoribates africanus sp. nov. and N. madagascarensis sp. nov. clearly differs from all species of the genus by the absence of interlamellar seta (including alveolus). An identification key and data on distribution and ecology of known African species of Parakalummidae are presented.
Microbiomes Reduce Their Host’s Sensitivity to Interspecific Interactions
Authors: Jackrel Sara L. , Schmidt Kathryn C. , Cardinale Bradley J. , Denef Vincent J.
Published: January 2020

Description of the Earth’s microbiota has recently undergone a phenomenal expansion that has challenged basic assumptions in many areas of biology, including hominid evolution, human gastrointestinal and neurodevelopmental disorders, and plant adaptation to climate change. By using the classic model system of freshwater phytoplankton that has been drawn upon for numerous foundational theories in ecology, we show that microbiomes, by facilitating their host population, can also influence between-species interactions among their eukaryotic hosts. Between-species interactions, including competition for resources, has been a central tenet in the field of ecology because of its implications for the diversity and composition of communities and how this in turn shapes ecosystem functioning.
Gut Feelings Begin in Childhood: the Gut Metagenome Correlates with Early Environment, Caregiving, and Behavior
Authors: Flannery Jessica E. , Stagaman Keaton , Burns Adam R. , Hickey Roxana J. , Roos Leslie E. , Giuliano Ryan J. , Fisher Philip A. , Sharpton Thomas J.
Published: January 2020

Childhood is a formative period of behavioral and biological development that can be modified, for better or worse, by the psychosocial environment that is in part determined by caregivers. Not only do our own genes and the external environment influence such developmental trajectories, but the community of microbes living in, on, and around our bodies—the microbiome—plays an important role as well. By surveying the gut microbiomes of a cross-sectional cohort of early school-aged children with a range of psychosocial environments and subclinical mental health symptoms, we demonstrated that caregiving behaviors modified the child gut microbiome’s association to socioeconomic risk and behavioral dysregulation.
Listeria monocytogenes Exploits Host Caveolin for Cell-to-Cell Spreading
Authors: Dhanda Aaron S. , Yu Connie , Lulic Katarina T. , Vogl A. Wayne , Rausch Valentina , Yang Diana , Nichols Benjamin J. , Kim Sung Hyun , Polo Simona , Hansen Carsten G. , Guttman Julian A.
Published: January 2020

Listeria monocytogenes
moves from one cell to another as it disseminates within tissues. This bacterial transfer process depends on the host actin cytoskeleton as the bacterium forms motile actin-rich membranous protrusions that propel the bacteria into neighboring cells, thus forming corresponding membrane invaginations. Here, we examine these membrane invaginations and demonstrate that caveolin-1–based endocytosis is crucial for efficient bacterial cell-to-cell spreading. We show that only a subset of caveolin-associated proteins (cavin-2 and EHD2) are involved in this process. Despite the absence of clathrin at the invaginations, the classical clathrin-associated protein epsin-1 is also required for efficient bacterial spreading. Using isolated
L. monocytogenes
protrusions added onto naive host cells, we demonstrate that actin-based propulsion is dispensable for caveolin-1 endocytosis as the presence of the protrusion/invagination interaction alone triggers caveolin-1 recruitment in the recipient cells. Finally, we provide a model of how this caveolin-1–based internalization event can exceed the theoretical size limit for this endocytic pathway.
IFITM3 Reduces Retroviral Envelope Abundance and Function and Is Counteracted by glycoGag
Authors: Ahi Yadvinder S. , Yimer Diborah , Shi Guoli , Majdoul Saliha , Rahman Kazi , Rein Alan , Compton Alex A.
Published: January 2020

The viral envelope glycoprotein, known as “Env” in
Retroviridae
, is found on the virion surface and facilitates virus entry into cells by mediating cell attachment and fusion. Env is a major structural component of retroviruses and is targeted by all arms of the immune response, including adaptive and innate immunity. Less is known about how cell-intrinsic immunity prevents retrovirus replication at the level of individual cells. Here, we show that cellular IFITM3 and IFITM2 inhibit the fusion potential of retroviral virions by inhibiting Env protein via a two-pronged mechanism. IFITM proteins inhibit Env abundance in cells and also impair its function when levels are low. The posttranslational block of retroviral Env function by IFITM proteins is likely to impede both exogenous and endogenous retrovirus replication. In support of a relevant role for IFITM3 in retrovirus control, the retroviral accessory protein glycoGag counteracts IFITM3 function to promote virus infectivity.
An Oral Inoculation Infant Rabbit Model for
Shigella
Infection
Authors: Kuehl Carole J. , D’Gama Jonathan D. , Warr Alyson R. , Waldor Matthew K.
Published: January 2020

Shigella
species are the leading bacterial cause of diarrheal death globally. The pathogen causes bacillary dysentery, a bloody diarrheal disease characterized by damage to the colonic mucosa and is usually spread through the fecal-oral route. Small animal models of shigellosis that rely on the oral route of infection are lacking. Here, we found that orogastric inoculation of infant rabbits with
S. flexneri
led to a diarrheal disease and colonic pathology reminiscent of human shigellosis. Diarrhea, intestinal colonization, and pathology in this model were dependent on the
S. flexneri
type III secretion system and IcsA, canonical
Shigella
virulence factors. Thus, oral infection of infant rabbits offers a feasible model to study the pathogenesis of shigellosis and to develop and test new therapeutics.
Planktonic and Sessile Artificial Colonic Microbiota Harbor Distinct Composition and Reestablish Differently upon Frozen and Freeze-Dried Long-Term Storage
Authors: Bircher Lea , Schwab Clarissa , Geirnaert Annelies , Greppi Anna , Lacroix Christophe
Published: January 2020

Fecal microbiota transplantation has been successfully applied in the treatment of recurrent
Clostridium difficile
infection and has been suggested as an alternative therapy for other intestinal disorders such as inflammatory bowel disease or metabolic syndrome. “Artificial” colonic microbiota delivered by PolyFermS continuous fermentation models can provide a controllable and reproducible alternative to fecal transplantation, but effective preservation strategies must be developed. In this study, we systematically investigated the response of sessile and planktonic artificial colonic microbiota to cryopreservation and lyophilization. We suggest that functional redundancy is an important factor in providing functional stability with respect to exposure to stress during processing and storage. Functional redundancy in compositionally reduced microbial systems may be considered when designing microbial products for therapy.
Clinical features and aetiology of cerebral palsy in children from Cross River State, Nigeria
Authors: Duke Roseline , Torty Chimaeze , Nwachukwu Kennedy , Ameh Soter , Kim Min , Eneli Nnena , Onyedikachi Ani , Aghaji Ada , Burton Kathryn , Dyet Leigh , Bowman Richard
Published: January 2020

Objective

There are few studies on cerebral palsy (CP) in African children and our study aimed to describe the aetiology, characteristics and severity of CP in children from Nigeria.

Design

A population-based study using key informant methodology (KIM) was conducted as part of a clinical research trial. Children aged 4–15 years were clinically assessed for CP.

Results

The estimated prevalence of CP using KIM was 2.3/1000 children (95% CI 2.0 to 2.5/1000). 388 children were diagnosed with CP, with Gross Motor Function Classification System level 1 in 70 (18.1%), II in 156 (40.2%), III in 54 (13.9%), IV in 54 (13.9%), V in 54 (13.9%). 300/388 (77.3%) had Manual Ability Classification Scale of level 1–3 and 88 (22.7%) of level 4–5. CP types were spastic in 271 (70%), with 60% of these bilateral and 40% unilateral, ataxic 38 (9.8%), dystonic 18 (4.6%), choreoathetoid 29 (7.5%) and unclassifiable 32 (8.3%). Postneonatal risk factors for CP were seen in 140 (36.1%) children including malaria with seizures 101/140 (72.1%), malaria with coma 21/140 (15.0%), meningitis 12/140 (8.6%), tuberculosis 2/140 (1.4%), sickle cell disease 3/140 (2.2%), HIV 1/221 (0.7%). Prenatal/perinatal risk factors were seen in 248 (63.9%%), birth asphyxia 118 (47.6%) and clinical congenital rubella syndrome 8 (3.3%) and hyperbilirubinaemia 59 (23.8%) were identified as preventable risk factors for CP.

Conclusion

The profile of CP in this population is similar to that found in other low-income and middle-income countries (LMIC). Some risk factors identified were preventable. Prevention and management strategies for CP designed for LMIC are needed.
Relation between retinal vessel diameter and posterior segment optical coherence tomography variables in middle-aged Caucasians: the Northern Finland Birth Cohort Eye Study
Authors: Geneid Mohamed I , Uusitalo Janne J , Leiviskä Ilmari L , Saarela Ville O , Liinamaa M Johanna
Published: January 2020

Aims

Studying the relationship between retinal vessel diameter (RVD) with (1) macular thickness and volume, (2) retinal nerve fibre layer (RNFL), (3) ganglion cell-inner plexiform layer (GC-IPL) and (4) optic nerve head (ONH) in a population cohort of middle-aged Caucasians.

Methods

We collected data from 3070 individuals. We used a semiautomated computer-assisted programme to measure central retinal arteriolar equivalent and central retinal venular equivalent. Macular and ONH parameters were assessed by optical coherence tomography.

Results

Data from 2155 persons were analysed. A larger RVD was associated with a thicker macula and increased macular volume; each SD increase in average macular thickness and volume was associated with a 3.28 µm and a 3.19 µm increase in arteriolar diameter and a 5.10 µm and a 5.08 µm increase in venular diameter, respectively (p<0.001 for all). A larger rim area, greater GC-IPL and RNFL thicknesses were associated with larger RVD; each SD increase in rim area, GC-IPL thickness and RNFL thickness was associated with a 1.21 µm, 2.68 µm and a 3.29 µm increase in arteriolar diameter and a 2.13 µm, 4.02 µm and 5.04 µm increase in venular diameter, respectively (p<0.001 for all).

Conclusions

Increased macular thickness, macular volume, GC-IPL thickness, RNFL thickness and optic nerve rim area were associated with larger RVDs in all subjects. This study clarified the anatomical correlations between both macular and ONH parameters with RVD for middle-aged Caucasians; these can represent a basis for further studies investigating the vascular aetiology of eye diseases.
Increasing physical activity by four legs rather than two: systematic review of dog-facilitated physical activity interventions
Authors: Rhodes Ryan E , Baranova Maria , Christian Hayley , Westgarth Carri
Published: January 2020

Objectives

Regular walking is a critical target of physical activity (PA) promotion, and dog walking is a feasible PA intervention for a large segment of the population. The purpose of this paper was to review PA interventions that have involved canine interactions and to evaluate their effectiveness. A secondary aim of this review was to highlight the populations, settings, designs and intervention components that have been applied so as to inform future research.

Design

Systematic review.

Data sources

We carried out literature searches to August 2019 using six common databases.

Eligibility criteria

Studies included published papers in peer-reviewed journals and grey literature (theses and dissertations) in the English language that included any PA behaviour change design (ie, randomised controlled trial, quasi-experimental) that focused on canine-related intervention. We grouped findings by population, setting, medium, research design and quality, theory and behaviour change techniques applied.

Results

The initial search yielded 25 010 publications which were reduced to 13 independent studies of medium and high risks of bias after screening for eligibility criteria. The approaches to intervene on PA were varied and included loaner dogs, new dog owners and the promotion of walking among established dog owners. Findings were consistent in showing that canine-assisted interventions do increase PA (82% of the studies had changes favouring the canine-facilitated intervention). Exploratory subanalyses showed that specific study characteristics and methods may have moderated the effects. Compared with studies with longer follow-up periods, studies with shorter follow-up favoured behaviour changes of the canine intervention over the control condition.

Conclusion

Canine
-
based PA interventions appear effective, but future research should move beyond feasibility and proof of concept studies to increase rigour, quality and generalisability of findings.
‘It all dials back to safety’: A qualitative study of social and economic vulnerabilities among transgender women participating in HIV research in the USA
Authors: Reisner Sari L , Chaudhry Aeysha , Cooney Erin , Garrison-Desany Henri , Juarez-Chavez Elisa , Wirtz Andrea L
Published: January 2020

Objectives

Transgender women (TW) are highly burdened by HIV infection in the USA. Research is needed into drivers of the HIV epidemic for TW, including longitudinal studies to identify risks for incident HIV infection and optimal intervention targets. This formative research sought to understand TW’s experiences with, perceptions of and barriers and facilitators to HIV research participation to inform future research implementation.

Design

Between August 2017 and January 2018, five online synchronous computer-mediated focus groups were conducted in English and two in Spanish. Recruitment used a mixed format of technology, such as geotargeted social media, and non-technology infused methods, such as peer referrals. Maximum variation sampling was used to enrol participants across a wide range of characteristics. Qualitative codes were iteratively developed and applied to focus group discussion transcripts by independent analysts.

Setting

Participants were recruited from Atlanta, Baltimore, Boston, Miami, New York City and Washington D.C.

Participants

Participants identified as TW≥18 years and resided in one of the six metropolitan areas or outlying regions. 33 participants elected to partake in English focus groups and eight participated in Spanish-led groups.

Results

The geographically diverse sample had a mean age of 41.1 years (SD=13.6), and 34% identified as Black African American and 29% as Hispanic/Latina. Social and economic factors were found to shape HIV research participation for TW. Barriers to HIV research participation included limited research opportunities, mistrust, fear of mistreatment, safety and confidentiality, competing priorities and HIV stigma. Facilitators to HIV research participation were peer involvement and engagement, monetary and non-monetary incentives, flexibility and choices, multiple modalities and methods, and transcenteredness.

Conclusion

It is critical to address the social and economic vulnerabilities surrounding HIV research participation for TW. Results from this study can inform the design and implementation of gender-affirming and culturally tailored approaches to HIV research with TW.
Forging a new identity: a qualitative study exploring the experiences of UK-based physician associate students
Authors: Brown Megan E L , Laughey William , Tiffin Paul Alexander , Finn Gabrielle M
Published: January 2020

Objective

To explore student physician associates’ (PAs) experiences of clinical training to ascertain the process of their occupational identity formation.

Setting

The role of the PA is relatively new within the UK. There has been a rapid expansion in training places driven by National Health Service (NHS) workforce shortages, with the Department of Health recently announcing plans for the General Medical Council to statutorily regulate PAs. Given such recent changes and the relative newness of their role, PAs are currently establishing their occupational identity. Within adjacent fields, robust identity development improves well-being and career success. Thus, there are implications for recruitment, retention and workplace performance. This qualitative study analyses the views of student PAs to ascertain the process of PA occupational identity formation through the use of one-to-one semistructured interviews. A constructivist grounded theory approach to data analysis was taken. Research was informed by communities of practice and socialisation theory.

Participants

A theoretical sample of 19 PA students from two UK medical schools offering postgraduate PA studies courses.

Results

A conceptual model detailing student PA identity formation is proposed. Factors facilitating identity formation include clinical exposure and continuity. Barriers to identity formation include ignorance and negativity regarding the PA role. Difficulties navigating identity formation and lacking support resulted in identity dissonance.

Conclusions

Although similarities exist between PA and medical student identity formation, unique challenges exist for student PAs. These include navigating a new role and poor access to PA role models. Given this, PA students are turning to medicine for their identity. Educators must provide support for student PA identity development in line with this work’s recommendations. Such support is likely to improve the job satisfaction and retention of PAs within the UK NHS.
What do we know about demand, use and outcomes in primary care out-of-hours services? A systematic scoping review of international literature
Authors: Foster Hamish , Moffat Keith R , Burns Nicola , Gannon Maria , Macdonald Sara , O'Donnell Catherine A
Published: January 2020

Objective

To synthesise international evidence for demand, use and outcomes of primary care out-of-hours health services (OOHS).

Design

Systematic scoping review.

Data sources

CINAHL; Medline; PsyARTICLES; PsycINFO; SocINDEX; and Embase from 1995 to 2019.

Study selection

English language studies in UK or similar international settings, focused on services in or directly impacting primary care.

Results

105 studies included: 54% from mainland Europe/Republic of Ireland; 37% from UK. Most focused on general practitioner-led out-of-hours cooperatives. Evidence for increasing patient demand over time was weak due to data heterogeneity, infrequent reporting of population denominators and little adjustment for population sociodemographics. There was consistent evidence of higher OOHS use in the evening compared with overnight, at weekends and by certain groups (children aged <5, adults aged >65, women, those from socioeconomically deprived areas, with chronic diseases or mental health problems). Contact with OOHS was driven by problems perceived as urgent by patients. Respiratory, musculoskeletal, skin and abdominal symptoms were the most common reasons for contact in adults; fever and gastrointestinal symptoms were the most common in the under-5s. Frequent users of daytime services were also frequent OOHS users; difficulty accessing daytime services was also associated with OOHS use. There is some evidence to suggest that OOHS colocated in emergency departments (ED) can reduce demand in EDs.

Conclusions

Policy changes have impacted on OOHS over the past two decades. While there are generalisable lessons, a lack of comparable data makes it difficult to judge how demand has changed over time. Agreement on collection of OOHS data would allow robust comparisons within and across countries and across new models of care. Future developments in OOHS should also pay more attention to the relationship with daytime primary care and other services.

PROSPERO registration number

CRD42015029741.
Getting to grips with sarcopenia: recent advances and practical management for the gastroenterologist
Authors: Hollingworth Thomas William , Oke Siddhartha M , Patel Harnish , Smith Trevor R
Published: January 2020

Sarcopenia is a progressive and generalised disorder of skeletal muscle strength, function and mass, that is most commonly associated with the normal ageing process. It is increasingly recognised that sarcopenia can also develop as a consequence of malabsorptive and inflammatory conditions, such as those seen by gastroenterologists and hepatologists. It affects 1%–30% of the general population, but is seen in approximately 40% of patients with gastrointestinal conditions including inflammatory bowel disease and cirrhosis. Within this group of patients, it is associated with increased complications and mortality. The pathogenesis of sarcopenia is multifactorial with several risk factors implicated in its development including undernutrition, physical inactivity and coexistent multimorbidity. The SARC-F questionnaire has been developed to screen for patients at risk of sarcopenia, however, this focuses on the functional consequences and will therefore not identify those patients who are early in the progression of sarcopenia. There are several different non-invasive techniques available to assess muscle quantity and quality including; grip strength, dual energy X-ray absorptiometry, CT which can be used together to diagnose sarcopenia. Assessment and correction of malnutrition, particularly protein intake, in those at risk of sarcopenia is important in preventing the development and progression of sarcopenia. There are no specific drugs that are available for the treatment of sarcopenia, however, resistance exercise programmes combined with nutritional interventions show promise. It is important that this common condition is screened for and recognised, with any contributing factors addressed to reduce the risk of its progression.
Accuracy of the revised Vienna Classification for predicting postendoscopic resection outcomes for gastric and oesophageal neoplasms: a retrospective cohort study of patients from a UK tertiary referral centre
Authors: Kuan Jen , Ratcliffe Elizabeth , Hayes Stephen , McGrath Stephen , Ang Yeng
Published: January 2020

Aims

To review the effectiveness of the revised Vienna classification (rVC) at predicting histological outcome and defining the postendoscopic resection (ER) clinical management plan of gastro-oesophageal dysplasia and early neoplasia in a UK tertiary-centre population.

Methods

This was a retrospective cohort study between November 2011 and May 2018. 157 patients from Salford Royal NHS Foundation Trust in the UK were included. The primary outcome was the histological results of postsurgical resection (SR) specimens compared with their post-ER rVC. The secondary outcome was overall survival rates of patients with category 4.4 and 5 of the rVC.

Results

One-hundred and thirteen patients were diagnosed with category ≥4 of the rVC. 23 patients (20.4%) were referred for additional surgery, whereas 69 patients (61.1%) were on endoscopic surveillance only. 60.9% of post-SR specimens (14/23) revealed no residual neoplasia. 78.6% of these cancer-free specimens were classed as category 5 rVC. The overall 7-year survival rate of 25 patients with category ≥4.4 was 68% with causes of mortality not linked to upper gastrointestinal neoplasia. The overall 7-year and 3-year survival rates of category 4.4 and 5 were 73.6% and 50%, respectively, although age and comorbid state played a role.

Conclusions

This study provides evidence of outcomes comparable to other reported cohorts for cases after ER in a single-centre UK population even at rVC 4.4/5. It suggests surgery may not be necessary in all cases due to the lack of residual disease and further refinement of the rVC category 5 may help guide management.
Prospective impact of tobacco eradication and overweight and obesity eradication on future morbidity and health-adjusted life expectancy: simulation study
Authors: Blakely Tony , Cleghorn Cristine , Petrović-van der Deen Frederieke , Cobiac Linda J , Mizdrak Anja , Mackenbach Johan P , Woodward Alistair , van Baal Pieter , Wilson Nick
Published: January 2020

Background

Interventions that reduce morbidity, in addition to mortality, warrant prioritisation. It is important to understand the magnitude of potential morbidity and health gains from changing risk factor distributions. We quantified the impact of tobacco compared with overweight/obesity eradication on future morbidity and health-adjusted life expectancy (HALE) for the New Zealand population alive in 2011.

Methods

Business-as-usual (BAU) future smoking rates were set based on past falling rates, but we assumed no future change in Body Mass Index (BMI) distribution, given historic trends. Population impact fractions and the percentage reduction in incidence rates for 16 tobacco-related and 14 overweight/obesity-related diseases (allowing for time lags) were calculated using the difference between BAU and eradication risk factor scenarios combined with tobacco and BMI incidence rate ratios. We used two multistate lifetable models to estimate HALE changes over the remaining lifespan and morbidity rate changes 30 years hence.

Results

HALE gains always exceeded life expectancy (LE) gains for overweight/obesity eradication (ie, absolute compression of morbidity), but for eradication of tobacco, the pattern was mixed. For example, among 32-year-olds in 2011, overweight/obesity eradication increased HALE by 2.06 years and LE by 1.21 years, compared with 0.54 and 0.50 years for tobacco eradication.

Morbidity rate reductions 30 years into the future were considerably greater for overweight/obesity eradication (eg, a 15.8% reduction for 72-year-olds in 2041, or the cohort that was aged 42 years in 2011) than for tobacco eradication (2.7%). The same rate of morbidity experienced at age 65 years under BAU was deferred by 5 years with overweight/obesity eradication.

Conclusions

Preventive programmes that reduce overweight and obesity have strong potential to reduce or compress morbidity, improving the average health status of ageing populations. This paper simulated eradication of tobacco and overweight/obesity; actual interventions will have lesser health impacts, but the relativities of morbidity to mortality gains should be similar.
Leukoaraiosis and collateral blood flow in stroke patients with anterior circulation large vessel occlusion
Authors: Mark Ian , Seyedsaadat Seyed Mohammad , Benson John C , Kallmes David F , Rabinstein Alejandro A , Brinjikji Waleed
Published: January 2020

Background

Leukoaraiosis and collateral blood flow are processes that involve small vessels, the former related to flow within the deep perforating arterioles and the latter involving the small, cortical pial-pial connections, both of which are independently used to predict cerebrovascular events and treatment outcomes. The aim of this study was to investigate their relationship to each other.

Methods

We retrospectively reviewed patients who underwent mechanical thrombectomy for stroke with pre-procedural CT imaging within 24 hours of the onset of symptoms. Leukoaraiosis was graded by the total Fazekas score on non-contrast CT, periventricular white matter (PVWM) and deep white matter (DWM) scores, both ranging from 0 to 3. Collateral cerebral blood flow was measured by the American Society of Interventional and Therapeutic Radiology/Society of Interventional Radiology (ASITN/SIR) collateral scale.

Results

178 patients were included with a mean age of 67.6±14.8 years. We found an inverse relationship between total Fazekas score and collateral flow (p<0.0001). Among patients with good collaterals, 75.1% had total Fazekas scores of 0–2, compared with 36.6% of patients with moderate collaterals and 32.7% of patients with poor collaterals with total Fazekas scores of 0–2. Mean Fazekas scores were 1.6±1.5, 3.1±1.5 and 3.4±1.6 for good, moderate and poor collaterals, respectively (p<0.0001). On multivariate analysis, total Fazekas score was the only variable independently associated with collateral status (p<0.0001).

Conclusions

Increasing severity of leukoaraiosis is associated with poor collateral grade among ischemic stroke patients with anterior circulation large vessel occlusion. These findings suggest that leukoaraiosis may be a marker for global cerebrovascular dysfunction.
Factors that influence smokers’ and ex-smokers’ use of IQOS: a qualitative study of IQOS users and ex-users in the UK
Authors: Tompkins Charlotte N E , Burnley Annabel , McNeill Ann , Hitchman Sara C
Published: January 2020

Background

One of the most widely available heated tobacco products is IQOS by Philip Morris International. However, there is a lack of independent research exploring IQOS initiation and subsequent use among smokers and ex-smokers.

Aims

To (1) explore the reasons why smokers and ex-smokers use and continue/discontinue IQOS and (2) consider implications for future research and policy.

Participants

Adult (18+) current (n=22) and ex-users (n=8) of IQOS who either currently smoked or quit smoking in the last 2 years.

Methods

Qualitative interview study in London, UK.

Results

Six main factors influenced initiation and use of IQOS: (1) Health—wanting to reduce/quit smoking and perceptions of reduced harm (while understanding IQOS was not risk-free). Branded packaging, absence of pictorial warnings and physical health improvements conveyed reduced harm. (2) Financial—including high start-up costs, but cheaper ongoing costs than smoking. (3) Physical—mixed views on enjoyment and satisfaction. Sensory experiences influenced use including discreetness, cleanliness, reduced smell and tactile similarities relative to combustible cigarettes. (4) Practical—issues of accessibility, shortcomings with maintenance/operation limited ongoing use, whereas use in smoke-free places increased use. (5) Psychological—similarities in rituals and routines, although new practices developed to charge and clean; some liked trailblazing new technology. (6) Social—improved social interactions from using IQOS instead of smoking, but with more limited shared social experiences for some.

Conclusion

For some, IQOS facilitated smoking substitution. Factors such as packaging, labelling, risk communication, price and smoke-free policies appear to influence initiation and use.