bluuebunny/crossref_metadata_2025 huggingface dataset:
Triggers of Primary Headaches: Issues and Pathways Forward
Authors: Martin Paul R.
Published: July 2020

The triggers of primary headaches have considerable significance for our understanding and management of headache and migraine. Triggers explain the variance in headaches – why they occur when they do. Trigger management is generally viewed as an important component of a comprehensive treatment approach for headaches. Historically, however, triggers have not had a prominent place in the headache literature. This situation began to change 20 to 30 years ago, and the pace of change has increased exponentially in recent times. Nevertheless, the field is beset with issues that have held it back from achieving more. This review will focus on elaborating those issues with the goal of suggesting ways forward. The first issue considered will be the definition of a trigger, and how specific triggers are labeled. Consideration will then be given to a classification system for triggers. The review will discuss next the evidence relating to whether self‐reported triggers can, indeed, precipitate headaches, and how the capacity to elicit headaches may be acquired or extinguished. Attention will be given to the very important clinical issue of trigger management. Finally, the pathways forward will be proposed. Perhaps the most useful thing to accomplish at this point in time would be agreement on a definition of headache triggers, a list of triggers, and a classification system for triggers. This would greatly assist in comparing research on triggers from different research groups as well as eliminating some of the issues identified in this review. An authoritative body such as theAmerican Headache Societyor theInternational Headache Society, could establish a multidisciplinary committee that would complete these tasks. Consideration should also be given to incorporating triggers into the International Classification of Headache Disorders as an axis or via the use of codes, as this would raise the profile of triggers in assessment and management.
Association between cardiovascular diseases and apical periodontitis: an umbrella review
Authors: Jakovljevic A. , Duncan H. F. , Nagendrababu V. , Jacimovic J. , Milasin J. , Dummer P. M. H.
Published: July 2020

Background

The existence of an association between cardiovascular diseases (CVDs) and apical periodontitis (AP) remains unclear because results obtained from previous clinical studies and reviews are inconsistent or inconclusive.

Objective

To conduct an umbrella review to determine whether there is an association between CVDs and the prevalence of AP in adults.

Methods

The protocol of the review was registered in the PROSPERO database (CRD42020185753). The literature search was conducted using the following electronic databases: Clarivate Analytics’ Web of Science Scopus, PubMed and Cochrane Database of Systematic Reviews, from inception to May, 2020, with no language restrictions. Systematic reviews with or without meta‐analysis that evaluated the association between CVDs and AP were included. Other types of studies, including narrative reviews, were excluded. Two reviewers independently performed a literature search, data extraction and quality assessment of included studies. Any disagreements or doubts were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool (A measurement tool to assess systematic reviews), with 16 items. A final categorization of the systematic reviews classified each as of ‘high’, ‘moderate’, ‘low’ or ‘critically low’ quality.

Results

Four systematic reviews were included in the current review. Three reviews were graded by AMSTAR 2 as ‘moderate’ quality, whereas one review was graded as ‘critically low’ quality.

Discussion

Only one systematic review included a meta‐analysis. Substantial heterogeneity amongst the primary studies included within each systematic review was notable in preventing a pooled analysis.

Conclusions

From the limited ‘moderate’ to ‘critically low’ quality evidence available, the current umbrella review concluded that a weak association exists between CVDs and AP. In the future, well‐designed, longitudinal clinical studies with long‐term follow‐up are required.
A novel bio‐active adhesive monomer induces odontoblast differentiation: a comparative study
Authors: Qiu Y. J. , Tang J. , Saito T.
Published: July 2020

Aim

To evaluate the in vitro effect of the novel adhesive monomer CMET, a calcium salt of 4‐methacryloxyethyl trimellitate (4‐MET), on the proliferation, mineralization and differentiation of odontoblast‐like cells, comparing with 4‐MET, calcium hydroxide (CH) and mineral trioxide aggregate (MTA).

Methodology

Rat odontoblast‐like MDPC‐23 cells were cultured in Dulbecco’s modified Eagle’s medium (DMEM) supplemented with 5% foetal bovine serum. The powder of four tested materials (CMET, 4‐MET, CH and MTA) was first dissolved in distilled water (dH2O) and then was diluted by DMEM to yield final concentrations. Solvent (dH2O) was used as a control. Cell viability was assessed using CCK‐8 assay. Real‐time RT‐PCR was used to quantify the mRNA expression of odontogenic markers, cytokines and integrins. Mineralization inducing capacity was evaluated by alkaline phosphatase (ALPase) activity and alizarin red S staining. Statistical analyses were performed using one‐way anova and post hoc Tukey’s HSD test, with the significance level at 1%.

Results

Cell viability was significantly greater in the CMET‐ (83 to 828 mmol L−1), CH‐ and MTA‐treated (low concentrations) groups than that in the control group (P < 0.01). Higher concentrations of each material decreased the viable cells to different extents (P < 0.01). CMET treatment augmented the expression of several integrin subunits and exhibited the highest mRNA expression levels of odontogenic markers among all groups (P < 0.01). CH and MTA treatment caused significantly greater upregulation of pro‐inflammatory cytokines expression than the other groups (P < 0.01). The calcific deposition of MDPC‐23 cells was dose‐dependently accelerated by the addition of CMET (P < 0.01); the enhancement of mineralization was also found in the fresh prepared CH and MTA treatments. Besides, CMET showed consistency in mineralization induction after 8 weeks storage. Exposure to SB202190, a specific p38 mitogen‐activated protein kinases inhibitor, significantly decreased the ALPase activity as well as the mineral deposition which was enhanced by CMET treatment (P < 0.01).

Conclusions

The novel bio‐active monomer had the lowest cytotoxicity among all groups and it induced the proliferation, mineralization and differentiation of odontoblast‐like cells under appropriate concentrations. This adhesive monomer possesses excellent biocompatibility and hence exhibits great potential in dentine regeneration.
Absolute lymphocyte count is a prognostic marker in Covid‐19: A retrospective cohort review
Authors: Wagner Jason , DuPont Andrew , Larson Scott , Cash Brooks , Farooq Ahmad
Published: July 2020

Introduction

Prognostic factors are needed to aid clinicians in managing Covid‐19, a respiratory illness. Lymphocytopenia has emerged as a simply obtained laboratory value that may correlate with prognosis.

Methods

In this article, we perform a retrospective cohort review study on patients admitted to one academic hospital for Covid‐19 illness. We analyzed basic demographic, clinical, and laboratory data to understand the relationship between lymphocytopenia at the time of hospital admission and clinical outcomes.

Results

We discovered that lymphocyte count is lower (P = .01) and lymphocytopenia more frequent by an odds ratio of 3.40 (95% CI: 1.06‐10.96; P = .04) in patients admitted to the Intensive Care Unit (ICU), a marker of disease severity, relative to those who were not. We additionally find that patients with lymphocytopenia were more likely to develop an acute kidney injury (AKI), a marker of organ failure, during admission by an odds ratio of 4.29 (95% CI: 1.35‐13.57; P = .01).

Conclusion

This evidence supports the hypothesis that lymphocytopenia can be an early, useful, and easily obtained, prognostic factor in determining the clinical course and disease severity of a patient admitted to the hospital for Covid‐19.
An analysis of documentation language and word choice among forensic mental health nurses
Authors: Martin Krystle , Stanford Callum
Published: July 2020

Documenting patient care is an important part of mental health services. The documentation is expected to be accurate, relevant, and informative for all future readers as it provides details about patients and the care they are receiving. Language can produce positive or negative emotions in individuals, and these emotions can influence their thoughts and actions. Considering this, nursing documentation can impact the future care of patients. In this study, our aim was to analyse the language and words nurses use when documenting about their patients. Through a qualitative review of notes transcribed by mental health nurses in a forensic setting (n = 55), we explored the adjectives and verbs used across a subsection of their documentation over a three‐month period. More specifically, we identified the most common words used, looked for patterns in use, and examined the emotional weight – or valence – of word choice. Examination of valence scores of the adjectives and verbs in the notes indicates that while nurses describe their patients in a rather neutral manner overall, some words and phrases are ambiguous and/or repetitive, and have the potential to negatively influence the perceptions of the reader regarding the patient. Clinical implications of patient care are discussed in the context of bias management. Nurses need to consider how word choice is linked to negative prosody and the need to provide additional information to avoid ambiguity. Without such care, notes can be subject to misinterpretation by readers leading to undue labels, stigma, and bias.
Interactive governance for satisfaction measurements: Stakeholder involvement in design processes for flood risk management
Authors: Nouzari Ehsan , Hartmann Thomas , Spit Tejo
Published: July 2020

The European Flood Directive (FD) shifted water management policy from flood protection to flood risk management. To facilitate the shift, a new instrument was introduced called the flood risk management plan. According to the FD, a flood risk management plan shall first take into account relevant aspects from water management, nature conservation, land use, spatial planning, navigation, and port infrastructure. Second, the flood risk management plan will be coordinated at the river basin level. This changes the spatial scope of water management compared to (old) flood protection approach and affects a broader group of stakeholder interests, namely landowners behind dikes. As a result, water management has to introduce a governance approach that facilitates stakeholder involvement in which different spatial interests are balanced, bargained and negotiated. Academic governance literature consists mostly of qualitative case studies, because of their complex nature. As a result, most governance literature operates on assumptions which make it difficult to formulate governance strategies that work based on general patterns. To contribute towards scientific methodologies for comparative research a quantitative method was developed to measure satisfaction in a stakeholder process. The method first provides new insights on the relation between interactive governance processes and the procedural satisfaction of stakeholders. Second, it provides insights that help to improve interactive governance in terms of managing a stakeholder process in such a way that greater procedural satisfaction can be achieved.
Material stock development of the transport sector in the city of Vienna
Authors: Gassner Andreas , Lederer Jakob , Fellner Johann
Published: July 2020

Societies aim to reduce primary raw material consumption, enhance waste recycling, and reduce waste disposal. In this regard, the circular‐economy concept has gained attention and is applied in policy papers, also on the urban level. However, to assess set targets and their achievement, a sound knowledge of anthropogenic material flows and stocks is required. The material turnover of transport systems has not been sufficiently investigated yet, although they have a significant impact on overall material turnover and have a high potential for making use of recycled construction materials. To close this gap, the present study investigates the anthropogenic stocks and flows related to an urban transport system, whereby both infrastructure and vehicles are included. A bottom‐up, multiyear material‐flow analysis was employed to calculate the material stock and the related input and output flows of Vienna's transport system for the period 1990–2015. The results indicate the increasing importance of more environmentally friendly modes of transport. The stock of motorized individual transport has increased in absolute terms since 1990, but the stock per capita remains unchanged at 34 t/cap, whereas the per capita stock of public transport (20 t/cap; +8%) and of non‐motorized individual transport (4 t/cap; +10%) has increased. However, the primary source of material consumption (>65%) is maintenance of infrastructure. This provides a potential for more circularity because outputs and inputs are equal in terms of mass and material. The study provides a systematic analysis for developing policy and management options for sustainable resource‐saving urban transport systems.
Cerebrovascular Perfusion among Older Adults with and Without Cardiovascular Disease
Authors: Makwana Bindal , Tart‐Zelvin Ariana , Xu Xiaomeng , Gunstad John J. , Cote Denise M. , Poppas Athena , Cohen Ronald A. , Sweet Lawrence H.
Published: July 2020

BACKGROUND AND PURPOSE

Cardiovascular disease (CVD) encompasses a range of disorders that affect health and functioning in older adults. While cognitive declines have been linked to both cardiovascular and cerebral blood perfusion, protective neurovascular mechanisms raise the question whether cerebrovascular perfusion differs as a function of cardiovascular health status. The present study examined whether cerebrovascular perfusion significantly differs between healthy older adults with and without diagnosed CVD. The study also examined whether previously documented sex differences in cerebral perfusion would be replicated.

METHODS

Twenty CVD patients without significant heart failure and 39 healthy controls were recruited to undergo a comprehensive assessment, including an interview, echocardiogram, and magnetic resonance imaging). Arterial spin labeling was used to quantify cerebral blood perfusion.

RESULTS

Both groups exhibited mean left ventricular ejection fractions that fell within normal limits. In line with previous research, women exhibited significantly higher cerebral perfusion than men. There were no significant group differences in whole brain cerebrovascular perfusion, regional perfusion, or white matter perfusion by patient status after accounting for sex and age.

CONCLUSIONS

These findings suggest that the effects of mild CVD on cerebrovascular perfusion are minimal. Future studies are needed to investigate the mechanisms involved in maintaining cerebrovascular perfusion in the context of altered peripheral perfusion and to determine whether this finding extends to more acute or severe CVD.
Interexaminer reliability of the German version of the DC/TMD
Authors: Asendorf Anne , Möllenkamp Johanna , Schierz Oliver , Rauch Angelika , Asendorf Thomas , Rammelsberg Peter , Eberhard Lydia
Published: July 2020

Aim

Verification of the interrater reliability of axis I diagnoses of the German version of the DC/TMD. The hypothesis was that the DC/TMD protocol yields comparable results, if examiner instructions are closely followed.

Material and Methods

A culturally equivalent German translation of the DC/TMD was developed. During a 1‐day calibration workshop at the University of Heidelberg, three examiners were trained by the DC/TMD Training and Calibration Center. According to the calibration guidelines, 16 models (11 cases, five non‐cases) were examined by four experienced TMD specialists. Reliability was calculated with reference to the reference standard examiner as percentage agreement and kappa coefficients for DC/TMD diagnoses and intraclass correlation coefficients (ICCs) for findings.

Results

Excellent reliability was achieved for the diagnoses myalgia, myofascial pain with referral, arthralgia, headache attributed to TMD, disc displacement (DD) with reduction, DD without reduction without limited opening (κ = 0.85…1.00). Degenerative joint disease was diagnosed with substantial agreement (κ = 0.64), DD with reduction with intermittent locking and DD without reduction with limited opening were not present in our sample. Overall percentage agreement was 94%‐100% for all diagnoses.

Conclusion

The German version of the DC/TMD shows very good reliability and can be recommended for the use in clinical and research settings.
Accuracy of Guided Implant Surgery in 25 Edentulous Arches: A Laboratory Observational Study
Authors: Ben Yehuda Daniel , Weber Hans‐Peter , Finkelman Matthew , Sicilia Elena , Muftu Ali , Chochlidakis Konstantinos , Papaspyridakos Panos
Published: July 2020

Purpose

To assess the accuracy of template‐guided implant surgery for edentulous arches.

Materials and Methods

The stone master casts of 25 edentulous arches treated with either 4 or 6 implants with CBCT generated template‐guided surgery were included in this observational cohort study. The stone casts generated from the surgical templates (group one) prior to implant placement were digitized into Standard Tesselation (STL) files with a reference scanner. For comparison, the stone master casts derived from intraoral complete‐arch impressions after implant placement (group two) were also digitized. The resultant STL files were superimposed and best‐fit‐alignment algorithm was used to quantify the 3D deviations present between the two groups. Descriptive statistics were computed for all categorical variables. Due to the presence of nonindependent samples between maxillary and mandibular casts, a mixed‐effects model was used.

Results

Deviations between the implant analogs of the stone casts representing digitally planned versus actually placed implants were found. The mean root‐mean‐square error (RMSE) between all 25 arches was found to be 0.2 mm (SD ± 0.15). The mean RMSE between presurgical and postsurgical maxillary stone casts were 0.19 ± 0.15 mm, while between mandibular stone casts were 0.21 ± 0.16 mm and were not significant (p = 0.67). The mean RMSE between presurgical and postsurgical stone casts arches with 4 versus 6 implants were found to be significant (p = 0.01).

Conclusions

According to the results of the study and based on the amount of 3D deviations between the digitally planned implant positions and the actually placed implants, template‐guided surgery is a safe treatment modality for implant placement in edentulous arches.
Therapeutic effects of Qianlie Tongli decoction on chronic prostatitis/chronic pelvic pain syndrome induced by peptide T2 in mice
Authors: Cui Xingxing , Naveed Muhammad , Baig Mirza Muhammad Faran Ashraf , Wang Wenlu , Mikrani Reyaj , Liu Ziwei , Ahmad Bilal , Tang Meng , Wazir Junaid , Zhou Xiaohui , Han Lei
Published: July 2020

Objectives

This study was undertaken to reveal therapeutic effects and the preliminary mechanism of Chinese medicine formula Qianlie Tongli decoction (QTD) in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Methods

A total of 50 male C57BL/6 mice were randomly divided into five groups. All groups except the control group were injected subcutaneously T2 peptide emulsion, which induced the CP/CPPS model. After the induction of CP/CPPS, the model group was given normal saline by oral gavage while low-dose, medium-dose and high-dose groups were treated with Chinese medicine formula. Micturition habits and pain behaviour of mice were analysed for each group. Haematoxylin and eosin (H&E) staining was used to investigate prostate inflammation. The serum level of tumour necrosis factor-α (TNF-α) was measured by enzyme-linked immunosorbent assay (ELISA) kit.

Key findings

Chinese medicine formula significantly reduced the number of urine spots and improved pain response frequency in the medium-dose and high-dose group. The high-dose group showed reduced considerably inflammatory lesion and inflammatory cell infiltration than the low-dose and medium-dose groups. Serum levels of TNF-α in the high-dose group were significantly reduced compared with the model group.

Conclusions

The results demonstrated the therapeutic effects of Qianlie Tongli decoction in CP/CPPS mice by analysing clinically relevant symptoms (urinary tract system, pelvic pain and prostate inflammation) and preliminarily explored the inflammatory-related treatment mechanisms by measuring TNF-α.
Autologous cancer cell vaccination, adoptiveT‐cell transfer, and interleukin‐2 administration results in long‐term survival for companion dogs with osteosarcoma
Authors: Flesner Brian K. , Wood Gary W. , Gayheart‐Walsten Pamela , Sonderegger F. Lynn , Henry Carolyn J. , Tate Deborah J. , Bechtel Sandra M. , Donnelly Lindsay L. , Johnson Gayle C. , Kim Dae Young , Wahaus Tammie A. , Bryan Jeffrey N. , Reyes Noe
Published: July 2020

Background

Osteosarcoma (OSA) in dogs is an aggressive bone tumor with frequent chemotherapy failure and translational relevance for human health.

Hypothesis/Objectives

We hypothesized that dogs with OSA could be treated safely by ex vivo activated T‐cells that were generated by autologous cancer vaccination and supported by interleukin‐2 (IL‐2) treatment with survival more than twice that reported for amputation alone.

Animals

Osteosarcoma‐bearing dogs (n = 14) were enrolled in a single‐arm prospective trial after complete staging before amputation. Four healthy dogs also were treated in a safety study.

Methods

Autologous cancer cell vaccinations were administered intradermally and dogs underwent leukapheresis. Mononuclear cell products were stimulated ex vivo with a T‐cell‐activating agent. Activated product was transfused and 5 SC IL‐2 injections were administered q48h. Dogs were monitored for metastasis by thoracic radiography every 3 months.

Results

Autologous cancer cell vaccine and activated cellular therapy (ACT) products were successfully generated. Toxicity was minimal after premedicants were instituted before ACT. With premedication, all toxicities were grade I/II. Median disease‐free interval for all dogs was 213 days. One dog developed cutaneous metastasis but then experienced spontaneous complete remission. Median survival time for all dogs was 415 days. Five dogs survived >730 days.

Conclusions and Clinical Importance

This immunotherapy protocol without cytotoxic chemotherapy is safe and tolerable. Compared to historical amputation reports, survival was notably prolonged in this group of patients. Additional prospective studies are warranted to elucidate active immunologic mechanisms and further improve disease response and survival.
Effects of climate change on treeline trees in Sagarmatha (Mt. Everest, Central Himalaya)
Authors: Pandey Sudip , Cherubini Paolo , Saurer Matthias , Carrer Marco , Petit Giai
Published: July 2020

Question

Tree growth at high altitude in the Himalayan region is limited by cold temperatures and also strongly influenced by the seasonality of the Asian monsoon. Understanding whether the ongoing increase in temperatures and changes in precipitation regimes in the Himalayan region can stimulate or limit tree growth is of particular importance to predict the local treeline dynamics.

Location

Altitudinal treeline (~4000 m a.s.l.) in the Sagarmatha (Mt. Everest) National Park (Central Himalaya, Eastern Nepal).

Methods

We assessed the relationships between ring widths and monthly precipitations and mean temperatures, and analysed cellulose stable isotopes (δ13C and δ18O) and their derived C discrimination (Δ13C), and intrinsic water use efficiency (iWUE) in Abies spectabilis and Betula utilis at the Himalayan treeline.

Results

Growth of A. spectabilis strongly depended on summer temperatures, whereas that of B. utilis on spring precipitation. δ13C and iWUE increased with time in both species, especially in A. spectabilis. The long‐term decrease in Δ13C was accompanied by an increase in δ18O in both species, thus suggesting an increase in photosynthetic efficiency rather than a stronger stomatal control of transpiration.

Conclusions

Climate change is progressively reducing the physiological limitations due to low temperatures and low spring precipitations at the Central Himalayan treeline, thus potentially facilitating a further altitudinal forest advance.
Scientific evidence underlying contraindications to the ketogenic diet: An update
Authors: Watanabe Mikiko , Tuccinardi Dario , Ernesti Ilaria , Basciani Sabrina , Mariani Stefania , Genco Alfredo , Manfrini Silvia , Lubrano Carla , Gnessi Lucio
Published: July 2020

First identified as a feasible treatment for intractable epilepsy, the ketogenic diet (KD) has recently gained popularity thanks to growing evidence on applications such as weight loss, most importantly, but also NAFLD, cancer, neurologic conditions and chronic pain. As with any treatment, whether pharmacologic or not, the KD might not be an appropriate intervention for every individual, and a number of contraindications have been proposed, now deeply rooted into clinical practice, excluding de facto many patients that could benefit from its use. However, many of these concerns were expressed due to the absence of clinical studies conducted on fragile populations, and an assessment of lately emerged evidence relative to KD safety is currently lacking and much needed. We herein provide a critical revision of the literature behind each safety alert, in order to guide through the treatment options in the case of subjects with an indication to the KD and a borderline safe situation. Based on available evidence, the possible use of this diet as a therapeutic intervention should be assessed on a patient‐to‐patient basis by adequately skilled medical doctors, keeping in mind current recommendations, but reading them through the knowledge of the current state of the art.
Criminal Threat, Immigrant/Minority Threat, and Political Ideology: An Examination of Handgun Permits Across Texas Counties
Authors: Costanza S. E. , Helms Ronald , Kilburn John C. , Bowers David A.
Published: July 2020

Objectives

To assess the extent to which crime, Hispanic‐to‐white population changes, black‐to‐white population changes, and conservative political appeals affect gun permit application rates across Texas counties.

Methods

This article uses spatial lag regression and robust regression with county‐level data to assess structural sources of variation in handgun permitting across Texas counties in 2016.

Conclusions

Spatial and robust regression model results confirm that median incomes, Republican votes, and rising rates of Hispanic‐to‐white populations are significant predictors of handgun permit application rates. The results call attention to the centrality of Hispanic threat and the prevalence of partisan politics in aggregate permit‐seeking processes.
School Geography under COVID‐19: Geographical Knowledge in the German Formal Education
Authors: Bagoly‐Simó Péter , Hartmann Johanna , Reinke Verena
Published: July 2020

This paper aims to explore some of the changes affecting the teaching and learning of secondary geography as a result of the COVID‐19 pandemic. In doing so, it sets a focus on geographical knowledge and its alteration in times of extraordinary measures to diagnose its challenges. Against the background of current debates on competence‐ and standard‐based education from the sociology and history of education as well as from geography education, problem‐centred interviews served to explore the perspectives of 15 German secondary school teachers on the alterations their Geography teaching suffered since the COVID‐19 lockdown. Analytical categories were general challenges, communication with stakeholders, educational media usage, and the role of COVID‐19 in geographical knowledge acquisition. The results uncovered, along with systemic challenges, two main areas in need of consideration to redefine subject‐specific knowledge in times of competence‐based education, namely geography teachers' professional identity and perspectives on the role of geographical competencies.
Gonioscopic iridocorneal angle morphology and incidence of postoperative ocular hypertension and glaucoma in dogs following cataract surgery
Authors: Zibura Ashley E. , Robertson James B. , Westermeyer Hans D.
Published: July 2020

Purpose

To investigate the relationship between gonioscopic iridocorneal angle (ICA) morphology and the incidence of postoperative ocular hypertension (POH) and postoperative glaucoma in dogs undergoing cataract surgery.

Animals studied

Retrospective analysis of 138 eyes of 78 canine patients who underwent phacoemulsification at North Carolina State University from December 1, 2015 through April 30, 2017.

Methods

Medical records of all phacoemulsification patients with preoperative RetCam gonioscopic images were reviewed for preoperative, intraoperative, and postoperative variables. Gonioscopic angle indices were calculated using a novel (ZibWest) angle grading system, and these indices were analyzed for outcome‐related significance.

Results

Increased surgeon experience was associated with increased probability of POH and vision loss. Higher average ZibWest Angle indices (ie, more open angles with less pectinate ligament dysplasia/ abnormality) were associated with a significantly decreased probability of medically unresponsive glaucoma. Increased patient age was significantly associated with an increased probability of both postoperative glaucoma and vision loss. Female dogs were significantly more likely to experience postoperative glaucoma compared to male dogs. Increased surgery time was significantly associated with increased probability of vision loss.

Conclusions

The ZibWest angle index may predict increased risk for developing medically unresponsive glaucoma with cataract surgery. Female sex, and increased patient age, surgical time, and surgeon experience were associated with increased postoperative morbidity.
Physical activity and advanced cancer: evidence of exercise‐sensitive genes regulating prostate cancer cell proliferation and apoptosis
Authors: Schwappacher Raphaela , Schink Kristin , Sologub Svetlana , Dieterich Walburga , Reljic Dejan , Friedrich Oliver , Herrmann Hans J. , Neurath Markus F. , Zopf Yurdagül
Published: July 2020

Key points

Physical activity is known to protect against cancer.

The resistance exercise method whole‐body electromyostimulation (WB‐EMS) has a significant anti‐cancer effect.

WB‐EMS‐conditioned serum from advanced prostate cancer patients decreased human prostate carcinoma cell growth and viability in vitro.

Multiplex analysis revealed that genes associated with human prostate cancer cell proliferation and apoptosis are sensitive for exercise.

Feasible exercise should be part of multimodal anti‐cancer therapies, also for physically weakened patients.

Regular physical activity is known to protect against cancer development. In cancer survivors, exercise reduces the risk of cancer recurrence and mortality. However, the link between exercise and decreased cancer risk and improved survival is still not well understood. Serum from exercising healthy individuals inhibits proliferation and activates apoptosis in various cancer cells, suggesting that mechanisms regulating cancer cell growth are affected by exercise. For the first time, we analysed serum from advanced‐stage cancer patients with prostate (exercise group n = 8; control group n = 10) or colorectal (exercise n = 6; control n = 6) cancer, after a 12‐week whole‐body electromyostimulation training (20 min/session, 2×/week; frequency 85 Hz; pulse width 350 µs; 6 s stimulation, 4 s rest), a tolerable, yet effective, resistance exercise for physically weakened patients. We report that serum from these advanced cancer patients inhibits proliferation and enhances apoptosis of human prostate and colon cancer cells in vitro using cell growth and death assays (5‐bromo‐2′‐deoxyuridine incorporation, cell counting, DNA fragmentation). Exercise‐mimicking electric pulse stimulation of human primary myotubes showed that electric pulse stimulation‐conditioned myotube medium also impairs human cancer cell viability. Gene expression analysis using a multiplex array of cancer‐associated genes and subsequent quantitative RT‐PCR revealed the presence of exercise‐sensitive genes in human prostate cancer cells that potentially participate in the exercise‐mediated regulation of malignant cell growth and apoptosis. Our data document the strong efficiency of the anti‐oncogenic effects of physical activity and will further support the application of regular therapeutic exercise during cancer disease.
Phylogenetic and physiological signals in metazoan fossil biomolecules
Authors: Wiemann Jasmina , Crawford Jason M. , Briggs Derek E. G.
Published: July 2020

Fossilization yields stable polymers diagnostic of tissue type, biomineralization, and the place of animals in the tree of life.
Engineering a far-red light–activated split-Cas9 system for remote-controlled genome editing of internal organs and tumors
Authors: Yu Yuanhuan , Wu Xin , Guan Ningzi , Shao Jiawei , Li Huiying , Chen Yuxuan , Ping Yuan , Li Dali , Ye Haifeng
Published: July 2020

A far-red light–activated split-Cas9 (FAST) system was developed for controlling gene editing in both mammalian cells and mice.
Apathy, but not depression, predicts all-cause dementia in cerebral small vessel disease
Authors: Tay Jonathan , Morris Robin G , Tuladhar Anil M , Husain Masud , de Leeuw Frank-Erik , Markus Hugh S
Published: July 2020

Objective

To determine whether apathy or depression predicts all-cause dementia in small vessel disease (SVD) patients.

Methods

Analyses used two prospective cohort studies of SVD: St. George’s Cognition and Neuroimaging in Stroke (SCANS; n=121) and Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort (RUN DMC; n=352). Multivariate Cox regressions were used to predict dementia using baseline apathy and depression scores in both datasets. Change in apathy and depression was used to predict dementia in a subset of 104 participants with longitudinal data from SCANS. All models were controlled for age, education and cognitive function.

Results

Baseline apathy scores predicted dementia in SCANS (HR 1.49, 95% CI 1.05 to 2.11, p=0.024) and RUN DMC (HR 1.05, 95% CI 1.01 to 1.09, p=0.007). Increasing apathy was associated with dementia in SCANS (HR 1.53, 95% CI 1.08 to 2.17, p=0.017). In contrast, baseline depression and change in depression did not predict dementia in either dataset. Including apathy in predictive models of dementia improved model fit.

Conclusions

Apathy, but not depression, may be a prodromal symptom of dementia in SVD, and may be useful in identifying at-risk individuals.
Ethicists, doctors and triage decisions: who should decide? And on what basis?
Authors: Camporesi Silvia , Mori Maurizio
Published: July 2020

We report here an emerging dispute in Italy concerning triage criteria for critically ill covid-19 patients, and how best to support doctors having to make difficult decisions in a context of insufficient life saving resources. The dispute we present is particularly significant as it juxtaposes two opposite views of who should make triage decisions, and how doctors should best be supported. There are both empirical and normative questions at stake here. The empirical questions pertain to the available level of evidence that healthcare professionals would rather not be left alone with their ‘clinical judgments’ to make triage decisions, and to the accounts of distributive justice that doctors and healthcare professionals rely on, when making triage decisions. The normative questions pertain to how this empirical evidence should inform guidelines on how prioritisation decisions are made in a context of emergency, and who gets to have the authority to do so. This debate goes beyond the discussion of the care of critically ill patients with COVID-19 and has broader implications beyond the national context for the discussion of how to relieve moral distress in contexts of imbalances between healthcare resources and clinical needs of a population.
The impact of thermal pasteurization on viral load and detectable live viruses in human milk and other matrices: a rapid review
Authors: Pitino Michael A. , O’Connor Deborah L. , McGeer Allison J. , Unger Sharon
Published: July 2020

Holder pasteurization (62.5 °C, 30 min) of human milk is thought to reduce the risk of transmitting viruses to an infant. Some viruses may be secreted into milk – others may be contaminants. The effect of thermal pasteurization on viruses in human milk has yet to be rigorously reviewed. The objective of this study is to characterize the effect of common pasteurization techniques on viruses in human milk and non-human milk matrices. Databases (MEDLINE, Embase, Web of Science) were searched from inception to April 20th, 2020, for primary research articles assessing the impact of pasteurization on viral load or detection of live virus. Reviews were excluded, as were studies lacking quantitative measurements or those assessing pasteurization as a component of a larger process. Overall, of 65 131 reports identified, 109 studies were included. Pasteurization of human milk at a minimum temperature of 56−60 °C is effective at reducing detectable live virus. In cell culture media or plasma, coronaviruses (e.g., SARS-CoV, SARS-CoV-2, MERS-CoV) are highly susceptible to heating at ≥56 °C. Although pasteurization parameters and matrices reported vary, all viruses studied, except parvoviruses, were susceptible to thermal killing. Future research important for the study of novel viruses should standardize pasteurization protocols and should test inactivation in human milk.

Novelty In all matrices, including human milk, pasteurization at 62.5 °C was generally sufficient to reduce surviving viral load by several logs or to below the limit of detection. Holder pasteurization (62.5 °C, 30 min) of human milk should be sufficient to inactivate nonheat resistant viruses, including coronaviruses, if present.
The effect of blood flow on tibialis anterior motor unit firing rates during sustained low-intensity isometric contractions
Authors: Copithorne David B. , Hali Kalter , Rice Charles L.
Published: July 2020

Low-intensity contractions with blood flow occlusion (BFO) result in neuromuscular adaptations comparable with high-intensity (>70% maximal voluntary contraction, MVC) exercise. Because BFO exercise can only be applied to limb muscles, it is of interest to explore whether muscles proximal to the occlusion site are affected. Therefore, the purpose of this study was to assess neural activation of the tibialis anterior (TA) when flow is occluded proximal and distal to the active muscle. Five males completed three protocols to observe the effect of BFO on motor unit firing rates (MUFR) of the TA at a fatiguing contraction intensity of ∼15% MVC. Two occlusion protocols, one proximal (BFOprox) to and one distal (BFOdis) to the TA, were compared with a control (free-flow) protocol time-matched to BFOdis. MVC was significantly reduced following the BFOprox (∼41%; P < 0.001) and BFOdis (∼27%, P < 0.001), but not following the control protocol (∼15%; P = 0.13). Surface electromyography (EMG) during BFOdis and BFOprox increased ∼14% and ∼28%, respectively, but was not different among protocols. MUFRs for BFOdis and BFOprox were significantly reduced (by ∼33% and ∼23%, respectively; P < 0.01) at task failure. Results indicate that although BFOprox results in the largest reductions of MUFRs, BFOdis shows greater impairments compared with the free-flow control condition.

Novelty Effects on motor unit firing rates of proximal versus distal blood flow occlusion were compared during low-intensity fatiguing task. Proximal occlusion results in greatest fatigue and reduction in motor unit rates, but distal occlusion elicits more fatigue and rate reduction than a control task.
Structure and function of secretory glochids and nectar composition in two Opuntioideae (Cactaceae) species
Authors: Silva Stefany Cristina de Melo , Machado Silvia Rodrigues , Nepi Massimo , Rodrigues Tatiane Maria
Published: July 2020

Cactaceae exhibit highly modified spines that are considered to be extrafloral nectaries (EFNs). Despite their ecological and taxonomical relevance in this family, little is known on their structure and function. We have described the anatomy, ontogenesis, and ultrastructure of the secretory glochids in two Opuntioideae species. Young cladodes of Brasiliopuntia brasiliensis (Willd.) A. Berger and Nopalea cochenillifera (L.) Salm-Dyck were processed for light and electron microscopy studies. The composition of the secretions was analyzed by high performance liquid chromatography. The secretory glochids were soft, massive, and barbed, as well as translucent. Hyaline droplets on the secretory glochid apex were collected by aggressive ants. The secretory glochids originated from the areolar meristem, beginning as small protuberances formed by protoderm and ground meristem. Mature secretory glochids consisted of a central multiseriate axis of ground cells covered by uniseriate epidermis with a continuous cuticle, and exhibited three regions: (i) dilated vascularized base with parenchyma cells exhibiting features associated to nectar secretion; (ii) elongated median region with juxtaposed fusiform non-lignified parenchyma cells; and (iii) tapered apical portion with immature fibers loosely arranged cells. The exudate was sucrose-dominant with a similar amino acid profile in both species. Our results shed light on the secretory activity of glochids in Cactaceae and their role in cactus–ant interactions.
Adsorption mechanisms and electronic and magnetic properties of oxygen on iron tetranitride
Authors: Li Zhi , Shi Tong-Tong , Zhao Zhen
Published: July 2020

The oxide layer on iron nitrides restricts the conductivity of electrode materials. The adsorption and dissociation processes of O2 on the Fe4N have been analyzed by using first-principles. Comparing all the O2Fe4N isomers, we find that O atom prefers to locate at the center site of Fe–Fe–Fe plane which stays away from N atom. It means that O2 molecule is dissociated on the surface of Fe4N molecule. Endothermic and exothermic processes occur with the adsorption and decomposition of O2 on the surface of Fe4N. All the O2Fe4N clusters still present higher kinetic activity. For the O2Fe4N clusters, the internal electrons transfer from 4[Formula: see text] to 3[Formula: see text] and 4[Formula: see text] orbitals which are obviously more than those transfer to the other atoms. O atoms acquire less electron from nearby Fe atoms which confirms that the adsorption of O2 on Fe4N is a physical adsorption process. The average spin of the ground-state O2Fe4N clusters is 1.805 [Formula: see text]/atom.
Understanding vibrant behavior of Si-circular diaphragm for low-pressure measurement
Authors: Samridhi  , Kumar Manish , Singh Kulwant , Kumar Shalendra , Alvi P. A.
Published: July 2020

Enhanced sensitivity, precise measurements and accuracy are the key factors to identify the performance of any sensor. In this paper, p-polycrystalline silicon micro-pressure sensor has been designed which works on the principle of piezoresistive effect. A theoretical modeling and computational simulation of the circular Si-diaphragm have been performed through the extensive study of stress and frequency response with the help of finite element method (FEM) within the framework of COMSOL. For a thin diaphragm ([Formula: see text][Formula: see text]50 [Formula: see text]m), the Eigen frequency and the frequency generated in a diaphragm under the influence of pressure has been optimized within the pressure range from 1–25 kPa. The modes of vibrations generated in the diaphragm have been optimized at wide-frequency range [Formula: see text][Formula: see text]200–800 kHz at various pressure values. The findings of the presented research have suggested that for a [Formula: see text][Formula: see text]50 [Formula: see text]m thin diaphragm, the optimized fundamental frequency is [Formula: see text][Formula: see text]310 kHz for showing better piezoresistive response which results into enhanced sensitivity. Moreover, the simulation results show that for the designed sensor, the pressure sensitivity of [Formula: see text][Formula: see text]11.51 mv/psi has been conveyed.
AN INVESTIGATION OF RETROFITTED MASONRY-INFILLED FRAMES (RMIF) WITH HYBRID FIBERS: AN EXPERIMENTAL APPROACH
Authors: NEELAMEGAM P. , KUMAR P. SURESH
Published: July 2020

A reinforced concrete frame with masonry wall infill, “framed-brick work”, is a composite basic structure demonstrated to be feasible and effective on account of in-plane smooth excitations. Numerous models have been proposed for simulation of the behavior of masonry infills. The act of utilizing infill walls has been under investigation as it has both positive and negative impacts on the behavior of the structure under horizontal load. An enormous number of experimental and diagnostic examinations have been embraced in the past to research the behavior of such frames. The paper has focused on the working principles and the fundamental highlights of a recently created retrofitted masonry infill frames (RMIF) with carbon fiber–reinforced polymer (CFRP) sheets of RMIF. The presence of CFRP retrofitted in infill frames changes the behavior of the structure under substantial loads. The behavior examination, for example, deflection, ductility and tensile strength, is investigated for clay brick and fly ash bricks examples. For approval reason, this investigation utilizes feed forward back propagation neural network (FFBN) procedure. The correlation between experimental and the predicted values demonstrated that while the mechanical properties can be predicted for each specimen up partly by a portion of these models with the exact outcome achieved as a minimum error.
ANALYSIS OF WEAR BEHAVIOR OF A NOVEL MAGNESIUM METAL–METAL COMPOSITE
Authors: SATHISH S. , ANANDAKRISHNAN V. , GUPTA MANOJ
Published: July 2020

The need of engineered materials with high strength to weight ratio was instrumental for the development of a novel magnesium metal–metal composite with the addition of titanium (reinforcement) and aluminum (alloying element) through disintegrated melt deposition technique. The X-ray diffraction analysis and scanning electron microscopy analysis used to explore the metallurgical insights of the developed magnesium metal–metal composite. Wear tests were carried out with pin-on-disc equipment by varying the input parameters load and sliding velocity over a sliding distance of 2000[Formula: see text]m. Wear was obtained as the output from the experiments, and the same was analyzed through Pareto analysis of variance, to identify the significant parameters. Also, a fuzzy logic-based model was developed to predict the wear behavior of the metal–metal composite. The wear mechanisms involved in the dry sliding wear behavior were analyzed through worn surface analysis and wear debris analysis.