bluuebunny/crossref_metadata_2025 huggingface dataset:
Epigraphica Dusaria I. Some Nabataean, Hismaic and Hismaic/Nabataean inscriptions with rock drawings from the Ḥismā desert, north‐west of Tabūk (Saudi Arabia)
Authors: Norris Jérôme , Al‐Manaser Ali
Published: April 2020

This paper studies a group of inscriptions and rock drawings from Ṭūr al‐Qawwās in the Ḥismā desert (Saudi Arabia). These include two Nabataean and three Hismaic inscriptions, in addition to a Hismaic/Nabataean bilingual. The presence of Hismaic and Nabataean texts carved side by side as well as this new ANA/Nabataean bilingual raise the question of the linguistic diversity in northern Arabia and that of the relationships between the Nabataeans and their nomadic neighbours. From the point of view of Nabataean grammar, the texts provide us with new lexical items at the same time as they illustrate a new example of an optative use of the prefix conjugation. One of the inscriptions is a prayer to Dushara that exhibits a unique religious formula requesting the deity’s protection. Leading to reflect on the association of rock art with Nabataean inscriptions, the drawings are also of interest. They include a rare representation of a bird, possibly an eagle, which could find its source of influence in the Nabataean sculpture. Just as interesting are a cameleer dressed withizārandridāʾ, and the figure of a saddled equid which suggests, for the first time, an occasional employment of horse saddles among the Nabataeans.
Randomized Trial of Therapy Dogs Versus Deliberative Coloring (Art Therapy) to Reduce Stress in Emergency Medicine Providers
Authors: Kline Jeffrey A. , VanRyzin Kimberly , Davis Jacob C. , Parra Jonathan A. , Todd Maxwell L. , Shaw Liza L. , Haggard Benjamin R. , Fisher Michelle A. , Pettit Katherine L. , Beck Alan M.
Published: April 2020

Objective

Cognitive stress during shift work contributes to burnout in emergency department (ED) workers. We hypothesize that if physicians and nurses interact with a therapy dog for 5 minutes while on ED shift, both their perceived and their manifested stress levels will decrease.

Methods

In this single‐center, prospective, randomized controlled clinical trial (NCT03628820), we tested the effectiveness of therapy dogs versus coloring a mandala and versus no intervention (control) on provider stress. Consenting emergency medicine physicians and nurses provided three self‐reported assessments of stress and saliva samples at the start (T1), at the middle (T2), and near the end (T3) of shift. Thirty minutes prior to T2, participants were randomized to either interacting with a therapy dog or coloring for 5 minutes; controls had neither. Stress was assessed on visual analog scale (VAS, 0–100 mm) and with salivary cortisol (Salimetrics) and the modified Perceived Stress Scale (mPSS‐10). To assess potential change in participant behavior, patients of providers in either group were asked to complete an internally derived survey of empathic behaviors displayed by providers at T1 and T3.

Results

We enrolled 122 providers (n = 39 control, n = 40 coloring, n = 43 dog); 48% were residents, and 60% enrolled on an evening shift. At T1, mean (±SD) VAS score was not different between groups (18.2 [±17.8] mm). At T3, VAS tended to increase with coloring (24.5 mm), remain unchanged in controls (20 mm), and decreased slightly with dogs (13.6 mm, p = 0.018 vs. coloring, Tukey’s post hoc). Salivary cortisol levels were consistently highest at the beginning of each providers’ shift and were significantly decreased versus control in both the dog and the coloring groups (p < 0.05, Tukeyʼs). We observed no difference between groups for the mPSS‐10 nor in patient reported survey of empathic behaviors.

Conclusion

This randomized controlled clinical trial demonstrates preliminary evidence that a 5‐minute therapy dog interaction while on shift can reduce provider stress in ED physicians and nurses.
Dihydromyricetin Protects the Liver via Changes in Lipid Metabolism and Enhanced Ethanol Metabolism
Authors: Silva Joshua , Yu Xin , Moradian Renita , Folk Carson , Spatz Maximilian H. , Kim Phoebe , Bhatti Adil A. , Davies Daryl L. , Liang Jing
Published: April 2020

Background

Excess alcohol (ethanol, EtOH) consumption is a significant cause of chronic liver disease, accounting for nearly half of the cirrhosis‐associated deaths in the United States. EtOH‐induced liver toxicity is linked to EtOH metabolism and its associated increase in proinflammatory cytokines, oxidative stress, and the subsequent activation of Kupffer cells. Dihydromyricetin (DHM), a bioflavonoid isolated from Hovenia dulcis, can reduce EtOH intoxication and potentially protect against chemical‐induced liver injuries. But there remains a paucity of information regarding the effects of DHM on EtOH metabolism and liver protection. As such, the current study tests the hypothesis that DHM supplementation enhances EtOH metabolism and reduces EtOH‐mediated lipid dysregulation, thus promoting hepatocellular health.

Methods

The hepatoprotective effect of DHM (5 and 10 mg/kg; intraperitoneal injection) was evaluated using male C57BL/6J mice and a forced drinking ad libitum EtOH feeding model and HepG2/VL‐17A hepatoblastoma cell models. EtOH‐mediated lipid accumulation and DHM effects against lipid deposits were determined via H&E stains, triglyceride measurements, and intracellular lipid dyes. Protein expression of phosphorylated/total proteins and serum and hepatic cytokines was determined via Western blot and protein array. Total NAD+/NADH Assay of liver homogenates was used to detect NAD + levels.

Results

DHM reduced liver steatosis, liver triglycerides, and liver injury markers in mice chronically fed EtOH. DHM treatment resulted in increased activation of AMPK and downstream targets, carnitine palmitoyltransferase (CPT)‐1a, and acetyl CoA carboxylase (ACC)‐1. DHM induced expression of EtOH‐metabolizing enzymes and reduced EtOH and acetaldehyde concentrations, effects that may be partly explained by changes in NAD+. Furthermore, DHM reduced the expression of proinflammatory cytokines and chemokines in sera and cell models.

Conclusion

In total, these findings support the utility of DHM as a dietary supplement to reduce EtOH‐induced liver injury via changes in lipid metabolism, enhancement of EtOH metabolism, and suppressing inflammation responses to promote liver health.
Socio‐economic differences in all‐cause mortality in people with alcohol use disorder: a prospective cohort study
Authors: Rossow Ingeborg , Amundsen Ellen J. , Samuelsen Sven Ove
Published: April 2020

Background and aims

While alcohol‐attributable mortality rates are higher in low socio‐economic status (SES) groups, less is known about SES differences in all‐cause mortality in alcohol use disorder (AUD). The aim of this study was to explore whether there are SES differences in people with AUD, regarding (i) treatment admission, (ii) all‐cause mortality risk and (iii) relative mortality risk.

Design and setting

A prospective cohort study in Norway, follow‐up period from 2009–10 to 2013. Data on SES and mortality were obtained through linkages to national registries, using national unique ID numbers.

Participants

AUD patients (age 20+) admitted to treatment in 2009–10 (n = 11 726) and age and gender frequency‐matched controls from the general population (n = 12 055).

Measurements

The SES indicator was education level (low, intermediate and high). Mortality was calculated as deaths per 1000 person‐years during the 4‐year observation period.

Findings

Admission to AUD treatment was elevated in the low compared with the high SES categories (OR = 3.31, 95% CI = 3.09, 3.55). Among AUD patients, mortality risk was elevated in the low SES category (HR = 1.23, 95% CI = 1.04, 1.45). Relative mortality risk from AUD was significantly higher in the high SES (HR = 8.65, 95% CI = 6.16, 12.14) compared with the low SES categories (HR = 3.29, 95% CI = 2.61, 4.15).

Conclusion

Admission to treatment for alcohol use disorders in Norway appears to decrease with increasing socio‐economic status, and relative mortality risk from alcohol use disorder appears to increase with increasing socio‐economic status.
Characterizing the predictive validity of measures of susceptibility to future use of combustible, vaporized and edible cannabis products in adolescent never‐users
Authors: Barrington‐Trimis Jessica L. , Bae Dayoung , Schiff Sara , Davis Jordan , Unger Jennifer B. , Leventhal Adam M.
Published: April 2020

Background and aims

The construct of susceptibility to substance use initiation (i.e. cognitive proclivity to future use) is critical for prevention efforts in adolescent populations. This study aimed to provide empirical evidence for the validity of the susceptibility construct for different cannabis products (i.e. combustible, edible or vaporized cannabis), and evaluate whether susceptibility measures are predictive of subsequent initiation.

Design

Prospective cohort study including baseline data (Spring 2015) and four follow‐up surveys administered every 6 months through Spring 2017.

Setting

Ten schools in the Los Angeles, California metropolitan area.

Participants

Adolescents [n = 2100; mean age = 16.1; standard deviation (SD) = 0.41; 54% female] who reported never having used any cannabis product at baseline.

Measurements

We assessed five indices of a susceptibility to use cannabis composite index at baseline, adapted from a validated tobacco use index (intention to use, willingness, curiosity and positive/negative cannabis use outcome expectancies, with four response categories, definitely not [1] to definitely yes [4]), by cannabis product (combustible, edible or vaporized). A composite index was created for each product by averaging responses across the five susceptibility items. Subsequent initiation of use of each cannabis product was assessed at each follow‐up wave.

Findings

Factorial validity for unidimensionality for each five‐item index (by product) was confirmed. The composite index for susceptibility to cannabis use was greatest for combustible (mean = 1.44; SD = 0.58), moderate for edible (mean = 1.37; SD = 0.53) and lowest for vaporized cannabis (mean = 1.30; SD = 0.44). The associations of each composite susceptibility index with subsequent initiation of that product and each of the other cannabis products over follow‐up (i.e. cross‐product associations) were statistically significant, with hazard ratios ranging from 2.30 to 2.80 across 24 months of follow‐up (all Ps < 0.05).

Conclusions

A five‐item susceptibility to cannabis use composite index (by product) appears to be useful for characterizing and predicting youth at risk for cannabis use initiation across a spectrum of cannabis products.
Bilirubin estimates from smartphone images of newborn infants’ skin correlated highly to serum bilirubin levels
Authors: Aune Anders , Vartdal Gunnar , Bergseng Håkon , Randeberg Lise Lyngsnes , Darj Elisabeth
Published: April 2020

Aim

Neonatal jaundice is an important cause of morbidity and mortality, and identifying the condition remains a challenge. This study evaluated a novel method of estimating bilirubin levels from colour‐calibrated smartphone images.

Methods

A cross‐sectional prospective study was undertaken at two hospitals in Norway from February 2017 to March 2019, with standardised illumination at one hospital and non‐standardised illumination at the other hospital. Healthy term‐born infants with a normal birthweight were recruited up to 15 days of age. The main outcome measures were bilirubin estimates from digital images, plus total bilirubin in serum (TSB) and transcutaneous bilirubin (TcB).

Results

Bilirubin estimates were performed for 302 newborn infants, and 76 had severe jaundice. The correlation between the smartphone estimates and TSB was measured by Pearson's r and was .84 for the whole sample. The correlation between the image estimates and TcB was 0.81. There were no significant differences between the hospitals. Sensitivity was 100%, and specificity was 69% for identifying severe jaundice of more than 250 µmol/L.

Conclusion

A smartphone‐based tool that estimated bilirubin levels from digital images identified severe jaundice with high sensitivity and could provide a screening tool for neonatal jaundice.
Canadian consumer acceptance of gene‐edited versus genetically modified potatoes: A choice experiment approach
Authors: Muringai Violet , Fan Xiaoli , Goddard Ellen
Published: April 2020

In 2016, second‐generation genetically modified (GM) potatoes were approved for production and sale in Canada. In this study, we analyze how consumer acceptance of GM potatoes may be affected by various factors, including the trait introduced (i.e., the product benefits), the type of breeding technology used, and the developer of the potato using any technology. We conduct an online survey and use a stated choice experiment to collect data on consumer acceptance of GM and other potatoes in Canada. Random utility models are used to analyze the economic value consumers place on the various attributes of the potatoes. Our results show that consumers are willing to pay more for a health attribute (reduced acrylamide produced when potatoes are fried) and an environmental attribute. Respondents in general need to face discounted prices to buy potatoes created by either gene editing or GM (either transgenic or cisgenic/intragenic) technologies. However, consumers are in general more accepting of the gene editing technology than the GM technologies. Our results also show that government is the most preferred developer of the potatoes, regardless of technology. Results from this study can help guide public and private management of the introduction of new foods when the products are developed with unpopular technologies.
Lessons Never Learned: Crisis and gender‐based violence
Authors: John Neetu , Casey Sara E , Carino Giselle , McGovern Terry
Published: April 2020

The COVID‐19 pandemic exposes underlying inequalities in our socio‐economic and health systems, such as gender‐based violence (GBV). In emergencies, particularly ones that involve quarantine, GBV often increases. Policymakers must utilize community expertise, technology and existing global guidelines to disrupt these trends in the early stages of the COVID‐19 epidemic. Gender norms and roles relegating women to the realm of care work puts them on the frontlines in an epidemic, while often excluding them from developing the response. It is critical to value women’s roles in society and include their voices in the decision‐making process to avoid unintended consequences and ensure a comprehensive response that caters to the needs of the most vulnerable groups.
What have we learned about renal protection from the cardiovascular outcome trials and observational analyses with SGLT2 inhibitors?
Authors: Sridhar Vikas S. , Rahman Habib U. , Cherney David Z.I.
Published: April 2020

Over the past 5 years, sodium‐glucose cotransport 2 (SGLT2) inhibitors have been increasingly regarded as glycaemic agents with cardiovascular (CV) and renal protective effects. The CV benefits of SGLT2 inhibitors have been well established in patients with type 2 diabetes (T2D) and a range of CV comorbidities at baseline. Subsequently, the renal benefits of SGLT2 inhibitors were established in the CREDENCE trial, a dedicated renal outcome trial where canagliflozin reduced the primary composite renal outcome by 30%. In light of these trials, clinical practice guidelines have rapidly evolved, recommending the use of SGLT2 inhibitors as renal and cardioprotective agents in appropriate patient populations. Accordingly, it is important to have an in‐depth understanding of the evidence underlying the use of SGLT2 inhibitors in patients with T2D based on published clinical trials and real‐world evidence (RWE) studies, as well as information related to potential safety concerns. To accomplish this, we reviewed the evidence for renal protection and safety with SGLT2 inhibitors in the EMPA‐REG OUTCOME, CANVAS Program and DECLARE‐TIMI 58 CV safety trials, and in the growing body of evidence emerging from real‐world studies. This body of work has shown that SGLT2 inhibitors reduce the risk of surrogate renal endpoints such as albuminuria and mitigate the risk of hard renal endpoints including doubling of serum creatinine and end‐stage kidney disease in patients with T2D.
An updated overview of diabetic nephropathy: Diagnosis, prognosis, treatment goals and latest guidelines
Authors: Selby Nicholas M. , Taal Maarten W.
Published: April 2020

Diabetic nephropathy (DN) is a major healthcare challenge. It occurs in up to 50% of those living with diabetes, is a major cause of end‐stage kidney disease (ESKD) that requires treatment with dialysis or renal transplantation, and is associated with significantly increased cardiovascular morbidity and mortality. DN is a clinical syndrome characterized by persistent albuminuria and a progressive decline in renal function, but it is increasingly recognized that the presentation and clinical course of kidney disease in diabetes is heterogeneous. The term diabetic kidney disease (DKD) is now commonly used to encompass the spectrum of people with diabetes who have either albuminuria or reductions in renal function. In this article, the clinical presentation and approach to diagnosis of DKD will be discussed, as will its prognosis. The general principles of management of DKD will also be reviewed with reference to current international guidelines.
Incense in medicine: an early medieval perspective
Authors: Burridge Claire
Published: April 2020

The production, use, and meaning of incense represent relatively untapped areas of study within early medieval history. In this article, I present evidence for the medical use of incense in the Carolingian world. Using a sample of eighth‐ and ninth‐century manuscripts, I analyse incense recipes, investigating their contexts and ingredients, as well as the use of incense itself as an ingredient in medical remedies. This evidence not only suggests that incense was understood as a multipurpose substance, but also offers a new window into exploring early medieval medical knowledge and practice and relates to the sacralization of medicine in this period.
Legacy effects override soil properties for CO2 and N2O but not CH4 emissions following digestate application to soil
Authors: Rosace Maria Chiara , Veronesi Fabio , Briggs Stephen , Cardenas Laura M. , Jeffery Simon
Published: April 2020

The application of organic materials to soil can recycle nutrients and increase organic matter in agricultural lands. Digestate can be used as a nutrient source for crop production but it has also been shown to stimulate greenhouse gas (GHG) emissions from amended soils. While edaphic factors, such as soil texture and pH, have been shown to be strong determinants of soil GHG fluxes, the impact of the legacy of previous management practices is less well understood. Here we aim to investigate the impact of such legacy effects and to contrast them against soil properties to identify the key determinants of soil GHG fluxes following digestate application. Soil from an already established field experiment was used to set up a pot experiment, to evaluate N2O, CH4 and CO2 fluxes from cattle‐slurry‐digestate amended soils. The soil had been treated with farmyard manure, green manure or synthetic N‐fertilizer, 18 months before the pot experiment was set up. Following homogenization and a preincubation stage, digestate was added at a concentration of 250 kg total N/ha eq. Soil GHG fluxes were then sampled over a 64 day period. The digestate stimulated emissions of the three GHGs compared to controls. The legacy of previous soil management was found to be a key determinant of CO2 and N2O flux while edaphic variables did not have a significant effect across the range of variables included in this experiment. Conversely, edaphic variables, in particular texture, were the main determinant of CH4 flux from soil following digestate application. Results demonstrate that edaphic factors and current soil management regime alone are not effective predictors of soil GHG flux response following digestate application. Knowledge of the site management in terms of organic amendments is required to make robust predictions of the likely soil GHG flux response following digestate application to soil.
Efficacy and safety of glecaprevir/pibrentasvir in patients with hepatitis C virus infection aged ≥75 years
Authors: Kinoshita Akiyoshi , Koike Kazuhiko , Mizuno Yusuke , Ogata Itsuro , Kobayashi Yutaro , Hasegawa Kiyoshi , Shiraishi Koichi , Yoshida Hideo , Nakata Ryo , Yamada Norie , Yasuda Kiyomi
Published: April 2020

Aim

Opportunities to treat older patients with hepatitis C virus infection have increased. We investigated the efficacy and safety of glecaprevir/pibrentasvir in patients with HCV infection aged ≥75 years.

Methods

We retrospectively evaluated 131 patients with hepatitis C virus infection treated with glecaprevir/pibrentasvir at nine institutions in Japan. The patients were divided into two groups according to their age: the elderly group (n = 43, aged ≥75 years) and younger group (n = 88, aged <75 years). We compared the clinical characteristics, virologic response and adverse events between the two groups. The predictive factors for adverse events were also assessed.

Results

The presence of cirrhosis (27.9%), a history of hepatocellular carcinoma (23.3%) and comorbidities (88.4%) were more frequently observed in the elderly group than in the younger group. Six (14.0%) patients in the elderly group and 19 (21.6%) in the younger group dropped out before the sustained virologic response 12 assessment. In the intention‐to‐treat population, 86.0% in the elderly group and 78.4% in the younger group achieved sustained virologic response 12 (P = 0.30). In the modified intention‐to‐treat population, all patients achieved sustained virologic response 12. A total of 27.5% of patients experienced adverse events. The most frequently observed adverse events was pruritus, and was significantly associated with female sex, the presence of hemodialysis and serum albumin at baseline <4.0 g/dL.

Conclusion

Glecaprevir/pibrentasvir therapy was effective and well tolerated, even in elderly patients with hepatitis C virus infection aged ≥75 years. Geriatr Gerontol Int 2020; ••: ••–••.
“Would you tell me If i smelled bad?,” 14‐year‐old Dylan diagnosed with olfactory reference syndrome: A case report
Authors: Alvarez David V.
Published: April 2020

Topic

Olfactory reference syndrome (ORS) is a psychiatric condition that is not known to many psychiatric providers and yet it is thought to be far more common than generally recognized. Symptoms of ORS are disruptive, debilitating, and can severely impair the daily functioning of patients dealing with it.

Purpose

This article provides an overview of ORS and explores how it can be mistaken for other diagnostic constellations. A case report that details the treatment of a 14‐year‐old male illustrates how a clinician employs a multimodal approach to address symptoms that overlap with other diagnoses to successfully treat a patient with ORS.

Sources

Existing literature on the treatment of ORS and obsessive–compulsive disorder in adults, adolescents, and children and the clinical experience of providing care to a 14‐year‐old patient in an outpatient setting.

Conclusions

Nurses and other healthcare providers should be made more aware of the symptoms, criteria, and diagnosis of ORS. Research needs to be increased to solidify ORS as a formal diagnosis and treatment recommendations are required to better treat this underserved population.
Pre‐operative ultrasound planning in the surgical management of patients with hidradenitis suppurativa
Authors: Cuenca‐Barrales C. , Salvador‐Rodríguez L. , Arias‐Santiago S. , Molina‐Leyva A.
Published: April 2020

Background

Ultrasonography can improve disease severity assessment in hidradenitis suppurativa (HS) patients. The use of pre‐operative ultrasonography could improve surgical outcomes in HS patients.

Objectives

(i) To assess changes in the projected skin‐excised area after the use of pre‐operative ultrasonography, (ii) to explore the clinical factors potentially associated with inaccurate clinical surgical delimitation and (iii) to compare recurrence rates after pre‐operative ultrasound vs clinical surgical margin delimitation at week 24.

Methods

Cohort study. Patient candidates for surgical treatment by wide excision and healing by secondary intention with a clinical projected skin‐excised area equal to or larger than 15 cm2 were included. The main variables of interest were the clinical and ultrasound projected skin‐excised area and surgical recurrence.

Results

Pre‐operative ultrasound surgical margin delimitation increased the mean excised area by 3.67 (SD 0.86) cm2, P = 0.004. The Bland–Altman plot showed that in 65% of surgical procedures the use of ultrasonography increased the projected skin‐excised area. Higher IHS4 scores, BMI, male sex and Hurley stage II vs III all increased the difference between clinical and ultrasound surgical delimitation. At week 24, the recurrence rate in the surgical clinical delimitation cohort was 30% compared to 10% in the cohort with pre‐operative ultrasonography (P = 0.10).

Conclusions

Pre‐operative ultrasonography improves surgical margin delimitation and can lower recurrence rates at 24 weeks in HS patients. Potential risk factors for inaccurate clinical surgical delimitation are obesity, male sex, Hurley II stage and elevated IHS4 scores, so special attention should be given to these patients when ultrasonography is not available and surgical delimitation is based only on clinical examination.
Existing value addition initiatives enhancing recognition of territorial traits of three Kenyan honey
Authors: Warui Mary W. , Mburu John , Kironchi Geoffrey , Gikungu Mary
Published: April 2020

Recognition of honeys with specific characteristics attributed to their territory (geographical origin) can enhance increased incomes to households in rural areas of Kenya, if protected and sold under Geographical Indications labels. This is mainly because product recognition can result in its demand, reputation, access to market and its protection from imitation and disappearance from the market. Initiatives undertaken by actors in the honey subsector and other sectors to promote recognition of Kenyan honeys and their territorial and local traits have not been documented. This study evaluated the existing value addition initiatives enhancing recognition of territorial or local traits of the three Kenyan honey, that is, honey from Kitui, West Pokot, and Baringo. Data collection methods used included literature review as well as interviews with relevant stakeholders in the honey subsector and other relevant sectors. Results showed that development of honey value chains, product certification, product promotional and marketing activities, and awareness on the link between product quality and geographical origin have greatly contributed to recognition of West Pokot, Baringo, and Kitui honey as well as their territorial traits.
Lifetime investment and consumption with recursive preferences and small transaction costs
Authors: Melnyk Yaroslav , Muhle‐Karbe Johannes , Seifried Frank Thomas
Published: April 2020

We investigate the effects of small proportional transaction costs on lifetime consumption and portfolio choice. The extant literature has focused on agents with additive utilities. Here, we extend this analysis to the archetype of nonadditive preferences: the isoelastic recursive utilities proposed by Epstein and Zin.
Effectiveness of body roundness index in predicting metabolic syndrome: A systematic review and meta‐analysis
Authors: Rico‐Martín Sergio , Calderón‐García Julían F. , Sánchez‐Rey Purificación , Franco‐Antonio Cristina , Martínez Alvarez Mariana , Sánchez Muñoz‐Torrero Juan F.
Published: April 2020

Body roundness index (BRI) is a new anthropometric index developed to predict both body fat and the percentage of visceral adipose tissue. Our aim was to investigate whether BRI is superior to traditional anthropometric indices in predicting metabolic syndrome (MetS). This systematic review and meta‐analysis was conducted using Pubmed, Scopus and Web of Sciences databases. The estimated pooled areas under curve (AUCs) for BRI predicting MetS was higher than body mass index (BMI), waist‐to‐hip ratio (WHR), body shape index (ABSI) and body adiposity index (BAI), similar to waist circumference (WC) and lower than waist‐to‐height ratio (WHtR). However, the difference between BRI and BMI, WC and WHtR predicting MetS was statistically non‐significant. Similar results were found with the summary receiver operating characteristic curve (AUC‐SROC). In addition, the non‐Chinese population had pooled AUCs greater than the Chinese population for all indices. Pooled ORs showed that BRI is associated with an increased MetS risk. In conclusion, BRI had good discriminatory power for MetS in adults of both sexes from diverse populations (AUC > 0.7; AUC‐SROC>0.7). However, WC and WHtR offer the best performance when screening for MetS, and non‐significant differences were found with BRI. In contrast, BRI was superior to BMI, WHR, ABSI and BAI in predicting MetS.
Special considerations for the management of COVID‐19 pediatric patients in the operating room and pediatric intensive care unit in a tertiary hospital in Singapore
Authors: Thampi Swapna , Yap Andrea , Fan Lijia , Ong Jacqueline
Published: April 2020

COVID‐19 was first identified in Wuhan, China and is caused by the novel coronavirus SARS‐CoV 2. It has now spread rapidly to over 190 countries and territories around the world and has been declared a global pandemic by the World Health Organization. The virus is spread through droplet transmission and currently has a mortality rate of over 4% globally. The pediatric population has been found to be less susceptible to the disease with the majority of children having milder symptoms and only one pediatric death being reported globally so far. Despite this, strategies need to be put in place to prevent further spread of the virus. We present a summary of the general measures implemented at a large adult and pediatric tertiary hospital in Singapore (National University Hospital) as well as the specific strategies in place for the operating room and pediatric intensive care unit.
Confirmation of success rate of landmark‐based caudal blockade in children using ultrasound: A prospective analysis
Authors: Boretsky Karen R. , Camelo Carlos , Waisel David B. , Falciola Veronique , Sullivan Cornelius , Brusseau Elena , Eastburn Elizabeth , Gomez‐Morad Andrea , Luckanavanich Wasin
Published: April 2020

Background

Caudal epidural anesthesia is a frequently performed regional anesthesia block in infants and young children. Traditional landmark‐based blind needle insertion remains the norm with no immediate, objective method to determine the presence of local anesthetic in the epidural space. Increasingly, ultrasound‐imaging is used in pediatric regional anesthesia with demonstrated improvements in block efficacy and efficiency. The value of ultrasound‐imaging in confirming success rate of traditional caudal placement is not well defined.

Aim

To assess the success rate of conventional landmark‐based caudal technique using ultrasound‐imaging.

Methods

Prospective observational study of 30 children ages 1 month to 7 years undergoing surgical procedures with consent for caudal blockade. Provider success rate of caudal blockade placed by landmark technique was measured using ultrasound‐imaging of needle tip and local anesthetic flow in the epidural space.

Results

Ultrasound‐imaging demonstrated 80% success to correct positioning of the needle tip and local anesthetic in the epidural space. Failure was associated with decreasing experience and presence of anatomic variances. All improperly positioned needles were subsequently successfully positioned using real‐time ultrasound‐imaging. Mean time for confirmatory ultrasound‐imaging (SD; range) was 1 minute (0.3; 1‐3).

Conclusion

The use of ultrasound‐imaging can be used to identify proper needle placement in the sacral epidural canal and facilitate subsequent corrected placement.
Short‐Term Effects of Media Reports on Terrorism That Are Consistent vs. Not Consistent with Media Recommendations on Mass Shootings: A Randomized Controlled Trial
Authors: Laido Zrinka , Till Benedikt , Niederkrotenthaler Thomas
Published: April 2020

Objective

Media recommendations for the reporting of events where one person or a small group kills multiple others in public settings have been developed recently by suicide prevention experts. Evidence on the effects of reports that are compliant or noncompliant with these recommendations is lacking.

Methods

We conducted a randomized controlled trial withn = 148 participants who were randomly assigned to read newspaper articles (A) on acts of terrorism assumed to be conducted by Islamist terrorists and not consistent with media recommendations, (B) the same articles differing only in their compliance with recommendations, or (C) articles of similar style that were about homicide. Islamophobia as well as suicidal ideation, stress, and mood were measured before reading the article (T1), immediately afterwards (T2), and one week later (T3). The primary hypothesis was that there is an increase in islamophobia after exposure to media portrayals not consistent with media recommendations.

Results

Compared to the control group, only participants reading media reports that were not consistent with media recommendations showed a short‐term increase in islamophobia.

Conclusion

These findings suggest that reporting on terrorism that is not consistent with media recommendations appears to increase islamophobia. In the context of reporting on Islamist terrorism, consistency with recommendations might help reduce negative attitudes toward Muslim minorities.
Toward a Viable Progressive Third Party in 2020 and Beyond1
Authors: Martin Jonathan H.
Published: April 2020

Creating a strong, influential third party has been an abiding aspiration on the American left, and were this goal to be achieved, it could be a great boon to subordinate groups in the United States. Yet widespread doubts persist, even among progressives that this is desirable, and especially that it is possible. Here, I briefly review compelling reasons for thinking otherwise; I then consider in some depth the potential for starting to build a viable left third party leading up to and after the pivotal 2020 election. In doing so, I go beyond the existing literature on third parties, which has yet to reflect systematically on progressive third party prospects in this period. Specifically, I assess how the emerging political environment may shape left third‐party building, and I evaluate ongoing and developing attempts by key groups engaged in that effort. I find a distinct tension between conditions encouraging progressives to reform versus abandon the Democratic Party, and I identify one alternative party‐building tendency that seems most able to exploit the latter impulse due to its already established electoral viability. Last, I highlight relevant questions that remain for activists hoping to create an effective national left third party.
Corneal anesthesia associated with topical application of 2% lidocaine nonophthalmic gel to healthy canine eyes
Authors: Robin Marie‐Claire , Papin Aurélie , Regnier Alain , Douet Jean-Yves
Published: April 2020

Objective

To assess the degree and duration of corneal anesthesia induced by topical application of 2% lidocaine gel to the healthy canine eye.

Animals

Nineteen adult Beagles free of ocular abnormalities.

Procedures

Baseline corneal touch threshold (CTT) was measured bilaterally with a Cochet‐Bonnet aesthesiometer. The 2% lidocaine gel (0.1 mL) was applied to one eye, randomly assigned, and the same volume of a lubricant gel was applied to the opposite eye. The CTT measurements were repeated bilaterally within 1 minute, after drug application, and every 5 minutes, until the baseline corneal sensitivity was restored. The potential for local adverse effects was evaluated.

Results

Complete desensitization of the cornea (CTT = 0) was achieved one minute after lidocaine gel application and was maintained during 25.3 ± 12.5 minutes. Overall, the corneal sensitivity was significantly decreased for 58.4 ± 16.6 minutes compared with baseline level. Minor and reversible punctate epithelial erosions of the cornea were observed in the two treatment groups and were attributed to the anesthetic effect and the aesthesiometry procedure.

Conclusions

In the current study, the 2% lidocaine gel provided a sustained, deep and well‐tolerated corneal anesthesia in ophthalmically normal dogs.
Regular moderate exercise alleviates gastric oxidative damage in rats via the contribution of oxytocin receptors
Authors: Arabacı Tamer Sevil , Üçem Selen , Büke Berk , Güner Muhammed , Karaküçük Alp Giray , Yiğit Niyazi , Şirvancı Serap , Çevik Özge , Ercan Feriha , Yeğen Berrak Ç.
Published: April 2020

Key points

A moderate level of exercise has beneficial effects for the prevention of gastric ulcers.

Although regular aerobic exercise was shown to elevate serum oxytocin levels and exogenously administered oxytocin exerts an anti‐ulcer activity, the role of endogenous oxytocin in the gastroprotective effects of exercise has not yet been elucidated.

We showed that increased anxiety and oxidative gastric damage induced by gastric ulcers were reversed in pre‐exercised rats, while reduced hypothalamic oxytocin expression and decreased myenteric oxytocin receptor expression due to gastric ulcers were abolished by exercise.

We also reported that the blockade of oxytocin receptors exaggerated gastric damage in exercised rats with ulcers.

Our data establish that endogenous oxytocin is the key mediator in the beneficial effects of regular physical activity in alleviating gastric injury.

Exercise increases serum oxytocin levels and exogenous oxytocin exerts an anti‐ulcer activity; but the role of oxytocin in the protective effects of exercise against gastric ulcers has not yet been evaluated. This study was designed to investigate the impact of regular swimming exercise on oxidative gastric injury, and the role of oxytocin receptor activity in the anxiolytic and anti‐inflammatory actions of exercise. Adult Wistar albino rats of both sexes performed swimming exercise (30 min/day, 5 days) or stayed sedentary. At the end of the 6‐week exercise/sedentary protocol, rats were injected intraperitoneally with atosiban (0.1 mg/kg/day) or saline for 4 days. On the 5th day, under anaesthesia, acetic acid (ulcer) or saline (sham) was applied onto the gastric serosa and the treatments were continued. On the 9th day, anxiety levels were determined; gastric blood flow was measured, and blood, gastric and brain tissues were obtained. Induction of ulcers in sedentary rats increased anxiety and serum corticosterone levels; but reduced gastric blood flow and resulted in apoptosis and oxidative gastric damage with increased cytokine expressions. However, when ulcers were induced in pre‐exercised rats, behavioural and biochemical alterations due to gastric damage were reversed. The inhibition of oxytocin receptors by atosiban exaggerated pro‐inflammatory cytokine expressions and gastric lipid peroxidation in the stomachs of exercised rats with ulcers. When rats had regularly exercised prior to ulcer induction, reductions in the immunolabelling of hypothalamic oxytocin and myenteric oxytocin receptors were abolished, suggesting that exercise‐induced alleviation of gastric injury may involve the reversal of down‐regulated oxytocinergic activity.
Mitigating Peak Impact Forces by Customizing the Passive Foot Dynamics of Legged Robots
Authors: Rond Jesse J. , Cardani Michael C. , Campbell Matthew I. , Hurst Jonathan W.
Published: April 2020

Impact forces are a destructive, yet common occurrence in legged locomotion. Every step produces a collision when the leg’s inertia stops as a result of ground contact. This results in peak forces and high-frequency vibrations that resonate through the system, damage components, and complicate control algorithms. Prior research considers how damping material, such as rubber, mitigates these effects. However, this paper shows the benefits of spring protection where both stiffness and maximum compression are customized to the leg. The spring mitigates the impact force peak by gradually bringing the leg’s inertia to rest. The maximum compression point (i.e., a hard stop) then provides a rigid surface that is ideal for stance. We provide a foot design methodology, validated through simulation and physical testing, that first considers springs in isolation, then in tandem with damping. We show that the coupling of springs and dampers reduces rigid body collisions and foot vibrations in a way that traditional methods—reliant on damping—have yet to achieve.
The Wear Performance at High Temperatures of ZrO2-Reinforced Aluminum Matrix Composites Produced by Mechanochemical Reaction Method
Authors: Sımsek Dogan , Ozyurek Dursun
Published: April 2020

In this study, high-temperature wear performance of A356+Gr-ZrO2 aluminum matrix composites (AMCs) produced by the mechanochemical reaction method was investigated. After the aluminum composite powders were cold-pressed (750 MPa), the green compacts were sintered under 10−6 mbar vacuum for an hour at 550 °C. Sintered AMCs have been characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), hardness and density measurements. Wear tests were conducted in two different loads (10 N and 30 N), five different temperatures, and three different sliding distances in the standard pin-on-disc type wear tester. Result showed that ZrO2 added to the matrix tends to cluster in grain boundaries. AMCs hardness and densities increased with the increasing amount of reinforcement, and the highest hardness and density value was obtained with 12% ZrO2-added AMCs. Weight loss increased with increasing load and temperature and decreased with increasing amount of reinforcement in the matrix at all loads and temperatures.
Abrasive Wear Mechanism of Microwave-Assisted Compression Molded Kenaf/HDPE Composite
Authors: Singh Manoj Kumar , Zafar Sunny
Published: April 2020

The present work aims to study the abrasive wear of kenaf/high-density polyethylene (HDPE) composites with 20% weight fraction reinforcement of the kenaf fiber. A unique technique of the microwave-assisted compression molding (MACM) was used to fabricate the composites. The pin-on-disc setup was used for two-body abrasive wear, in which the kenaf/HDPE composite acts as a pin and the abrasive paper (P100) acts as a counter surface. Two-body abrasive wear tests were conducted for HDPE and kenaf/HDPE composites at normal loads of 10 N, 20 N, and 30 N and the sliding speed of 1 m/s, 2 m/s, and 3 m/s within 100 m of sliding distance. Tribofilm formation was observed at higher values of load and speed, which helps in reducing the wear-rate of the composites. Wear mechanism of the kenaf/HDPE composite is discussed in detail and supported with scanning electron microscope (SEM) fractography.
Synaptic silencing of fast muscle is compensated by rewired innervation of slow muscle
Authors: Zempo Buntaro , Yamamoto Yasuhiro , Williams Tory , Ono Fumihito
Published: April 2020

Long-term silencing of synapses in fast muscles induced fast muscle–specific motor neurons to reroute to slow muscles.
Picoscale structural insight into superconductivity of monolayer FeSe/SrTiO
3
Authors: Peng Rui , Zou Ke , Han M. G. , Albright Stephen D. , Hong Hawoong , Lau Claudia , Xu H. C. , Zhu Yimei , Walker F. J. , Ahn C. H.
Published: April 2020

Experiments reveal interfacial atomic-scale structure that may be critical for the interface enhanced high
T
c
in FeSe/SrTiO
3
.
Complete aggregation pathway of amyloid β (1-40) and (1-42) resolved on an atomically clean interface
Authors: Nirmalraj Peter Niraj , List Jonathan , Battacharya Shayon , Howe Geoffrey , Xu Liang , Thompson Damien , Mayer Michael
Published: April 2020

High-resolution atomic force microscopy provides clean imaging of amyloid aggregates at graphene-water interface.
Randomized, Double-Blind, Placebo-Controlled, Multicentered Trial of the Efficacy of a Single Dose of Live Oral Cholera Vaccine CVD 103-HgR in Preventing Cholera following Challenge with
Vibrio cholerae
O1 El Tor Inaba Three Months after Vaccination
Authors: Tacket Carol O. , Cohen Mitchell B. , Wasserman Steven S. , Losonsky Genevieve , Livio Sofie , Kotloff Karen , Edelman Robert , Kaper James B. , Cryz Stanley J. , Giannella Ralph A. , Schiff Gilbert , Levine Myron M.
Published: April 2020

CVD 103-HgR is a live oral cholera vaccine strain constructed by deleting 94% of the gene for the enzymatically active A subunit of cholera toxin from classical Inaba
Vibrio cholerae
O1 569B; the strain also contains a mercury resistance gene as an identifying marker. This vaccine was well tolerated and immunogenic in double-blind, controlled studies and was protective in open-label studies of volunteers challenged with
V. cholerae
O1. A randomized, double-blind, placebo-controlled, multicenter study of vaccine efficacy was designed to test longer-term protection of CVD 103-HgR against moderate and severe El Tor cholera in U.S. volunteers. A total of 85 volunteers (50 at the University of Maryland and 35 at Children's Hospital Medical Center/University of Cincinnati) were recruited for vaccination and challenge with wild-type
V. cholerae
El Tor Inaba. Volunteers were randomized in a double-blind manner to receive, with buffer, a single oral dose of either CVD 103-HgR (2 × 10
8
to 8 × 10
8
CFU) or placebo (killed
E. coli
K-12). About 3 months after immunization, 51 of these volunteers were orally challenged with 10
5
CFU of virulent
V. cholerae
O1 El Tor Inaba strain N16961, prepared from a standardized frozen inoculum. Ninety-one percent of the vaccinees had a ≥4-fold rise in serum vibriocidal antibodies after vaccination. After challenge, 9 (39%) of the 23 placebo recipients and 1 (4%) of the 28 vaccinees had moderate or severe diarrhea (≥3-liter diarrheal stool) (
P
< 0.01; protective efficacy, 91%). A total of 21 (91%) of 23 placebo recipients and 5 (18%) of 28 vaccinees had any diarrhea (
P
< 0.001; protective efficacy, 80%). Peak stool
V. cholerae
excretion among placebo recipients was 1.1 × 10
7
CFU/g and among vaccinees was 4.9 × 10
2
CFU/g (
P
< 0.001). This vaccine could therefore be a safe and effective tool to prevent cholera in travelers.
Complete Protection against LethalToxoplasma gondiiInfection in Mice Immunized with a Plasmid Encoding theSAG1Gene
Authors: Nielsen Henrik Vedel , Lauemøller Sanne Lise , Christiansen Lone , Buus Søren , Fomsgaard Anders , Petersen Eskild
Published: April 2020

Infection with the protozoan parasiteToxoplasma gondiiis transmitted to humans from infected animals by tissue cysts and oocysts excreted by cats. Immunization with inactivated parasites or recombinant proteins has at best shown partial protection. We constructed a plasmid expressing the SAG1 surface antigen ofT. gondii, p1tPASAG1, and showed that animals immunized with the plasmid produce anti-SAG1 antibodies which recognize the native SAG1. Mice immunized with p1tPASAG1 showed 80 to 100% protection against challenge with the non-cyst-producing, virulent RH isolate, compared to an 80% mortality in mice immunized with empty plasmid, which is the greatest efficacy of any vaccine againstT. gondiiproduced so far. The SAG1 molecule was analyzed for potential cytotoxic T-lymphocyte (CTL) epitopes, and four peptides with the best fit were synthesized. The ability of the peptides to stimulate gamma interferon production by CD8+T cells from p1tPASAG1-immunized mice was tested in an ELISPOT assay, and one new CTL epitope was identified. Adoptive transfer of CD8+T cells from p1tPASAG1-immunized to naı̈ve mice showed partial protection. In conclusion, DNA vaccination with p1tPASAG1 gave effective protection in mice againstT. gondiiinfection and the protection could be adoptively transferred by purified CD8+T cells.