bluuebunny/crossref_metadata_2025 huggingface dataset:
Sport tourism: a perspective article
Authors: Higham James
Published: April 2020

Purpose

The purpose of this paper is to review the past 75 years of sports tourism and explore the potential of the next 75 years.

Design/methodology/approach

This is a personal perspective paper that reflects upon the emergence and development of the field of sport tourism, contemporary challenges and future pathways.

Findings

Research must extend to wider manifestations of sport, and sport-related tourism, in response to the growth of participation and pleasure sports and the increasingly important roles of those sports in addressing the growing social and environmental challenges of contemporary life.

Originality/value

This paper offers insights into the future of sports tourism.
Lung nuclear protein in testis carcinoma in an elderly Korean woman: A case report with cytohistological analysis
Authors: Cho Hwa Jin , Lee Hyun‐Kyung
Published: April 2020

Nuclear protein in testis (NUT) carcinoma is a rare, aggressive carcinoma that is a diagnostic challenge for pathologists. Here, we report a case of NUT carcinoma in a 63‐year‐old woman with uncommon immunohistochemical results. The initial bronchoscopic biopsy revealed a poorly differentiated carcinoma with p63 immunohistochemical stain positivity. However, the cytomorphological features of the pleural fluid were unusual. Immunohistochemical staining of the pleural fluid revealed diffuse positivity for vimentin and focal positivity for cytokeratin and neuroendocrine markers. Because of chemoresistance, other malignancies, including sarcomatoid carcinoma, combined small cell carcinoma, and an unusual form of NUT carcinoma, were considered as differential diagnoses. The diagnosis of NUT carcinoma was confirmed using NUT‐specific antibodies and fluorescence in situ hybridization. The current case was a diagnostic challenge because of the poorly differentiated cytomorphology and uncommon immunohistochemical results. Pathologists and clinicians should consider NUT carcinoma in the differential diagnosis, as this malignancy has a dismal prognosis and needs to be diagnosed accurately for the most effective treatment.

Key points

Metastatic NUT carcinoma can show diffuse vimentin positivity and focal neuroendocrine marker positivity. NUT carcinoma can be misdiagnosed as basaloid squamous cell carcinoma in routine diagnosis, especially in older‐aged patients.

This study was a diagnostic challenge because of the poorly differentiated cytomorphology and uncommon immunohistochemical results for NUT carcinoma. Pathologists should differentially diagnose NUT carcinoma when rare cytohistological features are observed at any age.
Causes of late mortality among ICU‐treated patients with sepsis
Authors: Wilhelms Susanne B. , Walther Sten M. , Sjöberg Folke , De Geer Lina
Published: April 2020

Background

Patients with sepsis may have an increased risk of late mortality, but the causes of late death are unclear. This retrospective matched cohort study aimed to determine the causes of late death (≥1 year) among patients with sepsis compared to patients without sepsis.

Methods

8760 patients with severe sepsis or septic shock (2001 consensus criteria) registered in the Swedish Intensive Care Registry (2008‐2013) were compared with a 1:1 matched (gender, age, SAPS3 probability for death, ICU length of stay) control group consisting of non‐septic ICU patients. Causes of death (International Classification of Diseases codes) were obtained from the Swedish Cause of Death Register (2008‐2014).

Results

During 2008‐2014, 903 patients with sepsis died at ≥365 days after their initial septic event, compared to 884 patients in the control group. Median time of follow‐up was 313 days (sepsis group, interquartile range 11‐838 days) vs 288 days (control group, 9‐836 days). The most common causes of death were heart diseases (sepsis: 50.2%, non‐septic: 48.6%) and cancer (sepsis: 33.7%, non‐septic: 31.7%). Infectious diseases were significantly more common cause of death in the sepsis group (24.3% vs 19.6%, respectively; P < .05). Pneumonia was a common infectious cause of death in both groups, whereas sepsis was more common in the sepsis group.

Conclusions

The most common causes of late death after ICU admission among patients with and without sepsis were heart diseases and cancer. However, patients with sepsis more frequently had infectious diseases as a cause of late death, compared to non‐septic patients.
Cost‐effectiveness of a specialist smoking cessation package compared with standard smoking cessation services for people with severe mental illness in England: a trial‐based economic evaluation from the SCIMITAR+ study
Authors: Li Jinshuo , Fairhurst Caroline , Peckham Emily , Bailey Della , Arundel Catherine , Hewitt Catherine , Heron Paul , Crosland Suzanne , Parrott Steve , Gilbody Simon ,   SCIMITAR+ collaborative
Published: April 2020

Aims

To evaluate the cost‐effectiveness of a specialist smoking cessation package for people with severe mental illness

Design

Incremental cost‐effectiveness analysis was undertaken from the UK National Health Service and Personal Social Services perspective over a 12‐month time horizon. Total costs, including smoking cessation, health‐care and social services costs and quality‐adjusted life years (QALYs), derived from the five‐level EuroQol 5‐dimension (EQ‐5D‐5 L), collected from a randomized controlled trial, were used as outcome measures. The bootstrap technique was employed to assess the uncertainty.

Setting

Sixteen primary care and 21 secondary care mental health sites in England.

Participants

Adult smokers with bipolar affective disorder, schizoaffective disorder or schizophrenia and related illnesses (n = 526).

Intervention and comparator

A bespoke smoking cessation (BSC) package for people with severe mental illness offered up to 12 individual sessions with a mental health smoking cessation practitioner versus usual care (UC). Of the participants who were randomized, 261 were in UC group and 265 were in BSC group.

Measurements

BSC intervention cost was estimated from the treatment log. Costs of UC, health‐care and social services and EQ‐5D‐5 L were collected at baseline, 6‐ and 12‐month follow‐ups. Incremental costs and incremental QLAYs were estimated using regression adjusting for respective baseline values and other baseline covariates.

Findings

The mean total cost in the BSC group was £270 [95% confidence interval (CI) = –£1690 to £1424] lower than in the UC group, while the mean QALYs were 0.013 (95% CI = –0.008 to 0.045) higher, leading to BSC dominating UC (76% probability of cost‐effective at £20 000/QALY).

Conclusions

A bespoke smoking cessation package for people with severe mental illness is likely to be cost‐effective over 12 months compared with usual care provided by the UK's National Health Service and personal social services.
Type 2 immunity in the skin and lungs
Authors: Akdis Cezmi A. , Arkwright Peter D. , Brüggen Marie-Charlotte , Busse William , Gadina Massimo , Guttman‐Yassky Emma , Kabashima Kenji , Mitamura Yasutaka , Vian Laura , Wu Jianni , Palomares Oscar
Published: April 2020

There has been extensive progress in understanding the cellular and molecular mechanisms of inflammation and immune regulation in allergic diseases of the skin and lungs during the last few years. Asthma and atopic dermatitis (AD) are typical diseases of type 2 immune responses. interleukin (IL)‐25, IL‐33, and thymic stromal lymphopoietin are essential cytokines of epithelial cells that are activated by allergens, pollutants, viruses, bacteria, and toxins that derive type 2 responses. Th2 cells and innate lymphoid cells (ILC) produce and secrete type 2 cytokines such as IL‐4, IL‐5, IL‐9, and IL‐13. IL‐4 and IL‐13 activate B cells to class‐switch to IgE and also play a role in T‐cell and eosinophil migration to allergic inflammatory tissues. IL‐13 contributes to maturation, activation, nitric oxide production and differentiation of epithelia, production of mucus as well as smooth muscle contraction, and extracellular matrix generation. IL‐4 and IL‐13 open tight junction barrier and cause barrier leakiness in the skin and lungs. IL‐5 acts on activation, recruitment, and survival of eosinophils. IL‐9 contributes to general allergic phenotype by enhancing all of the aspects, such as IgE and eosinophilia. Type 2 ILC contribute to inflammation in AD and asthma by enhancing the activity of Th2 cells, eosinophils, and their cytokines. Currently, five biologics are licensed to suppress type 2 inflammation via IgE, IL‐5 and its receptor, and IL‐4 receptor alpha. Some patients with severe atopic disease have little evidence of type 2 hyperactivity and do not respond to biologics which target this pathway. Studies in responder and nonresponder patients demonstrate the complexity of these diseases. In addition, primary immune deficiency diseases related to T‐cell maturation, regulatory T‐cell development, and T‐cell signaling, such as Omenn syndrome, severe combined immune deficiencies, immunodysregulation, polyendocrinopathy, enteropathy, X‐linked syndrome, and DOCK8, STAT3, and CARD11 deficiencies, help in our understanding of the importance and redundancy of various type 2 immune components. The present review aims to highlight recent advances in type 2 immunity and discuss the cellular sources, targets, and roles of type 2 mechanisms in asthma and AD.
Fragmented QRS in prediction of ischemic heart disease diagnosed by stress cardiovascular magnetic resonance imaging
Authors: Yooprasert Pimpimol , Vathesatogkit Prin , Thirawuth Varinsawat , Prasertkulchai Watcharee , Tangcharoen Tarinee
Published: April 2020

Background

In patients with ischemic heart disease (IHD), many studies demonstrated an association between fragmented QRS complex (fQRS) on 12‐lead ECG and myocardial scar, heart failure, and increased mortality. However, data in adults without history of IHD is limited. We aimed to evaluate whether there is an association between fQRS and IHD diagnosed by stress cardiac MRI.

Method

We retrospectively reviewed demographic data, 12‐lead ECG, and stress cardiac MRI data from 604 patients. Fragmented QRS was defined as the presence of additional R wave (R’), notching in the nadir of R or S wave, or the presence of more than one R’ in any ECG leads. Both cardiac MRI and ECG were analyzed by two independent observers.

Result

Final analysis included 554 patients, 39% were male, with a mean age of 67.8 ± 11.1 years. There was positive stress cardiac MRI in 219 patients (39.5%). Older age, diabetes mellitus, and hypertension were more frequent in the positive group (p < .05). fQRS was identified in 300 patients (54.2%). Baseline characteristic did not differ significantly between patients with and without fQRS. There is an association between fQRS and IHD, OR 1.605 (95% CI 1.14–2.27), p = .007. After adjustment for age, diabetes, hypertension, renal function, and left ventricular ejection fraction, the strong association between fQRS and IHD persisted, OR 1.71 (95% CI 1.18–2.47), p = .004.

Conclusion

In patients without known history of coronary artery disease, fragmented QRS is independently associated with ischemic heart disease diagnosed by stress cardiac MRI.
Cell investigation into the biocompatibility of adult human dermal fibroblasts with PCL nanofibers/TiO2 nanotubes on the surface of Ti–30Ta alloy for biomedical applications
Authors: Capellato Patrícia , Silva Gilbert , Popat Ketul , Simon‐Walker Rachael , Alves Claro Ana Paula , Zavaglia Cecilia
Published: April 2020

The polymer poly(ε‐caprolactone) (PCL) has been used in the biomaterial field for its relatively inexpensive price and suitability for modification. Also, its chemical and biological properties are desirable for biomedical applications. The electrospinning process has been used for producing polymer fibers of PCL due in large part to an increased interest in nanoscale properties and technologies. Moreover, the use of biocompatible polymers for the viability of cell growth is a promising alternative to improve osseointegration. Characterization techniques such as scanning electron microscopy and contact angle were used for analyses of samples. Adult human dermal fibroblasts (neonatal) were utilized to evaluate the biocompatibility of the association of the electrospinning process of the biocompatible polymer (PCL) with TiO2 nanotubes on the Ti–30Ta alloy surface. The results of this study showed a favorable response for adhesion on the surface. This promising material is due to the modulation of the biological response.
A Combined Health Action Process Approach and mHealth Intervention to Increase Non‐Sedentary Behaviours in Office‐Working Adults—A Randomised Controlled Trial
Authors: Rollo Scott , Prapavessis Harry
Published: April 2020

Background

Office‐working adults represent an at‐risk population for high levels of sedentary behaviour (SB), which has been associated with an increased risk for numerous chronic diseases. This study examined the effectiveness of a Health Action Process Approach (HAPA) based planning intervention augmented with tailored text messages to reduce workplace sitting time (primary outcome) and increase specific non‐SBs (i.e. standing time, walking time, stretching time, break frequency, break duration). A secondary purpose was to examine relationships among HAPA volitional constructs and sedentary and non‐SBs.

Methods

Full‐time office workers (Mage = 45.18 ± 11.33 years) from Canada were randomised into either a HAPA intervention (n = 29) or control (n = 31) condition. Workplace sitting time, time spent in specific non‐SBs, and HAPA volitional constructs were assessed at baseline, weeks 2, 4, 6 (post‐intervention), and 8 (follow‐up).

Results

Significant group by time interaction effects, that favoured the intervention group, were found for sitting time (p = .003, ɳp2 = .07), standing time (p = .019, ɳp2 = .05), and stretching time (p = .001, ɳp2 = .08) as well as for action planning (p < .001, ɳp2 = .20), coping planning (p < .001, ɳp2 = .18), and action control (p < .001, ɳp2 = .15). Significant correlations (p < .05) were also found between the HAPA constructs and time spent sitting, standing, walking, as well as break frequency.

Conclusions

Augmenting a HAPA‐based planning intervention with text messages can reduce workplace sitting time in office workers.

TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03461926.
The natural course of pregnancies in women with primary atypical haemolytic uraemic syndrome and asymptomatic relatives
Authors: Timmermans Sjoerd A. M. E. G. , Werion Alexis , Spaanderman Marc E. A. , Reutelingsperger Chris P. , Damoiseaux Jan G. M. C. , Morelle Johann , van Paassen Pieter
Published: April 2020

Pregnancy has been linked to various microangiopathies, including primary atypical haemolytic uraemic syndrome (aHUS). Complement dysregulation, often linked to rare variants in complement genes, is key for primary aHUS to manifest and may play a role in pregnancy complications of the mother and fetus. The burden of such complications is unknown, making counselling of women with primary aHUS and asymptomatic relatives difficult. We analyzed the maternal and fetal outcomes of 39 pregnancies from 17 women with primary aHUS and two asymptomatic relatives. Seven out of 39 pregnancies were complicated by pregnancy‐associated aHUS. Five out of 32 pregnancies not linked to pregnancy‐associated aHUS were complicated by pre‐eclampsia or HELLP. Rare genetic variants were identified in 10 women (asymptomatic relatives, n = 2) who had a total of 14 pregnancies, including 10 uncomplicated pregnancies. Thirty‐five out of 39 pregnancies resulted in live birth. Eight out of 19 women had progressed to end‐stage kidney disease, with an incidence of 2·95 (95% confidence interval, 1·37–5·61) per 100 person‐years after the first pregnancy. Thus, we emphasized the frequency of successful pregnancies in women with primary aHUS and asymptomatic relatives. Pregnancies should be monitored closely. Rare genetic variants cannot predict the risk of a given pregnancy.
Estimating a normal reference range for serum B‐cell maturation antigen levels for multiple myeloma patients
Authors: Jew Scott , Bujarski Sean , Soof Camilia , Chen Haiming , Safaie Tahmineh , Li Mingjie , Sanchez Eric , Wang Cathy , Emamy‐Sadr Marsiye , Swift Regina , Rahbari Ashkon , Patil Saurabh , Souther Eric , Spektor Tanya M. , Berenson James R.
Published: April 2020

The serum B‐cell maturation antigen (sBCMA) has been identified as a novel serum biomarker for patients with multiple myeloma. However, no study has yet established a reference range for sBCMA levels. Its levels were determined in 196 healthy subjects and showed a right‐tailed distribution with a median value of 37·51 ng/ml with a standard deviation of 22·54 ng/ml (range 18·78–180·39 ng/ml). Partitioning of subgroup reference ranges was considered but determined to be irrelevant. A non‐parametric method using the median ± 2 standard deviations suggests using a universal reference interval of <82·59 ng/ml.
Targeted and systematic cognitive freehand‐guided transperineal biopsy: is there still a role for systematic biopsy?
Authors: Neale Anoushka , Stroman Luke , Kum Francesca , Jabarkhyl Dost , Di Benedetto Antonina , Mehan Nicholas , Rusere Jonah , Chandra Ashish , Challacombe Ben , Cathcart Paul , Dasgupta Prokar , Elhage Oussama , Popert Rick
Published: April 2020

Objectives

To assess whether targeted cognitive freehand‐assisted transperineal biopsies using a PrecisionpointTM device still require additional systematic biopsies to avoid missing clinically significant prostate cancer, and to investigate the benefit of a quadrant‐only biopsy approach to analyse whether a quadrant or extended target of the quadrant containing the target only would have been equivalent to systematic biopsy.

Patients and Methods

Patients underwent combined systematic mapping and targeted transperineal prostate biopsies at a single institution. Biopsies were performed using the Precisionpoint device (Perineologic, Cumberland, MD, USA) under either local anaesthetic (58%, 163/282), i.v. sedation (12%, 34/282) or general anaesthetic (30%, 85/282). A mean (range) of 24 (5–42) systematic and 4.2 (1–11) target cores were obtained. Magnetic resonance imaging (MRI) scans were reported using the Likert scale. Clinically significant cancer was defined as Gleason 7 or above. Histopathological results were correlated with the presence of an MRI abnormality within a spatial quadrant and the other adjoining or non‐adjoining (opposite) quadrants. Histological concordance with radical prostatectomy specimens was analysed.

Results

A total of 282 patients were included in this study. Their mean (range) age was 66.8 (36–80) years, median (range) prostate‐specific antigen level 7.4 (0.91–116) ng/mL and mean prostate volume 45.8 (13–150) mL. In this cohort, 82% of cases (230/282) were primary biopsies and 18% (52/282) were patients on surveillance. In all, 69% of biopsies (195/282) were identified to have clinically significant disease (Gleason ≥3 + 4). Any cancer (Gleason ≥3 + 3) was found in 84% (237/282) of patients. Of patients with clinically significant disease, the target biopsies alone picked up 88% (171/195), with systematic biopsy picking up the additional 12% (24/195) that the target biopsies missed. This altered with Likert score; 73% of Likert score 3 disease was detected by target biopsy, 92% of Likert score 4 and 100% of Likert score 5. Target biopsies with additional same‐quadrant‐only systematic cores picked up 75% (18/24) of significant cancer that was missed on target only, found in the same quadrant as the target.

Conclusion

Systematic biopsy is still an important tool when evaluating all patients referred for prostate biopsy, but the need is decreased with increasing suspicion on MRI. Patients with very high suspicion of prostate cancer (Likert score 5) may not require systematic cores, unless representative surrounding biopsies are required for other specific treatments (e.g. focal therapy, or operative planning). More prospective studies are needed to evaluate this in full.
Plasma rich in growth factors reduces blue light‐induced oxidative damage on retinal pigment epithelial cells and restores their homeostasis by modulating vascular endothelial growth factor and pigment epithelium‐derived factor expression
Authors: Anitua Eduardo , de la Fuente Maria , del Olmo‐Aguado Susana , Suarez‐Barrio Carlota , Merayo‐Lloves Jesus , Muruzabal Francisco
Published: April 2020

Background

This study analysed the effectiveness of plasma rich in growth factors (PRGF) in reducing the oxidative stress induced by blue light exposition on retinal pigment epithelial (RPE) cells.

Methods

Blood from six healthy donors was collected to obtain the PRGF. Retinal pigment epithelium (ARPE‐19) cells were exposed to blue light. Then, cells were incubated with PRGF or with control for 24 and 48 hours maintaining exposure to blue light. The cytoprotective effect of PRGF on ARPE cells was evaluated by measuring the cell viability, the reactive oxygen species (ROS) production and the expression of different proteins such as heme oxygenase 1 (HO‐1), catalase (CAT), superoxide dismutase (SOD‐1), apoptosis‐inducing factor (AIF), pigment epithelium‐derived factor (PEDF) and vascular endothelial growth factor (VEGF).

Results

The cell viability increased significantly at 24 and 48 hours after PRGF treatment compared to the control group. ROS synthesis was significantly reduced in PRGF‐treated cells with respect to control. Furthermore, the levels of HO‐1, SOD‐1 and AIF were significantly reduced after PRGF treatment at both times of treatment. However, CAT levels were only significantly reduced after PRGF treatment at 48 hours. The high expression of VEGF by RPE cells exposed to blue light was only counterbalanced in the PRGF group by increasing the expression of PEDF in comparison to the control group.

Conclusion

The present results show that PRGF treatment reduces the cytotoxic effects induced in RPE cells exposed to an oxidative stress environment. Furthermore, PRGF treatment preserves the mitochondrial activity and cell viability of RPE cells subjected to an oxidative stress.
Muscle swelling following blood flow‐restricted exercise does not differ between cuff widths in the proximal or distal portions of the upper leg
Authors: Bell Zachary W. , Abe Takashi , Wong Vickie , Spitz Robert W. , Viana Ricardo B. , Chatakondi Raksha N. , Dankel Scott J. , Yamada Yujiro , Loenneke Jeremy P.
Published: April 2020

The purpose was to understand how wider cuffs, covering larger portions of the limb, may affect acute muscle swelling when used during low‐load knee extension exercise with blood flow restriction. A total of 96 individuals (53 females and 43 males) completed two visits, with visit one used for measuring maximal strength and arterial occlusion pressure (AOP), and visit two to compare between a narrow (5 cm) and a wide (12 cm) cuff for acute changes in muscle thickness and echo intensity following exercise. Ultrasound measurements were completed at a proximal and distal site within both legs, with the proximal site located beneath the cuff within the leg exercising using the wide cuff. Study findings indicate that the difference in acute changes for muscle thickness [median difference (95% credible interval) of 0.009 (−0.03, 0.05) cm] and echo intensity [median difference (95% credible interval) of 0.79 (−0.28, 1.89) AU] between cuff widths did not differ between proximal and distal sites. Additionally, acute changes in muscle thickness did not differ between cuff widths, sexes or participants who had AOP measured and those who were estimated. Lastly, acute changes in echo intensity did not differ between cuff widths and those who had AOP measured and those who were estimated. However, there was evidence showing how there might be greater reductions in echo intensity for females at the distal site. The previously observed attenuation of muscle growth under the cuff is unlikely to be related to differences in the acute muscle swelling response.
Dental sleep medicine: Time to incorporate sleep apnoea education in the dental curriculum
Authors: Herrero Babiloni Alberto , Beetz Gabrielle , Dal Fabbro Cibele , Martel Marc O. , Huynh Nelly , Masse Jean-François , Sessle Barry , Lavigne Gilles J.
Published: April 2020

Dental sleep medicine is a discipline that includes conditions such as sleep breathing disorders (eg snoring and sleep apnoea), sleep bruxism, orofacial pain and sleep‐related complaints, and to some extent gastro‐oesophageal reflux disorder and/or insomnia. Obstructive sleep apnoea (OSA) is a life‐threatening condition that dentists need to identify and manage when indicated in order to increase patient well‐being and to be taken in consideration in the dental curriculum. The main objective of this paper is to highlight the relevance of dental sleep medicine in the context of dental education, and to discuss potential educational content for integration in the dental curriculum with a focus on OSA, a condition that is not yet integrated in many dental training curricula around the world.
How dentists learn behaviour support skills for adults with intellectual developmental disorders: A qualitative analysis
Authors: Mac Giolla Phadraig Caoimhin , Griffiths Colin , McCallion Philip , McCarron Mary , Wride Michael A. , Nunn June H.
Published: April 2020

Introduction

An understanding of how dentists develop patient support techniques for use with adults with intellectual developmental disorders (IDD) may lead to a better understanding of how these techniques can be taught. In this study, we explored how skilled dentists developed non‐physical, non‐pharmacological patient support techniques (nPSTs) for use with adults with IDD.

Materials and methods

Adopting a qualitative descriptive design, a synchronous online group interview was undertaken with six dentists. Informants were subsequently contacted in pairs, or individually, for further interview. All data were analysed using thematic content analysis. Author biases and rigour are considered.

Results

Three categories emerged: Motivation to learn; Formal learning; and Informal learning, and the latter had three subcategories: Observation; Trial; and error and Experience. Motivators to learn PST skills included perceived empathy and a sense of responsibility towards patients with IDD. Formal undergraduate learning was lacking leaving dentists to rely on paediatric training “A paediatric model from your training… needs to be restructured and re‐emphasised with people with disabilities as they progress through the lifespan.”, whereas specialist training was reported to be helpful where available. Over time, practitioners developed an individualised skillset through observation, trial and error and experience. “You learn. Just like any job, you learn on the job. You learn a lot from experience and mistakes.”

Discussion

Essential patient support skills appear to be acquired in an ad hoc manner. How dentists learn their skills has implications for dental training for future and current dental professionals.

Conclusions

Specific recommendations to improve education are made.
Is the operationally defined fraction of soil organic matter, “GRSP” (glomalin‐related soil protein), stable in soils? Evidence from trends in long‐term bare fallow soil
Authors: Cissé Gaoussou , van Oort Folkert , Chenu Claire , Essi Marc , Staunton Siobhan
Published: April 2020

The operationally defined fraction of soil organic matter (SOM), glomalin‐related soil protein (GRSP), has been reported to be particularly stable. This is the first study to test this hypothesis. Archived soil has been used from the long‐term bare fallow trial, known as the 42‐Plots, in Versailles, France. With no input from plants for 80 years, changes in GRSP must result from either turnover of SOM or net mineralization. Intrinsically, stability of protein would lead to progressive enrichment in GRSP. Soils from treatments that influenced pH, soil C:N ratio and physical stability were studied. Soil having received manure amendment was also studied to give contrasting microbial activity. Both GRSP and soil organic carbon (SOC) contents declined over the 80‐year period, with the exception of the manure treatment. GRSP and SOC contents were positively correlated. SOC was continuously enriched in GRSP in the control treatment, suggesting greater stability of GRSP. The SOC in manure‐amended soil was also progressively enriched in GRSP, but this can be attributed to the GRSP content of added manure. For the other treatments, the ratio GRSP:SOC fell continuously (CaCO3 amendment) or fell to a minimum value after 45 years (KCl amendment) or levelled off after a progressive increase ((NH4)2SO4 amendment). Trends are compared with measured soil properties and changes in microbial activity inferred from soil pH. No reliable independent assessment of microbial composition of these archived soils is possible. The results cannot be explained by inherent chemical or physicochemical stability of GRSP. We conclude that recycling of SOM continually produces soil protein. The net change in GRSP content is a complex function of SOM cycling and protein mineralization. These findings add to the increasing body of evidence that the operationally defined fraction of SOM known as GRSP does not predominantly originate from arbuscular mycorrhizal fungal activity.

Highlights

Processes determining SOM enrichment in GRSP in C‐depleted soils are not understood.

GRSP decreased along with SOC, but relative rates of decline varied with amendments.

Levels of GRSP appear to be due to organic matter turnover as well as mineralization.

GRSP does not appear to originate from arbuscular mycorrhizal fungal activity.
Outcome of pregnancies after onset of the neuromyelitis optica spectrum disorder
Authors: Kim S.‐H. , Huh S.‐Y. , Jang H. , Park N. Y. , Kim Y. , Jung J. Y. , Lee M. Y. , Hyun J.‐W. , Kim H. J.
Published: April 2020

Background and purpose

Data on the pregnancy outcome of neuromyelitis optica spectrum disorder (NMOSD) remain limited, especially for woman who had received immunosuppressive treatment before becoming pregnant. The aim was to evaluate the outcome of pregnancy amongst patients with NMOSD who attempted to become pregnant after NMOSD onset and to identify risk factors that predict pregnancy‐related attack.

Methods

Medical records from 29 patients who attempted to become pregnant after NMOSD onset were retrospectively evaluated and the patients were interviewed for pregnancy outcomes. Pregnancy‐related attack was defined as an attack that occurred during pregnancy or within 1 year of delivery.

Results

Amongst the 29 patients, 26 had 33 pregnancies after NMOSD symptom onset. The 33 pregnancies after NMOSD onset resulted in 24 live births (healthy neonates except one with low birth weight), six miscarriages and three elective abortions. Pregnancy‐related attack occurred in nine (75%) of 12 pregnancies before initiation of immunosuppressive therapy, but in only five (24%) of 21 pregnancies after initiation of immunosuppressive therapy (P = 0.009). Multivariable analysis indicated that pregnancy‐related attack was negatively associated with pregnancy after initiation of rituximab (odds ratio 0.048, 95% confidence interval 0.004–0.546).

Conclusion

Successful pregnancy without maternal and neonatal complications may be feasible in patients with NMOSD. Rituximab treatment before pregnancy might help to prevent pregnancy‐related attack in patients with NMOSD.
Japan Society of Hepatology Guidelines for the Management of Hepatitis B Virus Infection: 2019 update
Authors:   Drafting Committee for Hepatitis Management Guidelines, the Japan Society of Hepatology
Published: April 2020

The Drafting Committee for Hepatitis Management Guidelines established by the Japan Society of Hepatology published the first version of the Guidelines for the Management of Hepatitis B in 2013 (first English version in 2014), and has since been publishing updates to the Guidelines as new drugs become available, with the latest original Japanese version being Version 3.1. Herein, the Drafting Committee publishes the second English version that contains all the changes made since the first English version of the guidelines was published in 2014. This 2019 version covers: (i) the nucleos(t)ide analogs, tenofovir disoproxil fumarate and tenofovir alafenamide; (ii) updates to treatment recommendations and management of drug‐resistant hepatitis B virus that reflect the new availability of these drugs; and (iii) new information about hepatitis B virus reactivation with each update. This latest update also contains information about treatment goals, indications for treatment and cessation of nucleos(t)ide analog therapy, most of which were covered by the first version.
Gastrointestinal tissue‐based molecular biomarkers: a practical categorisation based on the 2019 World Health Organization classification of epithelial digestive tumours
Authors: Quezada‐Marín Javier I , Lam Alfred K , Ochiai Atsushi , Odze Robert D , Washington Kay M , Fukayama Masashi , Rugge Massimo , Klimstra David S , Nagtegaal Iris D , Tan Puay‐Hoon , Arends Mark J , Goldblum John R , Cree Ian A , Salto‐Tellez Manuel
Published: April 2020

Molecular biomarkers have come to constitute one of the cornerstones of oncological pathology. The method of classification not only directly affects the manner in which patients are diagnosed and treated, but also guides the development of drugs and of artificial intelligence tools. The aim of this article is to organise and update gastrointestinal molecular biomarkers in order to produce an easy‐to‐use guide for routine diagnostics. For this purpose, we have extracted and reorganised the molecular information on epithelial neoplasms included in the 2019 World Health Organization classification of tumours. Digestive system tumours, 5th edn.
La reglamentación y el futuro del trabajo. La relación de trabajo como factor de innovación
Authors: ALOISI Antonio , DE STEFANO Valerio
Published: April 2020

La transformación digital y la reorganización de la empresa han generado fórmulas distintas de la relación de trabajo típica. Frente al modelo de disrupción digital que proclama la inadecuación del marco jurídico a los modelos de trabajo y de negocio «innovadores», en este artículo se aboga por la reglamentación laboral como factor de innovación. La relación de trabajo es un instrumento flexible y las formas típicas de empleo resultan rentables y eficientes. Además de permitir el pleno ejercicio de la prerrogativa empresarial y la flexibilidad interna en la gestión del trabajo, constituyen un mecanismo eficaz de formación y capacitación.
Efficacy of risankizumab in patients with moderate‐to‐severe plaque psoriasis by baseline demographics, disease characteristics and prior biologic therapy: an integrated analysis of the phase III UltIMMa‐1 and UltIMMa‐2 studies
Authors: Strober B. , Menter A. , Leonardi C. , Gordon K. , Lambert J. , Puig L. , Photowala H. , Longcore M. , Zhan T. , Foley P.
Published: April 2020

Background

Risankizumab is a humanized IgG monoclonal antibody that selectively inhibits interleukin‐23 through binding the p19 subunit. In Phase 3 trials, risankizumab demonstrated superior efficacy compared with adalimumab and ustekinumab in patients with moderate‐to‐severe plaque psoriasis. Here, we evaluated the impact of baseline characteristics on efficacy of risankizumab compared with ustekinumab in patients with moderate‐to‐severe plaque psoriasis.

Methods

This analysis included all patients initially randomized to risankizumab or ustekinumab from the replicate, double‐blinded, randomized, placebo‐controlled phase 3 trials, UltIMMa‐1 (NCT02684370) and UltIMMa‐2 (NCT02684357). Patients received either risankizumab (150 mg) or ustekinumab (weight‐based; 45 or 90 mg per label) at weeks 0, 4, 16, 28 and 40. Efficacy was assessed as the proportion of patients achieving ≥90% improvement in Psoriasis Area and Severity Index (PASI 90) at weeks 16 and 52 by baseline patient demographics, disease characteristics and prior biologic exposure. Mean per cent improvement in PASI was calculated by body weight and body mass index at week 52. Missing efficacy data were imputed as non‐responders for categorical variables and last observation carried forward for continuous variables. Logistic regression analyses assessed for interactions between treatment and five independent variables (age, sex, weight, baseline PASI score and presence of psoriatic arthritis) at both weeks 16 and 52.

Results

Baseline patient demographics, disease characteristics and prior biologic exposure were similar between patients randomized to risankizumab (n = 598) and ustekinumab (n = 199). At weeks 16 and 52, risankizumab demonstrated superior efficacy compared with ustekinumab across these patient characteristics (P < 0.01). Logistic regression analyses demonstrated that risankizumab was superior to ustekinumab at weeks 16 and 52 in all models tested (P < 0.0001 for all).

Conclusions

Risankizumab demonstrated consistent and superior efficacy compared with ustekinumab regardless of patient demographics, disease characteristics or prior biologic exposure.
Magnitude of and prediction for risk of hepatocellular carcinoma in patients with chronic hepatitis B taking entecavir or tenofovir therapy: A systematic review
Authors: Tseng Cheng‐Hao , Tseng Chao‐Ming , Wu Jia‐Ling , Hsu Yao‐Chun , El-Serag Hashem B.
Published: April 2020

Background and Aim

Entecavir (ETV) and tenofovir disoproxil fumarate (TDF) have been shown to reduce incidence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). This systematic review aims to evaluate the magnitude, change over time, and prediction of residual HCC risks in CHB patients treated with ETV/TDF therapy.

Methods

Available literature was systematically reviewed through searches of PubMed and EMBASE databases from January 1, 2006 to September 1, 2019, to identify cohort studies that reported HCC incidence in CHB patients during ETV/TDF therapy. Studies were screened by title and abstract and then evaluated for eligibility in terms of full text.

Results

We identified 141 studies for full‐text review, and 34 were eligible for analysis. From 19 studies with data separated by cirrhosis status, the 5‐year cumulative incidence of HCC was 0.5–6.9% in patients without cirrhosis, 4.5–21.6% in compensated cirrhosis, and 36.3–46.5% in decompensated cirrhosis. All four studies that addressed temporal changes in HCC risks consistently found the incidence rate decreased over time in patients with cirrhosis, although the findings were inconsistent in patients without cirrhosis. Six predictive scores were developed and validated to predict incident HCC during ETV/TDF therapy in CHB patients. Common scoring variables included age, sex, cirrhosis (fibrosis grade), and hepatic function. Conflicting results were reported in seven individual studies and two meta‐analyses that compared ETV versus TDF.

Conclusions

The residual risk of HCC remains during ETV/TDF treatment in CHB patients with cirrhosis but declines over time. Risk stratification is attainable by validated predictive scores.
American Geriatrics Society (AGS) Policy Brief: COVID‐19 and Assisted Living Facilities
Authors:   American Geriatrics Society
Published: April 2020

This policy brief sets forth the American Geriatrics Societyʼs (AGSʼs) recommendations to guide federal, state, and local governments when making decisions about care for older adults in assisted living facilities (ALFs) during the coronavirus disease 2019 (COVID‐19) pandemic. It focuses on the need for personal protective equipment, access to testing, public health support for infection control, and workforce training. The AGS continues to review guidance set forth in peer‐reviewed articles, as well as ongoing and updated guidance from the US Department of Health and Human Services, the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, and other key agencies. This brief is based on the situation and any federal guidance or actions as of April 15, 2020. Joining a separate AGS policy brief on COVID‐19 in nursing homes (DOI: 10.1111/jgs.16477), this brief is focused on ALFs, given that varied structure and staffing can impact their response to COVID‐19. J Am Geriatr Soc 68:1131–1135, 2020.
A survey of oncology advanced practice providers’ knowledge and attitudes towards sexual and gender minorities with cancer
Authors: Sutter Megan E. , Bowman‐Curci Meghan L. , Duarte Arevalo Luisa F. , Sutton Steven K. , Quinn Gwendolyn P. , Schabath Matthew B.
Published: April 2020

Aims and objectives

To evaluate the knowledge and attitudes towards sexual and gender minority (SGM) oncology patients’ needs among advanced practice providers (APPs).

Background

SGM individuals experience health disparities, in part due to lack of access to knowledgeable providers. Despite the important role of APPs in cancer care, less is known about their attitudes and knowledge towards SGM cancer patients.

Design

Cross‐sectional study.

Methods

A survey of APPs at a National Cancer Institute‐Designated Comprehensive Cancer Center assessed self‐reported demographics, attitudes, knowledge and postsurvey confidence in knowledge of SGM oncology patient needs. Reporting of this study adheres to STROBE guidelines.

Results

Knowledge of health needs was low with an average of 2.56 (SD = 1.27) items answered correctly out of 6. The majority of APPs self‐reported being comfortable treating SGM patients (93.6% and 87.2%, respectively), but less confident in knowledge of their health needs (68.0% and 53.8%, respectively). Although less than half of APPs believed education should be mandatory (44.9%), 79.5% were interested in education about SGMs’ unique health needs. Political affiliation, medical specialty, licensure, and having SGM friends or family were associated with various attitude items, but not knowledge. Moderation analyses indicated that APPs who had greater overall knowledge scores were more likely to agree, on average, that knowing sexual orientation, gender identity and sex assigned at birth are important to providing quality oncology care.

Conclusion

APPs report being comfortable providing care for SGMs with cancer, but knowledge gaps remain that may inhibit the quality of care provided. Given the interest in education, results would support the development of SGM‐related healthcare training for oncology APPs.

Relevance to clinical practice

Targeted education for providers during training and continuing education is likely to improve the provision of quality care for SGMs with cancer.
The more severe the merrier: Severity of error consequences stimulates learning from error
Authors: Keith Nina , Horvath Dorothee , Klamar Alexander
Published: April 2020

Errors at work can lead to learning but little is known about error attributes and person attributes that make learning more or less likely. This research tested the role of severity of error consequences (error attribute) and trait negative affectivity (person attribute) for learning from error. In two experimental vignette studies, participants responded to written error scenarios that typically happen to university students (Study 1, N = 216) or to employees at work (Study 2, N = 121). In support of the view that error consequences need to be severe enough to attract attention, severity of error consequences increased both affective learning (perceived utility of the error; Studies 1 and 2) and cognitive learning (correctly recalled error scenarios; Study 2). In both studies, trait negative affectivity was associated with decreased affective learning when error consequences were severe (interaction effect). The results suggest that some errors at work – at least errors with minor consequences – may not receive much attention and are easily forgotten. To fully exploit learning opportunities, organizations should give attention to all errors and take them seriously, irrespective of severity of immediate error consequences.

Practitioner points

Whether errors in organizations receive attention seems to depend on severity of error consequences, rather than on errors per se and their informational value.

This implies that valuable learning opportunities of errors may be missed.

To fully exploit learning opportunities, managers should encourage open communication and learning from error and avoid unproductive blaming.

This particularly applies to dispositionally anxious individuals who may feel threatened by errors more easily and who may, in turn, respond defensively.
Sacred Canopies or Religious Markets? The Effect of County‐Level Religious Diversity on Later Changes in Religious Involvement
Authors: Olson Daniel v.a. , Marshall Joey , Jung Jong Hyun , Voas David
Published: April 2020

Secularization theories, such as Berger's Sacred Canopy argument, hold that religious diversity leads to a decline in religious participation. Religious market models (e.g., Finke and Stark) argue the opposite. Voas, Olson, and Crockett found that nearly all of the vast research exploring this important question prior to 2002 was flawed due to a previously unrecognized noncausal statistical relationship between measures of religious diversity and measures of religious participation. Since 2002, this methodological issue has largely stymied research on this important topic. We first describe how, following Voas et al.’s recommendations, longitudinal models can overcome these problems. We then apply these methods to data measuring the religious composition of all U.S. counties found in the Religious Congregations and Membership Studies from 1980, 1990, 2000, and 2010. Using multilevel longitudinal regression models, we find that greater county‐level religious diversity is followed by later declines in county‐level religious participation rates. The negative effect size of religious diversity is large and robust to changes in the control variables and different methods of measuring religious diversity.
Heart murmurs in apparently healthy cats caused by iatrogenic dynamic right ventricular outflow tract obstruction
Authors: Ferasin Luca , Ferasin Heidi , Kilkenny Eoin
Published: April 2020

Background

Heart murmurs are detected commonly in apparently healthy cats during routine physical examination, and Doppler echocardiography ultimately is required to identify the source of flow turbulence causing the murmur. However, in some cases, the origin of the murmur cannot be identified on echocardiographic examination, even by experienced clinicians. The application of gentle pressure with the ultrasound transducer against the chest wall of a cat can induce temporary narrowing of the mid‐right ventricular (RV) lumen, causing blood flow turbulence even in the absence of cardiac abnormalities.

Objectives/Hypotheses

To evaluate the effect of pressure of the ultrasound transducer against the chest wall of cats during echocardiography (provocative testing) on RV blood flow. The main hypothesis is that provocative testing can increase RV outflow velocity and cause flow turbulence. The second hypothesis is that the effect of this maneuver is independent of changes in heart rate during testing.

Animals

Sixty‐one client‐owned, apparently healthy cats with heart murmurs on physical examination.

Methods

Retrospective review of echocardiographic examinations of 723 cats presented for investigation of a heart murmur.

Results

Outflow systolic velocity increased from 1.05 ± 0.26 to 1.94 ± 0.51 m/s during provocative testing (P < .0001); no correlation was found between RV outflow peak velocity and heart rate during provocative testing (P = .34; r = 0.1237).

Conclusions and Clinical Relevance

Right ventricular outflow tract obstruction and associated heart murmur can be iatrogenically induced in apparently healthy cats by increasing pressure on the right chest wall with an ultrasound probe.