bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical site infection in elective colonic and rectal resections: effect of oral antibiotics and mechanical bowel preparation compared with mechanical bowel preparation only
Authors: Ghuman A. , Kasteel N. , Brown C. J. , Karimuddin A. A. , Raval M. J. , Wexner S. D , Phang P. T.
Published: May 2020

Aim

Surgical site infections are disproportionately common after colorectal surgery and may be largely preventable. The objective of this retrospective cohort study was to determine the effect of oral antibiotics and mechanical bowel preparation on surgical site infections.

Method

A retrospective study of a consecutive series of elective colonic and rectal resections following an Enhanced Recovery After Surgery pathway, which also included mechanical bowel preparation, from 1 September 2014 to 30 September 2017. The addition of oral antibiotics (neomycin and metronidazole) to the mechanical bowel preparation procedure was assessed. Development of surgical site infections within 30 days was the main outcome measured. The secondary outcome was assessment of possible surgical site infection predictors.

Results

Seven‐hundred thirty‐two patients were included: 313 (43%) preintervention (mechanical bowel preparation only); and 419 (57%) postintervention (mechanical bowel preparation plus oral antibiotics). Surgical site infection rates preintervention and. postintervention were: overall, 20.8% vs 10.5%, P < 0.001; superficial, 10.9% vs 4.3%, P < 0.001; and organ space, 9.9% vs 6.2%, P = 0.03. Subgroup analysis of colonic resections revealed a significant reduction in overall (17.1% vs 6.8%), superficial (10.7% vs 4.3%) and organ space (6.4% vs. 2.6%) infections. Rectal resections had significant reduction in overall (26.2% vs 15.3%) and superficial (11.1% vs 4.4%) infection rates but not in organ space infections (15.1% vs 10.9%). Multivariate regression analysis revealed open vs minimally invasive surgery (P < 0.001) and omission of oral antibiotics (P = 0.004) as independent predictors of surgical site infections.

Conclusion

Administration of oral antibiotics resulted in significant reduction of superficial and organ space infections after colonic resection; after rectal resection, significant reduction only of superficial infections was found.
A novel method for near‐infrared fluorescence imaging of the urethra during perineal and transanal surgery: demonstration in a cadaveric model
Authors: Barberio M. , Al‐Taher M. , Forgione A. , Hoskere Ashoka A. , Felli E. , Agnus V. , Marescaux J. , Klymchenko A. , Diana M.
Published: May 2020

Aim

Transanal total mesorectal excision is a promising novel sphincter‐saving procedure for low rectal cancer. However, the transanal bottom‐up dissection is associated with increased rates of iatrogenic urethral injuries. Near‐infrared fluorescence (NIRF) imaging, given its deeper tissue penetration, has been explored in a limited number of studies for enhanced intra‐operative urethral visualization. In this study, we explored the feasibility of a novel, ultrabright, biocompatible fluorescent polymer to coat urinary catheters for the purpose of intra‐operative urethral visualization.

Methods

In an ex vivo experiment, using a near‐infrared laparoscope, the fluorescent signal of a coated catheter (near‐infrared coating of equipment, NICE) was qualitatively and quantitatively compared to the signal of indocyanine green (ICG)/Instillagel® mixtures and ICG‐filled catheters at several concentrations. Also, in three male human torsos, using fluorescent urinary catheters, NIRF‐guided perineal dissections and a transanal total mesorectal excision were performed. Intra‐operative NIRF‐based urethral visualization was performed systematically.

Results

During the qualitative and quantitative fluorescence signal assessment, NICE‐coated catheters were clearly superior to the ICG‐based solutions. In the cadaveric experiments, enhanced urethral visualization was possible even at early stages of dissection, when the organ was covered by several tissue layers.

Conclusions

NICE‐coated catheters represent a promising potential to allow for NIRF‐based intra‐operative urethral visualization.
How to Be Helpful to Multiple People at Once
Authors: Gates Vael , Griffiths Thomas L. , Dragan Anca D.
Published: May 2020

When someone hosts a party, when governments choose an aid program, or when assistive robots decide what meal to serve to a family, decision‐makers must determine how to help even when their recipients have very different preferences. Which combination of people’s desires should a decision‐maker serve? To provide a potential answer, we turned to psychology: What do people think is best when multiple people have different utilities over options? We developed a quantitative model of what people consider desirable behavior, characterizing participants’ preferences by inferring which combination of “metrics” (maximax, maxsum, maximin, or inequality aversion [IA]) best explained participants’ decisions in a drink‐choosing task. We found that participants’ behavior was best described by the maximin metric, describing the desire to maximize the happiness of the worst‐off person, though participant behavior was also consistent with maximizing group utility (the maxsum metric) and the IA metric to a lesser extent. Participant behavior was consistent across variation in the agents involved and  tended to become more maxsum‐oriented when participants were told they were players in the task (Experiment 1). In later experiments, participants maintained maximin behavior across multi‐step tasks rather than shortsightedly focusing on the individual steps therein (Experiment 2, Experiment 3). By repeatedly asking participants what choices they would hope for in an optimal, just decision‐maker, and carefully disambiguating which quantitative metrics describe these nuanced choices, we help constrain the space of what behavior we desire in leaders, artificial intelligence systems helping decision‐makers, and the assistive robots and decision‐makers of the future.
Brazilian foreign policy for the Global South: The creation of the Centre of Excellence against Hunger
Authors: Dri Clarissa Franzoi , Molinari da Silva Andressa Caroline
Published: May 2020

Motivation

This article analyses the conception and implementation of the Centre of Excellence against Hunger, established through a partnership between Brazil and the World Food Programme in order to disseminate Brazilian practices relating to school food and nutrition.

Purpose

The Centre’s headquarters are in Brasília, primarily funded by the Brazilian government, and it aims to share Brazilian expertise while being part of the United Nations institutional board. This article assesses why and how such a sui generis institution came to be set up in 2011?

Approach and methods

Methodologically, this case study is based on semi‐structured interviews with key stakeholders who participated in this institutional construction.

Findings

We argue that the Centre has its roots in a transnational government network animated by Brazilian officials. This idea originated primarily outside the context of international relations, fostered by education and school meals managers and technicians. It did find some development support within the sphere of international relations, involving the Brazilian government and the United Nations, and with the backing of actors invested in the new foreign policy guidelines presented by the Luiz Inácio Lula da Silva (henceforth “Lula") administration.

Policy implications

The trajectory of the Centre of Excellence against Hunger derives from the role of networks in the international system alongside the influence of individuals during periods of change or uncertainty in bureaucracies and international regimes. Conventional diplomacy and international organizations can benefit from cross‐fertilization with networks that include government actors.
The Association between Attachment Styles and Physical Intimate Partner Violence Perpetration and Victimization: A Meta‐Analysis
Authors: Spencer Chelsea M. , Keilholtz Brooke M. , Stith Sandra M.
Published: May 2020

In this meta‐analysis, we examine attachment styles—something commonly incorporated into couples therapy—and their association with physical intimate partner violence (IPV) perpetration and victimization among men and women. This meta‐analysis incorporated 33 studies that looked at the association between four different attachment styles and IPV. This study examined the strength of the correlation among different attachment styles and IPV perpetration and victimization, examined gender differences in the strength of the association among attachment styles and IPV, and compared the strength of the association with IPV among different attachment styles. We found that anxious attachment, avoidant attachment, and disorganized attachment styles were all significantly associated with physical IPV perpetration and victimization. Secure attachment was significantly negatively related to IPV perpetration and victimization. There was a significantly stronger association between avoidant attachment and IPV victimization for women compared to men. Clinical implications related to the importance of fostering secure attachments when working with couples or individuals who have experienced IPV are addressed.
Efficacy of combining electric‐field and coronal‐plane imaging to obtain ultrasound–ultrasound fusion images in monopolar radiofrequency ablation for patients with liver cancer
Authors: Hirooka Masashi , Koizumi Yohei , Tanaka Takaaki , Nakamura Yoshiko , Tokumoto Yoshio , Abe Masanori , Hiasa Yoichi
Published: May 2020

Aim

For radiofrequency ablation to treat patients diagnosed with liver cancer, the ablation area cannot be envisaged beforehand, even by experts. This study aimed to assess the clinical feasibility of applying a combination of electric (E)‐field and coronal (C)‐plane simulations to ultrasound–ultrasound (US–US) fusion images.

Methods

The study protocols were approved by the institutional ethics committee. Between October 2017 and July 2019, 151 patients with 151 hepatocellular carcinoma nodules (80 treated with navigation images and 71 without navigation images) were retrospectively compared in this cross‐sectional study. The E‐field, which is a simulated image that predicts the ablation area, was applied to the US–US fusion images. The C‐plane is defined as a sagittal plane in relation to the original 2‐D US images. The positions of each E‐field area in the maximum cross‐sectional area of the tumor were easily identified from C‐plane results. The primary end‐point of this study was achievement of an adequate safety margin (greater than 5 mm). The sphericity of the ablation volume was used as a secondary end‐point.

Results

The rate of achieving a sufficient safety margin was significantly higher in the group treated with navigation images (71/80) than in the group treated without navigation images (31/71, P < 0.001). The median sphericity was 0.55 with navigation images and 0.42 without navigation images (P < 0.001).

Conclusion

Using the combination of an E‐field and a C‐plane on US–US fusion images can be a feasible method for acquiring a sufficient safety margin.
The clinical significance of fungi in atopic dermatitis
Authors: Thammahong Arsa , Kiatsurayanon Chanisa , Edwards Steven W. , Rerknimitr Pawinee , Chiewchengchol Direkrit
Published: May 2020

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases and is caused by multiple factors including genetic factors, skin barrier defects, host immune responses, allergen sensitivity, environmental effects, and infections. Commonly, bacterial and viral infections are present in the eczematous lesions of AD patients and clearly aggravate the symptoms. However, studies of fungal infections in AD are limited in spite of the fact that there are reports showing that Malassezia, Candida, and some dermatophytes can affect the symptoms of AD. Moreover, certain fungal infections are sometimes overlooked and need to be considered particularly in AD patients with treatment failure as clinical features of those fungal infections could mimic eczematous lesions in AD. Here, we review the epidemiology, pathogenesis, clinical manifestations, and overlooked features of fungal infections associated with the symptoms of AD including the diagnosis and effectiveness of fungal treatments in AD patients.
Formation energies and site preference of substitutional divalent cations in carbonated apatite
Authors: Saito Tatsushi , Yokoi Tatsuya , Nakamura Atsutomo , Matsunaga Katsuyuki
Published: May 2020

First‐principles calculations were performed to examine defect formation energies and site preference of substitutional divalent cations M2+ (M = Mg, Cu, Zn, Cd, Sr, Pb, and Ba) in hydroxyapatite (HAp, Ca10(PO4)6(OH)2) and carbonated apatite (CAp). All inequivalent substitutional sites of

and M2+ were investigated to determine their most preferential sites. For all M2+ studied, their defect formation energies for the most stable substitutional sites were lower in CAp than in hydroxyapatite (HAp), demonstrating that M2+ are preferentially substituted into CAp over HAp. For Ca sites in CAp, correlations between the defect formation energies and Ca‐O bond lengths showed that bigger and smaller M2+ than Ca2+ are preferentially substituted for Ca sites with longer and shorter bond lengths than those in HAp, respectively. In addition, Ca sites with lower coordination numbers than 6 are preferentially substituted by Zn2+ and Cu2+ that originally tend to form 4‐ or 5‐fold coordination in their phosphate crystals.

substitution is therefore likely to effectively stabilize substitutional foreign ions by modifying bond lengths and coordination numbers of Ca sites from those in pure HAp. These effects may play an important role in enhancing the M2+ solubility into CAp.
Low‐temperature preparation of high‐performance porous ceramics composed of anorthite platelets
Authors: Han Lei , Huang Liang , Dong Longhao , Zhang Haijun , Pei Yuantao , Li Faliang , Jia Quanli , Zhang Shaowei
Published: May 2020

Platelet‐like anorthite based porous ceramics with improved mechanical strength were fabricated via direct gelcasting and firing at 1223‐1473 K using CaCO3, Al(OH)3, and SiO2 powders as the raw materials, along with H3BO3 and melamine sintering/crosslinking agents. Based on density functional theory calculations, H3BO3 promoted the formation of platelet‐like anorthite at a relatively low temperature via covering the {130} facet of anorthite and reducing the corresponding adsorption energy, which led to the preferential growth along the a‐ and b‐axes. The optimal amount of H3BO3 for the anorthite platelet formation was 0.9 wt%. The porous anorthite sample with an original solid content of 22.0 wt%, after firing at 1373 K, contained 71.0% porosity and exhibited a compressive strength as high as 5.7 MPa, which were comparable or even superior to those of porous anorthite ceramics prepared previously at a much higher temperature (1573‐1723 K), indicating that the preparation strategy reported in this paper is feasible in fabricating high‐performance porous anorthite ceramics at a much milder condition. The thermal conductivity of the porous anorthite sample at 1073 K was as low as 0.266 W/(m·K), much lower than that (0.645 W/(m·K)) of the control sample, suggesting that the former could be potentially used for thermal insulation at high temperatures.
Metformin regulates adiponectin signalling in epicardial adipose tissue and reduces atrial fibrillation vulnerability
Authors: Li Biao , Po Sunny S. , Zhang Baojian , Bai Fan , Li Jiayi , Qin Fen , Liu Na , Sun Chao , Xiao Yichao , Tu Tao , Zhou Shenghua , Liu Qiming
Published: May 2020

Epicardial adipose tissue (EAT) remodelling is closely related to the pathogenesis of atrial fibrillation (AF). We investigated whether metformin (MET) prevents AF‐dependent EAT remodelling and AF vulnerability in dogs. A canine AF model was developed by 6‐week rapid atrial pacing (RAP), and electrophysiological parameters were measured. Effective refractory periods (ERP) were decreased in the left and right atrial appendages as well as in the left atrium (LA) and right atrium (RA). MET attenuated the RAP‐induced increase in ERP dispersion, cumulative window of vulnerability, AF inducibility and AF duration. RAP increased reactive oxygen species (ROS) production and nuclear factor kappa‐B (NF‐κB) phosphorylation; up‐regulated interleukin‐6 (IL‐6), tumour necrosis factor‐α (TNF‐α) and transforming growth factor‐β1 (TGF‐β1) levels in LA and EAT; decreased peroxisome proliferator‐activated receptor gamma (PPARγ) and adiponectin (APN) expression in EAT and was accompanied by atrial fibrosis and adipose infiltration. MET reversed these alterations. In vitro, lipopolysaccharide (LPS) exposure increased IL‐6, TNF‐α and TGF‐β1 expression and decreased PPARγ/APN expression in 3T3‐L1 adipocytes, which were all reversed after MET administration. Indirect coculture of HL‐1 cells with LPS‐stimulated 3T3‐L1 conditioned medium (CM) significantly increased IL‐6, TNF‐α and TGF‐β1 expression and decreased SERCA2a and p‐PLN expression, while LPS + MET CM and APN treatment alleviated the inflammatory response and sarcoplasmic reticulum Ca2+ handling dysfunction. MET attenuated the RAP‐induced increase in AF vulnerability, remodelling of atria and EAT adipokines production profiles. APN may play a key role in the prevention of AF‐dependent EAT remodelling and AF vulnerability by MET.
Eurovisions: An Exploration and Explanation of Public Preferences for Future EU Scenarios
Authors: Goldberg Andreas C. , van Elsas Erika J. , De Vreese Claes H.
Published: May 2020

Public opinion on the EU has received growing attention in the last decades, with an ever‐increasing number of studies examining various aspects of it. Surprisingly, most studies focus on attitudes towards the past and present of the EU, yet we know very little about public attitudes towards the future of the EU. This study helps to fill this research gap by examining attitudes towards the EU's long‐term future using a novel approach. We developed eight concrete future EU scenarios based on an inductive analysis of qualitative survey data. Subsequently, respondents (in an independent survey) ranked their top three scenarios according to individual preferences. Using multidimensional unfolding, we show that these preferences form three clusters ordered along a more versus less EU dimension. In a second step, we used multinomial logistic regression to examine not only who supports which scenario (socio‐demographics) but also which EU attitudes lead to which future preferences. The analyses identify distinct characteristics and attitudes that drive people's preference for a given scenario. Overall, we find that factors such as occupational levels or left–right attitudes are strong determinants of preferences for the future of the EU, and that specific EU support (performance and utilitarian evaluations) is more important than diffuse EU support (identity and affect).
Protecting medical staff from skin injury/disease caused by personal protective equipment during epidemic period of COVID‐19: experience from China
Authors: Long H. , Zhao H. , Chen A. , Yao Z. , Cheng B. , Lu Q.
Published: May 2020

Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e210–e216.
Stigmatization and quality of life – psychological impact of congenital melanocytic naevi
Authors: Szalai Z.Z.
Published: May 2020

Linked article: K. Neuhaus, et al. J Eur Acad Dermatol Venereol 2020; 34: 1105–1111. https://doi.org/10.1111/jdv.16131.
Entry limiting agreements: First‐mover advantage, authorized generics, and pay‐for‐delay deals
Authors: Bokhari Farasat A. S. , Mariuzzo Franco , Polanski Arnold
Published: May 2020

During patent litigation, pay‐for‐delay (P4D) deals involve a payment from a patent holder of a branded drug to a generic drug manufacturer to delay entry and withdraw the patent challenge. In return for staying out of the market, the generic firm receives a payment, and/or an authorized licensed entry at a later date, but before the patent expiration. We examine why such deals are stable when there are multiple potential entrants. We combine the first‐mover advantage for the first generic with the ability of the branded manufacturer to launch an authorized generic (AG) to show when P4D deals are an equilibrium outcome. We further show that limiting a branded firm's ability to launch an AG before entry by a successful challenger will deter such deals. However, removing exclusivity period for the first generic challenger will not.
A new species of the Neotropical loricariid Hypostomus cochliodon group (Hypostominae) from the lower Rio Tapajós basin, Brazilian Amazon
Authors: de Oliveira Renildo R. , Ribeiro Frank R. V. , Canto André L. C. , Zawadzki Cláudio H.
Published: May 2020

A new species of Hypostomus with spoon‐shaped teeth is described from the Rio Cupari basin, a right margin affluent of the lower Rio Tapajós, Pará State, Brazil. The new species inhabits rocky bottom areas in the main channel of Rio Cupari and its tributaries. The new species can be distinguished from all its congeners, except from the Hypostomus cochliodon group, by having six to eight spoon‐shaped teeth, dentaries angled at less than 80° and the absence of a notch between the hyomandibular and the metapterygoid. The new species is distinguished from all species of the H. cochliodon group by its unique colour pattern, containing dark vermiculations on head and anterior portion of the trunk, and by the absence of medial buccal papillae.
At Palmyra Atoll, the fish‐community environmental DNA signal changes across habitats but not with tides
Authors: Lafferty Kevin D. , Garcia‐Vedrenne Ana E. , McLaughlin John P. , Childress Jasmine N. , Morse Marisa F. , Jerde Christopher L.
Published: May 2020

At Palmyra Atoll, the environmental DNA (eDNA) signal on tidal sand flats was associated with fish biomass density and captured 98%–100% of the expected species diversity there. Although eDNA spilled over across habitats, species associated with reef habitat contributed more eDNA to reef sites than to sand‐flat sites, and species associated with sand‐flat habitat contributed more eDNA to sand‐flat sites than to reef sites. Tides did not disrupt the sand‐flat habitat signal. At least 25 samples give a coverage >97.5% at this diverse, tropical, marine system.
Prevalence of E. coli, Salmonella, and Listeria spp. as potential pathogens: A comparative study for biofilm of sink drain environment
Authors: El‐Liethy Mohamed Azab , Hemdan Bahaa A. , El‐Taweel Gamila E.
Published: May 2020

Since knowledge and understanding of waterborne pathogens and their diseases are well illuminated, a few research publications on the prevalence of pathogenic microorganisms in various household sink drain pipes are often not extensively examined. Therefore, this study aims to (a) assess and monitor the densities of the bacterial community in the different natural biofilm that grow on plastic pipelines, (b) to detect Escherichia coli, Salmonella, and Listeria spp. from natural biofilm samples that are collected from the kitchen (n = 30), bathroom (n = 10), laboratories (n = 13), and hospital (n = 8) sink drainage pipes. Three bacterial species selected were assessed using a culture‐dependent approach followed by verification of isolates using both BIOLOG GEN III and polymerase chain reaction. The estimated number of each bacterium was 122 isolates, while 60, 20, 26, and 16 isolates were obtained from the natural biofilm samples, kitchen, bathroom, laboratories, and hospital, respectively. As for the tests, in all types of biofilm samples, the overall bacterial counts at low temperature (22°C) were higher than those at high temperature (37°C). Meanwhile, E. coli had the most significant number of bacterial microorganisms compared to the other two pathogens. Additionally, the most massive cell densities of E. coli, Salmonella, and Listeria species were discovered in the biofilm collected from the kitchen, then the hospital. Statistically, the results reveal that there is a positive correlation (p ≥ .0001) with significance between the sources of biofilm. This work certainly makes the potential of household sink drain pipes for reservoir contagious pathogens more explicitly noticeable. Such knowledge would also be beneficial for prospective consideration of the threat to human public health and the environment.
Prevalence of serrated lesions, risk factors, and their association with synchronous advanced colorectal neoplasia in asymptomatic screened individuals
Authors: Sekiguchi Masau , Kakugawa Yasuo , Matsumoto Minori , Nakamura Keiko , Mizuguchi Yasuhiko , Takamaru Hiroyuki , Yamada Masayoshi , Sakamoto Taku , Saito Yutaka , Matsuda Takahisa
Published: May 2020

Background and Aim

Serrated lesions (SLs) have attracted attention as precursors of colorectal cancer (CRC). However, their prevalence, risk factors, and clinical significance have not been satisfactorily elucidated. This study used high‐quality colonoscopy data to determine the prevalence of SLs and to identify their risk factors and relationship with synchronous advanced colorectal neoplasia (ACN) in asymptomatic screened individuals.

Methods

This study included data for 5218 individuals who underwent first‐time screening colonoscopy by highly experienced endoscopists. The relationships between baseline characteristics and the presence of SLs and those between the presence of SLs and synchronous ACN were assessed using the chi‐squared test and multivariate logistic regression.

Results

The proportions of individuals with SLs and right‐sided SLs were 23.3% and 7.6%, respectively. Age, sex, family history of CRC, smoking, and body mass index were significantly related with the presence of SLs, and current smoking was most strongly associated with SLs (adjusted odds ratio [aOR] 2.6, 95% confidence interval [CI] 2.1–3.2). The aOR (95% CI) of the presence of SLs, SLs sized ≥ 10 mm, and right‐sided SLs ≥ 5 mm for synchronous ACN was 1.4 (1.1–1.9), 3.5 (1.3–9.6), and 1.9 (1.0–3.8), respectively. The presence of left‐sided SLs ≥ 10 mm (without right‐sided SLs) was also significantly associated with ACN (aOR 8.1, 95% CI 2.0–33.7).

Conclusions

The relatively high prevalence of SLs and risk factors in screened individuals were elucidated and the significant relationship between SLs, particularly SLs ≥ 10 mm and right‐sided SLs ≥ 5 mm, and synchronous ACN was confirmed.
DOACs Versus VKAs in Older Adults Treated for Acute Venous Thromboembolism: Systematic Review and Meta‐Analysis
Authors: Chaudhary Rahul , Pagali Sandeep , Garg Jalaj , Murad M. Hassan , Wysokinski Waldemar E. , McBane Robert D.
Published: May 2020

BACKGROUND/OBJECTVES

Four direct‐acting oral anticoagulants (DOACs) are currently approved by the Food and Drug Administration for the treatment of venous thromboembolism (VTE). Limited efficacy and safety data are available for their use in older adults (aged ≥75 years).

METHODS

Medline, Cochrane Central Register of Controlled Trials, Embase, EBSCO, Web of Science, and CINAHL databases were searched for trials comparing DOACs with vitamin K antagonists (VKAs) for the treatment of VTE in older adults from inception through January 1, 2020. Meta‐analysis was performed to assess the combined endpoint of recurrent VTE and related deaths and bleeding events (composite of major and clinically relevant nonmajor bleeding). The Mantel‐Haenszel relative risk (RR) random effects model was used to pool results across studies.

RESULTS

Six randomized controlled trials at low risk of bias met criteria for inclusion with a total of 3,665 patients aged 75 years and older with follow‐up of 24 weeks or longer. Data for bleeding events were not available for dabigatran. Overall, DOACs had an improved efficacy over VKAs (RR = .56; 95% confidence interval [CI] = .38‐.82). There was no statistically significant difference in the safety outcomes (RR = .77; 95% CI = .56‐1.05). No significant heterogeneity was observed for efficacy outcome, and only moderate heterogeneity was observed for safety outcome.

CONCLUSION

In older adults with VTE, DOACs appear to improve rates of recurrent VTE and VTE‐related deaths compared with VKAs with similar bleeding outcomes.
Receptor for advanced glycation end products up‐regulation in cerebral endothelial cells mediates cerebrovascular‐related amyloid β accumulation after Porphyromonas gingivalis infection
Authors: Zeng Fan , Liu Yicong , Huang Wanyi , Qing Hong , Kadowaki Tomoko , Kashiwazaki Haruhiko , Ni Junjun , Wu Zhou
Published: May 2020

Cerebrovascular‐related amyloidogenesis is found in over 80% of Alzheimer's disease (AD) cases, and amyloid β (Aβ) generation is increased in the peripheral macrophages during infection of Porphyromonas gingivalis (P. gingivalis), a causal bacterium for periodontitis. In this study, we focused on receptor for advanced glycation end products (RAGE), the key molecule involves in Aβ influx after P. gingivalis infection to test our hypothesis that Aβ transportation from periphery into the brain, known as “Aβ influx,” is enhanced by P. gingivalis infection. Using cultured hCMEC/D3 cell line, in comparison to uninfected cells, directly infection with P. gingivalis (multiplicity of infection, MOI = 5) significantly increased a time‐dependent RAGE expression resulting in a dramatic increase in Aβ influx in the hCMEC/D3 cells; the P. gingivalis‐up‐regulated RAGE expression was significantly decreased by NF‐κB and Cathepsin B (CatB)‐specific inhibitors, and the P.gingivalis‐increased IκBα degradation was significantly decreased by CatB‐specific inhibitor. Furthermore, the P. gingivalis‐increased Aβ influx was significantly reduced by RAGE‐specific inhibitor. Using 15‐month‐old mice (C57BL/6JJmsSlc, female), in comparison to non‐infection mice, systemic P. gingivalis infection for three consecutive weeks (1 × 108 CFU/mouse, every 3 days, intraperitoneally) significantly increased the RAGE expression in the CD31‐positive endothelial cells and the Aβ loads around the CD31‐positive cells in the mice's brains. The RAGE expression in the CD31‐positive cells was positively correlated with the Aβ loads. These observations demonstrate that the up‐regulated RAGE expression in cerebral endothelial cells mediates the Aβ influx after P. gingivalis infection, and CatB plays a critical role in regulating the NF‐κB/RAGE expression.

image

Cover Image for this issue: https://doi.org/10.1111/jnc.15073
The caudal neurosecretory system: A novel thermosensitive tissue and its signal pathway in olive flounder (Paralichthys olivaceus)
Authors: Yuan Mingzhe , Li Xiaoxue , Lu Weiqun
Published: May 2020

Ectotherm animals, such as fish, are vulnerable when facing an extreme temperature fluctuation as a result of their inability to maintain body temperature. The caudal neurosecretory system (CNSS) is unique to fish and has been shown to maintain homeostasis in response to seasonal changes. However, its temperature sensitivity is unknown. Here, we used in vitro electrophysiological and anatomical approaches to investigate a thermosensory pathway in the CNSS. We showed that the CNSS responds directly to local hypothermal challenge via the TRP channel, and transmits this signal using the neurotransmitter, GABA, to the neurosecretory Dahlgren cells of the CNSS. These findings are the first demonstration of the thermal perception of the CNSS and add to our understanding of the physiological role of the CNSS in thermoregulation and seasonal adaptation.
To explore the experience of research nurses who obtain consent from adults in emergency settings to participate in clinical trials, either prospectively or post enrolment
Authors: Brown Pauline , Newham Roger , Hewison Alistair
Published: May 2020

Aim

To explore the understanding and experiences of research nurses who obtain informed consent from adult patients participating in emergency care research.

Design

Qualitative phenomenographic descriptive study.

Methods

Ten research nurses from six hospitals in England were recruited. Data were collected using semi‐structured face‐to‐face and telephone interviews between January 2019 and March 2019. Interviews were transcribed verbatim and analysed thematically, informed by phenomenography. COREQ was followed.

Results

Three main themes were identified: (a) emergency research is different, (b) protecting the patient, and (c) experience and confidence with recruitment. It was found that obtaining patient consent in emergency care research was challenging and timing of the process was crucial. Nurses with more experience of emergency care were more confident in approaching patients and their families. There was variability in out‐of‐hours recruitment which was a consequence of the range of informed consent processes used and the different levels of engagement of clinical teams.

Conclusion

There is a variety of organisational cultures, processes and procedures which affect the way consent is obtained in emergency care research. A team approach was evident in the hospitals where consent rates were high and was more successful than those reliant solely on the presence of a research nurse. Organisations were able to recruit successfully to emergency care research studies irrespective of size and configuration. Further investigation of their models of working and strategies for engagement is needed. Experienced research nurses made a positive difference to recruitment and were more likely to approach patients to obtain consent.

Relevance to clinical practice

The understanding and experiences of recruitment to clinical trials in emergency care research by research nurses can help identify barriers to recruitment. This study provides useful insights for healthcare practitioners, clinical trials coordinators and sponsors about how best to develop protocols and policies to increase recruitment to emergency care research.
Brassinin, a brassica-derived phytochemical, regulates monocyte-to-macrophage differentiation and inflammatory responses in human monocytes and murine macrophages
Authors: Kang Bobin , Hwang Jisu , Choi Hyeon-Son
Published: May 2020

Objectives

The effects and molecular mechanisms of brassinin (BR), an indole phytoalexin from cruciferous vegetables, on monocyte-to-macrophage differentiation and inflammatory responses were investigated in this study.

Methods

Inflammatory responses from RAW264.7 cells and THP-1 were stimulated by lipopolysaccharide (1 µg/ml), and monocyte-to-macrophage differentiation of THP-1 was induced by phorbol myristate acetate (50 ng/ml). The production of inflammatory mediators was determined by ELISA, Western blot or real-time PCR. Reactive oxygen species were examined by DCFH-DA assay.

Key findings

Brassinin at 50 µm suppressed lipopolysaccharide-induced production of nitric oxide synthase, cyclooxygenase-2, prostaglandin E2 and reactive oxygen species by 90%, 69%, 52% and 41%, respectively, in RAW264.7 cells. In THP-1 cells, BR inhibited phorbol myristate acetate-induced monocyte-to-macrophage differentiation by suppressing cluster of differentiation molecule β and CD36. In addition, BR suppressed translocation of nuclear factor ‘kappa-light-chain-enhancer’ of activated B cells (NF-κB) into the nucleus. However, BR activated the nuclear factor erythroid-derived 2-like 2 (Nrf2) and its target molecules hemoxygenase-1 (HO-1) and NAD(P)H: quinone oxidoreductase 1 (NQO1), with an increase in nuclear translocation of Nrf2.

Conclusions

Brassinin suppressed monocyte-to-macrophage differentiation and inflammatory responses by differentially regulating Nrf2 and NF-κB signallings.
Antiviral treatment using the adenosine nucleoside analogue GS‐441524 in cats with clinically diagnosed neurological feline infectious peritonitis
Authors: Dickinson Peter J. , Bannasch Michael , Thomasy Sara M. , Murthy Vishal D. , Vernau Karen M. , Liepnieks Molly , Montgomery Elizabeth , Knickelbein Kelly E. , Murphy Brian , Pedersen Niels C.
Published: May 2020

Feline infectious peritonitis (FIP) is caused by a mutant biotype of the feline enteric coronavirus. The resulting FIP virus (FIPV) commonly causes central nervous system (CNS) and ocular pathology in cases of noneffusive disease. Over 95% of cats with FIP will succumb to disease in days to months after diagnosis despite a variety of historically used treatments. Recently developed antiviral drugs have shown promise in treatment of nonneurological FIP, but data from neurological FIP cases are limited. Four cases of naturally occurring FIP with CNS involvement were treated with the antiviral nucleoside analogue GS‐441524 (5‐10 mg/kg) for at least 12 weeks. Cats were monitored serially with physical, neurologic, and ophthalmic examinations. One cat had serial magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) analysis (including feline coronavirus [FCoV]) titers and FCoV reverse transcriptase [RT]‐PCR) and serial ocular imaging using Fourier‐domain optical coherence tomography (FD‐OCT) and in vivo confocal microscopy (IVCM). All cats had a positive response to treatment. Three cats are alive off treatment (528, 516, and 354 days after treatment initiation) with normal physical and neurologic examinations. One cat was euthanized 216 days after treatment initiation following relapses after primary and secondary treatment. In 1 case, resolution of disease was defined based on normalization of MRI and CSF findings and resolution of cranial and caudal segment disease with ocular imaging. Treatment with GS‐441524 shows clinical efficacy and may result in clearance and long‐term resolution of neurological FIP. Dosages required for CNS disease may be higher than those used for nonneurological FIP.
Digestible energy, protein, and energy–protein ratio requirements of Pseudoplatystoma reticulatum
Authors: Silva Tarcila Souza de Castro , Zanon Ricardo Basso , Mourão Gerson Barreto , Cyrino José Eurico Possebon
Published: May 2020

The use of novel aquaculture species depends on the determination of their nutritional requirements. This study aims at determining dietary protein, energy, and protein–energy ratio requirements of juvenile striped surubim, Pseudoplatystoma reticulatum, an economically important carnivorous South American catfish for capture fisheries and highly regarded for fish farming purposes. Juvenile striped surubim (53.6 ± 1.30 g, n = 525) were randomly stocked (n = 7) in 75 test cages (210 L) and hand fed for 60 days, two daily meals, with 25 diets formulated to contain five levels of digestible protein (DP) (320, 360, 400, 440, and 480 g/kg) and five levels of digestible energy (DE) (15.1, 15.6, 16.1, 16.6, and 17.2 MJ/kg) in a completely randomized design, 5 × 5 factorial scheme (n = 3). Dietary energy and protein level affected performance, feed efficiency, and metabolism while the whole‐body composition was not affected by diets. Estimated dietary requirements for the best performance and best nutrient retention were 15.1 MJ/kg DE and 390 g/kg DP, therefore a 25.9 g/MJ of DP:DE ratio.
Party Government and Political Information
Authors: Fortunato David , Stevenson Randolph T.
Published: May 2020

We argue that the kind of political information voters should possess varies contextually in response to relevant political processes. Focusing on the partisan organization of legislatures, we derive hypotheses for what the typical American should know about politics at the national and state level and test these hypotheses in two studies. The first documents a dramatic change in American political knowledge at the national level in response to polarization—the replacement of individually oriented information with partisan information. While voters’ ability to identify the candidates running to represent them in Congress has been cut in half, their ability to rank order the parties ideologically has nearly doubled. The second study provides evidence that voters are better able to identify the majority party in their state legislature where partisan control of the legislative agenda and roll‐call voting is stronger. We conclude by discussing the implications of our findings.
Translating Laboratory Evidence into Classroom Practice with Teacher‐Led Randomized Controlled Trials—A Perspective and Meta‐Analysis
Authors: Churches Richard , Dommett Eleanor J. , Devonshire Ian M. , Hall Robin , Higgins Steve , Korin Astrid
Published: May 2020

We initiated and structured a single program that supervised teachers, some with neuroscience or psychology degrees, to collaborate and explore the effects of science of learning‐translated pedagogy. This article reports on the 34 findings from teacher‐led randomized controlled trials (RCTs) and replications. Teachers designed trials, looking at areas such as attention, memory, and spaced learning. Overall, positive effects were found over short periods (1–6 weeks; r = 0.15, p < .0001 [d = 0.30], N = 2,157). However, retrieval practice (testing as a learning experience) had differential effects mediated by age, approach, and lesson content. Results suggest science of learning‐translated pedagogy needs extensive replication to establish how best to use laboratory evidence in classrooms. Multiple planned replication of teacher‐led RCTs has potential as an evaluation tool, combining high levels of mundane realism with strong internal validity and the potential to build cost effective large samples for meta‐analysis.
Negotiating “True” Politics: Intergenerational Dynamics During Social Uprising in Sarajevo, Bosnia‐Herzegovina
Authors: Garić‐Humphrey Nataša
Published: May 2020

This article analyzes complex intergenerational dynamics during the 2014 uprising in Sarajevo, Bosnia‐Herzegovina, and critically engages with the Rancièrian notion of the political. During the Sarajevo uprising, those who had been excluded from participation in sociopolitical life and distribution of resources challenged the existing political status quo. Protesters emerged as new subjects that observers and participants could not define as any preexisting group occupying spaces within mainstream politics. However, members of different generations differed on whether violence was necessary to create positive change, whether this change should happen from within or outside of the existing political structure, and if power should be distributed horizontally or hierarchically. I argue that coming of age in three different political periods—socialist, immediate postwar, and a period of increased economic crisis—influenced divergent views on how to generate change. One view is not better than the other; they are simply different forms of political engagement signaling complex political subjectivities.
Risk prediction model in rheumatoid arthritis‐associated interstitial lung disease
Authors: Kim Ho Cheol , Lee Jeong Seok , Lee Eun Young , Ha You‐Jung , Chae Eun Jin , Han Minkyu , Cross Gary , Barnett Joseph , Joseph Jacob , Song Jin Woo
Published: May 2020

Background and objective

RA‐ILD has a variable clinical course, and its prognosis is difficult to predict. Moreover, risk prediction models for prognosis remain undefined.

Methods

The prediction model was developed using retrospective data from 153 patients with RA‐ILD and validated in an independent RA‐ILD cohort (n = 149). Candidate variables for the prediction models were screened using a multivariate Cox proportional hazard model. C‐statistics were calculated to assess and compare the predictive ability of each model.

Results

In the derivation cohort, the median follow‐up period was 54 months, and 38.6% of the subjects exhibited a UIP pattern on HRCT imaging. In multivariate Cox analysis, old age (≥60 years, HR: 2.063), high fibrosis score (≥20% of the total lung extent, HR: 4.585), a UIP pattern (HR: 1.899) and emphysema (HR: 2.596) on HRCT were significantly poor prognostic factors and included in the final model. The prediction model demonstrated good performance in the prediction of 5‐year mortality (C‐index: 0.780, P < 0.001); furthermore, patients at risk were divided into three groups with 1‐year mortality rates of 0%, 5.1% and 24.1%, respectively. Predicted and observed mortalities at 1, 2 and 3 years were similar in the derivation cohort, and the prediction model was also effective in predicting prognosis of the validation cohort (C‐index: 0.638, P < 0.001).

Conclusion

Our results suggest that a risk prediction model based on HRCT variables could be useful for patients with RA‐ILD.
Reactive bite‐related tongue lesions in cognitively impaired epilepsy patients: A report of two cases
Authors: Fukumoto Yutaka , Miyama Takeshi , Tanei Zen‐ichi , Saito Yuko , Ota Yoshihide
Published: May 2020

Aim

Tongue bites frequently occur during seizures in epilepsy patients. We report two cases of cognitively impaired Lennox‐Gastaut syndrome patients with reactive lesions on the tongues.

Case presentations

Case 1 was a 30‐year‐old man whose chief complaint was mouth pain. Local finding was a small bean‐sized pedunculated mass on the tongue, histopathologically diagnosed as inflammatory fibrous hyperplasia. Case 2 was a 45‐year‐old man whose chief complaint was bleeding from the mouth. His clinical finding was blood loss anemia. Local finding was a 20‐mm‐diameter pedunculated mass on the tongue, histopathologically diagnosed as pyogenic granuloma.

Conclusion

These mass lesions were believed to be reactive, caused by repetitive minor damage involving reparative fibrous tissue response. Therefore, the two cases may have involved reparative responses to mucosal injury incurred by accidental bites during epileptic seizures. Intellectual disability made medical treatment difficult and had allowed the massive lesions to form. It is necessary for cognitively impaired epilepsy patients to undergo regular dental examinations in order to get used to dental checks and to increase the number of intraoral observations in the context of close cooperation between dentists and epilepsy therapists.
Smoking and risk of surgical bleeding: nationwide analysis of 5,452,411 surgical cases
Authors: Nordestgaard Ask T. , Rasmussen Lars S. , Sillesen Martin , Steinmetz Jacob , King David R. , Saillant Noelle , Kaafarani Haytham M. , Velmahos George C.
Published: May 2020

BACKGROUND

Although smoking is associated with several postoperative complications, a possible association with surgical bleeding remains unclear. We examined if smoking is associated with a higher risk of surgical bleeding.

STUDY DESIGN AND METHODS

We included patients from the American College of Surgeons National Surgical Quality Improvement Program 2007‐2016 from 680 hospitals across the United States. Patients with information on age, sex, surgical specialty, and smoking status were included. Surgical bleeding was defined as 1 or more red blood cell (RBC) units transfused intraoperatively to 72 hours postoperatively. The association between smoking and surgical bleeding was examined using logistic regressions adjusted for age, sex, body mass index, ethnicity, comorbidities, laboratory values, American Society of Anesthesiologists score, type of anesthesia, duration of surgery, work relative value unit (surrogate for operative complexity), surgical specialty, and procedure year.

RESULTS

A total of 5,452,411 cases were recorded, of whom 19% smoked and 6% received transfusion. Odds ratios for transfusion were 1.06 (95% confidence interval [CI], 1.05‐1.07) for smokers versus nonsmokers and 1.06 (95% CI, 1.04‐1.09) for current smokers versus never‐smokers. Odds ratios for cumulative smoking were 0.97 (95% CI, 0.95‐1.00) for greater than 0 to 20 versus 0 pack‐years, 1.04 (95% CI, 1.01‐1.07) for greater than 20 to 40, and 1.12 (95% CI, 1.09‐1.15) for greater than 40 (p for trend < 0.001). Hazard ratios for reoperations due to any cause and to bleeding were 1.28 (95% CI, 1.27‐1.31) and 0.99 (95% CI, 0.93‐1.04).

CONCLUSION

Smoking was associated with a higher risk of RBC transfusion as a proxy for surgical bleeding across all surgical specialties combined.