bluuebunny/crossref_metadata_2025 huggingface dataset:
Epstein–Barr virus infection after adolescence and human herpesvirus 6A as risk factors for multiple sclerosis
Authors: Biström M. , Jons D. , Engdahl E. , Gustafsson R. , Huang J. , Brenner N. , Butt J. , Alonso‐Magdalena L. , Gunnarsson M. , Vrethem M. , Bender N. , Waterboer T. , Granåsen G. , Olsson T. , Kockum I. , Andersen O. , Fogdell‐Hahn A. , Sundström Peter
Published: October 2020

Background and purpose

Infections with human herpesvirus 6A (HHV‐6A) and Epstein–Barr virus (EBV) have been linked to multiple sclerosis (MS) development. For EBV, late infection has been proposed as a risk factor, but serological support is lacking. The objective of this study was to investigate how age affects the EBV and HHV‐6A associated risks of developing MS.

Methods

In this nested case–control study, Swedish biobanks were accessed to find pre‐symptomatically collected blood samples from 670 individuals who later developed relapsing MS and 670 matched controls. A bead‐based multiplex assay was used to determine serological response against EBV and HHV‐6A. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals.

Results

Seropositivity against EBV exhibited a pattern where associations switched from a decreased risk of developing MS in the group below 20 years of age to an increased risk amongst individuals aged 20–29 and 30–39 years (p for trend 0.020). The age of transition was estimated to be 18.8 years. In contrast, HHV‐6A was associated with increased MS risk in all age groups (total cohort odds ratio 2.1, 95% confidence interval 1.6–2.7).

Conclusions

This study suggests EBV infection after adolescence and age independent HHV‐6A infection as risk factors for MS.
Using quality improvement to implement the CNS/AAN quality measure on rescue medication for seizures
Authors: Patel Anup D. , Herbst James , Gibson Annika , Karn Mary , Terry Debbie , Debs Andrea , Yarosz Shannon , Parker William , Cohen Daniel M.
Published: October 2020

Objective

A multidisciplinary quality improvement (QI) team was established to conduct analysis of data for prescribed seizure rescue medication doses from January 2013 to December 2015 to identify and improve inappropriately low dose prescriptions. The QI team identified areas of focus for improvement opportunities and developed the project objective based on the 2017 American Academy of Neurology (AAN) and Child Neurology Society (CNS) quality measure.

Methods

Within a freestanding children's hospital, the QI team developed key drivers and implemented interventions, such as the midazolam prefilled syringe program with use of standardized dosing, electronic chart tools, monthly pharmacy review of all underdosed prescriptions, and provider and nursing education. The team created an automated monthly report to monitor prescribed seizure rescue medication dosing compliance. The year 2015 was used as the preliminary data baseline period with an average noncompliance rate of 3.5%.

Results

From January 2016 to December 2019, the team has decreased and sustained the noncompliance rate to an average of 0.38%. The data for the project included 12,975 seizure rescue medication prescribed by a neurology provider from January 2015 to December 2019. Compliance with properly dosed diazepam orders continues to be the largest area of opportunity. The data demonstrated a centerline shift in January 2019, moving the baseline average of 7.2% noncompliance to the current average rate of 0.22%. In comparison, underdosed midazolam orders occurred at an average rate of 0.037% in the same timeframe.

Significance

Using quality improvement methodologies, the team successfully and substantially decreased provider prescribed and signed underdosed rescue medication orders by an average of 89%. This QI project demonstrates successful implementation and improvement addressing the AAN/CNS quality measure of proper rescue seizure treatment dosing.
Clues that mitochondria are involved in the hair cycle clock: MPZL3 regulates entry into and progression of murine hair follicle cycling
Authors: Nicu Carina , Wikramanayake Tongyu C. , Paus Ralf
Published: October 2020

The molecular nature of the hair cycle clock (HCC), the intrinsic oscillator system that drives hair follicle (HF) cycling, remains incompletely understood; therefore, all relevant key players need to be identified. Here, we present evidence that implicates myelin protein zero‐like 3 (MPZL3), a multifunctional nuclear‐encoded mitochondrial protein known to be involved in epidermal differentiation, in HCC regulation. By analysing global Mpzl3 knockout (−/−) mice, we show that in the absence of functional MPZL3, mice commence HF cycling with retarded first catagen‐telogen transition after normal postnatal HF morphogenesis. However, Mpzl3 −/− mice subsequently display strikingly accelerated HF cycling, i.e. a precocious telogen‐to‐anagen transition during the second hair cycle, compared to controls, suggesting that MPZL3 inhibits anagen entry. We also show that intrafollicular MPZL3 protein expression fluctuates in a hair cycle‐dependent manner. In telogen HFs, MPZL3 is localized to the secondary hair germ, an epicentre of hair cycle regulation, where it partially co‐localizes with P‐cadherin. In early anagen HF, MPZL3 is localized immediately distal to the proximal hair matrix. These findings introduce the novel concept that mitochondria are more actively involved in hair cycle control than previously recognized and that MPZL3 plays a central role in the HCC.
“Always Thinking About Safety”: African American Lesbian Mothers’ Perceptions of Risk and Well‐being
Authors: Radis Brie , Nadan Yochay
Published: October 2020

Although there is a growing body of knowledge focusing on lesbian families and their parenting experiences, African American lesbian mothers are often underrepresented in research. This qualitative exploratory study aims to understand the constructions and perspectives of African American lesbian mothers, from an urban East Coast area, on risk and well‐being. Fifteen in‐depth semi‐structured interviews were conducted and analyzed at the end of 2016, coinciding with the presidential election yielding main themes that were significant for the participants pertaining to the mothers’ experiences and construction of the challenges and risks to well‐being. Main themes first focused on discrimination and insensitivity in everyday spaces; then moved into the effects of political climate on perceived safety and security, conditions and unintended consequences of the coming out process; and ended with strategies for reducing risk. Adoption of an intersectional framework to discuss our findings allowed us to explore the ways in which multiple identities engage to shape experiences and constructions of risk and well‐being among African American lesbian parents. The results suggest the importance of context (e.g., political, historical, gender‐related, racial) when working with LGBTQ+ families of color.
Global gaps in trait data for terrestrial vertebrates
Authors: Etard Adrienne , Morrill Sophie , Newbold Tim
Published: October 2020

Aim

Trait data are increasingly being used in studies investigating the impacts of global changes on the structure and functioning of ecological communities. Despite a growing number of trait data collations for terrestrial vertebrates, there is to date no global assessment of the gaps and biases the data present. Here, we assess whether terrestrial vertebrate trait data are taxonomically, spatially and phylogenetically biased.

Location

Global.

Time period

Present.

Major taxa studied

Terrestrial vertebrates.

Methods

We compile seven ecological traits and quantify coverage as the proportion of species for which an estimate is available. For a species, we define completeness as the proportion of non‐missing values across traits. We assess whether coverage and completeness differ across classes and examine phylogenetic biases in trait data. To investigate spatial biases, we test whether wider‐ranging species have more complete trait data than narrow‐ranging species. Additionally, we test whether species‐rich regions, which are of most concern for conservation, are less well sampled than species‐poor regions.

Results

Mammals and birds are well sampled even in species‐rich regions. For reptiles and amphibians (herptiles), only body size presents a high coverage (>80%), in addition to habitat‐related variables (amphibians). Herptiles are poorly sampled for other traits. The shortfalls are particularly acute in some species‐rich regions and for certain clades. Across all classes, geographically rarer species have less complete trait information.

Main conclusions

Trait information is less available on average in some of the most diverse areas and in geographically rarer species, both of which crucial for biodiversity conservation. Gaps in trait data might impede our ability to conduct large‐scale analyses, whereas biases can impact the validity of extrapolations. A short‐term solution to the problem is to estimate missing trait data using imputation techniques, whereas a longer‐term and more robust filling of existing gaps requires continued data‐collection efforts.
A global test of Allen’s rule in rodents
Authors: Alhajeri Bader H. , Fourcade Yoan , Upham Nathan S. , Alhaddad Hasan
Published: October 2020

Aim

We test whether geographical variation in the length of appendages in rodent species follows predictions of Allen's rule (a positive relationship between appendage length and temperature) at a broad taxonomic scale (order Rodentia). We also test whether the applicability of this rule varies based on the unit of analysis (species or assemblage), the appendage examined (tail, hind foot, ear), body size, occupied habitat, geographical range size, life mode and saltatorial ability.

Location

World‐wide.

Time period

Current.

Major taxa studied

Rodents (order Rodentia).

Methods

We assembled data on the morphology, ecology and phylogeny for ≤ 2,212 rodent species, representing c. 86% of all the described rodent species and c. 95% of the described genera. We tested the predicted Allen's rule associations among size‐corrected appendage lengths and both latitudinal and climatic variables (temperature and precipitation). We applied a cross‐species approach based on phylogenetic regressions and a cross‐assemblage approach based on spatial regressions in equal‐area 1.5° grid cells.

Results

Support for Allen's rule was greatest for the tail and was stronger across assemblages than across species. We detected a negative relationship between tail length and (absolute) latitude, which was accounted for by a positive association between tail length and temperature of the coldest month. This association was greatest in desert species. In addition, we observed a negative relationship between ear length and precipitation.

Main conclusions

In rodents, Allen's rule is confirmed only for tails, and this association seems to be driven by adaptation to the cold, rather than warm temperatures. Habitat type seems to influence conformity to this rule. Conformity to Allen's rule is likely to be the result of complex evolutionary trade‐offs between temperature regulation and other essential species traits.
Endovascular treatments of tunneled central venous catheter‐induced superior vena cava complete occlusion via through‐and‐through technique
Authors: Li Nan , Zeng Ni , Chen Bin , Huang Yonghui
Published: October 2020

Background

Superior vena cava occlusion (SVCO) induced by tunneled central venous catheter (tCVC) is an uncommon but challenging complication of hemodialysis patients. The aim of this study was to access the efficacy, safety, and patency of stents in tCVC‐related SVCO via through‐and‐through technique.

Method

We retrospectively identified seven patients with benign SVCO secondary to tCVC treated with endovascular approaches successfully between 1 March 2013 and 31 October 2019. Patients' demographic data, clinical signs and symptoms, and imaging data were followed up and recorded.

Results

Technical success was achieved in all cases. All the patients were performed with percutaneous transcatheter angioplasty (PTA) and subsequently stent placement via the through‐and‐through technique. During follow‐up, four patients underwent secondary interventions, including PTA and/or stent placement. The primary patency after 3, 6, 9 and 12 months was 100%, 100%, 86% and 86%, and secondary patency after 12 months was 100%. No procedure‐related deaths occurred.

Conclusions

Endovascular management of SVCO is a safe and effective approach. CT examination can provide a direction for endovascular treatment and periodic surveillance.
Comparing the anaesthetic efficacy of 1.8 mL and 3.6 mL of anaesthetic solution for inferior alveolar nerve blocks for teeth with irreversible pulpitis: a systematic review and meta‐analysis with trial sequential analysis
Authors: Nagendrababu V. , Abbott P. V. , Pulikkotil S. J. , Veettil S. K. , Dummer P. M. H.
Published: October 2020

Background

The scientific literature is contradictory in relation to selecting the appropriate volume of local anaesthetic solution for inferior alveolar nerve blocks (IANB) when attempting to anaesthetize mandibular teeth with irreversible pulpitis.

Objectives

To compare the efficacy of 1.8 and 3.6 mL of the same anaesthetic solution for IANBs when treating mandibular teeth with irreversible pulpitis.

Methods

A literature search was performed in PubMed, Scopus and EBSCOhost databases until May 2020. Randomized clinical trials published in English, comparing 1.8 with 3.6 mL of the same anaesthetic solution for IANBs in permanent mandibular teeth with irreversible pulpitis, were included. The risk of bias of the included trials was appraised using the revised Cochrane risk of bias tool. A meta‐analysis was performed using the random‐effects model. The effect of random errors on the results of the meta‐analysis was evaluated by trial sequential analysis and the quality of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

Four clinical trials involving 280 teeth from patients with ages ranging from 18 to 65 years were included. Among the four trials, three were categorized as having a ‘low’ risk of bias and one was categorized as having ‘some concerns’. The primary meta‐analysis revealed that 3.6 mL of anaesthetic solution when administered for IANBs was associated with significantly greater success rates compared with 1.8 mL (RR = 1.94; 95% CI, 1.07, 3.52; I2 = 77%). Similarly, the results of the sensitivity analysis (restricting trials only to those that used the Heft‐Parker visual analogue pain scale) revealed that the use of 3.6 mL significantly increased the success of IANBs compared with 1.8 mL. The trial sequential analysis confirmed the evidence for the beneficial effect of 3.6 mL to achieve success for IANBs was ‘conclusive’. The quality of evidence was graded as ‘high’.

Conclusion

Increasing the volume of anaesthetic solution from 1.8 to 3.6 mL improved the success rate for IANBs in mandibular molars with irreversible pulpitis. The quality of the evidence was ‘high’. Future high‐quality clinical trials are required with different types of anaesthetic solutions and other types of teeth.
Ulcerative versus non‐ulcerative panniculitis: is it time for a novel clinical approach to panniculitis?
Authors: Shavit Eran , Marzano Angelo Valerio , Alavi Afsaneh
Published: October 2020

Panniculitis, or inflammation of the fatty tissue, is an ongoing diagnostic challenge to both dermatologists and pathologists. The basis of the current panniculitis classification is histology, whether the inflammation is mainly located in the fibrovascular septa or in the adipose lobules thereafter with or without vasculitis. However, overall, the difficulty rises due to various terminologies and lack of clinical relevance with this classification. In addition to that, the majority of panniculitides have mixed infiltration of both lobular and septal and not a clear‐cut distinction. The aim of this article is to provide a novel clinical algorithm to the diagnosis of panniculitis and thus to provide guidelines for all clinicians who may encounter this challenging condition in their clinical practice.
Eosinophilic folliculitis due to wearing protective gear in citizens volunteering for sanitation services during the COVID‐19 pandemic – an original epidemiological, clinical, dermoscopic, and laboratory‐based study
Authors: Chuh Antonio
Published: October 2020

Background

An association between wearing protective gear and eosinophilic folliculitis has not been reported. We aimed to investigate such during the COVID‐19 pandemic.

Methods

In three outpatient clinics, we hand‐reviewed records of all patients having consulted us during a Study Period (90 days) in the early phase of the pandemic. Our inclusion criteria for Study Subjects were: (i) clear clinical diagnosis, (ii) dermoscopic confirmation, (iii) differential diagnoses excluded, (iv) eosinophilia, (v) protective gear worn during sanitation services, (vi) temporal correlation, (vii) distributional correlation, (viii) physician‐assessed association, and (ix) patient‐assessed association. Control Periods in the same season were elected.

Results

Twenty‐five study subjects fulfilled all inclusion criteria. The incidence was significantly higher than in the control periods (IR: 3.57, 95% CI: 1.79–7.43). Male predominance was significant (P < 0.001). Such for patients in the control periods were insignificant. Study subjects were 21.2 (95% CI: 11.0–31.4) years younger than patients in the control periods. For the study subjects, the distribution of erythematous or skin‐colored folliculocentric dome‐shaped papules and pustules were all compatible with body parts covered by the gear. Lesional biopsy performed on two patients revealed eosinophilic dermal infiltrates within and around the pilosebaceous units. Polarized dermoscopy revealed folliculitis with peri‐/interfollicular vascular proliferation. Lesion onsets were 6.4 (SD: 2.1) days after wearing gear. Remissions were 16.7 (SD: 7.5) days after ceasing to wear gear and treatments.

Conclusions

Wearing protective gear in volunteered sanitizing works could be associated with eosinophilic folliculitis. Owing to the significant temporal and distributional correlations, the association might be causal.
Amelanotic melanoma of the head and neck: analysis of tumor characteristics from the National Cancer Database
Authors: Huayllani Maria T. , Boczar Daniel , Saleem Humza Y. , Spaulding Aaron C. , Bagaria Sanjay P. , Lu Xiaona , Kassis Salam , Perdikis Galen , Forte Antonio Jorge
Published: October 2020

Background

Amelanotic melanoma is an extremely rare subtype of cutaneous melanoma. The tumor characteristics are still not well understood, especially for those located in the head and neck.

Methods

Tumor characteristics of patients diagnosed with amelanotic melanoma of the head and neck (AMHN) from January 1, 2004, to December 31, 2015, were analyzed by querying the National Cancer Database. Characteristics of AMHN were subsequently compared with common malignant melanoma of the head and neck (CMMHN).

Results

Three hundred and sixty‐eight patients were diagnosed with AMHN, and 69,267 were diagnosed with CMMHN. Of those with AMHN, 128 (34.8%) had melanoma located on the scalp and neck, and 172 (46.7%) were diagnosed with an early disease stage (i.e., 0, I, or II). When compared with CMMHN, patients with AMHN were more likely to be diagnosed after 80 years of age (25.3% vs. 18.2%; odds ratio [OR], 3.28; 95% CI, 1.09–9.84; P = 0.03), when Breslow depth was between 2.01 and 4.00 mm (28.5% vs. 6.5%; OR, 1.92; 95% CI, 1.15–3.19; P = 0.01), when ulceration was present (36.7% vs. 9.0%; OR, 1.99; 95% CI, 1.34–2.97; P = 0.001), and when mitotic count was 1 or more/mm2 (40.5% vs. 12.8%; OR; 2.53; 95% CI, 1.09–5.89; P = 0.03). No statistical difference was found for sex, specific location, stage, or lymph node involvement.

Conclusion

Our study determined that AMHN is associated with older age, increased Breslow depth, presence of ulceration, and greater mitotic count when compared with CMMHN.
Growth inhibition of Fusarium graminearum and deoxynivalenol detoxification by lactic acid bacteria and their application in sourdough bread
Authors: Cao Hui , Meng Denghui , Zhang Wei , Ye Tai , Yuan Min , Yu Jinsong , Wu Xiuxiu , Li Yan , Yin Fengqin , Fu Caili , Xu Fei
Published: October 2020

Eight lactic acid bacteria (LAB) strains were screened for their ability to inhibit Fusarium graminearum (F. graminearum) growth and remove deoxynivalenol (DON). Furthermore, the selected LAB strains were applied as starter cultures to evaluate their performance during the breadmaking process. Lactobacillus plantarum (L. plantarum) AR524 exhibited strong inhibitory activity against F. graminearum growth in a pH‐dependent manner and removed up to 40.9% of DON, mainly through cell wall binding. Compared with the control, L. plantarum AR524 inhibited 60.19% of F. graminearum growth and removed 50.53% of DON during breadmaking. The texture properties of the bread were also remarkably improved by L. plantarum AR524, and its shelf life was extended from 3 days to 6 days without the application of any chemical preservatives. Therefore, L. plantarum AR524 shows excellent potential for application as a bioprotective starter culture in bakery products.
Comorbidities that predict acute respiratory syndrome coronavirus 2 test positivity in Mexican Children: A case‐control study
Authors: Hernández‐Garduño Eduardo
Published: October 2020

Some comorbidities are risk factors for severe coronavirus disease (Covid‐19) but it is unknown whether some increase susceptibility to Covid‐19 in children. In this Mexican case‐control study, contact with patients with Covid‐19, or having obesity, or having diabetes, or hypertension or been immunosuppressed independently increased the risk for Covid‐19 in the whole sample analysis. However, only contact history and obesity remained statistically significant in the separated analysis of girls and boys. The results suggest that obesity is not only associated with severe disease but also increases risk for Covid‐19. Contrary to findings in adults, no difference between cases and controls was found for gender, presence of pneumonia or surrogates of severe disease including admission to intensive care unit, tracheal intubation or whether patient had died. This indicates that Covid‐19 is less severe in children than adults. Future research is needed to establish the mechanisms involved in obesity and Covid‐19 in children.
Differences in retinopathy prevalence and progression between Anglo‐Celt and Aboriginal Australians: the Fremantle Diabetes Study Phase II
Authors: Drinkwater Jocelyn J. , Davis Wendy A. , Turner Angus W. , McAullay Daniel , Davis Timothy M. E.
Published: October 2020

Background

Indigenous populations have higher rates of diabetes and diabetic complications, yet there is a paucity of contemporary data on diabetic retinopathy (DR) prevalence and incidence in urban dwelling Aboriginal Australians.

Aims

The aim of the study was to compare the prevalence of DR and incidence of new or worsening DR between Aboriginal Australians and Anglo‐Celts with Type 2 diabetes.

Methods

Participants from the community‐based Fremantle Diabetes Study Phase II (817 Anglo‐Celts, 94 Aboriginal people) recruited between 2008 and 2011 underwent fundus photography at baseline and biennial reviews. The prevalence of any DR and moderate non‐proliferative DR (NPDR), and the incidence of new or worsening DR were ascertained using baseline and 4‐year follow‐up data.

Results

Compared with Anglo‐Celts, the Aboriginal participants had a higher prevalence of any DR (33.0% vs 52.1%) and moderate NPDR or worse (5.1% vs 24.4%), and new or worsening DR during follow up (6.7% vs 23.5%). The unadjusted odds ratios (95% confidence interval) of any DR and moderate NPDR at baseline were 2.21 (1.43, 3.39) and 5.98 (3.40, 10.50), respectively, and of new or worsening DR 4.32 (1.33, 13.98). In adjusted models, Aboriginal ethnicity was only associated with the prevalence of moderate NPDR or worse (5.58 (2.44, 12.76)).

Conclusions

Aboriginal participants had a higher prevalence of DR and new or worsening DR, reflecting conventional risk factors including suboptimal glycaemic control. Their significantly higher odds of moderate NPDR or worse in adjusted models suggest ethnic‐specific determinants of DR severity. These findings highlight the need for equitable, culturally appropriate diabetes/ophthalmic care.
Aeromedical retrieval diagnostic trends during a period of Coronavirus 2019 lockdown
Authors: Gardiner Fergus W. , Gillam Marianne , Churilov Leonid , Sharma Pritish , Steere Mardi , Hannan Michelle , Hooper Andrew , Quinlan Frank
Published: October 2020

Background

Little is known on the trends of aeromedical retrieval (AR) during social isolation.

Aim

To compare the pre, lockdown, and post‐lockdown AR patient characteristics during a period of Coronavirus 2019 (COVID‐19) social isolation.

Methods

An observational study with retrospective data collection, consisting of AR between 26 January and 23 June 2020.

Results

There were 16 981 AR consisting of 1983 (11.7%) primary evacuations and 14 998 (88.3%) inter‐hospital transfers, with a population median age of 52 years (interquartile range 29.0–69.0), with 49.0% (n = 8283) of the cohort being male and 38.0% (n = 6399) being female. There were six confirmed and 230 suspected cases of COVID‐19, with the majority of cases (n = 134; 58.3%) in the social isolation period. As compared to pre‐restriction, the odds of retrieval for the restriction and post‐restriction period differed across time between the major diagnostic groups. This included, an increase in cardiovascular retrieval for both restriction and post‐restriction periods (odds ratio (OR) 1.12, 95% confidence interval (CI) 1.02–1.24 and OR 1.18 95%, CI 1.08–1.30 respectively), increases in neoplasm in the post restriction period (OR 1.31, 95% CI 1.04–1.64) and increases for congenital conditions in the restriction period (OR 2.56, 95% CI 1.39–4.71). Cardiovascular and congenital conditions had increased rates of priority 1 patients in the restriction and post restriction periods. There was a decrease in endocrine and metabolic disease retrievals in the restriction period (OR 0.72, 95% CI 0.53–0.98). There were lower odds during the post‐restriction period for retrievals of the respiratory system (OR 0.78, 95% CI 0.67–0.93), and disease of the skin (OR 0.78, 95% CI 0.6–1.0). Distribution between the 2019 and 2020 time periods differed (P < 0.05), with the lockdown period resulting in a significant reduction in activity.

Conclusion

The lockdown period resulted in increased AR rates of circulatory and congenital conditions.
Use and outcomes of chemotherapy for metastatic pancreatic cancer in Australia
Authors: Body Amy , Wong Rachel , Shapiro Jeremy , Jalali Azim , McLachlan Sue‐Anne , Ananda Sumitra , Lipton Lara , Cooray Prasad , Gibbs Peter , Lee Belinda , Lee Margaret
Published: October 2020

Background

Metastatic pancreatic ductal adenocarcinoma (mPDAC) is highly lethal. Combination chemotherapy regimens improve overall survival (OS). Historically, only one‐third of mPDAC patients in Victoria received chemotherapy.

Aim

To describe current Australian chemotherapy utilisation and outcomes in patients with mPDAC using the multi‐site PURPLE (Pancreatic cancer: Understanding Routine Practice and Lifting End Results) registry.

Methods

PURPLE collects longitudinal data on consecutive patients with pancreatic cancer seen since January 2016. Data were collated for patients with mPDAC from six Victorian sites, and analysed descriptively.

Results

Three hundred and sixty‐three patients with mPDAC were identified. Median age was 70 years (range 20–94 years). First‐line chemotherapy was administered in 195 (54%) patients. Prevalent regimens included gemcitabine‐nab‐paclitaxel (71%), gemcitabine alone (10%) and FOLFIRINOX (6%). Sixty‐two of 195 (32%) patients who received first line treatment have proceeded to second‐line chemotherapy. Chemotherapy‐treated patients were younger (69 versus 73 years; P < 0.01), with better Eastern Cooperative Oncology Group (ECOG) performance status (ECOG 0–1 89 vs 66%; P < 0.01) and lower median Charlson comorbidity index (3 vs 4; P < 0.01) compared with untreated patients. Median OS of the entire cohort from diagnosis of metastases was 5.1 months. Median OS was 9.3 months in the chemotherapy treated patients, and 2.5 months in chemotherapy‐untreated patients (P < 0.01).

Conclusions

A substantial proportion of patients with mPDAC still do not receive active treatment, which may in part by explained by age, poor performance status and comorbidity. Gemcitabine‐nab‐paclitaxel was the preferred first‐line chemotherapy regimen. Median OS for treated patients in this cohort was comparable to that of recent published clinical trials.
Unbound vitamin D concentrations are not decreased in critically ill patients
Authors: Palmer David , Soule Steven , Gaddam Ravinder R. , Elder Peter , Chambers Stephen , Doogue Matthew
Published: October 2020

Background

Free concentrations of highly protein bound hormones, such as cortisol and thyroxine, are unchanged in critical illness despite substantial decreases in total concentration. Total 25‐hydroxyvitamin D (25(OH)D) concentration is decreased in critical illness, but the free concentration of 25(OH)D has had less attention.

Aim

To compare total and calculated free 25(OH)D concentrations in critically ill patients with healthy controls.

Methods

In this case‐control study, 38 patients with critical illness were compared with 68 healthy controls; 25(OH)D was measured by liquid chromatography tandem mass spectrometry (LCMS/MS) and vitamin D binding protein (VDBP) by direct sandwich enzyme‐linked immunosorbent assay. Total and calculated free 25(OH)D concentrations were compared using unpaired t‐tests.

Results

Total 25(OH)D concentrations were significantly lower in critically ill patients than controls (37 (95% confidence interval 31–43) vs 57 (53–60) nmol/L). Calculated free concentrations of 25(OH)D were not lower in critically ill patients than healthy controls (26 (22–29) vs 19 (18–20) pmol/L).

Conclusions

Calculated free 25(OH)D concentrations are not decreased in critical illness. Measuring total 25(OH)D concentrations in patients with critical illness potentially underestimates vitamin D and overestimates the number of patients who are deficient in vitamin D.
Acromegaly might not negatively affect microvascular circulation
Authors: Hacioglu Yalcin , Kalfa Melike , Niyazoglu Mutlu , Kilickaya Pelin , Hatipoglu Esra
Published: October 2020

Background

Endothelial dysfunction and atherosclerosis are well known complications of acromegaly. However, current data on microvascular circulation are limited.

Aims

To evaluate microvascular circulation in patients with acromegaly.

Methods

This comparative study included a total of 21 patients with acromegaly and 20 age‐ and sex‐matched healthy subjects. A stereomicroscope under ×100 magnification was used by a single rheumatologist to evaluate the capillary dimensions (capillary loop length, capillary width) and capillary/mm count in the capillaries of subjects. Statistical data analysis was conducted using the SPSS 15.0 package program.

Results

The mean number of capillaries per millilitre (normal ≥8/mL) in the acromegaly group (AG) and healthy controls (HC) was 7.67 ± 1.88 and 8.67 ± 0.65, respectively (P = 0.04). In the AG and the HC, the number of tortuous capillaries, the mean capillary loop length and the mean capillary width were not different. Although the median number of capillaries in the AG was lower than in the HC, it was still within normal limits.

Conclusion

Although the number of capillaries was statistically lower in patients with acromegaly, they were within a normal range and the difference was not clinically significant. Moreover, there was no difference in morphological characteristics between the groups. While endothelial dysfunction is the earliest known marker of the atherosclerotic process and is considered to be one of the complications of acromegaly, the disease may not result in impairment of microvasculature of those people afflicted by it.
Retrospective study on the epidemiology of antineutrophil cytoplasmic autoantibodies‐associated vasculitis in two Australian health districts
Authors: Chung Edmund Y. M. , Risi Dante , Holt Jane L. , Lonergan Maureen , Kotwal Sradha , Yong Kenneth , Smyth Brendan , Chen Jenny H. C. , Wen Cheng
Published: October 2020

Background

Antineutrophil cytoplasmic autoantibodies (ANCA)‐associated vasculitis (AAV) is more prevalent in rural Australia compared with metropolitan areas, suggesting a role of environment in disease pathogenesis. However, the prevalence of environmental risk factors in Australian AAV patients has not been described.

Aims

To compare the incidence of AAV between two health districts (Illawarra Shoalhaven Local Health District (ISLHD), a mixed rural/metropolitan region, and South Eastern Sydney Local Health District (SESLHD), a metropolitan region) in Australia and its relationship to environmental exposures.

Methods

Cases of AAV from 2002 to 2017 were retrospectively identified from ISLHD and SESLHD using electronic medical records. Eligible participants were invited to complete a standardised questionnaire examining their exposure to silica, solvents, metal, dust, farming, gardening and sunlight.

Results

One hundred and fifty‐six cases of AAV were identified from 2002 to 2017. A higher cumulative incidence of AAV was observed in the ISLHD (184.2 (95% confidence interval (CI) 143.6–232.7) per million) compared with SESLHD (102.6 (95% CI 82.1–126.8) per million). Over 50% of the cohort had high levels of silica and solvents exposure, based on self‐reported questionnaires. There was no significant relationship between region and exposure to silica (P = 0.96), solvents (P = 0.44), metal (P = 0.33), dust (P = 0.25), farming (P = 0.90), gardening (P = 0.93) or sunlight (P = 0.55).

Conclusions

We found a higher incidence of AAV in ISLHD compared with SESLHD with high levels of exposure to silica and solvents in both regions based on self‐reported questionnaires. Prospective systematic collection of data, such as a registry of AAV, is warranted to further explore the relationship between environmental exposures and AAV.
Dental arch perimeter changes as a result from premature loss of primary anterior teeth due to trauma: A case series in infant and pre‐school children
Authors: Nadelman Patricia , Gárate Kriss Mélane , Oliveira Andressa , Pithon Matheus Mello , de Castro Amanda Cunha Regal , Maia Lucianne Cople
Published: October 2020

Background

The premature loss of primary anterior teeth in deciduous arches is a controversial topic in the literature, especially due to the lack of robust scientific evidence about the consequences in the arch perimeter space and magnitudes of the effects involved.

Aim

Evaluate the association between premature loss of primary anterior teeth and dental arch perimeter changes, according to clinical variables as deciduous arch type, erupted primary canines, midline involvement and deleterious oral habits, on infants and pre‐school children.

Design

Patients with avulsion or referral to extraction due to traumatic dental injuries (TDI) were evaluated. After the tooth loss, two trained operators measured the tooth/teeth space, both with a digital caliper and a dry tip compass. The clinical documentation included photographs and radiographs. Follow‐up visits occurred from the baseline and every two months over a 12‐month period. Chi‐square test was used to evaluate the association between arch perimeter changes and clinical variables (α = 0.05). A descriptive statistic was performed to explore the magnitude of space changes, with 95% confidence intervals.

Results

Eighteen infants/children (mean, 2.78 ± 1.39 years) were included. Nine patients presented space loss (50.0%) (mean, −1.32 mm), six patients gained space (33.3%) (mean, +1.55 mm), and three patients presented space maintenance (16.7%). Clinical variables did not influence dental arch perimeter changes. Conclusions: Premature loss of primary anterior teeth, as well as deleterious oral habits, deciduous arch type, midline involvement and erupted primary canines, were not associated with dental arch perimeter changes.
Valorization of Al slag in the production of green ceramic tiles: Effect of experimental conditions on microstructure and crystalline phase composition
Authors: Romero Maximina , Martín María Isabel , Barbieri Luisa , Andreola Fernanda , Lancellotti Isabella , López‐Delgado Aurora
Published: October 2020

This work reports the results of an investigation aimed at the development of sintered glass‐ceramic tiles by the sinter‐crystallization of mixtures composed of aluminum slag and reclaimed packaging glass. The thermal behaviors of mixtures incorporating 50 and 60 wt% Al slag were established by differential thermal analysis (DTA). Green compacts were sintered in a temperature range of 800°C‐1050°C and then soaked for 10‐60 minutes. The mineralogical characterizations of the sintered materials were obtained by X‐ray diffraction (XRD). The achieved results indicated that the sintering of aluminum slag and packaging glass reclaimed led to a glass‐ceramic material composed mainly of needle‐like crystals of wollastonite (CaSiO3). The bloating of samples during firing was evaluated according to a Cougny predictive diagram. After initial observations and according to bending strength characterizations, sintered tiles prepared from aluminum slag and glassy sand are appropriate for floor pavement and wall covering.
Community participation of families of children with profound intellectual and multiple disabilities in South Africa
Authors: McKenzie Judith Anne , Kahonde Callista , Mostert Karen , Aldersey Heather Michelle
Published: October 2020

Background

Families struggle to support family members with profound intellectual and multiple disabilities (PIMD), especially in low resourced settings where formal services may not be available.

Method

The adapted Family Community Participation survey, measuring perceptions of community participation, was administered to 67 primary caregivers of children with PIMD in Cape Town by community‐based rehabilitation workers.

Results

Families were most satisfied going to religious activities and getting together with family and friends. They were most dissatisfied with doing activities together in public and working or volunteering outside the home. Barriers to participation included negative attitudes, insufficient money and unavailability of community activities. Transportation, safety and security were additional challenges.

Conclusions

Participants advocate awareness raising, community support and provision of services to address barriers to community participation. Families should be consulted on community issues to integrate their specific family needs into the overall needs of the community.
Factors affecting accuracy of estimated effective number of chromosome segments for numerically small breeds
Authors: Marjanovic Jovana , Calus Mario P. L.
Published: October 2020

For numerically small breeds, obtaining a sufficiently large breed‐specific reference population for genomic prediction is challenging or simply not possible, but may be overcome by adding individuals from another breed. To prioritize among available breeds, the effective number of chromosome segments (Me) can be used as an indicator of relatedness between individuals from different breeds. TheMeis also an important parameter in determining the accuracy of genomic prediction. TheMecan be estimated both within a population and between two populations or breeds, as the reciprocal of the variance of genomic relationships. However, the threshold for number of individuals needed to accurately estimate within or between populationsMeis currently unknown. It is also unknown if a discrepancy in number of genotyped individuals in two breeds affects the estimates ofMebetween populations. In this study, we conducted a simulation that mimics current domestic cattle populations in order to investigate how estimatedMeis affected by number of genotyped individuals, single‐nucleotide polymorphism (SNP) density and pedigree availability. Our results show that a small sample of 10 genotyped individuals may result in substantial over or underestimation ofMe. While estimates of within populationMewere hardly affected by SNP density, between populationMevalues were highly dependent on the number of available SNPs, with higher SNP densities being able to detect more independent chromosome segments. When subtracting pedigree from genomic relationships before computingMe, estimates of within populationMewere three to four times higher than estimates with genotypes only; however, betweenMeestimates remained the same. For accurate estimation of within and between populationMe, at least 50 individuals should be genotyped per population. Estimates of withinMewere highly affected by whether pedigree was used or not. For withinMe, even the smallest SNP density (~11k) resulted in accurate representation of family relationships in the population; however, for betweenMe, many more markers are needed to capture all independent segments.
Trait‐specific trade‐offs prevent niche expansion in two parasites
Authors: Lievens Eva J. P. , Michalakis Yannis , Lenormand Thomas
Published: October 2020

It is often difficult to determine why parasites do not evolve broader niches, especially when there are closely related and ecologically similar hosts available. We used an experimental evolution approach to test whether source–sink demography or trade‐offs drive specialization, and its underlying traits, in two microsporidian parasites infecting two brine shrimp species. In the field, both parasites regularly infect both hosts, but experiments have shown that they are partially specialized. We serially passaged the parasites on one, the other, or an alternation of the two hosts; after 10 passages, we assayed the infectivity, virulence, and spore production of the evolved lines. Our results indicated a weak between‐host trade‐off acting on infectivity, but a strong trade‐off acting on spore production. Consequently, spore production maintained both parasites’ overall pattern of specialization. This study highlights that when trade‐off shapes differ among traits, one key trait can prevent the evolution of generalism.
Characterization and functional analysis of a galectin‐related protein B from Nile tilapia involved in the immune response to bacterial infection
Authors: Niu Jinzhong , Luo Guoling , Liu Xinchao , Huang Yu , Tang Jufen , Wang Bei , Lu Yishan , Cai Jia , Jian Jichang
Published: October 2020

Galectin‐related protein is a kind of lectin without canonical activity that regulates cell adhesion and cell growth. In this study, a novel galectin‐related protein B (OnGRPB) was identified from Nile tilapia (Oreochromis niloticus). The open reading frame of OnGRPB was 438 bp and encoded a peptide of 145 amino acids. The deduced protein sequence of OnGRPB possessed a conserved carbohydrate recognition domain (CRD) with partial sugar binding sites (N‐R, V‐N and W‐E) and shared high identities with other fish GRPB proteins. The qRT‐PCR analysis found that OnGRPB was widely distributed in various tissues and monocyte/macrophages (Mo/MΦ) of healthy tilapia. After Streptococcus agalactiae infection, OnGRPB transcripts were significantly up‐regulated in liver, spleen, head kidney and Mo/MΦ. The recombinant OnGRPB protein (rOnGRPB) had the binding activity and agglutination ability to bacteria. Also, rOnGRPB could modulate antibacterial activity and inflammatory factor expression of Mo/MΦ. These data collectively indicate that OnGRPB plays roles in the immune response of Nile tilapia against bacterial infection.
Absolute environmental sustainability assessment of a Danish utility company relative to the Planetary Boundaries
Authors: Ryberg Morten W. , Bjerre Troels K. , Nielsen Per Henrik , Hauschild Michael
Published: October 2020

Increasing environmental pressure from production and consumption of products and services is starting to affect Earth System stability. Thus, the Planetary Boundaries framework introduced a set of absolute boundaries for keeping the Earth System stable and delimiting a safe operating space for humanity. The sum of environmental pressures associated with human activities should not exceed the safe operating space. This includes utility companies whose activities relate to supply of water and treatment of waste‐ and stormwater. This study conducted an absolute environmental sustainability assessment (AESA) of a Danish utility company to evaluate if it could be considered absolutely sustainable relative to an assigned share of the safe operating space (SoSOS). The AESA evaluated the company's impacts relative to an assigned share of the Planetary Boundaries and relative to specific local boundaries for nitrogen and phosphorous emissions. Results showed that the assigned SoSOS was exceeded for 10 of 18 impact categories, for example, climate related boundaries were exceeded by up to a factor 7.8 while local nitrogen and phosphorus boundaries were exceeded by ca. a factor 16. The AESA can indicate to which degree the company exceeds its assigned SoSOS for certain impact categories and the processes and life‐cycle stages to focus on to become absolutely sustainable. This information is crucial for deriving specific impact reduction targets as part of environmental strategies for companies to become sustainable in an absolute sense.
L's approach: illumination pattern estimation technique for optical microscopy
Authors: BROOKSHIRE CHARLES , UCHIC MICHAEL , KRAMB VICTORIA , LESTHAEGHE TYLER , HIRAKAWA KEIGO
Published: October 2020

We propose a novel solution to the correction of illumination nonuniformity without removing the imaging sample. Calibration of the spatial illumination pattern in reflectance microscopy is challenging due to the fact that the illumination source is colocated with the objective lens and therefore cannot be observed directly. Our proposed methodology overcomes this by collecting three spatially translated images in a strategic way. We prove that ‘log‐illumination pattern’ recovery can be reformulated as a deconvolution of log‐ratio of captured images, and develop an efficient, noise‐robust implementation. Experiments with simulated and reflectance microscopy data verify the effectiveness of our proposed approach.

Lay Description

The proposed technique overcomes a common problem of nonuniform illumination in microscopy. For the case of reflectance microscopy, we show that a few images with large amounts of overlap can be used to recover the illumination pattern. In conjunction with an image formation model, the recovered illumination pattern may be used to correct the images captured under similar illumination conditions.