bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional, national and international datasets: How they improve our understanding of the acute harms associated with prescription medicine misuse
Authors: Wood David M. , Dargan Paul I.
Published: October 2020

Prescription medicine misuse is a significant problem in many areas of the world. Understanding the acute and chronic harms related to misuse of prescription medicines allows healthcare professionals, drug addiction treatment services and legislative authorities to determine what interventions may be beneficial to reduce these harms and protect individuals and society. However, it is difficult to obtain systematic data on the harms associated with prescription medicine misuse because of how patient visits to clinics and hospitals are recorded and coded in regional or national databases. In this review, we discuss how regional, national and international sources of information can help develop a greater understanding of the prevalence and pattern of acute harms related to prescription medicine misuse using data from ambulance attendances, emergency department presentations and poisons information services.
Association of risk factors and bleeding complications in Asian patients taking edoxaban
Authors: Lee Ok Sang , Kim Woorim , Jang Bo Min , Min Kyung Hyun , Cho Yoon Sook , Lee Myung Koo , Lee Kyung Eun
Published: October 2020

Aims

Asian patients are known to be more prone to bleeding complications than patients of other ethnicities. Therefore, there are possibilities of other risk factors that should be given special consideration for dosage adjustment in this specific ethnic group. This study aimed to investigate the risk factors for bleeding complications in Asian patients under appropriate edoxaban dosage regimens.

Methods

Data on patients taking proper dosages, based on the Lixiana package insert, were analysed. Univariate and multivariable analyses were conducted to evaluate associations between risk factors and bleeding outcomes. Subgroup analysis was performed on high‐risk patients for bleeding complications whose edoxaban dose was reduced according to the package insert.

Results

In total, 346 patients were included. Among them, 32 patients experienced bleeding complications. Patients with weight ≤60 kg and with cancer showed around 3.3‐ and 3.4‐fold increased risk of bleeding complications compared to heavier patients (>60 kg) and those without cancer, respectively. In subgroup analysis with high‐risk patients who took low‐dose edoxaban (15 and 30 mg), weight ≤60 kg remained a significant factor for bleeding outcomes.

Conclusion

This study showed that weight ≤60 kg and the presence of cancers could affect bleeding complications, which occurred despite proper edoxaban treatment in Asian patients. Therefore, more strict dosage guideline could be considered in populations with high proportions of Asian ethnicities.
Molecular phylogeny and trait evolution of Madeiran land snails: radiation of the Geomitrini (Stylommatophora: Helicoidea: Geomitridae)
Authors: Brozzo Alissa , Harl Josef , De Mattia Willy , Teixeira Dinarte , Walther Frank , Groh Klaus , Páll‐Gergely Barna , Glaubrecht Matthias , Hausdorf Bernhard , Neiber Marco T.
Published: October 2020

The Geomitrini is the most species‐rich group of land snails in the Madeiran Archipelago. The phylogeny of the group is reconstructed based on mitochondrial and nuclear genetic markers. The timing of diversification, the colonisation history of the islands of the Madeiran Archipelago and the evolution of characters of the dart apparatus are studied. The results of the phylogenetic analyses confirm the sister group relationship of Geomitrini and Cochlicellini, but also show that several previously accepted genus‐group taxa are not monophyletic. A new classification for the Geomitrini is proposed, including the description of two new genera, Domunculifex Brozzo, De Mattia, Harl & Neiber, n. gen. and Testudodiscula Brozzo, De Mattia, Harl & Neiber, n. gen. The onset of diversification of Geomitrini was dated in our analysis at 13 Ma, which largely coincides with the emergence of the present‐day islands. The ancestral state estimation recovered the presence of two appendiculae in the reproductive system as the ancestral state in Geomitrini. One appendicula was lost three times independently within the tribe and is even missing completely in one group. The ancestral area estimation suggests recurrent colonisations of Madeira (and the Ilhas Desertas) from the older island Porto Santo.
Renal outcomes and all‐cause death associated with sodium‐glucose co‐transporter‐2 inhibitors versus other glucose‐lowering drugs (CVD‐REAL 3 Korea)
Authors: Koh Eun Sil , Han Kyungdo , Nam You‐Seon , Wittbrodt Eric T. , Fenici Peter , Kosiborod Mikhail N. , Heerspink Hiddo J. L. , Yoo Soon‐Jib , Kwon Hyuk‐Sang
Published: October 2020

Aims

To investigate the effectiveness of sodium‐glucose co‐transporter‐2 (SGLT2) inhibitors on the risk of progression to end‐stage renal disease (ESRD) and all‐cause mortality in a broad range of patients with type 2 diabetes (T2D) using a Korean nationwide cohort.

Materials and Methods

Using data from the Korean National Health Insurance Service database from January 2014 to December 2017, a total of 701 674 patients were identified with T2D. We divided these patients into new users of SGLT2 inhibitors and new users of other glucose‐lowering drugs (oGLDs). Using propensity scores, patients in the two groups were matched 1:1. We assessed the risk of ESRD and all‐cause death.

Results

There were 45 016 patients in each group, and baseline characteristics were well balanced between the groups. The patients' mean age was 58.1 ± 10.6 years and mean estimated glomerular filtration rate (eGFR) was 89.2 ± 27.4 mL/min/1.73m2, and 8% of patients had proteinuria. We identified 167 incident ESRD cases and 1070 all‐cause deaths during follow‐up. Use of SGLT2 inhibitors versus oGLDs was associated with a lower risk of ESRD (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.34 to 0.65) and all‐cause death (HR 0.82, 95% CI 0.73 to 0.93). In a subgroup analysis by eGFR, initiation of SGLT2 inhibitor treatment, compared with oGLD treatment, was associated with lower risk of progression to ESRD among patients with eGFR 60 to 90 mL/min/1.73m2 and those with eGFR < 60 mL/min/1.73m2, and a lower risk of all‐cause death was associated with SGLT2 inhibitors versus oGLDs in patients with eGFR ≥90 and 60 to 90 mL/min/1.73m2.

Conclusion

In this large nationwide study of Korean patients with T2D, initiation of SGLT2 inhibitors versus oGLDs was associated with lower risk of ESRD and all‐cause death.
Why is a picture ‘worth a thousand words’? Pictures as information in perceived helpfulness of online reviews
Authors: Wu Ruijuan , Wu Heng‐Hui , Wang Cheng Lu
Published: October 2020

The hybrid review format (verbal reviews accompanied by pictures) is increasingly prevalent in online consumer reviews. However, the mechanism behind the superiority effect of hybrid reviews is still unclear. Unlike previous studies based on information processing theory that emphasize the imagery‐provoking ability of the verbal information, we contend that imagery in hybrid reviews is the information that adds more diagnostic value to online reviews and thus makes the reviews more helpful. Our experimental studies found that hybrid reviews were perceived as more helpful than word‐only reviews, and this effect was explained by the perceived amount of information. Moreover, the superiority effect of hybrid reviews on perceived helpfulness was found to be contingent on the review extremity and viewing tasks. These results confirmed our hypothesis of picture as information, explaining the superiority effect of hybrid reviews and pinpointed the conditions under which such an effect would occur or disappear.
Elucidation of health risks using metataxonomic and antibiotic resistance profiles of microbes in flood affected waterbodies, Kerala 2018
Authors: Shankar Aparna , Jagajeedas Devika , Radhakrishnan Megha Periyappilly , Paul Merin , Narendrakumar Lekshmi , Suryaletha Karthika , Akhila Velappan Savithri , Nair Sudha Babu , Thomas Sabu
Published: October 2020

The floods of 2018 caused havoc in the State of Kerala, situated in the extreme south‐west of India, in terms of infrastructure and health. This research article provides the first‐ever assessment of the bacterial diversity and its antibiotic susceptibility of the inundated areas of Pampa, Periyar and Vembanad waterbodies by comparing the data collected in two different time intervals succeeding the calamitous floods that is, immediately after flood and 5 months post‐flood. An elevated total coliform count was detected in the waterbodies after the flood thereby rendering it unsafe for drinking. Variation in bacterial diversity was observed in the river and lake water samples with a distinct increase in that of the river samples immediately after flood indicated by shannon diversity index (>5.5). Resistance to ampicillin and cefotaxime was observed in a major proportion of isolates from the three biotopes thus indicating the influence of antibiotic wastes accumulated from different sources of human interventions. Furthermore, operational taxonomic units clustering to Acinetobacter, Legionella, Pseudomonas and Burkholderia genera were detected by metataxonomic analysis which portray as a potential health risk in the future. The article emphasises the importance of adopting sanitation programmes for effective management of epidemic outbreaks post floods.
Efficacy of urgent colonoscopy for colonic diverticular bleeding: A propensity score‐matched analysis using a nationwide database in Japan
Authors: Moroi Rintaro , Tarasawa Kunio , Shiga Hisashi , Yano Kota , Shimoyama Yusuke , Kuroha Masatake , Kakuta Yoichi , Fushimi Kiyohide , Fujimori Kenji , Kinouchi Yoshitaka , Masamune Atsushi
Published: October 2020

Background and Aim

Although colonic diverticular bleeding (CDB) is considered to have good prognosis with conservative therapy, some cases are severe. The efficacy of urgent colonoscopy for CDB and clinical factors affecting CDB prognosis are unclear. This study aimed to evaluate the efficacy of urgent colonoscopy for CDB and identify risk factors for unfavorable events, including in‐hospital death during admission, owing to CDB.

Methods

We collected CDB patients' data using the Diagnosis Procedure Combination database system. We divided eligible patients into urgent and elective colonoscopy groups using propensity score matching and compared endoscopic hemostasis and in‐hospital death rates and length of hospital stay. We also conducted logistic regression analysis to identify clinical factors affecting CBD clinical events, including in‐hospital death, a relatively rare CDB complication.

Results

Urgent colonoscopy reduced the in‐hospital death rate (0.35% vs 0.58%, P = 0.033) and increased the endoscopic hemostasis rate (3.0% vs 1.7%, P < 0.0001) compared with elective colonoscopy. Length of hospitalization was shorter in the urgent than in the elective colonoscopy group (8 vs 9 days, P < 0.0001). Multivariate analysis also revealed that urgent colonoscopy reduced in‐hospital death (odds ratio = 0.67, 95% confidence interval: 0.46–0.97, P = 0.036) and increased endoscopic hemostasis (odds ratio = 1.84, 95% confidence interval: 1.53–2.22, P <  0.0001).

Conclusion

Urgent colonoscopy for CDB may facilitate identification of the bleeding site and reduce in‐hospital death. The necessity and appropriate timing of urgent colonoscopy should be considered based on patients' condition.
Combined isobutylamido thiazolyl resorcinol and low‐fluence Q‐switched Nd: YAG laser for the treatment of facial hyperpigmentation: A randomized, split‐face study
Authors: Vachiramon Vasanop , Leerunyakul Kanchana , Kositkuljorn Chaninan , Chayavichitsilp Pamela
Published: October 2020

Background

Isobutylamido thiazolyl resorcinol (ITR) is a novel anti‐tyrosinase recently shown to be effective in the treatment of hyperpigmentation. Low‐fluence Q‐switched Nd:YAG 1064‐nm laser (LFQS) has proven to be effective for various hyperpigmentary conditions. However, there is no study on the efficacy and safety of combined ITR and LFQS treatment.

Objectives

To compare the efficacy and safety of combined ITR and LFQS with LFQS monotherapy for facial hyperpigmentation.

Materials and Methods

Patients with symmetrical facial hyperpigmentation were treated with five sessions of once weekly LFQS on the whole face. One side was randomly treated with ITR and the other side received a placebo cream for 12 weeks. Patients were followed for 8 weeks after the last laser treatment. Relative lightness index (RL*I), Facial Hyperpigmentation Severity Score on the malar area (FHSSm), patient satisfaction, recurrence, and adverse events were recorded.

Results

Twenty‐four patients completed the study. Both sides demonstrated significant reductions of mean RL*I and mean FHSSm from baseline (P < .01). At the 4th week, the ITR‐treated side showed more improvement of mean RL*I than the placebo‐treated side (62.5% vs 47.3% improvement, P < .05). The mean FHSSm on the ITR‐treated was reduced at a significantly higher percentage than the placebo‐treated side (54.4% vs 40.2% reduction, P < .05). Partial recurrence was observed on both sides. No serious side effects were noted.

Conclusion

Combined ITR and LFQS therapy was more superior than LFQS monotherapy in the treatment of facial hyperpigmentation. ITR may serve as adjuvant for patients with such condition.
Novel Ultrafast Spiral Head MR Angiography Compared to Standard MR and CT Angiography
Authors: Greve Tobias , Sollmann Nico , Hock Andreas , Zimmer Claus , Kirschke Jan S.
Published: October 2020

BACKGROUND AND PURPOSE

Intracranial vessel imaging by time‐of‐flight MR angiography (TOF‐MRA) is one of the most frequently performed investigations in clinical neuroradiology. Particularly in the acute setting, fast imaging is needed for diagnostics, with a sequence ideally depicting even small vessels. The purpose of this study was to compare image and diagnostic quality of a novel ultrashort TOF‐MRA sequence accelerated by spiral imaging (TOF‐Spiral‐short) to a standard TOF‐MRA sequence accelerated by compressed sensing (TOF‐CS) and to CT angiography (CTA).

METHODS

Forty‐one patients (36.6% showing vessel pathologies) who had undergone TOF‐CS (acquisition duration: 4 minutes 8 seconds), TOF‐Spiral‐short (acquisition duration: 51 seconds; spiral imaging [accelerating factor 1.3], decreased field of view [accelerating factor 1.2], and increased voxel size [accelerating factor 3.3]), and CTA were retrospectively evaluated. Assessment of image quality, diagnostic confidence, and quantification of stenosis or aneurysm diameter were performed by two readers.

RESULTS

Image quality at the skull base was slightly reduced with TOF‐Spiral‐short compared to CTA and TOF‐CS (P < .05). Delineation of small intracranial vessels was improved by TOF‐Spiral‐short compared to CTA (P < .0001). In TOF‐Spiral‐short, diagnostic confidence was not reduced compared to TOF‐CS in patients with vessel pathologies. We observed no significant difference in quantitative pathology assessment between TOF‐Spiral‐short and the other two modalities. TOF‐Spiral‐short enabled the correct identification of all vessel pathologies.

CONCLUSIONS

Accelerating TOF‐MRA of brain‐feeding arteries by a novel ultrashort spiral imaging sequence shows adequate image quality and sufficient diagnostic performance. Thus, TOF‐Spiral‐short holds potential for fast and reliable diagnostics of vessel pathologies, particularly in the acute setting.
Landscape genomics reveals genetic evidence of local adaptation in a widespread tree, the Chinese wingnut (Pterocarya stenoptera)
Authors: Li Lin‐Feng , Cushman Samuel A. , He Yan‐Xia , Ma Xiao‐Fei , Ge Xue‐Jun , Li Jia‐Xin , Qian Zhi‐Hao , Li Yong
Published: October 2020

Understanding the genetic basis underpinning local adaptation is one of the fundamental issues in ecological and evolutionary biology. In this study, we investigated the genomic basis underlying local adaptation of the Chinese wingnut (Pterocarya stenopteraC. DC). Our population genomic analyses revealed nine spatial genetic clusters across the current distribution range of this species. Based on the assessment of genetic–environment association, we found that adaptive divergence of theP. stenopterapopulations were mainly shaped by solar radiation during fruit development, temperature seasonality, annual temperature, precipitation, and air humidity. In particular, our genome‐wide scanning identified a total of 801 candidate single nucleotide polymorphisms (SNPs) that are highly correlated with diverse environmental factors. Further functional annotation of the SNPs identified some candidate genes that are involved into temperature, water, and light adaptation. Taken together, our results suggest that natural selection during local adaptation has contributed to the success of survival to diverse heterogenous environmental conditions. Our study provides important insights into the fundamental knowledge of the genetic basis underlying the local adaptation of non‐model species.
A Bibliometric Analysis of China–Latin America Economic and Political Relations
Authors: Gil‐Barragan Juan M. , Aguilera‐Castillo Andres , Suárez Galeano Llanet
Published: October 2020

Este artículo presenta los resultados de un análisis bibliométrico sobre las relaciones económicas y políticas entre China y América Latina. A través de esta revisión de literatura, se identificaron los principales temas de investigación, la estructura intelectual y las principales tendencias en este campo académico. Adicionalmente, se propone una agenda de investigación para futuras investigaciones. El análisis bibliométrico se basó en la revisión de 102 documentos que incluye artículos, libros y capítulos de libros. Este análisis constató de una revisión bibliométrica y acoplamiento bibliográfico. El resultado muestra que este campo de investigación se ha desarrollado a través de tres etapas. La primera está integrada por artículos que investigan las relaciones económicas bilaterales. La segunda consiste en la evaluación de un posible “efecto negativo” de la relación económica entre China y los países latinoamericanos, como lo son la re‐primarización de la economía latinoamericana, la pérdida de participación de mercado en China y las crecientes presiones competitivas en el sector manufacturero. La tercera etapa está conformada por un análisis que incluye otras dimensiones, como las implicaciones de las relaciones entre China y América Latina como parte de la evolución del orden mundial y la inversión de China como herramienta política en América Latina. Finalmente, encontramos que, a pesar de los avances de estas tres etapas, este tema es un área de investigación relativamente incipiente.
Proton pump inhibitors and odds of cholangiocarcinoma: A retrospective case‐control study
Authors: Xiong Jianping , Wang Yaqin , Xu Weiyu , Liu Zhisong , Wang Haochen , Zhang Zhiyuan , Han Yanjing , Yin Chao , Cao Shasha , Yang Zheran , Su Tianhao , Wei Jian , Chen Guang , Jin Long
Published: October 2020

Background & Aims

Proton pump inhibitors (PPIs) have been reported to be associated with cholangitis and might possibly be carcinogenic. However, few studies have been conducted to investigate the association of PPIs with cholangiocarcinoma (CCA). Thus, a hospital‐based case‐control study was carried out in China to explore the association between PPIs and CCA.

Methods

In this study, 1468 CCA cases (826 intrahepatic cholangiocarcinoma (ICC) and 642 extrahepatic cholangiocarcinoma (ECC)) were included, which were observed at Beijing Friendship Hospital, from February 2002 to October 2018. We retrospectively extracted PPI use and other possible risk factors from clinical records, followed by an investigation of the relationship with CCA via calculation of odds ratios (ORs), adjusted odds ratios (AORs), and 95% confidence intervals (CIs) using logistic regression analysis.

Results

PPIs were used by 135 (9.2%) CCA cases and 173 (5.9%) controls. We found that PPI use was associated with a 1.61‐fold elevated CCA odds (P < .001) (AOR = 1.61, 95% CI = 1.28‐2.05; P < .001). After stratification by CCA subtypes, the AORs of PPIs were consistent for both CCA subtypes, with ORs of 1.36 (AOR = 1.36, 95% CI = 1.02‐1.83; P = .003) and 1.95 (AOR = 1.95, 95% CI = 1.46‐2.62; P < .001) for ICC and ECC respectively. Our results also showed that PPI use was slightly linked to the odds of CCA in a dose‐dependent manner.

Conclusion

PPI use was correlated with a significant 61% increased odds of CCA, particularly in the ECC. However, the retrospective design and observational nature cannot establish causation. Larger scale, multi‐centre prospective studies are required for further validation.
Anorectal manometry in pediatric settings: A systematic review of 227 studies
Authors: Yates Gregory , Friedmacher Florian , Cleeve Stewart , Athanasakos Eleni
Published: October 2020

Background

There is wide variation in the clinical use of diagnostic tools for children with chronic constipation and functional/structural fecal incontinence (CCFSFI). Anorectal manometry (ARM) is a well‐recognized technique to assess the function of the anorectum.

Purpose

Our aim was to perform an up‐to‐date review on ARM in pediatric patients with CCFSFI, with specific focus on the indication of use and protocol. Variation of its use in pediatrics will be explored.

Methods

A systematic search was conducted for empirical studies utilizing ARM with a pediatric sample. A keyword search of literature published in English before July 2018 was conducted and updated to October 2019. Data on demographics, clinical information, study aims, ARM parameters and use of sedation/anesthesia were collected.

Key Results

A total of 227 studies were included in this systematic review. The age of study participants at the time of ARM ranged from birth to 18 years. ARM was most commonly used in patients with organic conditions (65%) compared to functional constipation (41%). In almost half [108/227 (48%)] of the studies, ARM was performed awake. The ARM parameters most frequently assessed were the rectoanal inhibitory reflex, which was evaluated in 198/227 studies (87%) and the anal resting pressure [166/227 studies (73%)].

Conclusions and Inferences

This systematic review has highlighted the vast variation of ARM use within pediatrics and the need to strive toward standardization and use of consensus guidelines. We anticipate this will further advance our understanding of the pathophysiological mechanisms involved in children with defecation disorders.
Evidence for mycorrhizal cheating in Apostasia nipponica, an early‐diverging member of the Orchidaceae
Authors: Suetsugu Kenji , Matsubayashi Jun
Published: October 2020

Most land plants, from liverworts to angiosperms, form mutualistic mycorrhizal symbioses with fungal partners. However, several plants known as mycoheterotrophs exploit fungal partners by reversing the polarity of carbon movement, which usually moves from plant to fungus.

We investigated the physiological ecology of a photosynthetic orchid, Apostasia nipponica, which belongs to the first branching group within the Orchidaceae, to improve our understanding of mycoheterotrophic evolution in orchids. The fungal symbionts and nutrition modes of A. nipponica were investigated using molecular barcoding and carbon‐13 (13C) and nitrogen‐15 (15N) measurements, respectively.

Community profiling based on a metabarcoding technique revealed that A. nipponica associates with specific Ceratobasidium spp. within ectomycorrhizas‐forming clades, whereas isotope analysis revealed that A. nipponica was similar to fully mycoheterotrophic orchids in its 13C signature and was even more enriched in 15N than most of the fully mycoheterotrophic orchids that exploit ectomycorrhizal fungi.

Our molecular and mass‐spectrometric approaches demonstrated, for the first time, that a member of the Apostasioideae, the earliest‐diverging lineage of the Orchidaceae, gains carbon through both photosynthesis and fungal cheating (i.e. partial mycoheterotrophy) during the adult stage.
Apple B‐box protein BBX37 regulates jasmonic acid mediated cold tolerance through the JAZ‐BBX37‐ICE1‐CBF pathway and undergoes MIEL1‐mediated ubiquitination and degradation
Authors: An Jian‐Ping , Wang Xiao‐Fei , Zhang Xiao‐Wei , You Chun‐Xiang , Hao Yu‐Jin
Published: October 2020

The plant hormone jasmonic acid (JA) is involved in the cold stress response, and the inducer of CBF expression 1 (ICE1)‐ C‐repeat binding factor (CBF) regulatory cascade plays a key role in the regulation of cold stress tolerance. In this study, we showed that a novel B‐box (BBX) protein MdBBX37 positively regulates JA‐mediated cold‐stress resistance in apple.

We found that MdBBX37 bound to the MdCBF1 and MdCBF4 promoters to activate their transcription, and also interacted with MdICE1 to enhance the transcriptional activity of MdICE1 on MdCBF1, thus promoting its cold tolerance.

Two JA signaling repressors, MdJAZ1 and MdJAZ2 (JAZ, JAZMONATE ZIM‐DOMAIN), interacted with MdBBX37 to repress the transcriptional activity of MdBBX37 on MdCBF1 and MdCBF4, and also interfered with the interaction between MdBBX37 and MdICE1, thus negatively regulating JA‐mediated cold tolerance. E3 ligase MdMIEL1 (MIEL1, MYB30‐Interacting E3 Ligase1) reduced MdBBX37‐improved cold resistance by mediating ubiquitination and degradation of the MdBBX37 protein.

The data reveal that MIEL1 and JAZ proteins co‐regulate JA‐mediated cold stress tolerance through the BBX37‐ICE1‐CBF module in apple. These results will aid further examination of the post‐translational modification of BBX proteins and the regulatory mechanism of JA‐mediated cold stress tolerance.
Effectiveness of vergence/accommodative therapy for accommodative dysfunction in children with convergence insufficiency
Authors: Chen Angela M , Roberts Tawna L , Cotter Susan A , Kulp Marjean T , Sinnott Loraine T , Borsting Eric J , Tea Yin C , Jones‐Jordan Lisa A , Hertle Richard , Mitchell G Lynn , Eugene Arnold L , Chase Christopher , Scheiman Mitchell M ,   the Convergence Insufficiency Treatment Trial – Attention and Reading Trial (CITT‐ART) Investigator Group
Published: October 2020

Purpose

To determine the effectiveness of office‐based vergence/accommodative therapy for improving accommodative amplitude and accommodative facility in children with symptomatic convergence insufficiency and accommodative dysfunction.

Methods

We report changes in accommodative function following therapy among participants in the Convergence Insufficiency Treatment Trial – Attention and Reading Trial with decreased accommodative amplitude (115 participants in vergence/accommodative therapy; 65 in placebo therapy) or decreased accommodative facility (71 participants in vergence/accommodative therapy; 37 in placebo therapy) at baseline. The primary analysis compared mean change in amplitude and facility between the vergence/accommodative and placebo therapy groups using analyses of variance models after 4, 8, 12 and 16 weeks of treatment. The proportions of participants with normal amplitude and facility at each time point were calculated. The average rate of change in amplitude and facility from baseline to week 4, and from weeks 4 to 16, were determined in the vergence/accommodative therapy group.

Results

From baseline to 16 weeks, the mean improvement in amplitude was 8.6 dioptres (D) and 5.2 D in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 3.5 D, 95% confidence interval (CI): 1.5 to 5.5 D; p = 0.01). The mean improvement in facility was 13.5 cycles per minute (cpm) and 7.6 cpm in the vergence/accommodative and placebo therapy groups, respectively (mean difference = 5.8 cpm, 95% CI: 3.8 to 7.9 cpm; p < 0.0001). Significantly greater proportions of participants treated with vergence/accommodative therapy achieved a normal amplitude (69% vs. 32%, difference = 37%, 95% CI: 22 to 51%; p < 0.0001) and facility (85% vs. 49%, difference = 36%, 95% CI: 18 to 55%; p < 0.0001) than those who received placebo therapy. In the vergence/accommodative therapy group, amplitude increased at an average rate of 1.5 D per week during the first 4 weeks (p < 0.0001), then slowed to 0.2 D per week (p = 0.002) from weeks 4 to 16. Similarly, facility increased at an average rate of 1.5 cpm per week during the first 4 weeks (p < 0.0001), then slowed to 0.6 cpm per week from weeks 4 to 16 (p < 0.0001).

Conclusion

Office‐based vergence/accommodative therapy is effective for improving accommodative function in children with symptomatic convergence insufficiency and coexisting accommodative dysfunction.
His bundle pacing in a young child guided by electroanatomical mapping
Authors: Žižek David , Štublar Jernej , Weiss Miha , Jan Matevž
Published: October 2020

Pediatric patients with complete congenital atrio‐ventricular (AV) block are generally exposed to life‐long dyssynchronous right ventricular (RV) pacing. His bundle pacing (HBP) is an alternative method of pacing that better restores physiological ventricular activation which could prevent pacing‐induced cardiomyopathy. We present a case of a 5‐year‐old child with complete AV block who underwent successful permanent HBP implantation. Three‐dimensional electro‐anatomical mapping system was used to facilitate the procedure and reduce the fluoroscopy time. There were no acute procedure‐related complications, and electrical parameters were stable at short‐term follow‐up.
Resistance of kiwifruit cultivars to ceratocystis wilt: An approach considering the genetic diversity and variation in aggressiveness of the pathogen
Authors: Oliveira Leonardo S. S. , Pimenta Lucas V. A. , Guimarães Lúcio M. S. , de Souza Paulo V. D. , Bhering Leonardo L. , Alfenas Acelino C.
Published: October 2020

Kiwifruit (Actinidia spp.) is native to southern China, but was first cultivated in New Zealand and then spread worldwide. Emerging diseases such as ceratocystis wilt have attracted the attention of kiwifruit growers due to the great losses observed in southern Brazil. Effective control can be achieved by screening for resistance, but the genetic variability of the pathogen must be considered. Thus, this study aimed to assess the genetic diversity and variation in aggressiveness of Ceratocystis isolates from kiwifruit in southern Brazil and then evaluate the resistance of kiwifruit cultivars with the most aggressive isolates. A collection of 46 isolates were obtained from southern Brazil and 14 simple‐sequence repeat (SSR) markers was successfully used for genotyping. Out of 14 markers, 13 were polymorphic and identified 26 genotypes. Fourteen distinct genotypes were tested on a susceptible cultivar to select the most aggressive ones. Finally, inoculation with an equal mixture of five of the most aggressive isolates was used to evaluate the resistance of seven kiwifruit cultivars: Red Arguta, Green Arguta, Allison, Chieftain, Hayward, Monty, and Tomury. Cultivars varied in levels of susceptibility, with disease severity ranging from 40% to 100%. Considering the length of stem lesions, Chieftain showed the lowest level of severity at 40%, while no wilt symptoms were observed at 45 days after inoculation. In addition to the seven cultivars, a half‐sibling progeny with 618 plants of the rootstock cv. Bruno was also assessed, but only seven individuals were resistant. These seven plants can be cloned and used as resistant rootstocks in commercial orchards.
New insights into virus yellows distribution in Europe and effects of beet yellows virus, beet mild yellowing virus, and beet chlorosis virus on sugar beet yield following field inoculation
Authors: Hossain Roxana , Menzel Wulf , Lachmann Celin , Varrelmann Mark
Published: October 2020

Beet yellows virus (BYV), beet mild yellowing virus (BMYV), beet chlorosis virus (BChV), and beet mosaic virus (BtMV) cause virus yellows (VY) disease in sugar beet. The main virus vector is the aphid Myzus persicae. Due to efficient vector control by neonicotinoid seed treatment over the last decades, there is no current knowledge regarding virus species distribution. Therefore, Europe‐wide virus monitoring was carried out from 2017 to 2019, where neonicotinoids were banned in 2019. The monitoring showed that closterovirus BYV is currently widely spread in northern Europe. The poleroviruses BMYV and BChV were most frequently detected in the northern and western regions. The potyvirus BtMV was only sporadically detected. To study virus infestation and influence on yield, viruses were transmitted to sugar beet plants using viruliferous M. persicae in quadruplicate field plots with 10% inoculation density simulating natural infection. A plant‐to‐plant virus spread was observed within 4 weeks. A nearly complete infection of all plants was observed in all treatments at harvest. In accordance with these findings, a significant yield reduction was caused by BMYV and BChV (−23% and −24%) and only a moderate reduction in yield was observed for BYV (−10%). This study showed that inoculation at low densities mimics natural infection, and quick spreading induced representative yield effects. Within the background of a post‐neonicotinoid era, this provides the basis to screen sugar beet genotypes for the selection of virus tolerance/resistance and to test the effectiveness of insecticides for the control of M. persicae with a manageable workload.
Clinical features of patients undergoing hemodialysis with COVID‐19
Authors: Tian Ming , Li Hua , Yan Ting , Dai Yujie , Dong Liping , Wei Honglan , Song Xiaohong , Dong Junwu , Cheng Fangxiong , Li Wenzhou
Published: October 2020

Hemodialysis patients are susceptible to coronavirus disease 2019 (COVID‐19). The aim of this study was to describe the epidemiological, clinical characteristics, and mortality‐related risk factors for those who undergoing hemodialysis with COVID‐19. We conducted a retrospective study. A total of 49 hemodialysis patients with COVID‐19 (Group 1) and 74 uninfected patients (Group 2) were included. For patients in Group 1, we found the median age was 62 years (36‐89 years), 59.3% were male, and the median dialysis vintage was 26 months. Twenty‐eight patients (57%) had three or more comorbidities and two patients (4%) died. The most common symptoms were fever (32.7%) and dry cough (46.9%), while nine patients (18.4%) were asymptomatic. Blood routine tests indicated lymphocytopenia, the proportion of lymphocyte subsets was generally reduced, and chest CT scans showed ground‐glass opacity (45.8%) and patchy shadowing (35.4%). However, these findings were not specific to hemodialysis patients with COVID‐19, and similar manifestations could be found in patients without SARS‐CoV‐2 infection. In conclusion, for hemodialysis patients with COVID‐19, lymphocytopenia and ground‐glass opacities or patchy opacities were common but not specific to them, early active treatment and interventions against nosocomial infection can significantly reduce the mortality and the risk of SARS‐CoV‐2 infection.
Infectious complications after allogeneic hematopoietic stem cell transplantation in children in a bone marrow transplant unit in Colombia
Authors: Bravo Ana Milena , Arango Jailer , Ramirez Oscar , Portilla Carlos Andres , López Pio , Calle Juan Pablo , López‐Medina Eduardo
Published: October 2020

Objective

There is a relative lack of information about infections occurring in children following allogeneic hematopoietic stem cell transplants (allo‐HSCT) in developing countries. Herein, we describe the incidence rates of different infections according to the transplant period and baseline condition in Colombia.

Methods

In a retrospective cohort study of all children who underwent allo‐HSCTs from 2012 to 2017 in a hospital in Cali, Colombia, we reviewed medical records from the first post‐transplant day until day + 365 to describe microbiologically confirmed incidence rates of infections and deaths during three post‐transplant periods and according to baseline condition.

Results

Most allo‐HSCT (n = 144, 96%) were followed by infections over the following year, mostly due to bacteria and cytomegalovirus (4.3 and 3.3 per 1000 patient‐days, respectively). Children were at the highest risk for infection in the first 30 days post‐HSTC, but mortality was highest after 100 days. Overall, high mortality (n = 44, 31.7%) was associated with infections, especially from extensively drug‐resistant bacteria, adenovirus, and aspergillosis. Infection rates were similar independent of the baseline condition.

Conclusion

Almost all children in this cohort developed infections post allo‐HSCT. Describing the distribution of infections throughout the first post allo‐HSCT year allows clinicians to narrow the differential diagnosis of infections according to the post‐transplant period. This is especially useful when prioritizing interventions in children receiving HSCT in stringent healthcare systems in developing countries.
Expression dynamics of dehydration tolerance in the tropical plantMarchantia inflexa
Authors: Marks Rose A. , Smith Jeramiah J. , VanBuren Robert , McLetchie David Nicholas
Published: October 2020

Tolerance to prolonged water deficit occurs along a continuum in plants, with dehydration tolerance (DhT) and desiccation tolerance (DT) representing some of the most extreme adaptations to water scarcity. Although DhT and DT presumably vary among individuals of a single species, this variability remains largely unstudied. Here, we characterized expression dynamics throughout a dehydration−rehydration time‐course in six diverse genotypes of the dioecious liverwort Marchantiainflexa. We identified classical signatures of stress response inM.inflexa, including major changes in transcripts related to metabolism, expression of LEA and ELIP genes, and evidence of cell wall remodeling. However, we detected very little temporal synchronization of these responses across different genotypes ofM.inflexa, which may be related to genotypic variation among samples, constitutive expression of dehydration‐associated transcripts, the sequestration of mRNAs in ribonucleoprotein partials prior to drying, or the lower tolerance ofM.inflexarelative to most bryophytes studied to date. Our characterization of intraspecific variation in expression dynamics suggests that differences in the timing of transcriptional adjustments contribute to variation among genotypes, and that developmental differences impact the relative tolerance of meristematic and differentiated tissues. This work highlights the complexity and variability of water stress tolerance, and underscores the need for comparative studies that seek to characterize variation in DT and DhT.
Membrane lipid remodeling is required for photosystem II function under low CO2
Authors: Jimbo Haruhiko , Izuhara Taichi , Hirashima Takashi , Endo Kaichiro , Nakamura Yuki , Wada Hajime
Published: October 2020

Membrane lipid remodeling in plants and microalgae has a crucial role in their survival under nutrient‐deficient conditions. Aquatic microalgae have low access to CO2, an essential carbon source for photosynthetic assimilates; however, 70–90 mol% of their membrane lipids are sugar‐derived lipids (glycolipids) such as monogalactosyldiacylglycerol (MGDG). In this study, we discovered a new system of membrane lipid remodeling responding to CO2 in Synechocystis sp. PCC 6803, a unicellular, freshwater cyanobacterium. As compared with higher CO2 (HC; 1% CO2), under ambient air (lower CO2: LC), phosphatidylglycerol (PG) content was increased at the expense of MGDG content. To explore the biological significance of this alteration in content, we generated a transformant of Synechocystis sp. PCC 6803 overexpressing sll0545 gene encoding a putative phosphatidic acid phosphate (oxPAP), which produces diacylglycerol that is used for the synthesis of glycolipids, and examined the effect on membrane lipid remodeling and phototrophic growth responding to LC. Photosystem II (PSII) activity and growth rate were inhibited under LC in oxPAP cells. PG content was substantially reduced, and MGDG and sulfoquinovosyldiacylglycerol contents were increased in oxPAP cells as compared with control cells. These phenotypes in oxPAP cells were recovered under the HC condition or PG supplementation. Increased PG content may be required for proper functioning of PSII under LC conditions.
Retrospective evaluation of albuterol inhalant exposure in dogs: 36 cases (2007–2017)
Authors: Meroni Emiliana R. , Khorzad Roxanna , Bracker Kiko , Sinnott‐Stutzman Virginia
Published: October 2020

Objective

To describe the clinical features, clinicopathological features, treatment, and outcome of dogs presented for albuterol exposure.

Design

Retrospective case series from January 2007 to December 2017.

Setting

Tertiary veterinary facility.

Animals

Thirty‐six client‐owned dogs presenting for known or suspected albuterol exposure secondary to chewing on albuterol metered‐dose inhalers (MDIs).

Interventions

None.

Measurements and main results

All dogs presented with clinical signs attributable to albuterol exposure. The most common physical examination abnormality was sinus tachycardia, noted in 34 of 36 (94%) dogs. Twenty‐seven patients (75%) were admitted to the hospital for therapy, with a median length of hospitalization of 20.5 hours (16.75–24.5). Thirty‐two of 36 dogs had serum electrolytes evaluated at admission, with 22 of 32 (69%) presenting with hypokalemia ([K+] < 3.62 mmol/L]). Hyperlactatemia ([lactate] > 2.80 mmol/L) was noted in 23 of 28 (82%) dogs. A negative correlation was found between serum lactate and potassium (r = –0.64, r2 = 0.40, P = 0.0003). Hyperglycemia ([glucose] > 6.44 mmol/L) was noted in 20 of 30 (67%) dogs. Beta antagonist therapy was utilized in 20 of 36 (56%) of dogs.

Conclusions

Although uncommon, albuterol intoxication can lead to significant clinical and electrolyte abnormalities. Albuterol‐induced hypokalemia and associated tachyarrhythmias can be successfully managed, and albuterol intoxication has an excellent prognosis for survival to discharge. A minimum database should be evaluated in all dogs presenting for suspected albuterol exposure, with lactate and glucose monitored carefully in dogs with moderate or severe hypokalemia given the correlation found.
Evidence supporting wound care end points relevant to clinical practice and patients' lives. Part 3: The Patient Survey
Authors: Gould Lisa J. , Liu Jing , Wan Rou , Carter Marissa J. , Dotson Margaret (Peggy) , Driver Vickie R
Published: October 2020

The 2006 U.S. Food and Drug Administration Guidance for Industry emphasizes wound closure as the primary outcome for clinical trials in wound healing. Wound care professionals understand that complete wound healing is not always achievable when evaluating new treatments. FDA, Association for the Advancement of Wound Care, and Wound Healing Society are working collaboratively to identify scientifically achievable, clinically relevant, and patient‐centered endpoints with sufficient support to serve as primary outcomes for clinical trials. The Opinion Survey from People with Wounds presented here addresses an important but understudied issue: the gap between clinician, healthcare insurance companies, government agencies, and patient perspectives regarding clinically meaningful and scientifically achievable primary endpoints for wound care. The survey, adapted from the clinician survey with adjustment for health literacy, was pilot tested and revised based on a limited number of patients in a single clinic. After central IRB approval, the on‐line survey was administered in English and Spanish and submitted anonymously to a server with the cooperation of multiple wound clinics and societies. Four hundred and thirty‐eight patients and caregivers from across the United States responded over a 10‐month period. Based on this survey, the most valuable clinical endpoints were reduced infection, recurrence, and amputation. The most valuable quality of life outcomes were increased independence, reduced social isolation, and pain. The top five endpoints in terms of usefulness for measuring clinical trial success were time to heal, wound size, infection, recurrence, and pain. Narrative responses from wound patients emphasized the inability to perform activities of daily living and pain as major factors that impacted their daily lives. Engagement of patients in clinical trials and evaluation of potential treatments is critical to improving wound care. This survey provides insight into the needs of patients with wounds and provides a roadmap for structuring future clinical trials to better meet those needs.
Rational cobordisms and integral homology
Authors: Aceto Paolo , Celoria Daniele , Park JungHwan
Published: October 2020

We consider the question of when a rational homology $3$-sphere is rational homology cobordant to a connected sum of lens spaces. We prove that every rational homology cobordism class in the subgroup generated by lens spaces is represented by a unique connected sum of lens spaces whose first homology group injects in the first homology group of any other element in the same class. As a first consequence, we show that several natural maps to the rational homology cobordism group have infinite-rank cokernels. Further consequences include a divisibility condition between the determinants of a connected sum of $2$-bridge knots and any other knot in the same concordance class. Lastly, we use knot Floer homology combined with our main result to obstruct Dehn surgeries on knots from being rationally cobordant to lens spaces.
Analytical and Experimental Evaluation of Various Active Suspension Alternatives for Superior Ride Comfort and Utilization of Autonomous Vehicles
Authors: Cvok Ivan , Hrgetić Mario , Hoić Matija , Deur Joško , Hrovat Davor , Eric Tseng H.
Published: October 2020

Autonomous vehicles (AVs) give the driver opportunity to engage in productive or pleasure-related activities, which will increase AV’s utility and value. It is anticipated that many AVs will be equipped with active suspension extended with road disturbance preview capability to provide the necessary superior ride comfort resulting in almost steady work or play platform. This article deals with assessing the benefits of introducing various active suspensions and related linear quadratic regulator (LQR) controls in terms of improving the work/leisure ability. The study relies on high-performance shaker rig-based tests of a group of 44 drivers involved in reading/writing, drawing, and subjective ride comfort rating tasks. The test results indicate that there is a threshold of root-mean-square vertical acceleration, below which the task execution performance is similar to that corresponding to standstill conditions. For the given, relatively harsh road disturbance profile, only the fully active suspension with road preview control can suppress the vertical acceleration below the above critical superior comfort threshold. However, when adding an active seat suspension, the range of chassis suspension types for superior ride comfort is substantially extended and can include semi-active suspension and even passive suspension in some extreme cases that can, however, lead to excessive relative motion between the seat and the vehicle floor. The design requirements gained through simulation analysis, and extended with cost and packaging requirements related to passenger car applications, have guided design of two active seat suspension concepts applicable to the shaker rig and production vehicles.