bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychosocial burden of inflammatory bowel disease in adolescents and young adults
Authors: Halloran Jessica , McDermott Brett , Ewais Tatjana , Begun Jakob , Karatela Shamshad , d'Emden Helen , Corias Christian , Denny Simon
Published: August 2020

Background

This study examined the psychosocial burden of inflammatory bowel disease (IBD) in young people aged 15–25 years attending a tertiary specialist health centre for adolescents and young adults in Brisbane.

Aims

To describe the impact of IBD on psychosocial well‐being in young people and to compare well‐being in the IBD cohort to well‐being among young people with other chronic conditions, with a view to identifying characteristics and challenges unique to those with IBD.

Methods

Young people with IBD provided demographic information and psychosocial data through a cross‐sectional self‐report survey. Psychosocial data included the Kessler Psychological Distress Scale, Perceived Stress Scale, Brief Illness Perception Questionnaire, World Health Organisation Well‐being Index, Paediatric Quality of Life Inventory, Short Quality of Life Questionnaire for IBD, Multidimensional Scale of Perceived Social Support, Connor Davidson Resilience Scale 2 and the Multidimensional Health Locus of Control Scale.

Results

Surveys were collected from 51 young people with IBD and compared with surveys from 210 young people with juvenile rheumatic disease (n = 31), phenylketonuria (n = 21), cystic fibrosis (n = 33), renal transplants (n = 14) and craniomaxillofacial conditions (n = 111). On the psychosocial domains, 41% of young people with IBD had poor well‐being and 37% were at risk of depression. When assessed against the comparison group, young people with IBD reported higher depressive symptoms (P = 0.04), worse illness perceptions (P < 0.01) and lower internal locus of control (P < 0.01).

Conclusions

Early recognition and treatment of depression and other psychosocial comorbidities within integrated pathways of care is crucial in adolescents and young adults with IBD and likely to improve the course of IBD and their overall health and well‐being. Interventions aimed at enhancing self‐efficacy and increasing public awareness are also likely to be helpful.
Political devolution and employment relations in Great Britain: the case of the Living Wage
Authors: Heery Edmund , Hann Deborah , Nash David
Published: August 2020

This article examines the role of the devolved governments of Scotland and Wales in promoting the voluntary Living Wage. It shows that active promotion of the Living Wage standard has emerged in both countries from a broader commitment to an economic policy of ‘inclusive growth’. Employment law is not a devolved matter, and the article identifies a broad range of economic incentives and soft forms of regulation that have been used by the devolved governments to promote the Living Wage in the absence of hard power to legislate. Non‐legislative forms of state intervention are often regarded sceptically, but the article shows that the attempts of devolved governments to spread the Living Wage have been impactful, particularly in Scotland.
Inside debt and firm risk‐taking: Evidence from the UK pension reform
Authors: Li Hao , Zhao Jinsha
Published: August 2020

This paper provides new evidence on the relation between CEO inside debt and firm risk‐taking by exploiting the change in the tax treatment of UK pensions following two pension amendments. The 2006 pension reform introduces the annual and lifetime allowance for UK pension schemes, significantly increasing income taxes associated with CEO inside debt. The 2011 allowance cut, which substantially reduces the annual allowance introduced in 2006, further increases income taxes on inside debt. We find that CEO inside debt, in the form of executive pensions declines after the 2006 reform while cash‐in‐lieu increases significantly. This effect is more severe after the 2011 allowance cut than the 2006 pension reform. UK firms appear to substitute away from pensions towards cash‐in‐lieu, where income taxes are less punishing. If the association between CEO inside debt and firm risk‐taking is causal, we should observe a change of risk‐taking after the decline of inside debt. Our results, which exploit the exogenous nature of the reforms, show that the decline of CEO pensions does not lead to any change in firm risk‐taking. This result suggests that no causal relationship exists between CEO inside debt and firm risk‐taking. Our results extend the inside debt literature, where empirical evidence is mainly documented in the US. Contrary to findings in the US, our evidence suggests that the use of CEO inside debt is motivated to minimise income tax rather than a tool to moderate firm risk.
Delirium and Adverse Outcomes in Hospitalized Patients with COVID‐19
Authors: Garcez Flavia B. , Aliberti Marlon J. R. , Poco Paula C. E. , Hiratsuka Marcel , Takahashi Silvia de F. , Coelho Venceslau A. , Salotto Danute B. , Moreira Marlos L. V. , Jacob‐Filho Wilson , Avelino‐Silva Thiago J.
Published: August 2020

BACKGROUND

Little is known about the association between acute mental changes and adverse outcomes in hospitalized adults with COVID‐19.

OBJECTIVES

To investigate the occurrence of delirium in hospitalized patients with COVID‐19 and explore its association with adverse outcomes.

DESIGN

Longitudinal observational study.

SETTING

Tertiary university hospital dedicated to the care of severe cases of COVID‐19 in São Paulo, Brazil.

PARTICIPANTS

A total of 707 patients, aged 50 years or older, consecutively admitted to the hospital between March and May 2020.

MEASUREMENTS

We completed detailed reviews of electronic medical records to collect our data. We identified delirium occurrence using the Chart‐Based Delirium Identification Instrument (CHART‐DEL). Trained physicians with a background in geriatric medicine completed all CHART‐DEL assessments. We complemented our baseline clinical information using telephone interviews with participants or their proxy. Our outcomes of interest were in‐hospital death, length of stay, admission to intensive care, and ventilator utilization. We adjusted all multivariable analyses for age, sex, clinical history, vital signs, and relevant laboratory biomarkers (lymphocyte count, C‐reactive protein, glomerular filtration rate, D‐dimer, and albumin).

RESULTS

Overall, we identified delirium in 234 participants (33%). On admission, 86 (12%) were delirious. We observed 273 deaths (39%) in our sample, and in‐hospital mortality reached 55% in patients who experienced delirium. Delirium was associated with in‐hospital death, with an adjusted odds ratio of 1.75 (95% confidence interval = 1.15–2.66); the association held both in middle‐aged and older adults. Delirium was also associated with increased length of stay, admission to intensive care, and ventilator utilization.

CONCLUSION

Delirium was independently associated with in‐hospital death in adults aged 50 years and older with COVID‐19. Despite the difficulties for patient care during the pandemic, clinicians should routinely monitor delirium when assessing severity and prognosis of COVID‐19 patients.
Human uterine vasculature with respect to uterus transplantation: A comprehensive review
Authors: Kristek Jakub , Johannesson Liza , Novotny Robert , Kachlik David , Fronek Jiri
Published: August 2020

Due to the novelty of uterus transplantation, data on preferable inflow and outflow of the graft are limited. This paper reviews the technique, type of vessels and the outcome. A systematic search of the PubMed database was conducted. We extracted and analyzed data on the arteries and veins utilized, types of anastomosis, types of donors, complications and the outcome. Thirty eight sources reported 51 human uterine transplantations, 10 graft thromboses and 25 live births. Inflow was established with two uterine arteries (UA) with/without the anterior division of the internal iliac artery in 62% (n = 31) of cases, two UA arteries with a segment/patch of the internal iliac artery in 34% (n = 17) of cases or two UA with a conduit in 4% of cases (n = 2). Both cases with a conduit developed thrombosis (n = 2). Arterial thrombosis/ischemia developed in 8 of the 51 cases. In 50% of cases with arterial thrombosis, atherosclerosis was identified as a possible cause. Outflow was established by two internal iliac veins with patches/segments in 27.5% of cases (n = 14) followed by two utero‐ovarian veins in 25.5% (n = 13). Venous thrombosis occurred in 3 of the 51 cases. Uterine arteries with/without anterior division of the internal iliac artery were the most frequent arteries used for inflow and produced the highest patency rate. The presence of atherosclerosis and complex arterial reconstruction was associated with a high rate of arterial thrombosis. None of the veins utilized in the procedures appeared to be superior. There are insufficient data to draw a definite conclusion.
Autologous platelet‐rich plasma infusion does not improve pregnancy outcomes in frozen embryo transfer cycles in women with history of repeated implantation failure without thin endometrium
Authors: Tehraninejad Ensieh S. , Kashani Norieh G. , Hosseini Ali , Tarafdari Azam
Published: August 2020

Aim

The effect of intrauterine infusion of platelet‐rich plasma (PRP) which has been shown to improve the pregnancy outcomes in patients suffering from repeated implantation failure (RIF), is intended to be studied in patients with normal endometrial thickness.

Methods

We recruited 85 patients with RIF and normal endometrial thickness (≥7 mm). After obtaining their consent, they were stratified into the intervention (PRP) and control groups, according to the patient's decision. Out of 85 participants, 42 received PRP, while 43 were included in the control group. In the PRP group, 1 mL of PRP was extracted from 10 cc of whole blood via two rounds of centrifugation and infused 2 days before the embryo transfer (ET).

Results

The pregnancy outcomes, including biochemical, clinical and ongoing pregnancy (≥20 weeks of gestation) rates were similar between the PRP (35.7, 31.0 and 26.8%, respectively) and control (37.2, 37.2 and 25.6%, respectively) groups.

Conclusion

We concluded that PRP is not an effective adjuvant treatment for in vitro fertilization of patients with RIF and normal endometrial thickness undergoing ET.
Fracture Load of Different Zirconia Types: A Mastication Simulation Study
Authors: Abdulmajeed Awab , Sulaiman Taiseer , Abdulmajeed Aous , Bencharit Sompop , Närhi Timo
Published: August 2020

Purpose

To assess the effect of yttria mol% concentration and material thickness on the biaxial fracture load (N) of zirconia with and without mastication simulation.

Materials and methods

Disk‐shaped specimens (N = 120) of 3 mol% yttria‐partially stabilized zirconia, 3Y‐PSZ (Katana High Translucent, Kuraray Noritake), 4 mol% yttria‐partially stabilized zirconia, 4Y‐PSZ (Katana Super Translucent Multi Layered) and 5 mol% Yttria‐partially stabilized zirconia, 5Y‐PSZ (Katana Ultra Translucent Multi Layered) were prepared to thicknesses of 0.7 and 1.2 mm. For each thickness, the biaxial fracture load (N) was measured with and without mastication simulation with 1.2 million cycles at a 110‐N load and simultaneous thermal cycling at 5°C to 55°C. The data were analyzed by three‐way Analysis of Variance (α = 0.05) and Tukey‐Kramer adjusted multiple comparison test.

Results

Yttria mol% concentration and material thickness had a statistically significant effect on the mean biaxial fracture load (F = 388.16, p < 0.001 and F = 714.33, p < 0.001 respectively). The mean biaxial fracture load ranged from the highest to the lowest; 3Y‐PSZ, 4Y‐PSZ, and 5Y‐PSZ (p = 0.012). The mean biaxial fracture load of the 1.2 mm thickness groups was significantly higher than 0.7 mm thickness at any given condition (p = 0.002). Not all specimens survived the mastication simulation protocol. Fifty percent of the 0.7‐mm‐thick 4Y‐PSZ specimens, 70% of the 0.7‐mm‐thick 5Y‐PSZ specimens and 20% of 1.2‐mm‐thick 5Y‐PSZ specimens fractured during mastication simulation. Mastication simulation had no statistically significant effect on the biaxial fracture load (F = 1.24, p = 0.239) of the survived specimens.

Conclusions

Lowering yttria mol% concentration and increasing material thickness significantly increases the fracture load of zirconia. At 0.7 mm thickness, only 3Y‐PSZ survived masticatory simulation. A minimum material thickness of 1.2 mm is required for 4Y‐PSZ or 5Y‐PSZ.
Standard area diagrams to assess scab severity of entire‐margined leaves of sour passion fruit
Authors: Brás Verônica Vieira , Rios Jonas Alberto , Silva Leandro Castro , Santos Carlos Eduardo Magalhães , Nascimento Roxana Stefane Mendes , Rodrigues Fabrício Ávila
Published: August 2020

Scab caused by the Cladosporium cladosporioides complex is one of the most important diseases affecting passion fruit yield and fruit quality. Standard area diagrams are useful tools to improve the accuracy and reliability of the estimates of disease severity in many pathosystems. The interpretation of the accuracy of the resulting disease data may be the basis for providing better disease management. This study aimed to develop and validate standard area diagrams (SADs) to quantify scab severity of entire‐margined leaves of sour passion fruit plants. The SADs are composed of ten images of scab severity values (0.4%, 3.5%, 5.4%, 8.0%, 11.1%, 16.2%, 26.1%, 38.2%, 47.9% and 58.9%). Twenty raters (ten experienced and ten inexperienced ones) evaluated the SADs. The raters estimated the same set of fifty images twice. In the examination, the SADs were used, while in the second examination, they were not used. Accuracy was significantly improved by using the SADs. The coefficients of bias (Cb) were 0.96 and 0.98 for the experienced raters and 0.75 and 0.98 for the inexperienced raters without and with SADs, respectively. The correlation coefficient (r) values were 0.95 and 0.97 for the experienced raters and 0.89 and 0.97 for the inexperienced raters without and with the use of the SADs, respectively. Lin's concordance correlation coefficient (ρc) values were 0.91 and 0.95 for the experienced raters and 0.66 and 0.95 for the inexperienced raters without and with the use of the SADs, respectively. Moreover, the coefficient of determination (R2) significantly improved when the SADs were used. The SADs proposed in this study, if properly used, may improve both the accuracy and reliability during the evaluation of scab severity of entire‐margined leaves of sour passion fruit plants.
Childhood stunting and wasting in Myanmar: Key drivers and implications for policies and programmes
Authors: Blankenship Jessica L. , Cashin Jennifer , Nguyen Tuan T. , Ip Hedy
Published: August 2020

Child undernutrition is a public health and development problem in Myanmar that is jeopardizing children's physical and cognitive development and the country's social and economic progress. We identified key drivers of child stunting (low height‐for‐age) and wasting (low weight‐for‐height) in a nationally representative sample (n = 3,981) of children 0–59 months of age. The national prevalence of child stunting and wasting was 28% and 7%, respectively. Boys were more likely to be stunted or wasted than girls. Older children 24–35 months were at the highest risk of stunting compared with children under 6 months (risk ratios [RR] 10.34; 95% CI [6.42, 16.65]) whereas the youngest, under 6 months, were at the highest risk of wasting compared with children 36–59 months (RR 2.04; 95% CI [1.16, 3.57]). Maternal height <145 cm (RR 5.10; 95% CI [3.15, 8.23]), perceived small child size at birth (RR 2.08; 95% CI [1.62, 2.69]), and not benefiting from institutional delivery (RR 1.52; 95% CI [1.24, 1.87]) were associated with an increased risk of child stunting, as were maternal occupation, unimproved household drinking water, living in delta, coastal or upland areas, and poorer household wealth index quintile. Increased risk of child wasting was associated with maternal underweight (RR 1.64; 95% CI [1.11, 2.42]) and open defecation (RR 1.91; 95% CI [1.25, 2.92]) as well as maternal occupation and residence in a coastal area. Our findings indicate that the key drivers of child undernutrition in Myanmar are multifaceted and start in utero. Investing in scaling‐up multisectoral approaches that include nutrition‐specific and nutrition‐sensitive interventions with a focus on improving maternal nutrition is essential for reducing child undernutrition and contributing to further gains in the country's human and economic development.
Maternal mid‐upper arm circumference during pregnancy and linear growth among Cambodian infants during the first months of life
Authors: Kpewou Daniel Edem , Poirot Etienne , Berger Jacques , Som Somphos Vicheth , Laillou Arnaud , Belayneh Selamawit Negash , Wieringa Frank T.
Published: August 2020

Stunting prevalence among children under 5 years remains high in Cambodia, affecting about one‐third of children. In most low‐ and middle‐income countries, linear growth faltering of young children starts in the womb. The 1,000‐days window of opportunity to improve child nutritional status includes pregnancy, as maternal nutritional status is an important determinant of birthweight and child development. In Cambodia, nutritional status of pregnant women is poor, with some studies reporting >20% of pregnant women having a low mid‐upper arm circumference (MUAC < 23 cm). Few studies have investigated associations between maternal nutritional status during pregnancy and neonatal growth. Using data from a Cambodian cohort study conducted from 2016 through 2018 in selected districts of Phnom Penh, Kratie, and Ratanakiri provinces, we investigated associations between maternal MUAC during pregnancy as indicator of maternal nutritional status and their offspring linear growth during early life. Multivariate regression models were used to assess the associations between maternal MUAC during the last trimester of pregnancy and infant's length‐for‐age z‐scores during the first 3.5 months of life. Maternal MUAC was significantly associated with infant's length‐for‐age z‐scores (regression coefficient 0.06, 95% CI [0.03, 0.09]). Infants born from mothers with a low MUAC during pregnancy had a 1.6 times higher risk (odds ratio 1.621, 95% CI [0.998, 2.636]) of being stunted during the first 3.5 months of life compared with infants born from mothers with a MUAC >23 cm. This study underlines the importance of optimum maternal MUAC during pregnancy for optimal infant growth. Interventions that aim to tackle stunting in infants should integrate improving maternal MUAC during pregnancy.
Confucianism and Daoism: On the relationship between theAnalects, Laozi,andZhuangzi, Part II
Authors: D'Ambrosio Paul J.
Published: August 2020

This article is a continuation of Part I, which looked at the relationship between Confucianism and Daoism by first introducing general approaches, before moving on to (1) perspectives on names and actualities; (2) cultivation, learning, the natural; and (3) conceptions of the person. Continuing with the theme‐based comparison of Confucianism and Daoism by looking specifically at theLunyu論語 (Analects of Confucius),Daodejing道德經 (Classic of the Way and Virtuosity) orLaozi老子 (Book of Master Lao), and theZhuangzi莊子 (Book of Master Zhuang), this article looks at (1) politics, nonaction (wuwei無為), and virtuosity (de德); (2) morality, virtues, and human nature (xing性); and finally (3)Dao道, or “the way.” It references Part I, and while it can be read independently, it is best taken as a continuation of Part I. The conclusion included herein summarizes both Part II and Part I.
Institutional Conditions of Economic Globalization: Effects of Antitrust and Merger Laws on the Global Integration of the Acquisition Market1
Authors: Han Gru
Published: August 2020

A central insight from institutional theory about markets is that they cannot operate without governing rules to guide interactions among actors. Because most of these rules are made and enforced within national borders, international economic transactions are said to suffer from an “institutional abyss,” the lack of institutional arrangements for economic exchanges. Scholars have found that the abyss can be filled by two factors: network connectedness, such as inter‐governmental organizations, and intercountry economic agreements, such as the World Trade Organization or free trade. This article proposes a third factor: the global diffusion of governmental regulations. When countries adopt highly standardized regulations on a particular transaction, it provides legal familiarity for foreigners and reduces procedural uncertainty surrounding how the transaction should be executed. Using fixed‐effects models on longitudinal data, I show that the adoption of antitrust and merger laws increases the volume of cross‐border mergers—the transaction the laws are meant to regulate. This result stands in direct opposition to financial scholars’ predictions that antitrust and merger laws will reduce cross‐border mergers because the laws are meant to restrain, not liberate, the transaction. This article theorizes how the diffusion of regulations, not the elimination of regulations, can facilitate global market integration.
A novel HLA‐C*15:02 variant, HLA‐C*15:02:43, identified in a healthy individual from Brazil
Authors: Stelet Vinícius N. , Cita Rafael F. , Mendes Maristela F. , Romero Matilde , Abdelhay Eliana
Published: August 2020

Identification of the novel HLA‐C*15:02:43 allele that differs from HLA‐C*15:02:01 at one position in exon 4.
Saturated RISE Feedback Control for Uncertain Nonlinear MacPherson Active Suspension System to Improve Ride Comfort
Authors: Dinh Huyen T. , Trinh Tuan-Duong , Tran Van-Nhu
Published: August 2020

A continuous saturated controller using smooth saturation functions is established for MacPherson active suspension system which includes nonlinear uncertainties, unknown road excitations, and bounded disturbances. The developed controller exploits the properties of the hyperbolic functions to guarantee saturation limits are not exceeded, while stability analysis procedures of the robust integral of the sign of the error (RISE) control technique utilize the advantages of high gain control strategies in compensating for unknown uncertainties. The saturated controller guarantees asymptotic regulation of the sprung mass acceleration to improve the ride comfort despite model uncertainties and additive disturbances in the dynamics. Simulation results demonstrate the improvement in the ride comfort while tire deflection and the suspension deflection are within admissible range in comparison with three other suspensions.
A Procedure to Define Customized Musculoskeletal Models for the Analysis of the Crutch-Orthosis-Assisted Gait of Spinal Cord Injured Subjects
Authors: Michaud Florian , Lugris Urbano , Cuadrado Javier , Kecskemethy Andres , Ou Ye
Published: August 2020

Subjects suffering from spinal cord injury with lower extremity impairment generally use a wheelchair to move. However, some of them are capable of walking with the help of orthoses and crutches. Standing up and walking regularly have huge benefits for the general health state of these subjects, since it reduces the negative consequences of sedentarism. Therefore, achieving adherence to assisted gait is important, but there is a risk of abandoning due to several issues such as pain, fatigue, or very low speed, which can make the subject return to solely use the wheelchair. Musculoskeletal models can provide estimations of muscular forces and activations, which in turn enable to calculate magnitudes such as joint reactions, energetic cost, and bone stress and strain. These magnitudes can serve to evaluate the impact of assisted gait in the subject's health and to assess the likelihood of adherence. Moreover, they can be used as indicators to compare different assistive devices for a particular subject. As every spinal cord-injured (SCI) subject represents a different case, a procedure to define customized musculoskeletal models for the crutch-orthosis-assisted gait of SCI subjects is proposed in this paper. Issues such as selection of muscles and integration of models of trunk, upper and lower extremities, and assistive devices (crutches and orthoses) are addressed. An inverse-dynamics-based physiological static optimization method that takes into account muscle dynamics at low computational cost is applied to obtain estimates of muscle forces and joint reactions. The method is experimentally validated by electromyography in a case study.
Growth factors and SARS-CoV-2
Authors: Foley John F.
Published: August 2020

Phosphoproteomics analysis reveals that blocking growth factor receptor signaling inhibits SARS-CoV-replication.
In Vivo
Activity of QPX7728, an Ultrabroad-Spectrum Beta-Lactamase Inhibitor, in Combination with Beta-Lactams against Carbapenem-Resistant Klebsiella pneumoniae
Authors: Sabet Mojgan , Tarazi Ziad , Griffith David C.
Published: August 2020

Resistance to beta-lactams has created a major clinical issue. QPX7728 is a novel ultrabroad-spectrum cyclic boronic acid beta-lactamase inhibitor with activity against both serine and metallo-beta-lactamases developed to address this resistance for use in combination with beta-lactam antibiotics. The objective of these studies was to evaluate the activity of QPX7728 in combination with multiple beta-lactams against carbapenem-resistant
Klebsiella pneumoniae
isolates in a neutropenic mouse thigh infection model.
Syncing fault rock clocks: Direct comparison of U-Pb carbonate and K-Ar illite fault dating methods
Authors: Mottram C.M. , Kellett D.A. , Barresi T. , Zwingmann H. , Friend M. , Todd A. , Percival J.B.
Published: August 2020

The timing of slip on brittle faults in Earth’s upper crust is difficult to constrain, and direct radiometric dating of fault-generated materials is the most explicit approach. Here we make a direct comparison between K-Ar dating of fault gouge clay (authigenic illite) and U-Pb dating of carbonate slickenfibers and veins from the same fault. We have dated fault generated materials from the Big Creek fault, a northwest-striking, dextral strike-slip fault system in Yukon Territory, Canadian Cordillera. Both methods yielded dates at ca. 73 Ma and ca. 60–57 Ma, representing at least two periods of fault slip that form part of a complex fault and fluid-flow history. The Cretaceous result lies within previous indirect estimates for major slip on the fault. The Paleocene–Eocene result coincides with the estimated timing of slip of the nearby Tintina and Denali faults, which are crustal-scale, northwest-striking dextral faults, indicating Big Creek fault reactivation during regional faulting. The coincidence of periods of carbonate-crystallizing fracturing and fluid flow with intervals of seismic, gouge-generating slip supports the fault valve model, where fault strength is mediated by fluid pressures, and fluid emplacement requires seismic pumping in otherwise impermeable aseismic fault zones. The reproducibility of slip periods for distinct fault-generated materials using different decay systems indicates that these methods provide complimentary results and can be reliably applied to date brittle fault slip, opening new opportunities for investigating fault conditions with associated mineralizing fluid events.
Supplemental Material: Extraformational sediment recycling on Mars
Authors: Edgett K.S. , al. et
Published: August 2020

Supplement S1: Background text and figures regarding the formation of plateaus, mesas, and mounds of stratified rock within Martian impact structures. Supplement S2: List of source materials (archival data product identifiers) for Figures 1–19. Supplement S3: Text and figure explaining the methods used for the Alpha Particle X-ray Spectrometer (APXS) analysis of Funda. Supplement S4: Figure presenting a qualitative portrayal of Murray formation colors as a function of stratigraphic position. Supplement S5: Text and figures regarding the sedimentology of the Tumba-Funda and Balombo boulders and the petrology of nonsedimentary pebbles in the Tumba-Funda boulder. Supplement S6: Point cloud data product for the Funda surface relief map produced from four overlapping Mars Hand Lens Imager (MAHLI) images. Supplement S7: Figure showing additional examples of sedimentary rock fragments in the outcrop at Cooperstown.
Premature coronary disease, in-stent restenosis and vascular complications in a young man with Behçet syndrome
Authors: Stein Nathan R , Ramakrishna Satvik , Yeghiazarians Yerem
Published: August 2020

A young man with a history of early-onset coronary disease presented with an ST-elevation myocardial infarction at the age of 38. He subsequently had recurrent in-stent restenosis requiring repeating interventions and ultimately bypass surgery. After 4 years, he presents with systemic symptoms, new skin lesions and a femoral artery pseudoaneurysm. He is diagnosed with Behçet syndrome, a rare systemic vasculitis characterised by the triad of oral aphthous ulcers, genital ulcers and ocular involvement. Behçet is not associated with premature coronary disease but can have a variety of cardiac complications. Additionally, pathergy, an exaggerated inflammatory response to local injury, is characteristic. We hypothesise that in retrospect, subclinical inflammation and a vascular pathergy likely predisposed him to his cardiac and vascular complications. Here, we review risk factors and presentation of premature coronary artery disease and review the literature on the cardiovascular complications of Behçet syndrome.
Elimination ofStaphylococcus aureusfrom the bloodstream using a novel biomimetic sorbent haemoperfusion device
Authors: Seffer Malin-Theres , Eden Gabriele , Engelmann Susanne , Kielstein Jan T
Published: August 2020

Removal of bacteria from the blood by means of extracorporeal techniques has been attempted for decades. In late 2019, the European Union licensed the first ever haemoperfusion device for removal of bacteria from the blood. The active ingredient of Seraph 100 Microbind Affinity Blood Filter is ultrahigh molecular weight polyethylene beads with endpoint-attached heparin. Bacteria have been shown to bind to heparin as they would usually do to the heparan sulfate on the cell surface, thereby being removed from the blood stream. We describe the first case of a female chronic haemodialysis patient in which this device was clinically used for aStaphylococcus aureusinfection that persisted for 4 days despite antibiotic therapy. After a single treatment, the bacterial load decreased and the blood cultures at the end of a 4 hour haemoperfusion exhibited no bacterial growth.
Vasospasm induced myocardial ischaemia secondary to sumatriptan use
Authors: Okonkwo Kenneth , Ojha Utkarsh
Published: August 2020

Certain medications have been implicated in causing acute myocardial infarctions (AMI). Sumatriptan, a medication usually prescribed for acute migraine and cluster headaches has been documented as potentially causing coronary vasospasm, thereby leading to MI. This is usually seen in patients with strong risk factors for coronary artery disease (CAD) or in those with established CAD. Most cases thus far have been reported in patients using the subcutaneous preparation of sumatriptan. Here, we present a case of a patient without prior risk factors for CAD and angiographically unremarkable coronary arteries who presented with evidence of an AMI after oral sumatriptan use for migraines.
Quinidine hypersensitivity: a side effect of a forgotten antiarrhythmic
Authors: El-khatib Layan , Alrayes Hussayn , Sallam Omar , Elbanna Ahmed
Published: August 2020

Quinidine is one of the oldest antiarrhythmics known. Over the years, its use has decreased along with its side effects. Our case describes a 69-year-old woman with recurrent resistant ventricular tachycardia on Quinidine and Amiodarone who presented with acute liver toxicity. Drug-induced liver toxicity was at the top of our differential diagnosis list. Taking multiple factors into consideration, a decision was made to discontinue Quinidine, the patient’s symptoms and lab abnormalities resolved within 1 week, yielding the diagnosis of Quinidine hypersensitivity.
Rehabilitation of a maxillary partial edentulous patient using an implant-supported overdenture retained with two bilateral milled bars
Authors: Almadani Atif Mohammed , Huettig Fabian
Published: August 2020

The use of implants has enabled more treatment options for prosthetic rehabilitation of partially and completely edentulous patients. This clinical report describes a treatment approach for an 80-year-old patient taking advantage of the remaining natural teeth for prosthetic rehabilitation. The final treatment plan included natural tooth-supported and implant-supported crowns combined with a milled bar partial overdenture retained by tilted dental implants. The overdentures supported by the milled bar implants provide the advantages of both fixed and removable restorations. In addition to patient satisfaction, the overdentures also minimise alveolar bone resorption, increase longevity and stability and improve masticatory efficiency.
Disseminated histoplasmosis and tuberculosis: dual infection in a non-endemic region
Authors: Anot Karuna , Sharma Sanjana , Gupta Monica , Kaur Daljinderjit
Published: August 2020

Histoplasmosis is a systemic fungal infection caused byHistoplasma capsulatum,a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive therapy or in solid organ transplant recipients. Tuberculosis and histoplasmosis may cooccur rarely in HIV and the clinical resemblance of both diseases may hinder identification of patients’ harbouring dual infection, especially in regions non-endemic for histoplasmosis. We report a case of disseminated histoplasmosis with disseminated tuberculosis in an incidentally detected patient with HIV-positive who presented with reports of fever and skin rash for 10 days. The Mantoux positivity and CT of chest and abdomen revealing multiple necrotic lymph nodes coupled with bone marrow and skin biopsy divulging histoplasmosis and tuberculosis helped us clinch the concurrent infection.
Prevalence, control, and treatment of diabetes, hypertension, and high cholesterol in the Amish
Authors: He Shisi , Ryan Kathleen A , Streeten Elizabeth A , McArdle Patrick F , Daue Melanie , Trubiano Donna , Rohrer Yvonne , Donnelly Patrick , Drolet Maryann , Newcomer Sylvia , Shaub Susan , Weitzel Nancy , Shuldiner Alan R , Pollin Toni I , Mitchell Braxton D
Published: August 2020

Background

The burden of diabetes and cardiovascular risk is not uniform across the USA, with much of this disparity tracking differences in socioeconomic status, cultural practices and lifestyle. To further evaluate disparities in these disorders, we assessed the prevalence of diabetes, hypertension, and hypercholesterolemia in an Old Order Amish community that is characterized by distinctive sociocultural practices that include a very cohesive social structure and limited use of modern technologies and medications. We compared prevalence of these conditions with that of the overall US population.

Method

We performed a community-wide survey in 5377 Amish individuals aged 18 years and older from the Lancaster County, Pennsylvania, Amish settlement that included a basic physical examination and fasting blood draw during the period 2010–2018. We then compared the prevalence of diabetes, hypertension, and high cholesterol, defined using standard criteria, between the Amish and the European Caucasian subsample of the 2013–2014 US National Health and Nutrition Examination Survey (NHANES).

Results

Prevalence rates for diabetes, hypertension and hypercholesterolemia were 3.3%, 12.7%, and 26.2% in the Amish compared with 13.2%, 37.8% and 35.7% in NHANES (p<0.001 for all). Among individuals with these disorders, Amish were less likely to be aware that they were affected, and among those aware, were less likely to be treated with a medication for their disorder.

Conclusion

There is substantially lower prevalence of diabetes, hypertension and hypercholesterolemia in the Amish compared with non-Amish Caucasians in the USA. Possible factors contributing to this disparity include higher physical activity levels in the Amish or other protective sociocultural factors, a greater understanding of which could inform risk reduction interventions for these chronic diseases.
Maternal caffeine consumption and pregnancy outcomes: a narrative review with implications for advice to mothers and mothers-to-be
Authors: James Jack E.
Published: August 2020

Objectives

Caffeine is a habit-forming substance consumed daily by the majority of pregnant women. Accordingly, it is important that women receive sound evidence-based advice about potential caffeine-related harm. This narrative review examines evidence of association between maternal caffeine consumption and negative pregnancy outcomes, and assesses whether current health advice concerning maternal caffeine consumption is soundly based.

Methods

Database searches using terms linking caffeine and caffeinated beverages to pregnancy outcomes identified 1261 English language peer-reviewed articles. Screening yielded a total of 48 original observational studies and meta-analyses of maternal caffeine consumption published in the past two decades. The articles reported results for one or more of six major categories of negative pregnancy outcomes: miscarriage, stillbirth, low birth weight and/or small for gestational age, preterm birth, childhood acute leukaemia, and childhood overweight and obesity.

Results

Of 42 separate sets of findings reported in 37 observational studies, 32 indicated significantly increased caffeine-related risk and 10 suggested no or inconclusive associations. Caffeine-related increased risk was reported with moderate to high levels of consistency for all pregnancy outcomes except preterm birth. Of 11 studies reporting 17 meta-analyses, there was unanimity among 14 analyses in finding maternal caffeine consumption to be associated with increased risk for the four outcome categories of miscarriage, stillbirth, low birth weight and/or small for gestational age, and childhood acute leukaemia. The three remaining meta-analyses were also unanimous in reporting absence of a reliable association between maternal caffeine consumption and preterm birth. No meta-analyses were identified for childhood overweight and obesity, although four of five original observational studies reported significant associations linking maternal caffeine consumption to that outcome category.

Conclusions

The substantial majority finding from observational studies and meta-analyses is that maternal caffeine consumption is reliably associated with major negative pregnancy outcomes. Reported findings were robust to threats from potential confounding and misclassification. Among both observational studies and meta-analyses, there were frequent reports of significant dose–response associations suggestive of causation, and frequent reports of no threshold of consumption below which associations were absent. Consequently, current evidence does not support health advice that assumes "moderate" caffeine consumption during pregnancy is safe. On the contrary, the cumulative scientific evidence supports pregnant women and women contemplating pregnancy being advised to avoid caffeine.
May lamotrigine be an alternative to topiramate in the prevention of migraine with aura? Results of a retrospective study
Authors: Smeralda Carmelo Luca , Gigli Gian Luigi , Janes Francesco , Valente Mariarosaria
Published: August 2020

Background

Evidence suggests that lamotrigine could be effective in reducing aura frequency and duration. However, studies comparing lamotrigine to other, first-line prophylactic agents solely involving patients suffering from migraine with aura are still lacking. The aim of this study was to compare the efficacy of lamotrigine and topiramate for the preventive treatment of migraine with aura.

Methods

Fifty-three patients suffering from migraine with aura treated with lamotrigine or topiramate for at least 6 months were included. Pre- and post-treatment clinical data regarding monthly aura frequency and duration, monthly migraine frequency, days of headache and rescue medication used per month were collected.

Results

Responder rates were similar between the two treatment groups at 6-month follow-up. Interestingly, responder rates for aura frequency and duration were higher in the lamotrigine group compared with the topiramate group (88% vs 79% and 73% vs 54%). Moreover, 50% of the lamotrigine-treated patients reported a complete disappearance of migraine aura compared with 37% of topiramate-treated patients. Side effects were more frequent in topiramate group compared with lamotrigine group (p=0.004).

Conclusions

Lamotrigine should be considered in clinical practice for the preventive treatment of migraine with aura especially for patients reporting prolonged aura and who do not respond, have contraindications or discontinue topiramate treatment due to side effects.
Burden of adult neurological diseases in Odeda Area, Southwest Nigeria
Authors: Otubogun Folajimi Morenikeji , Akinyemi Rufus , Ogunniyi Sola
Published: August 2020

Background

Few population-based studies have been conducted to determine the burden of neurological diseases in sub-Saharan Africa. A better understanding of the magnitude and impact of these disorders is pivotal to effective planning and provision of neurological services.

Methods

A cross-sectional survey of 2392 adults in Odeda Local Government Area, Ogun State, Southwest Nigeria was conducted between May and June 2015. Trained non-medical interviewers administered a screening instrument designed to measure the prevalence of neurological diseases and disability, while positive responders were subsequently examined by neurologists. Diagnoses were made clinically according to well-established criteria.

Results

The mean age of respondents was 37.2±16.1 years. A total of 842 cases of neurological diseases/disability were diagnosed in 815 individuals (26 individuals with more than one disorder). The all-cause neurological morbidity rate was 352 per 1000, while the crude prevalence rates of common neurological disorders were 304.3 per 1000 for primary headaches, 16.3 per 1000 for tropical ataxic neuropathy, 7.11 per 1000 for stroke, 5.85 per 1000 for essential tremor and 4.18 per 1000 for Parkinson’s disease. Neurological years lost due to disability was 2806.18 per 100 000.

Conclusion

This study provides evidence of a high neurological disease burden within the communities surveyed, which may be representative of Southwest Nigeria. In comparison with findings from previous studies within the same region, this report suggests a persistence of toxiconutritional disorders and postinfectious neurological sequelae on one hand and increased prevalence of non-communicable neurological disorders such as stroke and Parkinson’s disease.
Online contraceptive discussion forums: a qualitative study to explore information provision
Authors: Courtenay Tom , Baraitser Paula
Published: August 2020

Background

Women in the UK spend up to 30 years avoiding pregnancy, and effective use of contraception requires detailed information and support. Online forums offer opportunities to discuss contraception with few restrictions. Analysis of these discussions may generate learning on the information needs and preferences of their users. We analysed contraceptive discussions on forums to explore content, motivation for engaging, behaviours observed and outcomes reported.

Methods

We selected 50 threads across five English-speaking public forums, which contained more than 1000 contraceptive-specific threads. We generated a stratified sample of these threads (n=250) and then completed a qualitative thematic analysis.

Results

Forum users seek urgent help, emotional support and the detailed accounts of others. The work of posting on forums is significant and includes framing the question to generate the desired response type, managing responses and assessing their value. Conversations were consistently framed in relation to healthcare and were important for preparing for, understanding and responding to consultations. Most of the technical information was accurate or corrected within the conversation. For most users this enquiry was part of a broader decision-making process and there was no evidence that users planned to make decisions based on forum discussions alone.

Conclusions

Our analysis has implications for healthcare organisations that offer or signpost to online information on contraception. It suggests that improvements in the online ‘wrap around’ information are needed to help decide when to consult, prepare for the consultation, understand the information given and manage post-consultation questions.
A novel homozygous variant in TRAPPC2L results in a neurodevelopmental disorder and disrupts TRAPP complex function
Authors: Al-deri Noraldin , Okur Volkan , Ahimaz Priyanka , Milev Miroslav , Valivullah Zaheer , Hagen Jacob , Sheng Yufeng , Chung Wendy , Sacher Michael , Ganapathi Mythily
Published: August 2020

Background

Next-generation sequencing has facilitated the diagnosis of neurodevelopmental disorders with variable and non-specific clinical findings. Recently, a homozygous missense p.(Asp37Tyr) variant in TRAPPC2L, a core subunit of TRAPP complexes which function as tethering factors during membrane trafficking, was reported in two unrelated individuals with neurodevelopmental delay, post-infectious encephalopathy-associated developmental arrest, tetraplegia and accompanying rhabdomyolysis.

Methods

We performed whole genome sequencing on members of an Ashkenazi Jewish pedigree to identify the underlying genetic aetiology of global developmental delay/intellectual disability in three affected siblings. To assess the effect of the identified TRAPPC2L variant, we performed biochemical and cell biological functional studies on the TRAPPC2L protein.

Results

A rare homozygous predicted deleterious missense variant, p.(Ala2Gly), in TRAPPC2L was identified in the affected siblings and it segregated with the neurodevelopmental phenotype within the family. Using a yeast two-hybrid assay and in vitro binding, we demonstrate that the p.(Ala2Gly) variant, but not the p.(Asp37Tyr) variant, disrupted the interaction between TRAPPC2L and another core TRAPP protein, TRAPPC6a. Size exclusion chromatography suggested that this variant affects the assembly of TRAPP complexes. Employing two different membrane trafficking assays using fibroblasts from one of the affected siblings, we found a delay in traffic into and out of the Golgi. Similar to the p.(Asp37Tyr) variant, the p.(Ala2Gly) variant resulted in an increase in the levels of active RAB11.

Conclusion

Our data fill in a gap in the knowledge of TRAPP architecture with TRAPPC2L interacting with TRAPPC6a, positioning it as a putative adaptor for other TRAPP subunits. Collectively, our findings support the pathogenicity of the TRAPPC2L p.(Ala2Gly) variant.