bluuebunny/crossref_metadata_2025 huggingface dataset:
Cosmology-insensitive estimate of IGM baryon mass fraction from five localized fast radio bursts
Authors: Li Z , Gao H , Wei J-J , Yang Y-P , Zhang B , Zhu Z-H
Published: May 2020

Five fast radio bursts (FRBs), including three apparently non-repeating ones, FRB 180924, FRB 181112, and FRB 190523, and two repeaters, FRB 121102 and FRB 180916.J0158+65, have already been localized so far. We apply a method developed recently by us to these five localized FRBs to give a cosmology-insensitive estimate of the fraction of baryon mass in the intergalactic medium, fIGM. Using the measured dispersion measure (DM) and luminosity distance dL data (inferred from the FRB redshifts and dL of Type Ia supernovae at the same redshifts) of the five FRBs, we constrain the local $f_{\rm IGM} = 0.84^{+0.16}_{-0.22}$ with no evidence of redshift dependence. This cosmology-insensitive estimate of fIGM from FRB observations is in excellent agreement with previous constraints using other probes. Moreover, using the three apparently non-repeating FRBs only we get a little looser but consistent result: $f_{\rm IGM} = 0.74^{+0.24}_{-0.18}$. In these two cases, reasonable estimations for the host galaxy DM contribution (DMhost) can be achieved by modelling it as a function of star formation rate. The constraints on both fIGM and DMhost are expected to be significantly improved with the rapid progress in localizing FRBs.
HomolWat: a web server tool to incorporate ‘homologous’ water molecules into GPCR structures
Authors: Mayol Eduardo , García-Recio Adrián , Tiemann Johanna K S , Hildebrand Peter W , Guixà-González Ramon , Olivella Mireia , Cordomí Arnau
Published: May 2020

Internal water molecules play an essential role in the structure and function of membrane proteins including G protein-coupled receptors (GPCRs). However, technical limitations severely influence the number and certainty of observed water molecules in 3D structures. This may compromise the accuracy of further structural studies such as docking calculations or molecular dynamics simulations. Here we present HomolWat, a web application for incorporating water molecules into GPCR structures by using template-based modelling of homologous water molecules obtained from high-resolution structures. While there are various tools available to predict the positions of internal waters using energy-based methods, the approach of borrowing lacking water molecules from homologous GPCR structures makes HomolWat unique. The tool can incorporate water molecules into a protein structure in about a minute with around 85% of water recovery. The web server is freely available at http://lmc.uab.es/homolwat.
Identification of a novel nucleolar protein complex required for mitotic chromosome segregation through centromeric accumulation of Aurora B
Authors: Fujimura Akiko , Hayashi Yuki , Kato Kazashi , Kogure Yuichiro , Kameyama Mutsuro , Shimamoto Haruka , Daitoku Hiroaki , Fukamizu Akiyoshi , Hirota Toru , Kimura Keiji
Published: May 2020

The nucleolus is a membrane-less nuclear structure that disassembles when cells undergo mitosis. During mitosis, nucleolar factors are thus released from the nucleolus and dynamically change their subcellular localization; however, their functions remain largely uncharacterised. Here, we found that a nucleolar factor called nucleolar protein 11 (NOL11) forms a protein complex with two tryptophan-aspartic acid (WD) repeat proteins named WD-repeat protein 43 (WDR43) and Cirhin in mitotic cells. This complex, referred to here as the NWC (NOL11-WDR43-Cirhin) complex, exists in nucleoli during interphase and translocates to the periphery of mitotic chromosomes, i.e., perichromosomal regions. During mitotic progression, both the congression of chromosomes to the metaphase plate and sister chromatid cohesion are impaired in the absence of the NWC complex, as it is required for the centromeric enrichment of Aurora B and the associating phosphorylation of histone H3 at threonine 3. These results reveal the characteristics of a novel protein complex consisting of nucleolar proteins, which is required for regulating kinetochores and centromeres to ensure faithful chromosome segregation.
Orthogonal tuning of gene expression noise using CRISPR–Cas
Authors: Wu Fan , Shim Jiyoung , Gong Ting , Tan Cheemeng
Published: May 2020

The control of gene expression noise is important for improving drug treatment and the performance of synthetic biological systems. Previous work has tuned gene expression noise by changing the rate of transcription initiation, mRNA degradation, and mRNA translation. However, these methods are invasive: they require changes to the target genetic components. Here, we create an orthogonal system based on CRISPR-dCas9 to tune gene expression noise. Specifically, we modulate the gene expression noise of a reporter gene in Escherichia coli by incorporating CRISPR activation and repression (CRISPRar) simultaneously in a single cell. The CRISPRar uses a single dCas9 that recognizes two different single guide RNAs (sgRNA). We build a library of sgRNA variants with different expression activation and repression strengths. We find that expression noise and mean of a reporter gene can be tuned independently by CRISPRar. Our results suggest that the expression noise is tuned by the competition between two sgRNAs that modulate the binding of RNA polymerase to promoters. The CRISPRar may change how we tune expression noise at the genomic level. Our work has broad impacts on the study of gene functions, phenotypical heterogeneity, and genetic circuit control.
Crossing the Cervicothoracic Junction During Posterior Cervical Fusion for Myelopathy Is Associated With Superior Radiographic Parameters But Similar Clinical Outcomes
Authors: Chan Andrew K , Badiee Ryan K , Rivera Joshua , Chang Chih-Chang , Robinson Leslie C , Mehra Ratnesh N , Tan Lee A , Clark Aaron J , Dhall Sanjay S , Chou Dean , Mummaneni Praveen V
Published: May 2020

Background

For laminectomy and posterior spinal fusion (LPSF) surgery for cervical spondylotic myelopathy (CSM), the evidence is unclear as to whether fusions should cross the cervicothoracic junction (CTJ).

Objective

To compare LPSF outcomes between those with and without lower instrumented vertebrae (LIV) crossing the CTJ.

Methods

A consecutive series of adults undergoing LPSF for CSM from 2012 to 2018 with a minimum of 12-mo follow-up were identified. LPSF with subaxial upper instrumented vertebrae and LIV between C6 and T2 were included. Clinical and radiographic outcomes were compared.

Results

A total of 79 patients were included: 46 crossed the CTJ (crossed-CTJ) and 33 did not. The mean follow-up was 22.2 mo (minimum: 12 mo). Crossed-CTJ had higher preoperative C2-7 sagittal vertical axis (cSVA) (33.3 ± 16.0 vs 23.8 ± 12.4 mm, P = .01) but similar preoperative cervical lordosis (CL) and CL minus T1-slope (CL minus T1-slope) (P > .05, both comparisons). The overall reoperation rate was 3.8% (crossed-CTJ: 2.2% vs not-crossed: 6.1%, P = .37). In adjusted analyses, crossed-CTJ was associated with superior cSVA (β = –9.7; P = .002), CL (β = 6.2; P = .04), and CL minus T1-slope (β = –6.6; P = .04), but longer operative times (β = 46.3; P = .001). Crossed- and not-crossed CTJ achieved similar postoperative patient-reported outcomes [Visual Analog Scale (VAS) neck pain, VAS arm pain, Nurick Grade, Modified Japanese Orthopedic Association Scale, Neck Disability Index, and EuroQol-5D] in adjusted multivariable analyses (adjusted P > .05). For the entire cohort, higher postoperative CL was associated with lower postoperative arm pain (adjusted Pearson's r –0.1, P = .02). No postoperative cervical radiographic parameters were associated with neck pain (P > .05).

Conclusion

Subaxial LPSF for CSM that crossed the CTJ were associated with superior radiographic outcomes for cSVA, CL, and CL minus T1-slope, but longer operative times. There were no differences in neck pain or reoperation rate.
Optical and X-ray observations of stellar flares on an active M dwarf AD Leonis with the Seimei Telescope, SCAT, NICER, and OISTER
Authors: Namekata Kosuke , Maehara Hiroyuki , Sasaki Ryo , Kawai Hiroki , Notsu Yuta , Kowalski Adam F , Allred Joel C , Iwakiri Wataru , Tsuboi Yohko , Murata Katsuhiro L , Niwano Masafumi , Shiraishi Kazuki , Adachi Ryo , Iida Kota , Oeda Motoki , Honda Satoshi , Tozuka Miyako , Katoh Noriyuki , Onozato Hiroki , Okamoto Soshi , Isogai Keisuke , Kimura Mariko , Kojiguchi Naoto , Wakamatsu Yasuyuki , Tampo Yusuke , Nogami Daisaku , Shibata Kazunari
Published: May 2020

We report on multi-wavelength monitoring observations of an M-dwarf flare star AD Leonis with the Seimei Telescope (6150–7930 Å), SCAT (Spectroscopic Chuo-university Astronomical Telescope; 3700–7500 Å), and NICER (Neutron Star Interior Composition Explorer; 0.2–12.0 keV), with the collaboration of the OISTER (Optical and Infrared Synergetic Telescopes for Education and Research) program. Twelve flares are detected in total, including ten Hα, four X-ray, and four optical-continuum flares; one of them is a superflare with a total energy of ∼2.0 × 1033 erg. We found that: (1) during the superflare, the Hα emission line full width at 1/8 maximum dramatically increases to 14 Å from 8 Å in the low-resolution spectra (R ∼ 2000) accompanied by large white-light flares, (2) some weak Hα/X-ray flares are not accompanied by white-light emissions, and (3) the non-flaring emissions show clear rotational modulations in X-ray and Hα intensity in the same phase. To understand these observational features, one-dimensional hydrodynamic flare simulations are performed using the RADYN code. We find the simulated Hα line profiles with hard and high-energy non-thermal electron beams to be consistent with the initial phase line profiles of the superflares, while those with a softer and/or weak-energy beam are consistent with those in decay phases, indicating the changes in the energy fluxes injected to the lower atmosphere. Also, we find that the relation between the optical continuum and Hα intensity is nonlinear, which can be one cause of the non-white-light flares. The flare energy budget exhibits diversity in the observations and models, and more observations of stellar flares are necessary for constraining the occurrence of various emission line phenomena in stellar flares.
Long-term systemic glucocorticoid therapy and weight gain: a population-based cohort study
Authors: Fardet Laurence , Nazareth Irwin , Petersen Irene
Published: May 2020

Objectives

To describe the variation in weight gain in people chronically exposed to systemic glucocorticoids in primary care and to identify the risk factors for weight gain.

Methods

Data were analysed from the British database, The Health Improvement Network. Body weight variations of individuals prescribed systemic glucocorticoids for at least 3 months at a mean dose ≥10 mg/day were described. The risk factors associated with weight gain ≥10% of the usual weight were assessed.

Results

A total of 31 516 adults prescribed glucocorticoids and 26 967 controls were included in the study. During glucocorticoid exposure, only 12 475 (39.6%) individuals gained >2 kg compared with their usual weight. Younger women were more likely to gain weight (mean weight gain in 18–39-year-old glucocorticoid-exposed women: 3.6 kg (s.d. 8.6) compared with 2 kg (s.d. 7.3) in the control group; the absolute mean difference was 1.6 kg (95% CI 0.9, 2.2; P < 0.001). Weight gain ≥10% of the usual weight was observed in 10.2% (n = 3208) of those chronically exposed to glucocorticoids. Women, younger people, those living in areas of higher deprivation, smokers, those on higher doses of the drug and those previously exposed to glucocorticoids were at higher risk. The risk was lower in people prescribed glucocorticoids for an inflammatory condition when compared with asthma or chronic obstructive pulmonary disease.

Conclusion

After taking into account usual weight rather than weight just before glucocorticoid initiation and the natural history of weight variation, the amount of weight gain induced by systemic glucocorticoids as prescribed in primary care is less than usually thought.

Clinical trial registration

18THIN081.
Understanding heterosexual women’s erotic flexibility: the role of attention in sexual evaluations and neural responses to sexual stimuli
Authors: Dickenson Janna A , Diamond Lisa , King Jace B , Jenson Kay , Anderson Jeffrey S
Published: May 2020

Many women experience desires, arousal and behavior that run counter to their sexual orientation (orientation inconsistent, ‘OI’). Are such OI sexual experiences cognitively and neurobiologically distinct from those that are consistent with one’s sexual orientation (orientation consistent, ‘OC’)? To address this question, we employed a mindful attention intervention—aimed at reducing judgment and enhancing somatosensory attention—to examine the underlying attentional and neurobiological processes of OC and OI sexual stimuli among predominantly heterosexual women. Women exhibited greater neural activity in response to OC, compared to OI, sexual stimuli in regions associated with implicit visual processing, volitional appraisal and attention. In contrast, women exhibited greater neural activity to OI, relative to OC, sexual stimuli in regions associated with complex visual processing and attentional shifting. Mindfully attending to OC sexual stimuli reduced distraction, amplified women’s evaluations of OC stimuli as sexually arousing and deactivated the superior cerebellum. In contrast, mindfully attending to OI sexual stimuli amplified distraction, decreased women’s evaluations of OI stimuli as sexually arousing and augmented parietal and temporo-occipital activity. Results of the current study constrain hypotheses of female erotic flexibility, suggesting that sexual orientation may be maintained by differences in attentional processing that cannot be voluntarily altered.
Systemic inflammation is associated with differential neural reactivity and connectivity to affective images
Authors: Alvarez Gabriella M , Hackman Daniel A , Miller Adam Bryant , Muscatell Keely A
Published: May 2020

Systemic inflammation is increasingly appreciated as a predictor of health and well-being. Further, inflammation has been shown to influence and be influenced by affective experiences. Although prior work has substantiated associations between inflammatory and affective processes, fewer studies have investigated the neurobiological correlates that underlie links between systemic, low-grade inflammation and affective reactivity. Thus, the current study examined whether markers of systemic inflammation (i.e. interleukin-6, C-reactive protein) are associated with differential patterns of neural activation and connectivity in corticolimbic regions in response to affective images. We investigated this question in a sample of 66 adults (44 women, M age = 54.98 years, range = 35–76) from the Midlife in the United States study. Higher levels of inflammation were associated with lower activity in limbic regions (i.e. amygdala, hippocampus, anterior insula, temporal pole) when viewing positive (vs neutral) images. Higher levels of inflammation were also associated with greater connectivity between the hippocampus and the medial prefrontal cortex in response to positive images. Inflammatory markers were not associated with significant differences in activation or connectivity to negative images. These findings highlight the utility of health neuroscience approaches in demonstrating that physiological processes such as inflammation are related to how our brains respond to affective information.
Standardized Natural Citrus Extract dietary supplementation influences sows’ microbiota, welfare, and preweaning piglets’ performances in commercial rearing conditions
Authors: Cisse Sekhou , Benarbia Mohammed El Amine , Burel Anne , Friedrich Marie , Gabinaud Beatrice , Belz Éric , Guilet David , Chicoteau Pierre , Zemb Olivier
Published: May 2020

We investigated the effect of the Standardized Natural Citrus Extract (SNCE; Nor-Spice AB, Nor-Feed SAS, France) on the microbiota of the sows and on the weight gain of their piglets. Fifty sows were randomly divided into two groups: a control group (23 sows) with a standard diet and a SNCE group (27 sows) with a standard diet supplemented with 2,500 ppm of SNCE. Supplementation occurred 10 d before and 5 d after farrowing. Fecal samples from 16 sows (8 randomly selected sows of each dietary treatment) were collected for the fecal microbiota analysis 5 d after farrowing. The supplementation of SNCE increases the amount of cultivable Lactobacillus threefold in vitro. Microbial DNA was extracted from the fecal samples for sequencing of the 16S rRNA gene. The SNCE, which affected the microbiota as a discriminant analysis, was able to separate the microbial communities of the eight sows that received SNCE from the three control sows with 21 Operational Taxonomic Units (area under the ROC curve = 96%). SNCE also reduced the interval between farrowing and the first dejection of the sow and increased their feed intake (P-value < 0.05). Furthermore, feeding the sows with SNCE improved the weight gain of the piglets in the first week of life. These results show that SNCE supplementation allows to enhance zootechnical performances of peripartum’ sows, possibly due to the modulation of the microbiota transmitted to the piglets.
The role of genetic sequencing and analysis in the polio eradication programme
Authors: Jorgensen David , Pons-Salort Margarita , Shaw Alexander G , Grassly Nicholas C
Published: May 2020

Genetic sequencing of polioviruses detected through clinical and environmental surveillance is used to confirm detection, identify their likely origin, track geographic patterns of spread, and determine the appropriate vaccination response. The critical importance of genetic sequencing and analysis to the Global Polio Eradication Initiative has grown with the increasing incidence of vaccine-derived poliovirus (VDPV) infections in Africa specifically (470 reported cases in 2019), and globally, alongside persistent transmission of serotype 1 wild-type poliovirus in Pakistan and Afghanistan (197 reported cases in 2019). Adapting what has been learned about the virus genetics and evolution to address these threats has been a major focus of recent work. Here, we review how phylogenetic and phylogeographic methods have been used to trace the spread of wild-type polioviruses and identify the likely origins of VDPVs. We highlight the analysis methods and sequencing technology currently used and the potential for new technologies to speed up poliovirus detection and the interpretation of genetic data. At a pivotal point in the eradication campaign with the threat of anti-vaccine sentiment and donor and public fatigue, innovation is critical to maintain drive and overcome the last remaining circulating virus.
Adaptation of turnip mosaic potyvirus to a specific niche reduces its genetic and environmental robustness
Authors: Butković Anamarija , González Rubén , Cobo Inés , Elena Santiago F
Published: May 2020

Robustness is the preservation of the phenotype in the face of genetic and environmental perturbations. It has been argued that robustness must be an essential fitness component of RNA viruses owed to their small and compacted genomes, high mutation rates and living in ever-changing environmental conditions. Given that genetic robustness might hamper possible beneficial mutations, it has been suggested that genetic robustness can only evolve as a side-effect of the evolution of robustness mechanisms specific to cope with environmental perturbations, a theory known as plastogenetic congruence. However, empirical evidences from different viral systems are contradictory. To test how adaptation to a particular environment affects both environmental and genetic robustness, we have used two strains of turnip mosaic potyvirus (TuMV) that differ in their degree of adaptation to Arabidopsis thaliana at a permissive temperature. We show that the highly adapted strain is strongly sensitive to the effect of random mutations and to changes in temperature conditions. In contrast, the non-adapted strain shows more robustness against both the accumulation of random mutations and drastic changes in temperature conditions. Together, these results are consistent with the predictions of the plastogenetic congruence theory, suggesting that genetic and environmental robustnesses may be two sides of the same coin for TuMV.
Developing an Elective on Spirituality for the BSN Curriculum
Authors: Hutchison Lynne M.
Published: May 2020

When a curriculum evaluation of a BSN program at a public university revealed a content gap on spirituality and spiritual assessment, faculty developed an elective covering a nurse's role in spiritual care and assessment of patients. The resulting 300-level course was of hybrid design and received positive evaluation from students after implementation.
Missing the Mark: The State of Health Care Literacy in Plastic Surgery
Authors: Barton Natalie , Janis Jeffrey E.
Published: May 2020

Background:

The Institute of Medicine defines health literacy as the degree to which individuals have the capacity to obtain, process, and understand basic health information. Low health literacy is at a crisis level in the United States. Health literacy is a stronger predictor of a person’s health than age, income, employment status, education level, and race. In the plastic surgery literature to date, there is no study that evaluates health communication between plastic surgery patients and providers. This study also aims to establish the readability of the American Society of Plastic Surgeons informed consent forms.

Methods:

A survey instrument was designed to assess health literacy of plastic surgery patient and health communication competencies of providers. The Readability Calculator and Hemingway Editor were used to determine the readability of a sample of the American Society of Plastic Surgeons informed consent forms.

Results:

Twenty-one percent of patients did not complete high school. Fifty-one percent of patients agreed that better communication with their provider would improve their health. Seventy-six percent of providers agreed that they have difficulty communicating with patients with different cultural backgrounds; 29% of providers stated that they offered patients low-literacy educational material. The average readability of the informed consents distributed to plastic surgery patients is above 12th grade.

Conclusions:

This study identifies the gap in communication between plastic surgery patients and providers in a county hospital setting. Failure to take appropriate actions toward eliminating inherent barriers in health communication is costly to both the hospital and the patients. These findings also raise concern about the understanding of informed consent in plastic surgery patients.
Measuring LDL-cholesterol: what is the best way to do it?
Authors: Wolska Anna , Remaley Alan T.
Published: May 2020

Purpose of review

Cholesterol on low-density lipoproteins (LDL-C) is one of the main drivers of atherosclerotic cardiovascular disease (ASCVD) and hence its measurement is critical in the management of patients at risk. Although LDL-C has routinely been either calculated by the Friedewald equation or measured with direct assays, these methods have limitations, particularly for patients with dyslipidaemias, low LDL-C, and hypertriglyceridemia. The focus of this review will be recent advances in the measurement of LDL for ASCVD risk management.

Recent findings

We first describe the recent recommendations on how LDL-C is used in ASCVD risk assessment and management. We then review the current approaches to the measurement of LDL-C and recent developments on new more accurate equations for calculating LDL-C. Finally, we present new and emerging LDL assays that may be superior to LDL-C for risk assessment, such as LDL particle number and small dense LDL-C, and several LDL-based lipid tests in early development.

LDL-C is valuable in ASCVD risk management but recent improvements in its measurement and the development of other LDL-related tests may further improve its value.
Sacroilitis in Preschool Children: A Case Series and Review of the Literature
Authors: Alcobendas Rosa María , Loza Sara Murias , Camba Agustín Remesal , Gascon Clara Udaondo , Rey Cristina Calvo
Published: May 2020

Pyogenic sacroilitis is an infrequent osteoarticular infection, and its diagnosis is a challenge in young children. A series of 20 cases is described. The median age was 15 months, 75% of them being under 2 years old. Fourteen (70%) reported fever. Refusal to sit was the main reason for consultation. Final diagnosis was confirmed by bone scintigraphy. All patients achieved a complete resolution without sequelae.
Clinical Analysis of 25 COVID-19 Infections in Children
Authors: Bai Ke , Liu Wenjun , Liu Chengjun , Fu Yueqiang , Hu Jun , Qin Yanran , Zhang Qiaoying , Chen Hongyan , Xu Feng , Li Changda
Published: May 2020

Background:

To describe the characteristics of clinical manifestations of children with 2019 novel coronavirus (2019-nCoV) infection in Chongqing.

Methods:

All 25 children with laboratory-confirmed 2019-nCoV infection by real-time reverse transcription-PCR (RNA-PCR) were admitted from the 4 designated treatment hospitals of 2019-nCoV in Chongqing from January 19 to March 12, 2020. Clinical data and epidemiologic history of these patients were retrospectively collected and analyzed.

Results:

The diagnosis was confirmed through RNA-PCR testing. Among the 25 cases, 14 were males and 11 were females. The median age was 11.0 (6.3–14.5) years (range 0.6–17.0 years). All children were related to a family cluster outbreak, and 7 children (28%) with a travel or residence history in Hubei Province. These patients could be categorized into different clinical types, including 8 (32%) asymptomatic, 4 (16%) very mild cases and 13 (52%) common cases. No severe or critical cases were identified. The most common symptoms were cough (13 cases, 52%) and fever (6 cases, 24%). The duration time of clinical symptoms was 13.0 (8.0–25.0) days. In the 25 cases, on admission, 21 cases (84%) had normal white blood cell counts, while only 2 cases (8%) more than 10 × 109/L and 2 cases (8%) less than 4 × 109/L, respectively; 22 cases(88%) had normal CD4+ T lymphocyte counts, while in the remaining 3 cases(8%) this increased mildly; 23 cases had normal CD8+ T lymphocyte counts, while in the remaining 2 cases (8%) CD8+ T lymphocyte counts were mildly increased as well. All Lymphocyte counts were normal. There were no statistical differences of lab results between the groups of asymptomatic cases, mild cases and common cases. There were only 13 cases with abnormal CT imaging, most of which were located in the subpleural area of the bottom of the lung. All patients were treated with interferon, 6 cases combined with Ribavirin, and 12 cases combined with lopinavir or ritonavir. The days from onset to RNA turning negative was 15.20 ± 6.54 days. There was no significant difference of RNA turning negative between the groups of interferon, interferon plus ribavirin and interferon plus lopinavir or ritonavir treatment. All the cases recovered and were discharged from hospital.

Conclusions:

The morbidity of 2019-nCoV infection in children is lower than in adults and the clinical manifestations and inflammatory biomarkers in children are nonspecific and milder than that in adults. RNA-PCR test is still the most reliable diagnostic method, especially for asymptomatic patients.
Pain can be conditioned to voluntary movements through associative learning: an experimental study in healthy participants
Authors: Alaiti Rafael Krasic , Zuccolo Pedro Fonseca , Hunziker Maria Helena Leite , Caneiro J.P. , Vlaeyen Johan W.S. , Fernandes da Costa Marcelo
Published: May 2020

Experimental data suggest that associative learning can influence defensive avoidance behavior and pain perception in humans. However, whether voluntary movements can become conditioned stimuli (CSs) and influence pain responses is yet to be evaluated. Forty healthy volunteers participated in this study. Electrocutaneous stimuli applied to the shoulder at pain threshold level (UStest) and at pain tolerance level (US) were determined before a movement-conditioning paradigm. First, reaching movements to visual cues shown on one side of a computer screen were associated with the US (CS+ movements) on 80% of trials, whereas reaching movements to visual stimuli shown on the other side were never associated with the nociceptive-US (CS− movements). Next, participants underwent a test phase in which movements to visual cues on both sides were paired with the UStest on 50% of trials. During the test phase, participants were asked to evaluate whether the movement was painful (yes/no) and to rate pain intensity after each trial. Movement onset and duration as well as skin conductance responses were collected. The UStest stimuli were more likely to be perceived as painful and were also rated as more painful during CS+ movements. Movement onset latency and skin conductance responses were significantly higher in anticipation of the CS+ movement as compared to the CS− movement. These findings suggest that pain can be conditioned to voluntary movements.
Health Risk Behavior Profile of Construction Workers, 32 States, 2013 to 2016
Authors: Boal Winifred L. , Li Jia , Dong Xiuwen Sue , Sussell Aaron
Published: May 2020

Background:

Research has suggested that several health risk behaviors were more prevalent among construction workers than among the general workforce.

Methods:

The prevalences of six health risk behaviors among construction workers were compared with workers in other industries using data from 32 states in the 2013 to 2016 Behavioral Risk Factor Surveillance System (BRFSS).

Results:

Smoking, smokeless tobacco use, binge drinking, no leisure-time physical activity, and not always using a seatbelt were significantly more prevalent (P < 0.001), and short sleep significantly less prevalent (P < 0.05), for all construction workers combined compared with workers in other industries. Prevalences varied substantially for all six health risk behaviors by construction occupation.

Conclusions:

Due to the high prevalence of some health risk behaviors, construction workers may benefit from interventions to reduce these behaviors, particularly since they are also potentially exposed to workplace hazards.
Unfractionated Heparin Versus Subcutaneous Nadroparin in Adults Supported With Venovenous Extracorporeal Membrane Oxygenation: a Retrospective, Multicenter Study
Authors: Piwowarczyk Paweł , Borys Michał , Kutnik Paweł , Szczukocka Marta , Sysiak-Sławecka Justyna , Szułdrzyński Konstanty , Ligowski Marcin , Drobiński Dominik , Czarnik Tomasz , Czuczwar Mirosław
Published: May 2020

Extracorporeal membrane oxygenation (ECMO) requires constant management of coagulation. Whereas unfractionated heparin remains the anticoagulant of choice, experienced centers report high bleeding rates. Biocompatibility of the extracorporeal circuit enables management of anticoagulation with subcutaneous low-molecular-weight heparins only. The aim of this study was to evaluate the safety and feasibility of anticoagulation with subcutaneous nadroparin compared with unfractionated heparin during respiratory ECMO in patients. We assessed for thrombotic complications and number of bleeding and life-threatening bleeding events. Additionally, we evaluated the change in resistance to flow in the oxygenator and the number of transfused blood products. Nadroparin and unfractionated heparin were comparable in terms of number of bleeding (34 vs. 53%; p = 0.12), life-threatening bleeding (2.8 vs. 9.3%; p = 0.26) events, and daily red blood cell transfusion rates (0.79 units/patient/day vs. 0.71 units/patient/day in nadroparin group; p = 0.87) during respiratory ECMO. The relative change in resistance to flow in the oxygenator was similar between groups (8.03 vs. 11.6%; p = 0.27). Nadroparin seemed equivalent to unfractionated heparin in the number of thrombotic and hemorrhagic events as well as in the daily red blood cell transfusion rates during venovenus-ECMO.
What Really Matters? Understanding Quality of Life Determinants Impacting Ventricular Assist Device Stakeholders
Authors: Ko Keum Hee Kimmi , Straker Karla , Dunn Jessica Lea , Wrigley Cara
Published: May 2020

Through the examination of digital channels, this study explores the determinants impacting the quality of life (QoL) of ventricular assist devices (VAD) stakeholders. Using nonparticipant online ethnography and qualitative content analysis, data were collected from 56 digital channels (Facebook, blogs, Forum, Instagram, YouTube, and podcasts) designed for VAD stakeholders. Data were classified across existing domains of QoL determinants to identify 12 new QoL determinants which address VAD stakeholders’ specific needs. Inter-relationships between each stakeholder group’s QoL determinants were also identified and explored through the VAD stakeholder QoL framework. This framework provides a holistic approach to the assessment of QoL by considering that QoL determinants are inter-related between stakeholder groups, whereby factors affecting a QoL determinant of one stakeholder can positively or negatively impact the same or other QoL determinants of other stakeholders. Further qualitative and longitudinal research with a focus on the various stages of the VAD patient journey is required to confirm our findings of QoL determinants and inter-relationship between VAD stakeholders from a holistic point of view and explore opportunities to support the QoL of all VAD stakeholders.
Validation of the Rossmax AC1000f upper-arm blood pressure monitor in adults according to the British Hypertension Society Protocol
Authors: Huang Jian-Feng , Li Yan , Wang Ji-Guang
Published: May 2020

Objective

To evaluate the accuracy of the Rossmax AC1000f oscillometric upper-arm blood pressure monitor in adults according to the British Hypertension Society Protocol.

Method

Eighty-five subjects (male 42 and female 43) with a mean age of 48.1 years were recruited to fulfill the blood pressure distribution criteria of the British Hypertension Society Protocol in general population using the same arm sequential blood pressure measurement method. For each subject, we sequentially measured blood pressure using a mercury sphygmomanometer (two observers) and the AC1000f device (one supervisor). Data analysis was carried out according to the British Hypertension Society Protocol.

Results

A total of 255 comparison pairs were obtained for analysis. The device achieved grade A. The percentage of blood pressure differences within 5, 10 and 15 mmHg was 66.7, 92.2 and 98.0%, respectively, for SBP, and 64.7, 90.2 and 98.4%, respectively, for DBP. The average (±SD) of the device-observer differences was −0.5 ± 6.0 mmHg for SBP and −1.4 ± 5.9 mmHg for DBP, respectively.

Conclusion

The automated upper-arm blood pressure monitor Rossmax AC1000f has passed the requirements of the British Hypertension Society Protocol, and hence can be recommended for blood pressure measurement in adults.
Disparities in Biomarkers for Patients With Diabetes After the Affordable Care Act
Authors: Marino Miguel , Angier Heather , Fankhauser Katie , Valenzuela Steele , Hoopes Megan , Heintzman John , DeVoe Jennifer , Moreno Laura , Huguet Nathalie
Published: May 2020

Background:

Racial and ethnic minorities are disproportionately affected by diabetes and at greater risk of experiencing poor diabetes-related outcomes compared with non-Hispanic whites. The Affordable Care Act (ACA) was implemented to increase health insurance coverage and reduce health disparities.

Objective:

Assess changes in diabetes-associated biomarkers [hemoglobin A1c (HbA1c) and low-density lipoprotein] 24 months pre-ACA to 24 months post-ACA Medicaid expansion by race/ethnicity and insurance group.

Research Design:

Retrospective cohort study of community health center (CHC) patients.

Subjects:

Patients aged 19–64 with diabetes living in 1 of 10 Medicaid expansion states with ≥1 CHC visit and ≥1 HbA1c measurement in both the pre-ACA and the post-ACA time periods (N=13,342).

Methods:

Linear mixed effects and Cox regression modeled outcome measures.

Results:

Overall, 33.5% of patients were non-Hispanic white, 51.2% Hispanic, and 15.3% non-Hispanic black. Newly insured Hispanics and non-Hispanic whites post-ACA exhibited modest reductions in HbA1c levels, similar benefit was not observed among non-Hispanic black patients. The largest reduction was among newly insured Hispanics versus newly insured non-Hispanic whites (P<0.05). For the subset of patients who had uncontrolled HbA1c (HbA1c≥9%) within 3 months of the ACA Medicaid expansion, non-Hispanic black patients who were newly insured gained the highest rate of controlled HbA1c (hazard ratio=2.27; 95% confidence interval, 1.10–4.66) relative to the continuously insured group.

Conclusions:

The impact of the ACA Medicaid expansion on health disparities is multifaceted and may differ across racial/ethnic groups. This study highlights the importance of CHCs for the health of minority populations.
Developing a New Version of the SF-6D Health State Classification System From the SF-36v2: SF-6Dv2
Authors: Brazier John E. , Mulhern Brendan J. , Bjorner Jakob B. , Gandek Barbara , Rowen Donna , Alonso Jordi , Vilagut Gemma , Ware John E.
Published: May 2020

Objective:

The objective of this study was to develop the classification system for version of the SF-6D (SF-6Dv2) from the SF-36v2. SF-6Dv2 is an improved version of SF-6D, one of the most widely used generic measures of health for the calculation of quality-adjusted life years.

Study Design and Setting:

A 3-step process was undertaken to generate a new classification system: (1) factor analysis to establish dimensionality; (2) Rasch analysis to understand item performance; and (3) tests of differential item function. To evaluate robustness, Rasch analyses were performed in multiple subsets of 2 large cross-sectional datasets from recently discharged hospital patients and online patient samples.

Results:

On the basis of factor analysis, other psychometric evidence, cross-cultural considerations, and amenability to valuation, the 6-dimension classification used in SF-6D was maintained. SF-6Dv2 resulted in the following modifications to SF-6D: a simpler classification of physical function with clearer separation between levels; a more detailed 5-level description of role limitations; using negative wording to describe vitality; and using pain severity rather than pain interference.

Conclusions:

The SF-6Dv2 classification system describes more distinct levels of health than SF-6D, changes the descriptions used for a number of dimensions and provides clearer wording for health state valuation. The second stage of the study has developed a utility value set using discrete choice methods so that the measure can be used in health technology assessment. Further work should investigate the psychometric characteristics of the new instrument.
Improvement of diagnostic accuracy of 18fluorine-fluorodeoxyglucose PET/computed tomography in detection of infective endocarditis using a 72-h low carbs protocol
Authors: Gazzilli Maria , Albano Domenico , Durmo Rexhep , Cerudelli Elisabetta , Mesquita Tinoco Claudio , Bertagna Francesco , Giubbini Raffaele
Published: May 2020

Background

The major challenge in diagnosing infective endocarditis using 18fluorine-fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) is the high physiological myocardial 18F-FDG uptake, which may interfere with the detection of pathological uptake. Our aim was to retrospectively analyse the impact of a low-carbohydrate, high-protein, high-fat (LCHPHF) diet starting 72 h before the examination with classic overnight fasting.

Methods

We included 92 patients (51 with LCHPHF diet 72 h before the examination and 41 with overnight fast only). Left ventricular (LV) myocardial 18F-FDG uptake was visually evaluated, to estimate the effect of LCHPHF on myocardial 18F-FDG uptake, we used a three-point visual scale: 0, negligible uptake and evaluable examination; 1, mild uptake and doubtful examination and 2, intense uptake and not evaluable examination. SUVmax and SUVmean were calculated putting a region of interest on LV myocardium at the level of the largest cardiac footprint and on the site of suspected lesion. Thus, a ratio between SUV of the suspect lesion and SUV of LV was calculated as SUV ratio.

Results

By visual assessment, in LCHPHF diet group 46 patients (96.1%) had score 0, 3 patients (5.9%) had score 1 and nobody had score 2. In control group, 23 patients (56.1%) had a score 2, 12 (29.3%) patients obtained a score 1 with a doubtful examination and 6 patients (14.6%) were classified with a score 0 with reportable examination.

Conclusion

We demonstrated that an LCHPHF diet can adequately suppress the physiological myocardial uptake leading to a significant improvement in the interpretability and diagnostic accuracy of 18F-FDG PET/CT in infective endocarditis.
Incidence and Sequelae of Liver Injury Among Children Treated for Solid Tumors
Authors: Cardenas Vanessa , Mankuzhy Nikhil , Mody Rajen , McCaffery Harlan , Fontana Robert J. , DiPaola Frank
Published: May 2020

Objectives:

Pediatric oncology patients are at risk of adverse drug events. The incidence and etiologies of liver injury in this population are not well characterized. We utilized a large, single‐center pediatric oncology registry to investigate the incidence, causes, and outcomes of liver injury during treatment for solid tumor malignancies.

Methods:

We reviewed all young individuals (age <25 years) who received treatment for any solid tumor at the University of Michigan between January 2004 and July 2016. Subjects with liver injury meeting predetermined laboratory criteria were identified. Cases were independently reviewed by 2 expert hepatologists to assign a cause of liver injury. Clinical characteristics of drug‐induced liver injury (DILI) and non‐DILI cases were compared. Cases of liver injury occurring after bone marrow or liver transplant were excluded.

Results:

Of 1136 solid tumor patients, 160 (14%) experienced liver injury, and the overall frequency of DILI was 4%. DILI was the leading identified cause of liver injury (31%), followed by infection (17%), metastatic/malignant biliary disease (13%), and perioperative liver injury (13%). Most DILI cases (>90%) were mild acute hepatocellular injury episodes that did not result in modification to the chemotherapy plan, and all DILI eventually resolved. Severe presentations involving jaundice and/or prolonged hospital course were significantly more common among non‐DILI versus DILI cases (23% vs 2%, P < 0.001).

Conclusions:

DILI is the leading cause of liver injury events among pediatric solid tumor patients. In our registry, DILI was of mild severity and did not result in an alteration of the treatment plan in most patients. In contrast, non‐DILI‐related liver injury events, including infection, were more likely to have a more severe presentation and a complicated course with a greater mortality during follow‐up.
Emotional Wellbeing in Parents of Children on Home Parenteral Nutrition
Authors: Halsey Mary , Hodgson Kate , Russell Rachel , Campion Anna , Machado Catarina , Beattie Robert M. , Batra Akshay
Published: May 2020

Objectives:

Caring for a child on home parenteral nutrition (HPN) is stressful, and its emotional impact not fully appreciated. This study explored the emotional wellbeing and coping styles of parents and children on HPN.

Methods:

Questionnaire data were collected for parents of children (0–18 years) on HPN. Children 8 years and older completed the revised children's anxiety and depression scale. Parents completed the Hospital Anxiety and Depression Scale, Paediatric Inventory for Parents (PIP) and brief COPE.

Results:

A total of 14 children were included, 20 parents (13 females) and 4 children completed the survey. Parents had mean PIP difficulty and frequency score of 117.9 and 124, respectively, higher compared to parents of children with other chronic illness. PIP scores were significantly higher where children were also enterally tube fed (P < 0.05). Thirty‐five per cent parents scored above clinical threshold on anxiety subscale of Hospital Anxiety and Depression Scale and 30% in borderline range. On depression subscale 15% scored above clinical threshold range and 15% in borderline range. Mean anxiety and depression scores in parents of children with short bowel syndrome (11.8, 7.8) were significantly higher than those with neuromuscular disease (5.8, 1.6) P < 0.05. Coping styles differed according to health condition and whether child was enterally fed.

Conclusions:

There is a significant emotional impact of caring for a child on HPN, assessment and treatment of anxiety, depression, and stress should be a routine part of care. Individual needs of the child and parent need to be taken into account in providing the most appropriate psychological support.
Role of Budesonide for the Treatment of Rejection in Pediatric Liver Transplantation
Authors: Chen Justin , Ferreira Johanna , Martinez Mercedes , Lobritto Steven , Goldner Dana , Vittorio Jennifer
Published: May 2020

Introduction:

Corticosteroids are an integral part of liver transplant (LT) immunosuppression regimens but are often accompanied by many adverse effects. Budesonide is an oral corticosteroid with extensive (80%–90%) hepatic first‐pass metabolism and minimal systemic absorption. The aim of this study was to examine the safety and efficacy of budesonide for management of acute cellular rejection (ACR) in pediatric LT recipients.

Methods:

A retrospective descriptive analysis was performed for all pediatric patients who underwent LT at our center and were prescribed oral budesonide for the treatment of ACR. Alanine aminotransferase (ALT) values and documented adverse effects were reviewed.

Results:

Twenty‐nine patients were prescribed budesonide for the treatment of ACR; 65.5% with biopsy‐proven acute rejection and 34.5% with presumed ACR. There was a significant decrease in ALT noted from the time of rejection when compared to values 1 month (P = 0.0011), 3 months (P = 0.0003), and 6 months (P = 0.0001) after treatment with budesonide. There was no difference noted between patient baseline ALT levels before rejection when compared to 1, 3, and 6 months posttreatment values suggesting resolution of rejection. Three patients required conversion from budesonide to systemic steroids. There were no discontinuations of budesonide secondary to adverse effects.

Conclusion:

Oral budesonide may be a promising alternative to systemic corticosteroids for the management of mild/moderate ACR and for empiric treatment of ACR in select pediatric LT recipients. Data from this study may provide the foundation for larger, prospective, multicenter trials to assess the effectiveness of budesonide in the treatment of ACR.