bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of calcifediol supplementation on markers of chronic kidney disease‐mineral and bone disorder in dogs with chronic kidney disease
Authors: Parker Valerie J. , Rudinsky Adam J. , Benedict Jason A. , Beizaei Azadeh , Chew Dennis J.
Published: October 2020

Background

Chronic kidney disease‐mineral and bone disorder (CKD‐MBD) in dogs is associated with hypovitaminosis D, increased parathyroid hormone (PTH), and increased fibroblast growth factor‐23 (FGF‐23) concentrations. Best practice for vitamin D metabolite supplementation in CKD‐MBD remains unknown.

Objective

To provide an extended‐release calcifediol supplement to dogs with CKD and to measure its effects on variables indicative of CKD‐MBD.

Animals

Ten dogs with International Renal Interest Society stages 2 and 3 CKD.

Methods

In a prospective study, dogs received a calcifediol supplement for 84 days. Serum 25‐hydroxyvitamin D (25[OH]D), 1,25‐dihydroxyvitamin D (1,25[OH]2D), 24,25‐dihydroxyvitamin D (24,25[OH]2D), creatinine, calcium, phosphorus, PTH, plasma FGF‐23 concentrations, and urine profiles were measured monthly during supplementation. Urine calcium to creatinine (UCa/Cr) ratios and fractional excretion of calcium, phosphorus, and sodium were determined.

Results

All serum vitamin D metabolite concentrations increased significantly by day 84 (P < .001): [25(OH)D (median 249.9 ng/mL; range, 149.7‐469.9 ng/mL) compared to baseline (median 50.2 ng/mL; range, 31.3‐66.0 ng/mL); 1,25(OH)2D (median 66.1 pg/mL; range, 56.9‐88.1 pg/mL) compared to baseline (median 37.3 pg/mL; range, 29.3‐56.7 pg/mL); 24,25(OH)2D (median 81.4 ng/mL; range, 22.1‐151.7 ng/mL) compared to baseline (median 15.4 ng/mL; range, 6.9‐40.6 ng/mL)]. There were no significant differences in calcium, phosphorus, PTH concentrations, UCa/Cr or fractional excretion of calcium. No dog developed ionized hypercalcemia. Plasma FGF‐23 concentrations increased by day 84 (median 1219 pg/mL; range, 229‐8824 pg/mL) compared to baseline (median 798 pg/mL; range, 103‐4.145 pg/mL) (P < .01).

Conclusions and Clinical Importance

Calcifediol supplementation for 84 days was well‐tolerated in dogs with IRIS stages 2 and 3 CKD. It remains to be determined how long‐term supplementation would affect CKD progression and QOL.
Pharmacokinetics of doxycycline after oral administration of multiple doses in dogs
Authors: De Lucas Jose Julio , Rodríguez Casilda , San Andrés Maria Dolores , Sainz Angel , Villaescusa Alejandra , García‐Sancho Mercedes , Rodríguez‐Franco Fernando , San Andrés Manuel I.
Published: October 2020

The aim of this study was to determine the pharmacokinetic parameters of doxycycline in dogs and assess the efficacy of an oral drug dosage regimen of 10 mg/kg daily for 28 days through Pharmacokinetic/Pharmacodynamic (PK/PD) target analysis based on Monte Carlo simulation, using previously published data for the zoonotic pathogen Staphylococcus pseudintermedius. After a multiple‐dosage regimen, the accumulation index was 1.88 ± 0.82. The Cmaxss and Cminss values were 5.18 ± 1.81 µg/ml and 1.91 ± 1.35 µg/ml, respectively. There were statistically significant differences for Cmax, Cmin at 24 hr, MRTt, AUCt and AUC∞ between days 1 and 28. The Cminss value was over the MIC of the principal pathogens, and Cmaxss was higher than the resistance values (>2 μg/ml). For AUC/MIC indices of 12, 25 and 40, the cumulative fraction responses (CFR) were 94.01%, 69.55% and 60.86%, respectively; for an MIC value of 2 µg/ml, the corresponding probability of target attainment (PTA) was 99.94%, 84.78% and 45.16%, respectively. Doxycycline was used against numerous localized infections in different organs and tissues. For the strains with MIC < 1 μg/mL, PTA was close to 100%, even for the most demanding ones, specifically 94.98% for an index of 40% and 99.9% for an index of 25.
Hybridization, polyploidy and clonality influence geographic patterns of diversity and salt tolerance in the model halophyte seashore paspalum (Paspalum vaginatum)
Authors: Goad David M. , Baxter Ivan , Kellogg Elizabeth A. , Olsen Kenneth M.
Published: October 2020

In plant species, variation in levels of clonality, ploidy and interspecific hybridization can interact to influence geographic patterns of genetic diversity. These factors commonly vary in plants that specialize on saline habitats (halophytes) and may play a role in how they adapt to salinity variation across their range. One such halophyte is the turfgrass and emerging genomic model system seashore paspalum (Paspalum vaginatum Swartz). To investigate how clonal propagation, ploidy variation, and interspecific hybridization vary across ecotypes and local salinity levels in wild P. vaginatum, we employed genotyping‐by‐sequencing, cpDNA sequencing and flow cytometry in 218 accessions representing > 170 wild collections from throughout the coastal southern United States plus USDA germplasm. We found that the two morphologically distinct ecotypes of P. vaginatum differ in their adaptive strategies. The fine‐textured ecotype is diploid and appears to reproduce in the wild both sexually and by clonal propagation; in contrast, the coarse‐textured ecotype consists largely of clonally‐propagating triploid and diploid genotypes. The coarse‐textured ecotype appears to be derived from hybridization between fine‐textured P. vaginatum and an unidentified Paspalum species. These clonally propagating hybrid genotypes are more broadly distributed than clonal fine‐textured genotypes and may represent a transition to a more generalist adaptive strategy. Additionally, the triploid genotypes vary in whether they carry one or two copies of the P. vaginatum subgenome, indicating multiple evolutionary origins. This variation in subgenome composition shows associations with local ocean salinity levels across the sampled populations and may play a role in local adaptation.
How medical school alters empathy: Student love and break up letters to empathy for patients
Authors: Laughey William F. , Brown Megan E. L. , Dueñas Angelique N. , Archer Rebecca , Whitwell Megan R. , Liu Ariel , Finn Gabrielle M.
Published: October 2020

Introduction

Medical education is committed to promoting empathic communication. Despite this, much research indicates that empathy actually decreases as students progress through medical school. In qualitative terms, relatively little is known about this changing student relationship with the concept of empathy for patients and how teaching affects it. This study explores that knowledge gap.

Methods

Adopting a constructivist paradigm, we utilised a research approach new to medical education: Love and Breakup Letter Methodology. A purposive sample of 20 medical students were asked to write love and break up letters to ‘empathy for patients’. The letters were prompts for the focus group discussions that followed. Forty letters and three focus group discussions were thematically analysed.

Results

The three major themes were: art and artifice; empathic burden; and empathy as a virtue. Students were uncomfortable with the common practice of faking empathic statements, a problem exacerbated by the need to ‘tick the empathy box’ during examinations. Students evolved their own empathic style, progressing from rote empathic statements towards phrases which suited their individual communication practice. They also learned non‐verbal empathy from positive clinician role‐modelling. Students reported considerable empathic burden. Significant barriers to empathy were reported within the hidden curriculum, including negative role‐modelling that socialises students into having less compassion for difficult patients. Students strongly associated empathy with virtue.

Conclusions

Medical education should address the problem of inauthentic empathy, including faking empathic s in assessments. Educators should remember the value of non‐verbal compassionate communication. The problems of empathic burden, negative role modelling and of finding empathy difficult for challenging patients may account for some of the empathy decline reported in quantitative research. Framing empathy as a virtue may help students utilise empathy more readily when faced with patients they perceive as challenging and may promote a more authentic empathic practice.
Gonadotroph tumours with a low SF‐1 labelling index are more likely to recur and are associated with enrichment of the PI3K‐AKT pathway
Authors: Hickman Richard A. , Bruce Jeffrey N. , Otten Marc , Khandji Alexander G. , Flowers Xena E. , Siegelin Markus , Lopes Beatriz , Faust Phyllis L. , Freda Pamela U.
Published: October 2020

Aims

The gonadotroph tumour (GT) is the most frequently resected pituitary neuroendocrine tumour. Although many symptomatic GT are successfully resected, some recur. We sought to identify histological biomarkers that may predict recurrence and explore biological mechanisms that explain this difference in behaviour.

Methods

SF‐1 immunohistochemistry of 51 GT, a subset belonging to a longitudinal prospective cohort study (n = 25), was reviewed. Four groups were defined: Group 1—recently diagnosed GT (n = 20), Group 2—non‐recurrent GT with long‐term follow up (n = 11), Group 3—initial resections of GT that recur (n = 7) and Group 4—recurrent GT (n = 13). The percentage of SF‐1 immunolabelling in the lowest staining fields (SF‐1 labelling index (SLI)) was assessed and RNA sequencing was performed on 5 GT with SLI <80% and 5 GT with SLI >80%.

Results

Diffuse, strong SF‐1 immunolabelling was the most frequent pattern in Groups 1/2, whereas patchy SF‐1 staining predominated in Groups 3/4. There was a lower median SLI in Groups 3/4 than 1/2. Overall, GT with SLI <80% recurred earlier than GT with SLI >80%. Differential expression analysis identified 89 statistically significant differentially expressed genes (FDR <0.05) including over‐expression of pituitary stem cell genes (SOX2, GFRA3) and various oncogenes (e.g. BCL2, ERRB4) in patchy SF‐1 GT. Gene set enrichment analysis identified significant enrichment of genes involved in the PI3K‐AKT pathway.

Conclusions

We speculate that patchy SF‐1 labelling in GT reflects intratumoural heterogeneity and are less differentiated tumours than diffusely staining GT. SF‐1 immunolabelling patterns may have prognostic significance in GT, but confirmatory studies are needed for further validation.
Stepwise increases in FT1 expression regulate seasonal progression of flowering in wheat (Triticum aestivum)
Authors: Gauley Adam , Boden Scott A.
Published: October 2020

Flowering is regulated by genes that respond to changing daylengths and temperature, which have been well studied using controlled conditions; however, the molecular processes underpinning flowering in nature remain poorly understood.

Here, we investigate the genetic pathways that coordinate flowering and inflorescence development of wheat (Triticum aestivum) as daylengths extend naturally in the field, using lines that contain variant alleles for the key photoperiod gene, Photoperiod‐1 (Ppd‐1).

We found flowering involves a stepwise increase in the expression of FLOWERING LOCUS T1 (FT1), which initiates under day‐neutral conditions of early spring. The incremental rise in FT1 expression is overridden in plants that contain a photoperiod‐insensitive allele of Ppd‐1, which hastens the completion of spikelet development and accelerates flowering time. The accelerated inflorescence development of photoperiod‐insensitive lines is promoted by advanced seasonal expression of floral meristem identity genes. The completion of spikelet formation is promoted by FLOWERING LOCUS T2, which regulates spikelet number and is activated by Ppd‐1.

In wheat, flowering under natural photoperiods is regulated by stepwise increases in the expression of FT1, which responds dynamically to extending daylengths to promote early inflorescence development. This research provides a strong foundation to improve yield potential by fine‐tuning the photoperiod‐dependent control of inflorescence development.
Environmental Regulations, Political Incentives and Local Economic Activities: Evidence from China*
Authors: Bo Shiyu
Published: October 2020

How do nationwide environmental regulations produce heterogeneous effects on the economic activities of manufacturing firms located in places with differently incentivized city leaders? This paper answers this question by drawing on a set of firm‐based pollution regulations in China from 2007 to investigate the relationship between political incentives and the effects of environmental regulations. I show that when a city's Party secretary has more incentives to be promoted, the adverse impacts on production by regulated firms tend to increase, but these losses for regulated firms are compensated by gains for other unregulated firms in polluting industries. Therefore, no overall reduction is seen in the manufacturing activities of the polluting industries. The findings suggest that if multitask problems for local governments are properly addressed, environmental regulations can effectively reduce the pollution and avoid large unintended costs to economic growth.
Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer
Authors: Warnakulasuriya Saman , Kujan Omar , Aguirre‐Urizar José M. , Bagan José V. , González‐Moles Miguel Ángel , Kerr Alexander R. , Lodi Giovanni , Mello Fernanda Weber , Monteiro Luis , Ogden Graham R. , Sloan Philip , Johnson Newell W.
Published: October 2020

Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term “potentially malignant disorders of the oral mucosa” (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with “oral lichenoid lesions” and among those diagnosed with oral manifestations of ‘chronic graft‐versus‐host disease’. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi‐center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence‐based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
An Agricultural Wealth Index for Multidimensional Wealth Assessments
Authors: Hackman Joseph , Hruschka Daniel , Vizireanu Mariya
Published: October 2020

Social scientists have increasingly used asset‐based wealth scores, like the Demographic and Health Survey (DHS) wealth index, to assess economic disparities. However, current indices primarily capture wealth in globalized market economies, thus ignoring other forms of prosperity, such as success in agricultural activities. Using a simple extension to the standard estimation of the DHS wealth index, we describe procedures for estimating an agricultural wealth index (AWI) that complements market‐based wealth indices by capturing household success in agricultural activities. We apply this procedure to household data from 129 DHS surveys from over 40 countries with sufficient land and livestock data to estimate a reliable and consistent AWI. We assess the construct validity of the AWI using benchmarks of growth in both adults and children. This alternative measure of wealth provides new opportunities for understanding the causes and consequences of wealth inequality, and how success along different dimensions of wealth creates different social opportunities and constraints for health and well‐being.
The impact of BRAF mutation status on clinical outcomes with anti‐PD‐1 monotherapy versus combination ipilimumab/nivolumab in treatment‐naïve advanced stage melanoma
Authors: Ma Vincent T. , Daignault‐Newton Stephanie , Waninger Jessica J. , Journey Sara , Chopra Zoey , Tezel Alangoya , Redman Bruce G. , Fecher Leslie A. , Green Michael D. , Alva Ajjai S. , Lao Christopher D.
Published: October 2020

Nearly half of all metastatic melanoma patients possess the BRAF V600 mutation. Several therapies are approved for advanced stage melanoma, but it is unclear if there is a differential outcome to various immunotherapy regimens based on BRAF mutation status. We retrospectively analyzed a cohort of metastatic or unresectable melanoma patients who were treated with combination ipilimumab/nivolumab (ipi/nivo) or anti‐PD‐1 monotherapy, nivolumab, or pembrolizumab, as first‐line treatment. 235 previously untreated patients were identified in our study. Our univariate analysis showed no statistical difference in progression‐free survival (PFS) or overall survival (OS) with ipi/nivo versus anti‐PD‐1 monotherapy in the BRAF V600 mutant cohort, but there was improved PFS [HR: 0.48, 95% CI, 0.28–0.80] and OS [HR: 0.50, 95% CI, 0.26–0.96] with ipi/nivo compared to anti‐PD‐1 monotherapy in the BRAF WT group. After adjusting for known prognostic variables in our multivariable analysis, the BRAF WT cohort continued to show PFS and OS benefit with ipi/nivo compared to anti‐PD‐1 monotherapy. Our single‐institution analysis suggests ipi/nivo should be considered over anti‐PD‐1 monotherapy as the initial immunotherapy regimen for metastatic melanoma patients regardless of BRAF mutation status, but possibly with greater benefit in BRAF WT.
A survey of hypercalciuria during chemotherapy in acute lymphoblastic leukemia
Authors: Hori Daiki , Kobayashi Ryoji , Suzuki Daisuke , Kodama Koya , Yanagi Masato , Matsushima Satoru , Kobayashi Kunihiko
Published: October 2020

Background

Urolithiasis is an extremely rare complication in childhood acute lymphoblastic leukemia (ALL), and some reports have implicated corticosteroids during chemotherapy as a risk factor for it. However, only a few reports have analyzed urinary electrolytes in this context.

Methods

We retrospectively analyzed 55 patients with ALL who underwent chemotherapy between October 2007 and January 2019. Their median age was 9.3 years (range, 0.3–24.0 years) with 30 males and 25 females. Lineages were B‐cell precursor ALL (BCP‐ALL) in 42 patients, T‐cell in nine and others in four patients. All patients received chemotherapy based on the Berlin‐Frankfurt‐Münster regimen.

Results

Forty‐nine out of the 55 ALL patients exhibited hypercalciuria at least once during chemotherapy. Moreover, 36 patients with BCP‐ALL, who were receiving identical Berlin‐Frankfurt‐Münster‐based regimens, exhibited significantly high urinary calcium excretion immediately following high‐dose glucocorticoid administration. Among the 55 ALL patients, urolithiasis was observed in one patient, a 6‐year‐old boy with BCP‐ALL who developed urolithiasis at reinduction chemotherapy just after cessation of high‐dose dexamethasone administration.

Conclusions

Nearly 90% of the ALL patients studied developed hypercalciuria during chemotherapy in strong association with corticosteroid administration.
Photoinactivation of the Coronavirus Surrogate phi6 by Visible Light
Authors: Vatter Petra , Hoenes Katharina , Hessling Martin
Published: October 2020

To stop the coronavirus spread, new inactivation approaches are being sought that can also be applied in the presence of humans or even on humans. Here, we investigate the effect of visible violet light with a wavelength of 405 nm on the coronavirus surrogate phi6 in two aqueous solutions that are free of photosensitizers. A dose of 1300 J cm−2 of 405 nm irradiation reduces the phi6 plaque‐forming unit concentration by three log‐levels. The next step should be similar visible light photoinactivation investigations on coronaviruses, which cannot be performed in our lab.
A One‐Health Quantitative Model to Assess the Risk of Antibiotic Resistance Acquisition in Asian Populations: Impact of Exposure Through Food, Water, Livestock and Humans
Authors: Opatowski Lulla , Opatowski Marion , Vong Sirenda , Temime Laura
Published: October 2020

Antimicrobial resistance (AMR) has become a major threat worldwide, especially in countries with inadequate sanitation and low antibiotic regulation. However, adequately prioritizing AMR interventions in such settings requires a quantification of the relative impacts of environmental, animal, and human sources in a One‐Health perspective. Here, we propose a stochastic quantitative risk assessment model for the different components at interplay in AMR selection and spread. The model computes the incidence of AMR colonization in humans from five different sources: water or food consumption, contacts with livestock, and interhuman contacts in hospitals or the community, and combines these incidences into a per‐year acquisition risk. Using data from the literature and Monte‐Carlo simulations, we apply the model to hypothetical Asian‐like settings, focusing on resistant bacteria that may cause infections in humans. In both scenarios A, illustrative of low‐income countries, and B, illustrative of high‐income countries, the overall individual risk of becoming colonized with resistant bacteria at least once per year is high. However, the average predicted incidence of colonization was lower in scenario B at 0.82 (CrI [0.13, 5.1]) acquisitions/person/year, versus 1.69 (CrI [0.66, 11.13]) acquisitions/person/year for scenario A. A high percentage of population with no access to improved water on premises and a high percentage of population involved in husbandry are shown to strongly increase the AMR acquisition risk. The One‐Health AMR risk assessment framework we developed may prove useful to policymakers throughout Asia, as it can easily be parameterized to realistically reproduce conditions in a given country, provided data are available.
Speech and mastication difficulties following treatment by a “street dentist”: A case of oral lipoma
Authors: Kamil Wan Nurhazirah Wan Ahmad , Zainal Mukarramah , Omar Aminda Faizura , Jamaluddin Tengku Intan Baizura Tengku , Ahmad Mas Suryalis
Published: October 2020

In this report, we present the case of a 68‐year‐old male patient with a complaint of mastication and speech limitations one year after the prescription of a fixed bridge and the construction of “connected” crowns by a “street dentist.” A thorough oral examination revealed a multilobulated swelling in the right buccal mucosa that extended to the buccal sulcus. The lesion, which was first noticed as a small, asymptomatic swelling by the patient one year prior, seemed to have undergone enlargement since the prostheses were prescribed. The lesion was completely removed via surgical excision under general anesthesia. Histopathological examination of the excisional mass revealed mature adipocytes and features consistent with conventional or classic lipoma. This case highlights the importance of receiving dental treatment from a qualified professional, whose responsibilities include performing a thorough examination of the oral cavity during treatment planning and delivery, review appointments, and regular dental visits. Such investigation is important to allow for early disease detection and control, especially for patients with complex treatment needs as well as those who may present with asymptomatic and slow‐growing lesions such as lipomas.
Strategies for effective patient care: Integrating quality communication with the patient‐centered approach
Authors: Tran Brandon Q.
Published: October 2020

Advancements in medicine and health technology have transformed the roles and dynamics of patient–provider interactions and communication in healthcare. To date, the health communication literature contains two distinct approaches to modern healthcare delivery, with earlier empirical works emphasizing features of effective communication and more recent studies endorsing patient‐centered care. Despite substantial overlap in both aims and methods, no work to date has considered these two approaches in tandem as complementary strategies for improving healthcare delivery. Thus, this study offers a novel framework, the person‐centered communication model of care, in an effort to integrate these two approaches to offer a unified and concise structure for future studies and development of innovative interventions to improve healthcare quality.
Overexpression of the ribosomal S30 subunit leads to indole‐3‐carbinol tolerance in Arabidopsis thaliana
Authors: Finkelshtein Alin , Khamesa Hala , Tuan Luu Anh , Rabanim Manely , Chamovitz Daniel A.
Published: October 2020

Indole‐3‐carbinol (I3C), a hydrolysis product of indole‐3‐methylglucosinolate, is toxic to herbivorous insects and pathogens. In mammals, I3C is extensively studied for its properties in cancer prevention and treatment. Produced in Brassicaceae, I3C reversibly inhibits root elongation in a concentration‐dependent manner. This inhibition is partially explained by the antagonistic action of I3C on auxin signaling through TIR1. To further elucidate the mode of action of I3C in plants, we have identified and characterized a novel Arabidopsis mutant tolerant to I3C, ICT1. This mutant was identified following screening of the Full‐length cDNA Over‐eXpression library (FOX) seed collection for root growth in the presence of exogenous I3C. ICT1 carries the AT2G19750 gene, which encodes an S30 ribosomal protein. Overexpression, but not knockout, of the S30 gene causes tolerance to I3C. The tolerance is specific to I3C, since ICT1 did not exhibit pronounced tolerance to other indole or benzoxazinoid molecules tested. ICT1 maintains I3C‐induced antagonism of auxin signaling, indicating that the tolerance is due to an auxin‐independent mechanism. Transcript profiling experiments revealed that ICT1 is transcriptionally primed to respond to I3C treatment.
Retrospective evaluation of Vitis vinifera ingestion in dogs presented to emergency clinics in the UK (2012–2016): 606 Cases
Authors: Croft Rachel , Clementi Elisabetta , Farmer Helen , Whalley Rachel , Dunning Mark , Firth Ava
Published: October 2020

Objective

To assess key presenting signs in dogs following Vitis vinifera fruit (VVF) ingestion (grapes, raisins, currants, and sultanas), outcome, and the incidence of acute kidney injury (AKI).

Design

Retrospective study (2012–2016).

Setting

Out‐of‐hours clinics in the United Kingdom.

Animals

The study population included 606 dogs attending 53 emergency clinics across the United Kingdom following ingestion of VVF.

Interventions

None.

Measurements and Main Results

Vitis vinifera fruits were found in vomit after more than 12 hours after ingestion. There was an increased incidence in December. Serum creatinine or urea was measured in 338 dogs; all were within reference intervals. In this cohort of dogs with VVF ingestion, there is no evidence for significant AKI in 32 of 33 cases within 24 hours of admission where supportive measures were introduced and repeated assessments of creatinine concentration were performed.

Conclusions

All dogs survived to discharge. One out of 33 cases with repeated creatinine concentration developed IRIS AKI grade I within 24 hours following VVF ingestion, when current emergency treatment guidelines were followed in whole or part.
Lung lobe torsion in 15 dogs: Peripheral band sign on ultrasound
Authors: Belmudes Audrey , Gory Guillaume , Cauvin Eddy , Combes Anaïs , Gallois‐Bride Hélène , Couturier Laurent , Rault Delphine N.
Published: October 2020

The diagnosis of lung lobe torsion in dogs is usually based on radiological, endoscopic, and CT features. Few ultrasonographic descriptions have been published. The purpose of this multicenter, retrospective, and prospective observational study was to investigate the presence of a hypoechoic area forming a pulmonary band or line at the periphery of the twisted lobe on ultrasonography and assess its significance by comparing it to CT and histological findings. Fifteen dogs with lung lobe torsion confirmed surgically or postmortem were included. All had received ultrasonography and CT examinations; 13 had additional histopathological examination performed. In 14 cases, thoracic ultrasonography revealed a peripheral hypoechoic band, overlying areas of scattered, hyperreflecting interfaces in the affected lobe. On CT, central emphysema was surrounded by a peripheral, soft tissue attenuation band, affecting the periphery in 14 cases. No band was observed in one case, in which the lobe was entirely consolidated. Histological examination yielded a comparable peripheral band, consisting of a thickened visceral pleura with or without hemorrhagic necrosis of the underlying pulmonary parenchyma. This peripheral band may be related to the specific fractal organization of airways and vessels, which plays an important role in lung perfusion and ventilation and makes the lung periphery more prone to ischemia. Our findings suggest that the presence of a peripheral hypoechoic band, associated with central emphysema in a noncollapsed lung lobe on ultrasonography, is suggestive of compromised blood supply and air flow, and lung lobe torsion should therefore be suspected.
Correlations between age, body size, sex, and conformation and ultrasound‐measured femoral vessel diameter in the dog, with implications for transvascular procedural planning
Authors: Cusack Katrina , Wesselowski Sonya , Saunders Ashley B. , Jeffery Nicholas
Published: October 2020

Transvascular interventional radiology procedures have advanced in veterinary medicine, but basic knowledge about expected vascular size and vascular imaging requires further exploration. A prospective analytical study of 230 client‐owned dogs was carried out to investigate correlations between ultrasound‐measured femoral artery (FA) and femoral vein (FV) diameter and various morphometric and demographic dog variables, compare ultrasound‐measured femoral vessel diameter to diameter predicted by body weight, compare right‐ and left‐sided femoral vessel diameter, and assess measurement repeatability. Internal diameter of the FA and FV was measured with ultrasound bilaterally. Allometrically scaled body weight had the strongest correlation with FA and FV diameter (correlation coefficients: 0.92 and 0.80, respectively), although thigh circumference (FA: 0.89; FV:0.78) and withers height (FA: 0.84; FV: 0.76) were also strongly correlated. Within the entire population, males had a smaller FA (P = .005), but not FV (P = .278), than females and age was negatively associated with FA (P = .031) and FV (P < .001) diameter. Compared to ultrasound‐derived measurements, body weight‐predicted diameter overestimated by at least one French gauge in 32.6% and 35.2% of dogs for the FA and FV, respectively. Comparison of left and right FA and FV diameter revealed minimal mean differences, though limits of agreement could encompass multiple French gauge sizes: (Mean difference [limits of agreement]: FA = 0.00 mm [0.85‐0.84 mm]; FV = 0.04 mm [1.92‐1.99 mm]). Intra‐ and interoperator repeatability coefficients of variation were <9%. Femoral vessel diameter in dogs is influenced by multiple factors, with potential for clinically relevant differences between right‐ and left‐sided vessels. Ultrasound measurement of femoral vessels could improve transvascular preprocedural planning.
Effects of platelet‐rich plasma on the healing of sternal wounds: A meta‐analysis
Authors: Yao Dan , Feng Guang , Zhao Fan , Hao Daifeng
Published: October 2020

Sternal wound infection (SWI) is a devastating complication after cardiac surgery. Platelet‐rich plasma (PRP) may have a positive impact on sternal wound healing. A systematic review with meta‐analyses was performed to evaluate the clinical effectiveness of topical application of autologous PRP for preventing SWI and promoting sternal wound healing compared to placebo or standard treatment without PRP. Relevant studies published in English or Chinese were retrieved from the Cochrane Central Register of Controlled Trials (The Cochrane Library), PubMed, Ovid EMBASE, Web of Science, Springer Link, and the WHO International Clinical Trials Registry Platform (ICTRP) using the search terms “platelet‐rich plasma” and “sternal wound” or “thoracic incision.” References identified through the electronic search were screened, the data were extracted, and the methodological quality of the included studies was assessed. The meta‐analysis was performed for the following outcomes: incidence of SWI, incidence of deep sternal wound infection (DSWI), postoperative blood loss (PBL), and other risk factors. In the systematic review, totally 10 comparable studies were identified, involving 7879 patients. The meta‐analysis for the subgroup of retrospective cohort studies (RSCs) showed that the incidence of SWI and DSWI in patients treated with PRP was significantly lower than that in patients without PRP treatment. However, for the subgroup of randomized controlled trials (RCTs), there was no significant difference in the incidence of SWI or DSWI after intervention between the PRP and control groups. There was no significant difference in PBL in both RCTs and RSCs subgroups. Neither adverse reactions nor in‐situ recurrences were reported. According to the results, PRP could be considered as a candidate treatment to prevent SWI and DSWI. However, the quality of the evidence is too weak, and high‐quality RCTs are needed to assess its efficacy on preventing SWI and DSWI.
Preliminary Assessment of Decay Heat Removal Systems in the ESFR-SMART Design: The Role of Natural Air Convection Around Steam Generators Outer Shells in Accidental Conditions
Authors: Bittan Jeremy , Bore Clement , Guidez Joel
Published: October 2020

In the frame of the ESFR-SMART European project, aiming at improving the safety level of the European sodium cooled fast reactor (ESFR), this paper presents the preliminary assessment of decay heat removal systems (DHRSs) in the ESFR-SMART design: the role of natural air convection around steam generators (SGs) outer shells in accidental conditions. Both theoretical and CATHARE code (thermal hydraulics reference code) calculations are presented. The impact of an additional chimney at the top of each casing as well as running primary and secondary pumps on the heat removal capacity is equally evaluated. This paper shows that the evacuation of decay heat thanks to completely passive air natural circulation alone, in case of Fukushima like accident, should lead to temperatures of sodium in the reactor vessel temporarily exceeding the safety criterion of 650 °C. The addition of chimneys increases the capacities but is not sufficient to evacuate the decay heat safely. If the primary and secondary side pumps are running, the safety criterion should be met.
Conjugate Heat Transfer Analysis Using the Discrete Green's Function
Authors: Hoffman Davis W. , Eaton John K.
Published: October 2020

Conjugate heat transfer problems generally require a coupled solution of the temperature fields in the fluid and solid domains. Implementing the boundary condition at the surface of the solid using a discrete Green's function (DGF) decouples the solutions. A DGF is determined first considering only the fluid domain with prescribed thermal boundary conditions, then the temperature distribution in the solid is calculated using standard numerical methods. The only compatibility requirement is that the DGF must be specified with the same discretization as the surface of the solid. The method is demonstrated for both steady-state and transient heating of a thin plate with laminar boundary layers flowing over both sides. The resulting set of linear algebraic equations for the steady-state problem or linear ordinary differential equations for the transient problem are easily solved using conventional scientific programming packages. The method converges with nearly second-order accuracy as the discretization resolution is increased.
‘Butterfly’: a residual bone independent technique for one-stage sinus lift
Authors: Filipov Iulian , Bolognesi Federico , Chirila Lucian
Published: October 2020

A 29-year-old woman with an extreme pneumatisation of the maxillary sinus and a missing molar was treated with one-stage sinus lifting and implant placement in a novel surgical approach.
Squamous cell carcinoma of the rectum
Authors: Chakrabarti Deep , Qayoom Sumaira , Akhtar Naseem , Gupta Rajeev
Published: October 2020

Lower gastrointestinal cancers are commonly adenocarcinoma in the colon and rectum, and of squamous cell histology in the anal canal. Squamous cell carcinoma of the rectum is a rare disease attributable to squamous metaplasia in the rectum. The tumour location and histopathology should both serve as indicators to planning treatment, and a robust multidisciplinary team meeting forms the backbone of such decisions.
Maternal complications of fetal triploidy: a case report
Authors: Wali Sarah , Wild Marianne
Published: October 2020

A 32-year-old woman underwent a medical termination in the second trimester of a spontaneously conceived triploid pregnancy after developing early-onset preeclampsia with subsequent haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Placental histology was normal (non-molar) and unusually, she developed ovarian hyperstimulation syndrome (OHSS) 4 weeks later. She was managed conservatively following multidisciplinary team input to exclude malignant pathology. The rarity of late-onset spontaneous OHSS could have resulted in inappropriate surgical management. In the absence of supportive treatment there is also a risk of the condition progressing to a critical stage. Follow-up ultrasonography after termination of pregnancy should be considered for women with evidence of ovarian hyperstimulation, particularly if other risk factors for OHSS are present. Delayed-onset OHSS should be considered in women presenting with bilateral cystic ovarian enlargement after triploid pregnancy.
Use of remdesivir in the presence of elevated LFTs for the treatment of severe COVID-19 infection
Authors: Sabers Andrew J , Williams Amber L , Farley T Michael
Published: October 2020

An 82-year-old man with an extensive medical history presented to the emergency room with complaints of generalised weakness and cough. He tested positive for COVID-19 10 days prior to presenting to the emergency room. Although his symptoms started a week prior to diagnosis, his weakness increased, warranting emergency response. A comprehensive metabolic panel was drawn from the patient on admission, indicating markedly high liver function tests (LFTs) ≥20 times above the upper limit of normal. On day 1 of admission, the decision was still made to start remdesivir (5-day course) due to decompensated acute respiratory failure as well as dexamethasone. The patient’s LFTs significantly improved throughout his hospital stay. The patient made a full recovery and was discharged on day 10 of hospitalisation.
Zenker’s diverticulum: a rare clinical condition with unusual oral manifestation
Authors: Dadhich Anuj , Saluja Harish , Shah Seemit , Nilesh Kumar
Published: October 2020

Oral mucosa exhibit clinical manifestations of a variety of systemic conditions and can serve as an indicator of overall health of an individual. Various systemic conditions like autoimmune, endocrine and haematological disorders can present with oral mucosal lesions, which can serve as an important diagnostic feature. These oral lesions can vary from oral ulceration, bleeding gums, xerostomia, chronic glossitis, to erosion and sensitivity of teeth. It is important that a clinician must be aware of the oral presentations of systemic conditions, so that timely diagnosis can be made and the necessary treatment is executed. This paper presents an unusual case of severe oral mucosal ulcerations and dysphagia in an elderly patient diagnosed with Zenker’s diverticulum. Patient was relieved of all oral symptoms once the underlying gastrointestinal tract pathology was diagnosed and surgically corrected.
Longitudinal assessment of quantitative ultra-widefield ischaemic and vascular parameters in sickle cell retinopathy
Authors: Sevgi Duriye Damla , Scott Adrienne W , Martin Alison , Mugnaini Christopher , Patel Shaivi , Linz Marguerite O , Nti Akosua A , Reese Jamie , Ehlers Justis P
Published: October 2020

Purpose

To evaluate longitudinal quantitative ischaemic and vasculature parameters, including ischaemic index, vessel area, length and geodesic distance in sickle cell retinopathy (SCR) on ultra-widefield fluorescein angiography (UWFA).

Methods

Optimal UWFA images from two longitudinal timepoints of 74 eyes from 45 patients with SCR were aligned and a common region of interest was determined. A deep-learning augmented ischaemia and vascular segmentation platform was used for feature extraction. Geodesic distance maps demonstrating the shortest distance within the vascular masks from the centre of the optic disc were created. Ischaemic index, vessel area, vessel length and geodesic distance were measured. Paired t-test and linear mixed effect model analysis were performed.

Results

Overall, 25 (44 eyes) patients with HbSS, 14 (19 eyes) with HbSC, 6 (11 eyes) with HbSthal and other genotypes were included. Mean age was 40.1±11.0 years. Mean time interval between two UWFA studies was 23.0±15.1 months (range: 3–71.3). Mean panretinal ischaemic index increased from 10.0±7.2% to 10.9±7.3% (p<0.005). Mean rate of change in ischaemic index was 0.5±0.7% per year. Mean vessel area (p=0.020) and geodesic distance (p=0.048) decreased significantly. Multivariate analysis demonstrated baseline ischaemic index and Goldberg stage are correlated with progression.

Conclusion

Longitudinal ischaemic index and retinal vascular parameter measurements demonstrate statistically significant progression in SCR. The clinical significance of these relatively small magnitude changes remains unclear but may provide insights into the progression of retinal ischaemia in SCR.
Relationship between mean follow-up intraocular pressure, rates of visual field progression and current target intraocular pressure guidelines
Authors: Melchior Bruna , De Moraes Carlos Gustavo , Paula Jayter S , A Cioffi George , Girkin Christopher A , Fazio Massimo A , N Weinreb Robert , M Zangwill Linda , M Liebmann Jeffrey
Published: October 2020

Aims

To investigate if eyes presenting intraocular pressure (IOP) within the limits of current guideline-driven target IOP indeed experience slow rates of glaucomatous visual field (VF) progression.

Methods

A total of 8598 24-2 VF tests from 603 eyes from the African Descent and Glaucoma Evaluation Study with manifest glaucoma were included. The sample was split into three groups based on baseline VF mean deviation (MD): G1 (better than −5.0 dB), G2 (−5.0 to −10 dB) and G3 (worse than −10 dB). We investigated the relationship between existing target IOP guidelines and rates of MD progression in these groups.

Results

For stable eyes, the medians and IQR of the mean follow-up IOP were G1=15.0 mmHg (IQR: 13.1 to 17.7), G2=13.2 mmHg (IQR: 11.6 to 14.3) and G3=11.9 mmHg (IQR: 10.1 to 13.8) (p<0.01). When considering the mean follow-up IOP within the limits proposed by current guidelines, the median MD slopes were: −0.20 dB/y (IQR: −0.43 to −0.02) for G1<21 mmHg, −0.19 dB/y (IQR: −0.51 to −0.01) for G2<18 mmHg and −0.15 dB/y (IQR: −0.47 to 0.05) for G3<15 mmHg (p=0.63). There were no significant differences between racial groups.

Conclusion

In a sample of patients with manifest glaucoma, despite substantial variability between eyes, adherence to treatment guidelines helped slow the rates of global VF progression at various stages of disease.

Trial registration number

clinicaltrials.gov Identifier: NCT00221923.
Reference architectures for ambient assisted living: a scoping review protocol
Authors: Bublitz Frederico , Sahota Naman K , Oetomo Arlene , Fadrique Laura , Morita Plinio P
Published: October 2020

Introduction

For the first time in human history, the number of older people will be higher than the number of children. The prevalence of chronic diseases, such as hypertension, cardiovascular disease, diabetes and mental disorders in older adults is high. Given that, it is essential to make usage of related technology to provide improved health conditions and reduce the costs for promoting ageing in place, and that is precisely the aim of Ambient Assisted Living technology. Considering that these systems provide significant benefit to a vast number of stakeholders, can be applied to the functional diversity of application domains and have high economic and social impacts, it is essential to create reusable and interoperable platforms and standards that are able to deal with the heterogeneity of applications and domains. In this sense, reference architectures have been proposed and evaluated. A comprehensive scoping review concerning the reference architectures must clarify specific aspects, such as what the main domains are and how the solutions effectively deal with them.

Methods

This scoping review will follow the methodology framework defined in ‘Scoping studies: advancing the methodology’. In this methodological framework, six stages are proposed for scoping review studies: identifying the research question; identifying relevant studies; study selection; charting the data; collating, summarising and reporting the results; and consultation. The research questions aim to investigate what are the motivations, stakeholders, benefits, domains, approaches, architectural components and governance aspects of the proposed reference architectures and models. The team will focus on the Scopus Document Search, PubMed (MEDLINE), IEEE Xplore Digital Library, ACM Digital Library and Science Direct electronic research databases. The search query is a combination of terms related to Ambient Assisted Living AND Reference Architecture.

Ethics and dissemination

This is a scoping review study and there is no requirement for ethical approval, as primary data will not be collected. The results from this scoping review will be published in a peer-reviewed journal and reported at scientific meetings. We intend to share the results with the International Standards and Conformity Assessment - SyC AAL from Canada to use the review as a basis for establishing an assessment model of reference architectures.