bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of natural killer cell activity as a biomarker for predicting immunotherapy response in non‐small cell lung cancer
Authors: Choi Myeong Geun , Kim Yeon Joo , Lee Jae Cheol , Rho Jin Kyung , Choi Chang‐Min
Published: October 2020

Background

The establishment of biomarkers that can be used to predict the response to immunotherapy for malignancy is extremely important. In particular, noninvasive analysis of immune cells from peripheral blood before treatment has gained increased attention, and natural killer (NK) cell activity has been shown to be related to treatment response. Here, we aimed to confirm the relationship between the response to immunotherapy and NK cell activity.

Methods

In this prospective observational study, patients with advanced NSCLC who were scheduled for immunotherapy from October 2018 to December 2019 were enrolled. Baseline NK cell activity was compared according to the best clinical response to immunotherapy.

Results

A total of 54 patients with advanced NSCLC were enrolled, and 34 patients were analyzed. The baseline NK cell activity was significantly higher in the non‐PD group than in the PD group (P = 0.002). At the cutoff level of ≥1200 pg/mL, baseline NK cell activity yielded a sensitivity of 80% and a specificity of 68.4% in predicting the response to immunotherapy (AUC = 0.8, P < 0.003). The median progression‐free survival (PFS) was significantly better in the high NK group (P = 0.003), and correlation between baseline NK cell activity and PFS was also confirmed (r = 0.517, P = 0.002).

Conclusions

Baseline NK cell activity was related to the response to immunotherapy and the PFS. We suggest that NK cell activity from peripheral blood before immunotherapy is a noninvasive, simple, and novel way to predicting the treatment response in patients with NSCLC.

Key points

Significant findings of the study

The response to immunotherapy was significantly better in patients with high baseline NK cell activity, and there was a significant correlation between baseline NK cell activity and PFS.

What this study adds

This study demonstrates the efficacy of baseline NK cell activity from peripheral blood as a biomarker for predicting immunotherapy response.
Indexing haemodynamic variables in young children
Authors: Sigurdsson Theodor S. , Lindberg Lars
Published: October 2020

Background

Haemodynamic studies in children are rare and most studies have included few subjects in the youngest age group. Haemodynamic variables need to be indexed to establish a reference of normality that is valid in all populations. The traditional way to index haemodynamic variables with body surface area (BSA) is complicated in young children due to its non‐linear relationship with body weight (BW). We examined several haemodynamic variables in children by indexing them with BSA and BW.

Methods

A single‐centre, observational cohort study comparing non‐indexed and indexed haemodynamic variables in children undergoing heart surgery (divided into three weight groups: 1‐5 kg, >5‐10 kg and >10‐15 kg).

Results

A total of 68 children were included in this study, mean age 11.1 months ± 11.1 month (range 0 to 43 months). All haemodynamic variables, cardiac output (CO), stroke volume (SV), total end‐diastolic volume (TEDV), central blood volume (CBV) and active circulation volume (ACV), increased with weight without indexing (P < .05). Indexing variables with BW produced a more linear relationship for all haemodynamic variables between weight groups than BSA. The mean BSA‐indexed haemodynamic values were CIBSA 3.5 ± 1.1 L/min/m2 and SVIBSA 27.3 ± 8.9 ml/min/m2. The mean BW‐indexed haemodynamic values were CIBW 180 ± 50 ml/min/kg and SVIBW 1.34 ± 0.38 ml/kg. Blood volume variables indexed with BW were TEDVBW 12.0 ± 2.8 ml/kg, CBVBW 21.3 ± 6.6 ml/kg and ACVBW 70.3 ± 15.2 ml/kg.

Conclusions

Indexing haemodynamic variables with BW produces a more appropriate body size‐independent scale in young children than BSA.

Summary statement

In this study, we studied indexing of haemodynamic variables and estimation of blood volumes in young children undergoing corrective heart surgery using an indicator dilution technology.
Association of CD200 expression in paternal lymphocytes with female Th1/Th2 balance and pregnancy establishment at immunotherapy of recurrent spontaneous abortion
Authors: Arefieva Alla , Nikolaeva Marina , Stepanova Elena , Krechetova Lubov , Golubeva Elena , Tetruashvili Nana , Sukhikh Gennady
Published: October 2020

Problem

We hypothesized that expression of transmembrane glycoprotein CD200 on paternal lymphocytes used for pre‐gestational lymphocyte immunotherapy (LIT) of recurrent spontaneous abortion (RSA) can suppress the pro‐inflammatory Th1‐type immunity required for successful implantation. To reveal the association between CD200 expression, female immune background after LIT, and pregnancy establishment, we have performed this work.

Method of study

Pre‐gestational alloimmunizations were given to 37 women using paternal peripheral blood leukocytes, combined with additional alloimmunizations in case of pregnancy. Lymphocyte phenotypes were determined by flow cytometry. Cytokines produced by mitogen‐stimulated female peripheral blood cells were estimated by FlowCytomix™ technology.

Results

We have shown that 78.4% (29/37) of women became pregnant within 12 menstrual cycles after pre‐gestational LIT. Pregnancy establishment depends on the intensity of CD200 expression, which is significantly higher on the CD200+ lymphocytes administered to women who later did not achieve pregnancy (P < .05). The expression of CD200 negatively correlates with the ratios of Th1/Th2 cytokines produced by female peripheral blood cells (P < .05) and positively correlates with the frequency of female circulating regulatory T cells after LIT (P < .05). The ROC analysis showed that the intensity of CD200 expression and the Th1/Th2 ratios are the significant predictors of pregnancy establishment after pre‐gestational LIT (P < .05 and P < .01, respectively).

Conclusion

Elevated CD200 expression on allogeneic lymphocytes most likely suppresses the pro‐inflammatory Th1‐type immunity needed for successful embryo implantation. Therefore, a personalized approach of LIT should be applied to avoid negative effects of such immunomodulation on pregnancy establishment.
Unburied Bodies — Hungarian National Identity 1989‐2020
Authors: Fekete Ilona
Published: October 2020

The erection of historical monuments is always an extension of national dentity — imagined by the ruling power. The current rehabilitation of Kossuth Square around the Budapest Parliament is intended to recreate its appearance as it was in 1944. The re‐configuration of urban space includes removal and exchange of current monuments and statues, as well as the erection of new ones. I will analyze the case of three statues and monuments that represent distinct events in Hungarian collective memory. The construction of the Memorial of National Unity and the erection of the Memorial for the Victims of the German Occupation are both seemingly attempts to cope with separate and intertwined national traumas, that are still haunting the collective memory. The removal of the Statue of Imre Nagy is also a telling example of the transformation of national identity, and an indication of how the 1956 revolution's status has changed within the nation's collective memory since 1989. These three monuments illustrate the transformation of Hungarian national identity after the system change, and point to possible further changes in the future.
Mental Health Conditions of Italian Healthcare Professionals during the COVID‐19 Disease Outbreak
Authors: Bettinsoli Maria Laura , Di Riso Daniela , Napier Jaime L. , Moretti Lorenzo , Bettinsoli Pierfrancesco , Delmedico Michelangelo , Piazzolla Andrea , Moretti Biagio
Published: October 2020

Background

The COVID‐19 pandemic in Italy represents a unique threat in terms of psychological distress. This cross‐sectional study aims to investigate the psychological health of Italian healthcare professionals during the COVID‐19 outbreak. We assessed participants’ current psychological distress and coping strategies in the midst of the COVID outbreak (March–April 2020), and also asked them to retrospectively report how they remember feeling before the COVID‐19 outbreak (December 2019). We examined associations between psychological distress and coping strategies with mental health and infection perceptions.

Methods

Self‐administered questionnaires were distributed online to healthcare professionals (N = 580) residing in different Italian regions from 26 March to 9 April 2020. The questionnaire measured changes in psychological states, coping strategies, and demographic variables testing variations in mental health and infection risk perception among Italian healthcare workers.

Results

Overall, approximately 33.5 per cent of healthcare professionals in our sample meet the threshold for psychiatric morbidity. Participants perceive their current psychological health to be worse during the COVID‐19 emergency outbreak as compared to before the outbreak, and this was especially true among women.

Conclusions

Both immediate and long‐term monitoring psychological assistance services for healthcare workers should be implemented by national institutions to re‐establish the psychological well‐being and enhance the self‐confidence and resilience of hospital personnel.
Climate change mitigation and adaptation in Bangladesh: The need for community‐based approaches
Authors: Roy Sajal , Sims Kearrin
Published: October 2020

Climate change is a leading threat to sustainable socio‐economic development in Bangladesh. Adverse impacts of climatic disasters including flash floods, recurrent cyclones and erratic rainfall patterns are already causing hardship for both rural and urban people and are expected to accelerate into the future. The aim of this research note is to identify the core contributing economic sectors to climate change in Bangladesh, and to consider effective mitigation strategies. Following the 5th Assessment Report (AR5) of the Intergovernmental Panel on Climate Change (IPCC) report (2014), in this paper, we argue that comprehensive mitigation measures are required in the energy, transport, buildings, industry and land‐use sectors to reduce Greenhouse Gas (GHG) emissions. Our findings indicate that it is crucial that government and non‐government mitigation efforts engage with community knowledge practices in order to most effectively reduce GHG emissions and combat the adverse impacts of climate change.
Global circulation of silver between Ming–Qing China and the Americas: Combining historical texts and scientific analyses
Authors: Sun L. , Yang G. , Liu R. , Pollard A. M. , Zhu T. , Liu C.
Published: October 2020

The circulation of silver between the Americas, Europe and China has provided a critical impetus for modern globalization since the 16th century. Even though substantial documentary information about this process has been collected and processed, there is still an ongoing debate about its underlying mechanism and the nature of the economic model. This article argues that the scientific analyses of the silver bullion and coins of Ming–Qing China and the Americas can offer a new source of information about this issue. This pilot study shows that the Ag concentration in Ming and Qing silver bullion is higher than that of the Americas, by around 3% and 8%, respectively. In particular, Qing silver bullion made in different reigns shows a remarkably consistent Ag content. Such a difference in the fineness could further contribute to the colossal arbitrage noted by scholars for decades, resulting in high volumes of global trading fundamentally driven by the higher price of silver in China. While quantifying its exact economic and political impacts still appears a distant prospect, as the current database is rather sketchy and many intermediate processes remain unclear, integrating scientific analyses into historical research illustrates several new patterns which helps to rethink the global silver circulation in the early modern period.
The mechanical stability of the world’s tallest broadleaf trees
Authors: Jackson Tobias D. , Shenkin Alexander F. , Majalap Noreen , Bin Jami Jamiluddin , Bin Sailim Azlin , Reynolds Glen , Coomes David A. , Chandler Chris J. , Boyd Doreen S. , Burt Andy , Wilkes Phil , Disney Mathias , Malhi Yadvinder
Published: October 2020

The factors that limit the maximum height of trees, whether ecophysiological or mechanical, are the subject of longstanding debate. Here, we examine the role of mechanical stability in limiting tree height and focus on trees from the tallest tropical forests on Earth, in Sabah, Malaysian Borneo, including the recently discovered tallest tropical tree, a 100.8 m Shorea faguetiana named Menara. We use terrestrial laser scans, in situ strain gauge data and finite element simulations, to map the architecture of tall tropical trees and monitor their response to wind loading. We demonstrate that a tree's risk of breaking due to gravity or self‐weight decreases with tree height and is much more strongly affected by tree architecture than by material properties. In contrast, wind damage risk increases with tree height despite the larger diameters of tall trees, resulting in a U‐shaped curve of mechanical risk with tree height. Our results suggest that the relative rarity of extreme wind speeds in north Borneo may be the reason it is home to the tallest trees in the tropics.

Abstract in MALAY is available with online material.
Comparable quality of bowel preparation with single‐day versus three‐day low‐residue diet: Randomized controlled trial
Authors: Machlab Salvador , Martínez‐Bauer Eva , López Pilar , Piqué Núria , Puig‐Diví Valentí , Junquera Félix , Lira Alba , Brullet Enric , Selva Anna , García‐Iglesias Pilar , Calvet Xavier , Campo Rafel
Published: October 2020

Background and Aims

There is controversy about the length of low‐residue diet (LRD) for colonoscopy preparation. The aim of the study was to compare one‐day vs. three‐day LRD associated to standard laxative treatment for achieving an adequate colonoscopy preparation in average risk subjects with positive fecal immunochemical test undergoing screening colonoscopy.

Methods

A non‐inferiority, randomized, controlled, parallel‐group clinical trial was performed in the setting of average risk colorectal cancer screening program. Participants were randomized to receive 1‐day vs. 3‐day LRD in addition to standard polyethilenglicol treatment. Adequacy of preparation was evaluated using the Boston Bowel Preparation Scale (BBPS). Primary outcome was achieving a BBPS ≥ 2 in all colon segments. Analysis was performed for a non‐inferiority margin of 5%, a 95% statistical power and one‐sided 0.05 significance level.

Results

A total of 855 patients were randomized. Adequate bowel preparation was similar between groups: 97.9% of patients in the 1‐day LRD group vs 96.9% in the 3‐day LRD group achieved the primary outcome (P‐value for non‐inferiority < 0.001). The percentage of patients with BBPS scores ≥ 8 was superior in the 1‐day LRD group (254 vs 221 in the 3‐day LRD group, P = 0.032). The 1‐day regimen was better tolerated than the 3‐day diet. 47.7% (vs 28.7%, P < 0.05) of patients rated the 1‐day LRD as very easy to follow.

Conclusion

The 1‐day LRD is non‐inferior to 3‐day LRD for achieving an adequate colon cleansing before average risk screening colonoscopy and it is better tolerated.
Dental education in the time of SARS‐CoV‐2
Authors: Sukumar Smitha , Dracopoulos Susie Athanasia , Martin Fjelda Elizabeth
Published: October 2020

Introduction

The SARS‐CoV‐2 virus has forced profound change on all aspects of society, with significant impact on dental education. Dental students like all other dental clinical personnel are considered to be at the highest risk amongst healthcare workers due to the nature of treatment, namely, working in the oral cavity (known reservoir for the virus) and the routine use of aerosol‐generating procedures. The nature of this pandemic has created several challenges to dental clinical education. The aim of this paper is to discuss these challenges and how educators have sought to overcome them.

Materials and Methods

This paper reviews the evidence base around bio‐aerosol and infection control measures specifically in the context of dental education.

Results

Using current knowledge of bio‐aerosol and increasing understanding of the virus, dental educators can implement evidence‐based measures to ensure safe teaching within both simulation and clinical environments.

Discussion

This paper contextualises the current pandemic in a dental education setting by providing a critical appraisal of the challenges posed by SARS‐CoV‐2 and how these challenges may be managed.

Conclusion

The SARS‐CoV‐2 pandemic has created unique challenges for dental schools worldwide. Dental educators have sought to identify these challenges and find solutions appropriate to the stage of the pandemic specific to their geographical location.
The relative contribution of α‐ and β‐adrenergic sweating during heat exposure and the influence of sex and training status
Authors: Amano Tatsuro , Fujii Naoto , Kenny Glen P. , Nishiyasu Takeshi , Inoue Yoshimitsu , Kondo Narihiko
Published: October 2020

While human eccrine sweat glands respond to adrenergic agonists, there remains a paucity of information on the factors modulating this response. Thus, we assessed the relative contribution of α‐ and β‐adrenergic sweating during a heat exposure and as a function of individual factors of sex and training status. α‐ and β‐adrenergic sweating was assessed in forty‐eight healthy young men (n = 35) and women (n = 13) including endurance‐trained (n = 12) and untrained men (n = 12) under non–heat exposure (temperate, 25°C; n = 17) and heat exposure (hot, 35°C; n = 48) conditions using transdermal iontophoresis of phenylephrine (α‐adrenergic agonist) and salbutamol (β‐adrenergic agonist) on the ventral forearm, respectively. Adrenergic sweating was also measured after iontophoretic administration of atropine (muscarinic receptor antagonist) or saline (control) to evaluate how changes in muscarinic receptor activity modulate the adrenergic response to a heat exposure (n = 12). α‐ and β‐adrenergic sweating was augmented in hot compared with temperate conditions (both P ≤ .014), albeit the relative increase was greater in β (~5.4‐fold)‐ as compared to α (~1.5‐fold)‐adrenergic‐mediated sweating response. However, both α‐ and β‐adrenergic sweating was abolished by atropinization (P = .001). Endurance‐trained men showed an augmentation in α‐ (P = .043) but not β (P = .960)‐adrenergic sweating as compared to untrained men. Finally, a greater α‐ and β‐adrenergic sweating response (both P ≤ .001) was measured in habitually active men than in women. We show that heat exposure augments α‐and β‐adrenergic sweating differently via mechanisms associated with altered muscarinic receptor activity. Sex and training status modulate this response.
Interparental Conflict, Attention to Angry Interpersonal Interactions, and Adolescent Anxiety
Authors: Lucas‐Thompson Rachel G. , Seiter Natasha S. , Lunkenheimer Erika S.
Published: October 2020

Objective

The goal of this study was to provide the first empirical investigation of associations among interparental conflict, adolescents' attention to emotion in interpersonal interactions, and adolescents' anxiety.

Background

Previous research suggests that both interparental conflict and attention biases have implications for youth anxiety.

Method

Adolescents (n = 60, aged 10–19 years) viewed neutral versus emotional (angry, happy) photo pairs of interpersonal interactions while gaze was measured using an eye‐tracking camera. Adolescents also reported their anxiety symptoms. Parents' self‐reported characteristics of their conflict were observed during an interparental conflict discussion.

Results

Parents who displayed less positive conflict behavior had adolescents who spent more time attending to angry interpersonal interactions; more negative conflict behavior by parents predicted less time attending to happy interpersonal interactions by adolescents. Interparental conflict interacted with attention to angry interpersonal interactions in relation to adolescent anxiety: More negative marital conflict was related to increased anxiety symptoms only when adolescents also displayed an attention bias toward angry interactions.

Conclusion

Interparental conflict and attention to angry interpersonal interactions may be risk factors for adolescent anxiety and interact in predicting anxiety.

Implications

Efforts aimed at improving the mental health of youth from poor‐quality family environments may benefit from considering strategies to modify attention to angry interpersonal interactions.
Fibroblast growth factor 23 as a risk factor for cardiovascular events and mortality in patients in the EVOLVE trial
Authors: Block Geoffrey A. , Chertow Glenn M. , Cooper Kerry , Xing Shan , Fouqueray Bruno , Halperin Marc , Danese Mark D.
Published: October 2020

Introduction

High mortality rates in patients with chronic kidney disease‐mineral and bone disorder (CKD‐MBD) receiving maintenance hemodialysis are largely due to cardiovascular (CV) events.

Methods

We evaluated associations between MBD parameters, fibroblast growth factor 23 (FGF23) concentrations, and clinically adjudicated CV events from the Evaluation of Cinacalcet Hydrochloride Therapy to Lower Cardiovascular Events (EVOLVE) trial. Patients enrolled in EVOLVE, who had not experienced any study endpoints between randomization and week 20 with evaluable baseline and week 20 values for key laboratory parameters (parathyroid hormone, calcium, phosphate, and FGF23), were assessed. We used adjusted Cox proportional hazards regression models to estimate relative risk of outcomes (primary composite, all‐cause mortality, and CV events) based on FGF23 and MBD parameters. Laboratory values were modeled with linear terms and using natural cubic splines with two degrees of freedom.

Findings

For the primary endpoint, patients assessed (N = 2309) were followed up over a mean duration of 3.1 years, during which 1037 CV events (497 deaths, 540 nonfatal events) occurred. Adjusted models showed an association between FGF23 and the risk of CV events. Hazard ratio per log unit of FGF23 at week 20 was 1.09 [95% CI: 1.03–1.16], and the hazard ratio per log unit change in FGF23 from week 0 to week 20 was 1.09 [95% CI: 1.00–1.17].

Discussion

Our data highlight FGF23 as an independent CV risk factor and potential biomarker and therapeutic target for patients with CKD‐MBD receiving maintenance hemodialysis.
Risk of Acute Myocardial Infarction, Heart Failure, and Death in Migraine Patients Treated with Triptans
Authors: Ghanshani Serena , Chen Cheng , Lin Bryan , Duan Lewei , Shen Yuh‐Jer Albert , Lee Ming‐Sum
Published: October 2020

Objective

The goal of this study is to determine the strength of association between treatment with triptans and acute myocardial infarction, heart failure, and death.

Background

Case reports in the literature have raised concerns over an association between treatment of migraine headaches with triptans and cardiovascular events. This study aims to systematically evaluate this association in a contemporary population‐based cohort. We hypothesized that triptan exposure is not associated with increased cardiovascular events.

Methods

A retrospective cohort study was conducted within an integrated healthcare delivery system in Southern California. From January 2009 to December 2018, 189,684 patients age ≥18 years had a diagnosis of migraine. In this group, 130,656 were exposed to triptans. Patients treated with triptans were matched 1:1 to those not exposed to triptans by using a propensity score. The primary outcome was acute myocardial infarction; secondary outcomes were heart failure, all‐cause death, and combined acute myocardial infarction, heart failure, and death.

Results

The incidence rate of acute myocardial infarction was 0.67 per 1000 person‐year in triptan‐exposed vs 1.44 per 1000 person‐year in not exposed patients. In propensity‐matched analyses, the adjusted hazard ratio for triptan exposure was 0.95 (95% confidence interval [CI] 0.84‐1.08) for acute myocardial infarction; 1.00 (95% CI 0.93‐1.08) for all‐cause death; 0.93 (95% CI 0.81‐1.08) for heart failure; and 0.99 (95% CI 0.93‐1.06) for a composite of acute myocardial infarction, heart failure, or death. Sensitivity analyses focusing on stratified subgroups based on age, gender, ethnicity, and several cardiac risk factors also revealed no significant association between triptan exposure and cardiovascular events.

Conclusions

No association was found between exposure to triptans and an increased risk of cardiovascular events. These data provide reassurance regarding the cardiovascular safety of utilizing triptans for the medical management of migraine headaches.
Pemphigus scalp lesions: is trichoscopy helpful in clinical diagnosis?
Authors: Ghiasi Maryam , Nasimi Maryam , Azizzadeh‐Roodpishi Shadi , Ansari Mahshid Sadat , Daneshpazhooh Maryam
Published: October 2020

Background

Pemphigus is an autoimmune intraepidermal bullous disease which can affect skin and∕or mucous membranes. Trichoscopy is a non‐invasive tool that can help in the clinical diagnosis especially if the patient is presented with only scalp lesions. We conducted this study to investigate the trichoscopic features of pemphigus scalp lesions.

Methods

A total of 100 patients with confirmed diagnosis of pemphigus entered the study; Seventy‐nine patients were diagnosed as pemphigus vulgaris (PV) and 21 as pemphigus foliaceus (PF). Trichoscopy of the scalp lesions was performed, and three dermatologists examined separately the trichoscopic images of each patient. The results were re‐checked simultaneously by the examiners. Association between variables was analyzed by using different tests including: chi‐square test or Fischer's exact test, independent T‐Test or Mann–Whitney nonparametric test and logistic regression model when applicable.

Results

Mean age of the patients was 45.41 ± 11.13 years, and 58% of cases were male. The most common trichoscopic features observed among all cases were diffuse scaling (71/100), presence of any types of vessels (67/100), and extravasation (63/100). Positive anagen pull test, extravasation, yellow hemorrhagic crust, and polymorphic vessels were more commonly seen in PV than PF cases (P value < 0.05), and by having data of these variables, we can differentiate between PV and PF scalp lesions with 74% sensitivity and 91% specificity.

Conclusion

Trichoscopy can help in clinical diagnosis of pemphigus scalp lesions but should be followed by other modalities such as biopsy and direct immunofluorescence for definite diagnosis.
Diagnostic value of clinical examination for identifying patients with large‐ and small‐fibre neuropathy
Authors: Chew Beng L. A. , Williams David B. , Attia John
Published: October 2020

Background

The diagnosis of polyneuropathy usually requires neurophysiological investigation, necessitating specialised testing and interpretation thereby increasing the time to final diagnosis.

Aims

To investigate the predictive value of the clinical examination in patients with potential neuropathies.

Methods

Patients were recruited based on their referral requesting neurophysiological testing. Two examiners tested ankle jerk reflexes and gradient to temperature sensation prior to the patient undergoing neurophysiology investigations, blinded to subsequent testing results. The neurophysiology investigations were either standard nerve conduction study (NCS) or thermal threshold testing (TTT) or both. These data were then analysed to determine the Kappa between examiners as well as sensitivity, specificity, and positive and negative likelihood ratios.

Results

There was a modest level of agreement between examiners for ankle jerk testing (Kappa = 0.6) but poor agreement for gradient temperature testing (Kappa = 0.3). Bilateral absence of ankle jerk reflexes was moderately associated with abnormal NCS, with the following characteristics: sensitivity 72%, specificity 91%, positive likelihood ratio 7.6 and negative likelihood ratio 0.3. The presence of a temperature gradient was poorly diagnostic for abnormal TTT: sensitivity 87%, specificity 14%, with positive and negative likelihood ratios close to 1.

Conclusion

The absence of ankle jerks performed moderately well in identifying patients likely to have large‐fibre neuropathy and could potentially be used to help decide who should be sent for NCS. Gradient temperature testing was much more subjective and did not change the likelihood of abnormal TTT.
Immune recognition of phosphoantigen‐butyrophilin molecular complexes by γδ T cells
Authors: Uldrich Adam P. , Rigau Marc , Godfrey Dale I.
Published: October 2020

Gamma‐delta (γδ) T cells are an important component of the immune system. They are often enriched in non‐lymphoid tissues and exhibit diverse functional attributes including rapid activation, cytokine production, proliferation, and acquisition of cytotoxicity following both TCR‐dependent and TCR‐independent stimulation, but poor capacity for immunological memory. They can detect a broad range of antigens, although typically not peptide‐MHC complexes in contrast to alpha‐beta (αβ) T cells. In humans, a prominent population of γδ T cells, defined as Vγ9Vδ2+ cells, reacts to small phosphorylated non‐peptide “phosphoantigens” (pAgs). The molecular mechanism underpinning this recognition is poorly defined, but is known to involve butyrophilin family members and appears to involve indirect pAg recognition via alterations to butyrophilin molecular complexes. In this review, we discuss recent advances in our understanding of pAg recognition by γδ T cells including the role of butyrophilins and in particular, a newly described role for butyrophilin 2A1.
Clinical application and efficacy of negative pressure wound therapy with instillation and dwell time (NPWTi‐d): A systematic review and meta‐analysis
Authors: Kanapathy Muholan , Mantelakis Angelos , Khan Natasha , Younis Ibby , Mosahebi Afshin
Published: October 2020

This study evaluates the current clinical evidence of Negative Pressure Wound Therapy with Instillation and dwell time (NPWTi‐d) to establish its clinical application and efficacy. MEDLINE, EMBASE, and CENTRAL databases were searched from 1946 to July 2019 for studies reporting clinical outcomes on wounds treated with NPWTi‐d. The primary outcome was proportion of wounds with complete healing. The secondary outcomes were mean time for healing, NPWTi‐d settings, cost, length of stay, and adverse events. Thirteen articles were included with a total of 624 wounds in 542 patients involving wounds of various aetiology. The pooled proportion of wound that achieved complete healing was 93.65% (95%CI: 84.02‐99.04). Normal saline was the most commonly used instillation solution with the mean dwell time of 14.23 minutes (95%CI: 10.88‐17.59) and instillation cycle every 4.17 ± 2.32 hourly. The mean therapy duration was 10.69 days (95%CI: 10.46‐10.91) with daily cost of $194.80. The mean hospital stay was 18.1 days (95%CI: 17.20‐19.00). There were no severe adverse effects reported. NPWTi‐d is an adjuntive therapy to aid complete healing of the vast majority of wounds. However, the current data are limited by the lack of level 1 evidence.
Formal caregivers’ perceptions and experiences of using pet robots for persons living with dementia in long‐term care: A meta‐ethnography
Authors: Scerri Anthony , Sammut Roberta , Scerri Charles
Published: October 2020

Aim

To explore the formal caregivers’ perceptions and experiences of using pet robots for persons living with dementia residing in long‐term care settings and the factors influencing their perceptions by evaluating, integrating, and synthesizing findings from relevant international research articles using a meta‐ethnography.

Design

Noblit and Hare's interpretative meta‐ethnography.

Data sources

Eight articles, published between 2013–2018, were identified following a systematic search of four databases (Scopus, ProQuest Central, EBSCO, and Google Scholar) between June 2019–February 2020.

Review methods

Two researchers independently appraised the selected articles. Noblit and Hare's seven steps and a meta‐ethnography reporting guidance were used. Reciprocal translation was used to obtain a line of argument synthesis.

Results

Three overarching themes were identified: a beneficial tool but not for everybody, a tool that has limitations but could be overcome, and a positive experience if appropriately introduced and sustained.

Conclusion

This meta‐ethnography contributes to the understanding of current potential benefits and limitations of pet robots for persons living with dementia residing in long‐term settings. It also identifies several factors, as perceived by caregivers, that may influence their acceptability, adoption, and routine use in practice.

Impact

Although for the past two decades pet robots have been used as a psychosocial intervention for persons living with dementia in long‐term care settings, there is a dearth of literature on the perception of formal caregivers and their experience of such interventions. While pet robots can have emotional, social, behavioural, and practical benefits, there are several technological, organizational, and contextual challenges and limitations that constrain their routine use. The solutions synthesized in this review can be of benefit to robot designers, facility managers, policy makers, and other health care professionals interested in introducing pet robots in long‐term care settings.
High site fidelity does not equate to population genetic structure for common goldeneye and Barrow's goldeneye in North America
Authors: Brown Joshua I. , Lavretsky Philip , Wilson Robert E. , Haughey Christy L. , Boyd W. Sean , Esler Daniel , Talbot Sandra L. , Sonsthagen Sarah A.
Published: October 2020

Delineation of population structure provides valuable information for conservation and management of species, as levels of demographic and genetic connectivity not only affect population dynamics but also have important implications for adaptability and resiliency of populations and species. Here, we measure population genetic structure and connectivity across the ranges of two sister species of sea ducks: Barrow's goldeneyeBucephala islandicaand common goldeneyeB. clangula. We use two different marker types: 7–8 nuclear microsatellite loci assayed across 229 samples and 3678 double digest restriction‐site associated DNA sequencing (ddRAD‐seq) loci assayed across 61 samples. First, both datasets found no evidence of genetic structure within common or Barrow's goldeneye, including between North American and European samples of common goldeneye. These results are in contrast with previous mitochondrial DNA, band recovery and telemetry data which suggest that goldeneyes are structured across their range. We posit that the discordance between autosomal genetic markers and other data types suggests that males, possibly subadult males, may be maintaining genetic connectivity across each species' respective ranges. Next, although mate choice consequences resulting from inter‐specific brood parasitism was hypothesized to cause some level of gene flow between goldeneye species, we only identified a single F1 hybrid with no further evidence of contemporary or historical gene flow. Despite ddRAD‐seq demographic analyses which recovered an optimum evolutionary model of split‐with‐migration (i.e. secondary contact), estimates of gene flow were <<1 migrant per generation in both directions. Together, we conclude that either strong ecological barriers or assortative mating are likely playing a role in preventing further backcrossing. Finally, demographic analyses estimated a relatively deep divergence time between Barrow's goldeneye and common goldeneye of ~1.6 million years before present and suggests that the genomes of both species have been under similar evolutionary constraints.
A novel screening tool to unmask potential interference between S‐ICD and left ventricular assist device
Authors: Zormpas Christos , Eiringhaus Jörg , Hillmann Henrike A. K. , Hohmann Stephan , Müller‐Leisse Johanna , Schmitto Jan D. , Veltmann Christian , Duncker David
Published: October 2020

Introduction

In patients with a left ventricular assist device (LVAD), the subcutaneous implantable cardioverter‐defibrillator (S‐ICD) can be an alternative to transvenous ICD systems due to reduced risk of systemic infection, which could lead to extraction of the ICD as well as the LVAD. S‐ICD eligibility is lower in patients with LVAD than in patients with end‐stage heart failure without LVAD. Several reports have shown inappropriate S‐ICD therapy in the coexistence of LVAD and S‐ICD. The aim of the present study was to evaluate S‐ICD eligibility in patients with LVAD using the established electrocardiogram (ECG)‐based screening test as well as a novel device‐based screening test to identify potentially inappropriate S‐ICD sensing in this specific patient cohort.

Methods and Results

The present study included 115 patients implanted with an LVAD. The standard ECG‐based screening test and a novel device‐based screening test were performed in all patients. Eighty patients (70%) were eligible for S‐ICD therapy with the standard ECG‐based screening test. Performance of the novel device‐based screening test identified device‐device interference in 14 of these 80 patients (12%).

Conclusion

Using a novel extended device‐based S‐ICD screening method, a small number of patients with LVAD deemed eligible for S‐ICD with the standard ECG‐based screening test exhibit device‐device interference. Careful S‐ICD screening should be performed in patients with LVAD, who are candidates for S‐ICD therapy, to prevent inappropriate sensing or ICD therapy.
Funduscopy: Yes or no? Hypertensive emergencies and retinopathy in the emergency care setting; a retrospective cohort study
Authors: Nijskens Charlotte M. , Veldkamp Saskia R. , Van Der Werf Dymph J. , Boonstra Arnold H. , Ten Wolde Marije
Published: October 2020

According to international guidelines, patients with a suspected hypertensive emergency (HE) admitted to the emergency department (ED) should undergo comprehensive evaluation including funduscopic examination. However, funduscopy is not always readily available and little is known about the prevalence of retinopathy among these patients in the ED setting. In order to characterize patients who should undergo funduscopy, we studied the prevalence, characteristics and clinical outcome in patients with a suspected HE and retinopathy grade III/IV. We conducted a retrospective cohort study of consecutive patients with severe elevation of blood pressure (BP) admitted to the ED between 2012 and 2015. Patients with a systolic blood pressure (SBP) ≥180 mm Hg or diastolic blood pressure (DBP) ≥120 mm Hg at time of presentation were included. A total of 271 patients were included, of whom 18 (6.6%; 95%CI 3.9‐10.5) had a HE. In 121 patients (44.6%; 95%CI 37.1‐53.3), funduscopy was performed, of whom 17 (14.0%; 95%CI 8.2‐22.5) had retinopathy grade III/IV. Mean SBP and DBP were significantly higher in patients with retinopathy (P < .001). However, retinopathy was also seen in patients with lower BP (SBP < 200 mm Hg and DBP < 120 mm Hg). No differences in other clinical characteristics, including visual disturbances, were found. One patient with retinopathy suffered an ischemic stroke after taking oral medication. The prevalence of retinopathy is high among examined patients. Except for higher BP, no clinical signs or symptoms are associated with the presence of retinopathy grade III/IV. We therefore conclude that funduscopic examination should be performed in every patient with a suspected HE.
Patagonian grouperAcanthistius patachonicus(Jenyns, 1840) forms massive spawning aggregations in theSouthwest Atlantic
Authors: Irigoyen Alejo , Riestra Cecilia , Lopez Sofía , Parma Ana M.
Published: October 2020

Here we describe massive spawning aggregations and seasonal changes in the large‐scale distribution of the Patagonian grouperAcanthistius patachonicusin the Southwest Atlantic based on three sources of information: (a) data from bottom trawl research surveys covering the distributional range of the species within the Argentine continental shelf; (b) folk ecological knowledge gathered from experienced captains of the Argentine industrial trawl fisheries; and (c) sampling of an artisanal trap fishery targeting the Patagonian grouper in a specific location off the coast of Buenos Aires Province. The trawl surveys showed a general pattern of aggregation of Patagonian grouper towards the coast during the reproductive period (September–December). Captains described massive aggregations of the species at specific near‐shore locations, where trawl catches of up to 15 t in a single haul were registered during the reproductive season. At a local scale, the artisanal trap fishery described operates exclusively during the reproductive period, targeting near‐shore aggregations with a high proportion of individuals releasing gametes onboard. These three sources of information provide evidence of the existence of massive transient spawning aggregations of Patagonian grouper in the Argentine shelf. This is the first report of a reef fish spawning aggregation in the southern region of the Southwest Atlantic. Anecdotal information gathered in this study points to the depletion of many of the aggregations targeted during the 1980s and 1990s by the industrial fleet. At the same time, the spawning aggregation site off Buenos Aires Province has been productive for the last 34 years, being exploited exclusively by traps. The Patagonian grouper is classified as Data Deficient by the International Union for Conservation of Nature, which highlights the need for further research to determine its stock status. Mapping its current spawning aggregations should be a priority to inform the design of a targeted monitoring program and management plan for this species.
Modeling and optimization of thin‐layer drying data of pretreated taro (Colocasia esculenta) corm slices
Authors: Olagunju Titilope Modupe , Aregbesola Omotayo A. , Akpan Godwin E.
Published: October 2020

Drying, an important but energy‐intensive unit operation, is necessary to ensure that perishable food produce is preserved for diverse industrial uses. Hence, modeling and optimizing this unit operation is vital. This study was carried out with the view of modeling and optimizing the thin‐layer drying of pretreated taro corm slices using three‐level factorial design of response surface methodology. Factors studied included different pretreatments (using either or a combination of sodium metabisulfite at concentrations of 1–4% w/w, steam‐blanching for durations of 1–6 min, and varying drying air temperature from 50 to 70°C). Seven responses (total drying time (TDT), specific energy consumption (SEC), final moisture content (FMC), activation energy (Ea), effective moisture diffusivity (Deff), percentage change in thickness (%∆TH) and percentage of moisture loss (%ML) were investigated. The optimum drying condition was further investigated for model fitness using nine existing drying models. The results showed that responses such as TDT and FMC ranged from 395.6 to 699.9 min and 5.29–12.4% wb, respectively. SEC was between 25.7 and 50.6 kWh/kg. Deff and Ea values ranged from 0.88 × 10−10 to 2.96 × 10−10 m2/s. and 33.9–40.9 kJ/mol, respectively. However, %∆TH and %ML ranged from 37.5 to 60.9% and 83.9 to 97.5%, respectively. The models generated were reliable and reproducible. Finally, optimization studies showed that pretreating taro slices by sulfiting at a concentration of 1.73% and blanching at a time of 2.37 min and drying at a temperature of 57.7°C would be optimum and fit Henderson and Pabis model best. In conclusion, the information provided by this study would be beneficial in designing and analyzing drying systems for taro products.

Practical applications

Taro (Colocasia esculenta) corm is an underutilized tuber crop with promising potentials for use in different food applications especially in the production of taro flour. Taro corm is however perishable, having high moisture content, hence, drying is an important unit operation in the production of flour from the corms. There is a need to establish optimum drying conditions to ensure that the drying process is efficient and economical. This study, therefore, was conducted to generate data that would provide information useful for drying pretreated taro slices.
Salicylic acid promotes quiescent center cell division through ROS accumulation and down‐regulation of PLT1, PLT2, and WOX5
Authors: Wang Zhuqing , Rong Duoyan , Chen Dixing , Xiao Yang , Liu Renyi , Wu Shuang , Yamamuro Chizuko
Published: October 2020

Salicylic acid (SA) plays a crucial role in plant immunity. However, its function in plant development is poorly understood. The quiescent center (QC), which maintains columella stem cells (CSCs) in the root apical meristem and typically exhibits low levels of cell division, is critical for root growth and development. Here, we show that the Arabidopsis thaliana SA overaccumulation mutant constitutively activated cell death 1 (cad1), which exhibits increased cell division in the QC, is rescued by additional mutations in genes encoding the SA biosynthetic enzyme SALICYLIC ACID INDUCTION DEFFICIENT2 (SID2) or the SA receptor NONEXPRESSER OF PR GENES1 (NPR1), indicating that QC cell division in the cad1 mutant is promoted by the NPR1‐dependent SA signaling pathway. The application of exogenous SA also promoted QC cell division in wild‐type plants in a dose‐dependent manner and largely suppressed the expression of genes involved in QC maintenance, including those encoding the APETALA2 (AP2) transcription factors PLETHORA1 (PLT1) and PLT2, as well as the homeodomain transcription factor WUSCHEL‐RELATED HOMEOBOX5 (WOX5). Moreover, we showed that SA promotes reactive oxygen species (ROS) production, which is necessary for the QC cell division phenotype in the cad1 mutant. These results provide insight into the function of SA in QC maintenance.
Extreme skeletal muscle loss during induction chemotherapy is an independent predictor of poor survival in advanced epithelial ovarian cancer patients
Authors: Yoshino Yasunori , Taguchi Ayumi , Nakajima Yujiro , Takao Maki , Kashiyama Tomoko , Furusawa Akiko , Kino Nao , Yasugi Toshiharu
Published: October 2020

Aim

Skeletal muscle loss is often observed in advanced cancer patients. This study investigates whether skeletal muscle loss is associated with survival outcomes of advanced epithelial ovarian cancer (EOC) patients after induction chemotherapy (IC) in a Japanese cohort. Whether serum inflammatory markers are associated with skeletal muscle changes is also addressed.

Methods

We retrospectively reviewed 60 patients with stage III/IV EOC who underwent IC between 2010 and 2017. Skeletal muscle area (SMA) was measured at the third lumbar vertebrae level on a single axial computed tomography‐scan image. Receiver operating curve analysis was used to determine cut‐off values of pre‐ and post‐IC SMA and SMA ratio (SMAR). Univariate and multivariate analyses of overall survival (OS) were conducted using the log–rank test and Cox proportional hazards regression model, respectively.

Results

The SMA decreased significantly after IC (P = 0.019). The cut‐off value between low and high SMAR was 0.96. High or low SMAR was observed in 34 (57%) and 26 (43%) patients, respectively. Univariate analysis revealed that low SMAR was associated with poor OS (P = 0.025). Multivariate analysis showed that incomplete resection during interval debulking surgery (hazard ratio, 0.30; 95% CI, 0.11–0.80; P = 0.016) and a low SMAR (hazard ratio, 3.17; 95% CI, 1.18–9.06; P = 0.022) were independent predictors of poor OS. Of the serum inflammatory markers investigated, only post‐IC absolute neutrophil count correlated significantly with SMAR (P = 0.012).

Conclusion

Low SMAR can be used to predict poor prognosis in advanced EOC patients who have undergone IC.