bluuebunny/crossref_metadata_2025 huggingface dataset:
FibroScan–aspartate aminotransferase score in an Asian cohort of non‐alcoholic fatty liver disease and its utility in predicting histological resolution with bariatric surgery
Authors: Anand Abhinav , Elhence Anshuman , Vaishnav Manas , Singh Amit Anurag , Rajput Mahendra Singh , Banyal Vikas , Jindal Vikas , Pathak Piyush , Kumar Peeyush , Nayak Baibaswata , Yadav Rajni , Das Prasenjit , Garg Harshit , Agarwal Lokesh , Aggarwal Sandeep , Kumar Ramesh , Shalimar
Published: November 2020

Background and Aim

The FibroScan–aspartate aminotransferase (FAST) score was developed for identifying patients with non‐alcoholic steatohepatitis, who also have an elevated non‐alcoholic fatty liver disease (NAFLD) activity score (NAS) ≥ 4 and significant fibrosis (F ≥ 2). We aimed to validate it in our NAFLD cohort and assess if it correlates with the histological changes after bariatric surgery.

Methods

Patients with NAFLD, including those undergoing bariatric surgery, were included. The FAST score was calculated using liver stiffness measure, controlled attenuation parameter, and aspartate aminotransferase. Calibration and discrimination of the model were assessed by calibration plots and area under the receiver operating characteristic curve, respectively. Sensitivity and specificity were assessed at the rule‐out and rule‐in cutoffs (≤0.35 and ≥0.67), respectively. Changes in the NAS and FAST scores were compared in the bariatric cohort 1 year after surgery.

Results

The cohort composed of 309 patients, of which 48 patients underwent repeat liver biopsy at 1 year. The model showed good discrimination with area under the receiver operating characteristic curve of 0.79 (0.74–0.84); however, it was not satisfactorily calibrated (Hosmer–Lemeshow test, P = 0.008). The sensitivity and specificity at the rule‐out and rule‐in cutoffs were 0.90 and 0.84, respectively. A significant correlation was seen between the 1‐year reduction in the NAS and FAST scores (r = 0.38, P = 0.009). A significant reduction in the median FAST score was seen in patients who had ≥2‐point reduction in NAS after bariatric surgery.

Conclusion

FibroScan–aspartate aminotransferase score demonstrated good discrimination for fibrotic non‐alcoholic steatohepatitis in our cohort. However, a miscalibration resulted in overprediction. The score correlated well with the histological response to interventions for NAFLD.
Fate of abstracts from American Society for Laser Medicine and Surgery Annual Meetings
Authors: Beltrami Eric J. , Feng Hao
Published: November 2020

Objectives

The American Society for Laser Medicine and Surgery (ASLMS) Annual Meeting provides a unique platform for the dissemination of research in laser and energy‐based technologies, which are regularly utilized in cosmetic dermatology. We sought to elucidate the fate of the abstracts presented at ASLMS meetings over 3 years.

Methods

We conducted a literature search for all abstracts presented at ASLMS meetings in 2013, 2014, and 2015 to determine publication rate, latency to publication, and journals of publication.

Results

The publication rate of abstracts presented at the 2013, 2014, and 2015 ASLMS meetings was 50.3%, 49.1%, and 43.5%, respectively. Average latency to publication was 16.1 months across these three years. Publication outcomes differed across general discipline, abstract type, poster category, clinical focus, and study design.

Conclusion

Our findings provide insight into the likelihood of publication, as well as potential contributing factors, for abstracts presented at ASLMS. With about half of all abstracts reaching publication, our study highlights the significant volume of research presented at this unique meeting that does not reach a broader audience through publication and thus is limited in its potential clinical applications in cosmetic dermatology.
A noncooperative model of contest network formation
Authors: Huremović Kenan
Published: November 2020

In this paper we study a model of weighted network formation. The bilateral interaction is modeled as a Tullock contest game with the possibility of a draw. We describe stable networks under different concepts of stability. We show that a Nash stable network is either the empty network or the complete network. The complete network is not immune to bilateral deviations. When we allow for limited farsightedness, a stable network immune to bilateral deviations must be a complete ‐partite network, with partitions of different sizes. We provide several comparative statics results illustrating the importance of the structure of stable networks in mediating the effects of shocks and interventions. In particular, we show that an increase in the likelihood of a draw has a nonmonotonic effect on the level of wasteful contest spending in the society. To the best of our knowledge, this paper is the first attempt to model weighted network formation when the actions of individuals are neither strategic complements nor strategic substitutes.
Lysionotus coccinus (Gesneriaceae), a new species from southwestern Yunnan, China
Authors: Tian Jing , Zhang Cai‐Fei , Peng Shuai , Wang Jun‐Jie , Wang Yan , Hu Guang‐Wan , Wang Qing‐Feng
Published: November 2020

Lysionotus coccinus G.W. Hu & Q.F. Wang, a distinct new species from Yingjiang County, southwestern Yunnan Province, China, is described and illustrated. It belongs to L. sect. Lysionotus, but has scarlet flowers while all other known species in this section have white, yellow, purple or pink flowers. Color photographs and a chart are provided for comparing the new species with related species.
Codeine induces increased resistance at the esophagogastric junction but has no effect on motility and bolus flow in the pharynx and upper esophageal sphincter in healthy volunteers: A randomized, double‐blind, placebo‐controlled, cross‐over trial
Authors: Geeraerts Annelies , Geysen Hannelore , Ballet Lisa , Hofmans Claudia , Clevers Egbert , Omari Taher , Manolakis Anastassios C. , Mols Raf , Augustijns Patrick , Vanuytsel Tim , Rommel Nathalie , Tack Jan , Pauwels Ans
Published: November 2020

Background

Chronic opioid use can induce esophageal dysfunction with symptoms resembling achalasia and a manometric pattern of esophagogastric junction—outflow obstruction (EGJ‐OO). However, the effect of opioids in acute setting on pharyngeal function and esophageal body contractility has not been investigated.

Methods

After positioning the high‐resolution impedance manometry (HRiM) catheter, codeine (60 mg) or placebo (glucose syrup) was infused intragastrically. Forty‐five minutes post‐infusion, participants received liquid, semi‐solid, and solid boluses to assess esophageal and pharyngeal function. HRiM analysis was performed adhering to the Chicago classification v3.0. (CC v3.0). Pressure flow analysis (PFA) for the esophageal body and the pharynx was performed using the SwallowGateway™ online platform.

Key Results

Nineteen healthy volunteers (HV) [5 male; age 38.3] were included. After codeine administration, higher integrated relaxation pressure 4 s values resulted in significantly reduced deglutitive EGJ relaxation and distal latency was significantly shorter. Distal contractility was similar in both conditions. Bolus flow resistance at the EGJ and distention pressures increased significantly after codeine infusion. Based on CC v3.0, acute infusion of codeine induced EGJ‐OO in six HV (p = 0.0003 vs. placebo). Codeine administration induced no significant alterations in any of the pharyngeal PFA metrics.

Conclusions & Inferences

In HV, acute administration of codeine increased bolus resistance at the EGJ secondary to induced incomplete EGJ relaxation leading to major motility disorders in a subset of subjects including EGJ‐OO. However, an acute single dose of codeine did not affect motility or bolus flow in pharynx and UES. ClinicalTrials.gov number, NCT03784105.
Severe gastroparesis is associated with an increased incidence of slow‐transit constipation as measured by wireless motility capsule
Authors: Radetic Mark , Kamal Afrin , Rouphael Carol , Kou Lei , Lyu Ruishen , Cline Michael
Published: November 2020

Background

Dysmotility in one region of the gastrointestinal tract has been found to predispose patients to developing motility disorders in other gastrointestinal segments. However, few studies have evaluated the relationship between gastroparesis and constipation.

Methods

Retrospective review of 224 patients who completed 4‐hour, solid‐phase gastric emptying scintigraphy (GES), and wireless motility capsule (WMC) testing to evaluate for gastroparesis and slow‐transit constipation, respectively. When available, anorectal manometry data were reviewed to evaluate for dyssynergic defecation. Patients were divided into two groups based on the results of the GES: 101 patients with normal gastric emptying and 123 patients with gastroparesis (stratified by severity). Differences in constipation rates were compared between the groups.

Key results

Slow‐transit constipation was more common in the gastroparesis group, but statistical significance was not reached (42.3% vs 34.7%, p = 0.304). Univariate logistical regression analysis found no association between slow‐transit constipation and gastroparesis (OR 1.38, 95% CI 0.80‐2.38, p = 0.245) nor dyssynergic defecation and gastroparesis (OR 0.88, 95% CI 0.29‐2.70, p = 0.822). However, when stratifying gastroparesis based on severity, slow‐transit constipation was found to be associated with severe gastroparesis (OR 2.45, 95% CI 1.20‐5.00, p = 0.014). This association was strengthened with the exclusion of patients with diabetes mellitus (OR 3.5, 95% CI 1.39‐8.83, p = 0.008) ‐ a potential confounder.

Conclusions & Inferences

Patients with severe gastroparesis (>35% gastric retention at the 4‐hour mark on solid‐phase GES) have an increased likelihood of having underlying slow‐transit constipation. Dyssynergic defecation does not appear to be associated with gastroparesis (of any severity).
Critical issues concerning biocreative strategy in contemporary temporary skeletal anchorage device orthodontics: A narrative review
Authors: Park Ki‐Ho , Choi Jin‐Young , Kim Kyung A , Kim Su‐Jung , Chung Kyu‐Rhim , Kim Seong‐Hun
Published: November 2020

Biocreative Orthodontic Strategy (BOS) is designed to establish a physiologically stable occlusion in harmony with masticatory and TMJ function and healthy supporting tissues with strategic use of temporary skeletal anchorage devices (TSADs). This narrative review surveys current research that demonstrates how BOS with TSADs uses a target approach to overcome the limitations experienced with conventional orthodontic treatment. A narrative review article including research on TSADs orthodontics in the permanent dentition. This review is a brief survey of five BOS principles for contemporary TSAD orthodontics: elegant selection of TSADs, bracket prescription to enhance TSAD orthodontics, antero‐posterior dimension control, transverse dimension control and airway control issues. Severe malocclusion and craniofacial dysmorphology can be treated with Biocreative Orthodontic Strategy with a minimum number of TSADs. In order to achieve successful treatment outcome using TSADs, it is critical to understand the key diagnosis and treatment principles of BOS and how to develop a target approach for the tooth and bone movement.
Acute urticaria in the infant
Authors: Minasi Domenico , Manti Sara , Chiera Fernanda , Licari Amelia , Marseglia Gian Luigi
Published: November 2020

Urticaria is a mast cell‐driven disease presenting with wheals, angioedema, or both. Acute urticaria (AU) lasts < 6 weeks. AU is a not common condition in newborns and infants since they are showing an immune system functionally insufficient. In newborns and infants, AU is typically generalized and featured by large, annular, or geographic plaques, often slightly raised. The clinical features of the disease depend on the peculiar structure of neonatal and infant skin. A careful morphological examination of the lesions is essential to differentiate AU from other skin eruptions that may have overlapping features and to treat it adequately. The second‐generation antihistamines are the first‐line treatment of AU; however, only antihistamines with proven efficacy and safety should be used in newborns and infants. Corticosteroids may be added in severe cases.
Is oxidative stress involved in vernal keratoconjunctivitis? Results from a pilot study in children
Authors: Zicari Anna Maria , Brindisi Giulia , De Castro Giovanna , Lollobrigida Valeria , Nebbioso Marcella , Duse Marzia
Published: November 2020

Background

Vernal keratoconjunctivitis (VKC) is a rare chronic conjunctivitis characterized by a predominantly eosinophil‐mediated inflammatory disorder that could develop critical complications such as blindness. Oxidative stress plays a pivotal role in the pathogenesis of several allergic diseases. The role of oxidative stress has been hypothesized in VKC, but no study explored this issue. Furthermore, cyclosporine A (CsA) exerts an anti‐inflammatory and antioxidant action on the conjunctiva.

This study aimed to assess the oxidative stress in VKC patients and controls and to study the effect of CsA on oxidative stress in these subjects.

Methods

Thirty‐six consecutive children, including 12 VKC (nine males, 75%; mean age 10.17; SD ± 2.48) patients without treatment, 12 VKC patients treated with CsA (nine males, 75%; mean age 9.08; SD ± 2.75), and 12 controls (CT) (seven males, 58%; mean age 8.58; SD ± 1.78), were recruited. A cross‐sectional study was performed to compare H2O2 in the serum with that in the tears of these children.

Results

Compared with CT and VKC children treated with CsA, VKC untreated children had significantly higher values of hydrogen peroxide (H2O2) in the serum and the tears. No significant differences were observed between CT and VKC treated with CsA. A significant correlation was found at the linear regression analysis between serum and tear H2O2 levels.

Conclusion

This study provides the first report attesting that patients with VKC have high oxidative stress; furthermore, it suggests that CsA could have an anti‐inflammatory and antioxidant action that could be useful to prevent the poor VKC outcome.
Insights into amphicarpy from the compact genome of the legume Amphicarpaea edgeworthii
Authors: Liu Yiyang , Zhang Xuejie , Han Kai , Li Rongchong , Xu Guoxin , Han Yan , Cui Feng , Fan Shoujin , Seim Inge , Fan Guangyi , Li Guowei , Wan Shubo
Published: November 2020

Amphicarpy (seed heteromorphy) is a unique and fascinating reproductive strategy wherein a single plant produces both aerial and subterranean fruits. This strategy is believed to be an adaptation to life under stressful or uncertain environments. Here, we sequenced and de novo assembled a chromosome‐level genome assembly of the legume Amphicarpaea edgeworthii Benth. The 299‐Mb A. edgeworthii genome encodes 27 899 protein‐coding genes and is the most compact sequenced legume genome reported until date. Its reduced genome size may be attributed to the reduced long‐terminal repeat retrotransposon content, which stems from the unequal homologous recombination. Gene families related to immunity and stress resistance have been contracted in A. edgeworthii, which is consistent with the notion that the amphicarpic reproductive strategy may be a complementary mechanism for its weak environmental‐adaptation ability. We demonstrated the ‘ABCE’ model for the differentiation of chasmogamous and cleistogamous flowers. In addition, the characteristics of aerial and subterranean seeds in hard‐seededness were explored. Thus, we suggest that the A. edgeworthii genome, which is the first of an amphicarpic plant, offers significant insights into its unusual reproductive strategy that is a key resource towards comprehending the evolution of angiosperms.
Association between attachment insecurity and couple adjustment: Moderation by couple memory networks
Authors: Lejeune Alexandre , Bouizegarene Nabil , Philippe Frederick L.
Published: November 2020

This study investigated whether couple‐related memories and their organization in memory networks could act as cognitive resources to protect against the negative impact of insecure attachment on couple adjustment. In two studies (n1 = 153, n2 = 567), participants in a romantic relationship described a significant couple‐related memory and provided networked memories associated with their couple‐related memory, to assess its organization in the memory system, and rated each memory for its level of need satisfaction. Findings across the two studies revealed significant moderations of need satisfaction in couple‐related memory networks, such that a higher level of satisfaction need within couple‐related memory networks was associated with a reduced negative association of attachment anxiety and avoidance with couple adjustment. When examined separately, it was shown that need‐satisfying networked memories, but not main couple‐related memories, moderated the negative association of insecure attachment with couple adjustment.
Preoperative successful thrombectomy and thrombolysis of acute extensive splanchnic venous system and TIPSS thrombosis in a child with Budd‐Chiari syndrome—Creating a window to enable living donor liver transplantation
Authors: Sonavane Amey , Raut Vikram , Marar Shaji , Sawant Ambreen , Shah Ketul , Raj Amruth , Thorat Ashok , Chaksota Harshit , Bagde Abhijit , Verma Rahul , Dharmapalan Dhanya , Vasanth Suresh , Nagral Aabha , Mirza Darius , Yewale Vijay
Published: November 2020

Preoperative extensive PV thrombosis can pose a technical challenge during liver transplantation surgery. Several strategies adopted to mitigate this problem include creation of a superior mesenteric vein—PV jump graft, use of a polytetrafluoroethylene graft, renoportal anastomosis, or cavoportal hemitransposition. Extensive and diffuse thrombosis of the splanchnic venous system may even necessitate multivisceral transplantation. We describe the case of a pediatric patient with Budd‐Chiari syndrome and decompensated cirrhosis, who developed extensive thrombosis of the porto‐spleno‐mesenteric venous system prior to liver transplantation. We used a combination technique of thrombus aspiration by a novel trans‐TIPPS approach followed by thrombolysis. Complete preoperative resolution of the extensive thrombosis was achieved. This allowed the creation of a brief window to enable planned LDLT. In prudently selected patients, performing an early mechanical and chemical thrombolysis of an extensive acute splanchnic venous thrombosis can thus help expedite a planned LDLT.
The gene NtMYC2a acts as a ‘master switch’ in the regulation of JA‐induced nicotine accumulation in tobacco
Authors: Sui X. , He X. , Song Z. , Gao Y. , Zhao L. , Jiao F. , Kong G. , Li Y. , Han S. , Wang B.
Published: November 2020

The biosynthesis and transport of nicotine has been shown to be coordinately upregulated by jasmonate (JA). MYC2, a member of basic helix‐loop‐helix (bHLH) transcription factor family, is well‐documented as the core player in the JA signalling pathway to regulate diverse plant development processes. Four MYC2 genes were found in the tobacco genome, NtMYC2a/2b and 1a/1b. In this study, we tested whether one of them, NtMYC2a, acts as a ‘master switch’ in the regulation of nicotine biosynthesis and transport in tobacco.

We generated NtMYC2a knockout tobacco plants using the CRISPR‐Cas9 technique and analysed the effect of NtMYC2a knockout on expression of the nicotine biosynthesis genes (NtAO, NtQS, NtPMT1a, NtQPT2, NtODC2, NtMPO1, NtA622 and NtBBLa) and transport genes (NtMATE2 and NtJAT1), as well as leaf accumulation of nicotine in the NtMYC2a knockout plants.

We found that all the nicotine biosynthesis and transport genes tested in this study were significantly downregulated (>50% reduction compared with wild‐type control) in the NtMYC2a knockout plants. Moreover, the leaf nicotine content in knockout plants was dramatically reduced by ca 80% compared with the wild‐type control.

These results clearly show that NtMYC2a acts as a ‘master switch’ to coordinate JA‐induced nicotine accumulation in tobacco and suggests that NtMYC2a might play an important role in tobacco nicotine‐mediated defence against herbivory.
M-Quantile Regression for Multivariate Longitudinal Data with an Application to the Millennium Cohort Study
Authors: Alfò Marco , Marino Maria Francesca , Ranalli Maria Giovanna , Salvati Nicola , Tzavidis Nikos
Published: November 2020

Motivated by the analysis of data from the UK Millennium Cohort Study on emotional and behavioural disorders, we develop an M-quantile regression model for multivariate longitudinal responses. M-quantile regression is an appealing alternative to standard regression models; it combines features of quantile and expectile regression and it may produce a detailed picture of the conditional response variable distribution, while ensuring robustness to outlying data. As we deal with multivariate data, we need to specify what it is meant by M-quantile in this context, and how the structure of dependence between univariate profiles may be accounted for. Here, we consider univariate (conditional) M-quantile regression models with outcome-specific random effects for each outcome. Dependence between outcomes is introduced by assuming that the random effects in the univariate models are dependent. The multivariate distribution of the random effects is left unspecified and estimated from the observed data. Adopting this approach, we are able to model dependence both within and between outcomes. We further discuss a suitable model parameterisation to account for potential endogeneity of the observed covariates. An extended EM algorithm is defined to derive estimates under a maximum likelihood approach.
Protein phosphorylation regulates maize endosperm starch synthase IIa activity and protein−protein interactions
Authors: Mehrpouyan Sahar , Menon Usha , Tetlow Ian J. , Emes Michael J.
Published: November 2020

Starch synthesis is an elaborate process employing several isoforms of starch synthases (SSs), starch branching enzymes (SBEs) and debranching enzymes (DBEs). In cereals, some starch biosynthetic enzymes can form heteromeric complexes whose assembly is controlled by protein phosphorylation. Previous studies suggested that SSIIa forms a trimeric complex with SBEIIb, SSI, in which SBEIIb is phosphorylated. This study investigates the post‐translational modification of SSIIa, and its interactions with SSI and SBEIIb in maize amyloplast stroma. SSIIa, immunopurified and shown to be free from other soluble starch synthases, was shown to be readily phosphorylated, affecting Vmax but with minor effects on substrate Kd and Km values, resulting in a 12‐fold increase in activity compared with the dephosphorylated enzyme. This ATP‐dependent stimulation of activity was associated with interaction with SBEIIb, suggesting that the availability of glucan branching limits SSIIa and is enhanced by physical interaction of the two enzymes. Immunoblotting of maize amyloplast extracts following non‐denaturing polyacrylamide gel electrophoresis identified multiple bands of SSIIa, the electrophoretic mobilities of which were markedly altered by conditions that affected protein phosphorylation, including protein kinase inhibitors. Separation of heteromeric enzyme complexes by GPC, following alteration of protein phosphorylation states, indicated that such complexes are stable and may partition into larger and smaller complexes. The results suggest a dual role for protein phosphorylation in promoting association and dissociation of SSIIa‐containing heteromeric enzyme complexes in the maize amyloplast stroma, providing new insights into the regulation of starch biosynthesis in plants.
Revisiting Pholidopterini (Orthoptera, Tettigoniidae): Rapid radiation causes homoplasy and phylogenetic instability
Authors: Çıplak Battal , Yahyaoğlu Özgül , Uluar Onur
Published: November 2020

This study aims to rectify the taxonomy of Pholidopterini (Orthoptera, Tettigoniidae, Tettigoniinae) using a phylogenetic approach. To this end, DNA sequences of three mitochondrial and two nuclear genes were produced and analysed. Reconstructed phylogenetic trees were consistent with the limits of the tribe and internal generic clades. However, the relationship among genera could not be resolved. Based on these trees and previous publications, we draw the following conclusions. Pholidopterini is monophyletic and consists of nine internal clades corresponding to generic level taxa. Pholidoptera, Eupholidoptera, Parapholidoptera, Apholidoptera, Uvarovistia and Exopholidoptera were previously given in the tribe, and Psorodonotus is transferred from Platycleidini. Aparapholidoptera Çıplak gen. n. and Spinopholidoptera Çıplak gen.n. are two new genera in the tribe. Additionally, the macro‐evolutionary pattern of the tribe was evaluated by correlating the tempo of radiation and the homology/homoplasy status of morphological characters used in generic descriptions/diagnoses. Results indicated that rapid radiation periods prior to achievement of lineage monophyly may leave their signature as instability or polytomy in present phylogenetic reconstruction, and cause the evolution of homoplasic characters and reticulate character sharing among the units in a lineage. This pattern may explain why genera in the Pholidopterini are definable by non‐unique character combinations.
Phylogeography of a widespread Palaearctic forest bird species: The White‐backed Woodpecker (Aves, Picidae)
Authors: Pons Jean‐Marc , Campión David , Chiozzi Giorgio , Ettwein Antonia , Grangé Jean‐Louis , Kajtoch Łukasz , Mazgajski Tomasz D. , Rakovic Marko , Winkler Hans , Fuchs Jérôme
Published: November 2020

We use multilocus molecular data and species distribution modelling to investigate the phylogenetics and the phylogeography of the White‐backed Woodpecker (Dendrocopos leucotos), a bird species widely distributed over the entire Palaearctic. Our phylogenetic results reveal three well‐supported clades within D. leucotos: the Chinese endemic subspecies (tangi, insularis), the northerly distributed subspecies (leucotos, uralensis) and the four poorly genetically differentiated Japanese subspecies (subcirris, stejnegeri, namiyei, owstoni), and the south‐western Palaearctic lilfordi subspecies. According to our results, the Amami Woodpecker, endemic to Amami Oshima Island (Ryukyu archipelago, Japan) sometimes treated as full species Dendrocopos owstoni, does not deserve a species‐level status. Based on the mitochondrial phylogeographic results, the Japanese archipelago was recently colonized only once by D. leucotos from eastern Eurasia. Our results suggest a split between the leucotos and lilfordi lineages that dates back to mid‐Pleistocene (around 0.6 Mya) with likely no gene flow between these two subspecies since then. Our results thus do not support a phylogeographic pattern in which Central Europe and Northern Europe were recolonized from one or several southern glacial refugia where lilfordi populations persisted through several Pleistocene glacial periods. Spatial variation in mitochondrial diversity across leucotos/uralensis populations and niche ecological modelling suggest a possible eastward population expansion from a unique glacial refugium likely located in Central Europe. Molecular species delimitation methods, gene flow analyses and differences in adult and juvenile plumage indicate that the lilfordi subspecies may warrant to be ranked as a valid phylogenetic species. Further studies are nevertheless needed in the Balkans, where leucotos and lilfordi came recently into contact to measure the effectiveness of reproductive barriers and gene flow.
The human preference for symmetric walking often disappears when one leg is constrained
Authors: Browne Michael G. , Smock Cameron S. , Roemmich Ryan T.
Published: November 2020

Key points

We hypothesized that minimization of metabolic power could drive people to walk asymmetrically when one leg is constrained

We studied healthy young adults and independently constrained one or both step lengths to be markedly shorter or longer than preferred using visual feedback

When one leg was constrained to take a shorter or longer step than preferred, asymmetric walking patterns were less metabolically costly than symmetric walking patterns

When one leg was constrained to take a shorter or longer step than preferred and the other leg was allowed to move freely, most participants naturally adopted an asymmetric gait

People may prefer to walk asymmetrically to minimize metabolic power when the function of one leg is constrained during fixed‐speed treadmill walking

The bilateral symmetry inherent in healthy human walking is often disrupted in clinical conditions that primarily affect one leg (e.g. stroke). This seems intuitive: with one leg constrained, gait becomes asymmetric. However, the emergence of asymmetry is not inevitable. Consider that symmetric walking could be preserved by matching the movement of the unconstrained leg to that of the constrained leg. While this is theoretically possible, it is rarely observed in clinical populations. Here, we hypothesized that minimization of metabolic power could drive people to walk asymmetrically when one leg is constrained, even when symmetric walking remains possible. We tested this hypothesis by performing two experiments in healthy adults. In Experiment 1, we constrained one step to be markedly shorter or longer than preferred. We observed that participants could significantly reduce metabolic power by adopting an asymmetric gait (one short/long step, one preferred step) rather than maintaining a symmetric gait (bilateral short/long steps). Indeed, when allowed to walk freely in this situation, participants naturally adopted a less effortful asymmetric gait. In Experiment 2, we applied a milder constraint that more closely approximated magnitudes of step length asymmetry that are observed in clinical populations. Responses in this experiment were more heterogeneous, though most participants adopted an asymmetric gait. These findings support two central conclusions: (1) symmetry is not necessarily energetically optimal in constrained human walking, and (2) people may prefer to walk asymmetrically to minimize metabolic power when one leg is constrained during fixed‐speed treadmill walking, especially when the constraint is large.
Acoustic and linguistic features influence talker change detection
Authors: Sharma Neeraj Kumar , Krishnamohan Venkat , Ganapathy Sriram , Gangopadhayay Ahana , Fink Lauren
Published: November 2020

A listening test is proposed in which human participants detect talker changes in two natural, multi-talker speech stimuli sets—a familiar language (English) and an unfamiliar language (Chinese). Miss rate, false-alarm rate, and response times (RT) showed a significant dependence on language familiarity. Linear regression modeling of RTs using diverse acoustic features derived from the stimuli showed recruitment of a pool of acoustic features for the talker change detection task. Further, benchmarking the same task against the state-of-the-art machine diarization system showed that the machine system achieves human parity for the familiar language but not for the unfamiliar language.
An Investigation Into Former High School Athletes’ Experiences of a Multidisciplinary Approach to Sport Injury Rehabilitation
Authors: Clement Damien , Arvinen-Barrow Monna
Published: November 2020

Context: A multidisciplinary approach is one of the many forms of professional practice that can be utilized by sports medicine professionals to provide care to injured athletes. While this approach has been empirically supported in the health care domain, studies supporting its utilization in the sport injury rehabilitation context—particularly at the high school level—are limited. Objective: To investigate former high school athletes’ experiences of a multidisciplinary model of care for sport injury rehabilitation. Design: Cross-sectional survey design. Setting: In-person, in a classroom setting at 2 Division I universities. Patients: A total of 186 former high school athletes. Main Outcome Measure: An author-constructed instrument developed using the multidisciplinary model of care for sport injury rehabilitation as a guide. Results: Family, athletic coaches, and athletic trainers were the closest professionals/individuals that injured athletes reported interacting with during sport injury rehabilitation. The data also revealed that these professionals/individuals had the closest and most direct relationships with the injured athletes. Conclusions: The findings from the present study provided support for the utilization of the multidisciplinary model of care for sport injury rehabilitation with high school athletes.
The Influence of Sagittal Plane Hip Position on Lower-Extremity Muscle Activity and Torque Output
Authors: Glaviano Neal R. , Bazett-Jones David M.
Published: November 2020

Context: Hip muscle strength has previously been evaluated in various sagittal plane testing positions. Altering the testing position appears to have an influence on hip muscle torque during hip extension, abduction, and external rotation. However, it is unknown how altering the testing position influences hip muscle activity during these commonly performed assessments. Objectives: To evaluate how hip sagittal plane position influences hip muscle activation and torque output. Study Design: Cross-sectional. Setting: Laboratory. Patients or Other Participants: A total of 22 healthy females (age = 22.1 [1.4] y; mass = 63.4 [11.3] kg; height = 168.4 [6.2] cm) were recruited. Intervention: None. Main Outcome Measures: Participants completed isometric contractions with surface electromyography on the superior and inferior gluteus maximus; anterior, middle, and posterior gluteus medius; biceps femoris, semitendinosus, adductor longus, and tensor fascia latae. Extension and external rotation were tested in 0°, 45°, and 90° of hip flexion and abduction was tested in −5°, 0°, and 45° of hip flexion. Repeated-measures analysis of variances were used for statistical analysis (P ≤ .01). Results: Activation of gluteal (P < .007), semitendinosus (P = .002), and adductor longus (P = .001) muscles were lesser for extension at 90° versus less flexed positions. Adductor longus activity was greatest during 90° of hip flexion for external rotation torque testing (P < .001). Tensor fascia latae (P < .001) and gluteus maximus (P < .001) activities were greater in 45° of hip flexion. Significant differences in extension (P < .001) and abduction (P < .001) torque were found among positions. Conclusions: Position when assessing hip extension and abduction torque has an influence on both muscle activity and torque output but only muscle activity for hip external rotation torque. Clinicians should be aware of the influence of position on hip extension, abduction, and external rotation muscle testing and select a position most in line with their clinical goals.
A 3 b.y. record of a biotic influence on terrestrial weathering
Authors: Beaty Brian J. , Planavsky Noah J.
Published: November 2020

Organic acids secreted by plants and microorganisms are ubiquitous in modern soils. These acids possess a particularly strong binding affinity for aluminum, accelerating its release from mineral surfaces and driving its preferential loss relative to immobile elements such as titanium. Aluminum-titanium (Al-Ti) decoupling in ancient soils may therefore serve as a tracer of a biotic influence on terrestrial weathering in Earth’s past. To explore this idea, we used a mass balance approach to quantify Al mobility in 33 definitive and chronologically well-constrained paleosols spanning the Archean to Miocene. We estimated expected Al release for a given weathering intensity under abiotic conditions using previously established experimental relationships between the relative losses of Al and magnesium (Mg), a mobile element with a much lower organic acid binding affinity. We report Al release likely attributable to organic acid weathering in all paleosols, with net loss in 13, net gain in 16, and a balance between loss and gain in four. This provides a new line of support for a significant terrestrial biosphere as far back as the mid-Archean. Interestingly, there is no statistically significant change in Al mobility across major transitions such as the Great Oxidation Event or the Paleozoic spread of vascular plants. This controversially suggests that localized organic acid weathering, at least within the surface environments captured by the paleosol record, may have been as common on early Earth as it is today.
The role of megacontinents in the supercontinent cycle
Authors: Wang Chong , Mitchell Ross N. , Murphy J. Brendan , Peng Peng , Spencer Christopher J.
Published: November 2020

Supercontinent Pangea was preceded by the formation of Gondwana, a “megacontinent” about half the size of Pangea. There is much debate, however, over what role the assembly of the precursor megacontinent played in the Pangean supercontinent cycle. Here we demonstrate that the past three cycles of supercontinent amalgamation were each preceded by ∼200 m.y. by the assembly of a megacontinent akin to Gondwana, and that the building of a megacontinent is a geodynamically important precursor to supercontinent amalgamation. The recent assembly of Eurasia is considered as a fourth megacontinent associated with future supercontinent Amasia. We use constraints from seismology of the deep mantle for Eurasia and paleogeography for Gondwana to develop a geodynamic model for megacontinent assembly and subsequent supercontinent amalgamation. As a supercontinent breaks up, a megacontinent assembles along the subduction girdle that encircled it, at a specific location where the downwelling is most intense. The megacontinent then migrates along the girdle where it collides with other continents to form a supercontinent. The geometry of this model is consistent with the kinematic transitions from Rodinia to Gondwana to Pangea.
Can we relate the surface expression of dike-induced normal faults to subsurface dike geometry?
Authors: Magee Craig , Jackson Christopher A.-L.
Published: November 2020

Many igneous dikes do not reach the surface, instead triggering normal faulting and graben formation in overlying rock. The surface expression of these dike-induced faults provides important records of active and ancient diking. For example, surface measurements of graben half-widths have been used to estimate dike upper-tip depths by projecting faults straight downdip, whereas extension measured at the surface across dike-induced fault pairs (i.e., their cumulative heave) is considered a proxy for dike thickness. We use three-dimensional seismic reflection data to test how the surface expression of two buried dike-induced faults relates to dike geometry. The dike-induced faults are nonplanar, suggesting fault dips should not be assumed constant when using graben half-widths to estimate dike depth. Multiple displacement maxima occur across the dike-induced faults, but rarely at their lower or upper tips, suggesting they formed through linkage of isolated faults that nucleated between the dike and free surface. Fault heave is greatest where these subsurface displacement maxima occur, meaning the cumulative heave of the dike-induced fault pair measured at the syn-faulting free surface underestimates their total extension and poorly reflects dike thickness. Our results imply that at-surface analyses of dike-induced fault geometry cannot be used to estimate key dike parameters without a priori knowledge of fault structure and kinematics or host rock lithological variations.
Association between neuraxial anaesthesia or general anaesthesia for lower limb revascularisation surgery in adults and clinical outcomes: population based comparative effectiveness study
Authors: Roberts Derek J , Nagpal Sudhir K , Kubelik Dalibor , Brandys Timothy , Stelfox Henry T , Lalu Manoj M , Forster Alan J , McCartney Colin JL , McIsaac Daniel I
Published: November 2020

Objective

To examine the associations between neuraxial anaesthesia or general anaesthesia and clinical outcomes, length of hospital stay, and readmission in adults undergoing lower limb revascularisation surgery.

Design

Comparative effectiveness study using linked, validated, population based databases.

Setting

Ontario, Canada, 1 April 2002 to 31 March 2015.

Participants

20 988 patients Ontario residents aged 18 years or older who underwent their first lower limb revascularisation surgery in hospitals performing 50 or more of these surgeries annually.

Main outcome measures

Primary outcome was 30 day all cause mortality. Secondary outcomes were in-hospital cardiopulmonary and renal complications, length of hospital stay, and 30 day readmissions. Multivariable, mixed effects regression models, adjusting for patient, procedural, and hospital characteristics, were used to estimate associations between anaesthetic technique and outcomes. Robustness of analyses were evaluated by conducting instrumental variable, propensity score matched, and survival sensitivity analyses.

Results

Of 20 988 patients who underwent lower limb revascularisation surgery, 6453 (30.7%) received neuraxial anaesthesia and 14 535 (69.3%) received general anaesthesia. The percentage of neuraxial anaesthesia use ranged from 0.6% to 90.6% across included hospitals. Furthermore, use of neuraxial anaesthesia declined by 17% over the study period. Death within 30 days occurred in 204 (3.2%) patients who received neuraxial anaesthesia and 646 (4.4%) patients who received general anaesthesia. After multivariable, multilevel adjustment, use of neuraxial anaesthesia compared with use of general anaesthesia was associated with decreased 30 day mortality (absolute risk reduction 0.72%, 95% confidence interval 0.65% to 0.79%; odds ratio 0.68, 95% confidence interval 0.57 to 0.83; number needed to treat to prevent one death=139). A similar direction and magnitude of association was found in instrumental variable, propensity score matched, and survival analyses. Use of neuraxial anaesthesia compared with use of general anaesthesia was also associated with decreased in-hospital cardiopulmonary and renal complications (odds ratio 0.73, 0.63 to 0.85) and a reduced length of hospital stay (−0.5 days, −0.3 to−0.6 days).

Conclusions

Use of neuraxial anaesthesia compared with general anaesthesia for lower limb revascularisation surgery was associated with decreased 30 day mortality and hospital length of stay. These findings might have been related to reduced cardiopulmonary and renal complications after neuraxial anaesthesia and support the increased use of neuraxial anaesthesia in patients undergoing these surgeries until the results of a large, confirmatory randomised trial become available.
SMART Vaccines 2.0 decision-support platform: a tool to facilitate and promote priority setting for sustainable vaccination in resource-limited settings
Authors: McCormick Benjamin J J , Waiswa Peter , Nalwadda Celia , Sewankambo Nelson K , Knobler Stacey L
Published: November 2020

In resource-constrained environments, priority setting is critical to making sustainable decisions for introducing new and underused vaccines and choosing among vaccine products. Donor organisations and national governments in low-income and middle-income countries (LMICs) recognise the need to support prioritisation of vaccine decisions driven by local health system capacity, epidemiology and financial sustainability.

Successful efforts have supported the establishment of National Immunisation Technical Advisory Groups (NITAGs) to undertake evidence-informed decision making (EIDM) in LMICs. Now, attention is increasingly focused on supporting their function to leverage local expertise and priorities. EIDM and priority-setting functions are complex and dynamic processes. Here, we report a pilot of a web-based decision-support tool. Applying tenets of multicriteria decision analysis, SMART Vaccines 2.0 supported transparent, reproducible and evidence-informed priority setting with an easy-to-use interface and shareable outputs.

The pilot was run by the Uganda NITAG who were requested by the Ministry of Health (MOH) in 2016 to produce recommendations on the prioritised introduction of five new vaccines. The tool was acceptable to the NITAG and supported their recommendations to the MOH. The tool highlighted sensitivity in the prioritisation process to the inherent biases of different stakeholders. This feature also enabled examination of the implications of data uncertainty. Feedback from users identified areas where the tool could more explicitly support evidence-to-recommendation frameworks, ultimately informing the next generation of the platform, PriorityVax.

Country ownership and priority setting in vaccine decisions are central to sustainability. PriorityVax promotes auditable and rigorous deliberations; enables and captures the decision matrix of users; and generates shareable documentation of the process.
Relative contributions of family history and a polygenic risk score on COPD and related outcomes: COPDGene and ECLIPSE studies
Authors: Moll Matthew , Lutz Sharon M. , Ghosh Auyon J. , Sakornsakolpat Phuwanat , Hersh Craig P. , Beaty Terri H. , Dudbridge Frank , Tobin Martin D. , Mittleman Murray A. , Silverman Edwin K. , Hobbs Brian D. , Cho Michael H.
Published: November 2020

Introduction

Family history is a risk factor for chronic obstructive pulmonary disease (COPD). We previously developed a COPD risk score from genome-wide genetic markers (Polygenic Risk Score, PRS). Whether the PRS and family history provide complementary or redundant information for predicting COPD and related outcomes is unknown.

Methods

We assessed the predictive capacity of family history and PRS on COPD and COPD-related outcomes in non-Hispanic white (NHW) and African American (AA) subjects from COPDGene and ECLIPSE studies. We also performed interaction and mediation analyses.

Results

In COPDGene, family history and PRS were significantly associated with COPD in a single model (PFamHx<0.0001; PPRS<0.0001). Similar trends were seen in ECLIPSE. The area under the receiver operator characteristic curve for a model containing family history and PRS was significantly higher than a model with PRS (p=0.00035) in NHWs and a model with family history (p<0.0001) alone in NHWs and AAs. Both family history and PRS were significantly associated with measures of quantitative emphysema and airway thickness. There was a weakly positive interaction between family history and the PRS under the additive, but not multiplicative scale in NHWs (relative excess risk due to interaction=0.48, p=0.04). Mediation analyses found that a significant proportion of the effect of family history on COPD was mediated through PRS in NHWs (16.5%, 95% CI 9.4% to 24.3%), but not AAs.

Conclusion

Family history and the PRS provide complementary information for predicting COPD and related outcomes. Future studies can address the impact of obtaining both measures in clinical practice.