bluuebunny/crossref_metadata_2025 huggingface dataset:
How do patients with systemic sclerosis experience currently provided healthcare and how should we measure its quality?
Authors: Spierings Julia , van den Ende Cornelia H M , Schriemer Rita M , Bernelot Moens Hein J , van der Bijl Egon A , Bonte-Mineur Femke , de Buck Marieke P D , de Kanter Meeke A E , Knaapen-Hans Hanneke K A , van Laar Jacob M , Mulder Udo D J , Potjewijd Judith , de Pundert Lian A J , Schoonbrood Thea H M , Schouffoer Anne A , Stel Alja J , Vercoutere Ward , Voskuyl Alexandre E , de Vries-Bouwstra Jeska K , Vonk Madelon C ,   for the ARCH Study Group
Published: August 2019

Objectives

To gain insight into SSc patients’ perspective on quality of care and to survey their preferred quality indicators.

Methods

An online questionnaire about healthcare setting, perceived quality of care (CQ index) and quality indicators, was sent to 2093 patients from 13 Dutch hospitals.

Results

Six hundred and fifty patients (mean age 59 years, 75% women, 32% limited cutaneous SSc, 20% diffuse cutaneous SSc) completed the questionnaire. Mean time to diagnosis was 4.3 years (s.d. 6.9) and was longer in women compared with men (4.8 (s.d. 7.3) vs 2.5 (s.d. 5.0) years). Treatment took place in a SSc expert centre for 58%, regional centre for 29% or in both for 39% of patients. Thirteen percent of patients was not aware of whether their hospital was specialized in SSc. The perceived quality of care was rated with a mean score of 3.2 (s.d. 0.5) (range 1.0–4.0). There were no relevant differences between expert and regional centres. The three prioritized process indicators were: good patient-physician interaction (80%), structural multidisciplinary collaboration (46%) and receiving treatment according to SSc guidelines (44%). Absence of disease progression (66%), organ involvement (33%) and digital ulcers (27%) were the three highest rated outcome indicators.

Conclusion

The perceived quality of care evaluated in our study was fair to good. No differences between expert and regional centres were observed. Our prioritized process and outcome indicators can be added to indicators suggested by SSc experts in earlier studies and can be used to evaluate the quality of care in SSc.
STUDY OF EFFECT OF CONSECUTIVE HEATING ON THERMOLUMINESCENCE GLOW CURVES OF MULTI-ELEMENT TL DOSEMETER IN HOT GAS-BASED READER SYSTEM
Authors: Pathan Munir S , Pradhan S M , Datta D , Selvam T Palani
Published: August 2019

The objective of this paper is to study the effect of consecutive heating of TL elements of a thermoluminescence dosemeter (TLD) card in hot N2 gas-based TLD badge reader. The effect is studied by theoretical simulations of clamped heating profiles of the discs and resulting TL glow curves. The simulated temperature profile accounts for heat transfer to disc from hot gas as well as radiative and convective heat exchanges between the disc and the surrounding. The glow curves are simulated using 10 component glow peak model for CaSO4:Dy using the simulated temperature profile. The shape of the simulated glow curves and trend in total TL signal of the three discs were observed to match closely with the experimental observations when elevated surrounding temperature was considered for simulation. It is concluded that the readout (heating) of adjacent TLD disc affects the surrounding temperature leading to the changes in temperature profile of the next disc.
REFERENCE SURFACE FOR IN SITU GAMMA SPECTROMETRY
Authors: Kroupa Tomáš , Setnička Michal , Čtvrtečková Alena , Marek René
Published: August 2019

Chemical laboratories of the Fire Rescue Service of the Czech Republic are part of the radiation monitoring network and participate in the radiation situation monitoring in the Czech Republic. Measurements in situ are crucial for monitoring the radiation situation in emergencies associated with the deposition of radioactive substances on a large area. Those data can be used for estimating a possible dose obtained either by staying in a contaminated area or by consumption of food produced in the area. For correct setting of device parameters (e.g. efficiency calibration), standard samples should be measured regularly. Unlike in laboratory, verification in field conditions is difficult. Therefore, a search for suitable reference areas containing a higher amount of 137Cs homogeneously dispersed after the fall of a radioactive cloud passing through our territory following the Chernobyl accident was conducted. Small airports in the East Bohemia regions were identified as suitable candidates.
RADIOACTIVE REMEDIATION OF AQUATIC ECOSYSTEMS USING MICROALGAE
Authors: Galanda Dušan , Tatarová Dominika , Kuruc Jozef , Gaálová Barbora , Slimáková Jana
Published: August 2019

Radionuclides that have entered the environment through nuclear weapon tests, nuclear accidents or other human activities represent an ecological hazard. Many decontamination techniques are technically and financially demanding and often not environmentally beneficial. A suitable alternative is bioremediation techniques. One of them, phycoremediation utilizes the metabolic activity of microorganisms that degrade or eliminate contaminants from the environment. In our work, we focused on phycoremediation with microalgae Dunaliella salina and Chlorella vulgaris. An important parameter was the determination of the optimal pH values of the environment and subsequent monitoring of the radionuclide activity decline over time.
DETERMINATION OF TOLERANCE LEVELS IN RADIOTHERAPY DOSIMETRY BASED ON STATISTICAL INTERFERENCE
Authors: Koniarová Irena , Kotík Lukáš
Published: August 2019

The most important dosimetry quantity that is determined at radiotherapy centers is the absorbed dose to water for external beams. Fixed tolerances for absorbed doses measured under reference conditions with an ionization chamber for high-energy photon and electron beams are usually 2 and 3%, respectively, regardless of uncertainties of the input variables and other conditions during evaluation. In reality, this agreement should be evaluated considering the uncertainties of the input variables because they affect the size of the random deviations of the measurements from their true values. The aim of this work was to develop a new approach to evaluate the agreement between measured and reported values based on statistical interference rather than to use fixed tolerance levels. The proposed method considers different scenarios that can occur during the evaluation of agreement. Because the method is described in general, it can be used in all similar situations when partial uncertainties can be established.
RADIATION EXPOSURE OF PAEDIATRIC GENERAL RADIOGRAPHY, FLUOROSCOPY AND CT PROCEDURES IN THE CZECH REPUBLIC—PILOT STUDY
Authors: Chytrá Kateřina , Novák Leoš , Rejtar Pavel , Homola Martin , Daníčková Kateřina , Cĕrvinková Ivana
Published: August 2019

The pilot dose survey on paediatric general radiography, fluoroscopy and CT procedures was performed in four university hospitals. The analysis of data was focused on the radiography and CT imaging of head, chest, abdomen, pelvis and spine and fluoroscopic procedures of gastrointestinal and urinary tracts. The survey was conducted by the National Radiation Protection Institute. Two hospitals exported data from the patient dose management system, while the others collected the data manually. The methodology of diagnostic reference levels assessment was proposed and tested. Local diagnostic reference levels were calculated in terms of air kerma-area product $P_{KA}$, CT air kerma-length product $P_{KL,CT}$ and volumetric CT air kerma index $C_{VOL}$. The lack of procedure standardisation, e.g. in tube voltage setting irrespective of patient’s weight, was revealed at one hospital. Dose and exposure parameters distributions with respect to patient’s anatomical constitution are presented in this article. In future, this pilot study will be a base for national survey of paediatric diagnostic reference levels.
VARIATION OF RADON ACTIVITY CONCENTRATION IN SELECTED KINDERGARTENS IN SLOVAKIA
Authors: Müllerová Monika , Holý Karol , Smetanová Iveta , Kureková Patrícia
Published: August 2019

Radon measurements were carried out in four kindergartens in Slovakia. RSKS detectors (Radosys Ltd., Hungary) and RamaRn (SUJCHBO, Czech Republic) were used for integral measurement in indoor air. AlphaGUARD (Saphymo, Germany) and TERA system (Tesla, Czech Republic) were used for continual measurement in indoor air. An annual variation with a maximum during the summer holidays was observed. Daily variation strongly depended on the ventilation of rooms. The average radon activity concentration per unit of time calculated from integral measurements was higher than that calculated for working time only.
PRE-ANTHROPIC AND PRESENT OUTDOOR GAMMA EQUIVALENT DOSE RATE OF THE HISTORIC CENTER OF ROME (ITALY)
Authors: Daniela Guglietta , Carloni Serena , Voltaggio Mario , Di Lisa Giuseppe Antonino
Published: August 2019

The outdoor gamma background of the historic center of Rome was studied by in situ measurements and average values of the outcropping geological formations. The survey resulted in two maps of dose equivalent rate, related to pre-anthropic and present conditions. Presently, the average of the dose equivalent rate from outdoor gamma-ray field is equal to 0.31 μSv h−1, corresponding to an outdoor annual effective dose equivalent of 0.548 mSv a−1 and to an outdoor excess lifetime cancer risk [International Commission on Radiological Protection (ICRP). Recommendations of the ICRP, 21, 1/3, Publication 60, 1990] of 2.56 × 10−3. The originary radioactivity was enhanced by anthropic action up to a level of health risk comparable to that one deriving by fine particulate matter. The assessment of the evolution and dispersion of the outdoor gamma background offers a new perspective to study the urban architectural evolution. Such a mapping allows us to individuate mitigation actions and neighborhoods in which the monitoring of illicit trafficking of radioactive material can be efficiently tested.
Race, Gender, and the Rape-Lynching Nexus in the U.S. South, 1881-1930
Authors: Smångs Mattias
Published: August 2019

Scholarship has long recognized the centrality of white racial sexual fears in the rhetoric and practice surrounding the lynching of African Americans in the U.S. South in the decades around 1900. The topic has not previously been taken up for systematic study beyond event-level analyses. This article presents theoretical and empirical evidence that whites’ intersecting racial and gender concerns converging in racial sexual fears were conducive to lynching related to interracial sex, but not to those unrelated to interracial sex, under certain conditions. The empirical findings, based on lynchings in 11 southern states from 1881–1930, demonstrate that lynchings related to interracial sex were more likely to occur in contexts characterized by higher levels of white female dependents residing with white male householders, higher levels of white female school attendance, and higher levels of adult black male literacy. These findings suggest that interracial sex-related lynching served to recover and retain white men’s racial and gender status, which postbellum developments had undermined, by oppressing not only African American men and women but disempowering white women as well. White racial sexual fears during the lynching era should, therefore, be seen as constituting a social force in their own right with long-term consequences for race and gender relations and inequalities.
Cellular RNA Hubs: Friends and Foes of Plant Viruses
Authors: Xu Min , Mazur Magdalena J. , Tao Xiaorong , Kormelink Richard
Published: August 2019

RNA granules are dynamic cellular foci that are widely spread in eukaryotic cells and play essential roles in cell growth and development, and immune and stress responses. Different types of granules can be distinguished, each with a specific function and playing a role in, for example, RNA transcription, modification, processing, decay, translation, and arrest. By means of communication and exchange of (shared) components, they form a large regulatory network in cells. Viruses have been reported to interact with one or more of these either cytoplasmic or nuclear granules, and act either proviral, to enable and support viral infection and facilitate viral movement, or antiviral, protecting or clearing hosts from viral infection. This review describes an overview and recent progress on cytoplasmic and nuclear RNA granules and their interplay with virus infection, first in animal systems and as a prelude to the status and current developments on plant viruses, which have been less well studied on this thus far.
Can functional oligosaccharides reduce the risk of diabetes mellitus?
Authors: Zhu Di , Yan Qiaojuan , Liu Jun , Wu Xia , Jiang Zhengqiang
Published: August 2019

Diabetes significantly affects the life quality and length of patients with diabetes, and almost half of the 4 million people who die from diabetes are under the age of 60. Because of the increasing number of patients with diabetes and the side effects of antidiabetic drugs, the search for new dietary supplementation from natural resources, especially functional oligosaccharides, has attracted much attention among scientific researchers. Functional oligosaccharides are potential antidiabetic treatments because of their nondigestible, low‐calorie, and probiotic features. The antidiabetic activity of multiple functional oligosaccharides such as fructo‐oligosaccharides, galacto‐oligosaccharides, and xylo‐oligosaccharides has been reviewed in this paper. Molecular mechanisms involved in the antidiabetic activity of oligosaccharides have been systematically discussed from multiple perspectives, including the improvement of pancreas function, α‐glucosidase inhibition, the relief of insulin and leptin resistance, anti‐inflammatory effects, regulation of gut microbiota and hormones, and the intervention of diabetic risk factors. In addition, the antidiabetic effects of functional oligosaccharides through the complex gut‐brain‐liver axis are summarized. The concepts addressed in this review have important clinical implications, although more works are needed to confirm the antidiabetic mechanisms of functional oligosaccharides, standardize safe dose levels, and clarify their metabolism in the human body.—Zhu, D., Yan, Q., Liu, J., Wu, X., Jiang, Z. Can functional oligosaccharides reduce the risk of diabetes mellitus? FASEB J. 33, 11655‐11667 (2019). www.fasebj.org
LIN28‐let‐7 axis regulates genes in immortalized human trophoblast cells by targeting the ARID3B‐complex
Authors: Ali Asghar , Anthony Russell V. , Bouma Gerrit J. , Winger Quinton A.
Published: August 2019

Abnormal placental development is one of the main etiological factors for intrauterine growth restriction (IUGR). Here, we show that LIN28A and LIN28B are significantly lower and lethal‐7 (let‐7) microRNAs (miRNAs) significantly higher in term human IUGR vs. normal placentas. We hypothesize that let‐7 miRNAs regulate genes with known importance for human placental development [high‐mobility group AT‐hook 1 (HMGA1), transcriptional regulator Myc‐like (c‐myc), vascular endothelial growth factor A (VEGF‐A), and Wnt family member 1 (WNT1)] by targeting the AT‐rich interacting domain (ARID)‐3B complex. ACH‐3P cells with LIN28A and LIN28B knockout (DKOs) significantly increased let‐7 miRNAs, leading to significantly decreased ARID3A, ARID3B, and lysine demethylase 4C (KDM4C). Similarly, Sw.71 cells overexpressing LIN28A and LIN28B (DKIs) significantly decreased let‐7 miRNAs, leading to significantly increased ARID3A, ARID3B, and KDM4C. In ACH‐3P cells, ARID3A, ARID3B, and KDM4C make a triprotein complex [triprotein complex comprising ARID3A, ARID3B, and KDM4C (ARID3B‐complex)] that binds the promoter regions of HMGA1, c‐MYC, VEGF‐A, and WNT1. ARID3B knockout in ACH‐3P cells disrupted the ARID3B‐complex, leading to a significant decrease in HMGA1, c‐MYC, VEGF‐A, and WNT1. DKOs had a significant reduction, whereas DKIs had a significant increase in HMGA1, c‐MYC, VEGF‐A, and WNT1, potentially due to regulation by the ARID3B‐complex. This is the first study showing regulation of let‐7 targets in immortalized human trophoblast cells by the ARID3B‐complex.—Ali, A., Anthony, R. V., Bouma, G. J., Winger, Q. A. LIN28‐let‐7 axis regulates genes in immortalized human trophoblast cells by targeting the ARID3B‐complex. FASEB J. 33, 12348–12363 (2019). www.fasebj.org
The Anatomical Study and Clinical Significance of the Sinuvertebral Nerves at the Lumbar Levels
Authors: Zhao Qinghao , Cheng Liang , Yan Huibo , Deng Shangxi , Zhao Jianjun , Liu Zezheng , Tan Xuemei , Zhong Enyi , Zhuo Wentao , Jin Dadi , Li Qingchu
Published: August 2019

Study Design.

A dissection-based study of 10 embalmed human cadavers.

Objective.

The purpose of this study was to describe the sinuvertebral nerves at the lumbar level and to discuss their possible clinical significance.

Summary of Background Data.

Discogenic low-back pain is mediated by the sinuvertebral nerves. However, the detailed descriptions of the sinuvertebral nerves at the lumbar level are lacking.

Methods.

One hundred L1-L5 intervertebral foramina from 10 embalmed cadavers were studied. The presence of the sinuvertebral nerves was noted. The quantity, origin, pathway, innervation range, and spatial orientations of the sinuvertebral nerves in the L1-L5 intervertebral foramina were examined.

Results.

A total of 450 sinuvertebral nerves were identified in the 100 lumbar intervertebral foramina; sinuvertebral nerves were observed in 100.00% of the intervertebral foramina. The sinuvertebral nerves were routinely divided into the following two types: the sinuvertebral nerve deputy branch and sinuvertebral nerve main trunk. Three hundred twelve sinuvertebral nerve deputy branches were found; on average, there were approximately 3.12 (range, 1–8) branches in each intervertebral foramen. One hundred thirty-eight sinuvertebral nerve main trunks were found, and sinuvertebral nerve main trunks were observed in 97.00% of the intervertebral foramina. The initial portion of the sinuvertebral nerve was located along the posterior-lateral edge of the disc to the spinal canal. Sixty-one (44.20%) sinuvertebral nerve main trunks originated from the starting point of the gray ramus communicans of the nerve root; 77 (55.80%) sinuvertebral nerve main trunks originated from the anterior surface of the spinal ganglia of the nerve root.

Conclusion.

This is a systematic anatomy study that describes the sinuvertebral nerve at the lumbar level and may be of clinical importance to spinal surgeons. A comprehensive understanding of the distribution of sinuvertebral nerves may lead to significant benefits for patients undergoing percutaneous endoscopic treatment for discogenic low-back pain.

Level of Evidence: 4
Does Lumbar Interbody Cage Size Influence Subsidence? A Biomechanical Study
Authors: Yuan Wei , Kaliya-Perumal Arun-Kumar , Chou Siaw Meng , Oh Jacob Yoong-Leong
Published: August 2019

Study Design.

An experimental laboratory-based biomechanical study.

Objective.

To investigate the correlation between cage size and subsidence and to quantify the resistance to subsidence that a larger cage can provide.

Summary of Background Data.

The assumption that a bigger interbody cage confers less subsidence has not been proven. There was no previous study that has shown the superiority of lateral cages to bullet cages in terms of subsidence and none that has quantified the correlation between cage size and subsidence.

Methods.

A cage was compressed between two standardized polyurethane foam blocks at a constant speed. Four sizes of bullet cages used for transforaminal lumbar interbody fusion (TLIF) and six sizes of lateral cages used for lateral lumbar interbody fusion (LLIF) were tested. The force required for a 5 mm subsidence, axial area of cages, and stiffness were analyzed.

Results.

A larger cage required a significantly higher force for a 5 mm subsidence. Longer bullet cages required marginal force increments of only 6.2% to 14.6% compared to the smallest bullet cage. Lateral cages, however, required substantially higher increments of force, ranging from 136.4% to 235.7%. The average force of lateral cages was three times that of bullet cages (6426.5 vs. 2115.9 N), and the average stiffness of the LLIF constructs was 3.6 times that of the TLIF constructs (635.5 vs. 2284.2 N/mm). There was a strong correlation between the axial area of cages and the force for a 5 mm subsidence. Every 1 mm2 increment of axial area corresponded to approximately 8 N increment of force.

Conclusion.

Cage size correlated strongly with the force required for a 5 mm subsidence. The LLIF constructs required higher force and were stiffer than the TLIF constructs. Among bullet cages, longer cages only required marginal increments of force. Lateral cages, however, required substantially higher force.

Level of Evidence: N/A
Impact of Multifidus Muscle Swelling on C5 Palsy After Cervical Laminoplasty
Authors: Usami Yoshitada , Nakaya Yoshiharu , Hayama Sachio , Nakano Atsushi , Fujishiro Takashi , Neo Masashi
Published: August 2019

Study Design.

Retrospective radiological analysis

Objective.

The aim of this study was to identify the effects of posterior cervical muscle swelling on C5 palsy (C5P) by evaluating early postoperative magnetic resonance (MR) images.

Summary of Background Data.

Cervical laminoplasty is an established technique, but the risk of C5P after surgery has not been fully resolved. Studies have reported that lateral stretching and postoperative swelling of the multifidus muscle may cause stretching of the medial branches and cervical nerves.

Methods.

A total of 214 C5 nerves of 107 consecutive patients who underwent laminoplasty were examined. We reviewed their demographic and surgical data and radiographic and MR images as parameters, including the axial cross-sectional area (CSA) of the posterior muscles. The patients and C5 nerves were divided into C5P and non-C5P groups. The parameters and changes were compared between the two groups to examine correlations with C5P.

Results.

In demographic data, age, sex, history of smoking, diabetes mellitus, and preoperative Japanese Orthopedic Association scores were not significantly different between the groups. Only body mass index (BMI) was significantly higher in the C5P group. Regarding the surgical and imaging data, the number of laminoplasty, operative time, decompression trough width, cervical sagittal alignment, preoperative spinal cord rotation, and posterior shift of the spinal cord were not significantly different, but the multifidus CSA change ratio was significantly higher in the C5P group. Multiple logistic regression analyses revealed that the multifidus CSA change ratio and BMI were significant independent factors.

Conclusion.

Multifidus swelling is associated with C5P, possibly through traction of the C5 nerve via the medial branches of the cervical dorsal rami. The medial branch is the shortest of the dorsal rami and may have the largest effect by traction force. Therefore, a gentle maneuver of the deep posterior muscles during surgery is a potential countermeasure to prevent C5P.

Level of Evidence: 3
Acquired Leukonychia of the Distal Nail Plate: A Morphologic and Proteomic Analysis
Authors: Ates Deniz , Kosemehmetoglu Kemal
Published: August 2019

Leukonychia, or whitening of the nail plate, is a common disease that was first described in 1919. Leukonychia is classified as acquired or congenital and may be due to abnormality of the nail bed (pseudoleukonychia) or nail plate (true leukonychia). The distal whitened area of the nail plate was clipped from a 31-year-old woman with striated leukonychia and a 32-year-old man and 34-year-old woman with punctate leukonychia. Routine hematoxylin and eosin staining of all clipped samples was performed. A piece of nail with leukonychia and a normal nail from case 2 were sent to the Mayo Clinic for mass spectrometric analysis. On hematoxylin and eosin examination, all leukonychia samples showed odd-appearing eosinophilic linear parakeratinization in the mid-segment of the nail plate. Mass spectrometric analysis of case 2 revealed serum proteins (albumin, serotransferrin IgG, gamma chain, IgG lambda chain, and haptoglobulin) and hair proteins that were not found in the keratin content of the normal nail (keratin type Ha1 and cuticular keratin Ha4). This is the first description of odd-appearing linear parakeratosis and the first proteomic analysis showing abnormal protein content in acquired leukonychia.
Maternal Depressive Symptoms and Perceived Picky Eating in a Low-Income, Primarily Hispanic Sample
Authors: Katzow Michelle , Canfield Caitlin , Gross Rachel S. , Messito Mary Jo , Cates Carolyn Brockmeyer , Weisleder Adriana , Johnson Samantha Berkule , Mendelsohn Alan L.
Published: August 2019

Objective:

Feeding concerns are common in the first 2 years of life and typically reflect maternal perceptions occurring within the larger context of the parent-child relationship. We aimed to determine whether (1) maternal depressive systems predicted perceived picky eating, mediated by maternal negative perceptions; (2) receipt of the Video Interaction Project (VIP) parenting intervention impacted perceived picky eating through this pathway; and (3) perceived picky eating was associated with child growth or subsequent dietary patterns.

Methods:

We performed a partial longitudinal analysis of 187 low-income, predominantly Hispanic mother-child dyads enrolled in a randomized controlled trial of the VIP. Mother-infant dyads were enrolled postpartum in an urban public hospital. Participants randomized to the VIP met with an interventionist on days of well-child visits; sessions were designed to facilitate interactions in play and shared reading through provision of learning materials and review of videotaped parent-child interaction; the curriculum did not contain feeding-specific elements. We used structural equation modeling to determine direct, indirect, and total effects of maternal depressive symptoms, maternal negative perceptions, and the VIP on perceived picky eating. We then tested associations between perceived picky eating and (1) child growth, using multivariable linear regression and multilevel modeling; and (2) subsequent child dietary consumption, using multivariable multinomial logistic regression.

Results:

Maternal depressive symptoms had significant total effects on negative maternal perceptions (β = 0.32,p< 0.001) and perceived picky eating (β = 0.21,p< 0.01) after controlling for potential confounders. This effect was partially mediated by maternal negative perceptions (indirect effect: β = 0.06,p= 0.04). When used in the model as the predictor, the VIP had a significant total effect on perceived picky eating (β = −0.16,p= 0.02), which was partially mediated by maternal depressive symptoms and negative perceptions (indirect effect: β = −0.05,p= 0.02). Perceived picky eating was not associated with child diet at age 2 years or adiposity from 6 months to 3 years.

Conclusion:

Maternal concerns about picky eating may reflect deeper depressive symptoms and negative perceptions of her child's behavior. Interventions designed to facilitate positive parenting in general may lessen feeding-specific concerns, such as picky eating. Although reassurance about growth and nutritional outcomes for children perceived as picky eaters is appropriate, clinicians should also consider probing for underlying symptoms of depression that could lead to eating concerns.
Botulinum Toxin A Improves Supramuscular Fat Graft Retention by Enhancing Angiogenesis and Adipogenesis
Authors: Wu Mengfan , Li Ye , Wang Zijue , Feng Jingwei , Wang Jing , Xiao Xiuyun , Lu Feng , Dong Ziqing
Published: August 2019

BACKGROUND

Autologous fat grafting is commonly used for soft-tissue augmentation and reconstruction in plastic surgery. However, long-term graft retention rates are unpredictable, especially in muscle-related fat grafting.

OBJECTIVE

To determine whether botulinum neurotoxin type A (BoNTA) may improve supramuscular fat grafting retention by reducing muscle movement, thereby enhancing angiogenesis and adipogenesis.

MATERIALS AND METHODS

Pre-BTX+ nude mice were injected with BoNTA on the right quadriceps femoris and underwent supramuscular fat grafting 1 week later. BTX+ nude mice simultaneously underwent BoNTA injection and transplantation. Control nude mice underwent transplantation without BoNTA. Graft volumes were determined, and grafts underwent histological analyses and immunostaining. CatWalk XT gait analysis was conducted on BTX+ mice.

RESULTS

Pre-BTX+ and BTX+ groups had significantly higher retention rates and exhibited better angiogenesis and adipocyte survival than the Control group.

CONCLUSION

BoNTA injections improved the long-term retention of supramuscular fat grafts by reducing muscle movement, possibly by augmenting angiogenesis and adipogenesis.
Acute Air Pollution Exposure and the Risk of Violent Behavior in the United States
Authors: Berman Jesse D. , Burkhardt Jesse , Bayham Jude , Carter Ellison , Wilson Ander
Published: August 2019

Background:

Violence is a leading cause of death and an important public health threat, particularly among adolescents and young adults. However, the environmental causes of violent behavior are not well understood. Emerging evidence suggests exposure to air pollution may be associated with aggressive or impulsive reactions in people.

Methods:

We applied a two-stage hierarchical time-series model to estimate change in risk of violent and nonviolent criminal behavior associated with short-term air pollution in U.S. counties (2000–2013). We used daily monitoring data for ozone and fine particulate matter (PM2.5) from the Environmental Protection Agency and daily crime counts from the Federal Bureau of Investigation. We evaluated the exposure–response relation and assessed differences in risk by community characteristics of poverty, urbanicity, race, and age.

Results:

Our analysis spans 301 counties in 34 states, representing 86.1 million people and 721,674 days. Each 10 µg/m3 change in daily PM2.5 was associated with a 1.17% (95% confidence interval [CI] = 0.90, 1.43) and a 10 ppb change in ozone with a 0.59% (95% CI = 0.41, 0.78) relative risk increase (RRI) for violent crime. However, we observed no risk increase for nonviolent property crime due to PM2.5 (RRI: 0.11%; 95% CI = −0.09, 0.31) or ozone (RRI: −0.05%; 95% CI = −0.22, 0.12). Our results were robust across all community types, except rural regions. Exposure–response curves indicated increased violent crime risk at concentrations below regulatory standards.

Conclusions:

Our results suggest that short-term changes in ambient air pollution may be associated with a greater risk of violent behavior, regardless of community type.
Test-Negative Designs
Authors: Vandenbroucke Jan P. , Pearce Neil
Published: August 2019

Test-negative studies recruit cases who attend a healthcare facility and test positive for a particular disease; controls are patients undergoing the same tests for the same reasons at the same healthcare facility and who test negative. The design is often used for vaccine efficacy studies, but not exclusively, and has been posited as a separate type of study design, different from case–control studies because the controls are not sampled from a wider source population. However, the design is a special case of a broader class of case–control designs that identify cases and sample “other patient” controls from the same healthcare facilities. Therefore, we consider that new insights into the test-negative design can be obtained by viewing them as case–control studies with “other patient” controls; in this context, we explore differences and commonalities, to better define the advantages and disadvantages of the test-negative design in various circumstances. The design has the advantage of similar participation rates, information quality and completeness, referral/catchment areas, initial presentation, diagnostic suspicion tendencies, and preferences by doctors. Under certain assumptions, valid population odds ratios can be estimated with the test-negative design, just as with case–control studies with “other patient” controls. Interestingly, directed acyclic graphs (DAGs) are not completely helpful in explaining why the design works. The use of test-negative designs may not completely resolve all potential biases, but they are a valid study design option, and will in some circumstances lead to less bias, as well as often the most practical one.
Cardiotonic Steroids Induce Vascular Fibrosis Via Pressure-Independent Mechanism in NaCl-Loaded Diabetic Rats
Authors: Fedorova Olga V. , Fadeev Artem V. , Grigorova Yulia N. , Marshall Courtney A. , Zernetkina Valentina , Kolodkin Nikolai I. , Agalakova Natalia I. , Konradi Alexandra O. , Lakatta Edward G. , Bagrov Alexei Y.
Published: August 2019

Endogenous cardiotonic steroid, marinobufagenin (MBG), induces Fli1-dependent tissue fibrosis. We hypothesized that an increase in MBG initiates the development of aortic fibrosis in salt-loaded rats with type 2 diabetes mellitus (DM2) via pressure-independent mechanism. DM2 was induced by a single intraperitoneal administration of 65 mg/kg streptozotocin to neonatal (4–5 days) male Wistar rats. Eight-week-old DM2 rats received water or 1.8% NaCl (DM-NaCl) solution for 4 weeks (n = 16); half of DM-NaCl rats were treated with anti-MBG monoclonal antibody (mAb) (DM-NaCl-AB) during week 4 of salt loading; control intact rats received water (n = 8/group). Blood pressure, MBG, erythrocyte Na/K-ATPase activity, aortic weights, levels of fibrosis markers (Fli1, protein kinase Cδ, transforming growth factor-β1, receptors of the transforming growth factor beta5, fibronectin, collagen-1), and sensitivity of the aortic explants to the vasorelaxant effect of sodium nitroprusside were assessed. No changes in systolic blood pressure were observed while erythrocyte Na/K-ATPase was inhibited by 30%, plasma MBG was doubled, and aortic markers of fibrosis became elevated in DM-NaCl rats versus control. Treatment of DM-NaCl rats with anti-MBG mAb activated Na/K-ATPase, prevented increases in aortic weights, and the levels of fibrosis markers returned to the control levels. The responsiveness of the aortic rings from DM-NaCl rats to the relaxant effect of sodium nitroprusside was reduced (half maximal effective concentration (EC50) = 29 nmol/L) versus control rings (EC50 = 7 nmol/L) and was restored by anti-MBG mAb (EC50 = 9 nmol/L). Our results suggest that in salt-loaded diabetic rats, MBG stimulates aortic collagen synthesis in a pressure-independent fashion and that 2 profibrotic mechanisms, Fli1 dependent and transforming growth factor-β dependent, underlie its effects.
Severe Respiratory Syncytial Virus Infection in Preterm Infants and Later Onset of Asthma
Authors: Jalink Matthew B. , Langley Joanne M. , Dodds Linda , Andreou Pantelis
Published: August 2019

Background:

Respiratory syncytial virus (RSV) is the leading cause of viral lower respiratory tract infections in infants. Preterm infants are at increased risk for hospitalization with RSV (RSV-H), but there are few data on the relationship between RSV-H and asthma in preterm infants, or any data stratified by gestational age, and most studies have short follow-up periods. We sought to evaluate the relationship between serious RSV illness and onset of asthma up to 5 years of age in a cohort of preterm children and to quantify this association.

Methods:

A retrospective birth cohort of preterm infants (29 weeks 0 days to 35 weeks 6 days gestational age) was constructed from a provincial population-based database, and children were followed forward for 5 years. Incidence rates of RSV-H and asthma were determined. In a Cox proportional hazards model, controlled for putative confounding factors for asthma, the hazard ratio and 95% CI of asthma in children with and without RSV-H was evaluated.

Results:

Among 3916 premature children, the incidence rate of RSV-H was 25/1000 infants. The cumulative incidence rate of asthma at 5 years of age in children with RSV-H was 57.9/1000 person-years compared with 36.7 in those without RSV-H; the adjusted hazards ratio for asthma in RSV-H infants was elevated at 1.58 (95% CI: 1.03–2.41).

Conclusions:

In prematurely born children, there is a moderate association between severe RSV infection, as measured by RSV-H in the first year of life, and asthma up to 5 years of age.
Global Divergence From World Health Organization Treatment Guidelines for Neonatal and Pediatric Sepsis
Authors: Jackson Charlotte , Hsia Yingfen , Basmaci Romain , Bielicki Julia , Heath Paul T. , Versporten Ann , Goossens Herman , Sharland Mike
Published: August 2019

We used data from 2 global point prevalence surveys of antibiotic prescribing to describe the treatment of sepsis in hospitalized neonates and children. One hundred eighty-five of 824 neonates (22.5%) and 9/786 children (1.1%) received a World Health Organization-recommended first-line treatment; of the remainder, 9/639 neonates (1.4%) and 102/777 children (13.1%) received a World Health Organization-recommended second-line treatment. Reasons for this low adherence to guidance should be explored.
Long-Acting Injectables Versus Oral Antipsychotics
Authors: Miura Gentaro , Misawa Fuminari , Kawade Yuko , Fujii Yasuo , Mimura Masaru , Kishimoto Taishiro
Published: August 2019

Purpose

Mirror-image studies, which compare equal periods of time before and after a new treatment is introduced, may reflect the real-world impact of that treatment. However, most mirror-image studies that have investigated the impact of long-acting injectable antipsychotics (LAIs) were unidirectional in design, for patients switching from oral antipsychotics (OAPs) to LAIs. Therefore, we conducted a bidirectional mirror-image study comparing LAIs and OAPs.

Methods

We included 126 schizophrenia or schizoaffective disorder patients' LAI treatment data from 3 psychiatric hospitals. Patients took OAPs for 6 months or more before initiating LAIs, or the reverse. We obtained data on the number of hospitalizations as a primary outcome, plus the total duration and mean duration of hospitalization as secondary outcomes during the 6 months of the patients' first treatment, and the 6 months after the patients started their second type of treatment.

Results

The results indicated that there was no significant difference in any outcomes between LAI and OAP treatment when going from LAIs to OAPs (n = 59). However, when patients started with OAPs and switched to LAIs (n = 67), they were hospitalized a significantly fewer number of times, and the duration of their stays was shorter in the LAI phase than in the OAP phase. When combined with bidirectional data, LAI superiority was still observed.

Conclusions

The findings endorse the relative effectiveness of LAIs over OAPs in the real world, although the inherent flaws of mirror-image studies such as expectation bias and having no parallel comparator should be considered.
Is Antipsychotic Treatment Associated With Risk of Pneumonia in People With Serious Mental Illness?
Authors: Chan Hung-Yu , Lai Chien-Liang , Lin Yi-Chun , Hsu Chun-Chi
Published: August 2019

Background

Most pneumonia-related researches in people with severe mental illness were based on insurance claims data. This study aimed for a comprehensive analysis of factors potentially associated with risk of pneumonia in psychiatric inpatients.

Methods

Inpatients at a large psychiatric hospital diagnosed with pneumonia during the course of hospitalization were enrolled as cases. Controls were matched by ward and date. The diagnosis of pneumonia was confirmed by physicians based on clinical features, chest radiographs, and blood tests. A stepwise conditional logistic regression model was used to identify potential risk factors for pneumonia.

Results

Seventy-five pneumonia cases and 436 matched controls were enrolled. Conditional logistic regression revealed 3 variables significantly associated with an increased risk of pneumonia: a higher score on the Clinical Global Impression—Severity scale (adjusted odds ratio [aOR], 3.7; 95% confidence interval [CI]. 1.5–9.1), a higher score on the Charlson comorbidity index (aOR, 2.2; 95% CI, 1.5–3.2), and a longer duration of antipsychotic treatment (aOR, 1.0; 95% CI, 1.0–1.0). Two variables were significantly associated with a decreased risk of pneumonia: a higher score on the Global Assessment of Functioning scale (aOR, 0.9; 95% CI, 0.8–0.9) and an older age of onset (aOR, 0.9; 95% CI, 0.9–1.0). After adjusting for potential confounders, use of antipsychotic or other psychotropic medications was not found to be a significant risk factor for pneumonia.

Conclusions

Physical comorbidities, long duration of antipsychotic treatment, early onset, severe psychiatric symptoms, and poor global functioning are associated with pneumonia in people with serious mental illness.
Evaluation of Prescribing Patterns of Long-Acting Injectable Antipsychotics Within a Community Health System
Authors: Netley Jared , Gaul Jamie , Ferguson Chelsea
Published: August 2019

Purpose/Background

Long-acting injectable antipsychotics (LAIAs) are used in the management of schizophrenia, bipolar disorder, and related psychiatric conditions. The efficacy of LAIAs has been established in randomized controlled trials; however, usage of LAIAs outside of randomized controlled trials may not correlate to naturalistic prescribing habits. The purpose of this analysis was to evaluate the prescribing patterns of LAIAs within our health system and identify any inconsistencies between medications' published labeling information and clinical practice.

Methods/Procedures

All patients who received a LAIA at the time of the analysis were included for review. Areas of inconsistency between the prescribed LAIA and each medication's published labeling information were targeted and assessed. Frequency statistics were used to review the following areas for inconsistencies: indication, trial of oral therapy, dose, frequency, and titration method.

Findings/Results

This analysis included 427 patient cases who received a combined 1480 injections during the analysis period. Overall consistency rates between labeling information and prescribed LAIAs within the analysis period were as follows: 71.2% for indication, 67.4% for trial of oral therapy, 94.4% for dose of LAIA, 84.5% for injection frequency, and 93.9% for titration method.

Implications/Conclusions

Inconsistencies were observed between labeling information and clinical practice for LAIAs prescribed within the community health system. Patients who are more symptomatic and have additional psychological comorbidities are commonly excluded from clinical trials. Alternative dosing may be clinically necessary to obtain an adequate response, and this may have been captured in this review. This analysis may be hypothesis generating for future studies on LAIAs.
Auditory Performances in Older and Younger Adult Cochlear Implant Recipients: Use of the HEARRING Registry
Authors: Hofkens-Van den Brandt Anouk , Mertens Griet , Gilles Annick , Fransen Erik , Lassaletta Luis , Gavilan Javier , Calvino Miryam , Yanov Yuri , Kuzovkov Vladislav , Kliachko Dmitrii , Zernotti Mario , Gregorio Dra Maria Fernanda Di , Van Rompaey Vincent , Van de Heyning Paul , Sugarova Seraphima
Published: August 2019

Objective:

To evaluate the hearing outcomes of cochlear implantation in different age groups by using data collected in the HEARRING registry.

Methods:

A multicenter study. Data of 146 patients were collected in a HEARRING registry. Patients were divided into three different age groups; ≤ 55 years old (age group 1, n = 66), 56 to 69 years old (age group 2, n = 45), and ≥ 70 years old (age group 3, n = 35). Speech in quiet (SPIQ), speech in noise (SPIN), and hearing implant sound quality index (HISQUI19) scores were evaluated for the different age groups at different test moments (preoperatively, 3, 6, 12, and 24 mo after first fitting).

Results:

A statistically significant difference (p < 0.01) was found between preoperative scores and the scores on all the follow-up moments across all age groups. For SPIQ and SPIN, none of the time points showed a statistically significant age effect (p = 0.88 and p = 0.89). For HISQUI19 scores, a statistically significant age effect was found at 12 months after first fitting. The oldest age group scored significantly lower on the HISQUI19 compared with the youngest age group.

Conclusion:

Hearing outcomes of adult cochlear implant users of different age groups were evaluated. The SPIQ and SPIN tests showed no significant differences between the different age groups. Nevertheless, the youngest group scored significantly better on self -perceived benefit (HISQUI19) with a cochlear implant compared with the oldest age group.

Further research is needed to receive more insight into cochlear implantation in the elderly and its implications on rehabilitating and supporting this expanding older population.
Case report: painful exanthems caused by enterovirus D68 in an adolescent
Authors: Chang Tu-Hsuan , Yang Tzu-I , Hsu Wei-Yun , Huang Li-Min , Chang Luan-Yin , Lu Chun-Yi
Published: August 2019

Rationale:

Unlike other enteroviruses which can cause herpangina or hand-foot-and-mouth disease, enterovirus D68 (EV-D68) has usually been linked to respiratory and neurological problems in young children. Skin manifestations had rarely been described in current literatures.

Patient concerns:

We report a 17-year-old girl with fever and painful skin rash over legs and soles for 9 days. Pitting edema was also noted below the knees. There was no respiratory tract or neurological symptoms in this patient.

Diagnoses:

EV-D68 was detected from a throat swab by RT-PCR and confirmed to be subclade B3 by sequencing.

Interventions:

Supportive management.

Outcomes:

The patient was afebrile after 9 days and got full recovery on the 23rd day at outpatient follow-up.

Lessons:

To the best of our knowledge, this is the first report of EV-D68 infection with skin manifestations, clinical images, and detailed clinical course. Our findings in this particular case extend the understanding of the disease spectrum.