bluuebunny/crossref_metadata_2025 huggingface dataset:
Stage-specific links between plasma neurofilament light and imaging biomarkers of Alzheimer’s disease
Authors: Benedet Andréa L , Leuzy Antoine , Pascoal Tharick A , Ashton Nicholas J , Mathotaarachchi Sulantha , Savard Melissa , Therriault Joseph , Kang Min Su , Chamoun Mira , Schöll Michael , Zimmer Eduardo R , Gauthier Serge , Labbe Aurélie , Zetterberg Henrik , Rosa-Neto Pedro , Blennow Kaj ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: September 2020

Neurofilament light (NfL) is a marker of neuroaxonal injury, a prominent feature of Alzheimer’s disease. It remains uncertain, however, how it relates to amyloid and tau pathology or neurodegeneration across the Alzheimer’s disease continuum. The aim of this study was to investigate how plasma NfL relates to amyloid and tau PET and MRI measures of brain atrophy in participants with and without cognitive impairment. We retrospectively examined the association between plasma NfL and MRI measures of grey/white matter volumes in the Alzheimer’s Disease Neuroimaging Initiative [ADNI: n = 1149; 382 cognitively unimpaired control subjects and 767 cognitively impaired participants (mild cognitive impairment n = 420, Alzheimer’s disease dementia n = 347)]. Longitudinal plasma NfL was measured using single molecule array (Simoa) technology. Cross-sectional associations between plasma NfL and PET amyloid and tau measures were independently assessed in two cohorts: ADNI [n = 198; 110 cognitively unimpaired, 88 cognitively impaired (MCI n = 67, Alzheimer’s disease dementia n = 21), data accessed October 2018]; and Translational Biomarkers in Aging and Dementia [TRIAD, n = 116; 74 cognitively unimpaired, 42 cognitively impaired (MCI n = 16, Alzheimer’s disease dementia n = 26), data obtained November 2017 to January 2019]. Associations between plasma NfL and imaging-derived measures were examined voxel-wise using linear regression (cross-sectional) and linear mixed effect models (longitudinal). Cross-sectional analyses in both cohorts showed that plasma NfL was associated with PET findings in brain regions typically affected by Alzheimer’s disease; associations were specific to amyloid PET in cognitively unimpaired and tau PET in cognitively impaired (P < 0.05). Longitudinal analyses showed that NfL levels were associated with grey/white matter volume loss; grey matter atrophy in cognitively unimpaired was specific to APOE ε4 carriers (P < 0.05). These findings suggest that plasma NfL increases in response to amyloid-related neuronal injury in preclinical stages of Alzheimer’s disease, but is related to tau-mediated neurodegeneration in symptomatic patients. As such, plasma NfL may a useful measure to monitor effects in disease-modifying drug trials.
Beyond “Commercial Realism”: Extending Goffman’s Gender Display Framework to Networked Media Contexts
Authors: Butkowski Chelsea P.
Published: September 2020

Erving Goffman’s gender display framework is a typology of nonverbal posing codes that connote the subordination of women in commercial imagery and a prominent tool for assessing visualizations of gender stereotyping in mass media. Researchers have recently begun to apply the advertisement-based framework to a new context: user-generated social media photos. Despite findings that gender display appears prevalent in such images, deeper critical examinations of how the framework changes when applied across media contexts have not been meaningfully undertaken. Drawing from the interplay of Goffman’s concepts of hyper-ritualization and commercial realism, I argue that the manifestations and interpretive implications of gender display are contingent upon the standard of realism at play, proposing a standard of networked realism that differently modulates gender display in user-generated photography. Ultimately, I suggest that gender display must be more thoroughly contextualized in networked media research and provide a groundwork for future feminist studies of visual gender stereotyping.
DS-GCNs: Connectome Classification using Dynamic Spectral Graph Convolution Networks with Assistant Task Training
Authors: Xing Xiaodan , Li Qingfeng , Yuan Mengya , Wei Hao , Xue Zhong , Wang Tao , Shi Feng , Shen Dinggang
Published: September 2020

Functional connectivity (FC) matrices measure the regional interactions in the brain and have been widely used in neurological brain disease classification. A brain network, also named as connectome, could form a graph structure naturally, the nodes of which are brain regions and the edges are interregional connectivity. Thus, in this study, we proposed novel graph convolutional networks (GCNs) to extract efficient disease-related features from FC matrices. Considering the time-dependent nature of brain activity, we computed dynamic FC matrices with sliding windows and implemented a graph convolution–based LSTM (long short–term memory) layer to process dynamic graphs. Moreover, the demographics of patients were also used as additional outputs to guide the classification. In this paper, we proposed to utilize the demographic information as extra outputs and to share parameters among three networks predicting subject status, gender, and age, which serve as assistant tasks. We tested the performance of the proposed architecture in ADNI II dataset to classify Alzheimer’s disease patients from normal controls. The classification accuracy, sensitivity, and specificity reach 90.0%, 91.7%, and 88.6%, respectively, on ADNI II dataset.
High-power short duration vs. conventional radiofrequency ablation of atrial fibrillation: a systematic review and meta-analysis
Authors: Ravi Venkatesh , Poudyal Abhushan , Abid Qurrat-Ul-Ain , Larsen Timothy , Krishnan Kousik , Sharma Parikshit S , Trohman Richard G , Huang Henry D
Published: September 2020

Aims

We sought to compare the effectiveness and safety of high-power short-duration (HPSD) radiofrequency ablation (RFA) with conventional RFA in patients with atrial fibrillation (AF).

Methods and results

MEDLINE, Cochrane, and ClinicalTrials.gov databases were searched until 15 May 2020 for relevant studies comparing HPSD vs. conventional RFA in patients undergoing initial catheter ablation for AF. A total of 15 studies involving 3718 adult patients were included in our meta-analysis (2357 in HPSD RFA and 1361 in conventional RFA). Freedom from atrial arrhythmia was higher in HPSD RFA when compared with conventional RFA [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.10–1.90; P = 0.009]. Acute PV reconnection was lower (OR 0.56, P = 0.005) and first-pass isolation was higher (OR 3.58, P < 0.001) with HPSD RFA. There was no difference in total complications between the two groups (P = 0.19). Total procedure duration [mean difference (MD) −37.35 min, P < 0.001], fluoroscopy duration (MD −5.23 min, P = 0.001), and RF ablation time (MD −16.26 min, P < 0.001) were all significantly lower in HPSD RFA. High-power short-duration RFA also demonstrated higher freedom from atrial arrhythmia in the subgroup analysis of patients with paroxysmal AF (OR 1.80, 95% CI 1.29–2.50; P < 0.001), studies with ≥50 W protocol in the HPSD RFA group (OR 1.53, 95% CI 1.08–2.18; P = 0.02] and studies with contact force sensing catheter use (OR 1.65, 95% CI 1.21–2.25; P = 0.002).

Conclusion

High-power short-duration RFA was associated with better procedural effectiveness when compared with conventional RFA with comparable safety and shorter procedural duration.
The effects of earth model uncertainty on the inversion of seismic data for seismic source functions
Authors: Poppeliers Christian , Preston Leiph
Published: September 2020

We use Monte Carlo simulations to explore the effects of earth model uncertainty on the estimation of the seismic source time functions that correspond to the six independent components of the point source seismic moment tensor. Specifically, we invert synthetic data using Green’s functions estimated from a suite of earth models that contain stochastic density and seismic wave-speed heterogeneities. We find that the primary effect of earth model uncertainty on the data is that the amplitude of the first-arriving seismic energy is reduced, and that this amplitude reduction is proportional to the magnitude of the stochastic heterogeneities. Also, we find that the amplitude of the estimated seismic source functions can be under- or overestimated, depending on the stochastic earth model used to create the data. This effect is totally unpredictable, meaning that uncertainty in the earth model can lead to unpredictable biases in the amplitude of the estimated seismic source functions.
Understanding the Best Interests of the Child as a Procedural Obligation: The Example of the European Court of Human Rights
Authors: Sormunen Milka
Published: September 2020

According to Article 3(1) of the United Nations Convention on the Rights of the Child, the best interests of the child have to be a primary consideration in all cases concerning children. The Committee on the Rights of the Child understands Article 3(1) as a ‘threefold concept’: a substantive right, an interpretive principle and a rule of procedure. This article argues that the provision is best understood as a procedural obligation. Understanding Article 3(1) as a procedural obligation remedies key problems that originate from interpreting the provision as a substantive right. A significant strength of the procedural approach is that it can be consistently applied in different case groups. This article illustrates the argument with the case law of the European Court of Human Rights related to children, in which the article detects three layers of a procedural approach to the best interests of the child.
Methylation marks of prenatal exposure to maternal smoking and risk of cancer in adulthood
Authors: Dugué Pierre-Antoine , Hodge Allison M , Wong Ee Ming , Joo JiHoon E , Jung Chol-Hee , Hopper John L , English Dallas R , Giles Graham G , Milne Roger L , Southey Melissa C
Published: September 2020

Background

Prenatal exposure to maternal smoking is detrimental to child health but its association with risk of cancer has seldom been investigated. Maternal smoking induces widespread and long-lasting DNA methylation changes, which we study here for association with risk of cancer in adulthood.

Methods

Eight prospective case–control studies nested within the Melbourne Collaborative Cohort Study were used to assess associations between maternal-smoking-associated methylation marks in blood and risk of several cancers: breast (n = 406 cases), colorectal (n = 814), gastric (n = 166), kidney (n = 139), lung (n = 327), prostate (n = 847) and urothelial (n = 404) cancer and B-cell lymphoma (n = 426). We used conditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between cancer and five methylation scores calculated as weighted averages for 568, 19, 15, 28 and 17 CpG sites. Models were adjusted for confounders, including personal smoking history (smoking status, pack-years, age at starting and quitting) and methylation scores for personal smoking.

Results

All methylation scores for maternal smoking were strongly positively associated with risk of urothelial cancer. Risk estimates were only slightly attenuated after adjustment for smoking history, other potential confounders and methylation scores for personal smoking. Potential negative associations were observed with risk of lung cancer and B-cell lymphoma. No associations were observed for other cancers.

Conclusions

We found that methylation marks of prenatal exposure to maternal smoking are associated with increased risk of urothelial cancer. Our study demonstrates the potential for using DNA methylation to investigate the impact of early-life, unmeasured exposures on later-life cancer risk.
Differential gene expression, irrespective of circulating Hepatitis B Surface Antigen levels, between Inactive Carrier and Nucleos(t)ide Analogue-Treated Hepatitis B Virus patients
Authors: Montanari Noé R , Conceição-Neto Nádia , Van Den Wyngaert Ilse , Van Oord Gertine W , Groothuismink Zwier M A , Van Tilburg Sandra , de Man Robert A , Aerssens Jeroen , Boonstra André
Published: September 2020

Long-term viremia control in chronic HBV patients occurs either spontaneously in inactive carrier (IC) patients or therapy-induced by nucleos(t)ide analogues (NUC). To better understand the characteristics of viremia control, we evaluated gene expression in purified leukocyte subsets from IC versus NUC-treated patients, and evaluated the putative modulatory effects of hepatitis B surface antigen (HBsAg). We observed that gene expression in NUC-treated patients differed markedly from IC patients, especially in dendritic cells, monocytes, and CD8+ T cells, while serum HBsAg levels had little effect. Nevertheless, based on our findings it cannot be excluded that HBsAg may act locally in the infected liver or preferentially affects HBV-specific cells.
Clostridioides difficile Binary Toxin Is Recognized by the Toll-Like Receptor 2/6 Heterodimer to Induce a Nuclear Factor-κB Response
Authors: Simpson Morgan , Frisbee Alyse , Kumar Pankaj , Schwan Carsten , Aktories Klaus , Petri William A
Published: September 2020

Clostridioides difficile infection (CDI) represents a significant burden on the health care system, one that is exacerbated by the emergence of binary toxin (CDT)-producing hypervirulent C. difficile strains. Previous work from our laboratory has shown that Toll-like receptor 2 (TLR2) recognizes CDT to induce inflammation. Here we explore the interactions of CDT with TLR2 and the impact on host immunity during CDI. We found that the TLR2/6 heterodimer, not TLR2/1, is responsible for CDT recognition, and that gene pathways including nuclear factor-κB and MAPK downstream of TLR2/6 are upregulated in mice with intact TLR2/6 signaling during CDI.
Identity Collision: Older Gay Men Using Technology
Authors: Marciano Avi , Nimrod Galit
Published: September 2020

This study examines identity work among older gay men in relation to Information and Communication Technology (ICT). It draws on the notion of IT identity—the extent to which individuals experience technology as integral to their sense of selves—to explore how their homosexuality and advanced age shape their relationships with technology. Applying thematic analysis to 17 semi-structured, in-depth interviews with gay male users aged 66–81, we show that while homosexuality and technology enable and reinforce one another, the relationship between technology and advanced age can be better defined by alienation and estrangement. Consequently, we argue that technology constitutes a crossroads at which the gay and elder identities intersect and collide. In this sense, technology is similar to other cultural constructs, like sexuality, that challenge the merger of advanced age and homosexuality, rendering the older gay identity almost impossible.
First Report ofAedes albopictus(Diptera: Culicidae) in District Mirpur, Azad Jammu and Kashmir, Pakistan
Authors: Jabeen Aliya , Ansari Jamil A , Ikram Aamer , Khan Mumtaz Ali , Qaisrani Moin Iqbal , Khan Saira , Safdar Muhammad
Published: September 2020

Our article documents the presence of Aedes albopictus (Skuse) from urban and rural locations in the lower Himalaya Mountains, northern Pakistan. Larvae were collected from graveyards, junkyards, plant nurseries, parks, and houses. Used tires, bird drinking pots, and water storage containers were the most common containers used by this mosquito. In the absence of Aedes aegypti (L.) (Diptera: Culicidae), Ae. albopictus appears to be the primary vector of recent dengue virus outbreaks.
Simplified rabies pre-exposure prophylaxis in last-minute travellers
Authors: Soentjens Patrick , Croughs Mieke
Published: September 2020

Less can be more: simplified two-visit rabies pre-exposure prophylaxis once in a lifetime will certainly increase compliance in last-minute travellers and ease the post-exposure procedures after animal risks in endemic countries. Different arguments are being put forward to shorten this vaccination scheme even further into an effective one-day scheme.
Functional divergence of diacylglycerol acyltransferases in the unicellular green alga Haematococcus pluvialis
Authors: Ma Haiyan , Wu Xiaoying , Wei Ziwang , Zhao Liang , Li Zhongze , Liang Qing , Zheng Jie , Wang Yu , Li Yanhua , Huang Linfei , Hu Qiang , Han Danxiang
Published: September 2020

Acyl-CoA:diacylglycerol acyltransferase (DGAT) catalyzes the final committed step in triacylglycerol biosynthesis in eukaryotes. In microalgae, the copy number of DGAT genes is extraordinarily expanded, yet the functions of many DGATs remain largely unknown. This study revealed that microalgal DGAT can function as a lysophosphatidic acyltransferase (LPAAT) both in vitro and in vivo while losing its original function as DGAT. Among the five DGAT-encoding genes identified and cloned from the green microalga Haematococcus pluvialis, four encoded HpDGATs that showed triacylglycerol synthase activities in yeast functional complementation analyses; the exception was one of the type II DGAT encoding genes, HpDGTT2. The hydrophobic recombinant HpDGTT2 protein was purified in soluble form and was found to function as a LPAAT via enzymatic assay. Introducing this gene into the green microalga Chlamydomonas reinhardtii led to retarded cellular growth, enlarged cell size, and enhanced triacylglycerol accumulation, identical to the phenotypes of transgenic strains overexpressing CrLPAAT. This study provides a framework for dissecting uncharacterized DGATs, and could pave the way to decrypting the structure–function relationship of this large group of enzymes that are critical to lipid biosynthesis.
Comptonization of CMB in galaxy clusters. Monte Carlo computations
Authors: Gornostaev M I , Lipunova G V
Published: September 2020

The problem under consideration is to determine the change of the cosmic microwave background (CMB) spectral shape due to the thermal Sunyaev–Zeldovich (tSZ) effect. We numerically model the spectral intensity of the CMB radiation Comptonized by the hot intergalactic Maxwellian plasma. To this aim, a relativistic Monte Carlo code with photon weights is developed. The code enables us to construct the Comptonized CMB spectrum in a wide energy range. The results are compared with known analytical solutions and previous numerical simulations. We also calculate the angular distributions of the intensity of radiation emerging from the cloud, which show that the spectral shape of the tSZ effect is not universal for different directions of escaping photons. The numerical method can be applied to simulate the processes of Comptonization for different optical depths, temperatures, initial spectra of photon sources, and their spatial distributions, the obtained results may have implications on investigating the profiles of galaxy clusters.
A flexible, interpretable, and accurate approach for imputing the expression of unmeasured genes
Authors: Mancuso Christopher A , Canfield Jacob L , Singla Deepak , Krishnan Arjun
Published: September 2020

While there are >2 million publicly-available human microarray gene-expression profiles, these profiles were measured using a variety of platforms that each cover a pre-defined, limited set of genes. Therefore, key to reanalyzing and integrating this massive data collection are methods that can computationally reconstitute the complete transcriptome in partially-measured microarray samples by imputing the expression of unmeasured genes. Current state-of-the-art imputation methods are tailored to samples from a specific platform and rely on gene-gene relationships regardless of the biological context of the target sample. We show that sparse regression models that capture sample-sample relationships (termed SampleLASSO), built on-the-fly for each new target sample to be imputed, outperform models based on fixed gene relationships. Extensive evaluation involving three machine learning algorithms (LASSO, k-nearest-neighbors, and deep-neural-networks), two gene subsets (GPL96–570 and LINCS), and multiple imputation tasks (within and across microarray/RNA-seq datasets) establishes that SampleLASSO is the most accurate model. Additionally, we demonstrate the biological interpretability of this method by showing that, for imputing a target sample from a certain tissue, SampleLASSO automatically leverages training samples from the same tissue. Thus, SampleLASSO is a simple, yet powerful and flexible approach for harmonizing large-scale gene-expression data.
Upper Mantle Mush Zones beneath Low Melt Flux Ocean Island Volcanoes: Insights from Isla Floreana, Galápagos
Authors: Gleeson Matthew L M , Gibson Sally A , Stock Michael J
Published: September 2020

The physicochemical characteristics of sub-volcanic magma storage regions have important implications for magma system dynamics and pre-eruptive behaviour. The architecture of magma storage regions located directly above high buoyancy flux mantle plumes (such as Kīlauea, Hawai’i and Fernandina, Galápagos) are relatively well understood. However, far fewer constraints exist on the nature of magma storage beneath ocean island volcanoes that are distal to the main zone of mantle upwelling or above low buoyancy flux plumes, despite these systems representing a substantial proportion of ocean island volcanism globally. To address this, we present a detailed petrological study of Isla Floreana in the Galápagos Archipelago, which lies at the periphery of the upwelling mantle plume and is thus characterized by an extremely low flux of magma into the lithosphere. Detailed in situ major and trace element analyses of crystal phases within exhumed cumulate xenoliths, lavas and scoria deposits indicate that the erupted crystal cargo is dominated by disaggregated crystal-rich material (i.e. mush or wall rock). Trace element disequilibria between cumulus phases and erupted melts, as well as trace element zoning within the xenolithic clinopyroxenes, reveal that reactive porous flow (previously identified beneath mid-ocean ridges) is an important process of melt transport within crystal-rich magma storage regions. In addition, application of three petrological barometers reveals that the Floreana mush zones are located in the upper mantle, at a depth of 23·7 ± 5·1 km. Our barometric results are compared with recent studies of high melt flux volcanoes in the western Galápagos, and other ocean island volcanoes worldwide, and demonstrate that the flux of magma from the underlying mantle source represents a first-order control on the depth and physical characteristics of magma storage.
The Legendre–Hadamard condition in Cosserat elasticity theory
Authors: Shirani Milad , Steigmann David J , Neff Patrizio
Published: September 2020

The Legendre–Hadamard necessary condition for energy minimizers is derived in the framework of Cosserat elasticity theory.
Invisible Poetry: Women, Ethnic Minorities and the Forgotten History of Carcanet Magazine
Authors: Jaillant Lise
Published: September 2020

Before it became a leading poetry publisher, Carcanet was a student magazine set up by undergraduates who wanted to link Oxford and Cambridge. This article sheds light on the forgotten history of Carcanet magazine, focusing particularly on women and ethnic minorities. Prior to Michael Schmidt’s takeover of the magazine in late 1967, Carcanet offered opportunities to writers from India and ex-colonies (including Adil Jussawalla and Edward Brathwaite) to publish their work, before moving on to more mainstream venues. Carcanet magazine can be seen as a site of struggle between various players: between the Oxford and Cambridge literary sets, and between British/European and postcolonial groups. Drawing on extensive archival work in neglected collections, as well as oral history interviews, this article tells an alternative history of Carcanet magazine as a case study for the larger literary field of post-war Britain. The story is less focused on Michael Schmidt, without diminishing his accomplishment in transforming a student magazine into an enduring publishing enterprise.
Mental Health Consequences and Service Use of Older Adults at Risk of Financial Exploitation
Authors: Lavery Angela L , Hasche Leslie , DePrince Anne , Gagnon Kerry , Srinivas Tejaswinhi , Boyce Erin
Published: September 2020

This study examines whether the experience of financial exploitation is associated with increased likelihood of mental health consequences and subsequent use of mental health services. Interviews were conducted with 99 participants, age 60 and older, at risk for elder abuse. The authors and research team administered standardized measures of elder mistreatment, depression, trauma, social support, and service use. Older adults who experienced financial exploitation reported worse trauma symptoms and depression than those who did not experience financial exploitation. Those with increased functional impairment were least likely to rely on mental health services. The findings highlight the importance of interventions to address and enhance response to depression, trauma, and social support in older adults who are victims of financial exploitation.
Declarative tracing or backwards tracing—a welcomed development or a misnomer
Authors: Chong Conrad
Published: September 2020

In Federal Republic of Brazil v Durant International Corpn [2016], the Privy Council upheld the long-disputed concept of backwards tracing. This article argues in favour of the establishment of backwards tracing and attempts to clarify several confusions arising in the development of backwards tracing, in particular those terminological difficulties. Deriving from the clarification effort, it is advocated that the orthodox tracing process can be interpreted from an additional perspective, based on the ‘negative option’ obtained (but often neglected) by a tracer. Accordingly, it is time to rename backwards tracing as ‘Declarative Tracing’.
Putting Workers on the Map: Agricultural Atlases and the Willamette Valley’s Hidden Labor Landscape
Authors: Korsunsky Alex
Published: September 2020

Analyzing Oregon agricultural atlases from 1878 to 1958, I show that, despite these texts’ projection of impartial authority, they function to extend a discourse of natural bounty in which agricultural abundance is linked to inherent characteristics of the land, hiding the role of racialized and disenfranchised laborers in production. Using a combination of Agricultural Census data, historical and contemporary records from farmers and agricultural extension services, and GIS software, I demonstrate a method for reconstructing historical and contemporary agricultural labor landscapes, filling in—at least partially—the spatial absence of farmworkers. Using maps I have produced for a limited set of crops as a case study, alongside worker testimonies and ethnographic accounts, I argue that this sort of counter-mapping of the agricultural landscape can form the basis for an alternative spatial narrative of changing landscapes, replacing the depopulated and bountiful nature of conventional agricultural atlases with maps that reveal the agricultural landscape from a worker’s perspective that centers the hidden the toil and suffering entailed in the creation of Oregon’s agricultural bounty.
Classification and Treatment of Pediatric Tibial Spine Fractures: Assessing Reliability Among a Tibial Spine Research Interest Group
Authors: Ellis Henry B. , Zynda Aaron J. , Cruz Aristides I. , Sachleben Brant , Sargent Catherine , Green Daniel , Schmale Gregory , Jagodzinski Jason , Rhodes Jason , Mistovich Justin , Fabricant Peter D. , McKay Scott , Lee Rushyuan J. , Yen Yi-Meng , Ganley Theodore
Published: September 2020

Background:

Treatment decisions for patients with tibial spine fractures depend heavily on radiographic measurements. The purpose of this study was to determine whether existing classification systems and radiographic measurements are reliable among a multicenter tibial spine research interest group. A secondary purpose was to evaluate agreement in treatment of tibial spine fractures.

Methods:

Using a deidentified radiographic imaging series and identical imaging software, we examined the interobserver and intraobserver reliability of the Meyers and McKeever classification, as well as a cohort of measurements of tibial spine fractures and treatment recommendations. Forty patients were included based on previous reliability studies. Interobserver and intraobserver data were analyzed using kappa and intraclass correlation coefficient reliability measures for categorical and continuous variables, respectively.

Results:

Good interobserver reliability was seen with superior displacement measurements of the anterior portion of the tibial spine fracture (0.73, 0.78) and excellent intraobserver reliability with an intraclass correlation coefficient of 0.81. Several measurements demonstrated moderate interobserver and intraobserver reliability including posterior-proximal displacement, and length and height of the tibial spine fracture. Moderate intraobserver reliability was seen with a majority of measurements and classification schemata (0.42 to 0.60) except for a poor agreement in posterior-sagittal displacement (0.27). Classifying tibial spine fractures according to the original Meyers and McKeever classification demonstrated fair agreement [κ=0.35, 0.33 (inter); 0.47 (intra)]. When combining Type III and IV, agreement increased for both reviews [κ=0.42, 0.44 (inter); 0.52 (intra)]. A total of 24 (60%) fractures were classified as 3 different types. There was fair agreement in both reviews regarding open reduction (either open or arthroscopic) versus closed reduction for initial treatment [κ=0.33, 0.38 (inter); 0.51 (intra)].

Conclusions:

Measurement of superior displacement of the anterior portion of tibial spine fractures on the lateral images is the only radiographic assessment with good interobserver and intraobserver reliability. Reliability of radiographic measurements and a modified classification for tibial spine fractures remains fair, and perhaps unacceptable, even among a group of pediatric sports medicine specialty-trained surgeons.

Level of Evidence:

Level III—diagnostic reliability study of nonconsecutive patients.
Citalopram in Treatment of Pregnant Women With Panic Disorder
Authors: Uguz Faruk
Published: September 2020

Purpose

The study aimed to investigate efficacy of citalopram in pregnant women with panic disorder.

Methods

The study data with 22 patients were retrospectively collected from clinical registers. The study was conducted in patients with and without comorbid major depression. The patients were evaluated using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, the Clinical Global Impression-Improvement Scale, the Hamilton Depression Rating Scale, and the Hamilton Rating Scale for Anxiety.

Findings

The Hamilton Depression Rating Scale and the Hamilton Rating Scale for Anxiety scores were significantly reduced after treatment with citalopram at 20 mg/d for 8 weeks. The response rate based on Clinical Global Impression-Improvement Scale was 68.2%. Patients with comorbid major depression seemed to have a lower response rate compared with nondepressed patients.

Implications

The current study suggests that citalopram may be beneficial for in pregnant women with panic disorder.
Nonantibiotic treatments for urinary cystitis: an update
Authors: Barea Bianca M. , Veeratterapillay Rajan , Harding Chris
Published: September 2020

Purpose of review

Urinary tract infections (UTIs) are one of most common infections in everyday clinical practice. Given the increase in antimicrobial therapy resistance, there has been an increased interest in nonantibiotic treatment options for common infections.

Recent findings

A review of the recent literature including on nonantibiotic options for management of UTIs, symptoms of cystitis and prevention of recurrent UTIs.

The article provides an overview on alternative therapy to antibiotics in the treatment of cystitis and recurrent UTI prophylaxis, including alkalinization of urine, cranberry products, probiotics, NSAIDS, d-mannose, herbal medicine, methenamine hippurate, oral immunostimulants (immunotherapy), topical oestrogens, vitamins and acupuncture. The last few years of intense research has focused on an effort to find evidence to corroborate potentially efficacious non antibiotic treatments. However, alternative treatments for UTIs have not brought conclusive evidence that antibiotic usage can be replaced completely by nonantibiotic options. The reason for this is largely due to a lack of good-quality randomized controlled trials on this subject.
Efficacy of Early Percutaneous Catheter Drainage in Acute Pancreatitis of Varying Severity Associated With Sterile Acute Inflammatory Pancreatic Fluid Collection
Authors: Zhang Yun , Yu Wen-Qiao , Zhang Jian , Fu Shui-Qiao , Fu Qing-Hui , Liang Ting-Bo
Published: September 2020

Objective

The aim of the study was to evaluate the efficacy of early percutaneous catheter drainage (PCD) for sterile acute inflammatory pancreatic fluid collection (AIPFC) in acute pancreatitis (AP) of varying severity.

Methods

Retrospective analyses were performed based on the presence of sterile AIPFC and different AP severities according to 2012 Revised Atlanta Classification.

Results

Early PCD contributed to obvious decreases in operation rate (OR, P = 0.006), infection rate (IR, P = 0.020), and mortality (P = 0.009) in severe AP (SAP). In moderate SAP with sterile AIPFCs, however, early PCD was associated with increased OR (P = 0.009) and IR (P = 0.040). Subgroup analysis revealed that early PCD led to remarkable decreases in OR for patients with persistent organ failure (OF) within 3 days (P = 0.024 for single OF, P = 0.039 for multiple OF) and in mortality for patients with multiple OF (P = 0.041 for OF within 3 days and P = 0.055 for 3–14 days). Moreover, lower mortality was found in SAP patients with early PCD-induced infections than with spontaneous infections (P = 0.027).

Conclusions

Early PCD may improve the prognosis of SAP with drainable sterile AIPFCs by reducing the OR, IR, and mortality.
Quality of Parental Care and Traumatic Experiences in Childhood Related to Schizophrenic Disorders
Authors: Neumann Eva , Juckel Georg , Haussleiter Ida S.
Published: September 2020

In recent times, an increasing interest in the role of childhood adversities in schizophrenia can be seen. In this study, 37 schizophrenic patients were compared with 25 individuals from the general population with regard to the quality of parental care and traumatic experiences in childhood. Two self-report scales for retrospective measurement of these variables were used that differentiate between maternal and paternal rejection, emotional warmth and control on the one hand, and trauma subtypes on the other. The schizophrenic patients scored lower regarding both parents' emotional warmth and higher regarding emotional and physical abuse and neglect. Group membership was correctly predicted with these childhood variables in 83% of cases, with the mother's emotional warmth being the best predictor. The findings underline the relevance of childhood adversities in schizophrenic diseases in adulthood, with special emphasis on the role of emotional acceptance from the primary caregiver.
Personality Disturbances in Melancholic and Nonmelancholic Unipolar Major Depression
Authors: Valerio Marina P. , Blasco Belén , Tagni Florencia , Szmulewicz Alejandro G. , Martino Diego J.
Published: September 2020

Although melancholic depression has been associated with a more adequate premorbid personality style, the empirical evidence supporting this statement is inconclusive. We conducted a systematic review and meta-analyzed studies comparing the presence of personality disturbances in melancholic and nonmelancholic subtypes of major depressive disorder (MDD). We defined a) a continuous outcome, defining personality traits as a dimensional construct, and b) a dichotomous outcome, defined as the presence/absence of personality disorders (PD). We also evaluated the role of potential moderators. Our results showed significantly higher levels of neuroticism and interpersonal sensitivity, and a higher likelihood of presenting a PD in nonmelancholic depression. No significant differences were found for extraversion. The scarcity of studies and high heterogeneity were among our limitations. In conclusion, personality disturbances seem to be overrepresented in nonmelancholic MDD. The assessment of personality disturbances can be useful in clinical practice and in the study of MDD heterogeneity.
Quality Improvement Analyses Revealed a Hidden Shift Following a Retrospective Study on Breastfeeding Rates
Authors: Sedler Jennifer , Khaki I. Sheevaun , Phillipi Carrie A. , Dukhovny Dmitry , DeVane Kenneth , Gievers Ladawna
Published: September 2020

Introduction:

Factors affecting exclusive breastfeeding rates are complex. Evaluations for early-onset sepsis can negatively impact breastfeeding success. We sought to determine whether implementing an algorithm utilizing the sepsis risk score (SRS) in chorioamnionitis-exposed newborns would increase exclusive breastfeeding rates. We collaborated with healthcare systems experts to analyze and understand our outcomes.

Methods:

We describe a retrospective cohort study of chorioamnionitis-exposed newborns 35 weeks and older gestation in the Mother-Baby Unit at our institution following a quality improvement project that implemented an SRS algorithm. We compared exclusive breastfeeding rates over 2 time periods, 33 months before and 15 months after SRS algorithm implementation. We completed bivariate comparisons using chi-square and Mann–Whitney U tests to understand the factors contributing to exclusive breastfeeding rates. In a secondary analysis, breastfeeding rates and demographic patterns were examined using p-charts.

Results:

Following algorithm implementation, exclusive breastfeeding rates increased from 49% to 58% (P = 0.10) in chorioamnionitis-exposed newborns. Factors associated with increased exclusive breastfeeding included Caucasian race, English as the primary language, private insurance, vaginal delivery, and positive group B Streptococcus status. In the secondary analysis, the proportion of non-Hispanic mothers increased from 63% to 80% during the study.

Conclusions:

Despite SRS implementation, exclusive breastfeeding rates increased but not significantly, and certain sociodemographic factors remain associated with exclusive breastfeeding. Secondary analysis revealed an overall demographic shift affecting the dataset, highlighting the importance of thorough data analysis when evaluating a quality improvement project.
Screening Social Determinants of Health in a Multidisciplinary Severe Asthma Clinical Program
Authors: Leibel Sydney , Geng Bob , Phipatanakul Wanda , Lee Euyhyun , Hartigan Phyllis
Published: September 2020

Introduction:

Asthma is the most common cause of chronic disease in children and has high healthcare utilization costs. Minority children living in poverty have a higher asthma burden. These health disparities are associated with the social determinants of health (SDH). A severe asthma clinic was implemented at Rady Children’s Hospital in San Diego to determine whether a multidisciplinary approach, including an asthma home visit addressing SDH, would lead to decreased healthcare utilization in terms of emergency department (ED) visits and hospitalizations.

Methods:

Patients with 2 or more ED visits in the past 6 months or 2 or more hospitalizations in the previous year were recruited to Rady Children’s Hospital Severe Asthma Clinic. A multidisciplinary team evaluated each patient systematically. A subset of patients on capitated Medicaid insurance plans also had a comprehensive asthma home visit with community health workers as part of the Community Approach to Severe Asthma (CASA) program.

Results:

A significant reduction in ED visits (75%, P < 0.001) and hospitalization days (73%, P < 0.001) was demonstrated in 74 Severe Asthma Clinic participants with 1 year of pre-/postdata to analyze. In a subset of 12 patients in the CASA program, further reductions in ED visits (90%, P = 0.002) were also demonstrated. Basic needs, including shelter, food, and assistance with utilities, were the most common domain of SDH identified and addressed in CASA participants.

Conclusion:

We demonstrate that a novel pediatric severe asthma clinic with a multidisciplinary approach, including actively addressing SDH, is associated with decreasing health care utilization.
Improved Viral Suppression With Streamlined Care in the SEARCH Study
Authors: Hickey Matthew D. , Ayieko James , Kwarisiima Dalsone , Opel Fredrick J. , Owaraganise Asiphas , Balzer Laura B. , Chamie Gabriel , Jain Vivek , Peng James , Camlin Carol , Charlebois Edwin D. , Cohen Craig R. , Bukusi Elizabeth A. , Kamya Moses R. , Petersen Maya L. , Havlir Diane V.
Published: September 2020

Background:

HIV differentiated service delivery (DSD) models are scaling up in resource-limited settings for stable patients; less is known about DSD outcomes for patients with viremia. We evaluated the effect on viral suppression (VS) of a streamlined care DSD model implemented in the SEARCH randomized universal test and treat trial in rural Uganda and Kenya (NCT:01864603).

Methods:

We included HIV-infected adults at baseline (2013) who were country guideline antiretroviral therapy (ART) eligible (prior ART experience or CD4 ≤ 350) with ≥1 HIV clinic visit between 2013 and 2017 in SEARCH communities randomized to intervention (N = 16) or control (N = 16). We assessed the effect of streamlined care in intervention community clinics (patient-centered care, increased appointment spacing, improved clinic access, reminders, and tracking) on VS at 3 years. Analysis was stratified by the baseline care status: ART-experienced with viremia, ART-naïve with CD4 ≤ 350, or ART-experienced with VS.

Results:

Among 6190 ART-eligible persons in care, year 3 VS was 90% in intervention and 87% in control arms (RR 1.03, 95% CI: 1.01 to 1.06). Among ART-experienced persons with baseline viremia, streamlined care was associated with higher VS (67% vs 47%, RR 1.41, 95% CI: 1.05 to 1.91). Among ART-naïve persons, VS was not significantly higher with streamlined care (83% vs 79%, RR 1.05, 95% CI: 0.95 to 1.16). Among ART-experienced persons with baseline VS, nearly all remained virally suppressed in both arms (97% vs 95%, RR 1.01, 95% CI: 1.00 to 1.03).

Conclusions:

Streamlined care was associated with higher viral suppression among ART-experienced patients with viremia in this randomized evaluation of ART-eligible patients who were in care after universal HIV testing.
Brief mindfulness training increased glutamate metabolism in the anterior cingulate cortex
Authors: Tang Yi-Yuan , Askari Pegah , Choi Changho
Published: September 2020

Mindfulness meditation has become a promising intervention for promoting health and well-being. Neuroimaging studies have shown its beneficial effects on brain functional activity, connectivity, and structures following months to years of practice. A series of randomized controlled trials indicated that one form of mindfulness meditation, the integrative body-mind training (IBMT) induces brain functional and structural changes in brain regions related to self-control networks such as the anterior cingulate cortex (ACC) after 2–10 h of practice. However, whether IBMT could change brain metabolism in the ACC remains unexplored. Utilizing a noninvasive 3T proton magnetic resonance spectroscopy, our results showed a significant increase in glutamate metabolism in the rostral ACC following 10 h of IBMT, suggesting that brief training not only increases ACC activity and structure, but also induces neurochemical changes in regions of the self-control networks. To our knowledge, this is the first study demonstrating the positive effects on brain metabolism in the ACC following brief intervention, suggesting a potential mechanism and implications of mindfulness meditation in ameliorating disorders such as addiction, depression and schizophrenia, which often involve the dysfunction of self-control networks and glutamatergic system (i.e. lower glutamate metabolism).
Incidence of canine dilated cardiomyopathy, breed and age distributions, and grain-free diet sales in the United States from 2000-2019: A retrospective survey
Authors: Quest Bradley , Clark Stephanie D. , Garimella Shiva , Konie August , Leach Stacey B. , Oxford Eva M.
Published: September 2020

Background

Dilated cardiomyopathy (DCM) is considered a predominantly inherited disease in dogs. Recent reports suggest an increased incidence of DCM in atypical breeds eating grain-free and/or legume-rich diets. However, little data regarding incidence of DCM within the US is available; and no existing data quantifies DCM among breeds over time.

Hypothesis

We hypothesized that DCM incidence among breeds could be estimated by retrospective polling of veterinary cardiologists. Further, if a correlation existed between grain-free diets and DCM, an increase in DCM would be on trend with increased grain-free pet food sales.

Materials and Methods

Thirty-six U.S. cardiology specialty practices were asked for all initial canine and DCM cases evaluated from 2000-2019; fourteen cardiology practices participated. DCM signalment data was provided by three hospitals over 15 years; representing 68 breeds. Age distribution of DCM cases upon diagnosis were compared to other cardio cases and general hospital population from one hospital. All data were evaluated using linear regression models. Grain-free pet food sales data was evaluated from 2011-2019.

Results

Fourteen hospitals participated and reported 67,243 unique canine patients. Nationally, data did not support a significant change in percent DCM over time (p=0.85). The overall average incidence rate of DCM during the study period was 3.83% (range 2.41-5.65%), while grain-free diet sales increased 500% from 2011-2019. No correlation between overall DCM incidence and grain free diet sales was discovered. A significant upward trend in mixed breeds diagnosed with DCM, with no significant trend in other breeds was appreciated. An upward trend in age at DCM diagnosis was identified, correlating with trends from overall hospital populations.

Conclusions

These data do not support overall increased DCM incidence, or a correlation with grain-free pet food sales. Additional data are necessary to understand whether regional factors contribute to increased DCM within smaller cohorts.