bluuebunny/crossref_metadata_2025 huggingface dataset:
Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic – a narrative review
Authors: Cook T. M.
Published: April 2020

Personal protective equipment has become an important and emotive subject during the current coronavirus disease 2019 epidemic. Coronavirus disease 2019 is predominantly caused by contact or droplet transmission attributed to relatively large respiratory particles which are subject to gravitational forces and travel only approximately 1 metre from the patient. Airborne transmission may occur if patient respiratory activity or medical procedures generate respiratory aerosols. These aerosols contain particles that may travel much longer distances and remain airborne longer, but their infective potential is uncertain. Contact, droplet and airborne transmission are each relevant during airway manoeuvres in infected patients, particularly during tracheal intubation. Personal protective equipment is an important component, but only one part, of a system protecting staff and other patients from coronavirus disease 2019 cross‐infection. Appropriate use significantly reduces risk of viral transmission. Personal protective equipment should logically be matched to the potential mode of viral transmission occurring during patient care – contact, droplet or airborne. Recommendations from international organisations are broadly consistent, but equipment use is not. Only airborne precautions include a fitted high‐filtration mask, and this should be reserved for aerosol generating procedures. Uncertainty remains around certain details of personal protective equipment including use of hoods, mask type and the potential for re‐use of equipment.
Hospital surge capacity in a tertiary emergency referral centre during the COVID‐19 outbreak in Italy
Authors: Carenzo L. , Costantini E. , Greco M. , Barra F. L. , Rendiniello V. , Mainetti M. , Bui R. , Zanella A. , Grasselli G. , Lagioia M. , Protti A. , Cecconi M.
Published: April 2020

The first person‐to‐person transmission of the 2019 novel coronavirus in Italy on 21 February 2020 led to an infection chain that represents one of the largest known COVID‐19 outbreaks outside Asia. In northern Italy in particular, we rapidly experienced a critical care crisis due to a shortage of intensive care beds, as we expected according to data reported in China. Based on our experience of managing this surge, we produced this review to support other healthcare services in preparedness and training of hospitals during the current coronavirus outbreak. We had a dedicated task force that identified a response plan, which included: (1) establishment of dedicated, cohorted intensive care units for COVID‐19–positive patients; (2) design of appropriate procedures for pre‐triage, diagnosis and isolation of suspected and confirmed cases; and (3) training of all staff to work in the dedicated intensive care unit, in personal protective equipment usage and patient management. Hospital multidisciplinary and departmental collaboration was needed to work on all principles of surge capacity, including: space definition; supplies provision; staff recruitment; and ad hoc training. Dedicated protocols were applied where full isolation of spaces, staff and patients was implemented. Opening the unit and the whole hospital emergency process required the multidisciplinary, multi‐level involvement of healthcare providers and hospital managers all working towards a common goal: patient care and hospital safety. Hospitals should be prepared to face severe disruptions to their routine and it is very likely that protocols and procedures might require re‐discussion and updating on a daily basis.
Split‐week gestational age model provides valuable information on outcomes in extremely preterm infants
Authors: Thomas Sumesh , van Dyk Jessie , Zein Hussein , Nettel Aguirre Alberto , Hendson Leonora , Church Paige , Banihani Rudaina , Asztalos Elizabeth
Published: April 2020

Aim

To compare composite outcomes of neonatal mortality or morbidity using a split‐week gestational age (GA) model to completed weeks GA maturity at 23‐26 weeks gestation.

Methods

This was a retrospective cohort study of infants born at 23‐26 weeks GA. Outcomes using a split‐week GA model defined as early (X, 0‐3) and late (X, 4‐6) with X being 23‐26 weeks GA were compared to outcomes using completed weeks GA, with a similar comparison between the late split of the preceding week (X, 4‐6) and early split of the subsequent week (X + 1, 0‐3).

Results

A total of 1345 infants were included in the study. Statistically significant differences were noted in outcomes between the early and late split of the gestational week at 24 (early vs late, 85.6% vs 73.0%), 25 (69.6% vs 56.6%) and 26 weeks (55.9% vs 37.4%), but not at 23 weeks GA (95.2% vs 94.5%). No statistically significant differences were noted between the late vs early part of the subsequent week (23, 4‐6) vs (24, 0‐3), and (24, 4‐6) vs (25, 0‐3) GA.

Conclusion

Neonatal outcome estimates using a split week model differs from that based on the use of completed weeks of gestational maturity.
Polarized light microscopy casts new light on plants used to make tapa
Authors: Smith C. A. , Lowe B. J. , Fraser N. L. , Boucher J.‐J.
Published: April 2020

Information about plant materials of construction in artefacts advances knowledge about human history, agriculture, trade, migration and adaptation to new environments. Typically, materials identification in artefacts made from plants is problematic, since processing, age, dirt and surface treatments can mask identifying features, while ethical considerations relating to sampling limit the use of some analytical techniques. The study tests the usefulness of polarized light microscopy for identifying the New Zealand and Pacific plant species used to make tapa, indicating birefringent and morphological characteristics that can be used to differentiate fibres at the level Moraceae (Pacific; from genera Artocarpus, Broussonetia and Ficus) and Malvaceae (New Zealand; from genera Hoheria and Plangianthus).
Between east and west: Glass beads from the eighth to third centuries bce from Poland
Authors: Purowski T. , Syta O. , Wagner B.
Published: April 2020

The study analyses the chemical composition of 57 glass samples from 40 beads discovered at 20 archaeological sites in Poland. The beads are dated to Hallstatt C–Early La Tène periods (c.800/750–260/250 bce). Analyses were carried out using laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS). Two groups were distinguished among the glasses based on the MgO/K2O ratio: high‐magnesium glass (HMG), five samples; and low‐magnesium glass (LMG), 52 samples. The former were melted with halophyte plant ash, the second with mineral soda. These glasses were produced in the Eastern Mediterranean (more likely in Mesopotamia or Syro‐Palestine than in Egypt) and transported in the form of semi‐products to secondary glass workshops in Europe. Some of the white opaque glass was coloured and opacified in Europe.
Lead isotopic analyses of copper ores in the Early Bronze Age central Hexi Corridor, north‐west China
Authors: Chen G. , Cui Y. , Liu R. , Wang H. , Yang Y. , Pollard A. M. , Li Y.
Published: April 2020

This paper explores the possible provenance of ores employed for metallurgical production during the Early Bronze Age in the central Hexi Corridor of north‐west China. In total, 78 pieces of copper (Cu) ore samples were collected from five Early Bronze Age sites and one Cu deposit site (the Beishantang Cu deposit) in the Heihe River region of the central corridor. These sites were dated to the late Machang (4100–4000 bp), Xichengyi (4000–3700 bp), Qijia (4000–3600 bp) and Siba (3700–3400 bp) cultures. After comparing with published lead (Pb) isotopic data from other possible Cu deposits in north‐west China, the results show that the Cu ores collected from the Early Bronze Age sites were most likely derived from the adjacent Beishan Cu deposit. More intriguingly, for the first time in Hexi Corridor, a dozen Cu ores were discovered containing highly radiogenic Pb. Though fundamentally different from those in the Central Plains, they illustrate a possible new type of Cu used in Bronze Age western China, and the first‐hand materials are significant for further understanding the provenance of raw metals for metallurgical production in the prehistoric Hexi Corridor.
Composition of white paste inlay on the pottery from sites of the 10th–8th centuries bce in the northern Pontic region
Authors: Kulkova M. , Kashuba M. , Gavrylyuk N. , Kulkov A. , Kaiser E. , Vetrova M. , Zanoci A. , Platonova N. , Hellström K. , Winger K.
Published: April 2020

For the first time, the mineralogical–geochemical compositions of the white paste inlay found on vessels from sites (10th–8th centuries bce) in the northern Pontic region are investigated. Samples of the white paste on vessels from settlements, burials of sedentary groups and graves of early nomads were analysed by means of scanning electron microscopy with energy‐dispersive X‐ray spectrometry (SEM‐EDX) and X‐ray diffraction (XRD) methods. Between the 10th and eighth centuries bce, various innovations occurred in the working area. Iron processing technology and the manufacture of iron products also appeared. Other innovations were changes in the manufacturing technology of ceramics. A high‐quality, polished/burnished surface and ornaments with white paste inlay are characteristic of this pottery. When collating white paste mixtures of different European sites, similarities in the preparation of white paste recipes for vessels from the Balkan and northern Pontic regions are evident. During the Early Iron Age, further changes in the manufacture of the white paste were discovered in the northern Pontic region, namely the application of high‐temperature firing to obtain more resistant synthesized material such as calcium alumosilicates and silicates (wollastonite). The development of iron metallurgy in this period could provide a basis for the elaboration of new techniques in ceramic manufacture.
Impact on operative outcomes of laparoscopic simultaneous resection of colorectal cancer and synchronous liver metastases
Authors: Kawakatsu Shoji , Ishizawa Takeaki , Fujimoto Yoshiya , Oba Atsushi , Mise Yoshihiro , Inoue Yousuke , Ito Hiromichi , Takahashi Yu , Ueno Masashi , Saiura Akio
Published: April 2020

Introduction

The efficacy of laparoscopic simultaneous resection of primary colorectal cancer and synchronous colorectal liver metastases (SCRLM) remains unclear.

Methods

We retrospectively evaluated data from 258 patients who had undergone simultaneous curative resection of the primary tumor and SCRLM from 2006 to 2017. We compared surgical outcomes between open, hybrid (laparoscopic colorectal resection and open hepatectomy), and pure laparoscopic approaches. Surgical outcomes were also evaluated between the open hepatectomy (OH) group (ie, open/hybrid surgery) and the laparoscopic hepatectomy (LH) group (ie, pure laparoscopic surgery) in 141 patients later in the study period (2013‐2017), when the clinical indications for laparoscopic hepatectomy were restricted to simple wedge resection and/or left lateral sectionectomy in our center.

Results

The pure laparoscopic approach was associated with significantly less intraoperative blood loss and a significantly shorter postoperative hospital stay than the open and hybrid approaches. Late in the study period, operative outcomes in the LH group (n = 37) were more favorable than for the OH group (n = 104) in terms of intraoperative blood loss and postoperative hospital stay. In patients with rectal cancer, however, earlier postoperative recovery in the LH group did not differ significantly from the OH group.

Conclusion

Laparoscopic simultaneous resection of SCRLM with the primary tumor by simple hepatectomy is safe and may enhance patients' postoperative recovery, especially in patients with colon cancer.
TA1 agonists attenuate extended‐access cocaine self‐administration and yohimbine‐induced reinstatement of cocaine‐seeking
Authors: Liu Jianfeng , Johnson Bernard , Wu Ruyan , Seaman Robert , Vu Jimmy , Zhu Qing , Zhang Yanan , Li Jun‐Xu
Published: April 2020

Background and Purpose

The trace amine‐associated receptor 1 (TA1) negatively modulates dopamine transmission. Our previous studies demonstrated that TA1 agonists attenuated cue‐ and drug‐induced cocaine‐seeking and increased the elasticity of the cocaine demand curve, in the short‐access cocaine self‐administration model. Compulsive use of cocaine, which is an essential criterion of cocaine use disorder, can be induced by extended access to cocaine self‐administration.

Experimental Approach

To characterize the role of TA1 in compulsive cocaine use, we evaluated the effects of activation of TA1 on cocaine intake, cocaine binge and cue‐induced cocaine‐seeking using the extended‐access cocaine self‐administration model in adult male Sprague–Dawley rats. We also investigated the role of TA1 in stress‐triggered cocaine relapse by using the α2‐adrenoceptor antagonist yohimbine‐induced reinstatement of cocaine‐seeking.

Key Results

The selective TA1 partial agonist RO5263397 attenuated cocaine intake and did not develop tolerance during the 10‐day extended‐access cocaine self‐administration. RO5263397 reduced a 12‐h binge intake of cocaine after forced abstinence. RO5263397 also decreased cue‐induced cocaine‐seeking after prolonged abstinence from extended‐access cocaine self‐administration. Furthermore, RO5263397 and the selective TA1 full agonist RO5166017 reduced yohimbine‐induced reinstatement of cocaine‐seeking behaviour.

Conclusion and Implications

Activation of TA1 attenuated extended‐access cocaine self‐administration and stress‐induced cocaine reinstatement. These results suggest that TA1 agonists are promising pharmacological interventions to treat cocaine use disorder and relapse.
Activation of μ‐opioid receptors by MT‐45 (1‐cyclohexyl‐4‐(1,2‐diphenylethyl)piperazine) and its fluorinated derivatives
Authors: Baptista‐Hon Daniel T. , Smith Mark , Singleton Samuel , Antonides Lysbeth H. , Nic Daeid Niamh , McKenzie Craig , Hales Tim G.
Published: April 2020

Background and Purpose

A fluorinated derivative (2F‐MT‐45) of the synthetic μ‐opioid receptor agonist MT‐45 (1‐cyclohexyl‐4‐(1,2‐diphenylethyl)piperazine) was recently identified in a seized illicit tablet. While MT‐45 is a Class A drug, banned in a number of countries, nothing is known about the pharmacology of 2F‐MT‐45. This study compares the pharmacology of MT‐45, its fluorinated derivatives and two of its metabolites.

Experimental Approach

We used a β‐arrestin2 recruitment assay in CHO cells stably expressing μ receptors to quantify the apparent potencies and efficacies of known (MT‐45, morphine, fentanyl and DAMGO) and potential agonists. In addition, the GloSensor protein was transiently expressed to quantify changes in cAMP levels. We measured Ca2+ to investigate whether MT‐45 and its metabolites have effects on GluN1/N2A NMDA receptors stably expressed in Ltk‐ cells.

Key Results

The fluorinated MT‐45 derivatives have higher apparent potencies (2F‐MT‐45: 42 nM) than MT‐45 (1.3 μM) for inhibition of cAMP accumulation and β‐arrestin2 recruitment (2F‐MT‐45: 196 nM; MT‐45: 23.1 μM). While MT‐45 and 2F‐MT‐45 are poor recruiters of β‐arrestin2, they have similar efficacies for reducing cAMP levels as DAMGO. Two MT‐45 metabolites displayed negligible potencies as μ receptor agonists, but one, 1,2‐diphenylethylpiperazine, inhibited the NMDA receptor with an IC50 of 29 μM.

Conclusion and Implications

Fluorinated derivatives of MT‐45 are potent μ receptor agonists and this may pose a danger to illicit opioid users. Inhibition of NMDA receptors by a metabolite of MT‐45 may contribute to the reported dissociative effects.
Care coordination for children with medical complexity in Japan: Caregivers' perspectives
Authors: Matsuzawa Akemi , Shiroki Yuko , Arai Junichi , Hirasawa Akemi
Published: April 2020

Background

Little is known about the provision of care coordination to children with medical complexity (CMC) and their families in Japan. The aim of this study was to describe provision of care coordination and explore the factors associated with quality of care coordination for Japanese CMC and their families.

Methods

We used an exploratory cross‐sectional study design. Participants were recruited at a children's hospital located in one prefecture, Japan. Primary caregivers raising children aged between <1 and 20 years and receiving reimbursements for their home‐based medical care at a children's hospital were eligible to participants in this study. The study examined the relationship between parents' ratings of care coordination as ‘adequate,’ ‘inadequate’ or ‘not received’ and characteristics of children, parents, and families.

Results

Ninety‐nine parents caring for CMC were included in the analysis. Of those, 22.2% reported their child had a care coordinator. Caregivers were divided into three groups depending on the quality of care coordination: Group 1 reported adequate care coordination; Group 2 reported inadequate care coordination; and Group 3 had no need for care coordination. We compared the socio‐demographics of children, parents and families, their service use and the health‐related quality of life (HR‐QOL) and caregiver burden scores of parents across the three groups. The parents' free time, access to timely care for children and service satisfaction were positively associated with adequate care coordination for CMC and their families.

Conclusions

Providing adequate care coordination for CMC and their families is essential for access to timely services and more positive psychological health of parents. High quality care coordination for CMC and their families is urgently needed in Japan.
Biological tumor markers associated with local control after primary radiotherapy in laryngeal cancer: A systematic review
Authors: Noordhuis Maartje G. , Kop Emiel A. , van der Vegt Bert , Langendijk Johannes A. , van der Laan Bernard F. A. M. , Schuuring Ed , de Bock Geertruida H.
Published: April 2020

Background

The choice of treatment in laryngeal cancer is mainly based on tumor stage, post‐treatment morbidity and quality of life. Biological tumor markers might also be of potential clinical relevance.

Objective of the review

The aim was to systematically review the value of published biological tumor markers to predict local control in laryngeal cancer patients treated with definitive radiotherapy.

Type of Review

Systematic review.

Search strategy

PubMed, Embase, Cochrane Library.

Evaluation Method

A literature search was performed using multiple terms for laryngeal cancer, radiotherapy, biological markers, detection methods and local control or survival. Studies regarding the relation between biological tumor markers and local control or survival in laryngeal cancer patients primarily treated with radiotherapy were included. Markers were clustered on biological function. Quality of all studies was assessed. Study selection, data extraction and quality assessment was performed by two independent reviewers.

Results

A total of 52 studies out of 618 manuscripts, concerning 118 markers, were included. EGFR and P53 showed consistent evidence for not being predictive of local control after primary radiotherapy, whereas proliferation markers (ie high Ki‐67 expression) showed some, but no consistent, evidence for being predictive of better local control. Other clusters of markers (markers involved in angiogenesis and hypoxia, apoptosis markers, cell cycle, COX‐2 and DNA characteristics) showed no consistent evidence towards being predictors of local control after primary radiotherapy.

Conclusions

Cell proliferation could be of potential interest for predicting local control after primary radiotherapy in laryngeal cancer patients, whereas EGFR and p53 are not predictive in contrast to some previous analyses. Large diversity in research methods is found between studies, which results in contradictory outcomes. Future studies need to be more standardised and well described according to the REMARK criteria in order to have better insight into which biomarkers can be used as predictors of local control after primary radiotherapy.
Feasibility of a deep learning algorithm to distinguish large cell neuroendocrine from small cell lung carcinoma in cytology specimens
Authors: Gonzalez Daniel , Dietz Robin L. , Pantanowitz Liron
Published: April 2020

Introduction

Distinguishing small cell lung carcinoma (SCLC) from large cell neuroendocrine carcinoma (LCNEC) in cytology is challenging. Our aim was to design a deep learning algorithm for classifying high‐grade neuroendocrine carcinomas in fine needle aspirations.

Methods

Archival cytology cases of high‐grade neuroendocrine carcinoma (17 small cell, 13 large cell, 10 mixed/unclassifiable) were retrieved. Each case included smears (Diff‐Quik® and Papanicolaou stains) and cell block or concomitant core biopsies (haematoxylin and eosin [H&E] stain). All slides (n = 114) were scanned at 40× magnification, randomised and split into training (11 large, nine small) and test (two large, eight small, 10 mixed) groups. Tumour was annotated using QuPath and exported as JPEG image tiles. Three distinct deep learning convolutional neural networks, one for each preparation/stain, were designed to classify each tile and provide an overall diagnosis for each slide.

Results

The H&E‐trained algorithm correctly classified 7/8 (87.5%) SCLC cases and 2/2 (100%) LCNEC cases. The Papanicolaou stain algorithm correctly classified 6/7 (85.7%) SCLC. and 1/1 (100%) LCNEC cases. The algorithm trained on Diff‐Quik® stained images correctly classified 7/8 (87.5%) SCLC and 1/1 (100%) LCNEC cases.

Conclusion

Using open source software, it was feasible to design a deep learning algorithm to distinguish between SCLC and LCNEC. The algorithm showed high precision in distinguishing between these two categories on H&E sectioned material and direct smears. Although the dataset was limited, our deep learning models show promising results in the classification of LCNEC and SCLC. Additional work using a larger dataset is necessary to improve the algorithm's performance.
Interaction between the predatorXylocoris sordidusandBacillus thuringiensisbioinsecticides
Authors: dos Santos Nathália A. , Ramalho Dagmara G. , Marques Hortência M. , Godoy Joana D.S. , De Bortoli Caroline P. , de Magalhães Gustavo O. , Vacari Alessandra Marieli , De Bortoli Sergio A.
Published: April 2020

Xylocorisspecies (Hemiptera: Anthocoridae) are known to occur in various habitats and attack a diversity of agriculturally important prey. Other groups of organisms, such as strains ofBacillus thuringiensisBerliner (Bt) bacteria, also have been extensively studied and applied as biological control agents. The use of theseBt‐bioinsecticides in association with predators may be a good strategy in integrated pest management. This work had the objective to study predator behaviour, predatory capacity, and functional response of fifth‐instar nymphs ofXylocoris sordidus(Reuter) to eggs ofPlutella xylostella(L.) (Lepidoptera: Plutellidae) andCorcyra cephalonica(Stainton) (Lepidoptera: Pyralidae) treated with one of three commercialBt‐bioinsecticides. The predator presented a type II functional response to untreatedP. xylostellaeggs (control) and to eggs treated with Agree, whereas the response was type III toP. xylostellaeggs treated with Xentari and Dipel. However, on a diet ofC. cephalonicaeggs the predator displayed a type II response curve on eggs treated with each of the three bioinsecticides, and a type III response on untreated eggs. Bioinsecticides based onB. thuringiensismay be used in association withX. sordiduspredators to control lepidopterous pest species.
Detection and characterization of Ralstonia pseudosolanacearum infecting Eucalyptus sp. in Brazil
Authors: Freitas Rodrigo G. , Hermenegildo Pollyane S. , Guimarães Lúcio M. S. , Zauza Edival A. V. , Badel Jorge L. , Alfenas Acelino C.
Published: April 2020

Ralstonia solanacearum sensu lato causes bacterial wilt in many agronomic crops and tree species economically important worldwide. It is a species complex that has been divided into phylotypes and sequevars, commonly related to geographic distribution. Knowledge of the phylotype composition and genetic variability in populations of this phytopathogenic bacterium is useful for implementing effective control measures. In a survey conducted in 2019, six bacterial strains were obtained from wilted Eucalyptus urophylla trees in plantations located in the municipality of Dom Eliseu, Pará state, Brazil. Multiplex PCR based on the internal transcribed spacer (ITS) indicated that the bacterial strains belonged to two different species, namely R. pseudosolanacearum (phylotype I) and R. solanacearum (phylotype II). In a phylogenetic analysis, the nucleotide sequence of the endoglucanase (egl) gene from eucalypt strains of phylotype I clustered together with sequevar 18 sequences from GenBank. Separation of the strains into two different species was confirmed by repetitive element palindromic PCR (rep‐PCR). Pathogenicity tests demonstrated that the R. solanacearum and R. pseudosolanacearum strains recovered from E. urophylla cause disease in both tomato and eucalypt plants. Until now, only R. solanacearum (Phylotype II) has been reported causing wilt symptoms on Eucalyptus spp. in Brazil. Therefore, the presence of R. pseudosolanacearum and a need for better understanding of its genetic and aggressiveness variability as well as possible differences between the two species should be considered in breeding programmes aimed at the deployment of host resistance.
Drug‐induced vitiligo: a case/non‐case study in Vigibase®, the WHO pharmacovigilance database
Authors: Anthony Norah , Bourneau‐martin Delphine , Ghamrawi Sarah , Lagarce Laurence , Babin Marina , Briet Marie
Published: April 2020

Vitiligo is a common depigmenting disorder ensuing the loss of epidermal melanocytes. It is a multifactorial disease with immunological, genetic and environmental factors including drug exposure. The purpose of the study was to investigate the drugs and therapeutic subclasses associated with vitiligo occurrence reported in VigiBase®, the WHO pharmacovigilance database. A case/non‐case study was carried out by defining cases as vitiligo reports and non‐cases as all other reports. The reporting odds ratio (ROR) was calculated for the ‘suspected’ drugs and drug classes according to ATC level 4. During the study period, 741 cases of vitiligo were registered. Mean age was 49 ± 20 years. The disproportionality analysis showed an association between vitiligo and pembrolizumab (ROR 116.9, 95% Confidence Interval (CI) 94.8, 144.3), nivolumab (ROR 22.6, 95% CI 15.8, 32.4), ipilimumab (ROR 41.7, 95% CI 25.0, 69.7), imiquimod (ROR 152.8, 95% CI 103.0, 226.7), adalimumab (ROR 3.8, 95% CI 2.5,5.8), infliximab (ROR 2.6, 95% CI 1.65, 4.01), alemtuzumab (ROR 27.8, 95% CI 17.6, 43.9), and ustekinumab (ROR 9.3, 95% CI 5.6, 15.6). Concerning the pharmacological classes ATC level 4, a significant association was found with monoclonal antibodies, interferons, selective immunosuppressants, TNF‐alpha inhibitors, interleukin inhibitors, and topical antivirals. This study confirmed the expected associations between vitiligo and immune checkpoint inhibitors and strengthened the emerging signal about the association between vitiligo and imiquimod, TNF‐alpha inhibitors and interferons. New signals were shown with selective immunosuppressants including alemtuzumab and interleukin inhibitors.
Migraine and Ischemic Stroke in Women. A Narrative Review
Authors: Tietjen Gretchen E. , Maly Emily F.
Published: April 2020

Objective/Background

Migraine is associated with ischemic stroke. Women are 3‐fold as likely as men to have migraine, and high estrogen states increase the risk of migraine with aura (MWA), venous thromboembolism (VTE), and of stroke. We review the epidemiological and mechanistic evidence of the migraine‐stroke relationship and its risk factors, with a focus on women and conditions that exclusively or predominantly affect them. 

Methods

We performed a search of MEDLINE/PubMed database, then a narrative review of the epidemiological evidence of the migraine‐stroke relationship as well as the evidence for arterial, thrombophilic, and cardiac mechanisms to explain this connection. We examine the implications of this evidence for the diagnostic evaluation and treatment of MWA.

Results

MWA is associated with multiple stroke risk factors, such as hypertension, hyperlipidemia, diabetes mellitus, cigarette smoking, atrial fibrillation, and patent foramen ovale. In women, MWA is also associated with biomarkers of endothelial activation, hormonal contraceptive use, pregnancy, and VTE. This suggests that a subset of auras may be secondary, that is, induced by ischemia related to microemboli or in situ thrombosis. MWA‐associated ischemic stroke is more common in young (<45 years old) women with high frequency of migraine attacks, hormonal contraception use, and with pregnancy and preeclampsia. There is increasing evidence that cardioembolism, often in conjunction with thrombophilia, plays a prominent role in MWA‐associated cerebral infarction.

Conclusion

The commonality of factors associated with MWA and with MWA‐associated stroke suggest that persons with secondary, ischemia‐induced aura may be at elevated risk of stroke. Although further research is needed, we recommend consideration of a diagnostic evaluation of MWA that mirrors the evaluation of transient ischemic attack, given that prophylactic treatment targeting the ischemic origin of secondary aura may prevent migraine as well as stroke.
The regulation effects of anger rumination on different foci of anger
Authors: Ding Xinfang , Qian Mingyi
Published: April 2020

Previous studies have shown that anger rumination plays a critical role in increasing anger. The present study examined whether these effects were different with respect to different foci of anger. In Study 1, 96 participants were asked to ruminate about their shame‐related or shame‐unrelated anger experiences either in an analytical or an experiential way after recalling an autobiographical anger memory. In Study 2, either shame‐related or shame‐unrelated anger was evoked in participants (n = 176) by an accomplice, and then the participants were instructed to ruminate in one of the following ways: self‐distanced analytical, self‐distanced experiential, self‐immersed analytical, and self‐immersed experiential rumination. Study 1 showed significant interaction effects between the foci of anger and the mode of processing. Study 2 showed significant three‐way interaction effects among the foci of anger, the mode of processing and the vantage perspective of rumination. Specifically, the results indicated that self‐immersed analytical rumination was more useful than the other types of rumination in reducing shame‐unrelated anger, while no difference was found regarding shame‐related anger. These findings indicated that the effects of anger rumination are different regarding the foci of anger.
Periodontitis and airflow limitation in older Swedish individuals
Authors: Winning Lewis , Polyzois Ioannis , Sanmartin Berglund Johan , Renvert Stefan
Published: April 2020

Aim

To investigate whether there was an association between periodontitis and airflow limitation in older Swedish individuals.

Materials and Methods

Study individuals were randomly selected from the Swedish civil registration database representing the ageing population in Karlskrona, Sweden. Clinical and radiographic examinations were performed, alongside which participants completed questionnaires gathering information on their medical history, social circumstances, demographic background and tobacco use. A physical examination assessed anthropometric measures. Standard spirometry was performed to identify subjects with airflow limitation. Periodontitis was defined based on radiographic periodontal bone loss. Analysis included multiple logistic regression with adjustment for various confounders.

Results

A total of 826 Caucasian dentate subjects were included in the analysis. The median age of participants was 73.2 (IQR 66–81) years, and 443 (54.6%) subjects were female. Eighty‐six (10.4%) individuals presented with airflow limitation. The proportion of participants presenting with periodontitis in the airflow limitation group was 65.1% compared to 41.5% with normal respiratory function (p < .001). Multiple logistic regression analysis showed that periodontitis was independently associated with airflow limitation with an odds ratio of 2.31 (95% CI 1.27–4.22) p < .01.

Conclusion

In this group of older dentate individuals, periodontitis was significantly associated with airflow limitation independent of other known risk factors.
Efficacy and safety of direct acting antiviral regimens for hepatitis C virus and human immunodeficiency virus co‐infection: systematic review and network meta‐analysis
Authors: Zheng Yi‐Xiang , Ma Shu‐Juan , Xiong Ying‐hui , Fan Xue‐Gong
Published: April 2020

Background and Aim

Various all‐oral direct‐acting antiviral (DAA) regimens are being widely used in the treatment of human immunodeficiency virus (HIV)/hepatitis C virus (HCV) co‐infected patients; however, the comparative efficacy and safety of different types and combinations of DAAs are not completely clear. There is still a lack of integration of evidence for optimized therapies for HIV/HCV co‐infection.

Methods

We conducted a systematic literature search in several databases up to January 1, 2020. All the studies that reported the sustained virologic response (SVR) and adverse events of DAAs in HIV/HCV co‐infected patients were included. The Bayesian Markov Chain Monte Carlo method was used for the pooled estimates of network meta‐analysis.

Results

We identified 33 eligible articles with 7 combinations of all‐oral DAAs for the analyses of efficacy and safety. Grazoprevir–elbasvir ± ribavirin (GZR/EBR ± RBV: 95.6%; 95% CrI, 91.7–98.1%), ombitasvir/paritaprevir/ritonavir and dasabuvir ± ribavirin (3D ± RBV: 95.3%; 95% CrI, 93.4–96.9%), sofosbuvir–ledipasvir ± ribavirin (SOF/LDV ± RBV: 95.2%; 95% CrI, 93.7–96.6%), and sofosbuvir–daclatasvir ± ribavirin (SOF/DCV ± RBV: 94.8%; 95% CrI, 92.5–96.6%) were the most effective combinations for HIV/HCV co‐infected patients, with SVR rates of approximately 94% and above while severe adverse events were rare. However, the SVR rates of sofosbuvir–ribavirin (SOF/RBV) and sofosbuvir–simeprevir ± ribavirin (SOF/SMV ± RBV) both failed to reach 90%, and the incidences of adverse events were higher than 5%.

Conclusions

Efficacy and safety of all‐oral DAAs were in prospect for HIV/HCV co‐infection patients. GZR/EBR ± RBV was the optimal combination recommended for HIV/HCV co‐infected patients based on the excellent treatment effects and insignificant adverse events.
Serial serologic changes of hepatitis D virus in chronic hepatitis B patients receiving nucleos(t)ides analogues therapy
Authors: Jang Tyng‐Yuan , Wei Yu‐Ju , Hsu Cheng‐Ting , Hsu Po‐Yao , Liu Ta‐Wei , Lin Yi‐Hung , Liang Po‐Cheng , Hsieh Meng‐Hsuan , Ko Yu‐Min , Tsai Yi‐Shan , Chen Kuan‐Yu , Lin Ching‐Chih , Tsai Pei‐Chien , Wang Shu‐Chi , Huang Ching‐I , Yeh Ming‐Lun , Lin Zu‐Yau , Chen Shinn‐Cherng , Chuang Wan‐Long , Huang Jee‐Fu , Dai Chia‐Yen , Huang Chung‐Feng , Yu Ming‐Lung
Published: April 2020

Background and Aim

The serial serologic changes of hepatitis D virus (HDV) infection among chronic hepatitis B virus (HBV) infected patients who received oral nucleotide/nucleoside analogues are elusive.

Methods

Serum anti‐HDV and HDV RNA among chronic hepatitis B (CHB) patients were tested at the time of initiating anti‐HBV therapy and subsequently during the follow‐up period.

Results

The seropositive rate of anti‐HDV and HDV RNA among 2850 CHB patients, was 2.7% and 0.9%, respectively. Factors associated with anti‐HDV seropositivity were platelet counts (odds ratio [OR]/95% confidence intervals [CI]: 0.995/0.992–0.999; P = 0.006), HBV DNA levels (OR/CI: 0.81/0.70–0.94; P = 0.005), and hepatitis B e‐antigen (HBeAg) seropositivity (OR/CI: 0.22/0.05–0.95; P = 0.04). The only factor associated with HDV RNA positivity among anti‐HDV seropositive patients was age (OR/CI: 0.95/0.90–1.00; P = 0.03). The spontaneous clearance rate of serum anti‐HDV antibody was 3.0 per 100 person‐years with a median follow‐up period of 3.5 years (range 2–12 years), whereas the seroclearance rate of HDV RNA was 4.3 per 100 person‐years among anti‐HDV seropositive patients after a median follow‐up period of 6.0 years (range 2–11 years). A baseline anti‐HDV titer < 0.5 cut‐off index was the only factor predictive of anti‐HDV seroclearance (hazard ratio [HR]/CI: 30.11/3.73–242.85; P = 0.001).

Conclusions

HDV infection was not common among patients treated for HBV in Taiwan. Seroclearance of anti‐HDV and HDV RNA did occur over time, albeit the chance is rare.
Comment on: The Impact of Nursing Home Socioeconomic and Racial Composition
Authors: Gifford David R.
Published: April 2020

This letter comments on the article by Shekinah Fashaw
A contribution to the ontology of the Fundamentals of Care framework from a wonder‐based approach
Authors: Hansen Finn Thorbjørn , Jørgensen Lene Bastrup
Published: April 2020

Aim and objectives

To critically discuss the ontological framework of Fundamentals of Care (FoC), as developed by Uhrenfeldt, et al. (2018), Journal of Clinical Nursing, 27, 3197–3204; to suggest theoretical improvements by taking a wonder‐based approach; and to show how this approach can be applied in healthcare sectors.

Background

Based on a critical discussion of a discursive study on the ontology of FoC, studies in phenomenology of wonder and two action research projects involving “Wonder Labs,” this article discusses whether the ontology and reflective practices behind FoC can be qualified further by an existential phenomenology of wonder and with practices of “Wonder Labs.”

Design

This is a discursive study critically discussing Uhrenfeldt et al.'s primary focus on dyadic and relational openness and person‐oriented attentiveness in a nurse–patient relationship. This is done by unfolding the phenomenology of wonder and wonder experiences at a hospice and a hospital, and by critically examining the psychologically influenced interpretation of Heidegger.

Conclusion

The first attempts by Uhrenfeldt et al. to identify the philosophical roots and ontology of FoC by pointing to existential phenomenology and philosophy are acknowledged. However, in this article, we further elaborate this attempt by focusing on the phenomenology of wonder. We show that Heidegger speaking about “existential homecoming” referred to a philosophical practice focusing on the resonance with being, rather than on interpersonal and psychological relations. In conclusion, the article recognises the importance of integrating these two approaches described on the one hand as a person‐oriented and lifeworld‐led approach, and on the other hand as a being‐ and phenomenon‐oriented approach to the nurse–patient relationship.

Relevance to clinical practice

To be open to the “musicality” of the being dimension, as the core values of FoC, a wonder‐based approach to value clarifications and phenomenological dialogues is pivotal for the presence of openness, trust and attentiveness of the nurse–patient relationship. The practices of the “Wonder Lab” may be an approach for training nurses in hearing the call of this “ontological resonance.”
Tuberculosis and ovarian malignancy: Sometimes mimics, sometimes coexists
Authors: Saini Arunima , Yadav Garima , Gothwal Meenakshi , Singh Pratibha , Kathuria Priyanka , Elhence Poonam
Published: April 2020

Tuberculosis is a disease prevalent all over the world with India contributing to a larger share. Pulmonary tuberculosis presents with generalized symptoms of malaise, low grade fever and cough. On the other hand, genital tuberculosis presents with a variety of symptoms in each age group and is often underdiagnosed and missed. In an unmarried female, the usual presentations are menstrual complaints or presence of a solid cystic mass and ascites. In reproductive age group, patients may present with primary or secondary infertility or rarely with tubo‐ovarian masses with peritoneal deposits, omental thickening and lymph node enlargement, hence mimicking ovarian carcinoma. In postmenopausal females, it can present as postmenopausal bleeding, leucorrhea or pyometra giving suspicion of endometrial carcinoma. We hereby report two cases operated with provisional diagnosis of ovarian malignancy but final histopathology ruled out malignancy in first and confirmed coexistence of malignancy and tuberculosis in another.
Pyoluteorin induces cell cycle arrest and apoptosis in human triple-negative breast cancer cells MDA-MB-231
Authors: Ding Ting , Yang Luo-Jie , Zhang Wei-Dong , Shen Yun-Heng
Published: April 2020

Objectives

To screen the cytotoxic activity of six secondary metabolites isolated from soil fungus Aspergillus niger. Importantly, to investigate the mechanism that pyoluteorin induced human triple-negative breast cancer MDA-MB-231 cells apoptosis in vitro.

Methods

The cell viability assay was tested with CTG assay. Cell cycle, apoptosis and intracellular reactive oxygen species (ROS) production assay were tested with flow cytometry. Additionally, intracellular ROS production assay and mitochondrial membrane potential assay were determined with laser scanning confocal microscopy. The expression of apoptosis-related proteins was determined with Western blot.

Key findings

Pyoluteorin displayed significantly selective cytotoxicity against human triple-negative breast cancer MDA-MB-231 cells (IC50 = 0.97 µm) with low toxicity against human breast epithelial cell MCF-10A. It was found that pyoluteorin could arrest MDA-MB-231 cells cycle at G2/M phase and induce cell apoptosis. Further experiments demonstrated that the apoptosis-inducing effect of pyoluteorin was related to reduction of mitochondrial membrane potential, accumulation of ROS and change of apoptosis-related protein expressions.

Conclusion

Our studies revealed that pyoluteorin had potent proliferation inhibition against MDA-MB-231 cells through arresting cell cycle at G2/M phase and inducing caspase-3-dependent apoptosis by mitochondrial pathway, implying that pyoluteorin may be a potential lead compound for drug discovery of human triple-negative breast cancer.
Understanding the dynamics of forest understorey: Combination of monitoring and legacy data reveals patterns across temporal scales
Authors: Hédl Radim , Chudomelová Markéta
Published: April 2020

Aims

The dynamics of plant communities varies across temporal scales. A correct understanding of temporal patterns is crucial for the interpretation of monitoring outputs. Focusing on the understorey community of an ancient coppice at three temporal scales, our aims were to: (a) assess the link between year‐to‐year variations and a decadal successional change; (b) estimate how seasonal cyclical dynamics could interfere with the changes at interannual and decadal scales; and (c) account for the effects of coppicing restoration.

Location

Mt Děvín, S Moravia, Czech Republic.

Methods

Composition of a temperate forest understorey was monitored in 26 permanent plots on a year‐to‐year basis for a decade (2008–2018) and monthly (2015–2016). Adjacent semi‐permanent plots (23 in total) were resurveyed in 1953–2003. The three scales of temporal variation were statistically analyzed and compared looking at the vascular plant diversity (species richness) and compositional turnover (dissimilarity measures and patterns in multivariate space).

Results

Each of the three temporal scales captures specific patterns in herbaceous understorey species richness and turnover. The interannual variation shows fluctuations rather than trends and is lower than the magnitude of changes on a decadal scale. However, canopy thinning was responsible for rapid changes compatible with the long‐term trend of biodiversity decline following the abandonment of coppicing decades ago. The seasonal dynamics showed a distinct cyclical development typical of temperate forests. It exceeded the magnitude of interannual changes, pointing at the potentially significant source of error from the timing of data collection.

Conclusions

Comparison of the monitoring and legacy data revealed complex patterns in the forest understorey dynamics. Contrary to general assumptions, the short‐term dynamics of forest understorey can be significant. It is recommended that monitoring designs consider not only permanent plots but also resurveys of semi‐permanent plots. Considering more than one temporal scale will improve our understanding of the plant community dynamics.
Multiple chromosomal inversions contribute to adaptive divergence of a dune sunflower ecotype
Authors: Huang Kaichi , Andrew Rose L. , Owens Gregory L. , Ostevik Kate L. , Rieseberg Loren H.
Published: April 2020

Both models and case studies suggest that chromosomal inversions can facilitate adaptation and speciation in the presence of gene flow by suppressing recombination between locally adapted alleles. Until recently, however, it has been laborious and time‐consuming to identify and genotype inversions in natural populations. Here we apply RAD sequencing data and newly developed population genomic approaches to identify putative inversions that differentiate a sand dune ecotype of the prairie sunflower (Helianthus petiolaris) from populations found on the adjacent sand sheet. We detected seven large genomic regions that exhibit a different population structure than the rest of the genome and that vary in frequency between dune and nondune populations. These regions also show high linkage disequilibrium and high heterozygosity between, but not within, arrangements, consistent with the behaviour of large inversions, an inference subsequently validated in part by comparative genetic mapping. Genome–environment association analyses show that key environmental variables, including vegetation cover and soil nitrogen, are significantly associated with inversions. The inversions colocate with previously described “islands of differentiation,” and appear to play an important role in adaptive divergence and incipient speciation within H. petiolaris.
Rapid repeatable phenotypic and genomic adaptation following multiple introductions
Authors: van Boheemen Lotte A. , Hodgins Kathryn A.
Published: April 2020

Uncovering the genomic basis of repeated adaption can provide important insights into the constraints and biases that limit the diversity of genetic responses. Demographic processes such as admixture or bottlenecks affect genetic variation underlying traits experiencing selection. The impact of these processes on the genetic basis of adaptation remains, however, largely unexamined empirically. We here test repeatability in phenotypes and genotypes along parallel climatic clines within the native North American and introduced European and Australian Ambrosia artemisiifolia ranges. To do this, we combined multiple lines of evidence from phenotype‐environment associations, FST‐like outlier tests, genotype‐environment associations and genotype‐phenotype associations. We used 853 individuals grown in common garden from 84 sampling locations, targeting 19 phenotypes, >83 k SNPs and 22 environmental variables. We found that 17%–26% of loci with adaptive signatures were repeated among ranges, despite alternative demographic histories shaping genetic variation and genetic associations. Our results suggest major adaptive changes can occur on short timescales, with seemingly minimum impacts due to demographic changes linked to introduction. These patterns reveal some predictability of evolutionary change during range expansion, key in a world facing ongoing climate change, and rapid invasive spread.