bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart transplantation in the era of the SARS‐CoV‐2 pandemic: Is it safe and feasible?
Authors: Esmailian Gabriel , Kobashigawa Jon A. , Nishihara Keith , Patel Jignesh K. , Czer Lawrence , Megna Dominick , Emerson Dominic , Ramzy Danny , Trento Alfredo , Chikwe Joanna , Esmailian Fardad
Published: July 2020

As the SARS‐CoV‐2–pandemic continues to unfold, the number of heart transplants completed in the United States has been declining steadily. The current case series examines the immediate short‐term outcomes of seven heart transplant recipients transplanted during the SARS‐CoV‐2 pandemic. We hope to illustrate that with proper preparation, planning, and testing, heart transplantation can be continued during a pandemic. We assessed 7 patients transplanted from March 4, 2020, to April 15, 2020. The following endpoints were noted: in‐hospital survival, in‐hospital freedom from rejection, in‐hospital nonfatal major cardiac adverse events (NF‐MACE), severe primary graft dysfunction, hospital length of stay, and ICU length of stay. There were no expirations throughout the hospital admission. In addition, there were no patients with NF‐MACE or treated rejection, and 1 patient developed severe primary graft dysfunction. Average length of stay was 17.2 days with a standard deviation of 5.9 days. ICU length of stay was 7.7 days with a standard deviation of 2.3 days. Despite the decreasing trend in completed heart transplants due to SARS‐CoV‐2, heart transplantation appears to be feasible in the immediate short term. Further follow‐up is needed, however, to assess the impact of SARS‐CoV‐2 on post–heart transplant outcomes months after transplantation.
Evaluation of cytopathological screening results and risk factors of women who underwent Papanicolaou test in a maternity school in Fortaleza, Ceará, Brazil
Authors: Tavares Maria do Carmo , Nicol Alcina F. , Yokobatake Elizabeth Ribeiro , Melo Mayara Magna Lima , Vitoriano Bruna Ferreira , Carvalho‐Costa Filipe Anibal , Martinelli Katrini Guidolini , de Paula Vanessa Salete
Published: July 2020

Introduction

Papanicolaou test (Pap smear) is the standard screening test of pre‐neoplastic lesions and cervical cancer. This study aimed to investigate cervical cancer screening results and risk factors such as age, reason for the examination, the epithelia detected in the sample, microbiota and signs of sexually transmitted infection (STIs) of women in a maternity school in Fortaleza, Ceará, Brazil.

Methods

In this cross‐sectional study, data were retrieved of 353 women who underwent Pap smear between April 2016 and January 2017 at the Federal University of Ceará.

Results

Of all Pap smear samples retrieved, 54.1% (191/353) had glandular epithelium and 40.2% (142/353) had metaplastic epithelium. After statistical analyses adjusted for the final model, age ≥51 years (odds ratio = 3.47) and signs of STIs (odds ratio = 4.95) remained as risk factors.

Conclusions

The diagnosis of high‐grade lesions and carcinomas in patients older than 50 years indicates a deficiency in cervical screening. Women with signs and symptoms of STIs and candidiasis sought medical services more frequently than asymptomatic women, and presence of these signs and symptoms contributes to the diagnosis of cervical cancer. We highlight the importance of obtaining a correct smear sampling to allow prompt detection of all preneoplastic lesions; moreover, the implementation of human papillomavirus vaccination and an efficient routine Pap screening are necessary in low‐resource settings.
‘Extreme personal stress’ and ‘a lot of pain’: Exploring the physical, mental and social contexts of extramedical pharmaceutical opioid use in Australian paramedic case descriptions
Authors: Wilson James , Lam Tina , Scott Debbie , Crossin Rose , Matthews Sharon , Smith Karen , Lubman Dan I. , Nielsen Suzanne
Published: July 2020

Introduction and Aims

Despite growing concerns over the extramedical use of pharmaceutical opioids, few studies have focused on the contexts that shape this use or how it might lead to harm. There is also limited research examining how contexts might vary across different opioids, such as those with well‐established abuse liabilities (e.g. oxycodone) and newer ‘atypical’ opioids (e.g. tapentadol). We aimed to address these gaps.

Design and Methods

We analysed Australian paramedic case descriptions for tapentadol cases (n = 82) and a representative sample of oxycodone cases (n = 82) from a 6‐year period (2013–2018). We used framework analysis to identify ‘contexts’ shaping extramedical use from cases where use of tapentadol or oxycodone was assessed to have significantly contributed to the attendances.

Results

Demographically, case descriptions from both drug types were broadly similar (approximately 55% female, 44% were 35–54 years old), as were the contextual factors. The most prevalent contexts common to both oxycodone and tapentadol cases were psychological distress, physical pain and social stressors. Suicidal intent was present across multiple contexts.

Discussion and Conclusions

This study is one of the first to explore the contexts of extramedical pharmaceutical opioid use leading to acute harm. Our analysis found patients in complex, emergency situations, seeking rapid relief from physical pain, psychological distress, social issues and/or suicidal thoughts. These data highlight the complex needs of those experiencing harm from extramedical pharmaceutical opioid use, regardless of opioid type, and the importance of contextual factors shaping both use and subsequent harm.
Characteristics of diabetes medication‐taking in people with mild to moderate intellectual disability compared to those without: a mixed‐methods study
Authors: Paterson R. E. , Taggart L. , Hoyle L. , Brown M.
Published: July 2020

Aim

To compare the frequency and factors associated with diabetes medication‐taking (depression, perceived side effects, self‐efficacy and social support) in people with mild to moderate intellectual disability and those without intellectual disability.

Methods

In stage 1 of this study, we collated information on diabetes medication‐taking and associated factors in 111 people with diabetes: 33 adults with mild to moderate intellectual disability and 78 adults without intellectual disability. Validated instruments measuring medicine‐taking, self efficacy, depressive symptoms, perceived level of social support and perceived side effects were administered in both groups. In stage 2, we used an abductive qualitative approach to triangulate stage 1 findings with carers responses (n = 12).

Results

The instruments showed good internal reliability (Cronbach’s α = 0.7–0.9). Comparisons between people with intellectual disabilities and those without revealed similar frequency of medication‐taking (70% vs 62%; P = 0.41). People with intellectual disabilities and diabetes had significantly higher depressive symptoms, as measured by the Glasgow Depression Scale for people with a Learning Disability (P = 0.04), higher levels of perceived side effects (P = 0.01), and lower confidence levels, as measured by the Perceived Confidence Scale (P = 0.01). The results of stage 2 showed how carers of people with intellectual disabilities and diabetes optimized medication‐taking yet infrequently discussed the side effects of medicines.

Conclusions

Further investigation of medication‐taking and side effects may result in the development of an evidence‐informed intervention to improve medicines safety in people with intellectual disabilities.
SNAP EXPANSIONS AND PARTICIPATION IN GOVERNMENT SAFETY NET PROGRAMS
Authors: Han Jeehoon
Published: July 2020

This paper investigates the interactions between health and nutritional assistance programs such as Medicaid, SNAP, WIC, and school lunch programs. Exploiting variation in SNAP eligibility across states and over time, I find strong evidence of program interactions: when a state moves from the federal rule to the most extensive SNAP eligibility rule, enrollment in free school lunch and WIC increases by 4.1 and 7.9 percentage points, respectively. I estimate that the federal government spends an additional 74 cents on the school lunch program and WIC for each dollar spent on SNAP due to the expansion. (JEL H53, I38, J22)
Can melatonin and its metabolites boost the efficacy of targeted therapy in patients with advanced melanoma?
Authors: Kleszczyński Konrad , Böhm Markus
Published: July 2020

Despite groundbreaking new treatments such as checkpoint inhibition and targeted therapy, the overall response and survival rates are limited in patients with metastatic melanoma. Here, we hypothesize that melatonin and its metabolites could be promising boosters of the efficacy of BRAF/MEK inhibitors in patients with advanced melanoma. Melatonin, a well‐known endogenous synchronizer of the circadian biorhythm has a variety of promising effects for melanoma biology. It regulates proliferation, apoptosis and oxidative phosphorylation via melatonin receptors, and receptor‐independent pathways due to its lipophilicity. By means of interfering with the above cellular pathways, melatonin and related compounds may alter the cAMP‐PKA‐MITF axis, modulate tumor cell metabolism, affect MAPK signalling pathway thereby enhancing the suppressive effect of BRAF/MEK inhibitors on melanoma cell growth, and survival. Such findings could fuel preclinical studies and clinical studies where melatonin or its metabolites are combined with targeted therapy to better treat patients with metastatic melanoma.
Study of crack arrest mechanism and dynamic behaviour using arc‐bottom specimen under impacts
Authors: Lang Lin , Zhu Zheming , Deng Shuai , Niu Caoyuan , Wan Duanying
Published: July 2020

In this paper, a large size trapezoidal open crack with arc‐bottom (TOCAB) configuration specimen was proposed. Experiments were carried out using 0°, 60°, 90° and 120° TOCAB specimens under drop weight impacts with loading rate from 150 to 350 GPa/s. The crack length and crack speed were calculated by using fractal method. It shows that the crack speed corrected by fractal method is more than 12% the original speed calculated using the straight length. The AUTODYN code was employed to simulate crack propagation path and crack speed. The dynamic stress intensity factors (DSIFs) were calculated using ABAQUS code. The experimental and numerical results show that all the three TOCAB specimens have arresting function on running cracks; crack propagation velocity increases with loading rates; the critical DSIFs at initiation are higher than those at propagation. The study presents how to arrest a running crack and how to protect significant structures from being completely damaged.
Seagrass losses since mid‐20th century fuelled CO2 emissions from soil carbon stocks
Authors: Salinas Cristian , Duarte Carlos M. , Lavery Paul S. , Masque Pere , Arias‐Ortiz Ariane , Leon Javier X. , Callaghan David , Kendrick Gary A. , Serrano Oscar
Published: July 2020

Seagrass meadows store globally significant organic carbon (Corg) stocks which, if disturbed, can lead to CO2 emissions, contributing to climate change. Eutrophication and thermal stress continue to be a major cause of seagrass decline worldwide, but the associated CO2 emissions remain poorly understood. This study presents comprehensive estimates of seagrass soil Corg erosion following eutrophication‐driven seagrass loss in Cockburn Sound (23 km2 between 1960s and 1990s) and identifies the main drivers. We estimate that shallow seagrass meadows (<5 m depth) had significantly higher Corg stocks in 50 cm thick soils (4.5 ± 0.7 kg Corg/m2) than previously vegetated counterparts (0.5 ± 0.1 kg Corg/m2). In deeper areas (>5 m), however, soil Corg stocks in seagrass and bare but previously vegetated areas were not significantly different (2.6 ± 0.3 and 3.0 ± 0.6 kg Corg/m2, respectively). The soil Corg sequestration capacity prevailed in shallow and deep vegetated areas (55 ± 11 and 21 ± 7 g Corg m−2 year−1, respectively), but was lost in bare areas. We identified that seagrass canopy loss alone does not necessarily drive changes in soil Corg but, when combined with high hydrodynamic energy, significant erosion occurred. Our estimates point at ~0.20 m/s as the critical shear velocity threshold causing soil Corg erosion. We estimate, from field studies and satellite imagery, that soil Corg erosion (within the top 50 cm) following seagrass loss likely resulted in cumulative emissions of 0.06–0.14 Tg CO2‐eq over the last 40 years in Cockburn Sound. We estimated that indirect impacts (i.e. eutrophication, thermal stress and light stress) causing the loss of ~161,150 ha of seagrasses in Australia, likely resulted in the release of 11–21 Tg CO2‐eq since the 1950s, increasing cumulative CO2 emissions from land‐use change in Australia by 1.1%–2.3% per annum. The patterns described serve as a baseline to estimate potential CO2 emissions following disturbance of seagrass meadows.
Immunohistological expression of oestrogen receptor, progesterone receptor, mammaglobin, human epidermal growth factor receptor 2 and GATA‐binding protein 3 in non‐small‐cell lung cancer
Authors: Kriegsmann Katharina , Zgorzelski Christiane , Muley Thomas , Christopoulos Petros , von Winterfeld Moritz , Herpel Esther , Goeppert Benjamin , Mechtersheimer Gunhild , Sinn Peter , Stenzinger Albrecht , Schirmacher Peter , Winter Hauke , Eichinger Monika , Warth Arne , Kriegsmann Mark
Published: July 2020

Aims

Non‐small‐cell lung cancer (NSCLC) and breast cancer are common entities. Staining for oestrogen receptor (ER), progesterone receptor (PgR), mammaglobin (MAMG) and GATA‐binding protein 3 (GATA3) is frequently performed to confirm a mammary origin in the appropriate diagnostic setting. However, comprehensive data on the immunohistological expression of these markers in NSCLC are limited. Therefore, the aim of this study was to analyse a large cohort of NSCLCs and correlate the staining results with clinicopathological variables.

Methods and results

A tissue microarray was stained for ER, PgR, MAMG, human epidermal growth factor receptor 2 (HER2), and GATA3, and included 636 adenocarcinomas (ADCs), 536 squamous cell carcinomas (SqCCs), 65 large‐cell‐carcinomas, 34 pleomorphic carcinomas, and 20 large‐cell neuroendocrine carcinomas. HER2 status was determined for immunohistochemically positive cases with chromogenic in‐situ hybridisation. Markers with a proportion of ≥5% positive cases in ADC and SqCC were considered for survival analysis. Among ADCs, 62 (10%), 17 (3%), one (<1%), seven (1%), and 49 (8%) cases were positive for ER, PgR, MAMG, HER2, and GATA3, respectively. Among SqCCs, 10 (2%), 14 (3%), two (<1%) and 109 (20%) cases were positive for ER, PgR, HER2, and GATA3, but none of the samples showed positivity for MAMG. ER positivity was associated with ADC, female sex, smaller tumour size, and lower clinical stage. None of the markers had an impact on survival.

Conclusion

We report on ER, PgR, MAMG, HER2 and GATA3 expression in a large cohort of NSCLCs. Interpretation of these markers in the differential diagnostic setting should be based on a multimarker panel.
Beyond plug and play: The acquisition and meaning of vibrators in heterosexual relationships
Authors: Mayr Cornelia
Published: July 2020

This article presents an exploration into women's purchasing of vibrators and how they negotiate the meaning of these sex toys with their partners' preferences and attitudes. Drawing on semi‐structured interviews with 32 female consumers, the study identifies ways in which emotional, transformative and contextual aspects of meaning revolve around choosing, buying and using vibrators in heterosexual relationships. In analysing such experiences, the article points to the potential of vibrators to become imbued with notions of desire, maintenance, privacy and preference. Overall, this research draws attention to salient and nonsalient meanings attached to vibrators that constitute the sex toys' significance beyond simply functional elements. The paper enriches research on consumer behaviour and vibrator use in sexual relationships and proposes an understanding of object relations grounded in the intimate spheres of consumer studies.
Influences of chitosan on freeze–thaw stability of Arenga pinnata starch
Authors: Mei Jiang‐Yang , Huang Ting , Bai Cong‐Hao , Fu Zhen
Published: July 2020

This study aims to investigate chitosan (CS) with five different molecular weight (Mw) on freeze–thaw stability of Arenga pinnata starch (APS) gel subjected to five freeze–thaw cycles (FTC). The syneresis of APS gels was reduced by adding CS and the APS gel with high Mw CS had lower syneresis duo to a higher water holding capacity (P < 0.05). The addition of CS significantly decreased the hardness and molecular ordered structure of APS gel. In addition, CS could improve the microstructural stability. The results suggested that CS could effectively improve the freeze–thaw stability of APS gel, and CS with higher Mw might have more practical utility to improve stability of APS gel.
‘Between heaven and hell’: Subjective well‐being of asylum seekers
Authors: Hartonen Ville R. , Väisänen Pertti , Karlsson Liisa , Pöllänen Sinikka
Published: July 2020

Nearly 1.4 million asylum seekers arrived in Europe in 2015. With an unprecedented 822% increase in the number of asylum applicants, Finland experienced the largest increase in applicants than any other European country that year. In this study, we investigated asylum seekers’ experienced subjective well‐being (ExSWB) construct in comparison with their evaluated subjective well‐being (EvSWB) construct. A mixed methods approach with convergent design was adopted for the study, which combined quantitative data on asylum seekers’ (n = 181) ExSWB and EvSWB with qualitative data on the elements of ExSWB and EvSWB. The findings point at a limbus phase in asylum seekers’ livelihood transition between the borders for international protection in Finland. The Cantril self‐anchoring striving scale was used by the participants to describe this passage ritual of ambiguity. Furthermore, we also found gender differences related to coping and subjective well‐being, which supports previous findings on asylum seekers’ well‐being.

Key Practitioner Message: •The concept of the limbus phase of the asylum seeker livelihood transition is useful for describing asylum seekers’ experiences while waiting for an asylum decision;•Asylum seeker SWB is closely related to status dissonance, separation and capitals, causing anxiety, worry and fear, and inflicting cognitive disruption;•Equal, institutional‐level functions should be organised in the reception centre for easing the anxiety related to the asylum‐seeking process.
Multidrug resistant organism predicts ulcer recurrence following surgical management of diabetic foot osteomyelitis
Authors: Schmidt Brian M. , Ye Wen , Zhou Shiwei
Published: July 2020

Diabetic foot ulcers commonly precede diabetic foot osteomyelitis (DFO) and once the latter occurs, surgical management is often performed. The presence of osteomyelitis is an independent risk factor for the development of re‐ulceration. We investigated the relationship between causative organisms in osteomyelitis and 1‐year diabetic foot outcomes (re‐ulceration, amputation, and death) following surgical management in an observational cohort of 223 patients. Univariate and multivariate analyses were performed for available demographic, clinical, and laboratory data. In addition, random forest plots were used to identify microbiologic predictors of 1‐year outcomes. Patients with osteomyelitis managed surgically were younger and exhibited more painful peripheral neuropathy than outpatients with diabetes alone (both P < .0001). Osteomyelitis proximal margin cultures were diverse, at times polymicrobial, and included multidrug‐resistant organisms in 13.9% of the cohort. In patients who underwent surgery, 44.5% experienced a re‐ulceration on the same foot within 12 months of surgery. The presence of multidrug‐resistant organisms on proximal bone culture was found to be a significant predictor of diabetic foot ulcer recurrence in univariate modelling (P < .001) and importance rankings. This is the first study to use prediction modelling to identify a relationship between multidrug‐resistant organisms and diabetic foot ulcer recurrence following DFO.
Antimony substituted lanthanum orthoniobate proton conductor – Structure and electronic properties
Authors: Mielewczyk‐Gryń Aleksandra , Wachowski Sebastian , Witkowska Agnieszka , Dzierzgowski Kacper , Skubida Wojciech , Świerczek Konrad , Regoutz Anna , Payne David J. , Hull Stephen , Zhang Hangfeng , Abrahams Isaac , Gazda Maria
Published: July 2020

X‐ray and neutron diffraction have been utilized to analyze the crystalline and electronic structure of lanthanum orthoniobate substituted by antimony. Using X‐ray absorption spectroscopy and photoelectron spectroscopy, changes in the electronic structure of the material upon substitution have been analyzed. The structural transition temperature between fergusonite and scheelite phases for 30 mol% antimony substitution was found to be 15°C. Based on the neutron data, the oxygen nonstoichiometry was found to be relatively low. Moreover no influence on the position of the valence band maximum was observed. The influence of the protonation on the electronic structure of constituent oxides has been studied. Absorption data show that the incorporation of protonic defects into the lanthanum orthoniobate structure leads to changes in lanthanum electronic structure and a decrease in the density of unoccupied electronic states.
Readmission and mortality among heart failure patients with history of hypertension in a statewide database
Authors: Giakoumis Michail , Sargsyan Davit , Kostis John B. , Cabrera Javier , Dalwadi Sanketkumar , Kostis William J. ,   for the Myocardial Infarction Data Acquisition System (MIDAS 36) Study Group
Published: July 2020

Objective was to examine the temporal trends in readmission and mortality of heart failure (HF) patients with history of hypertension. This study includes 51 141 patients with history of hypertension who were discharged with a first diagnosis of HF between January 1, 2000, and December 31, 2014. Data were obtained from the Myocardial Infarction Data Acquisition System (MIDAS), a statewide database of all hospitalizations for cardiovascular (CV) disease in New Jersey. The temporal trends of mortality, rates of HF‐specific readmission, and all‐cause readmissions up to 1 year after discharge were examined using multivariable logistic regression. The difference in all‐cause mortality at 3 years between patients who were readmitted compared to those who were not readmitted at 1 year was examined. The number of patients with history of hypertension and HF remained unchanged during the study period. Male gender, black race, comorbidities, and admission to non‐teaching hospitals were predictors of HF readmission and CV mortality (P < .05 for all). Readmission rate for any cause increased during the study period (P < .001) while rates of HF readmissions and mortality remained relatively unchanged. Patients that had been readmitted within a year exhibited a significantly higher 3‐year mortality (P < .001). CV mortality among HF patients with history of hypertension did not change significantly between 2000 and 2014, while the rates of all‐cause readmission increased. Patients who were readmitted had higher 3‐year mortality (P < .001) than those who were not.
Positive feedback in Cav‐1‐ROS signalling in PSCs mediates metabolic coupling between PSCs and tumour cells
Authors: Shao Shan , Qin Tao , Qian Weikun , Yue Yangyang , Xiao Ying , Li Xuqi , Zhang Dong , Wang Zheng , Ma Qingyong , Lei Jianjun
Published: July 2020

Caveolin‐1 (Cav‐1) is the principal structural component of caveolae, and its dysregulation occurs in cancer. However, the role of Cav‐1 in pancreatic cancer (PDAC) tumorigenesis and metabolism is largely unknown. In this study, we aimed to investigate the effect of pancreatic stellate cell (PSC) Cav‐1 on PDAC metabolism and aggression. We found that Cav‐1 is expressed at low levels in PDAC stroma and that the loss of stromal Cav‐1 is associated with poor survival. In PSCs, knockdown of Cav‐1 promoted the production of reactive oxygen species (ROS), while ROS production further reduced the expression of Cav‐1. Positive feedback occurs in Cav‐1‐ROS signalling in PSCs, which promotes PDAC growth and induces stroma‐tumour metabolic coupling in PDAC. In PSCs, positive feedback in Cav‐1‐ROS signalling induced a shift in energy metabolism to glycolysis, with up‐regulated expression of glycolytic enzymes (hexokinase 2 (HK‐2), 6‐phosphofructokinase (PFKP) and pyruvate kinase isozyme type M2 (PKM2)) and transporter (Glut1) expression and down‐regulated expression of oxidative phosphorylation (OXPHOS) enzymes (translocase of outer mitochondrial membrane 20 (TOMM20) and NAD(P)H dehydrogenase [quinone] 1 (NQO1)). These events resulted in high levels of glycolysis products such as lactate, which was secreted by up‐regulated monocarboxylate transporter 4 (MCT4) in PSCs. Simultaneously, PDAC cells took up these glycolysis products (lactate) through up‐regulated MCT1 to undergo OXPHOS, with down‐regulated expression of glycolytic enzymes (HK‐2, PFKP and PKM2) and up‐regulated expression of OXPHOS enzymes (TOMM20 and NQO1). Interrupting the metabolic coupling between the stroma and tumour cells may be an effective method for tumour therapy.
Effects of phosphodiesterase‐5 inhibitor sildenafil on esophageal secondary peristalsis: Studies with high‐resolution manometry
Authors: Wong Ming‐Wun , Yi Chih‐Hsun , Liu Tso‐Tsai , Lei Wei‐Yi , Hung Jui‐Sheng , Liu Chao‐Zong , Chen Chien‐Lin
Published: July 2020

Background and Aim

Secondary peristalsis contributes to the clearance of retained refluxate from the esophagus. Sildenafil, a phosphodiesterase‐5 inhibitor, inhibits primary esophageal peristalsis, but its effects on secondary peristalsis remain unknown. This study sought to investigate whether sildenafil could influence physiological characteristics of secondary peristalsis by applying high‐resolution manometry (HRM).

Methods

Seventeen healthy volunteers (15 men and 2 women, aged 30.2 ± 6.4 years) underwent two HRM studies on separate days following the administration of either a placebo or 50 mg of sildenafil in a random order. Both studies were performed using a water‐perfused HRM catheter containing one air injection channel positioned in the mid‐esophagus. Secondary peristalsis was stimulated by a rapid mid‐esophageal injection of 10 or 20 mL of air 1 h after the administration of either the placebo or sildenafil. The frequency and distal contractile integral of secondary peristalsis were then compared.

Results

Complete secondary peristalsis triggered by the 20‐mL air injection was more frequent than observed with the 10‐mL air injection (P < 0.001). The vigor of secondary peristalsis triggered by the injection of either volume of air was lower than that of primary peristalsis (P < 0.001). Sildenafil significantly reduced the success rate (P ≤ 0.001) and vigor (P < 0.001) of secondary peristalsis relative to the effects of the placebo at both distension volumes.

Conclusions

Secondary peristalsis can be successfully triggered by rapid air injection during HRM. Sildenafil reduces both the success rate and the vigor of secondary peristalsis, similar to that seen with primary peristalsis.
Distinct differences in gut microbial composition and functional potential from lean to morbidly obese subjects
Authors: Meijnikman A. S. , Aydin O. , Prodan A. , Tremaroli V. , Herrema H. , Levin E. , Acherman Y. , Bruin S. , Gerdes V.E. , Backhed F. , Groen A.K. , Nieuwdorp M.
Published: July 2020

Introduction

The gut microbiome may contribute to the development of obesity. So far, the extent of microbiome variation in people with obesity has not been determined in large cohorts and for a wide range of body mass index (BMI). Here, we aimed to investigate whether the faecal microbial metagenome can explain the variance in several clinical phenotypes associated with morbid obesity.

Methods

Caucasian subjects were recruited at our hospital. Blood pressure and anthropometric measurements were taken. Dietary intake was determined using questionnaires. Shotgun metagenomic sequencing was performed on faecal samples from 177 subjects.

Results

Subjects without obesity (n = 82, BMI 24.7 ± 2.9 kg m−2) and subjects with obesity (n = 95, BMI 38.6 ± 5.1 kg m−2) could be clearly distinguished based on microbial composition and microbial metabolic pathways. A total number of 52 bacterial species differed significantly in people with and without obesity. Independent of dietary intake, we found that microbial pathways involved in biosynthesis of amino acids were enriched in subjects with obesity, whereas pathways involved in the degradation of amino acids were depleted. Machine learning models showed that more than half of the variance in body fat composition followed by BMI could be explained by the gut microbiome, composition and microbial metabolic pathways, compared with 6% of variation explained in triglycerides and 9% in HDL.

Conclusion

Based on the faecal microbiota composition, we were able to separate subjects with and without obesity. In addition, we found strong associations between gut microbial amino acid metabolism and specific microbial species in relation to clinical features of obesity.
The success rate of oral appliances based on multiple criteria according to obstructive sleep apnoea severity, BMI and age: A large multicentre study
Authors: Okuno Kentaro , Furuhashi Akifumi , Nakamura Shuhei , Suzuki Hiroshi , Arisaka Takehiro , Taga Hitoshi , Tamura Masataka , Katahira Haruto , Furuhata Minoru , Iida Chisato
Published: July 2020

Background

The efficacy of oral appliance (OA) varies greatly in patients with obstructive sleep apnoea (OSA).

Objective(s)

The purpose of this cross‐sectional study was to investigate the success rate of OA for OSA patients.

Methods

This study was based on a cross‐sectional multicentre survey of OA therapy for the management of OSA called the JAMS (Japanese Cross‐sectional Multicenter Survey) Study performed at 10 medical institutions. A total of 442 patients fulfilled the selection criteria, which patients had worn OA, and undergone overnight polysomnography to assess both the pre‐treatment baseline and follow‐up for OA. Age, sex, BMI and apnoea‐hypopnea index (AHI) at the time of diagnosis and follow‐up for OA were extracted.

Results

After OA treatment, the mean AHI decreased from 22.6 ± 13.8 to 10.0 ± 10.2/h, and the mean rate of decrease in the AHI was 52.5 ± 38.4%. Regarding the success rate to OA therapy, criterion 1 (AHI < 5/h), criterion 2 (AHI < 10/h), criterion 3 (AHI < 15/h) and criterion 4 (AHI reduction rate ≥ 50%) accounted for 33.5, 66.3, 80.5 and 63.3%, respectively. The success rate of OA treatment decreased according to the increase in OSA severity, obesity level (higher BMI) and older age.

Conclusions

This study revealed the treatment success rate of OA on multiple criteria according to OSA severity, BMI and age. It may support for the clinician to make a decision on the OSA management.
Straight leg raise metrics on high‐resolution manometry associate with esophageal reflux burden
Authors: Rogers Benjamin D. , Rengarajan Arvind , Ali Ijlal A. , Hasak Stephen L. , Hansalia Vivek , Gyawali C. Prakash
Published: July 2020

Background

Straight leg raise (SLR) is a provocative maneuver that assesses esophagogastric junction (EGJ) barrier function during high‐resolution manometry (HRM). We evaluated the value of SLR in symptomatic reflux patients undergoing ambulatory reflux monitoring.

Methods

Adult patients being evaluated for reflux symptoms with esophageal physiologic testing off antisecretory therapy over a 12 month period were studied. Demographics, clinical presentation, HRM studies, and reflux monitoring studies were analyzed. Intra‐abdominal and intra‐esophageal pressures were extracted at baseline and during SLR from HRM studies. Acid exposure time (AET) was derived from reflux monitoring studies, and EGJ morphology and tone from HRM studies. SLR pressure metrics predicting abnormal AET were evaluated.

Key Results

Of 122 patients, 70 (57.4%) had ≥50% peak intra‐abdominal pressure increase during SLR (58.0 ± 1.4 years, 75.7% female). Peak intra‐esophageal pressure gradient between baseline and SLR predicted pathologic AET when ≥100% (AUC 0.78, sensitivity 71%, specificity 75%, P < .001), seen in 60.7% with AET > 6%, but only 23.7% with AET < 4% (P = .01). Peak intra‐esophageal pressure gradient ≥100% was most discriminative in identifying abnormal acid burden in type 1 EGJ morphology (P = .005) but trended toward significance in type 2 and type 3 morphology (P = .1). Normal and abnormal EGJ contractile integral did not associate with peak intra‐esophageal pressure gradient either collectively or when subdivided by EGJ morphology (P ≥ .2).

Conclusions & Inferences

Analysis of intra‐esophageal pressure gradients during SLR, a simple HRM maneuver, may augment evaluation of symptomatic GERD, and provide adjunctive evidence supporting GERD.
Efficacy and safety of different interventions to accelerate maxillary canine retraction following premolar extraction: A systematic review and network meta‐analysis
Authors: MacDonald Laura , Zanjir Maryam , Laghapour Lighvan Nima , da Costa Bruno R. , Suri Sunjay , Azarpazhooh Amir
Published: July 2020

Decreasing orthodontic treatment duration is at the forefront of innovation for clinical orthodontics. This network meta‐analysis aimed to determine the relative efficacy and safety of treatments for accelerated orthodontic tooth movement (OTM) in patients undergoing extraction of maxillary first premolars followed by canine retraction in any orthodontic setting. MEDLINE, EMBASE, Cochrane CENTRAL, CINAHL and SCOPUS were searched (from inception to 20 April 2020). Study selection and data extraction were performed in duplicate. Eligible randomized controlled trials (RCTs) were meta‐analysed to estimate the rate of tooth movement, 95% credible interval and surface under the cumulative ranking curve (SUCRA) in the first 3 months following the application of the adjunctive accelerative method. Eligible RCTs were assessed by Cochrane risk of bias tool, and quality of evidence was assessed by GRADE approach, obtained from CINeMA web application. Interventions were ranked for efficacy and reviewed for safety. Nineteen studies pertaining to eight interventions, with data from 415 patients were included. Quality of evidence was very low to moderate. Very low‐to low‐quality evidence suggests that corticotomy is an efficacious and safe adjunctive treatment to accelerate OTM in comparison with conventional treatment in the first 2 months of treatment. Low‐quality evidence suggests that piezocision and micro‐osteoperforations (MOP) are efficacious and safe adjunctive treatments only in the first month of treatment. Frequent MOP in conjunction with low‐level laser therapy appeared to be an efficacious and safe adjunctive treatment only in the first month following its initial application but not thereafter.
Dentition and nutritional status of aged New Zealanders living in aged residential care
Authors: van Kuijk Maria , Smith Moira B. , Ferguson Catherine Anna , Kerse Ngaire M. , Teh Ruth , Gribben Barry , Thomson William Murray
Published: July 2020

Background

Previous studies of the nutritional status of older individuals have used measures such as plasma vitamin and mineral levels, which can be difficult to interpret. The relationship between nutrition and dentition has been limited to studying exposures such as the number of posterior occluding pairs of teeth, edentulousness, and the number of natural teeth.

Objectives

To investigate the association between dentition status and nutritional status in a national survey of older New Zealanders living in aged residential care facilities.

Material and methods

Secondary analysis of clinical oral status and nutrition data collected in 2012 in New Zealand's Older People's Oral Health Survey. The validated Mini Nutritional Assessment short format was used to categorize participants as “normal nutritional status,” “at risk of malnutrition” or “malnourished.”

Results

Just under half of older New Zealanders living in aged residential care facilities were classified as either at risk of malnutrition or malnourished (with about one in sixteen in the latter category). The prevalence of malnutrition was higher among those in hospital‐level and psychogeriatric‐level care, as well as in those of high socioeconomic status. Individuals who were at risk of malnutrition had the most untreated dental caries and untreated coronal caries. Relative to their counterparts in nursing‐home‐level care, dentate individuals in hospital‐level care were 2.4 times—and those in psychogeriatric‐level care were 2.8 times—as likely to be malnourished or at risk of it.

Conclusions

Just under half of the New Zealanders living in aged residential care were at risk of malnutrition or were malnourished. Greater experience of untreated dental caries was associated with a higher rate of being malnourished or at risk of it. Poorer cognitive function and greater dependency were important risk indicators for malnutrition.
Dysregulation of CCN3 (NOV) expression in the epidermis of systemic sclerosis patients with pigmentary changes
Authors: Henrot Pauline , Pain Catherine , Taïeb Alain , Truchetet Marie‐Elise , Cario Muriel
Published: July 2020

Systemic sclerosis (SSc) is a severe disease whose pathophysiology remains partly unknown, combining autoimmune, vascular, and fibrotic features. Recently, we evidenced a link between vasculopathy and pigmentary changes in SSc. CCN3 (NOV) is a matricellular protein implicated in both angiogenesis and pigmentation regulation, in particular melanocyte adhesion to the basal layer. We decided to study CCN3 expression in SSc epidermis. We show that in SSc patients with pigmentary changes compared to patients with normal pigmentation, CCN3 is specifically downregulated in situ in melanocytes and upregulated in keratinocytes. Moreover, the number of melanocytes is significantly decreased in SSc patients with a disease duration of more than 5 years compared to the other patients. Altogether, our findings could provide new insights on the mechanisms of pigmentary changes in SSc patients, as well as treatment adaptation in a personalized manner.
Evaluation of biochemical profile of dairy cows with metabolic diseases in tropical conditions
Authors: Paiano Renan Braga , Birgel Daniela Becker , Bonilla Jeannine , Birgel Junior Eduardo Harry
Published: July 2020

The aims of this study were to characterize the biochemical profile, the reproductive performance and to identify potential predictive biomarkers of disease state of dairy cows with hyperketonemia, lipomobilization and hypocalcemia raised in tropical conditions in southeastern Brazil. Dairy cows (n = 50) were divided into a group of healthy cows (n = 14), cows with lipomobilization (n = 14), cows with hypocalcemia (n = 11), and a group of cows with hyperketonemia (n = 11). Evaluation of body condition score (BCS), body weight (BW) and blood samples was performed on 21, 14, 7, 4 and 2 days before calving, parturition, 1, 7, 14, 21, 30, 45 and 60 days post‐partum and milk production was recorded on days 7, 14, 21, 30, 45 and 60 after parturition. Blood samples were assayed for aspartate aminotransferase (AST), gamma‐glutammyltransferase (GGT), albumin, total protein, globulin, fibrinogen, total cholesterol, triglyceride, urea and creatinine concentrations. The biochemical profile, BCS, BW, milk production and reproductive performance differed (p < .05) among the groups. Our findings indicate changes in the biochemical profile of dairy cows with metabolic diseases and impaired production and fertility of dairy cows in this group. Variable importance in projection plots demonstrated that cholesterol, urea, total protein, albumin and fibrinogen in the serum were the strongest discriminators between cows with hypocalcemia and healthy cows; and AST, cholesterol, urea and triglycerides for cows with hyperketonemia and healthy cows; and cholesterol, urea, triglycerides, total protein and fibrinogen for lipomobilization and healthy cows, which might be useful as predictive biomarkers of the disease state.
Interaction of restored hydrological connectivity and herbicide suppresses dominance of a floodplain invasive species
Authors: Hutchinson Rachel A. , Fremier Alexander K. , Viers Joshua H.
Published: July 2020

Invasive species present one of the largest threats to the recruitment and persistence of native plant communities. Land managers generally apply two approaches to help control invasive species and restore native plant communities: (1) improve ecosystem processes that preferentially support native species (e.g. reintroduce disturbance regimes) or (2) directly treat non‐native species (e.g. herbicide use). Few utilize both. Over nearly a decade, we tracked the establishment and population growth of Lepidium latifolium (perennial pepperweed) on a hydrologically restored floodplain and adjacent grassland sites, concurrently with a controlled herbicide application experiment. We found that perennial pepperweed stem counts were lower in years with longer duration flood events (p < 0.0001) and after herbicide application (p < 0.0005). In floodplain areas, native species increased in the years following herbicide treatments or after wet water years, while grassland sites were reinvaded by other non‐native species. Our results suggest that long inundation periods can effectively control perennial pepperweed over large areas when used in concert with herbicide control during dry years or in drier areas. Given the natural variability in inundation periods, our study highlights the need for longer‐term (>3–5 years) studies to evaluate the effectiveness of invasive species control programs. Overall, our study emphasized the need for further integration of traditional weed control approaches with restored ecological function to effectively control invasive plants and stimulate native plant recovery.
Algorithmic state surveillance: Challenging the notion of agency in human rights
Authors: Kosta Eleni
Published: July 2020

This paper explores the extent to which current interpretations of the notion of agency, as traditionally perceived under human rights law, pose challenges to human rights protection in light of algorithmic surveillance. After examining the notion of agency under the European Convention on Human Rights as a criterion for applications' admissibility, the paper looks into the safeguards of notification and of redress – crucial safeguards developed by the Court in secret surveillance cases – which are used as examples to illustrate their insufficiency in light of algorithmic surveillance. The use of algorithms creates new surveillance methods and challenges fundamental presuppositions on the notion of agency in human rights protection. Focusing on the victim status does not provide a viable solution to problems arising from the use of Artificial Intelligence in state surveillance. The paper thus raises questions for further research concluding that a new way of thinking about agency for the protection of human rights in the context of algorithmic surveillance is needed in order to offer effective protection to individuals.
Probabilistic Analysis of Dam Accidents Worldwide: Risk Assessment for Dams of Different Purposes in OECD and Non‐OECD Countries with Focus on Time Trend Analysis
Authors: Kalinina Anna , Spada Matteo , Burgherr Peter
Published: July 2020

This study presents probabilistic analysis of dam accidents worldwide in the period 1911–2016. The accidents are classified by the dam purpose and by the country cluster, where they occurred, distinguishing between the countries of the Organization for Economic Cooperation and Development (OECD) and nonmember countries (non‐OECD without China). A Bayesian hierarchical approach is used to model distributions of frequency and severity for accidents. This approach treats accident data as a multilevel system with subsets sharing specific characteristics. To model accident probabilities for a particular dam characteristic, this approach samples data from the entire data set, borrowing the strength across data set and enabling to model distributions even for subsets with scarce data. The modelled frequencies and severities are combined in frequency‐consequence curves, showing that accidents for all dam purposes are more frequent in non‐OECD (without China) and their maximum consequences are larger than in OECD countries. Multipurpose dams also have higher frequencies and maximum consequences than single‐purpose dams. In addition, the developed methodology explicitly models time dependence to identify trends in accident frequencies over the analyzed period. Downward trends are found for almost all dam purposes confirming that technological development and implementation of safety measures are likely to have a positive impact on dam safety. The results of the analysis provide insights for dam risk management and decision‐making processes by identifying key risk factors related to country groups and dam purposes as well as changes over time.
Updated Characterization of Post‐OPV Cessation Risks: Lessons from 2019 Serotype 2 Outbreaks and Implications for the Probability of OPV Restart
Authors: Kalkowska Dominika A. , Pallansch Mark A. , Cochi Stephen L. , Kovacs Stephanie D. , Wassilak Steven G. F. , Thompson Kimberly M.
Published: July 2020

After the globally coordinated cessation of any serotype of oral poliovirus vaccine (OPV), some risks remain from undetected, existing homotypic OPV‐related transmission and/or restarting transmission due to several possible reintroduction risks. The Global Polio Eradication Initiative (GPEI) coordinated global cessation of serotype 2‐containing OPV (OPV2) in 2016. Following OPV2 cessation, the GPEI and countries implemented activities to withdraw all the remaining trivalent OPV, which contains all three poliovirus serotypes (i.e., 1, 2, and 3), from the supply chain and replace it with bivalent OPV (containing only serotypes 1 and 3). However, as of early 2020, monovalent OPV2 use for outbreak response continues in many countries. In addition, outbreaks observed in 2019 demonstrated evidence of different types of risks than previously modeled. We briefly review the 2019 epidemiological experience with serotype 2 live poliovirus outbreaks and propose a new risk for unexpected OPV introduction for inclusion in global modeling of OPV cessation. Using an updated model of global poliovirus transmission and OPV evolution with and without consideration of this new risk, we explore the implications of the current global situation with respect to the likely need to restart preventive use of OPV2 in OPV‐using countries. Simulation results without this new risk suggest OPV2 restart will likely need to occur (81% of 100 iterations) to manage the polio endgame based on the GPEI performance to date with existing vaccine tools, and with the new risk of unexpected OPV introduction the expected OPV2 restart probability increases to 89%. Contingency planning requires new OPV2 bulk production, including genetically stabilized OPV2 strains.