bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of GABA, Somatostatin, and Corticotrophin-Releasing Hormone Expression in Axon Terminals That Target the Parabrachial Nucleus
Authors: Lundy Robert
Published: February 2020

Several forebrain areas have been shown to project to the parabrachial nucleus (PBN) and exert inhibitory and excitatory influences on taste processing. Some sources of descending input such as the central nucleus of the amygdala (CeA) might utilize somatostatin (Sst) and/or corticotrophin-releasing hormone (Crh) to influence taste processing in the PBN (Panguluri S, Saggu S, Lundy R. 2009. Comparison of somatostatin and corticotrophin-releasing hormone immunoreactivity in forebrain neurons projecting to taste-responsive and non-responsive regions of the parabrachial nucleus in rat. Brain Res 1298:57–69; Magableh A, Lundy R. 2014. Somatostatin and corticotrophin releasing hormone cell types are a major source of descending input from the forebrain to the parabrachial nucleus in mice. Chem Senses 39:673–682). Since the predominate effect of CeA stimulation on PBN taste-evoked responses is inhibition, this study used transgenic reporter lines (Sst/TdTomato and Crh/TdTomato) and electron microscopy to assess Sst/gamma aminobutyric acid (GABA) and Crh/GABA coexpression in axon terminals within the PBN. Robust expression of Sst and Crh axon terminals was observed in the PBN. The majority of Sst-positive axon terminals were positive for GABA expression, while the majority of Crh terminals were not. The results indicate that Sst-expressing neurons, but not Crh neurons, are a source of GABAergic input to the PBN. To assess whether the CeA is a source of GABAergic input to the PBN, the CeA of Sst-cre mice was injected with cre-dependent enhanced yellow fluorescent protein (EYFP) virus and PBN tissue processed for GABA and EYFP expression. Again, the majority of EYFP Sst-positive axon terminals in the PBN coexpressed GABA. Together, the present results suggest that CeA neurons marked by Sst expression represent a major extrinsic source of GABAergic input to the PBN and this could underlie the predominate inhibitory effect of CeA stimulation on taste-evoked responses in the PBN.
Winter-Active Spider Fauna is Affected by Plantation Forest Type
Authors: Ingle Kapilkumar , Kaur Hardeep , Gallé-Szpisjak Nikolett , Bürgés József , Szabó Áron , Gallé Róbert
Published: February 2020

Plantations of non-native trees for commercial use are common practice in Europe. They are known to have severe ecological impacts on arthropod fauna by altering microclimatic conditions and reducing microhabitat diversity. However, the effect of plantation tree species on winter-active fauna is relatively unknown. Spiders are a diverse predatory arthropod taxon with strong effect on their prey populations. The composition of spider communities sensitively indicates changes in habitat structure. We established 40 sampling sites in five non-native pine and five native poplar plantations and collected spiders with pitfall traps for two winters in the Southern part of Hungary. We assessed the average height of vegetation and percentage cover of leaf litter, mosses, herbaceous vegetation, and shrubs to characterize habitat structure. We found species richness and activity density of spiders in the non-native compared to the native plantations, presumably due to the more temperate microclimate in pine than in poplar plantations. However, there was no significant effect of habitat structure and its interaction with forest type on species richness and activity density of spiders. Species composition of non-native and native plantation forests differed significantly. Furthermore, we identified six characteristic spider species of non-native plantations with preference for relatively moist habitat conditions. The single characteristic species, (Agroeca cuprea Menge, 1873) for the native plantations preferred dry and partly shaded habitats. We conclude that the effect of microclimatic differences and prey availability presumably overrides the effect of habitat structure on winter-active spiders.
Left atrial remodelling, mid-regional pro-atrial natriuretic peptide, and prognosis across a range of ejection fractions in heart failure
Authors: Putko Brendan N , Savu Anamaria , Kaul Padma , Ezekowitz Justin , Dyck Jason R , Anderson Todd J , White James A , Paterson D Ian , Thompson Richard B , Oudit Gavin Y
Published: February 2020

Aims 

Measures of structural and functional remodelling of the left atrium (LA) are emerging as useful biomarkers in heart failure (HF). We hypothesized that LA volume and its contribution to stroke volume (SV) would predict a composite endpoint of HF hospitalization or death in patients with HF.

Methods and results 

We recruited 57 controls and 86 patients with HF, including preserved and reduced left ventricular ejection fraction (LVEF). Cardiac magnetic resonance imaging was used to evaluate LA volumes and contribution to LV SV. Plasma mid-region pro-atrial natriuretic peptide (MR-proANP) was evaluated. LA volume was negatively correlated with LVEF (P = 0.001) and positively correlated with LV mass in HFrEF (P < 0.001) but not in HFpEF. LA volume at end-diastole was associated with the composite endpoint in HFrEF (hazard ratio 1.26, 95% confidence interval 1.01–1.54; P = 0.044), but not HFpEF (1.06, 0.85–1.30; P = 0.612), per 10 mL/m increase. Active contribution to SV was negatively associated with the composite endpoint in HFpEF (0.32, 0.14–0.66; P = 0.001), but not HFrEF (0.91, 0.38–2.1; P = 0.828) per 10% increase. MR-proANP was associated with the composite endpoint in HFpEF (1.46, 1.03–1.94; P = 0.034), but not in HFrEF (1.14, 0.88–1.37; P = 0.278), per 100 pM increase.

Conclusion 

We found different relationships between LA remodelling and biomarkers in HFrEF and HFpEF. Our results support the hypothesis that the pathophysiologic underpinnings of HFpEF and HFrEF are different, and atrial remodelling encompasses distinct components for each HF subtype.
Early and long-term results of total arch replacement with the frozen elephant trunk technique for acute type A aortic dissection
Authors: Yoshitake Akihiro , Tochii Masato , Tokunaga Chiho , Hayashi Jun , Takazawa Akitoshi , Yamashita Kentaro , Chubachi Fumiya , Hori Yuuto , Nakajima Hiroyuki , Iguchi Atsushi , Gatate Yodo , Nakano Shintaro , Asakura Toshihisa
Published: February 2020

OBJECTIVES

We evaluated the operative and long-term outcomes of the frozen elephant trunk (FET) technique for acute type A aortic dissection.

METHODS

This study evaluated 426 consecutive patients who underwent aortic repair for acute type A aortic dissection from June 2007 to December 2018 at our centre. Of these, 139 patients underwent total arch replacement with FET (FET group), and 287 underwent other procedures (no FET group). Ninety-two patients in the FET group were matched to 92 patients in the no FET group by using propensity score matching analysis.

RESULTS

Thirty-day mortality and neurological dysfunction were not significantly different between the FET and no FET groups (1.4% vs 2.4%, P = 0.50 and 5.0% vs 6.3%, P = 0.61, respectively). Long-term survival was better in the FET group than in the no FET group (P = 0.008). Freedom from distal thoracic reintervention was similar in the FET and no FET groups (P = 0.74). In the propensity-matched patients, freedom from aortic-related death was better in the FET group than in the no FET group (P = 0.044).

CONCLUSIONS

Operative outcomes showed no significant difference between the 2 groups. FET contributes to better long-term survival in patients with acute type A aortic dissection.
Bioenergetic influence on the historical development and decline of industrial fisheries
Authors: Guiet J , Galbraith E D , Bianchi D , Cheung W W L
Published: February 2020

The global wild capture fishery expanded rapidly over the 20th century as fishing technology improved, peaking in the 1990s as most fisheries transitioned to fully- or over-exploited status. Historical records for individual large marine ecosystems (LMEs) tend to echo this same progression, but with local variations in the timing and abruptness of catch peaks. Here, we provide objective descriptions of these catch peaks, which generally progressed from high- to low-latitude LMEs, and attribute the temporal progression to a combination of economic and ecological factors. We show that the ecological factors can be remarkably strong by using a spatially resolved, observationally-constrained, coupled macroecological-economic model to which we impose an idealized, globally homogeneous increase in catchability. The globally-uniform technology creep produces a spatial progression of fishing from high-to-low latitudes that is similar to observations, primarily due to the impact of temperature on ecosystem metabolism. In colder LMEs, low respiration rates allow the build-up of larger pristine standing stocks, so that high-latitude fisheries are profitable earlier, at lower levels of fishing technology. We suggest that these bioenergetic characteristics contributed significantly to the historical progression of this human-ecological system.
Scandalizing the judiciary: An analysis of the uneven response of the Supreme Court of India to sexual harassment allegations against judges
Authors: Jain Sanjay , Mishra Saranya
Published: February 2020

The Supreme Court of India (SC) pronounced a momentous judgment in Vishaka v. State of Rajasthan in 1997, categorically recognizing the menace of sexual harassment (SH) at workplace and constitutionally rendering it as being in violation of fundamental rights guaranteed by Articles 15, 19, and 21 of the Constitution of India 1950. The Court also provided a mechanism for redressal against SH, which was ultimately reinforced by Parliament with the enactment of Sexual Harassment at Workplace (Prevention, Prohibition and Redressal) Act 2013 (POSH Act). However, when it comes to allegations of SH against judges in the SC and High Courts by its employees, interns, or lower court judges, the response of the SC has been abysmal to say the least. There is a systematic pattern to suggest foul play and conspiracy in each such allegation, and judges, including even the Chief Justice of India (CJI), have not hesitated to openly indulge in victim-shaming and-blaming. In other words, the court has not been able to uphold its own jurisprudence on sexual harassment, which it expects to be scrupulously adhered to by other organs of the state. It is submitted that in not supporting the cause of victims alleging SH against judges, the other organs of the state are also party to this constitutional decay and serious infraction of fundamental rights. It leads us to ask the question, how can we guard against the guardians?
High-resolution inversion for dispersion characteristics of acoustic logging waveforms
Authors: Chen Da , Guan Wei , Zhang Chao , Zhou Qihang , Hu Hengshan
Published: February 2020

In acoustic logging, most published studies of extracting array data characteristics are difficult to avoid the interference from the false modes. The false modes contribute little to the acoustic waveforms but makes the true modes hard to identify. We introduce a threshold of the energy spectrum into the pole-calculation method to remove the false modes, thereby eliminating their interferences to the true modes. To avoid the separation of multiple crossings of pole distribution, we directly acquire the slowness dispersion of multiple modes by superposing the single-mode results calculated from the weighted spectral semblance method. We processed the slowness-frequency snapshot and design an extreme-point extraction formula to generate the multi-mode scatterplot, which provide a precise slowness dispersion result. In terms of four synthetic cases of acoustic logging, it has demonstrated that the proposed algorithm can provide a high-resolution slowness dispersion profile for multiple modes. Even for acoustic logging while drilling with strong tool wave components, the aliases and interferences of false modes do not exist. Finally, a test proves that the proposed algorithm also has a good anti-noise ability.
Patient Reflections on Individual Music Therapy for a Major Depressive Disorder or Acute Phase Schizophrenia Spectrum Disorder
Authors: Paul Natalie , Lotter Carol , van Staden Werdie
Published: February 2020

Reflections of patients have not been studied qualitatively after a completed course of individual music therapy for a major depressive disorder (MDD) or an acute phase of a schizophrenia spectrum disorder (SSD). Our interpretivist study explored patient reflections through individual interviews with 15 hospitalized patients after a completed course of eight individual music therapy sessions that were flexibly structured in blended fashion utilizing a set of active and receptive music therapy methods. Our analyses yielded 8 themes, supported by 23 subthemes. These themes were grouped into three domains, capturing respectively participants’ praise for music therapy, the distress from which change emerged, and various perceived gains. Participants cast the perceived gains from music therapy in the wake of their distress. The domain of distress comprised two themes: distress before and during therapy, and a process of opening up and dealing with old wounds. The themes expressing their gains were: new perspectives, growing strong, emotional fulfillment, becoming socially closer and more adept, and becoming liberated and creatively inspired. These client perspectives on a completed course of music therapy augment the evidence base established in clinician terms of what matters as a potential gain from music therapy. These perspectives, furthermore, inform on the gains and the distress from which gains emerged, congruent with a strengths-oriented therapeutic pursuit in music therapy for an MDD or an acute phase of SSD. Music therapists in similar settings may draw on these perspectives in the planning and strengthening of a course of music therapy.
Solidarity with China as it holds the global front line during COVID-19 outbreak
Authors: Lin Leesa
Published: February 2020

Though COVID-19 seems to be highly contagious, eight weeks into the outbreak, the epidemic had been largely contained within Hubei province. The Chinese epidemic control efforts bought life-saving time for the rest of the country and the international community, allowing for more research on treatment strategies and better epidemic preparedness.
Classical probabilities and belief functions in legal cases
Authors: Meester Ronald
Published: February 2020

I critically discuss a recent suggestion in Nance (Belief Functions and Burdens of Proof. Law, Probability and Risk, 18:53–76, 2018) concerning the question which ratios of beliefs are appropriate when in criminal or civil cases one works with belief functions instead of classical probabilities. I do not call into question the use of belief functions themselves in this context, and I agree with in Nance (Belief Functions and Burdens of Proof. Law, Probability and Risk, 18:53–76, 2018) that so-called ‘uncommitted support’, possible in the framework of belief functions, should not be taken into account in a decision-theoretic framework. However, I argue against in Nance (Belief Functions and Burdens of Proof. Law, Probability and Risk, 18:53–76, 2018) in that, at least in criminal law, relative sizes of beliefs should not be used for decision-making at all. I will argue that only the individual, absolute beliefs should be considered. Since belief functions generalize classical probabilities, this position seems at first sight to conflict with the fact that odds are abundant when we use classical probabilities in a legal context. I will take the opportunity, then, to point out that also in the classical setting, odds are not our primary concern either. They are convenient since they appear, together with the likelihood ratio, in the odds form of Bayes’ rule. Apart from that, they do not have any individual significance. I also note that in civil law the conclusions might be different.
Is Falcine Meningioma a Diffuse Disease of the Falx? Case Series and Analysis of a “Grade Zero” Resection
Authors: Mooney Michael A , Abolfotoh Mohammad , Bi Wenya Linda , Tavanaiepour Daryoush , Almefty Rami O , Bassiouni Hischam , Pravdenkova Svetlana , Dunn Ian F , Al-Mefty Ossama
Published: February 2020

BACKGROUND

Falcine meningiomas have unique characteristics including their high rates of recurrence, association with high grade pathology, increased male prevalence, and potential for diffuse involvement of the falx.

OBJECTIVE

To address these issues in a substantial series of falcine meningiomas and report on the impact of extent of resection for this distinct meningioma entity.

METHODS

Retrospective analysis of characteristics and outcomes of 59 falcine meningioma patients who underwent surgery with the senior author. A “Grade Zero” category was used when an additional resection margin of 2 to 3 cm from the tumor insertion was achieved.

RESULTS

For de novo falcine meningiomas, gross total resection (GTR) was associated with significantly decreased recurrence incidence compared with subtotal resection (P ≤ .0001). For recurrent falcine meningiomas, median progression-free survival (PFS) was significantly improved for GTR cases (37 mo vs 12 mo; P = .017, hazard ratio (HR) .243 (.077-.774)). “Grade Zero” resection demonstrated excellent durability for both de novo and recurrent cases, and PFS was significantly improved with “Grade Zero” resection for recurrent cases (P = .003, HR 1.544 (1.156-2.062)). The PFS benefit of “Grade Zero” resection did not achieve statistical significance over Simpson grade 1 during the limited follow-up period (mean 2.8 yr) for these groups.

CONCLUSION

The recurrence of falcine meningiomas is related to the diffuse presence of tumor between the leaflets of the falx. Increased extent of resection including, when possible, a clear margin of falx surrounding the tumor base was associated with the best long-term outcomes in our series, particularly for recurrent tumors.
Failed Foramen Magnum Decompression in Chiari I Malformation Is Associated With Failure to Restore Normal Intracranial Compliance: An Observational Cohort Study
Authors: Dyson Edward W , Chari Aswin , Toma Ahmed K , Thorne Lewis W , Watkins Laurence D
Published: February 2020

BACKGROUND

The standard treatment for symptomatic Chiari malformation (CM) I is foramen magnum decompression (FMD) to facilitate cerebral spinal fluid flow through the foramen magnum, improve intracranial compliance, and alleviate symptoms (commonly headache). This procedure has a variable success rate, with a significant proportion of patients having persistent symptoms after surgery.

OBJECTIVE

To investigate intracranial pressure (ICP) hydrodynamics in symptomatic surgery-naïve patients with CM I and symptomatic patients who have had prior FMD.

METHODS

We undertook a retrospective, observational cohort study, extracting data from our departmental ICP database. Patients with untreated (“Virgin”) Chiari malformations (VCM), patients with previous “failed” FMD (ie, with persistent classical Chiari symptoms) (fFMD) and a normal control group, all with existing continuous ICP monitoring date were included. Median ICP (mICP) and median pulse amplitude (mPA) were compared between the groups.

RESULTS

A total of 33 CM patients (22 VCM and 11 fFMD) and 42 normal controls were included for analysis. mICP did not differ significantly between the normal control, VCM, and fFMD groups. mPA in the VCM and fFMD groups was significantly higher than the control group (P < .01 and P < .05, respectively).

CONCLUSION

In this cohort, patients with persistent symptoms after FMD have persistently impaired intracranial compliance, similar to patients who have not undergone surgery at all when compared with a control group. The reasons for this are not clear, and further research is required to establish the causation and optimum management for failed FMD.
RAF and MEK inhibitor therapy in adult patients with brain tumors: a case-based overview and practical management of adverse events
Authors: Schreck Karisa C , Patel Mallika P , Wemmer Jan , Grossman Stuart A , Peters Katherine B
Published: February 2020

AbstractTargeted therapy has gained mainstream attention with notable successes against specific genetic mutations in many cancers. One particular mutation, the BRAF V600E mutation, is present in a small subset of gliomas in adults. Although clinical experience and trial data of RAF-targeted therapy in adults with glioma are lacking at this time, the poor prognosis of adult high-grade glioma has led neuro-oncology practitioners to consider the use of targeted therapy in these patients. In this manuscript, we describe the use of RAF and MEK inhibitors in adults with recurrent glioma. We discuss the utility of these agents, describe their toxicities, and give examples of management strategies. Given the significant toxicities of RAF and MEK inhibitors, along with the long potential duration of treatment, neuro-oncology providers should counsel patients carefully before initiating therapy and monitor them closely while undergoing treatment with RAF-targeted therapy.
Contrasting trends of PM2.5 and surface-ozone concentrations in China from 2013 to 2017
Authors: Wang Yonghong , Gao Wenkang , Wang Shuai , Song Tao , Gong Zhengyu , Ji Dongsheng , Wang Lili , Liu Zirui , Tang Guiqian , Huo Yanfeng , Tian Shili , Li Jiayun , Li Mingge , Yang Yuan , Chu Biwu , Petäjä Tuukka , Kerminen Veli-Matti , He Hong , Hao Jiming , Kulmala Markku , Wang Yuesi , Zhang Yuanhang
Published: February 2020

Although much attention has been paid to investigating and controlling air pollution in China, the trends of air-pollutant concentrations on a national scale have remained unclear. Here, we quantitatively investigated the variation of air pollutants in China using long-term comprehensive data sets from 2013 to 2017, during which Chinese government made major efforts to reduce anthropogenic emission in polluted regions. Our results show a significant decreasing trend in the PM2.5 concentration in heavily polluted regions of eastern China, with an annual decrease of ∼7% compared with measurements in 2013. The measured decreased concentrations of SO2, NO2 and CO (a proxy for anthropogenic volatile organic compounds) could explain a large fraction of the decreased PM2.5 concentrations in different regions. As a consequence, the heavily polluted days decreased significantly in corresponding regions. Concentrations of organic aerosol, nitrate, sulfate, ammonium and chloride measured in urban Beijing revealed a remarkable reduction from 2013 to 2017, connecting the decreases in aerosol precursors with corresponding chemical components closely. However, surface-ozone concentrations showed increasing trends in most urban stations from 2013 to 2017, which indicates stronger photochemical pollution. The boundary-layer height in capital cities of eastern China showed no significant trends over the Beijing–Tianjin–Hebei, Yangtze River Delta and Pearl River Delta regions from 2013 to 2017, which confirmed the reduction in anthropogenic emissions. Our results demonstrated that the Chinese government was successful in the reduction of particulate matter in urban areas from 2013 to 2017, although the ozone concentration has increased significantly, suggesting a more complex mechanism of improving Chinese air quality in the future.
Potential for, and readiness to, dietary-style changes during the retirement status passage: a systematic mixed-studies review
Authors: Baer Nadja R , Deutschbein Johannes , Schenk Liane
Published: February 2020

Context

Unfavorable diets contribute to the global burden of disease and particularly affect individuals’ health in old age. To promote healthy aging, it is vital to understand the biographical circumstances under which diets manifest and change.

Objective

This systematic mixed-studies review explored changes in dietary styles of people facing retirement.

Data Sources

Seven electronic databases were searched systematically, along with reference lists.

Data Extraction

Five qualitative and five quantitative studies were identified out of n = 974 records screened. Relevant study characteristics were extracted with a piloted form.

Data Synthesis

A qualitative convergent synthesis design was conducted.

Results

Study results were inconsistent. The majority of studies identified various dietary-style changes after retirement – some in favorable ways (eg, increased vegetable consumption [n = 4]) and some in rather unfavorable ways (eg, increased snacking [n = 2]). Influencing factors were changes in mealtime structures, available time, and financial situations accompanying retirement.

Conclusion

More high-quality, longitudinal research is needed to build a sound basis for interventions by utilizing the retirement transition as a window of opportunity for dietary changes.

Systematic Review Registration

PROSPERO registration no. CRD42018074049.
Shared Agency Without Shared Intention
Authors: Asarnow Samuel
Published: February 2020

The leading reductive approaches to shared agency model that phenomenon in terms of complexes of individual intentions, understood as plan-laden commitments. Yet not all agents have such intentions, and non-planning agents such as small children and some non-human animals are clearly capable of sophisticated social interactions. But just how robust are their social capacities? Are non-planning agents capable of shared agency? Existing theories of shared agency have little to say about these important questions. I address this lacuna by developing a reductive account of the social capacities of non-planning agents, which I argue supports the conclusion that they can enjoy shared agency. The resulting discussion offers a fine-grained account of the psychological capacities that can underlie shared agency, and produces a recipe for generating novel hypotheses concerning why some agents (including, arguably, the great apes) do not engage in shared agency.
Bulk–edge correspondence and stability of multiple edge states of a $\mathcal{PT}$-symmetric non-Hermitian system by using non-unitary quantum walks
Authors: Kawasaki Makio , Mochizuki Ken , Kawakami Norio , Obuse Hideaki
Published: February 2020

Topological phases and the associated multiple edge states are studied for parity and time-reversal ($\mathcal{PT}$)-symmetric non-Hermitian open quantum systems by constructing a non-unitary three-step quantum walk retaining $\mathcal{PT}$ symmetry in one dimension. We show that the non-unitary quantum walk has large topological numbers of the $\mathbb{Z}$ topological phase and numerically confirm that multiple edge states appear as expected from the bulk–edge correspondence. Therefore, the bulk–edge correspondence is valid in this case. Moreover, we study the stability of the multiple edge states against a symmetry-breaking perturbation so that the topological phase is reduced to $\mathbb{Z}_2$ from $\mathbb{Z}$. In this case, we find that the number of edge states does not become one unless a pair of edge states coalesce at an exceptional point. Thereby, this is a new kind of breakdown of the bulk–edge correspondence in non-Hermitian systems. The mechanism of the prolongation of edge states against the symmetry-breaking perturbation is unique to non-Hermitian systems with multiple edge states and anti-linear symmetry. Toward experimental verifications, we propose a procedure to determine the number of multiple edge states from the time evolution of the probability distribution.
The Composition Operation on Spaces of Holomorphic Mappings
Authors: Acosta María D , Galindo Pablo , Moraes Luiza A
Published: February 2020

We discuss the continuity of the composition on several spaces of holomorphic mappings on open subsets of a complex Banach space. On the Fréchet space of entire mappings that are bounded on bounded sets, the composition turns out to be even holomorphic. In such a space, we consider linear subspaces closed under left and right composition. We discuss the relationship of such subspaces with ideals of operators and give several examples of them. We also provide natural examples of spaces of holomorphic mappings where the composition is not continuous.
RADIATION DOSE DURING PELVIC RADIOGRAPHY IN RELATION TO BODY MASS INDEX
Authors: Zalokar Nika , Resnik Anja , Mekiš Nejc
Published: February 2020

The purpose of this research was to investigate the impact of body mass index (BMI) on dose area product (DAP), effective dose (E), dose to the organs and image quality (IQ) on 200 patients referred to pelvic radiography. Patients were classified into three groups according to BMI: normal (<24.99), overweight (25.0–29.99) and obese (>30). The results showed 52% and 135% higher DAP for overweight and obese patients compared to normal-weight patients (p < 0.001). A 46 and 123% rise of E for overweight and obese patients compared to normal-weight patients (p < 0.001) was discovered. Overweight patients received 37% higher dose and obese patients 107% higher dose to the organs compared to normal-weight patients. There were no statistically significant differences between IQ, except between normal weight and overweight patients. A strong correlation (r = 0.733) was found between BMI and DAP and between BMI and E (r = 0.776).
Altered Signaling in CB1R-5-HT2AR Heteromers in Olfactory Neuroepithelium Cells of Schizophrenia Patients is Modulated by Cannabis Use
Authors: Guinart Daniel , Moreno Estefanía , Galindo Liliana , Cuenca-Royo Aida , Barrera-Conde Marta , Pérez Ezequiel J , Fernández-Avilés Cristina , Correll Christoph U , Canela Enric I , Casadó Vicent , Cordomi Arnau , Pardo Leonardo , de la Torre Rafael , Pérez Víctor , Robledo Patricia
Published: February 2020

Schizophrenia (SCZ) has been associated with serotonergic and endocannabinoid systems dysregulation, but difficulty in obtaining in vivo neurological tissue has limited its exploration. We investigated CB1R-5-HT2AR heteromer expression and functionality via intracellular pERK and cAMP quantification in olfactory neuroepithelium (ON) cells of SCZ patients non-cannabis users (SCZ/nc), and evaluated whether cannabis modulated these parameters in patients using cannabis (SCZ/c). Results were compared vs healthy controls non-cannabis users (HC/nc) and healthy controls cannabis users (HC/c). Further, antipsychotic effects on heteromer signaling were tested in vitro in HC/nc and HC/c. Results indicated that heteromer expression was enhanced in both SCZ groups vs HC/nc. Additionally, pooling all 4 groups together, heteromer expression correlated with worse attentional performance and more neurological soft signs (NSS), indicating that these changes may be useful markers for neurocognitive impairment. Remarkably, the previously reported signaling properties of CB1R-5-HT2AR heteromers in ON cells were absent, specifically in SCZ/nc treated with clozapine. These findings were mimicked in cells from HC/nc exposed to clozapine, suggesting a major role of this antipsychotic in altering the quaternary structure of the CB1R-5-HT2AR heteromer in SCZ/nc patients. In contrast, cells from SCZ/c showed enhanced heteromer functionality similar to HC/c. Our data highlight a molecular marker of the interaction between antipsychotic medication and cannabis use in SCZ with relevance for future studies evaluating its association with specific neuropsychiatric alterations.
Gut microbiota and metabolic syndrome
Authors: Wang Peng-Xu , Deng Xin-Ru , Zhang Chen-Hong , Yuan Hui-Juan
Published: February 2020

Metabolic syndrome (MetS) describes a set of risk factors that can eventually lead to the occurrence of cardiovascular and cerebrovascular disease. A detailed understanding of the MetS mechanism will be helpful in developing effective prevention strategies and appropriate intervention tools. In this article, we discuss the relationship between the clinical symptoms of MetS and differences in the gut microbial community compared with healthy individuals, characterized by the proliferation of potentially harmful bacteria and the inhibition of beneficial ones. Interactions between gut microbiota and host metabolism have been shown to be mediated by a number of factors, including inflammation caused by gut barrier defects, short-chain fatty acids metabolism, and bile acid metabolism. However, although we can clearly establish a causal relationship between gut microbial profiles and MetS in animal experiments, the relationship between them is still controversial in humans. Therefore, we need more clinical studies to augment our understanding of how we can manipulate the gut microbiota and address the role of the gut microbiota in the prevention and treatment of MetS.
Quality Measures in Postmastectomy Breast Reconstruction: Identifying Metrics to Improve Care
Authors: Nasser Jacob S. , Chung William H. J. , Gudal Ryan A. , Kotsis Sandra V. , Momoh Adeyiza O. , Chung Kevin C.
Published: February 2020

Background:

Specific measures tailored to the properties of individual procedures will ensure the appropriate evaluation of quality. Because postmastectomy breast reconstruction (PMBR) is becoming increasingly common, a review of the literature is timely to identify potential breast reconstruction–specific measures that can be applied by institutions and national healthcare organizations to improve quality.

Methods:

We searched PubMed and Embase for studies examining the quality of care for patients undergoing PMBR. Data extracted from the articles include basic study characteristics, the number of quality metrics, type of quality metric (defined by Donabedian model), and the domain of quality (defined by the National Academy of Medicine).

Results:

A total of 2,158 articles were identified in the initial search, and 440 studies were included for data extraction. The most common type of quality measure was outcome measures (91%), and the least common measure was structure measures (1%). The most common metrics were operative time (41%), hospital type (28%), and aspects of the patient–provider interactions (20%). Additionally, we found that timeliness and equity were least common among the 6 National Academy of Medicine domains.

Conclusions:

We identified metrics utilized in the PMBR, some of which can be further investigated through high-level evidence studies and incorporated into policy. Because many factors influence surgical outcomes and breast reconstruction is driven by patient preferences, an inclusion of structure, process, and outcome metrics will help improve care for this patient population. Moreover, nonpunitive initiatives, specifically quality collaboratives, may provide an avenue to improve care quality without compromising patient safety.
Osteoradionecrosis of the Chest Wall
Authors: Pruksapong Chatchai , Burusapat Chairat , Satayasoontorn Kantang
Published: February 2020

We present the case of a 48-year-old woman with a chronic ulcer with bony erosion over the right chest wall who had undergone adjuvant chemoradiotherapy for right breast cancer 18 years previously. Preoperative computed tomography revealed a large soft tissue ulcerative lesion with bony destruction of the anterolateral aspect of the right fifth and sixth ribs. Biopsy showed no evidence of recurrent malignancy. En bloc resection including the necrotic ulcer and partial resection of the fourth to sixth ribs was performed, resulting in a chest wall defect that exposed the right diaphragm and the right, middle, and lower lobes of the lung. Synthetic mesh was used to reconstruct the rib defect and prevent paradoxical respiration. A pedicle transverse rectus abdominis musculocutaneous flap was used for soft tissue and skin reconstruction.
Women and In-hospital Stroke Code Activation
Authors: Colsch Renee
Published: February 2020

Background

Women have worse stroke outcomes than men, and almost 17% of all stroke cases have symptom onset when admitted to the hospital for a separate condition.

Objective

The aim of this study was to investigate the distinctive factors that impact the activation of an in-hospital stroke code and outcomes in women who have a stroke while admitted to the hospital for a separate condition.

Methods

A retrospective observational propensity score study guided by the model for nursing effectiveness was used.

Results

In-hospital stroke code was activated in 46 of 149 or 30.9% of women and 15 of 149 or 10.1% of women received thrombolytic therapy. Activation of an in-hospital stroke code was significant (P < .001) for women receiving thrombolytic therapy and significant to a home discharge status (P = .014). Age (P < .001), ethnicity (P < .001), common (P ≤ .001) and unique (P = .012) stroke symptoms, stroke risk factors (P < .001), comorbid conditions (P < .001), time last known well (P = .041), and diagnostic imaging (P < .001) were all significantly related to activation of an in-hospital stroke code.

Conclusions

Activation of an in-hospital stroke is a key indicator for women to receive thrombolytic therapy and be discharged to home. Younger married women from non-Caucasian ethnic groups and women with stroke risk factors and comorbid conditions are at a greater risk for delayed stroke symptom detection and not having an in-hospital stroke code activated. Awareness of these factors that hinder early stroke detection in women is crucial to improving stroke treatment and outcomes in women.
Spike protein binding prediction with neutralizing antibodies of SARS-CoV-2
Authors: Park Tamina , Lee Sang-Yeop , Kim Seil , Kim Mi Jeong , Kim Hong Gi , Jun Sangmi , Kim Seung Il , Kim Bum Tae , Park Edmond Changkyun , Park Daeui
Published: February 2020

Coronavirus disease 2019 (COVID-19) is a new emerging human infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2, also previously known as 2019-nCoV), originated in Wuhan seafood and animal market, China. Since December 2019, more than 69,000 cases of COVID-19 have been confirmed in China and quickly spreads to other counties. Currently, researchers put their best efforts to identify effective drugs for COVID-19. The neutralizing antibody, which binds to viral capsid in a manner that inhibits cellular entry of virus and uncoating of the genome, is the specific defense against viral invaders. In this study, we investigate to identify neutralizing antibodies that can bind to SARS-CoV-2 Sipke (S) protein and interfere with the interaction between viral S protein and a host receptor by bioinformatic methods. The sequence analysis of S protein showed two major differences in the RBD region of the SARS-CoV-2 S protein compared to SARS-CoV and SARS-CoV related bat viruses (btSARS-CoV). The insertion regions were close to interacting residues with the human ACE2 receptor. Epitope analysis of neutralizing antibodies revealed that SARS-CoV neutralizing antibodies used conformational epitopes, whereas MERS-CoV neutralizing antibodies used a common linear epitope region, which contributes to form the β-sheet structure in MERS-CoV S protein and deleted in SARS-CoV-2 S protein. To identify effective neutralizing antibodies for SARS-CoV-2, the binding affinities of neutralizing antibodies with SARS-CoV-2 S protein were predicted and compared by antibody-antigen docking simulation. The result showed that CR3022 neutralizing antibody from human may have higher binding affinity with SARS-CoV-2 S protein than SARS-CoV S protein. We also found that F26G19 and D12 mouse antibodies could bind to SARS-CoV S protein with high affinity. Our findings provide crucial clues towards the development of antigen diagnosis, therapeutic antibody, and the vaccine against SARS-CoV-2.
Usability of a Machine-Learning Clinical Order Recommender System Interface for Clinical Decision Support and Physician Workflow
Authors: Kumar Andre , Chiang Jonathan , Hom Jason , Shieh Lisa , Aikens Rachael , Baiocchi Michael , Morales David , Saini Divya , Musen Mark , Altman Russ , Goldstein Mary K , Asch Steven , Chen Jonathan H
Published: February 2020

Objective

To determine whether clinicians will use machine learned clinical order recommender systems for electronic order entry for simulated inpatient cases, and whether such recommendations impact the clinical appropriateness of the orders being placed.

Materials and Methods

43 physicians used a clinical order entry interface for five simulated medical cases, with each physician-case randomized whether to have access to a previously-developed clinical order recommendation system. A panel of clinicians determined whether orders placed were clinically appropriate. The primary outcome was the difference in clinical appropriateness scores of orders for cases randomized to the recommender system. Secondary outcomes included usage metrics and physician opinions.

Results

Clinical appropriateness scores for orders were comparable for cases randomized to the recommender system (mean difference -0.1 order per score, 95% CI:[-0.4, 0.2]). Physicians using the recommender placed more orders (mean 17.3 vs. 15.7 orders; incidence ratio 1.09, 95% CI:[1.01-1.17]). Case times were comparable with the recommender system. Order suggestions generated from the recommender system were more likely to match physician needs than standard manual search options. Approximately 95% of participants agreed the system would be useful for their workflows.

Discussion

Machine-learned clinical order options can meet physician needs better than standard manual search systems. This may increase the number of clinical orders placed per case, while still resulting in similar overall clinically appropriate choices.

Conclusions

Clinicians can use and accept machine learned clinical order recommendations integrated into an electronic order entry interface. The clinical appropriateness of orders entered was comparable even when supported by automated recommendations.
Low back pain in compensated Australian workers: a retrospective cohort study
Authors: Di Donato Michael , Buchbinder Rachelle , Iles Ross , Gray Shannon , Collie Alex
Published: February 2020

Objectives

To describe incidence, duration, and patterns of working time loss claims in compensated Australian workers with low back pain (LBP), and compare this with other musculoskeletal conditions.

Methods

The National Dataset for Compensation-based Statistics (NDS) was used for this study. Any accepted workers’ compensation time loss claims for LBP, limb fracture or limb soft tissue disease occurring between July 2010 and June 2015 were included. Demographic information, occupation, and total cumulative time loss data were extracted. Counts, rates per 10,000 covered workers, the relative risk and median duration of time loss were calculated. Multivariate Cox and quantile regression models were used to determine factors affecting time loss duration and patterns.

Results

There were 56,102 LBP claims, 42,957 limb fracture claims, and 18,249 limb soft tissue disease claims. The relative risk of a claim for LBP was significantly greater than limb fractures after adjustment for all covariates (RR 1.30, 95%CI 1.29 – 1.32, p < 0.001). LBP claims had longer median time loss (9.39 weeks) than limb fracture claims (9.21 weeks). Quantile regression demonstrated that LBP claims were more likely than limb fracture claims to resolve within seven weeks, and to persist for periods beyond seven weeks.

Conclusions

There were differential patterns of time loss in LBP claims and limb fracture claims. The interaction between conditions, and policies and practices may contribute to these patterns. The findings should reiterate to workers’ compensation stakeholders the importance of returning a worker to work as soon as practicable, to avoid future delays or challenges.

KEY MESSAGES

What is already known about this subject?

LBP is a prevalent musculoskeletal symptom the leading contributor to the burden of disability for people of working age.

Musculoskeletal conditions like LBP comprise the largest proportion of compensated conditions in Australia.

What are the new findings?

The incidence of claims for work-related LBP is higher than other work-related musculoskeletal conditions.

Median time loss associated with a claim for LBP is similar to time loss for a claim for a limb fracture but less than for limb soft tissue disease claims.

The likelihood of time loss duration is greater for workers with claims LBP than claims for limb fracture in the short term (seven weeks), but lower than limb fracture claims after this time.

How might this impact on policy or clinical practice in the foreseeable future?

Workers’ compensation stakeholders including clinicians, insurers, and workers’ compensation authorities should carefully consider the importance of returning a worker to work as soon as practicable to avoid future challenges, particularly for a condition as burdensome as LBP.
Prevalence and clinical features of 2019 novel coronavirus disease (COVID-19) in the Fever Clinic of a teaching hospital in Beijing: a single-center, retrospective study
Authors: Liang Ying , Liang Jingjin , Zhou Qingtao , Li Xiaoguang , Lin Fei , Deng Zhonghua , Zhang Biying , Li Lu , Wang Xiaohua , Zhu Hong , Ma Qingbian , Tong Xiaomei , Xu Jie , Sun Yongchang
Published: February 2020

Background

With the spread of COVID-19 from Wuhan, Hubei Province to other areas of the country, medical staff in Fever Clinics faced the challenge of identifying suspected cases among febrile patients with acute respiratory infections. We aimed to describe the prevalence and clinical features of COVID-19 as compared to pneumonias of other etiologies in a Fever Clinic in Beijing.

Methods

In this single-center, retrospective study, 342 cases of pneumonia were diagnosed in Fever Clinic in Peking University Third Hospital between January 21 to February 15, 2020. From these patients, 88 were reviewed by panel discussion as possible or probable cases of COVID-19, and received 2019-nCoV detection by RT-PCR. COVID-19 was confirmed by positive 2019-nCoV in 19 cases, and by epidemiological, clinical and CT features in 2 cases (the COVID-19 Group, n=21), while the remaining 67 cases served as the non-COVID-19 group. Demographic and epidemiological data, symptoms, laboratory and lung CT findings were collected, and compared between the two groups.

Findings

The prevalence of COVID-19 in all pneumonia patients during the study period was 6.14% (21/342). Compared with the non-COVID-19 group, more patients with COVID-19 had an identified epidemiological history (90.5% versus 32.8%, P<0.001). The COVID-19 group had lower WBC [5.19×109/L (±1.47) versus 7.21×109/L (±2.94), P<0.001] and neutrophil counts [3.39×109/L (±1.48) versus 5.38×109/L (±2.85), P<0.001] in peripheral blood. However, the count of lymphocytes was not different. On lung CT scans, involvement of 4 or more lobes was more common in the COVID-19 group (45% versus 16.4%, P=0.008).

Interpretation

In the period of COVID-19 epidemic outside Hubei Province, the prevalence of COVID-19 in patients with pneumonia visiting our Fever Clinic in Beijing was 6.14%. Epidemiological evidence was important for prompt case finding, and lower blood WBC and neutrophil counts may be useful for differentiation from pneumonia of other etiologies.

Funding

None.