bluuebunny/crossref_metadata_2025 huggingface dataset:
Systematic review of the emerging literature on the effectiveness of naloxone access laws in the United States
Authors: Smart Rosanna , Pardo Bryce , Davis Corey S.
Published: June 2020

Background and Aims

Naloxone access laws (NALs) have been suggested to be an important strategy to reduce opioid‐related harm. We describe the evolution of NALs across states and over time and review existing evidence of their overall association with naloxone distribution and opioid overdose as well as the potential effects of specific NAL components.

Methods

Descriptive analysis of temporal variation in US regional adoption of NAL components, accompanied by a systematic search of 13 databases for studies (published between 2005 and 20 December 2019) assessing the effects of NALs on naloxone distribution or opioid‐related health outcomes. Eleven studies, all published since 2018, met inclusion criteria. Study time‐frames spanned 1999–2017. Opioid‐related overdose mortality, emergency department episodes and naloxone distribution were correlated with the presence of a NAL and, where data were available, NAL components.

Results

Existing evidence suggests mixed, but generally beneficial, effects for NALs. Nearly all studies show that NALs, particularly those that permit naloxone distribution without patient‐specific prescriptions, are associated with increased naloxone access [incidence rate ratios (IRR) range from 1.40, 95% confidence interval (CI) = 1.15–1.66 to 7.75, 95% CI = 1.22–49.35] and increased opioid‐related emergency department visits (IRR range from 1.14, 95% CI = 1.07–1.20 to 1.15, 95% CI = 1.02–1.29). Most studies show NALs are associated with reduced overdose mortality, although findings vary depending on the specific NAL components and time‐period analyzed (IRR range from 0.66, 95% CI = 0.42–0.90 to 1.27, 95% CI = 1.27–1.27). Few studies account for the variation in opioid environments (i.e. illicit versus prescription) or other policy dimensions that may be correlated with outcomes.

Conclusions

The existing literature on naloxone access laws in the United States supports beneficial effects for increased naloxone distribution, but provides inconclusive evidence for reduced fatal opioid overdose. Mixed findings may reflect variation in the laws’ design and implementation, confounding effects of concurrent policy adoption, or differential effectiveness in light of changing opioid environments.
SF‐6Dv2 preference value set for health utility in food allergy
Authors: Dufresne Élise , Poder Thomas G. , Samaan Kathryn , Lacombe‐Barrios Jonathan , Paradis Louis , Des Roches Anne , Bégin Philippe
Published: June 2020

Background

The lack of a value set allowing the calculation of QALY is an important limitation when establishing the value of emerging therapies to treat food allergy. The aim of this study was to develop a Short‐Form Six‐Dimension version 2 (SF‐6Dv2) preference value set for the calculation of health utility from the Canadian food‐allergic population.

Methods

Two hundred ninety‐five parents of patients aged 0‐17 years old and 154 patients aged 12 years old and above with food allergy were recruited in clinic and online. Participants were asked to complete a self‐administered online questionnaire including generic health‐related quality of life questionnaires. Various health states described by the SF‐6Dv2 were valued with time‐trade‐off and discrete choice experiments. Data from elicitation techniques were combined using the hybrid regression model.

Results

A total of 241 parents and 125 patients performed 3904 time‐trade‐off and 5112 discrete choice experiments. Utility decrements were estimated for each level of each SF‐6Dv2 dimension. Utility values calculated based on the validated preference set were in average 0.15 lower (95%CI: 0.12‐0.18) and were poorly correlated (R2 = 0.46) with those derived from the EQ‐5D‐5L generic questionnaire in the same cohort.

Conclusion

A representative preference value set for patients with food allergy was determined using the SF‐6Dv2 generic questionnaire. This adapted preference set will contribute to improve the validity of future utility estimates in this population for the appraisal of upcoming potentially impactful but sometimes costly therapies.
Uncertain Times: Linguistic Anthropology in 2019
Authors: Paz Alejandro I.
Published: June 2020

This year, linguistic and semiotic anthropologists are responding in particular to multiple sources of uncertainty and discuss a growing sense of crisis and anxiety across several different settings and contexts. The politics of truth and the uncertainty about the future, as well as the shifts due to new communicative technologies, are well represented in this last year of publications. To consider this collective response, this article reviews published work in this field in three parts: (1) the semiotic interplay of certainty and uncertainty, especially in relation to evidence and agency; (2) the remediation of semiosis across media technologies and infrastructures; and (3) the semiosis of the state‐citizen divide. More generally, this review considers how linguistic/semiotic anthropologists are renewing foundational concepts and approaches at the same time as they express a strong desire to turn their expertise into a more public form of political agency. This process of renewal is leading to the emergence of new agendas. [language, semiotics, uncertainty, media, state]
SARS‐CoV‐2 in the semen: Where does it come from?
Authors: Massarotti Claudia , Garolla Andrea , Maccarini Elena , Scaruffi Paola , Stigliani Sara , Anserini Paola , Foresta Carlo
Published: June 2020

Background

The recent report of SARS‐CoV‐2 presence in semen samples of six patients, including two subjects who were recovering from the clinical disease, re‐opened the discussion on possible male genital tract infection, virus shedding in semen, sexual transmission and safety of fertility treatments during the pandemic period.

Objectives

To explore current data and hypothesis on the possible sites of SARS‐CoV‐2 infection in the male reproduction system.

Materials and methods

We reviewed the current literature to describe: a) the evidences on angiotensin‐converting enzyme 2 (AC2E) and transmembrane serine protease 2 (TMPRSS2) expression in the testes, accessory glands (including prostate) and the urinary tract; b) other coronaviruses’ (SARS and MERS) ability to infect these sites.

Results

The co‐expression of both ACE2 and TMPRSS2 genes was reported in spermatogonial stem cells, elongated spermatids, in at least a small percentage of prostate hillock cells and in renal tubular cells. Testicular damage was described in autopsies of SARS patients, without evidence of the virus in the specimens. Prostate is a known infection site for MERS‐CoV. SARS‐CoV‐2 was detected in urines.

Discussion

There are still al lot of open questions on the effects of SARS‐CoV‐2 infection on the male reproductive tract. The presence of receptors is not a proof that the testis provides a site for viral infection and it is still unknown if SARS‐CoV‐2 is capable to pass the blood‐testis barrier. The possibility of a prostate involvement has not been investigated yet: we have no data, but theoretically it cannot be excluded. Moreover, the RNA detected in semen could have been just a residual of urinary shedding.

Conclusion

Opening our prospective beyond the testis could be the key to better understand the possibility of a semen‐related viral transmission as well as COVID19 short and long‐term effects on male reproductive function.
In utero exposure to low doses of genistein and di‐(2‐ethylhexyl) phthalate (DEHP) alters innate immune cells in neonatal and adult rat testes
Authors: Walker Casandra , Ghazisaeidi Shahrzad , Collet Berenice , Boisvert Annie , Culty Martine
Published: June 2020

Background

Although humans are exposed to mixtures of endocrine disruptor chemicals, few studies have examined their toxicity on male reproduction. We previously found that fetal exposure to a mixture of the phytoestrogen genistein (GEN) and the plasticizer di(2‐ethylhexyl) phthalate (DEHP) altered gene expression in adult rat testes.

Objectives

Our goal was to investigate the effects of fetal exposure to GEN‐DEHP mixtures at two doses relevant to humans on testicular function and transcriptome in neonatal and adult rats.

Materials and methods

Pregnant SD rats were gavaged with vehicle, GEN or DEHP, alone or mixed at 0.1 and 10 mg/kg/day, from gestation day 14 to birth. Fertility, steroid levels, and testis morphology were examined in neonatal and adult rats. Testicular transcriptomes were examined by gene array and functional pathway analyses. Cell‐specific genes/proteins were determined by quantitative real‐time PCR and immunohistochemistry.

Results

GEN‐DEHP mixtures increased the rates of infertility and abnormal testes in adult rats. Gene array analysis identified more genes exclusively altered by the mixtures than individual compounds. Altered top canonical pathways included urogenital/reproductive developmental and inflammatory processes. GEN‐DEHP mixtures increased innate immune cells and macrophages markers at both doses and ages, more strongly and consistently than DEHP or GEN alone. Genes exclusively increased by the mixture in adult testis related to innate immune cells and macrophages included Kitlg, Rps6ka3 (Rsk2), Nr3c1, Nqo1, Lif, Fyn, Ptprj (Dep‐1), Gpr116, Pfn2, and Ptgr1.

Discussion and conclusion

These findings demonstrate that GEN‐DEHP mixtures at doses relevant to human induce adverse testicular phenotypes, concurrent with age‐dependent and non‐monotonic changes in testicular transcriptomes. The involvement of innate immune cells such as macrophages suggests immediate and delayed inflammatory responses which may contribute to testicular dysfunction. Moreover, these effects are complex and likely involve multiple interactions between immune and non‐immune testicular cell types that will entail further studies.
Reconciling different truths about isomorphic pressure and distinctive behavior at European cooperative banks: Back to the future with Raiffeisen's principles
Authors: Groeneveld Hans
Published: June 2020

This article employs a new approach to address a key question in an expanding literature on European cooperative banks: are they still distinctive and sources of social innovation or did they suffer from organizational isomorphism throughout their history? First, we go back to the time when Friedrich Wilhelm Raiffeisen (1818–1888) formulated his principles for the forerunners of many contemporary cooperative banks. Subsequently, we identify areas where major adaptations to the archetypical model of cooperative banks have taken place or are still taking place today. We integrate a detailed explanation of the backgrounds and motivations of these steps with an analysis of isomorphic consequences and loss of distinctiveness that have allegedly emanated from these adjustments. Against the latter common opinion, we place an equally well‐founded dissenting view and formulate recommendations to stay on or return to the cooperative track. Thus, we reconcile conflicting assessments in scientific publications and present a balanced view on the current peculiarity of cooperative banks, substantiated by up‐to‐date figures. With the economic disruption caused by the coronavirus outbreak, we argue that, now more than ever, cooperative banks could demonstrate their solidarity, long‐term orientation and local anchoring—namely bringing Raiffeisen's principles back to the future.
The timing of cyclic cytotoxic chemotherapy can worsen neutropenia and neutrophilia
Authors: Mackey Michael C. , Glisovic Sanja , Leclerc Jean‐Marie , Pastore Yves , Krajinovic Maja , Craig Morgan
Published: June 2020

Despite recent advances in immunotherapies, cytotoxic chemotherapy continues to be a first‐line treatment option for the majority of cancers. Unfortunately, a common side effect in patients undergoing chemotherapy treatment is neutropenia. To mitigate the risk of neutropenia and febrile neutropenia, prophylactic treatment with granulocyte‐colony stimulating factor (G‐CSF) is administered. Extensive pharmacokinetic/pharmacodynamic modelling of myelosuppression during chemotherapy has suggested avenues for therapy optimization to mitigate this neutropenia. However, the issue of resonance, whereby neutrophil oscillations are induced by the periodic administration of cytotoxic chemotherapy and the coadministration of G‐CSF, potentially aggravating a patient's neutropenic/neutrophilic status, is not well‐characterized in the clinical literature. Here, through analysis of neutrophil data from young acute lymphoblastic leukaemia patients, we find that resonance is occurring during cyclic chemotherapy treatment in 26% of these patients. Motivated by these data and our previous modelling studies on adult lymphoma patients, we examined resonance during treatment with or without G‐CSF. Using our quantitative systems pharmacology model of granulopoiesis, we show that the timing of cyclic chemotherapy can worsen neutropenia or neutrophilia, and suggest clinically‐actionable schedules to reduce the resonant effect. We emphasize that delaying supportive G‐CSF therapy to 6–7 days after chemotherapy can mitigate myelosuppressive effects. This study therefore highlights the importance of quantitative systems pharmacology for the clinical practice for developing rational therapeutic strategies.
Extinction Learning and Cognitive Reappraisal: Windows Into the Neurodevelopment of Emotion Regulation
Authors: Silvers Jennifer A.
Published: June 2020

Over the past two decades, interest in the development of emotion regulation has surged. In this review, I argue for the utility of contrasting the neurodevelopment of two distinct and powerful forms of emotion regulation: extinction learning and cognitive reappraisal. Using extinction learning and cognitive reappraisal as illustrative examples of implicit and explicit emotion regulation, respectively, I propose that these two forms develop on different timelines and use partially overlapping and partially distinct neural circuits in the brain. I then use this extinction/reappraisal framework to consider how experiences like early life stress may differentially shape distinct aspects of the neurodevelopment of emotion regulation. I conclude by raising questions for the field and suggesting directions to advance neurodevelopmental accounts of emotion regulation.
Spontaneous pregnancies in female survivors of childhood allogeneic haemopoietic stem cell transplant for haematological malignancies
Authors: Lee Samantha Lai‐Ka , Tiedemann Karin , Zacharin Margaret
Published: June 2020

Objective

Spontaneous pregnancies and live births are rarely reported after haematopoietic stem cell transplant (HSCT). We report spontaneous pregnancy outcomes of sexually active female survivors of childhood allogeneic HSCT, to provide more data for future counselling.

Design, Patients and Measurements

Retrospective review of all female survivors of childhood haematological malignancies who had allogeneic HSCT at the Royal Children Hospital between 1985 and 2011. Data were retrieved from medical records, updated from treating haematologist or endocrinologist, and were cross‐referenced with self‐reported questionnaires. Female survivors who were sexually inactive were excluded from analysis.

Results

Six of 37 (16.2%) female survivors reported spontaneous pregnancies resulting in 8 live births. Amongst 22 women who received total body irradiation (n = 21) ± cranial irradiation or isolated cranial irradiation (n = 1), and high‐dose cyclophosphamide, three reported pregnancy resulting in live births (14%), whilst three of 15 women who received chemotherapy alone had pregnancy with live births (20%).

Conclusions

Our current finding, albeit a small sample size, reinforces the importance of counselling female survivors of HSCT about the possibility of spontaneous pregnancy occurring despite documented ovarian failure and for need of contraception to avoid unplanned pregnancy.
Potentials of care: The uncertain politics of social and emotional ability and difference in American childhood
Authors: Davidson Elsa
Published: June 2020

This article examines middle class children's and parents' complex engagements with contemporary practices of cultivation, care and surveillance focused on children's social and emotional capacities and differences. Emblematic of a sociality and emotion‐focused biopolitics of childhood, such care provokes moments of spontaneous connection and self‐expression for children even as they engage dynamics of disciplining control and normalisation, an outcome that may work against and towards the objectives of care. Moreover, parental investments in social–emotional care reveal adults' conflicted implication in dynamics of child normalisation, and the potential of this form of caretaking to generate politically valuable empathic insight.
The effectiveness of voice therapy on voice‐related handicap: A network meta‐analysis
Authors: Barsties v. Latoszek Ben , Watts Christopher R. , Neumann Katrin
Published: June 2020

Background

Treatment approaches for voice therapy are diverse, yet their differential effects are not well understood. Evaluations of treatment effects across approaches are important for clinical guidance and evidence‐based practice.

Objective of review

To quantify the evidence of treatment effectiveness on the outcome measure Voice Handicap Index with the 30‐items (VHI‐30) from existing randomised controlled/clinical trials (RCT) of voice therapy using the statistical approach of a network meta‐analysis (NMA) with a random effects model.

Type of review

Meta‐analysis.

Search strategy

We searched in MEDLINE (PubMed, 1950 to 2019), Embase (1974 to 2019) and Science Citation Index (1994 to 2019) using five key terms. The inclusion criteria were reports of randomised controlled/clinical trials (RCTs) published in English or German which evaluated the effectiveness of a specific voice therapy treatment using VHI‐30 as an outcome measure in adult participants with non‐organic or organic voice disorders. Studies were excluded if participants had been diagnosed with neurological motor speech disorders or who were vocally healthy. Furthermore, no medical, pharmacological or instrumental (eg voice amplification) treatments were considered.

Evaluation method

The primary outcome variable was VHI‐30 with a score from 0 to 120. The pre‐post treatment change in VHI‐30 scores was an average score of 13 points related to various VHI‐30 test‐retest results.

Results

We retrieved 464 publications (ie with duplicates) and included 13 RCTs, which evaluated nine interventions, in the final analysis. The most effective intervention with a significant and clinically relevant effect was Stretch‐and‐Flow Phonation (SFP) (mean pre‐post difference −28.37, 95% confidence interval [CI], −43.05 to‐13.68). Resonant Voice (RV), the Comprehensive Voice Rehabilitation Program (CVRP) and Vocal Function Exercises (VFE) also demonstrated significant improvements.

Conclusions

Of the nine voice interventions identified with the present NMA, SFP, RVT, CVRP, and VFE effectively improved VHI‐30 scores from pre‐ to post‐treatment. SFP proved to be the most significant and clinically relevant treatment. Further contributions of high‐quality intervention studies are needed to support evidence‐based practice in vocology.
Health and quality of life among a cohort of patients having lateral internal sphincterotomy for anal fissures
Authors: Sutherland J. M. , Karimuddin A. , Liu G. , Crump T. , Akbar H. , Phang T. , Redfern K. , Manoharan S. , Brown C. J. , Raval M. J.
Published: June 2020

Aim

The aim of this study is to report changes in health‐related quality of life attributable to lateral internal sphincterotomy for treatment of anal fissure. There is very little evidence on whether the overall health‐related quality of life of patients is detrimentally affected by the condition, or which aspects of self‐perceived health status improve after lateral internal sphincterotomy. This study will articulate which aspects of health tend to improve and guide postoperative expectations appropriately. Knowledge gained from this study may also identify gaps in an individual patient's episode of care.

Method

Patients were prospectively identified when they consented to surgical treatment of their anal fissure and were contacted by phone to participate. Participants completed a number of patient‐reported outcomes preoperatively and 6 months postoperatively. Faecal incontinence‐related quality of life, pain and depression were measured at both time points. The severity of faecal incontinence was measured at both times.

Results

Participants reported high levels of pain preoperatively. Postoperatively, improvement in pain exceeded the threshold of clinical relevance (P < 0.01). Thirty‐five per cent of participants reported significant effects of faecal incontinence preoperatively, while 26% did so postoperatively. Participants with multiple comorbidities were more likely to report faecal incontinence postoperatively than preoperatively.

Conclusion

This study reports that lateral internal sphincterotomy improved pain symptoms without adverse effects on continence. Not all domains of health‐related quality of life were similarly positively affected by anal fissure repair.
Water‐body segmentation from satellite images using Kapur's entropy‐based thresholding method
Authors: Aalan Babu A , Mary Anita Rajam V
Published: June 2020

Water body segmentation helps in extracting water bodies like lake, pond, river, and reservoir from high resolution satellite images. This also helps in discovering new water bodies. But, extraction of water bodies from satellite images is much complicated, mainly due to the severe disparity in size, shape, and appearance of the water bodies. In this article, Kapur's entropy‐based thresholding method is proposed for the segmentation of water bodies from Very High Resolution (VHR) satellite images. The dataset used in this article is AIRS (Aerial Imagery for Roof Segmentation) dataset, with VHR satellite images, from which only the images with water bodies are considered. Experimental results show that the proposed method yields better segmentation performance with an overall accuracy of 98.43% and Structural Similarity Index rate of 0.9712.
Combined mechanistic modelling predicts changes in species distribution and increased co‐occurrence of a tropical urchin herbivore and a habitat‐forming temperate kelp
Authors: Castro Louise C. , Cetina‐Heredia Paulina , Roughan Moninya , Dworjanyn Symon , Thibaut Loic , Chamberlain Matthew A , Feng Ming , Vergés Adriana
Published: June 2020

Aim

Identify climate change impacts on spawning and settlement of a tropical herbivore (Tripneustes), optimal habitat of a temperate kelp (Ecklonia) and implications for these species regions of interaction under future climate.

Location

Along eastern Australia and into the Tasman Sea including Lord Howe Island (LHI).

Time period

A contemporary scenario (2006–2015) and future “business as usual” RCP 8.5 climate change scenario (2090–2100).

Major taxa studied

The tropical sea urchin, Tripneustes gratilla, and the temperate kelp, Ecklonia radiata.

Methods

We combined mechanistic models to create a predictive map of Ecklonia and Tripneustes distributions, and their future potential to co‐occur. We use 3D velocity and temperature fields produced with a state‐of‐the‐art configuration of the Ocean Forecasting Model version 3 that simulates the contemporary oceanic environment and projects it under an RCP 8.5 climate change scenario. We map the contemporary and future Ecklonia's realized and fundamental thermal niche; and simulate Tripneustes larval dispersal under both climate scenarios.

Results

Based on the thermal affinity of kelp and increases in projected temperatures, we predict a poleward range contraction of ~530 km by 2100 for kelp on Australia's east coast. Climate‐driven changes in dispersal of Tripneustes lead to its range expansion into Bass Strait and poleward, ~340–650 km further into Ecklonia's habitat range inducing new areas of co‐occurrence in the future. We find warming decreases spawning and settlement of Tripneustes in the tropics by 43%, and causes significant connectivity changes for LHI with future reliance on self‐recruitment.

Major conclusions

We predict novel regions of co‐occurrence between a temperate Ecklonia and tropical Tripneustes species which may lead to greater loss of kelp. Our results provide a new modelling approach for predicting species range shifts that is transferable to other marine ecosystems; it considers species response to abiotic change, predicts spatial spread and anticipates new regions for species interactions.
Declining human pressure and opportunities for rewilding in the steppes of Eurasia
Authors: Baumann Matthias , Kamp Johannes , Pötzschner Florian , Bleyhl Benjamin , Dara Andrey , Hankerson Brett , Prishchepov Alexander V. , Schierhorn Florian , Müller Daniel , Hölzel Norbert , Krämer Roland , Urazaliyev Ruslan , Kuemmerle Tobias
Published: June 2020

Aim

Large and ecologically functioning steppe complexes have been lost historically across the globe, but recent land‐use changes may allow the reversal of this trend in some regions. We aimed to develop and map indicators of changing human influence using satellite imagery and historical maps, and to use these indicators to identify areas for broad‐scale steppe rewilding.

Location

Eurasian steppes of Kazakhstan.

Methods

We mapped decreasing human influence indicated by cropland abandonment, declining grazing pressure and rural outmigration in the steppes of northern Kazakhstan. We did this by processing ~5,500 Landsat scenes to map changes in cropland between 1990 and 2015, and by digitizing Soviet topographic maps and examining recent high‐resolution satellite imagery to assess the degree of abandonment of >2,000 settlements and >1,300 livestock stations. We combined this information into ahuman influence index(HI), mapped changes in HI to highlight where rewilding might take place and assessed how this affected the connectivity of steppe habitat.

Results

Across our study area, about 6.2 million ha of cropland were abandoned (30.5%), 14% of all settlements were fully and 81% partly abandoned, and 76% of livestock stations were completely dismantled between 1990 and 2015, suggesting substantially decreasing human pressure across vast areas. This resulted in increased connectivity of steppe habitat.

Main conclusions

The steppes of Eurasia are experiencing massively declining human influence, suggesting large‐scale passive rewilding is taking place. Many of these areas are now important for the connectivity of the wider steppe landscape and can provide habitat for endangered megafauna such as the critically endangered saiga antelope. Yet, this window of opportunity may soon close, as recultivation of abandoned cropland is gaining momentum. Our aggregate human influence index captures key components of rewilding and can help to devise strategies for fostering large, connected networks of protected areas in the steppe.
Focal epilepsy in SCN1A‐mutation carrying patients: is there a role for epilepsy surgery?
Authors: Vezyroglou Aikaterini , Varadkar Sophia , Bast Thomas , Hirsch Edouard , Strobl Karl , Harvey A Simon ,   Epilepsy Surgery in SCN1A Study Group, Scheffer Ingrid E , Sisodiya Sanjay M , Cross J Helen
Published: June 2020

Variants in the gene SCN1A are a common genetic cause for a wide range of epilepsy phenotypes ranging from febrile seizures to Dravet syndrome. Focal onset seizures and structural lesions can be present in these patients and the question arises whether epilepsy surgery should be considered. We report eight patients (mean age 13y 11mo [SD 8y 1mo], range 3–26y; four females, four males) with SCN1A variants, who underwent epilepsy surgery. Outcomes were variable and seemed to be directly related to the patient’s anatomo‐electroclinical epilepsy phenotype. Patients with Dravet syndrome had unfavourable outcomes, whilst patients with focal epilepsy, proven to arise from a single structural lesion, had good results. We conclude that the value of epilepsy surgery in patients with an SCN1A variant rests on two issues: understanding whether the variant is pathogenic and the patient’s anatomo‐electroclinical phenotype. Careful evaluation of epilepsy phenotype integrated with understanding the significance of genetic variants is essential in determining a patient’s suitability for epilepsy surgery. Patients with focal onset epilepsy may benefit from epilepsy surgery, whereas those with Dravet syndrome do not.

What this paper adds

Patients should not automatically be excluded from epilepsy surgery evaluation if they carry an SCN1A variant.

Patients with focal epilepsy may benefit from epilepsy surgery; those with Dravet syndrome do not.
Endovascular treatment of intracranial vascular malformations in children
Authors: Lubicz Boris , Christiaens Florence
Published: June 2020

Paediatric intracranial vascular malformations are rare and different from adult ones in vascular anatomy, pathophysiology, and symptoms. Their impact on the brain and their symptoms will differ in the antenatal period, in neonates, infants, and children. Clinical presentation includes seizures, focal neurological deficit, haemorrhage, congestive heart failure, hydrovenous disorder, and developmental delays. These malformations are thus associated with a poor prognosis if left untreated. Therefore, aggressive management is generally recommended and must be performed by a multidisciplinary team with extensive experience. Endovascular treatment is the first‐choice treatment for most paediatric intracranial vascular malformations. Indication and timing for treatment should be decided on the basis of a careful assessment of neurological symptoms, growth and development, cardiac and other systemic manifestations, and imaging of the malformation and the brain tissue.

What this paper adds

Paediatric intracranial vascular malformations are rare, but their prognosis is poor if left untreated.

Improved clinical, anatomical, and pathophysiological understanding of these complex lesions has improved prognosis.
Joint British Diabetes Societies for Inpatient Care (JBDS‐IP) Clinical Guideline Inpatient care of the frail older adult with diabetes: an Executive Summary
Authors: Sinclair A. J. , Dashora U. , George S. , Dhatariya K. ,   JBDS‐IP Writing Group
Published: June 2020

We present an Executive Summary of a guideline produced by a Joint British Diabetes Societies for Inpatient Care Writing Group for managing frail older inpatients with diabetes. This represents a multidisciplinary stakeholder consensus document providing more than 100 recommendations in eight areas: functional assessment and detection of frailty; preventative care: assessing risk factors and avoiding hospital admissions; general inpatient management principles; managing therapy choices for the frail older inpatient with diabetes; managing associated comorbidities and concerns; pre‐operative assessment and care; discharge planning and principles of follow‐up; and end of life care. The document is intended to guide effective clinical decision‐making in an inpatient setting and is supported by four appendices: Appendix 1, STOPPFRAIL criteria; Appendix 2, Acute care toolkit 3—Royal College of Physicians; Appendix 3, a description of physical performance and frailty measures for routine NHS application; and Appendix 4, Inpatient Frailty Care Pathway—template. This document is expected to enhance clinical outcomes and overall health status for this vulnerable inpatient population of older people with diabetes. The full version of the guideline, including the appendices, can be found at https://abcd.care/sites/abcd.care/files/resources/Inpatient_Care_of_the_Frail_Older_Adult.pdf
Postprandial hyperglycaemia following insulin suspensions by the artificial pancreas: Implications for bolus calculators
Authors: Major Sandrine , El Fathi Anas , Palisaitis Emilie , Kearney Robert , Von Oettingen Julia E. , Krishnamoorthy Preetha , Legault Laurent , Haidar Ahmad
Published: June 2020

Conventional bolus calculators apply negative prandial corrections when premeal glucose levels are low. However, no study has evaluated the need for this negative correction with closed‐loop systems. We analysed data retrospectively from a cohort study evaluating a closed‐loop artificial pancreas system conducted in a diabetes camp over a period of 11 days. Meal boluses with negative correction (n = 98) of 47 participants aged 8 to 22 years were examined. If there was no insulin‐on‐board from previous boluses at mealtime, the postprandial hyperglycaemia rate increased with increased duration of insulin suspension (P = .03), with odds ratios being exaggerated by 17% per 10 minutes of suspension. However, if there was insulin‐on‐board from previous boluses, the hyperglycaemia rate did not change with increased duration of insulin suspension (P = .24). When there was no insulin‐on‐board, the rate of hyperglycaemia after meals preceded by no suspension was 21% (3/14), compared with 52% (12/23) and 64% (9/14) after meals preceded by suspensions of ≥50 and ≥70 minutes, respectively. Meal size did not influence these results. We conclude that, in the absence of insulin‐on‐board, negative prandial corrections may not be necessary following long insulin suspensions.
Linking variability of tree water use and growth with species resilience to environmental changes
Authors: Pappas Christoforos , Peters Richard L. , Fonti Patrick
Published: June 2020

Tree growth is an indicator of tree vitality and its temporal variability is linked to species resilience to environmental changes. Second‐order statistics that quantify the cross‐scale temporal variability of ecophysiological time series (statistical memory) could provide novel insights into species resilience. Species with high statistical memory in their tree growth may be more affected by disturbances, resulting in lower overall resilience and higher vulnerability to environmental changes. Here, we assessed the statistical memory, as quantified with the decay in standard deviation with increasing time scale, in tree water use and growth of co‐occurring European larch Larix decidua and Norway spruce Picea abies along an elevational gradient in the Swiss Alps using measurements of stem radius changes, sap flow and tree‐ring widths. Local‐scale interspecific differences between the two conifers were further explored at the European scale using data from the International Tree‐Ring Data Bank. Across the analysed elevational gradient, tree water use showed steeper variability decay with increasing time scale than tree growth, with no significant interspecific differences, highlighting stronger statistical memory in tree growth processes. Moreover, Norway spruce displayed slower decay in growth variability with increasing time scale (higher statistical memory) than European larch; a pattern that was also consistent at the European scale. The higher statistical memory in tree growth of Norway spruce in comparison to European larch is indicative of lower resilience of the former in comparison to the latter, and could potentially explain the occurrence of European larch at higher elevations at the Alpine treeline. Single metrics of resilience cannot often summarize the multifaceted aspects of ecosystem functioning, thus, second‐order statistics that quantify the strength of statistical memory in ecophysiological time series could complement existing resilience indicators, facilitating the assessment of how environmental changes impact forest growth trajectories and ecosystem services.
Household responsibility system and China's agricultural Growth revisited: Addressing endogenous institutional change
Authors: Sun Shengmin , Chen Qiang
Published: June 2020

The rise of the Household Responsibility System has been widely viewed as a significant contribution to China's agricultural growth. However, this empirical conclusion is rested upon a convenient but doubtful presumption that the process of institutional change, also known as decollectivization, is exogenous. We contribute to this literature by explicitly recognizing the endogeneity of institutional changes, and exploit exogenous variations in lagged weather shocks and initial fixed assets for consistent estimation. With improved data on irrigation, mechanization, weather and institutional changes in a provincial panel data during 1970–1987, the results of panel instrumental estimations reveal that the Household Responsibility System had a significantly positive effect on China's agricultural growth, which was larger than indicated by OLS estimates that suffer from adverse selection and attenuation biases.
Managing the phase‐down of amalgam amongst Nigerian dental professionals and students: A national survey
Authors: Makanjuola John O. , Umesi Donna C. , Ndukwe Anne N. , Enone Lillian L. , Sotunde Olawale A. , Omo Julie O. , Idon Paul I. , Alalade Olusegun , Adebayo Gbenga E. , Ekowmwnhenhen Uyi I. , Arotiba Godwin T.
Published: June 2020

Background

Amalgam is one of the most reliable dental restorative materials. Health and environmental concerns associated with the mercury content of amalgam have necessitated an amalgam phase‐down in clinical practice.

Objectives

This study investigated the level of awareness and preparedness for the planned amalgam phase‐down recommended by the Minamata Convention amongst Nigerian dental students and dentists.

Methods

This cross‐sectional national survey was performed across all geopolitical zones of Nigeria. Data regarding awareness, practice and level of preparedness for amalgam phase‐down were obtained using a questionnaire that was distributed amongst clinical dental students and dentists of different cadres, who routinely place dental restorations, in public and private practice. The questionnaires were administered online or were hand delivered. Data were analysed using the chi‐square test and Spearman's rank correlation coefficient. A p value ≤ 0.05 was considered statistically significant.

Results

Notably, 845 dental students and dentists participated in the survey. Mean age (±standard deviation) of participants was 30.15 ± 7.67 years, 33.8% were students, and 66.2% were dentists (most dentists [77.1%] were employed at public hospitals). A significant percentage of respondents had poor knowledge of the Minamata Convention (87.7%) and lacked training in the use of alternatives to amalgam (72.0%). Amalgam continues to be commonly used by 39.1% and 31.3% of dental students and dentists, respectively. Only 4.7% of the respondents admitted to following good amalgam phase‐down practices. Awareness (P = 0.013) and amalgam phase‐down practices (P = 0.011) were significantly higher amongst dentists than amongst dental students.

Conclusion

We observed low levels of awareness regarding the Minamata Convention, amalgam phase‐down, mercury hygiene practices and training in alternatives to amalgam use amongst Nigerian dental professionals and students.
Neural networks of different species, brain areas and states can be characterized by the probability polling state
Authors: Xu Zhi‐Qin John , Gu Xiaowei , Li Chengyu , Cai David , Zhou Douglas , McLaughlin David W.
Published: June 2020

Cortical networks are complex systems of a great many interconnected neurons that operate from collective dynamical states. To understand how cortical neural networks function, it is important to identify their common dynamical operating states from the probabilistic viewpoint. Probabilistic characteristics of these operating states often underlie network functions. Here, using multi‐electrode data from three separate experiments, we identify and characterize a cortical operating state (the “probability polling” or “p‐polling” state), common across mouse and monkey with different behaviors. If the interaction among neurons is weak, the p‐polling state provides a quantitative understanding of how the high dimensional probability distribution of firing patterns can be obtained by the low‐order maximum entropy formulation, effectively utilizing a low dimensional stimulus‐coding structure. These results show evidence for generality of the p‐polling state and in certain situations its advantage of providing a mathematical validation for the low‐order maximum entropy principle as a coding strategy.
What is a good level of soil organic matter? An index based on organic carbon to clay ratio
Authors: Prout Jonah M. , Shepherd Keith D. , McGrath Steve P. , Kirk Guy J. D. , Haefele Stephan M.
Published: June 2020

Simple measures of appropriate levels of soil organic matter are needed for soil evaluation, management and monitoring, based on readily measurable soil properties. We test an index of soil organic matter based on the soil organic carbon (SOC) to clay ratio, defined by thresholds of SOC/clay ratio for specified levels of soil structural quality. The thresholds were originally delineated for a small number of Swiss soils. We assess the index using data from the initial sampling (1978–83) of the National Soil Inventory of England and Wales, covering 3,809 sites under arable land, grassland and woodland. Land use, soil type, annual precipitation and soil pH together explained 21% of the variance in SOC/clay ratio in the dataset, with land use the most important variable. Thresholds of SOC/clay ratio of 1/8, 1/10 and 1/13 indicated the boundaries between “very good”, “good”, “moderate” and “degraded” levels of structural condition. On this scale, 38.2, 6.6 and 5.6% of arable, grassland and woodland sites, respectively, were degraded. The index gives a method to assess and monitor soil organic matter at national, regional or sub‐regional scales based on two routinely measured soil properties. Given the wide range of soils and land uses across England and Wales in the dataset used to test the index, we suggest it should apply to other European soils in similar climate zones.

Highlights

We assess the use of SOC/clay ratios as guidelines for soil management in England and Wales.

We use data from 3,809 sites to assess thresholds based on work for Polish, French and Swiss soils.

SOC/clay threshold values can indicate degraded and good soil structural condition.

The thresholds show the effect of land use and provide an index for use in England and Wales.
Comparison of the single simple question and the patient acceptable symptom state in myasthenia gravis
Authors: Menon D. , Barnett C. , Bril V.
Published: June 2020

Background and purpose

The single simple question (SSQ) is a simple and validated question asking what percentage of normal a patient feels with respect to their myasthenia gravis (MG), with 100% being normal. Patient acceptable symptom states (PASS) are based on a dichotomous ‘Yes’ or ‘No’ response, asking whether a patient is satisfied overall with their current status and thus measures holistic satisfaction with their MG state. Both are patient‐reported self‐assessments but assess different dimensions of MG. The objective was to determine thresholds for the SSQ when patients with MG achieve an acceptable PASS status.

Methods

A retrospective chart review was performed of consecutive MG patients attending a neuromuscular clinic, and SSQ and PASS responses, demographic, clinical and serological characteristics and disease severity by the MG impairment index were extracted.

Results

One hundred and fifty‐seven consecutive patients were identified: 43 (27.4%) patients responded ‘No’ to the PASS question. Between the PASS ‘Yes’/‘No’ groups, only SSQ (87.5 ± 13.4 vs. 52.3 ± 23.3; P < 0.001) and MG impairment index scores (9.2 ± 10.3 vs. 29.6 ± 16; P < 0.001) were significantly different. The receiver operating characteristic curve for PASS and SSQ had an area under the curve of 0.92 ± 0.024 (confidence interval 0.872–0.965, P < 0.001). An SSQ score ≥72.5% had 84.2% sensitivity and 86% specificity to classify patients as PASS positive.

Conclusion

The PASS and SSQ patient‐reported outcomes are closely associated and a SSQ threshold ≥72.5% predicts an acceptable MG state. Other demographic and disease‐related factors did not influence the PASS response in this study.
Planning stereoelectroencephalography using automated lesion detection: Retrospective feasibility study
Authors: Wagstyl Konrad , Adler Sophie , Pimpel Birgit , Chari Aswin , Seunarine Kiran , Lorio Sara , Thornton Rachel , Baldeweg Torsten , Tisdall Martin
Published: June 2020

Objective

This retrospective, cross‐sectional study evaluated the feasibility and potential benefits of incorporating deep‐learning on structural magnetic resonance imaging (MRI) into planning stereoelectroencephalography (sEEG) implantation in pediatric patients with diagnostically complex drug‐resistant epilepsy. This study aimed to assess the degree of colocalization between automated lesion detection and the seizure onset zone (SOZ) as assessed by sEEG.

Methods

A neural network classifier was applied to cortical features from MRI data from three cohorts. (1) The network was trained and cross‐validated using 34 patients with visible focal cortical dysplasias (FCDs). (2) Specificity was assessed in 20 pediatric healthy controls. (3) Feasibility of incorporation into sEEG implantation plans was evaluated in 34 sEEG patients. Coordinates of sEEG contacts were coregistered with classifier‐predicted lesions. sEEG contacts in seizure onset and irritative tissue were identified by clinical neurophysiologists. A distance of <10 mm between SOZ contacts and classifier‐predicted lesions was considered colocalization.

Results

In patients with radiologically defined lesions, classifier sensitivity was 74% (25/34 lesions detected). No clusters were detected in the controls (specificity = 100%). Of the total 34 sEEG patients, 21 patients had a focal cortical SOZ, of whom eight were histopathologically confirmed as having an FCD. The algorithm correctly detected seven of eight of these FCDs (86%). In patients with histopathologically heterogeneous focal cortical lesions, there was colocalization between classifier output and SOZ contacts in 62%. In three patients, the electroclinical profile was indicative of focal epilepsy, but no SOZ was localized on sEEG. In these patients, the classifier identified additional abnormalities that had not been implanted.

Significance

There was a high degree of colocalization between automated lesion detection and sEEG. We have created a framework for incorporation of deep‐learning–based MRI lesion detection into sEEG implantation planning. Our findings support the prospective evaluation of automated MRI analysis to plan optimal electrode trajectories.
Exploration of potential lipid biomarkers for premature canities by UPLC‐QTOF‐MS analyses of hair follicle roots
Authors: Wang Hecong , Wang Jiateng , He Congfen
Published: June 2020

Background

The rate of premature greying, referred to as canities, varies among populations, and effective treatments are lacking. However, few studies at the molecular level have been reported.

Objectives

Comparing lipid profiles of individuals with premature canities and healthy volunteers to explore the mechanism of premature canities.

Methods

Ultra‐performance liquid chromatography/quadrupole time‐of‐flight mass spectrometry (UPLC‐QTOF‐MS) was used to detect lipids in the hair follicle root. Multivariate data analysis was used to show lipid changes in follicle roots.

Results

We identified lipids in the hair follicle root that differ between black and white hair and analysed key lipids contributing to white hair development. We divided the samples into three groups: PC‐WH (Premature canities‐White hair), PC‐PH (Premature canities‐Pigmented hair), Control‐PH (Pigmented hair). Phosphatidylethanolamine (PE), phosphatidylcholine (PC), vitamin D3 (VD3) and cholesterol in Control‐PH were higher than those in PC‐WH. Sphingomyelin (SP), phosphatidic acid (PA), VD3 and diglyceride (DG) were lower in PC‐WH than in PC‐PH. Levels of VD3 were highest in Control‐PH, gradually decreased as the severity of PC‐PH increased and were lowest in PC‐WH.

Conclusion

There are 7 main class candidate compounds involved in the generation of white hair. VD3 showed a substantial decrease in white hair and was a potential target for further studies of premature canities.