bluuebunny/crossref_metadata_2025 huggingface dataset:
Postpartum haemorrhage requiring transfusion and risk of cardiovascular disease later in life: a retrospective cohort study
Authors: Cho GJ , Lee K‐M , Kim HY , Han SW , Oh M‐J , Chiec L , Chae YK
Published: September 2020

Objective

To determine whether postpartum haemorrhage (PPH) is associated with cardiovascular disease (CVD), including cerebrovascular and ischaemic heart disease beyond the peripartum period.

Design

Population‐based cohort study.

Setting

Merged databases of the Korea National Health Insurance (KNHI) claims, National Health Screening Examination and National Health Screening Program for Infants and Children.

Population

Women who gave birth in 2007 in the Republic of Korea and who were tracked through to 2015 for the occurrence of CVD.

Methods

Patients were identified and the occurrences of PPH and transfusion were determined using the KNHI claims database. The occurrence of CVD was tracked through 2015 using codes from the International Classification of Diseases, tenth revision (ICD‐10).

Main outcome measures

The risk of CVD after PPH.

Results

Among 150 381 women who gave birth during the study period, 9107 were diagnosed with PPH and 899 were treated with transfusion. The risk of CVD in women with PPH was no different than in women without PPH, after adjustment (HR 1.03, 95% CI 0.93–1.13). The risk of CVD in women with PPH requiring transfusion was significantly increased compared with women without PPH, after adjustment (HR 1.60, 95% CI 1.25–2.06). The risk of CVD in women with PPH without transfusion was not significantly different compared with women without PPH (HR 0.96, 95% CI 0.86–1.07).

Conclusions

Postpartum haemorrhage (PPH) requiring transfusion is associated with an increased risk of CVD. Guidelines for management should be established, and further studies on the mechanisms involved should be conducted.

Tweetable abstract

PPH requiring transfusion is associated with an increased risk of CVD.
Resolving Information Asymmetry Through Contractual Risk Sharing: The Case of Private Firm Acquisitions
Authors: JANSEN MARK
Published: September 2020

When private firms are acquired, buyers commonly rely on seller financing and earnouts. Using a novel database of private acquisitions, I find that seller financing and earnouts become more common as information asymmetry increases between the acquirer and the target. Financial statement audits of the targets attenuate these results, which suggests that audits decrease information asymmetry in firm acquisitions. Seller‐financed acquisitions also close faster and at higher prices, reducing the private firm discount. These findings suggest that these contract structures are an important channel through which privately held firms mitigate adverse selection that arises from information asymmetry.
Correlation between CXCR4, CXCR5 and CCR7 expression and survival outcomes in patients with clinical T1N0M0 non‐small cell lung cancer
Authors: Yue Zhao , Ningning Ding , Lin Yang , Jianming Ying , Hongtu Zhang , Ligong Yuan , Feng Li , Shuaibo Wang , Yousheng Mao
Published: September 2020

Background

Lung cancer is the leading cause of cancer‐related death. Even if early detection and treatment have proven to be effective, the survival outcomes are still poor.

Methods

Tissue samples and clinicopathological data of 244 patients with clinical T1N0M0 NSCLC were collected. We investigated CXCR4, CXCR5 and CCR7 expression levels using the immunohistochemical method and analyzed their correlations with clinicopathological characteristics and survival outcomes.

Results

Elevated expression levels of CXCR4, CXCR5 and CCR7 were found in tumor tissues (P < 0.001). The expression levels were remarkably different in histological type (CXCR4, P = 0.032; CXCR5, P < 0.001; CCR7, P < 0.001) and LVI (CXCR4, P = 0.017; CXCR5, P = 0.030; CCR7, P < 0.001). In addition, CXCR4 and CXCR5 expression were significantly different in tumor differentiation (CXCR4, P < 0.001; CXCR5, P < 0.001). Survival analysis showed that patients with positive CXCR4 expression had a significantly lower five‐year DFS (P = 0.007) and a lower five‐year OS (P = 0.010). Patients in the CXCR5 positive group had a significantly lower five‐year DFS (P = 0.038) and a lower five‐year OS (P = 0.220), which were statistically insignificant. However, five‐year DFS and five‐year OS of patients with positive CCR7 expression were significantly higher (DFS: P < 0.001; OS: P < 0.001). CXCR5 and CCR7 expression were found to be independent prognostic factors through multivariate analysis.

Conclusions

Expression levels of CXCR4, CXCR5 and CCR7 were significantly higher in tumor tissues, and expression of CXCR5 and CCR7 were independent prognostic factors for survival. Moreover, all three chemokines were correlated to the survival outcomes of patients with clinical T1N0M0 NSCLC, providing potential prognosticators and therapy targets for lung cancer treatment.
Evaluation of Alcohol Taxes as a Public Health Opportunity to Reduce Liver Transplant Listings for Alcohol‐Related Liver Disease
Authors: Shen Nicole T. , Bray Jeremy , Wahid Nabeel A. , Raver Michael , Hutchison Nicholas , Brown Robert S. , Schackman Bruce R.
Published: September 2020

Background

Alcohol‐related liver disease (ALD) is a leading indication for liver transplantation.

Methods

State consumption of spirits, wine, and beer was determined from published sources. Excise and ad valorem alcohol taxes of spirits, wine, and beer were calculated following standard practices and correlated using multiple logistic regression models to 2002 to 2015 ALD transplant listing data from the United Network for Organ Sharing database.

Results

21.22% (29,161/137,440) of transplant listings were for ALD. Increased consumption of spirits was associated with increased ALD transplant listings (odds ratio [OR]: 1.67; 95% CI: 1.12 to 2.49, p = 0.01), but wine and beer consumption did not have a statistically significant association with ALD transplant listings. Spirits excise taxes on‐ and off‐premise were inversely associated with ALD transplant listing (OR: 0.79 and 0.82, respectively, both p < 0.02). Beer and wine taxes were not significantly associated with ALD transplant listings.

Conclusions

Transplant listings for ALD are directly associated with spirit consumption and inversely associated with spirits excise taxes. These findings suggest a possible public health benefit of increasing excise taxes for spirits.
Changes in alcohol consumption associated with social distancing and self‐isolation policies triggered by COVID‐19 in South Australia: a wastewater analysis study
Authors: Bade Richard , Simpson Bradley S. , Ghetia Maulik , Nguyen Lynn , White Jason M. , Gerber Cobus
Published: September 2020

Aim

To assess the effects of social distancing and social isolation policies triggered by COVID‐19 on alcohol consumption using wastewater analysis in Adelaide, South Australia.

Design

Longitudinal quantitative analysis of influent wastewater data for alcohol concentration.

Setting

Adelaide, South Australia.

Participants

Wastewater catchment area representative of 1.1 million inhabitants.

Measurements

Twenty‐four hour composite influent wastewater samples were collected from four wastewater treatment plants in Adelaide, South Australia for 7 consecutive days (Wednesday–Tuesday) every 2 months from April 2016–April 2020. The alcohol metabolite ethyl sulfate was measured in samples using chromatography–tandem mass spectrometry. Data were population‐weighted adjusted with consumption expressed as standard drinks/day/1000 people. Weekly consumption and weekend to mid‐week consumption ratios were analysed to identify changes in weekday alcohol use pattern.

Findings

Estimated weekend alcohol consumption was significantly lower (698 standard drinks/day/1000 people) after self‐isolation measures were enforced in April 2020 compared with the preceding sampling period in February 2020 (1047 standard drinks/day/1000 people), P < 0.05. Weekend to midweek consumption ratio was 12% lower than the average ratio compared with all previous sampling periods. April 2020 recorded the lowest alcohol consumption relative to April in previous years, dating back to 2016.

Conclusions

Wastewater analysis suggests that introduction of social distancing and isolation policies triggered by COVID‐19 in Adelaide, South Australia, was associated with a decrease in population‐level weekend alcohol consumption.
Group acceptance and commitment therapy for patients and caregivers in psychosis services: Feasibility of training and a preliminary randomized controlled evaluation
Authors: Jolley Suzanne , Johns Louise C. , O’Donoghue Emma , Oliver Joseph , Khondoker Mizanur , Byrne Majella , Butler Lucy , De Rosa Carmine , Leal Daniela , McGovern Jessica , Rasiukeviciute Brigita , Sim Faye , Morris Eric
Published: September 2020

Objective

Psychological interventions reduce the impact of psychosis, but widescale implementation is problematic. We tested the feasibility of group acceptance and commitment therapy for Psychosis (G‐ACTp), delivered by frontline staff, and co‐facilitated by service‐user experts‐by‐experience (SU‐EbyE), for service‐users and informal caregivers (ISRCTN: 68540929). We estimated recruitment/retention rates and outcome variability for future evaluation.

Methods

Staff and SU‐EbyE facilitators completed 1‐day workshops, then delivered closely supervised G‐ACTp, comprising four sessions (weeks 1–4) and two boosters (10 and 12 weeks). Participants recruited from adult community psychosis services were randomized to receive G‐ACTp immediately or after 12 weeks, completing outcome assessments at 0, 4, and 12 weeks. Service‐use/month was calculated for 1‐year pre‐randomization, weeks 0–12, and 5‐year uncontrolled follow‐up.

Results

Of 41 facilitators trained (29 staff, 12 SU‐EbyE), 29 (71%; 17 staff, 12 SU‐EbyE) delivered 18 G‐ACTp courses. Participant refusal rates were low (9% of service‐users [10/112]; 5% of caregivers [4/79]); 60% of those invited to participate attended ≥1 G‐ACTp session (64% of service‐users [39/61]; 56% of caregivers [35/63]). Randomization of facilitators and participants proved problematic and participant follow‐up was incomplete (78% [66/85]; 82% of service‐users [36/44]; 73% of caregivers [30/41]). Effect sizes ranged from very small to large mostly favouring treatment. Service‐use reductions require cautious interpretation, as very few participants incurred costs.

Conclusions

Implementation appears feasible for service‐users; for caregivers, retention needs improving. Outcome variability indicated n = 100–300/arm followed up (α = 0.05, 90% power). Methodological limitations’ mean replication is needed: identified sources of potential bias may be reduced in a cluster randomized design with sessional outcome completion.

Practitioner points

Group acceptance and commitment therapy can be successfully adapted for people with psychosis and their caregivers.

Implementation (training and delivery) is possible in routine community mental health care settings.

Clinical and economic outcomes are promising, but replication is needed.

Recommendations are made for future studies.
An overview on synthetic and pharmaceutical prospective of pyrido[2,3‐d]pyrimidines scaffold
Authors: Yadav Pratibha , Shah Kamal
Published: September 2020

Pyrido[2,3‐d]pyrimidine, a fused hetero‐bicyclic nucleus containing pyridine and pyrimidine rings has attained the momentary attention in the sphere of multicomponent synthetic protocol and medicinal chemist. Pyrido[2,3‐d]pyrimidine derived drugs have manifested diverse pharmacological activities, particularly, anti‐inflammatory, cytotoxic, antimicrobial, phosphodiesterase inhibitors and cytokine inhibitors etc. The present review illustrates various modern synthetic strategies adopted, the structure–activity relationship (SAR) aspects and discloses the extensive crucial biological properties (anticancer, anti‐infectious, anti‐diabetics and CNS agents) of pyrido[2,3‐d]pyrimidines.
Efficacy of psychological interventions in young individuals at ultra‐high risk for psychosis: A naturalistic study
Authors: Janssen Hella , Maat Arija , Slot Margot I. E. , Scheepers Floortje
Published: September 2020

Aim

Early detection and intervention in individuals at risk for developing psychosis have become a priority for many clinical services around the world. Limited naturalistic evidence is available on whether detection and intervention for ultra‐high risk (UHR) is effective by means of reducing psychosis risk and improving functioning.

Methods

We compared functioning scores over 5.9 (±7.7) months of time between UHR individuals (n = 61) and help‐seeking adolescents without a specific UHR profile (general adolescent help‐seeking population [HSP]; n = 82) aged 12 to 25 years receiving psychological interventions at a specialized UHR service in the Netherlands. Attenuated psychotic symptoms (APS) were evaluated over time within the UHR group. In addition, the impact of duration of treatment, <7 sessions, 8 to 21 sessions and >20 sessions, as well as treatment type, that is, cognitive behavioural therapy (CBT) and CBT + add on treatment, were evaluated.

Results

Both UHR and HSP showed an increase in functioning over time (P < .001), with no difference between these groups. The UHR group showed a reduction of APS over time (P < .001). More than 20 treatment sessions was more effective than 1 to 6 treatment sessions (P < .01, partial eta squared = .08) and CBT was equally effective as CBT‐add on in improving functioning.

Conclusions

The findings of this study suggest that psychological treatment is just as effective in improving functioning in UHR as in HSP. Moreover, it decreases APS in UHR. Improvement in functioning is not affected by treatment type, but positively affected by the duration of treatment.
Hot droughts compromise interannual survival across all group sizes in a cooperatively breeding bird
Authors: Bourne Amanda R. , Cunningham Susan J. , Spottiswoode Claire N. , Ridley Amanda R.
Published: September 2020

Climate change is affecting animal populations around the world and one relatively unexplored aspect of species vulnerability is whether and to what extent responses to environmental stressors might be mitigated by variation in group size in social species. We used a 15‐year data set for a cooperatively breeding bird, the southern pied babblerTurdoides bicolor, to determine the impact of temperature, rainfall and group size on body mass change and interannual survival in both juveniles and adults. Hot and dry conditions were associated with reduced juvenile growth, mass loss in adults and compromised survival between years in both juveniles (86% reduction in interannual survival) and adults (60% reduction in interannual survival). Individuals across all group sizes experienced similar effects of climatic conditions. Larger group sizes may not buffer individual group members against the impacts of hot and dry conditions, which are expected to increase in frequency and severity in future.
Seizure‐onset regions demonstrate high inward directed connectivity during resting‐state: An SEEG study in focal epilepsy
Authors: Narasimhan Saramati , Kundassery Keshav B. , Gupta Kanupriya , Johnson Graham W. , Wills Kristin E. , Goodale Sarah E. , Haas Kevin , Rolston John D. , Naftel Robert P. , Morgan Victoria L. , Dawant Benoit M. , González Hernán F. J. , Englot Dario J.
Published: September 2020

Objective

In patients with medically refractory focal epilepsy, stereotactic‐electroencephalography (SEEG) can aid in localizing epileptogenic regions for surgical treatment. SEEG, however, requires long hospitalizations to record seizures, and ictal interpretation can be incomplete or inaccurate. Our recent work showed that non‐directed resting‐state analyses may identify brain regions as epileptogenic or uninvolved. Our present objective is to map epileptogenic networks in greater detail and more accurately identify seizure‐onset regions using directed resting‐state SEEG connectivity.

Methods

In 25 patients with focal epilepsy who underwent SEEG, 2 minutes of resting‐state, artifact‐free, SEEG data were selected and functional connectivity was estimated. Using standard clinical interpretation, brain regions were classified into four categories: ictogenic, early propagation, irritative, or uninvolved. Three non‐directed connectivity measures (mutual information [MI] strength, and imaginary coherence between and within regions) and four directed measures (partial directed coherence [PDC] and directed transfer function [DTF], inward and outward strength) were calculated. Logistic regression was used to generate a predictive model of ictogenicity.

Results

Ictogenic regions had the highest and uninvolved regions had the lowest MI strength. Although both PDC and DTF inward strengths were highest in ictogenic regions, outward strengths did not differ among categories. A model incorporating directed and nondirected connectivity measures demonstrated an area under the receiver‐operating characteristic (ROC) curve (AUC) of 0.88 in predicting ictogenicity of individual regions. The AUC of this model was 0.93 when restricted to patients with favorable postsurgical seizure outcomes.

Significance

Directed connectivity measures may help identify epileptogenic networks without requiring ictal recordings. Greater inward but not outward connectivity in ictogenic regions at rest may represent broad inhibitory input to prevent seizure generation.
Rheological characterisation of yolk‐based gels and Staphylococcus growth
Authors: Alonso Paula , Laca Amanda , Laca Adriana , Díaz Mario
Published: September 2020

Model yolk‐based (10% v/v) gels with different concentrations of κ‐carrageenan (0–2% w/w) were characterised employing rheological measurements, textural analysis and scanning electron microscopy. Additionally, the effect of the microstructure of the model gels on the growth rate of Staphylococcus was also evaluated. In all cases, the nature of the gel was dominated by the elastic component, specifically, 1.5, 1.75 and 2% κ‐carrageenan samples can be described as ‘true gels’ (tan δ < 0.1). Maximum strength of the interactions between rheological units (A) was observed with 1.75% κ‐carrageenan (4.74 ± 0.38 kPa), which indicates that the strength of interactions was determined not only by κ‐carrageenan concentration, but also by the amount of yolk. Finally, an inverse linear correlation was found between the maximum specific growth rate of Staphylococcus and rheological data (R2 > 0.99).
Effect of heat‐treated wheat germ on dough properties and crackers quality
Authors: Meriles Silvina Patricia , Penci Maria Cecilia , Steffolani Maria Eugenia , Ribotta Pablo Daniel
Published: September 2020

This study aims to analyse the influence of heat‐treated wheat germ on dough properties and cracker quality. Different substitution levels of wheat flour were evaluated (0%, 10%, 20% and 30%). Dough rheological properties and stress relaxation behaviour were determined. Chemical characteristics, baking performance, texture, water activity and sensory analyses were performed on crackers. Wheat germ weakened the dough structure. The following mechanisms were suggested to explain this weakening effect: the addition of wheat germ diluted gluten; flour components and germ competed for water and decreased the water availability for gluten formation; and germ particles physically disrupted the continuity of the gluten network. Nevertheless, good quality crackers were obtained and their nutritional value was improved, with remarkable increments in protein, fibre and mineral contents. Also, high acceptance in sensory evaluation was recorded at substitution levels of 20% and 30% of germ, compared to control sample (0%).
Analysis of consumer‐oriented quality characteristics of raw and boiled plantains in Cameroon: implication for breeding
Authors: Ngoh Newilah Gérard , Kendine Vepowo Cédric , Takam Ngouno Annie , Bouniol Alexandre , Rolland‐Sabaté Agnès , Meli Meli Vivien , Yong Lemoumoum Judéon Socrates , Forsythe Lora , Dufour Dominique , Fliedel Geneviève
Published: September 2020

This study aimed at understanding users’ demand for raw and boiled plantains in rural and urban areas in West and Littoral regions of Cameroon. Surveys conducted in eight rural localities consisted of key informant interviews, gender‐disaggregated focus group discussions, market and individual interviews. Processing and cooking diagnoses were done with restaurant cooks in urban areas, to know the details of plantain processing and boiling and to understand the quality characteristics of raw plantain that give a most‐liked boiled plantain. Local favourite landraces, most cultivated landraces in Cameroon (Batard and Big ebanga) and a new CARBAP/CIRAD hybrid (CARBAP K74) were used. The preference for plantain cultivars was both gender and region‐dependent. High‐quality plantain should be mature, with big fingers and having a dark green peel colour. The fruit length and girth, pulp pH, dry matter content and firmness were found to be relevant postharvest quality characteristics for plantain breeding improvement.
Hospital‐in‐the‐Home experience of first 23 COVID‐19 patients at a regional NSW hospital
Authors: Lwin Nilar , Burgess Jenny , Johnston Claire , Johnson Nyomie , Chung Steven
Published: September 2020

Ambulatory care is an important service for patients with the COVID‐19 infection especially in a regional area where most of the patients underwent home isolation. Escalation of treatment and timely transition to inpatient care are critical when COVID‐19 patients deteriorate. Equally important is ensuring transfer into facility is carried out in a well‐planned, safe manner to prevent exposure to health care professionals as well as other inpatients. This study is a summary of our COVID Hospital‐in‐the‐Home (HITH) service and clinical presentation of COVID‐19 patients.
The Habitat Amount Hypothesis implies negative effects of habitat fragmentation on species richness
Authors: Saura Santiago
Published: September 2020

The habitat amount hypothesis (HAH) predicts that species richness in a habitat site increases with the amount of habitat in the ‘local landscape’ defined by an appropriate distance around the site, with no distinct effects of the size of the habitat patch in which the site is located. It has been stated that a consequence of the HAH, if supported, would be that it is unnecessary to consider habitat configuration to predict or manage biodiversity patterns, and that conservation strategies should focus on habitat amount regardless of fragmentation. Here, I assume that the HAH holds and apply the HAH predictions to all habitat sites over entire landscapes that have the same amount of habitat but differ in habitat configuration. By doing so, I show that the HAH actually implies clearly negative effects of habitat fragmentation, and of other spatial configuration changes, on species richness in all or many of the habitat sites in the landscape, and that these habitat configuration effects are distinct from those of habitat amount in the landscape. I further show that, contrary to current interpretations, the HAH is compatible with a steeper slope of the species–area relationship for fragmented than for continuous habitat, and with higher species richness for a single large patch than for several small patches with the same total area (SLOSS). This suggests the need to revise the ways in which the HAH has been interpreted and can be actually tested. The misinterpretation of the HAH has arisen from confounding and overlooking the differences in the spatial scales involved: the individual habitat site at which the HAH gives predictions, the local landscape around an individual site and the landscapes or regions (with multiple habitat sites and different local landscapes) that need to be analysed and managed. The HAH has been erroneously viewed as negating or diminishing the relevance of fragmentation effects, while it actually supports the importance of habitat configuration for biodiversity. I conclude that, even in the cases where the HAH holds, habitat fragmentation and configuration are important for understanding and managing species distributions in the landscape.
Quantitative trait loci (QTL) associated with resistance of rainbow trout Oncorhynchus mykiss against the parasitic ciliate Ichthyophthirius multifiliis
Authors: Jaafar R , Ødegård J , Mathiessen H , Karami A M , Marana M H , von Gersdorff Jørgensen L , Zuo S , Nielsen T , Kania P W , Buchmann K
Published: September 2020

The parasitic ciliate Ichthyophthirius multifiliis has a low host specificity eliciting white spot disease (WSD) in a wide range of freshwater fishes worldwide. The parasite multiplies rapidly whereby the infection may reach problematic levels in a host population within a few days. The parasite targets both wild and cultured fish but the huge economic impact of the protozoan is associated with mortality, morbidity and treatment in aquacultural enterprises. We have investigated the potential for genetic selection of WSD‐resistant strains of rainbow trout. Applying the DNA typing system Affymetrix® and characterizing the genome of the individual fish by use of 57,501 single nucleotide polymorphisms (SNP) and their location on the rainbow trout chromosomes, we have genetically characterized rainbow trout with different levels of natural resistance towards WSD. Quantitative trait loci (QTL) used for the selection of breeders with specific markers for resistance are reported. We found a significant association between resistance towards I. multifiliis infection and SNP markers located on the two specific rainbow trout chromosomes Omy 16 and Omy 17. Comparing the expression of immune‐related genes in fish—with and without clinical signs—we recorded no significant difference. However, trout surviving the infection showed high expression levels of genes encoding IgT, T‐cell receptor TCRβ, C3, cathelicidins 1 and 2 and SAA, suggesting these genes to be associated with protection.
Seawater transmission and infection dynamics of pilchard orthomyxovirus (POMV) in Atlantic salmon (Salmo salar)
Authors: Samsing Francisca , Rigby Megan , Tengesdal Hedda K. , Taylor Richard S. , Farias Daniela , Morrison Richard N. , Godwin Scott , Giles Carla , Carson Jeremy , English Chloe J. , Chong Roger , Wynne James W.
Published: September 2020

The Tasmanian salmon industry had remained relatively free of major viral diseases until the emergence of pilchard orthomyxovirus (POMV). Originally isolated from wild pilchards, POMV is of concern to the industry as it can cause high mortality in farmed salmon (Salmo salar). Field observations suggest the virus can spread from pen to pen and between farms, but evidence of passive transmission in sea water was unclear. Our aim was to establish whether direct contact between infected and naïve fish was required for transmission, and to examine viral infection dynamics. Atlantic salmon post‐smolts were challenged with POMV by either direct exposure via cohabitation or indirect exposure via virus‐contaminated sea water. POMV was transmissible in sea water and direct contact between fish was not required for infection. Head kidney and heart presented the highest viral loads in early stages of infection. POMV survivors presented low viral loads in most tissues, but these remained relatively high in gills. A consistent feature was the infiltration of viral‐infected melanomacrophages in different tissues, suggesting an important role of these in the immune response to POMV. Understanding POMV transmission and host–pathogen interactions is key for the development of improved surveillance tools, transmission models and ultimately for disease prevention.
Shared decision‐making with people with intellectual disabilities in the last phase of life: A scoping review
Authors: Noorlandt H. W. , Echteld M. A. , Tuffrey‐Wijne I. , Festen D. A. M. , Vrijmoeth C. , van der Heide A. , Korfage I. J.
Published: September 2020

Background

Shared decision‐making (SDM) is the process in which healthcare professionals and patients jointly discuss and decide which care and treatment policy is to be followed. The importance of SDM is increasingly being recognised across health settings, including palliative care. Little is known about SDM with people with intellectual disabilities (IDs) in the last phase of life. This review aimed to explore to which extent and in which way people with ID in the last phase of life are involved in decision‐making about their care and treatment.

Method

In this scoping review, we systematically searched in the Embase, Medline and PsycINFO databases for empirical studies on decision‐making with people with ID in the last phase of life.

Results

Of a total of 281 identified titles and abstracts, 10 studies fulfilled the inclusion criteria. All focused on medical end‐of‐life decisions, such as foregoing life‐sustaining treatment, do‐not‐attempt‐resuscitation orders or palliative sedation. All studies emphasise the relevance of involving people with ID themselves, or at least their relatives, in making decisions at the end of life. Still, only two papers described processes of decision‐making in which persons with ID actively participated. Furthermore, in only one paper, best practices and guidelines for decision‐making in palliative care for people with ID were defined.

Conclusion

Although the importance of involving people with ID in the decision‐making process is emphasised, best practices or guidelines about what this should look like are lacking. We recommend developing aids that specifically support SDM with people with ID in the last phase of life.
Experimental techniques for the development of a uterus transplantation model in cynomolgus macaques
Authors: Kisu Iori , Banno Kouji , Obara Hideaki , Kato Yojiro , Yamada Yohei , Matsubara Kentaro , Matoba Yusuke , Adachi Masataka , Emoto Katsura , Masugi Yohei , Saiki Yoko , Ishigaki Hirohito , Itagaki Iori , Kawamoto Ikuo , Iwatani Chizuru , Nakagawa Takahiro , Murase Mitsuru , Tsuchiya Hideaki , Nakagawa Kenshi , Shiina Takashi , Aoki Daisuke
Published: September 2020

Uterus transplantation (UTx) is now a treatment for women with uterine factor infertility to have a child. However, UTx is still largely at the experimental stage, and many medical issues remain unsolved. Therefore, adequate studies in large animals including non‐human primates are required for validation of these issues. UTx research, especially in non‐human primates, can provide important information for its full establishment in humans due to the anatomical and physiological similarities between the two. We accumulated data from UTx studies using cynomolgus macaques since 2009 and established autologous and allogeneic UTx models which led to deliveries after performing the procedure. In this paper, we summarized key points to develop UTx models in cynomolgus macaques based on our experience. UTx models in non‐human primates can surely contribute new and beneficial knowledge in this field and can be useful for the further development of UTx in humans.
Where You Lead, I Will Follow: Exploring Sibling Similarity in Brain and Behavior During Risky Decision Making
Authors: Rogers Christy R. , Lee Tae‐Ho , Fry Cassidy M. , Telzer Eva H.
Published: September 2020

This exploratory study examined whether social learning increases similarity in adolescent siblings’ behavior and neural patterns during risky decision making. Participants included 86 adolescents (43 sibling dyads; younger siblings: Mage = 12.2 years; 22 females; older siblings: Mage = 14.6 years; 20 females) who completed questionnaires, and a decision‐making task during an fMRI scan. Younger siblings became more similar to their older siblings’ risky decision making after observing their older sibling take risks). Younger siblings who reported greater modeling of their older sibling, and less differentiation from them, showed increased neural similarity to their older siblings in the ventromedial prefrontal cortex, and the right anterior insula and ventral striatum, respectively. These findings highlight siblings as salient social agents in how adolescents process risky decision making.
Hyperlipasemia in critically ill dogs with and without acute pancreatitis: Prevalence, underlying diseases, predictors, and outcome
Authors: Prümmer Julia K. , Howard Judith , Grandt Lisa M. , Obrador de Aguilar Rafael , Meneses Felix , Peters Laureen M.
Published: September 2020

Background

Hyperlipasemia is frequent in critically ill people without evidence of acute pancreatitis (AP), and has been associated with increased morbidity and mortality.

Objective

To evaluate the prevalence of hyperlipasemia at admission and development of hyperlipasemia during hospitalization in critically ill dogs, explore factors associated with hyperlipasemia, and evaluate association with outcome.

Animals

Critically ill, client owned dogs (n = 1360), presented on emergency and admitted to the intensive care unit, that had 1,2‐o‐dilauryl‐rac‐glycero‐3‐glutaric acid‐(6′‐methylresorufin) ester (DGGR) lipase activity measured within 24 hours of admission.

Methods

Retrospective cross‐sectional study of clinical and laboratory records.

Results

The DGGR lipase activity was increased >3× the upper reference limit at admission in 216/1360 (16%) dogs, of which 70/216 (32%) had a clinical diagnosis of AP. Other primary conditions associated with hyperlipasemia were renal, endocrine, and immune‐mediated diseases, and upper airway obstruction. Predictors of hyperlipasemia at admission were prior glucocorticoid administration, vomiting and abdominal pain, increased age, plasma bilirubin and creatinine concentrations, and decreased hematocrit. Of dogs with repeat measurements, 78/345 (23%) had significantly increased lipase during hospitalization, of which 13/78 (17%) had a clinical diagnosis of AP. Other primary conditions associated with in‐hospital hyperlipasemia were renal and immune‐mediated disorders. Predictors of developing hyperlipasemia during hospitalization were hemodialysis events, increased plasma bilirubin and creatinine concentrations, and decreased hematocrit. Hyperlipasemia both at admission and during hospitalization was associated with longer hospitalization and higher mortality.

Conclusions and Clinical Importance

Significant DGGR‐hyperlipasemia is frequent in critically ill dogs and associated with a variety of nonpancreatic conditions and negative outcome.
COVID‐19 and hepatic involvement: The liver as a main actor of the pandemic novel
Authors: Napodano Cecilia , Pocino Krizia , Stefanile Annunziata , Marino Mariapaola , Miele Luca , Gulli Francesca , Basile Valerio , Pandolfi Franco , Gasbarrini Antonio , Rapaccini Gian Ludovico , Basile Umberto
Published: September 2020

In the natural history of SARS‐CoV‐2 infection, liver injury is frequent but quite mild and it is defined as any liver damage occurring during disease progression and treatment of infection in patients with or without pre‐existing liver diseases. The underlying mechanisms for hepatic injury in patients with COVID‐19 are still unclear but the liver damage in SARS‐CoV‐2 infection seems to be directly caused by virus‐induced cytopathic effects. In this review, we will summarize all data of updated literature, regarding the relationship between SARS‐CoV‐2 infection, acute response and liver involvement. An overview will be given on liver injury, liver transplant and the possible consequences of COVID‐19 in patients with pre‐existing liver diseases.
Serum canine thymus and activation‐regulated chemokine (TARC/CCL17) concentrations correlate with disease severity and therapeutic responses in dogs with atopic dermatitis
Authors: Asahina Ryota , Ueda Kazunori , Oshima Yuri , Kanei Toshitaka , Kato Masahiro , Furue Masutaka , Tsukui Toshihiro , Nagata Masahiko , Maeda Sadatoshi
Published: September 2020

Contexte

La TARC/CCL17 (thymus and activation‐regulated chemokine) a été impliquée dans la pathogénie de la dermatite atopique canine (cAD). Les concentrations sériques de TARC sont un biomarqueur fiable chez l’homme atopique ; cependant, leur potentiel en tant que biomarqueur pour cAD n’a pas été étudié.

Hypothèses/Objectifs

Etudier si les concentrations sériques de TARC corrèlent avec la sévérité de la maladie et les réponses thérapeutiques pour cAD.

Sujets

Trente – neuf chiens avec cAD et 42 chiens sains ont été inclus.

Matériels et méthodes

Les concentrations sériques en TARC chez les chiens avec cAD et les chiens sains ont été mesurées par ELISA avec anticorps anti‐TARC canin. La sévérité clinique de cAD a été notée par CADESI‐04 (Canine Atopic Dermatitis Extent and Severity Index, 4th iteration). Les concentrations de TARC sériques ont été comparées entre les chiens avec cAD et les chiens sains contrôles, et leur relation avec CADESI‐04 a été étudiée. Les concentrations sériques de TARC ont aussi été mesurées chez 20 chiens avec cAD traités par prednisolone ou oclacitinib pendant quatre semaines.

Résultats

Les concentrations sériques de TARC étaient significativement plus élevées chez les chiens avec cAD que chez les chiens sains (P < 0.001). Chez les chiens avec cAD, les concentrations sériques de TARC corrélaient avec les scores de CADESI‐04 (ρ = 0.457, P< 0.01). En outre, les concentrations sériques de TARC diminuaient significativement chez les chiens traités avec atténuation des signes cliniques (P < 0.001). Les changements de concentrations sériques de TARC avant et après traitement corrélaient avec ceux des scores CADESI‐04 (ρ = 0.746, P < 0.001).

Conclusions et importance clinique

Les concentrations sériques de TARC ont le potentiel d’être un outil clinique et de recherche pour l’évaluation objective de l’intensité de la maladie et de la réponse thérapeutique de la CAD.
Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study
Authors: Müller Werner de Andrade , Mielke Grégore Iven , da Silva Inácio Crochemore M. , Silveira Mariangela F. , Domingues Marlos Rodrigues
Published: September 2020

Background: Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. Methods: PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. Results: PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36–0.96) was associated with the outcome. Conclusions: PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.
Influence of Insulin Resistance on the Association Between Physical Activity and Heart Rate Variability: The Toon Health Study
Authors: Saito Isao , Maruyama Koutatsu , Kato Tadahiro , Takata Yasunori , Tomooka Kiyohide , Kawamura Ryoichi , Uesugi Yuichi , Naito Yoshihiko , Osawa Haruhiko , Tanigawa Takeshi
Published: September 2020

Background: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. Methods: This population-based study between 2009 and 2012 included 2016 men and women aged 30–79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). Results: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. Conclusions: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.
Intermolecular vibrations mediate ultrafast singlet fission
Authors: Duan Hong-Guang , Jha Ajay , Li Xin , Tiwari Vandana , Ye Hanyang , Nayak Pabitra K. , Zhu Xiao-Lei , Li Zheng , Martinez Todd J. , Thorwart Michael , Miller R. J. Dwayne
Published: September 2020

Vibrational quantum dynamics of conical intersection mediating singlet fission provides mechanistic insight on a structural level.
Viral cGAMP nuclease reveals the essential role of DNA sensing in protection against acute lethal virus infection
Authors: Hernáez Bruno , Alonso Graciela , Georgana Iliana , El-Jesr Misbah , Martín Rocío , Shair Kathy H. Y. , Fischer Cornelius , Sauer Sascha , Maluquer de Motes Carlos , Alcamí Antonio
Published: September 2020

DNA sensing inhibition by viral cGAMP nuclease impairs anti-viral responses and protective immunity.
RELATe enables genome-scale engineering in fungal genomics
Authors: Li Zhongming , Kim Kwang Sik
Published: September 2020

Genomic DNA can be converted into sgRNA libraries for genome-wide screening of fungal factors in blood-brain barrier penetration.
High-Throughput Generation of Product Profiles for Arabinoxylan-Active Enzymes from Metagenomes
Authors: Maurício da Fonseca Maria João , Armstrong Zachary , Withers Stephen G. , Briers Yves
Published: September 2020

Arabinoxylan is mainly found in the hemicellulosic fractions of rice straw, corn cobs, and rice husk. Converting arabinoxylan into (arabino)xylo-oligosaccharides as added-value products that can be applied in food, feed, and cosmetics presents a sustainable and economic alternative for the biorefinery industries. Efficient and profitable AX degradation requires a set of enzymes with particular characteristics. Therefore, enzyme discovery and the study of substrate preferences are of utmost importance. Beavers, as consumers of woody biomass, are a promising source of a repertoire of enzymes able to deconstruct hemicelluloses into soluble oligosaccharides. High-throughput analysis of the oligosaccharide profiles produced by these enzymes will assist in the selection of the most appropriate enzymes for the biorefinery.
Temporal Changes in Outer Surface Proteins A and C of the Lyme Disease-Associated Spirochete,
Borrelia burgdorferi
, during the Chain of Infection in Ticks and Mice
Authors: Schwan Tom G. , Piesman Joseph
Published: September 2020

The Lyme disease-associated spirochete,
Borrelia burgdorferi
, is maintained in enzootic cycles involving
Ixodes
ticks and small mammals. Previous studies demonstrated that
B. burgdorferi
expresses outer surface protein A (OspA) but not OspC when residing in the midgut of unfed ticks. However, after ticks feed on blood, some spirochetes stop making OspA and express OspC. Our current work examined the timing and frequency of OspA and OspC expression by
B. burgdorferi
in infected
Ixodes scapularis
nymphs as they fed on uninfected mice and in uninfected
I. scapularis
larvae and nymphs as they first acquired spirochetes from infected mice. Smears of midguts from previously infected ticks were prepared at 12- or 24-h intervals following attachment through repletion at 96 h, and spirochetes were stained for immunofluorescence for detection of antibodies to OspA and OspC. As shown previously, prior to feeding spirochetes in nymphs expressed OspA but not OspC. During nymphal feeding, however, the proportion of spirochetes expressing OspA decreased, while spirochetes expressing OspC became detectable. In fact, spirochetes rapidly began to express OspC, with the greatest proportion of spirochetes having this protein at 48 h of attachment and then with the proportion decreasing significantly by the time that the ticks had completed feeding. In vitro cultivation of the spirochete at different temperatures showed OspC to be most abundant when the spirochetes were grown at 37°C. Yet, the synthesis of this protein waned with continuous passage at this temperature. Immunofluorescence staining of spirochetes in smears of midguts from larvae and nymphs still attached or having completed feeding on infected mice demonstrated that OspA but not OspC was produced by these spirochetes recently acquired from mice. Therefore, the temporal synthesis of OspC by spirochetes only in feeding ticks that were infected prior to the blood meal suggests that this surface protein is involved in transmission from tick to mammal but not from mammal to tick.
Case of COVID-19 infection and polycythaemia presenting with massive acute pulmonary embolism
Authors: Nawazani Asadullah , Ghanaim Mahmoud , Tariq Sadia
Published: September 2020

We are reporting a middle-aged male patient with polycythaemia vera comorbidity. The patient was exhibiting symptoms including fever, cough and shortness of breath and was found to have acute pulmonary embolism. He was diagnosed with SARS-CoV-2. This case suggests that a high index of suspicion should be taken into consideration for thromboembolic events, when treating patients with COVID-19 with breathing difficulty and low oxygen saturation levels, especially in those who have underlying predisposing conditions for coagulopathy.
Psychological interventions for chronic non-specific low back pain: protocol of a systematic review with network meta-analysis
Authors: Ho Emma , Ferreira Manuela , Chen Lingxiao , Simic Milena , Ashton-James Claire , Comachio Josielli , Hayden Jill , Ferreira Paulo
Published: September 2020

Introduction

Psychological factors such as fear avoidance beliefs, depression, anxiety, catastrophic thinking and familial and social stress, have been associated with high disability levels in people with chronic low back pain (LBP). Guidelines endorse the integration of psychological interventions in the management of chronic LBP. However, uncertainty surrounds the comparative effectiveness of different psychological approaches. Network meta-analysis (NMA) allows comparison and ranking of numerous competing interventions for a given outcome of interest. Therefore, we will perform a systematic review with a NMA to determine which type of psychological intervention is most effective for adults with chronic non-specific LBP.

Methods and analysis

We will search electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS and CINAHL) from inception until 22 August 2019 for randomised controlled trials comparing psychological interventions to any comparison interventions in adults with chronic non-specific LBP. There will be no restriction on language. The primary outcomes will include physical function and pain intensity, and secondary outcomes will include health-related quality of life, fear avoidance, intervention compliance and safety. Risk of bias will be assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2) tool and confidence in the evidence will be assessed using the Confidence in NMA (CINeMA) framework. We will conduct a random-effects NMA using a frequentist approach to estimate relative effects for all comparisons between treatments and rank treatments according to the mean rank and surface under the cumulative ranking curve values. All analyses will be performed in Stata.

Ethics and dissemination

No ethical approval is required. The research will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42019138074.