bluuebunny/crossref_metadata_2025 huggingface dataset:
Liver transplantation for acute‐on‐chronic liver failure predicts post‐transplant mortality and impaired long‐term quality of life
Authors: Goosmann Lukas , Buchholz Angela , Bangert Katrin , Fuhrmann Valentin , Kluge Stefan , Lohse Ansgar W. , Huber Samuel , Fischer Lutz , Sterneck Martina , Huebener Peter
Published: December 2020

Background

Among patients with cirrhosis, candidate selection and timing of liver transplantation (LT) remain problematic. Acute‐on‐chronic liver failure (ACLF) is a severe complication of cirrhosis with excessive short‐term mortality rates under conservative therapeutic measures. The role of LT in the management of ACLF is uncertain.

Objective

To assess the impact of ACLF on post‐LT survival and long‐term graft function, morbidity and quality of life (QoL).

Methods

We retrospectively analysed all cirrhosis patients undergoing LT at our institution between 01/2009 and 12/2014. Median follow‐up was 8.7 years. Long‐term LT survivors were interviewed with established QoL questionnaires.

Results

Of 250 LT recipients, 98 fulfilled the EASL diagnostic ACLF criteria before LT (‘ACLF‐LT’). ACLF associated with reduced post‐LT survival (HR for 6‐month survival compared to non‐ACLF‐LT: 0.18; HR for 10‐year‐survival: 0.47; both P < .001) depending on ACLF severity before LT, and mainly inferred by infections both in the early and late phases after LT. In ACLF patients, CLIFc‐OFs was superior to MELD score in predicting post‐LT mortality. Long‐term follow‐up revealed comparable graft functions and comorbidity burden in ACLF‐LT and non‐ACLF‐LT survivors. ACLF‐LT patients reported significantly impaired health and QoL, particularly with regards to anxiety/depression and physical and psychological health (all P < .05). LabMELD score, presence of ACLF at LT and duration of post‐LT intensive care associated with poor long‐term QoL.

Conclusion

ACLF predicts impaired post‐LT survival. While long‐term graft function and extrahepatic comorbidities are comparable in ACLF and non‐ACLF LT survivors, the strikingly low QoL in many ACLF‐LT recipients warrants consideration during follow‐up patient care.
A qualitative study of caring in hospice wards in Shanghai
Authors: Chen Shu Hui , Lai Xiao Bin , Chen Li Qun , Xia Hai Ou , Chen Chun Yan
Published: December 2020

Despite the large number of people with cancer who need hospice care, utilization rates at community hospice service in Shanghai are low. This study aimed to review the care provided in these hospice wards and examine the difficulties in delivering service. Fourteen hospice care providers were interviewed, and the data analyzed using qualitative content analysis. Three themes emerged from the interviews: (i) characteristics of hospice patients, mostly cancer patients at the end‐of‐life stage (within 3‐months of life expectancy) who were admitted without awareness of their condition; (ii) components of care, from physicians and nurses who focused mainly on physical problems as psycho‐spiritual care stagnated at a superficial level; and (iii) difficulties in care, including a lack of patients as well as inadequacies in service, along with suggestions for the future. Efforts at improvement should be made in both the health care system and society. To address the lack of patients, doctors in secondary/tertiary care hospitals need improved skills in discussing end‐of‐life care, while the general public needs better awareness and acceptance of hospice care. Solutions should respect the perspective of patients and their families, while hospice care providers must also enhance their skills of communication and psycho‐spiritual care.
SPX4 interacts with both PHR1 and PAP1 to regulate critical steps in phosphorus‐status‐dependent anthocyanin biosynthesis
Authors: He Yuqing , Zhang Xueying , Li Linying , Sun Zongtao , Li Junmin , Chen Xiaoya , Hong Gaojie
Published: December 2020

Phosphate (Pi) is the plant‐accessible form of phosphorus, and its insufficiency limits plant growth. The over‐accumulation of anthocyanins in plants is often an indication of Pi starvation. However, whether the two pathways are directly linked and which components are involved in this process await identification.

Here, we demonstrate that SPX4, a conserved regulator of the Pi response, transduces the Pi starvation signal to anthocyanin biosynthesis in Arabidopsis. When phr1spx4 plants were grown under low Pi conditions, DFR expression and anthocyanin biosynthesis were induced, which distinguished the plant from the behavior reported in the phr1 mutant. We also provide evidence that SPX4 interacts with PAP1, an MYB transcription factor that controls the anthocyanin biosynthetic pathway, in an inositol polyphosphate‐dependent manner.

Through a physical interaction, SPX4 prevented PAP1 from binding to its target gene promoter; by contrast, during Pi‐deficient conditions, in the absence of inositol polyphosphates, PAP1 was released from SPX to activate anthocyanin biosynthesis.

Our results reveal a direct link between Pi deficiency and flavonoid metabolism. This new regulatory module, at least partially independent from PHR1, may contribute to developing a strategy for plants to adapt to Pi starvation.
Aggregatibacter actinomycetemcomitans induces a proatherosclerotic response in human endothelial cells in a three‐dimensional collagen scaffold model
Authors: Torres Maria A. , Gualtero Diego F. , Lafaurie Gloria I. , Fontanilla Marta R.
Published: December 2020

The role of periodontopathogens in inflammatory endothelial dysfunction is not known. This study characterizes a three‐dimensional model with human coronary artery endothelial cells on three‐dimensional (HCAEC‐3D) type I collagen scaffolds to evaluate whether infection with Aggregatibacter actinomycetemcomitans induces a proinflammatory response associated with atherosclerosis. The HCAEC‐3D culture was physicochemically characterized with regard to biocompatibility and barrier function. Then, the culture was infected with A. actinomycetemcomitans strain ATCC 29522 at multiplicities of infection (MOIs) of 1:1, 1:10, and 1:100. Cultures without infection and stimulated with A. actinomycetemcomitans lipopolysaccharide were used as controls. The secretion of soluble factors (IL‐6, IL‐1β, MCP‐1, RANTES, MIP‐1, IL‐8, IL‐1α, and TNF‐α) was evaluated via flow cytometry; TGF‐β1 was evaluated via enzyme‐linked immunosorbent assay (ELISA). The adhesion and migration of fluorescent human THP‐1 monocytes was evaluated. IL‐8, MCP‐1, and IL‐6 secretion increased in a dose‐dependent manner with A. actinomycetemcomitans infection and was significantly greater than that under control treatment. The concentration of TGF‐β1 was significantly higher at MOI 1:100 than in controls. Treatment of the 3D cultures with A. actinomycetemcomitans at different MOIs induced significant differences in the adhesion of monocytes to the endothelium compared to the control without infection. Lastly, conditioned media from 3D cultures treated with A. actinomycetemcomitans induced monocyte migration. The effects of IL‐8, MCP‐1, IL‐6, and TGF‐β1 on the endothelium indicate the ability of A. actinomycetemcomitans to induce an inflammatory response through a mechanism of monocyte adhesion and migration and endothelial dysfunction.
Transcriptome and translatome changes in germinated pollen under heat stress uncover roles of transporter genes involved in pollen tube growth
Authors: Poidevin Laetitia , Forment Javier , Unal Dilek , Ferrando Alejandro
Published: December 2020

Plant reproduction is one key biological process that is very sensitive to heat stress and, as a result, enhanced global warming becomes a serious threat to agriculture. In this work, we have studied the effects of heat on germinated pollen of Arabidopsis thaliana both at the transcriptional and translational level. We have used a high‐resolution ribosome profiling technology to provide a comprehensive study of the transcriptome and the translatome of germinated pollen at permissive and restrictive temperatures. We have found significant down‐regulation of key membrane transporters required for pollen tube growth by heat, thus uncovering heat‐sensitive targets. A subset of the heat‐repressed transporters showed coordinated up‐regulation with canonical heat‐shock genes at permissive conditions. We also found specific regulations at the translational level and we have uncovered the presence of ribosomes on sequences annotated as non‐coding. Our results demonstrate that heat impacts mostly on membrane transporters thus explaining the deleterious effects of heat stress on pollen growth. The specific regulations at the translational level and the presence of ribosomes on non‐coding RNAs highlights novel regulatory aspects on plant fertilization.
Macroeconomic instability and targeting rules for monetary policy in an endogenously growing small open economy
Authors: Chen Kuan‐jen , Lai Ching‐chong , Lai Ting‐wei
Published: December 2020

By using the feature that money can lower unit transaction costs, this paper develops a monetary endogenous growth model for a one‐sector small open economy, and uses it to examine the possibility of the occurrence of belief‐driven fluctuations. It is found that the emergence of belief‐driven fluctuations is crucially related to targeting rules for monetary policy. More specifically, when the monetary authorities target the specific money growth rate, macroeconomic instability generated by belief‐driven fluctuations can arise even if labor externalities are totally absent. This finding runs in sharp contrast to the Benhabib–Farmer assertion needed for the occurrence of belief‐driven fluctuations. It is also found that, when the monetary authorities target the specific inflation rate, macroeconomic instability generated by belief‐driven fluctuations can never prevail regardless of the extent of the unit transaction costs.
Predictors of caring ability and its dimensions among nurses in China: A cross‐sectional study
Authors: Xu Tianmeng , Wang Yongli , Wang Rongjin , Lamb Karen V. , Ren Dianxu , Dai Guizhi , Wang Li , Yue Peng
Published: December 2020

Background

Caring is an essential component of professional nursing practice, which directly affects the quality of patient care. Nurses' caring ability may not meet patients' demands for high‐quality care. There are challenges in designing and implementing interventions to improve nurses’ caring ability, especially in China. Understanding Chinese nurses' caring ability and related influential factors serves as the basis for effective interventions to improve their ability to care for patients.

Aim

To describe the caring ability of nurses and its potential predictors in China.

Methods

From January to February 2018, a cross‐sectional survey was conducted among 2304 Registered Nurses working at different levels of hospitals across 29 provinces in China. The structured online survey included socio‐demographic information, Caring Ability Inventory, Caring Efficacy Scale and Professional Quality of Life. Descriptive statistics, univariate analyses and multivariate analyses were conducted.

Results

Overall caring ability and its three dimensions of the participants were all significantly lower than the Nkongho’ norm, an international scoring standard of nurse’s caring ability. Age, employment type, workplace, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were predictors of knowing, explaining 41.8% of the variance. Predictors of courage were educational level, bereavement experience, caring efficacy, compassion satisfaction and burnout (31.7% of the variance). Educational level, workplace, exposure to critically ill patients, caring efficacy, compassion satisfaction, burnout and secondary traumatic stress were influencing factors of patience, accounting for 19.5% of the variance.

Conclusions

Chinese nurses' caring ability, with patience, knowing, and courage in descending order. Particular attention needs to be paid to the courage dimension of the nurses' caring ability. Further, the predictors of overall caring ability and each dimension were diverse. These results indicate that nurse educators and administrators need to identify training priorities and design targeted interventions based on the influencing factors.
Fatal sepsis associated with a storage container leak permitting platelet contamination with environmental bacteria after pathogen reduction
Authors: Fadeyi Emmanuel A. , Wagner Stephen J. , Goldberg Corinne , Lu Thea , Young Pampee , Bringmann Peter W. , Meier Nathaniel M , Namen Andrew M. , Benjamin Richard J. , Palavecino Elizabeth
Published: December 2020

Background

Pathogen reduction technology and enhanced bacterial culture screening promise to significantly reduce the risk of transfusion‐associated septic reactions due to contaminated platelets. Recent reports suggest that these interventions lack efficacy for post‐collection and processing contamination with environmental organisms if the storage bag integrity is compromised.

Case Report

We report a fatal septic transfusion reaction in a 63‐year‐old patient with chronic kidney and liver disease who received a pathogen reduced platelet transfusion in anticipation of surgery.

Methods

The residual platelet concentrate was cultured, with the detected microorganisms undergoing 16S genotype sequencing. Separate pathogen reduction studies were performed on the recovered bacteria, including assessment for amotosalen photoproducts. The storage container was subjected to pressure testing and microscopic examination. Environmental culture screening was performed at the hospital.

Results

Gram negative rods were detected in the platelet unit and cultures of both platelet component and the patient's blood grewAcinetobacter baumannii complex,Leclercia adecarboxylata and Staphylococcus saprophyticus.These strains were effectively inactivated with >7.2, 7.7, and >7.1 log10kill, respectively. The platelet storage container revealed a leak visible only on pressure testing. Hospital environmental cultures were negative and the contamination source is unknown.A. baumannii complexandS. saprophyticus16S genotyping sequences were identical to those implicated in a previously reported septic reaction.

Conclusion

Findings are compatible with post‐processing environmental contamination of a pathogen reduced platelet concentrate via a non‐visible, acquired storage container leak. Efforts are warranted to actively prevent damage to, and detect defects in, platelet storage containers, and to store and transport components in clean environments.
Retrieval transfusion protocol in New South Wales, Australia: A retrospective review of the first 5 years
Authors: Shand Sophie , Curtis Kate , Dinh Michael , Burns Brian
Published: December 2020

Background

Ambulance service blood transfusion is an area of rapid development. In New South Wales, Australia, the blood products carried by ambulance medical teams are often the first available to patients with critical bleeding. In addition to the blood products routinely carried by these teams, the Service created and implemented a method of initiating large‐volume, mixed‐product transfusions using existing blood banks: the Retrieval Transfusion Procedure (RTP). This article describes the trends and characteristics of New South Wales Ambulance RTP activations.

Materials and Methods

This retrospective database review examines the patient records for all RTP activations. Key areas of investigation include logistics, product requests, population demographics, etiologies, physiology, mission timings, and transfusions.

Results

Ambulance medical teams attended 27 531 missions in the reviewed period, 1573 patients received transfusion, and there were 138 RTP activations. Blood products were sourced from 40 banks and transported by police (46.7%), ambulance (27.1%), and helicopter (13.0%) to refueling stops (39.2%), prehospital scenes (24.2%) and hospitals (15.8%). The median time engaged on each mission was 189 minutes for metropolitan and 222 minutes for rural locations. Seventy‐eight patients were transfused with RTP blood products; 83.3% were traumas, of which 63.1% were motor vehicle collisions. Up to 18 units of blood products were administered before hospital arrival. There was significant (P < .001) improvement in the mean shock index of transfused patients between the first and final observations recorded.

Conclusions

Ambulance service extended blood product transfusion is logistically achievable and facilitates emergency transfusions throughout the state with minimal additional infrastructure.
Binaural detection as a joint function of masker bandwidth, masker interaural correlation, and interaural time delay: Empirical data and modeling
Authors: Bernstein Leslie R. , Trahiotis Constantine
Published: December 2020

Empirical data are reported demonstrating how binaural detection is affected by joint variation of masker bandwidth, masker interaural correlation, and interaural time delay (ITD) of both masker and tonal signal. Most of the data were obtained with stimuli centered at 500 Hz; supplemental measures were obtained with stimuli centered at 4 kHz. The results indicate that as the interaural correlation of the masker (ρ) is decreased there is (1) an overall increase in threshold signal-to-noise ratio (S/N) and (2) a progressively smaller effect on threshold S/N as ITD is increased. All of the data were accounted for quite accurately using the same quantitative, interaural cross-correlation-based model that was recently shown to account for binaural detection and discrimination data obtained in previous experiments. Importantly, the new data were predicted and explained using values of model parameters that were identical or very close to those found to predict accurately the earlier data. The success of the enterprise attests to the robustness of the approach and the generality of the model's ability to make accurate predictions of binaural performance over a wide range of historically important stimulus conditions.
Concurrent Measurement of Global Positioning System and Event-Based Physical Activity Data: A Methodological Framework for Integration
Authors: Iveson Anna M.J. , Granat Malcolm H. , Ellis Brian M. , Dall Philippa M.
Published: December 2020

Objective: Global positioning system (GPS) data can add context to physical activity data and have previously been integrated with epoch-based physical activity data. The current study aimed to develop a framework for integrating GPS data and event-based physical activity data (suitable for assessing patterns of behavior). Methods: A convenience data set of concurrent GPS (AMOD) and physical activity (activPAL) data were collected from 69 adults. The GPS data were (semi)regularly sampled every 5 s. The physical activity data output was presented as walking events, which are continuous periods of walking with a time-stamped start time and duration (to nearest 0.1 s). The GPS outcome measures and the potential correspondence of their timing with walking events were identified and a framework was developed describing data integration for each combination of GPS outcome and walking event correspondence. Results: The GPS outcome measures were categorized as those deriving from a single GPS point (e.g., location) or from the difference between successive GPS points (e.g., distance), and could be categorical, scale, or rate outcomes. Walking events were categorized as having zero (13% of walking events, 3% of walking duration), or one or more (52% of walking events, 75% of walking duration) GPS points occurring during the event. Additionally, some walking events did not have GPS points suitably close to allow calculation of outcome measures (31% of walking events, 22% of walking duration). The framework required different integration approaches for each GPS outcome type, and walking events containing zero or more than one GPS points.
Static Ankle Dorsiflexion and Hip and Pelvis Kinematics During Forward Step-Down in Patients With Hip-Related Groin Pain
Authors: Foster Stefanie N. , Harris Michael D. , Hastings Mary K. , Mueller Michael J. , Salsich Gretchen B. , Harris-Hayes Marcie
Published: December 2020

Context: The authors hypothesized that in people with hip-related groin pain, less static ankle dorsiflexion could lead to compensatory hip adduction and contralateral pelvic drop during step-down. Ankle dorsiflexion may be a modifiable factor to improve ability in those with hip-related groin pain to decrease hip/pelvic motion during functional tasks and improve function. Objective: To determine whether smaller static ankle dorsiflexion angles were associated with altered ankle, hip, and pelvis kinematics during step-down in people with hip-related groin pain. Design: Cross-sectional Setting: Academic medical center. Patients: A total of 30 people with hip-related groin pain (12 males and 18 females; 28.7 [5.3] y) participated. Intervention: None. Main Outcome Measures: Weight-bearing static ankle dorsiflexion with knee flexed and knee extended were measured via digital inclinometer. Pelvis, hip, and ankle kinematics during forward step-down were measured via 3D motion capture. Static ankle dorsiflexion and kinematics were compared with bivariate correlations. Results: Smaller static ankle dorsiflexion angles were associated with smaller ankle dorsiflexion angles during the step-down for both the knee flexed and knee extended static measures. Among the total sample, smaller static ankle dorsiflexion angle with knee flexed was associated with greater anterior pelvic tilt and greater contralateral pelvic drop during the step-down. Among only those who did not require a lowered step for safety, smaller static ankle dorsiflexion angles with knee flexed and knee extended were associated with greater anterior pelvic tilt, greater contralateral pelvic drop, and greater hip flexion. Conclusions: Among those with hip-related groin pain, smaller static ankle dorsiflexion angles are associated with less ankle dorsiflexion motion and altered pelvis and hip kinematics during a step-down. Future research is needed to assess the effect of treating restricted ankle dorsiflexion on quality of motion and symptoms in patients with hip-related groin pain.
Alkoxylalkyl Esters of Nucleotide Analogs Inhibit Polyomavirus DNA Replication and Large T Antigen Activities
Authors: Onwubiko Nichodemus O. , Diaz Suraya A. , Krečmerová Marcela , Nasheuer Heinz Peter
Published: December 2020

Polyomavirus-related infections are ubiqutious in immunocompromised individuals, and in some cases are intractable and fatal. Due to a lack of approved drugs to treat polyomavirus infections, cidofovir, a phosphonate nucleotide analog approved to treat cytomegalovirus infections, has been repurposed as an antipolyomavirus agent.
Flagellar Structures from the Bacterium Caulobacter crescentus and Implications for Phage

ϕ

CbK Predation of Multiflagellin Bacteria
Authors: Montemayor Eric J. , Ploscariu Nicoleta T. , Sanchez Juan C. , Parrell Daniel , Dillard Rebecca S. , Shebelut Conrad W. , Ke Zunlong , Guerrero-Ferreira Ricardo C. , Wright Elizabeth R.
Published: December 2020

Bacterial flagellar filaments serve as an initial attachment point for many bacteriophages to bacteria. Some bacteria harbor numerous flagellin genes and are therefore able to generate flagellar filaments with complex compositions, which is thought to be important for evasion from bacteriophages.
The CckA-ChpT-CtrA Phosphorelay Controlling Rhodobacter capsulatus Gene Transfer Agent Production Is Bidirectional and Regulated by Cyclic di-GMP
Authors: Farrera-Calderon Reynold G. , Pallegar Purvikalyan , Westbye Alexander B. , Wiesmann Christina , Lang Andrew S. , Beatty J. Thomas
Published: December 2020

The CckA, ChpT, and CtrA phosphorelay proteins are widespread in the alphaproteobacteria, and there are two groups of organisms that differ in terms of whether this pathway is essential for cell viability. Little is known about the biochemical function of these proteins in organisms where the pathway is not essential, a group that includes
Rhodobacter capsulatus
.
HIV-1 Vpr-Induced Proinflammatory Response and Apoptosis Are Mediated through the Sur1-Trpm4 Channel in Astrocytes
Authors: Li Ge , Makar Tapas , Gerzanich Volodymyr , Kalakonda Sudhakar , Ivanova Svetlana , Pereira Edna F. R. , Andharvarapu Sanketh , Zhang Jiantao , Simard J. Marc , Zhao Richard Y.
Published: December 2020

Effective antiretroviral therapies can now prolong patients’ lives to nearly normal life span. The current challenge faced by many HIV-infected patients is chronic neuroinflammation and neurotoxicity that contributes to HIV-associated neurocognitive disorders (HAND).
Longitudinal analysis of microvascular perfusion and neurodegenerative changes in early type 2 diabetic retinal disease
Authors: Aschauer Julia , Pollreisz Andreas , Karst Sonja , Hülsmann Martin , Hajdu Dorottya , Datlinger Felix , Egner Berit , Kriechbaum Katharina , Pablik Eleonore , Schmidt-Erfurth Ursula Margarethe
Published: December 2020

Aim

To prospectively monitor subclinical changes in capillary perfusion and retinal layer thickness in patients with type 2 diabetes and early diabetic retinal disease over 2 years.

Methods

In this longitudinal study we performed biannual retinal vascular imaging using optical coherence tomography angiography (RTVue) to analyse the foveal avascular zone (FAZ) area, perimeter, acircularity index (AI) and parafoveal superficial/deep vessel density (VD). Spectral-domain optical coherence tomography (Spectralis) was used to measure the thickness of nine macular layers and the peripapillary nerve fibre layer.

Results

Among 117 eyes (58 left) of 59 patients (21 female), 105 had no diabetic retinopathy (DR), 6 mild and 6 moderate non-proliferative DR at baseline. We found DR progression in 13 eyes at year 2. The FAZ area (+0.008±0.002 mm2/year, p<0.0001), perimeter (+0.036±0.010 mm/year, p=0.006) and AI (+0.005±0.002/year, p=0.0280) increased significantly. A pronounced decrease was found in the superficial (−1.425±0.290%/year, p<0.0001) but not the deep VD. Inner neuroretinal loss was confined to the ganglion cell (−0.539±0.150 µm/year, p=0.0004) and the inner plexiform layer (−0.361±0.127 µm/year, p=0.0045). In the outer retina, we observed a statistically significant decrease in thickness in the outer plexiform, photoreceptor layer and pigment epithelium of −0.921±0.161 µm/year, −0.325±0.139 µm/year and −0.385±0.084 µm/year, respectively.

Conclusion

Subclinical signs of microangiopathy and neurodegeneration appear in parallel and are highly progressive even in the earliest stages of diabetic retinal disease.

Trial registration number EudraCT20156000239634.
Outcomes of enucleation and porous polyethylene orbital implant insertion in patients with paediatric retinoblastoma: a long-term follow-up study
Authors: Yang Min Kyu , Lee Min Joung , Kim Namju , Choung Hokyung , Khwarg Sang In
Published: December 2020

Background/Aims

To report the long-term outcomes of enucleation and insertion of porous polyethylene (PP) orbital implant according to the evolving surgical techniques and implant in patients with paediatric retinoblastoma .

Methods

Patients with paediatric retinoblastoma who underwent enucleation and PP implant insertion from December 1998 to December 2014 were retrospectively reviewed and divided into four groups: group A, classic enucleation +PP implant; group B, enucleation +PP implant +anterior closure of the posterior Tenon’s (ACPT) capsule; group C, enucleation +PP implant +free orbital fat graft +ACPT and group D, enucleation +smooth surface tunnel PP implant +ACPT. Survival analysis of implant exposure and eyelid malpositions was performed.

Results

One hundred and ninety-eight eyes of 196 patients were included. The median follow-up period was 13.0 years (range, 5.0–21.1). A 20 mm implant was inserted for 149 eyes (75.3%). The 10-year exposure-free survival probabilities were 44.6% in group A, 96.4% in group B, 97.4% in group C and 97.7% in group D. ACPT was associated with significant reduction in implant exposure (p<0.001). The most common eyelid malposition was upper eyelid ptosis (24.2%). The eyelid malposition-free survival probability did not differ among the four groups. However, the insertion of a 20 mm implant was associated with significant reduction in upper eyelid ptosis and lower eyelid entropion (p=0.004 and 0.038, respectively).

Conclusions

The long-term postenucleation implant exposure was rare after PP implant insertion and ACPT, even with a 20 mm-diameter implant. A larger implant can be beneficial in long-term prevention of eyelid malposition.
High genetic contribution to anterior cruciate ligament rupture: Heritability ~69%
Authors: Magnusson Karin , Turkiewicz Aleksandra , Hughes Velocity , Frobell Richard , Englund Martin
Published: December 2020

Objectives

We aimed to determine the lifetime genetic risk for anterior cruciate ligament (ACL) rupture.

Methods

We used a twin study approach, linking the Swedish Twin Register with national healthcare data to form a 30 year, population wide, longitudinal twin cohort. We studied ACL rupture in this cohort of 88 414 identical and fraternal twins, aged ≥17 years, to determine the familial risk and heritability of ACL rupture.

Results

The incidence rate of ACL rupture was 70 (95% CI 66 to 74) per 100 000 person years. The familial risk, which is the excess risk ratio (RR) of the second twin having ACL rupture given that the first twin has had such a rupture, was higher in identical twin pairs (RR=8.6, 95% CI 6.2 to 11.0) than in fraternal twin pairs (RR=1.9, 95% CI 0.9 to 3.0). The overall heritability of ACL rupture was high, 69% (95% CI 47 to 91), increasing from 60% at age 17 years to 80% at age 60 years. Women and men had similar familial risk and heritability of ACL rupture.

Conclusion

The genetic contribution to ACL rupture of ~69% is high and suggests strong familial clustering. If clinicians recognise the high genetic risk of such injury, they may be better able to counsel athletes whose near relatives have had ACL rupture.
Providing culturally sensitive diabetes self-management education and support for black African and Caribbean communities: a qualitative exploration of the challenges experienced by healthcare practitioners in inner London
Authors: Goff Louise M , Moore Amanda , Harding Seeromanie , Rivas Carol
Published: December 2020

Introduction

Poor access to, and engagement with, diabetes healthcare is a significant issue for black British communities who are disproportionately burdened by type 2 diabetes (T2D). Tackling these inequalities is a healthcare priority. The purpose of this research was to explore the experiences of healthcare practitioners providing diabetes self-management education and support (DSMES) to African and Caribbean adults living with T2D to inform the development of a culturally tailored DSMES program.

Research design and methods

Semi-structured interviews were carried out with a range of healthcare practitioners including diabetes specialist nurses, dietitians and general practitioners based in primary care in inner London. Thematic content analysis was used to identify barriers and facilitators relating to the provision of effective DSMES.

Results

Ten interviews were conducted. There was a strong consensus among healthcare practitioners for the importance of DSMES in T2D healthcare. However, practitioners discussed this area of practice as overwhelmingly challenging and recognized a wide range of barriers that they face. Four themes were identified: (1)The tension between structural and responsive care needs, particularly with growing numbers of patients alongside incentivized targets driving a care agenda that does not meet the needs of diverse communities; (2)challenges posed by cultural beliefs and practices, particularly a distrust of conventional medicine, rejection of body mass index standards and a belief in ‘God’s will’; (3)building relationships through cultural understanding: insiders and outsiders, particularly the benefits of racial concordance and cultural knowledge/resources and (4)getting the messages across, particularly the need to address gaps in structured education.

Conclusion

Provision of culturally sensitive DSMES is a challenging area of practice for practitioners, who recognize the need for more training and resources to support them in developing cultural competence. Nonetheless, practitioners recognize the importance of DSMES and are striving to provide culturally sensitive care to their patients.
TANDEM TRIAL: a factorial randomised controlled trial of dose and review schedule of bevacizumab (Avastin) for neovascular macular degeneration in the East Midlands
Authors: Foss Alexander , Haydock Rebecca , Childs Margaret , Duley Lelia M , Empeslidis Theo , Dhar-Munshi Sushma , Montgomery Alan A , Ogollah Reuben , Ozolins Mara , Tesha Paul , Mitchell Eleanor
Published: December 2020

Objective

Neovascular age-related macular degeneration (nAMD) causes damage to the macula and severe vision loss. Bevacizumab is the most cost-effective nAMD treatment. The TANDEM trial was designed to determine whether, in patients with nAMD, low-dose bevacizumab is non-inferior to the standard dose in terms of visual deterioration and whether a bimonthly regimen is non-inferior to monthly, treatment as required, regimens.

Methods

This was a multicentre, 2×2 factorial, double-masked, non-inferiority randomised trial with patients considered eligible if they met the National Institute for Health and Care Excellence criteria for nAMD treatment with ranibizumab. Participants were randomly assigned to standard (1.25 mg) or low (0.625 mg) dose bevacizumab and either monthly or bimonthly review regimen. The primary outcome was time to vision deterioration, defined as reduction of ≥15 letters (three lines) during the loading phase (visual acuity scores at visits B and C compared with the initial visit A), or ≥6 letters (one line) during the maintenance phase (visual acuity scores at subsequent visits compared with mean vision at visits A–C).

Results

In total 812 participants (918 eyes) were randomised into the trial. The low dose showed some evidence of being non-inferior to standard dose (HR 1.07; 95% CI 0.80 to 1.42), however, there was no strong evidence of bimonthly review being non-inferior to monthly review (HR 1.45; 95% CI 1.09 to 1.94). There was no difference in visual acuity when assessed at 9 months and no major differences in the frequency of serious adverse events or reactions between the groups.

Conclusion

The standard dose of bevacizumab can be halved without compromising efficacy. Bimonthly review cannot be considered to be no worse than monthly review.
Iqgap3-Ras axis drives stem cell proliferation in the stomach corpus during homoeostasis and repair
Authors: Matsuo Junichi , Douchi Daisuke , Myint Khine , Mon Naing Naing , Yamamura Akihiro , Kohu Kazuyoshi , Heng Dede Liana , Chen Sabirah , Mawan Nur Astiana , Nuttonmanit Napat , Li Ying , Srivastava Supriya , Ho Shamaine Wei Ting , Lee Nicole Yee Shin , Lee Hong Kai , Adachi Makoto , Tamura Atsushi , Chen Jinmiao , Yang Henry , Teh Ming , So Jimmy Bok-Yan , Yong Wei Peng , Tan Patrick , Yeoh Khay Guan , Chuang Linda Shyue Huey , Tsukita Sachiko , Ito Yoshiaki
Published: December 2020

Objective

Tissue stem cells are central regulators of organ homoeostasis. We looked for a protein that is exclusively expressed and functionally involved in stem cell activity in rapidly proliferating isthmus stem cells in the stomach corpus.

Design

We uncovered the specific expression of Iqgap3 in proliferating isthmus stem cells through immunofluorescence and in situ hybridisation. We performed lineage tracing and transcriptomic analysis of Iqgap3 +isthmus stem cells with the Iqgap3-2A-tdTomato mouse model. Depletion of Iqgap3 revealed its functional importance in maintenance and proliferation of stem cells. We further studied Iqgap3 expression and the associated gene expression changes during tissue repair after tamoxifen-induced damage. Immunohistochemistry revealed elevated expression of Iqgap3 in proliferating regions of gastric tumours from patient samples.

Results

Iqgap3 is a highly specific marker of proliferating isthmus stem cells during homoeostasis. Iqgap3+isthmus stem cells give rise to major cell types of the corpus unit. Iqgap3 expression is essential for the maintenance of stem potential. The Ras pathway is a critical partner of Iqgap3 in promoting strong proliferation in isthmus stem cells. The robust induction of Iqgap3 expression following tissue damage indicates an active role for Iqgap3 in tissue regeneration.

Conclusion

IQGAP3 is a major regulator of stomach epithelial tissue homoeostasis and repair. The upregulation of IQGAP3 in gastric cancer suggests that IQGAP3 plays an important role in cancer cell proliferation.
Childhood adversity and trajectories of multimorbidity in mid-late life: China health and longitudinal retirement study
Authors: Yang Lei , Hu Yaoyue , Silventoinen Karri , Martikainen Pekka
Published: December 2020

Background

The association between childhood adversity and an individual’s health in later life has been extensively studied in Western societies; however, little is known about this association for the development of multimorbidity in China.

Methods

Three waves (2011–2012, 2013 and 2015) of the China Health and Retirement Longitudinal Study were used for adults aged 45–101 years. Multimorbidity was assessed by the summed scores of self-reported physician diagnoses of 14 chronic diseases. Childhood adversity was measured by the incidence of childhood abuse and neglect, negative caregiver’s characteristics and low socioeconomic status. Latent growth curve modelling was used to investigate the trajectory of multimorbidity by childhood adversity.

Results

Parental physical abuse was associated with increased number of chronic diseases (intercept: 0.119; 95% CI: 0.033 to 0.205 for men and 0.268: 95% CI: 0.188 to 0.348 for women) and a higher rate of increase (slope: 0.013: 95% CI: 0.000 to 0.027 for men and 0.022: 95% CI: 0.008 to 0.036 for women) in multimorbidity. Adequacy of food was associated with a lower number chronic diseases at baseline (men: −0.171: 95% CI: −0.245 to -0.097; women: −0.223: 95% CI: −0.294 to -0.152) and a slower rate of change in multimorbidity (men: −0.015 per year: 95% CI: −0.027 to -0.003; women: −0.012 per year: 95% CI: −0.024 to -0.001).

Conclusions

The results demonstrate that childhood adversity exerts long-lasting effects on multimorbidity among older adults in China. Prevention of childhood maltreatment may delay or even avert the emergence of multimorbidity in later life.
Rhomboencephalitis
Authors: Cleaver Jonathan , James Richard , Rice Claire M
Published: December 2020

Rhomboencephalitis—inflammation of the brainstem and cerebellum—has myriad clinical presentations including encephalopathy, cranial neuropathies, long tract signs and cerebellar dysfunction and is associated with significant morbidity and mortality. There are a variety of potential underlying causes that respond variably to treatment, including infections, parainfective syndromes, inflammatory disorders including autoimmune encephalitis and paraneoplastic syndromes. Here, we review its clinical presentation and outline a practical approach to its investigation, aiming to facilitate prompt diagnosis and confirmation of the underlying cause, to start appropriate management early and optimise the clinical outcome.
Theobromine ameliorates nonalcoholic fatty liver disease by regulating hepatic lipid metabolism via mTOR signaling pathway in vivo and in vitro
Authors: Wei Dan , Wu Shaofei , Liu Jie , Zhang Xiaoqian , Guan Xiaoling , Gao Li , Xu Zhipeng
Published: December 2020

Theobromine, a methylxanthine present in cocoa, has been shown to possess many beneficial pharmacological properties such as anti-oxidative stress, anti-inflammatory property, and anti-microbial activity. In this study, we investigated the effects of theobromine on nonalcoholic fatty liver disease (NAFLD) and the possible underlying mechanisms in vivo and in vitro. The results showed that theobromine reduced body weight and fat mass and improved dyslipidemia. Theobromine mitigated liver injury and significantly reduced hepatic triglyceride level in mice with obesity. Histological examinations also showed hepatic steatosis was alleviated after theobromine treatment. Furthermore, theobromine reversed the elevated mRNA and protein expression of SREBP-1c, FASN, CD36, FABP4, and the suppressed expression of PPARα and CPT1a in the liver of mice with obesity, which were responsible for lipogenesis, fatty acid uptake, and fatty acid oxidation respectively. In vitro, theobromine also downregulated SREBP-1c, FASN, CD36, FABP4 and upregulated PPARα and CPT1a mRNA and protein levels in hepatocytes in a dose-dependent manner, while these changes were reversed by L-leucine, a mammalian target of rapamycin (mTOR) agonist. The present study demonstrated that theobromine improved NAFLD by inhibiting lipogenesis and fatty acid uptake and promoting fatty acid oxidation in the liver and hepatocytes, which might be associated with its suppression of mTOR signaling pathway.

Novelty: Theobromine protects against high-fat diet – induced NAFLD. Theobromine inhibits lipogenesis and fatty acid uptake and promotes fatty acid oxidation in the liver and hepatocytes via inhibiting mTOR signaling pathway.
Junction conditions and local spacetimes in general relativity
Authors: Huber Albert
Published: December 2020

In the present work, a theoretical framework focussing on local geometric deformations is introduced in order to cope with the problem of how to join spacetimes with different geometries and physical properties. This framework is used to show that two Lorentzian manifolds can be matched by considering local deformations of the associated spacetime metrics. Based on the fact that metrics can be suitably matched in this way, it is shown that the underlying geometric approach allows the characterization of local spacetimes in general relativity. Furthermore, it is shown that said approach not only extends the conventional thin shell formalism, but also allows the treatment of geometric problems that cannot be treated with standard gluing techniques.
Multistage thermoelectric La(Ce)B6 cryocoolers
Authors: Gulian Anahit , Gulian A. M.
Published: December 2020

Using finite element modeling based on the COMSOL package, we analyzed the static and dynamic performance of a multistage cryocooler, the coldest stage of which is constituted of thermoelectric legs. Using published data on the achievable parameters of lanthanum-cerium hexaborides, we modeled a single and double-stage thermoelectric cooler. Estimates are also provided for an N-stage cooler. The results can be used for practical realization of additional cooling stages for reaching temperatures below 1.8 K in commercially available cryostats.
Periodicity and bifurcation of a bouncing ball system with rigidly connected harmonic limiters
Authors: Li Ruihai , Qiu Ruiyang
Published: December 2020

The bouncing ball system with two rigidly connected harmonic limiters is revisited in order to further analyze its periodic movement and bifurcation dynamics. By using the impulsive impact maps, we obtain several sufficient conditions for the existence and local stability of three different types of periodic orbits, respectively, and then plot the bifurcation diagrams in the space of the relative velocity and the restitution coefficient for different parameters of the limiter. The numerical simulation results are consistent with those of the theoretical analysis.
On the double-pole solutions of the complex short-pulse equation
Authors: Xu Jian , Guo Ning , Li Hongyu , Tu Youzhi
Published: December 2020

In non-linear optics, it is well known that the non-linear Schrödinger (NLS) equation was always used to model the slowly varying wave trains. However, when the width of optical pulses is in the order of femtosecond ([Formula: see text] s), the NLS equation becomes less accurate. Schäfer and Wayne proposed the so-called short pulse (SP) equation which provided an increasingly better approximation to the corresponding solution of the Maxwell equations. Note that the one-soliton solution (loop soliton) to the SP equation has no physical interpretation as it is a real-valued function. Recently, an improvement for the SP equation, the so-called complex short pulse (CSP) equation, was proposed in Ref. 9. In contrast with the real-valued function in SP equation, [Formula: see text] is a complex-valued function. Since the complex-valued function can contain the information of both amplitude and phase, it is more appropriate for the description of the optical waves. In this paper, the new types of solutions — double-pole solutions — which correspond to double-pole of the reflection coefficient are obtained explicitly, for the CSP equation with the negative order Wadati–Konno–Ichikawa (WKI) type Lax pair by Riemann–Hilbert problem method. Furthermore, we find that the double-pole solutions can be viewed as some proper limits of the soliton solutions with two simple poles.
Temperature dependence of conduction and low frequency noise characteristics in GaN Schottky barrier diodes
Authors: Chen Ya-Yi , Liu Yuan , Ren Yuan , Wu Zhao-Hui , Wang Li , Li Bin , En Yun-Fei , Chen Yi-Qiang
Published: December 2020

In this paper, the forward bias conduction and low frequency noise (LFN) characteristics of GaN Schottky barrier diodes (SBDs) have been measured and studied in the temperature range from 300 K to 450 K. Based on I–V measured results, the temperature dependence of ideality factor and zero bias Schottky barrier height reveals the inhomogeneities of Schottky barriers at the metal-semiconductor (MS) interface. Further study of the LFN measured results shows that the flicker noise ([Formula: see text] noise) is the main component of LFN in GaN SBDs. The current dependence of LFN indicates the influences of the Schottky barrier and the series resistance on [Formula: see text] noise, and the temperature dependence of LFN is analyzed according to Luo’s model and the barrier inhomogeneities model.
APPLICATION OF FUNCTIONAL NEAR-INFRARED SPECTROSCOPY IN NEUROLOGICAL DISEASES: EPILEPSY, STROKE AND PARKINSON
Authors: HU XINHUA , XIAO GANG , ZHU KEXIN , HU SHUYI , CHEN JIU , YU YUN
Published: December 2020

The functional near-infrared spectroscopy (fNIRS) technology is an optical imaging technology that applies near-infrared light to measure the oxygenated and deoxygenated hemoglobin concentration alteration in cortical brain structures. It has the ability to directly measure changes in the blood oxygen level of the high temporal resolution associated with neural activation. Thus, it has been utilized in different neurological diseases, such as epilepsy, stroke, and Parkinson. The work of this paper will focus on the application of the fNIRS in the three neurological diseases and the principle of fNIRS. Moreover, the difficulties and challenges that the technology is currently experiencing have been discussed.