bluuebunny/crossref_metadata_2025 huggingface dataset:
Social vulnerability underlying disability amongst older adults: A systematic review
Authors: Cappelli Miriam , Bordonali Alessandro , Giannotti Chiara , Montecucco Fabrizio , Nencioni Alessio , Odetti Patrizio , Monacelli Fiammetta
Published: April 2020

Background

Older adults face radical changes in their social life during ageing, dealing with several age‐related social adaptations. The aim of this review is to systematically explore the literature on social vulnerability (SV) and its association with functional decline activity of daily living (ADL)/instrumental activities of daily living (IADL) as an endpoint in older adults.

Methods

We searched for relevant studies in three different databases: PubMed, Ovid Medline and PsychInfo. Inclusion criteria included: prospective cohort studies assessing SV correlation; studies in English, Italian, French and Spanish to the end of March 2018; a general population aged >65 years living in a community setting and/or studies including younger participants if the mean age was >65 years; and basic ADL and/or IADL by Katz and Lawton, respectively, as functional decline and clinical outcomes.

Results

We identified 65 manuscripts that assessed the role of SV in functional decline. Our systematic analysis showed that 26, 36 and 19 studies observed a correlation between Basic Social Needs, Social Resources and Social Behaviour and Activity, respectively, and the onset of ADL/IADL functional decline. Twenty‐six studies explored the correlation between General Social Resources and the onset of ADL/IADL functional decline.

Conclusions

When examining a wide set of social variables, the “quality,” rather than just structure, and “type” of social relationship represents the core feature of SV that predicts functional decline in older adults. By defining individual SV, its measurement and evaluation, we can plan effective social interventions aimed at preventing or delaying functional decline or death.
Reduced past‐oriented mind wandering in left compared to right medial temporal lobe epilepsy
Authors: Krakau Sofie , Chaieb Leila , Helmstaedter Christoph , von Wrede Randi , Fell Juergen
Published: April 2020

Mind wandering refers to a shift of attention away from a task at hand to task‐unrelated thoughts. Several groups have shown increased activation of the left medial temporal lobe (MTL) before and during spontaneous thoughts suggesting that the left MTL may play a crucial role in mind wandering. Due to its relevance for long‐term memory, we further hypothesized that the left MTL is particularly involved in mind wandering towards the past. Accordingly, we predicted a reduced propensity to mind wander and less past‐oriented mind wandering in patients with left MTL epilepsies. To this end, we experimentally investigated mind wandering in 89 in‐patients undergoing diagnostic evaluation of their putative epileptic disorder. Patients performed a sustained attention to response task with embedded experience sampling probes aiming to assess occurrence, meta‐awareness and temporal orientation (past/present/future) of mind‐wandering episodes. We did not find significant differences in the propensity to mind wander between patient subgroups. However, the left MTL epilepsy subgroup showed significantly reduced past‐oriented mind wandering compared to right MTL epilepsies, as well as a trend towards diminished past‐oriented mind wandering compared to idiopathic epilepsies. Possibly due to compensatory mechanisms, the right MTL epilepsy subgroup showed significantly increased past‐oriented mind wandering compared to extratemporal epilepsies and patients with syncopes. These behavioural findings point to a rejection of the hypothesis that the amount of time engaged in mind wandering crucially depends on the left MTL. However, our data do support the idea that the left MTL is particularly involved in mind wandering towards the past.
Sex differences in the performance of cognitive tasks in a murine model of metabolic syndrome
Authors: Espinosa‐García Claudia , Fuentes‐Venado Claudia Erika , Guerra‐Araiza Christian , Segura‐Uribe Julia , Chávez‐Gutiérrez Edwin , Farfán‐García Eunice Dalet , Estrada Cruz Norma Angélica , Pinto‐Almazán Rodolfo
Published: April 2020

The metabolic syndrome includes changes in blood glucose levels, arterial hypertension, triglycerides, dyslipidemia and central obesity. Countless reports have described the correlation between the metabolic syndrome and cognitive impairment. However, only a few reports have assessed cognitive impairment associated with the metabolic syndrome in animals of both sexes. For this purpose, Sprague‐Dawley male and female rats were fed either with a hypercaloric diet as model of the metabolic syndrome or with a standard chow diet as controls. Subsequently, spatial learning and memory (Morris water maze) as well as short‐ and long‐term memory (passive avoidance task) were evaluated. Body weight, blood pressure, triglycerides, and total cholesterol significantly increased (F(1, 36) = 94.89, p < .001) in rats fed with hypercaloric diet compared to control rats. Furthermore, cognitive impairment was observed in spatial learning and spatial memory on male rats but not on female rats fed with hypercaloric diet. In addition, a long‐term memory impairment was observed in both groups fed with hypercaloric diet in comparison to their respective control group (F(1, 32) = 10.61, p = .0027). Immunohistochemistry results showed no changes in the number of positive cells for NeuN, GFAP and Ox‐42. In males fed with a hypercaloric diet, a decrease in testosterone levels was observed, whereas estradiol levels decreased in females when compared with their respective control group (p < .0001). In this MetS animal model, metabolic and cognitive differences were observed in males and females, which demonstrates that sex hormones play a significant role in metabolic regulation and neuroprotection related to the CA1 region of the hippocampus.
Phosphorus supply shifts the quotas of multiple elements in algae and Daphnia: ionomic basis of stoichiometric constraints
Authors: Jeyasingh Punidan D. , Goos Jared M. , Lind Patrick R. , Roy Chowdhury Priyanka , Sherman Ryan E.
Published: April 2020

The growth rate hypothesis posits that the rate of protein synthesis is constrained by phosphorus (P) supply. P scarcity invokes differential expression of genes involved in processing of most if not all elements encompassing an individual (the ionome). Whether such ionome‐wide adjustments to P supply impact growth and trophic interactions remains unclear. We quantified the ionomes of a resource‐consumer pair in contrasting P supply conditions. Consumer growth penalty was driven by not only P imbalance between trophic levels but also imbalances in other elements, reflecting complex physiological adjustments made by both the resource and the consumer. Mitigating such imbalances requires energy and should impact the efficiency at which assimilated nutrients are converted to biomass. Correlated shifts in the handling of multiple elements, and variation in the supplies of such elements could underlie vast heterogeneity in the rates at which organisms and ecosystems accrue biomass as a function of P supply.
Advanced multiparametric magnetic resonance imaging of multinodular and vacuolating neuronal tumor
Authors: Lecler A. , Broquet V. , Bailleux J. , Carsin B. , Adle‐Biassette H. , Baloglu S. , Forestier G. , Bonneville F. , Calvier E. , Chauvet D. , Comby P. O. , Cottier J. P. , Cotton F. , Deschamps R. , Diard‐Detoeuf C. , Ducray F. , Drissi C. , Elmaleh M. , Farras J. , Aguilar Garcia J. , Gerardin E. , Grand S. , Jianu D. C. , Kremer S. , Loiseau H. , Magne N. , Mejdoubi M. , Moulignier A. , Ollivier M. , Nagi S. , Rodallec M. , Shor N. , Tourdias T. , Vandendries C. , Anxionnat R. , Duron L. , Savatovsky J.
Published: April 2020

Background and purpose

Multinodular and vacuolating neuronal tumor (MVNT) of the cerebrum is a rare brain lesion with suggestive imaging features. The aim of our study was to report the largest series of MVNTs so far and to evaluate the utility of advanced multiparametric magnetic resonance (MR) techniques.

Methods

This multicenter retrospective study was approved by our institutional research ethics board. From July 2014 to May 2019, two radiologists read in consensus the MR examinations of patients presenting with a lesion suggestive of an MVNT. They analyzed the lesions’ MR characteristics on structural images and advanced multiparametric MR imaging.

Results

A total of 64 patients (29 women and 35 men, mean age 44.2 ± 15.1 years) from 25 centers were included. Lesions were all hyperintense on fluid‐attenuated inversion recovery and T2‐weighted imaging without post‐contrast enhancement. The median relative apparent diffusion coefficient on diffusion‐weighted imaging was 1.13 [interquartile range (IQR), 0.2]. Perfusion‐weighted imaging showed no increase in perfusion, with a relative cerebral blood volume of 1.02 (IQR, 0.05) and a relative cerebral blood flow of 1.01 (IQR, 0.08). MR spectroscopy showed no abnormal peaks. Median follow‐up was 2 (IQR, 1.2) years, without any changes in size.

Conclusions

A comprehensive characterization protocol including advanced multiparametric magnetic resonance imaging sequences showed no imaging patterns suggestive of malignancy in MVNTs. It might be useful to better characterize MVNTs.
Mode II fracture energy characterization of brittle adhesives using compliance calibration method
Authors: Akhavan‐Safar Alireza , Salamat‐talab Mazaher , Ajdani Arsalan , Ayatollahi Majid R. , da Silva Lucas F.M.
Published: April 2020

The end‐notched flexure (ENF) test is widely used for measuring the Mode II critical strain energy release rate of adhesively bonded joints (ABJs). Unstable crack growth in ENF joints with brittle adhesives is a common phenomenon. Classic data reduction methods like the direct beam theory (DBT) and the compliance‐based beam method (CBBM) usually result in unacceptable scatter when crack grows unstable. In this study, the application of a compliance calibration method (CCM) for ENF adhesive joints with a brittle adhesive is experimentally investigated. For this purpose, ENF specimens were manufactured and tested. Different data reduction methods were considered for treating the results. Afterwards, the obtained fracture energies were used as an input parameter in a finite element (FE) analysis with a cohesive zone model to evaluate the validity of the experimental data. It is shown that the fracture loads obtained by the CCM have the best agreement with the experimental ones comparing with the other data reduction approaches. To study the effect of geometry on the CCM results, ENF specimens with different adhesive thicknesses, substrate thicknesses and span lengths were also considered in this study, and some general conclusions are made about the geometrical parameters effect on the Mode II fracture energy.
Long‐term results of the treatment of primary hyperhidrosis with oxybutynin: follow‐up of 1,658 cases
Authors: Wolosker Nelson , Kauffman Paulo , de Campos José R. M. , Faustino Carolina B. , da Silva Marcelo F. A. , Teivelis Marcelo P. , Puech‐Leão Pedro
Published: April 2020

Background

Hyperhidrosis (HH) is characterized by exaggerated sweating in a specific region due to hyperfunction of the sweat glands. In the late 2000s, we started treating patients with an anticholinergic, oxybutynin, that was not being used until then.

Objectives

To present, after 12 years of utilizing this medication in our service, the substantial experience obtained with the use of oxybutynin as an initial treatment of HH in a large series of 1,658 patients.

Methods

We analyzed 1,658 patients treated with oxybutynin for HH from May 2006 to June 2018. The patients were divided into four groups according to the main site of HH: the plantar group, the axillary group, the facial group, and the palmar group. To measure the degree of satisfaction, a quality of life (QoL) questionnaire was used.

Results

Pre‐treatment QoL was poor or very poor in more than 94% of the cases, and the palmar group had the worst quality of life. After treatment, we observed an improvement in the quality of life in 77% of patients. More than 70% of the patients in all groups present moderate or optimal subjective clinical improvement in sweating after treatment. The group with the best result was the facial group. Intense dry mouth was reported in 24.9% of all patients in all groups.

Conclusions

This study included a large number of patients followed for a long period and demonstrated the good effectiveness of treatment with oxybutynin for hyperhidrosis in the main sites of sweating.
PRMT5 silencing selectively affects MTAP‐deleted mesothelioma: In vitro evidence of a novel promising approach
Authors: Barbarino Marcella , Cesari Daniele , Bottaro Maria , Luzzi Luca , Namagerdi Asadoor , Bertolino Franca Maria , Bellan Cristiana , Proietti Fabrizio , Somma Pasquale , Micheli Mariacarolina , de Santi Maria Margherita , Guazzo Raffaella , Mutti Luciano , Pirtoli Luigi , Paladini Piero , Indovina Paola , Giordano Antonio
Published: April 2020

Malignant mesothelioma (MM) is an aggressive asbestos‐related cancer of the serous membranes. Despite intensive treatment regimens, MM is still a fatal disease, mainly due to the intrinsic resistance to current therapies and the lack of predictive markers and new valuable molecular targets. Protein arginine methyltransferase 5 (PRMT5) inhibition has recently emerged as a potential therapy against methylthioadenosine phosphorylase (MTAP)‐deficient cancers, in which the accumulation of the substrate 5'‐methylthioadenosine (MTA) inhibits PRMT5 activity, thus sensitizing the cells to further PRMT5 inhibition. Considering that the MTAP gene is frequently codeleted with the adjacent cyclin‐dependent kinase inhibitor 2A (CDKN2A) locus in MM, we assessed whether PRMT5 could represent a therapeutic target also for this cancer type. We evaluated PRMT5 expression, the MTAP status and MTA content in normal mesothelial and MM cell lines. We found that both administration of exogenous MTA and stable PRMT5 knock‐down, by short hairpin RNAs (shRNAs), selectively reduced the growth of MTAP‐deleted MM cells. We also observed that PRMT5 knock‐down in MTAP‐deficient MM cells reduced the expression of E2F1 target genes involved in cell cycle progression and of factors implicated in epithelial‐to‐mesenchymal transition. Therefore, PRMT5 targeting could represent a promising new therapeutic strategy against MTAP‐deleted MMs.
Therapeutic potential for insulin on type 1 diabetes‐associated periodontitis: Analysis of experimental periodontitis in streptozotocin‐induced diabetic rats
Authors: Nishikawa Toru , Suzuki Yuki , Sawada Noritaka , Kobayashi Yasuko , Nakamura Nobuhisa , Miyabe Megumi , Miyajima Shin‐ichi , Adachi Kei , Minato Tomomi , Mizutani Makoto , Toriumi Taku , Ohno Norikazu , Kikuchi Takeshi , Honda Masaki , Noguchi Toshihide , Mitani Akio , Matsubara Tatsuaki , Naruse Keiko
Published: April 2020

Aims/Introduction

The association between diabetes and periodontal disease is considered to be bidirectional. However, there is still controversy surrounding the relationship between periodontal disease and type 1 diabetes. We investigated whether insulin improves periodontitis without any local treatments for periodontitis under type 1 diabetes conditions using the ligature‐induced experimental periodontitis model.

Materials and Methods

Type 1 diabetic rats were induced by streptozotocin injection. Experimental periodontitis was induced by ligature in normal and diabetic rats. Half of the diabetic rats were treated with insulin. Two weeks after the ligature, periodontitis was evaluated.

Results

Insulin treatment significantly improved inflammatory cell infiltration and inflammatory cytokine gene expression, leading to suppression of alveolar bone loss, in the periodontitis of diabetic rats. Insulin also suppressed the periodontitis‐increased nitric oxide synthase‐positive cells in periodontal tissue of the diabetic rats. Even without induction of periodontitis, diabetic rats showed decreased gingival blood flow and an increased number of nitric oxide synthase‐positive cells in the gingiva and alveolar bone loss compared with normal rats, all of which were ameliorated by insulin treatment. We further confirmed that insulin directly suppressed lipopolysaccharide‐induced inflammatory cytokine expressions in THP‐1 cells.

Conclusions

There were abnormalities of periodontal tissue even without the induction of periodontitis in streptozotocin‐induced diabetic rats. Insulin treatment significantly ameliorated periodontitis without local periodontitis treatment in diabetic rats. These data suggest the therapeutic impacts of insulin on periodontitis in type 1 diabetes.
Heating of liquid foods in cans: Effects of can geometry, orientation, and food rheology
Authors: Borah Rituraj , Gupta Sanjay , Mishra Lubhani , Chhabra Raj P.
Published: April 2020

In this work, the effect of geometry and orientation of food cans on the heating characteristics of processed liquid foods and the resulting lethality target values as a function of the processing times have been investigated. For this purpose, the governing differential equations have been solved numerically for elliptical and cylindrical cans of varying aspect ratios in different orientations in order to delineate their effect on the heating rate (especially of the slowest heating zone [SHZ]) and lethality values over wide ranges of rheological features including shear thinning (n < 1), Newtonian (n = 1), and shear thickening (n > 1) behaviors. The flow and heat transfer characteristics were analyzed with the help of velocity vectors, isotherm contours, average Nusselt number, SHZ temperature and heat penetration parameters, and lethality target values. Also, comparisons were made in terms of the sterilization time and heat penetration parameters to identify the preferable geometries and orientations of food cans for effective heating of non‐Newtonian foodstuffs. Finally, favorable conditions in terms of the shape and orientation of the can and the rheological properties have been delineated which lead to superior heating characteristics.

Practical Applications

Processed foodstuffs are produced in various forms ranging from that in solid, liquid, or as heterogeneous mixtures. Often such liquid and heterogeneous suspensions products are viscous non‐Newtonian in character and their thermal processing (including pasteurization, sterilization, etc.) tends to be much more challenging than that of their Newtonian counterparts like air and water. This work explores heating of non‐Newtonian liquid foodstuffs in cans of various shapes, geometries and in different orientations in the free convection regime. The results show that depending upon the rheological properties of the products, some orientations and/or geometries offer potential advantages in terms of shorter processing times and lethality values. This information can be of great potential in customizing the design of containers for different food products as well as of different rheological properties.
How different surrounding environments influence the characteristics of flash flood‐mortality: The case of the 2017 extreme flood in Mandra, Greece
Authors: Diakakis Michalis , Deligiannakis Giorgos , Andreadakis Emmanouil , Katsetsiadou Katerina N. , Spyrou Navsika I. , Gogou Marilia E.
Published: April 2020

In November 2017, a high‐intensity storm caused a catastrophic flash flood that devastated the city of Mandra, in Greece, and led to the tragic loss of 24 people. The storm caused flooding in the two main tributaries of the basin, creating two very similar hydrological responses with similar flood characteristics that hit two different environments: one within the city and one outside. This work examines the fatal incidents that occurred in relation to the characteristics of the surrounding environment, to investigate the role of the latter in flood mortality. Then, the analysis carried out for the 2017 flood is expanded to a broader database of flood deaths for Greece (1960–2018) for comparison. Results show that certain mortality characteristics differ substantially depending on the setting. Outdoor incidents are more abundant in nonurban environments, in which victims exhibit mostly an active or risk‐taking behaviour against the imminent risk. Urban environments are characterised by a greater diversity of victim activities, higher percentages of indoor deaths, especially for older victims and more passive behaviours. Overall, the study presents evidence on how risk situations develop differently between urban and nonurban settings. Findings are relevant in shaping policy and education programs aiming to mitigate risk.
Somato‐dendritic vasopressin and oxytocin secretion in endocrine and autonomic regulation
Authors: Brown Colin H. , Ludwig Mike , Tasker Jeffrey G. , Stern Javier E.
Published: April 2020

Somato‐dendritic secretion was first demonstrated over 30 years ago. However, although its existence has become widely accepted, the function of somato‐dendritic secretion is still not completely understood. Hypothalamic magnocellular neurosecretory cells were among the first neuronal phenotypes in which somato‐dendritic secretion was demonstrated and are among the neurones for which the functions of somato‐dendritic secretion are best characterised. These neurones secrete the neuropeptides, vasopressin and oxytocin, in an orthograde manner from their axons in the posterior pituitary gland into the blood circulation to regulate body fluid balance and reproductive physiology. Retrograde somato‐dendritic secretion of vasopressin and oxytocin modulates the activity of the neurones from which they are secreted, as well as the activity of neighbouring populations of neurones, to provide intra‐ and inter‐population signals that coordinate the endocrine and autonomic responses for the control of peripheral physiology. Somato‐dendritic vasopressin and oxytocin have also been proposed to act as hormone‐like signals in the brain. There is some evidence that somato‐dendritic secretion from magnocellular neurosecretory cells modulates the activity of neurones beyond their local environment where there are no vasopressin‐ or oxytocin‐containing axons but, to date, there is no conclusive evidence for, or against, hormone‐like signalling throughout the brain, although it is difficult to imagine that the levels of vasopressin found throughout the brain could be underpinned by release from relatively sparse axon terminal fields. The generation of data to resolve this issue remains a priority for the field.
A Roadmap for Global Acceleration of Genomics Integration Across Nursing
Authors: Tonkin Emma , Calzone Kathleen A. , Badzek Laurie , Benjamin Caroline , Middleton Anna , Patch Christine , Kirk Maggie
Published: April 2020

Purpose

The changes needed to accelerate integration of genomics across nursing are complex, with significant challenges faced globally. Common themes lend themselves to a coordinated and collaborative strategic approach to sustained change. We aim to synthesize the outputs of a research program to present a roadmap for nursing leadership to guide integration of genomics across practice.

Design

Mixed methods involving a purposive sample of global nursing leaders and nursing organizations in a sustained, highly interactive program.

Methods

Experts in nursing, health care and healthcare services, policy, and leadership were recruited. Online surveys preceded a 3‐day residential meeting utilizing participatory methods and techniques to gain consensus on the essential elements of a roadmap to promote genomics integration.

Findings

Twenty‐three leaders representing 19 countries and seven organizations participated overall. Data on the scope and status of nursing, genomics health care, and resources have been synthesized. Participants identified 117 facilitators to genomics integration across diverse sources. Barriers and priorities identified were mapped to the constructs of the Consolidated Framework for Implementation Research. The roadmap is underpinned by a maturity matrix created by participants to guide and benchmark progress in genomics integration.

Conclusions

Nurse leaders seeking to accelerate change can access practical guidance with the roadmap, underpinned by support through the Global Genomics Nursing Alliance and its strategic priorities.

Clinical Relevance

Genomics is shaping the future of healthcare, but change is needed for integration across nursing. This practical roadmap, adaptable to local health systems and clinical and educational contexts, is relevant to nurse leaders aiming to accelerate change.
Big data in vascular surgery: registries, international collaboration and future directions
Authors: Sutzko D. C. , Mani K. , Behrendt C.‐A. , Wanhainen A. , Beck A. W.
Published: April 2020

Given the increasing availability of large data set, small single‐institutional series raise decreasing attention. Rapid expansion of technology from electronic medical records to easily accessible internet access, and widespread use and acceptance of registries in the medical world has allowed for research and quality improvement efforts using ‘big data’. Big data, although technically not defined, typically refers to large databases that can be used to investigate common or rare disease processes or outcomes, describe variation in clinical practices across and between different specialties at various practice location, whilst allowing important information about trends over time. Big data have allowed investigators to quickly assimilate cohorts of patients and/or procedures to answer current questions, with more complete population representation and improved generalizability whilst decreasing the likelihood of power problems and type II errors. On the other hand, pitfalls still exist with the growing problem of hypothesis fishing, lack of granularity and the fear by many clinicians that registry transparency may have already gone too far, where surgery groups or individual surgeon outcomes are readily available to patients and referring providers. Within vascular surgery specifically, big data have expanded over the last decade and now includes regional, national and global registries that have major benefits of gathering specific clinical and procedural information within vascular surgery. In this review, we highlight the main vascular surgery registries and recap a few success stories of how the registries have been leveraged to benefit discovery, quality improvement and ultimately patient care. Additionally, we outline future directions that will be imperative for continued expansion, acceptance and adoption of ‘big data’ utilization inpatients with vascular disease.
BCG scarring and improved child survival: a combined analysis of studies of BCG scarring
Authors: Benn C. S. , Roth A. , Garly M.‐L. , Fisker A. B. , Schaltz‐Buchholzer F. , Timmermann A. , Berendsen M. , Aaby P.
Published: April 2020

Bacillus Calmette–Guérin (BCG) vaccine against tuberculosis (TB) is recommended at birth in TB‐endemic areas. Currently, BCG vaccination programmes use “BCG vaccination coverage by 12 months of age” as the performance indicator. Previous studies suggest that BCG‐vaccinated children, who develop a scar, have better overall survival compared with BCG‐vaccinated children, who do not develop a scar. We summarized the available studies of BCG scarring and child survival. A structured literature search for studies with original data and analysis of BCG scarring and mortality were performed. Combined analyses on the effect of BCG scarring on overall mortality. We identified six studies covering seven cohorts, all from Guinea‐Bissau, West Africa, with evaluation of BCG scarring amongst BCG‐vaccinated children and follow‐up for mortality. Determinants of BCG scarring were BCG strain, intradermal injection route, size of injection wheal, and co‐administered vaccines and micronutrients. In a combined analysis, having a BCG scar vs. no BCG scar was associated with a mortality rate ratio (MRR) of 0.61 (95% CI: 0.51–0.74). The proportion with a BCG scar varied from 52 to 93%; the estimated effect of a BCG scar was not associated with the scar prevalence. The effect was strongest in the first (MRR = 0.48 (0.37–0.62)) and second (MRR = 0.63 (0.44–0.92)) year of life, and in children BCG‐vaccinated in the neonatal period (MRR = 0.45 (0.36–0.55)). The effect was not explained by protection against TB. Confounding and genetic factors are unlikely to explain the strong association between BCG scarring and subsequent survival. Including “BCG scar prevalence” as a BCG vaccination programme performance indicator should be considered. The effect of revaccinating scar‐negative children should be studied.
The Effect of Ticagrelor on Platelet Reactivity in Patients with Clopidogrel Resistance Undergoing Neuroendovascular Procedures
Authors: Qureshi Adnan Iqbal , Jahngir Muhammad Umair , Qualls Kathryn , Akinci Yasemin , Lobanova Iryna , Liaqat Jahanzeb , Gao Xiaoyu , Akhtar Iqra Naveed , Kraus Jacqueline , Uzun Guven , French Brandi , Siddiq Farhan , Ramiro Gomez Camilo
Published: April 2020

BACKGROUND AND PURPOSE

Suboptimal platelet inhibition by clopidogrel (clopidogrel resistance) may be associated with high rates of stent thrombosis and ischemic events. Our objective was to determine if ticagrelor, a P2Y12 receptor inhibitor, can result in platelet inhibition in patients with clopidogrel resistance.

METHODS

A thromboelastography‐platelet mapping assay was used in all patients undergoing neuroendovascular procedures requiring oral clopidogrel. In patients with suboptimal platelet inhibition (<60%) on clopidogrel, ticagrelor was imitated after an oral bolus of 180 mg followed by 90 mg twice daily and the platelet mapping assay was repeated. The primary endpoint was hemorrhagic complications classified as major (hemoglobin decrease >5 g/dL or intracranial hemorrhage with deficits), minor (hemoglobin decrease 3‐5 g/dL or intracranial hemorrhage without residual deficits), or insignificant.

RESULTS

Suboptimal platelet inhibition on clopidogrel was seen in 70 of 106 patients undergoing neuroendovascular procedures. There was a significantly higher magnitude of platelet inhibition with ticagrelor compared with clopidogrel in patients with clopidogrel resistance (mean ± SD: 85.90 ± 10.74% vs. 29.26 ± 17.71%; P < .001); 50 of 70 patients showed optimal inhibition. Two patients had major (fatal) hemorrhagic events (both received either intravenous thrombolytics and/or eptifibatide infusion). Three patients had minor hemorrhagic events, and two patients had insignificant hemorrhagic events. Four of seven hemorrhagic events occurred in patients with optimal response to clopidogrel, two occurred in patients with suboptimal response to ticagrelor, and one occurred in a patient with optimal response to ticagrelor.

CONCLUSIONS

Oral ticagrelor can augment platelet inhibition in patients who have clopidogrel resistance.
Self‐reported factors associated with dental care utilization among Hispanic migrant farmworkers in South Florida
Authors: Serna Claudia A. , Sanchez Jesus , Arevalo Oscar , Tomar Scott L. , McCoy Virginia , Devieux Jessy , De La Rosa Mario , Bastida Elena
Published: April 2020

Objectives

To explore patterns of dental care utilization among adult Hispanic migrant farmworkers utilizing the Andersen Behavioral Model of Health Services.

Methods

In 2010, 278 Hispanic migrant workers participated in the oral health assessment. Hierarchical logistic regression modeling was used to assess the effects of multiple factors on having a past‐year dental visit. Predisposing variables included age, education, and knowledge toward preventing tooth decay. Enabling factors included medical insurance, place for medical care, and social support. Need measures included oral health problems and treatment.

Results

Only 20.5 percent of Hispanic migrant farmworkers reported a past‐year dental visit. More than one‐half (52.5 percent) needed oral health treatment and nearly two‐thirds (61.2 percent) stated that they perceived their mouth to be in poor condition. The final model indicated that those who reported preventing tooth decay by brushing and flossing, brushed their teeth once a day, and stated a good condition of their mouth were more likely to have had a past‐year dental visit.

Conclusions

Most Hispanic migrant farmworkers in south Florida have not had a past year dental visit. Similar to other ethnic minorities in the United States, migrant farmworkers experience poor oral health outcomes and have inadequate access to health‐care services.
Severe acute exacerbation of HCV infection in cancer patients who undergo chemotherapy without antiviral prophylaxis
Authors: Li Yuan‐Rung , Chen Wen‐Chi , Tsai Wei‐Lun , Cheng Jin‐Shiung , Tsay Feng‐Woei , Kao Sung‐Shuo , Chen Hui‐Chun , Hsu Ping‐I
Published: April 2020

No guidelines have been developed for the management of HCV‐infected cancer patients receiving chemotherapy. The current study aimed to investigate the incidence of severe acute exacerbation of HCV infection in cancer patients receiving chemotherapy and to search for risk factors predicting severe acute exacerbation of HCV infection. This retrospective cohort study reviewed the clinical data of the cancer patients receiving chemotherapy in our institute from August 2012 to December 2017. Incidences of severe acute exacerbation of HCV infection in different kinds of cancers were assessed, and risk factors were analysed. Cancer patients with HCV infection (n = 306) had a higher frequency of severe acute liver injury (2.3% vs 0.7%; P = .003) than those without HCV infection (n = 4419). The incidence of severe acute exacerbation in HCV‐infected haematological cancer patients was higher than that in those with HCC and non‐HCC solid tumours (9.4% vs 1.9% and 1.1%). Rituximab‐containing chemotherapy and haematological malignancy were the risk factors related to the acute exacerbation (P < .001 and P = .004, respectively). None of the patients with severe acute HCV flares developed hepatic decompensation or mortality. However, 57.1% of them discontinued chemotherapy due to liver dysfunction. In conclusion, HCV infection increases the risk of acute severe liver injury in cancer patients undergoing chemotherapy. Rituximab‐containing chemotherapy and haematological malignancy are the risk factors related to severe acute exacerbation of HCV infection in cancer patients undergoing chemotherapy. Pre‐chemotherapy HCV testing is therefore mandatory before rituximab‐containing chemotherapy for the treatment of haematological malignancy.
The role of hepatitis C virus genotypes and core mutations in hepatocellular carcinoma in Cameroon
Authors: Amougou‐Atsama Marie , Jean Adrien Atangana Paul , Noah Noah Dominique , Fewou Moundipa Paul , Pineau Pascal , Njouom Richard
Published: April 2020

Background

Hepatitis C virus (HCV) infection is known to be an important risk factor for hepatocellular carcinoma (HCC) in Cameroon. However, the effect of HCV‐related factors on HCC development still remains unknown in the Central Africa. In this study, we investigated the role of HCV genotypes and core mutations in HCC development in Cameroonian patients.

Methods

A case‐control study was conducted using patients with HCV‐related HCC and matched controls individuals with chronic HCV infection but without HCC. HCV genotypes and mutations were determined using a hemi‐nested amplification and sequencing analysis focus on the core and NS5B HCV regions.

Results

We identify HCV genotype 1, 2 and 4 in both groups. Interestingly, genotype 4 was significantly more prevalent in HCC patients (53.3%). Overall, distribution of genotypes was very different between cases and controls (P = 4.2 E‐7). The risk factors analysis showed that infection with HCV‐4 is strongly associated with HCC development with odd ratio, 95% confidence interval and p‐values of 7.4 (95% CI: 2.08‐26.6; P = .001). Furthermore, the risk of developing HCC increased even more significantly in case of infection with HCV subtype 4f with the odd ratio of 20.8 (95% CI, 4.1‐66.8; P < .001). Mutations K10R, T72E, K74R and G77A were significantly more frequent in patients with HCC. Remarkably, HCV‐4f isolates from HCC patients carried significantly more mutations when compared to controls with HCV‐4f or others genotypes (P = .0001).

Conclusions

Our results indicate that patients infected with HCV‐4f or with selected variants affecting HCV core gene are at increased risk to develop HCC.
Longitudinal analysis of serum microRNAs as predictors of cirrhosis regression during treatment of hepatitis B virus infection
Authors: Orr Cody , Myers Rob , Li Biao , Jiang Zhaoshi , Flaherty John , Gaggar Anuj , Meissner Eric G.
Published: April 2020

Background and Aims

Most patients with cirrhosis induced by chronic HBV infection experience fibrosis regression after long‐term antiviral treatment, while some remain cirrhotic. Fibrosis regression is associated with lower odds of developing hepatic decompensation and hepatocellular carcinoma, but mechanisms impacting differential fibrosis regression between individuals are unclear. We asked whether soluble molecules, including serum microRNAs, could serve as biomarkers of fibrosis regression.

Methods

We analysed cryopreserved sera from clinical trials in which cirrhotic HBV‐infected patients (baseline Ishak fibrosis score of 5‐6) received 240 weeks of nucleotide analogue treatment. Liver biopsies at week 240 in these trials showed 71/96 patients (74%) had fibrosis regression (Ishak ≤ 4) while 25/96 (26%) remained cirrhotic (Ishak 5‐6). We quantified inflammatory markers (CXCL10, soluble CD163) and miRNAs (n = 179) from serum at baseline, week 48 and week 240 of treatment in a sub‐cohort of patients with (n = 14) or without (n = 14) fibrosis regression.

Results

CXCL10, sCD163 and miRNAs previously associated with HBV replication and inflammation decreased during treatment but did not differ based on fibrosis regression. Two miRNAs (miR‐421 and miR‐454‐3p) had lower baseline expression in patients with subsequent fibrosis regression. In all, 27 miRNAs differed at week 240 and had higher expression in patients with fibrosis regression (eg miR‐199a‐3p, miR‐423‐3p, miR‐142‐3p, miR‐let‐7d‐5p). Several miRNAs (miR‐141‐3p, let‐7d‐5p) that correlated with regression have previously been implicated in the pathophysiology of non‐alcoholic steatohepatitis.

Conclusions

In cirrhotic patients with chronic HBV infection treated with antiviral therapy, serum miRNAs have differential expression based on fibrosis regression, suggesting potential utility as biomarkers.
What's in a name? Renaming ‘NAFLD’ to ‘MAFLD’
Authors: Fouad Yasser , Waked Imam , Bollipo Steven , Gomaa Ahmed , Ajlouni Yousef , Attia Dina
Published: April 2020

In medicine, language matters and the words used to name and describe a disease can have a profound impact on patients and their families. Over the last two decades, many criticisms have been voiced about the nomenclature and definition of non‐alcoholic fatty liver disease (NAFLD) in regards not only to the prominent role that alcohol plays in the definition but also on the negative impacts of the nomenclature including trivialization, stigmatization and less consideration of the disease in health policy. Recently, a consensus of international experts proposed that the disease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or ‘MAFLD’. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery. Here we review the history of, and definitions of MAFLD in the context of advancing our understanding of the pathogenesis of the disease. We also address the reasons, signals, promises, challenges and the way going forward from the name change from various stakeholder perspectives.
Reading Aloud Narrative Material as a Means for the Student's Cognitive Empowerment
Authors: Bartolucci Marco , Batini Federico
Published: April 2020

Listening to stories and brain processing of narrative material activates many areas devoted not only to the linguistic processing. In this sense, it could be hypothesized that if this activity would be integrated within the school curricula, it could bring benefits in terms of understanding the text as well as in basic essential cognitive dimensions. In a series of studies with different age groups, we investigated the effects of an intensive training in narrative listening, through different tools such as the standardized tests of understanding of the text. We also used a neuropsychological battery investigating basic cognitive processes (cognitive assessment system) that are directly related to the ability of text comprehension. Results show a significant improvement in all tests for all age groups in the experimental groups, in comparison with the control groups.
Association between prenatal depressive symptoms and eczema in infants: The Born in Guangzhou Cohort Study
Authors: Wei Dongmei , Au Yeung Shiu Lun , Lu Minshan , Xiao Wanqing , Lu Jinhua , Shen Songying , Lam Kin Bong Hubert , Qiu Xiu
Published: April 2020

Background

Eczema is a growing threat on infants’ health, and the role of maternal depression in the risk of eczema's early onset is unclear. This study aimed to examine the associations of different exposure timing of prenatal depressive symptoms with offspring's eczema in infancy.

Methods

The study was part of the ongoing prospective Born in Guangzhou Cohort Study. Maternal depressive symptoms were assessed at both early (<20th week of gestation) and late pregnancy (≥33rd week of gestation to delivery) using the Self‐Rating Depression Scale. Information on the diagnosis of eczema was collected when the children were 1 year old. Multivariable logistic regression was used to examine the association between prenatal depressive symptoms and infants’ eczema and test for moderation by parental history of allergic diseases.

Results

In this population, 7.7% (447/5825) of mothers experienced persistent depressive symptoms during pregnancy, 10.1% (590/5825) had depressive symptoms only at early pregnancy, and 8.4% (489/5825) of women experienced depressive symptoms only at late pregnancy. After adjusting for potential confounders, higher risks of eczema were observed in infants of mothers with persistent prenatal depressive symptoms when compared to those children without maternal depressive symptoms throughout pregnancy (OR: 1.55, 95% CI 1.19‐2.03). These associations were marginally more pronounced among children in families without parents affected by allergic diseases than in other families (P for interaction = .064 for courses of prenatal depressive symptoms).

Conclusion

Persistent maternal depressive symptoms during pregnancy increased the risk of infants’ eczema, especially in children without family history of allergic diseases. These associations, if proved to be causal, could be an intervention target not only to improve women's health but also to prevent offspring's eczema.
The case of missing skin: Congenital Volkmann ischemic contracture
Authors: Coerdt Kathleen M. , Guo Emily L. , Saardi Karl M. , Habeshian Kaiane A.
Published: April 2020

Congenital Volkmann ischemic contracture (CVIC) is an exceedingly rare neonatal compartment syndrome caused by intrauterine ischemia and external compression. It presents at birth with necrotic cutaneous lesions and neurologic impairment, typically in a distal upper extremity. Diagnosis and treatment are often delayed in neonates, leading to long‐term neurologic sequelae. We present a rare case of CVIC in order to raise awareness of its presentation and management in hopes of improving outcomes.
Encouraging and enabling action research in innovation management
Authors: Guertler Matthias R. , Kriz Anton , Sick Nathalie
Published: April 2020

Although action research offers great advantages of connecting academia and practice, it is surprisingly underutilised in innovation management. This paper, therefore, focuses on how innovation management research and researchers can more effectively and efficiently apply action research to their domain. The analysis commences with the rationale for aligning action research and innovation management before assessing the strengths and limitations of existing interdisciplinary action research approaches from an innovation management perspective. Combining and enhancing the strengths of these approaches, a new Action Innovation Management Research (AIM‐R) framework is developed to assist in resolving the increasing demand for action‐orientation in innovation management. AIM‐R offers a structured research process for systematically applying action research as a way of encouraging rigorous research processes, while also importantly stimulating relevant practical outcomes. AIM‐R specifically considers different change levels (individual, team, organisational) and objects (e.g. outcome, process, capability) critical for the multi‐faceted character of innovation management. A real‐world example towards the end of the article illustrates how AIM‐R has been applied to a complex problem‐solution space. This example adds important insights for readers wanting to apply this more engaged, but currently underutilised, innovation management research technique.
New Income Comparisons for the late Nineteenth and Early Twentieth Century
Authors: Ward Marianne , Devereux John
Published: April 2020

We provide current price GDP comparisons covering 13 Western economies for 1872 and 1910. The current price measures compare income with the prices of the comparison year rather than the fixed recent prices of earlier approaches. Our work fills a gap in the literature since current price GDP comparisons generally do not reach before 1950. As it turns out, the current price results differ from the familiar Maddison projections in constant 1990 prices as they raise relative income for the U.S. and Canada while they lower income for Belgium, the Netherlands, Switzerland and the U.K.
Local Food and Civic Engagement: Do Farmers Who Market Local Food Feel More Responsible for Their Communities?
Authors: Schoolman Ethan D.
Published: April 2020

Do farmers who participate in local food systems attach greater importance to civic engagement than farmers whose livelihood is not tied to the vitality of local markets? The literature on local food as a social movement continues to paint a picture of local food systems as contributing to, and benefiting from, rich networks of civil society groups. Yet to date, few studies have directly addressed the question of whether marketing local food is actually associated with higher levels of civic engagement among farmers. In this paper, I draw on local capitalism theory to identify two different mechanisms—depth of economic reliance on local markets, and breadth of social networks related to local food sales—that might spur farmers who market local food to feel more responsible for their communities. Then, using data from a large‐scale survey of specialty crop growers, I explore whether a relationship exists between farmer involvement with local food markets and attitudes toward civic engagement. Results suggest that while farmers strongly committed to local food markets attach greater importance to civic engagement, participation in multiple categories or kinds of local food supply chains is not necessarily associated with stronger civic values.