bluuebunny/crossref_metadata_2025 huggingface dataset:
Noisy neighbours among the selfish herd: a critical song distance mediates mate recognition within cicada emergences (Hemiptera: Cicadidae)
Authors: Chatfield-Taylor Will , Cole Jeffrey A
Published: August 2019

Cicadas probably experience mate recognition challenges as a result of the densities that may occur during adult emergence events, and in Okanagana, the most speciose genus of North American cicadas, high alpha diversities during protoperiodical emergences will exacerbate the mate recognition problem. Using 227 songs from 23 taxa, a linear plateau model regressed recognition potential, estimated from linear discriminant analysis, against song distance, revealing a critical song distance of 0.728 standard deviations in z-transformed song parameter space accompanied by a recognition of 91.6%. Based on detailed examination of museum specimen localities, field observations and habitat, taxa were classified as sympatric or allopatric. Sympatric species were separated by song distances that were significantly greater than this critical distance. As expected for mate recognition characters, little within-species variance was observed in the songs of most species, and the relationship between increases in syllable rate and improved recognition was one of diminishing returns. For several taxa that sang with extreme syllable rates of high variance, a mate recognition – sexual selection continuum is proposed. Along this continuum rapid rates simultaneously prevent mate recognition errors while signalling male quality to females.
Targeting mitochondrial dysfunction in amyotrophic lateral sclerosis: a systematic review and meta-analysis
Authors: Mehta Arpan R , Walters Rachel , Waldron Fergal M , Pal Suvankar , Selvaraj Bhuvaneish T , Macleod Malcolm R , Hardingham Giles E , Chandran Siddharthan , Gregory Jenna M
Published: August 2019

Interventions targeting mitochondrial dysfunction have the potential to extend survival in preclinical models of amyotrophic lateral sclerosis. The aim of this systematic review was to assess the efficacy of targeting mitochondria as a potential therapeutic target in amyotrophic lateral sclerosis. Preclinical studies written in the English language were identified with no restrictions on publication date from PubMed, Medline and EMBASE databases. All studies adopting interventions targeting mitochondria to treat amyotrophic lateral sclerosis in genetic or drug-induced organism models were considered for inclusion. A total of 76 studies were included in the analysis. Survival data were extracted, and the meta-analysis was completed in RevMan 5 software. We show that targeting mitochondrial dysfunction in amyotrophic lateral sclerosis results in a statistically significant improvement in survival (Z = 5.31; P < 0.00001). The timing of administration of the intervention appears to affect the improvement in survival, with the greatest benefit occurring for interventions given prior to disease onset. Interventions at other time points were not significant, although this is likely to be secondary to a lack of publications examining these timepoints. The quality score had no impact on efficacy, and publication bias revealed an overestimation of the effect size, owing to one outlier study; excluding this led to the recalculated effect size changing from 5.31 to 3.31 (P < 0.00001). The extant preclinical literature indicates that targeting mitochondrial dysfunction may prolong survival in amyotrophic lateral sclerosis, particularly if the intervention is administered early. A limitation of current research is a significant bias towards models based on superoxide dismutase 1, with uncertainty about generalisability to amyotrophic lateral sclerosis with an underlying TAR DNA binding protein 43 proteinopathy. However, further mechanistic research is clearly warranted in this field.
ExhibitingItalianità: Anna Magnani and Sophia Loren asMadri della Patria
Authors: Khrebtan-Hörhager Julia , Burgchardt Carl
Published: August 2019

In this essay, we analyze how the temporary photographic exhibits of Anna Magnani and Sophia Loren served as artifacts of creating, circulating, and negotiating italianità: the essence of Italian culture and national identity. The photography exhibits in Rome and Sorrento anchor our study, but in order to understand more fully how they invite or reinforce cultural meaning, we evaluated these works in their larger architectural, regional, and urban contexts. We conclude that the exhibits communicate contrasting versions of italianità in order to subvert patriarchic tendencies in society, withstand globalization, challenge pan-European transnationalism, and create a strong sense of shared, yet diverse, identity by Italians, as well as manifest national pride to the visitors of the Belpaese.
The world in Auerbach’s mouth: Weltliteratur after philhellenism
Authors: Umachandran Mathura
Published: August 2019

We live in an age of globalized and globalizing phenomena: the contemporary agenda of academic inquiry takes in ‘networks’, ‘connectivity’, and other modes of articulating complex structures of human activity. In Comparative Literature and beyond, the idea of world literature has borne the weight of idealist intercultural understanding, the hopes of translation studies, and the anxieties around the failure of communication. Erich Auerbach offers a touchstone in the conceptual genealogy of world literature (Weltliteratur). This article illuminates how Auerbach’s Weltliteratur is predicated on a polemic with German philhellenism, tracked through Auerbach’s declaration that his idea is ‘ungoethisch’. Auerbach’s revisions to Weltliteratur constituted a strategy to render it a historicist concept. Since Auerbach’s notion of historicism was itself derived from nineteenth-century German humanism, this essay argues that Auerbach was attempting to go with Goethe beyond Goethe. Finally, this essay assesses how successful Auerbach’s decoupling of Weltliteratur from universalism, under the sign of Goethe and the Greeks. I suggest that Weltliteratur is still a pertinent concept today because of Auerbach’s intervention to install historicist and dialectical resources therein.
A case report of unusual clinical features of a spontaneous coronary artery rupture: pathologic findings in the rupture site
Authors: Fujimoto Daichi , Takami Mitsuru , Kozuki Amane , Shite Junya
Published: August 2019

Background

Spontaneous coronary artery rupture (SCAR) is an extremely rare but life-threatening state. The aetiology and the pathologic findings remain to be fully elucidated.

Case summary

A 62-year-old woman, who had been on haemodialysis for 27 years, presented with chest discomfort worsening on deep inspiration that had been ongoing for the past 2 weeks. An echocardiogram and computed tomography showed diffuse pericardial fluid. ST elevation in the broad leads, especially in leads I, II, and aVF, and increased C-reactive peptide and Troponin I levels suggested pericarditis. The patient initially had a stable course with no medications. The chest symptoms disappeared and her vital signs were stable. On Day 13 after admission, however, she had a sudden cardiopulmonary arrest due to a cardiac tamponade. An emergency coronary angiography showed extravasation of the contrast into the epicardium from the branch of the circumflex artery. She was diagnosed with SCAR and underwent a successful coil embolization. However, she went into an irreversible coma due to the cerebral hypoxia. On Day 33, she died of pneumonia. An autopsy showed a rupture of the internal elastic layer of the coronary artery. However, no specific findings, such as aneurysm and dissection, were evident. The common atherosclerotic changes were observed.

Discussion

The stable condition lasting for over 2 weeks was a rare clinical course for SCAR. Long-term hypertension and dialysis would have caused the rupture of the coronary artery with common atherosclerotic changes. We should consider SCAR as one of the differential diagnoses when we observe pericardial fluid.
Seismic signal recognition by unsupervised machine learning
Authors: Huang Weilin
Published: August 2019

Seismic signal recognition can serve as a powerful auxiliary tool for analysing and processing ever-larger volumes of seismic data. It can facilitate many subsequent procedures such as first-break picking, statics correction, denoising, signal detection, events tracking, structural interpretation, inversion and imaging. In this study, I propose an automatic technique of seismic signal recognition taking advantage of unsupervised machine learning. In the proposed technique, seismic signal recognition is considered as a problem of clustering data points. All the seismic sampling points in time domain are clustered into two clusters, that is, signal or non-signal. The hierarchical clustering algorithm is used to group these sampling points. Four attributes, that is, two short-term-average-to-long-term-average ratios, variance and envelope are investigated in the clustering process. In addition, to quantitatively evaluate the performance of seismic signal recognition properly, I propose two new statistical indicators, namely, the rate between the total energies of original and recognized signals (RTE), and the rate between the average energies of original and recognized signals (RAE). A large number of numerical experiments show that when the signal is slightly corrupted by noise, the proposed technique performs very well, with recognizing accuracy, precision and RTE of nearly 1 (i.e. 100 per cent), recall greater than 0.8 and RAE about 1–1.3. When the signal is moderately corrupted by noise, the proposed technique can hold recognizing accuracy about 0.9, recognizing precision nearly to 1, RTE about 0.9, recall around 0.6 and RAE about 1.5. Applications of the proposed technique to real microseismic data induced from hydraulic fracturing and reflection seismic data demonstrate its feasibility and encouraging prospect.
Genetic Diversity, Population Structure, and Migration Scenarios of the Marsupial “Monito del Monte” in South-Central Chile
Authors: Valladares-Gómez Alejandro , Celis-Diez Juan L , Sepúlveda-Rodríguez Constanza , Inostroza-Michael Oscar , Hernández Cristián E , Palma R Eduardo
Published: August 2019

In this study, we quantified the 3 pivotal genetic processes (i.e., genetic diversity, spatial genetic structuring, and migration) necessary for a better biological understanding and management of the singular “living-fossil” and near-threatened mouse opossum marsupial Dromiciops gliroides, the “Monito del Monte,” in south-central Chile. We used 11 microsatellite loci to genotype 47 individuals distributed on the mainland and northern Chiloé Island. Allelic richness, observed and expected heterozygosity, inbreeding coefficient, and levels of genetic differentiation were estimated. The genetic structure was assessed based on Bayesian clustering methods. In addition, potential migration scenarios were evaluated based on a coalescent theory framework and Bayesian approach to parameter estimations. Microsatellites revealed moderate to high levels of genetic diversity across sampled localities. Moreover, such molecular markers suggested that at least 2 consistent genetic clusters could be identified along the D. gliroides distribution (“Northern” and “Southern” cluster). However, general levels of genetic differentiation observed among localities and between the 2 genetic clusters were relatively low. Migration analyses showed that the most likely routes of migration of D. gliroides occurred 1) from the Southern cluster to the Northern cluster and 2) from the Mainland to Chiloé Island. Our results could represent critical information for future conservation programs and for a recent proposal about the taxonomic status of this unique mouse opossum marsupial.
Long-term lichen trends in a rust belt region
Authors: Warren Robert J , Casterline Shannon , Goodman Madeson , Kocher Megan , Zaluski Rachel , Battaglia Jim H
Published: August 2019

Deindustrialization and national air pollution standards greatly reduced air pollution in the USA since the mid-20th century, particularly in the ‘rust belt’ industrial cities of the Great Lakes and Northeastern regions. Still, sprawling urbanization, vehicular traffic and coal-fired power plants may maintain regional heat islands and NOx and SO2 pollution. Lichens are one of the first, and longest used, bioindicators of urban heat island effects and atmospheric pollution, but there are few long-term studies of lichen bioindications. We examined herbaria records for lichens collected between 1869 and 2016 in the Western New York (WNY) region (USA). We hypothesized a long-term trend of increasing pollution-sensitive lichens in the region as well as increased desiccation-tolerant species from urban heat island effects. We also evaluated local (urban and tree land use cover) and regional (ecological zones) influences on pollution-sensitive and desiccation-tolerant lichens. We found that the WNY lichen communities appear to be shaped by urbanization with desiccation- and pollution-tolerant species dominating areas adjacent to the urbanized/industrialized core, and direct local effects of the urban heat island and vehicle traffic within the urban core. These results suggest that despite deindustrialization and tighter air quality standards, an industrial imprint remains on the lichen communities of WNY. However, despite urban filtering toward desiccation- and pollution-tolerant lichen species, the urban landscape contributed unique lichen species to the region, increasing WNY’s overall lichen biodiversity as much as the relatively pristine Allegheny Plateau. Hence, the urbanized areas of WNY contribute unique species to the regional lichen flora.
KSHV RNA-binding protein ORF57 inhibits P-body formation to promote viral multiplication by interaction with Ago2 and GW182
Authors: Sharma Nishi R , Majerciak Vladimir , Kruhlak Michael J , Yu Lulu , Kang Jeong Gu , Yang Acong , Gu Shuo , Fritzler Marvin J , Zheng Zhi-Ming
Published: August 2019

Cellular non-membranous RNA-granules, P-bodies (RNA processing bodies, PB) and stress granules (SG), are important components of the innate immune response to virus invasion. Mechanisms governing how a virus modulates PB formation remain elusive. Here, we report the important roles of GW182 and DDX6, but not Dicer, Ago2 and DCP1A, in PB formation, and that Kaposi’s sarcoma-associated herpesvirus (KSHV) lytic infection reduces PB formation through several specific interactions with viral RNA-binding protein ORF57. The wild-type ORF57, but not its N-terminal dysfunctional mutant, inhibits PB formation by interacting with the N-terminal GW-domain of GW182 and the N-terminal domain of Ago2, two major components of PB. KSHV ORF57 also induces nuclear Ago2 speckles. Homologous HSV-1 ICP27, but not EBV EB2, shares this conserved inhibitory function with KSHV ORF57. By using time-lapse confocal microscopy of HeLa cells co-expressing GFP-tagged GW182, we demonstrated that viral ORF57 inhibits primarily the scaffolding of GW182 at the initial stage of PB formation. Consistently, KSHV-infected iSLK/Bac16 cells with reduced GW182 expression produced far fewer PB and SG, but 100-fold higher titer of infectious KSHV virions when compared to cells with normal GW182 expression. Altogether, our data provide the first evidence that a DNA virus evades host innate immunity by encoding an RNA-binding protein that promotes its replication by blocking PB formation.
TrmB, a tRNA m7G46 methyltransferase, plays a role in hydrogen peroxide resistance and positively modulates the translation of katA and katB mRNAs in Pseudomonas aeruginosa
Authors: Thongdee Narumon , Jaroensuk Juthamas , Atichartpongkul Sopapan , Chittrakanwong Jurairat , Chooyoung Kamonchanok , Srimahaeak Thanyaporn , Chaiyen Pimchai , Vattanaviboon Paiboon , Mongkolsuk Skorn , Fuangthong Mayuree
Published: August 2019

Cellular response to oxidative stress is a crucial mechanism that promotes the survival of Pseudomonas aeruginosa during infection. However, the translational regulation of oxidative stress response remains largely unknown. Here, we reveal a tRNA modification-mediated translational response to H2O2 in P. aeruginosa. We demonstrated that the P. aeruginosa trmB gene encodes a tRNA guanine (46)-N7-methyltransferase that catalyzes the formation of m7G46 in the tRNA variable loop. Twenty-three tRNA substrates of TrmB with a guanosine residue at position 46 were identified, including 11 novel tRNA substrates. We showed that loss of trmB had a strong negative effect on the translation of Phe- and Asp-enriched mRNAs. The trmB-mediated m7G modification modulated the expression of the catalase genes katA and katB, which are enriched with Phe/Asp codons at the translational level. In response to H2O2 exposure, the level of m7G modification increased, consistent with the increased translation efficiency of Phe- and Asp-enriched mRNAs. Inactivation of trmB led to decreased KatA and KatB protein abundance and decreased catalase activity, resulting in H2O2-sensitive phenotype. Taken together, our observations reveal a novel role of m7G46 tRNA modification in oxidative stress response through translational regulation of Phe- and Asp-enriched genes, such as katA and katB.
The autoregulator Aca2 mediates anti-CRISPR repression
Authors: Birkholz Nils , Fagerlund Robert D , Smith Leah M , Jackson Simon A , Fineran Peter C
Published: August 2019

CRISPR-Cas systems are widespread bacterial adaptive defence mechanisms that provide protection against bacteriophages. In response, phages have evolved anti-CRISPR proteins that inactivate CRISPR-Cas systems of their hosts, enabling successful infection. Anti-CRISPR genes are frequently found in operons with genes encoding putative transcriptional regulators. The role, if any, of these anti-CRISPR-associated (aca) genes in anti-CRISPR regulation is unclear. Here, we show that Aca2, encoded by the Pectobacterium carotovorum temperate phage ZF40, is an autoregulator that represses the anti-CRISPR–aca2 operon. Aca2 is a helix-turn-helix domain protein that forms a homodimer and interacts with two inverted repeats in the anti-CRISPR promoter. The inverted repeats are similar in sequence but differ in their Aca2 affinity, and we propose that they have evolved to fine-tune, and downregulate, anti-CRISPR production at different stages of the phage life cycle. Specific, high-affinity binding of Aca2 to the first inverted repeat blocks the promoter and induces DNA bending. The second inverted repeat only contributes to repression at high Aca2 concentrations in vivo, and no DNA binding was detectable in vitro. Our investigation reveals the mechanism by which an Aca protein regulates expression of its associated anti-CRISPR.
Estimating glomerular filtration rate in patients with acute kidney injury: a prospective multicenter study of diagnostic accuracy
Authors: Pelletier Karyne , Lafrance Jean-Philippe , Roy Louise , Charest Mathieu , Bélanger Marie-Claire , Cailhier Jean-François , Albert Martin , Duca Anatolie , Elftouh Naoual , Bouchard Josée
Published: August 2019

Background

Estimating glomerular filtration rate (GFR) in acute kidney injury (AKI) is challenging, with limited data comparing estimated and gold standard methods to assess GFR. The objective of our study was to assess the performance of the kinetic estimated GFR (KeGFR) and Jelliffe equations to estimate GFR in AKI, using a radioisotopic method (technetium-diethylenetriaminepentaacetic acid) as a reference measure.

Methods

We conducted a prospective multicenter observational study in hospitalized patients with AKI. We computed the Jelliffe and KeGFR equations to estimate GFR and compared these estimations to measured GFR (mGFR) by a radioisotopic method. The performances were assessed by correlation, Bland–Altman plots and smoothed and linear regressions. We conducted stratified analyses by age and chronic kidney disease (CKD).

Results

The study included 119 patients with AKI, mostly from the intensive care unit (63%) and with Stage 1 AKI (71%). The eGFR obtained from the Jelliffe and KeGFR equations showed a good correlation with mGFR (r = 0.73 and 0.68, respectively). The median eGFR by the Jelliffe and KeGFR equations was less than the median mGFR, indicating that these equations underestimated the mGFR. On Bland–Altman plots, the Jelliffe and KeGFR equations displayed a considerable lack of agreement with mGFR, with limits of agreement >40 mL/min/1.73 m2. Both equations performed better in CKD and the KeGFR performed better in older patients. Results were similar across AKI stages.

Conclusions

In our study, the Jelliffe and KeGFR equations had good correlations with mGFR; however, they had wide limits of agreement. Further studies are needed to optimize the prediction of mGFR with estimatation equations.
A Positive Feedback Loop Comprising LHW–TMO5 and Local Auxin Biosynthesis Regulates Initial Vascular Development in Arabidopsis Roots
Authors: Ohashi-Ito Kyoko , Iwamoto Kuninori , Nagashima Yoshinobu , Kojima Mikiko , Sakakibara Hitoshi , Fukuda Hiroo
Published: August 2019

The phytohormone auxin governs various developmental processes in plants including vascular formation. Auxin transport and biosynthesis are important factors in determining auxin distribution in tissues. Although the role of auxin transport in vein pattern formation is widely recognized, that of auxin biosynthesis in vascular development is poorly understood. Heterodimer complexes comprising two basic helix–loop–helix protein families, LONESOME HIGHWAY (LHW) and TARGET OF MONOPTEROS5 (TMO5)/TMO5-LIKE1 (T5L1), are master transcriptional regulators of the initial process of vascular development. The LHW–TMO5/T5L1 dimers regulate vascular initial cell production, vascular cell proliferation and xylem fate determination in the embryo and root apical meristem (RAM). In this study, we investigated the function of local auxin biosynthesis in initial vascular development in RAM. Results showed that LHW–T5L1 upregulated the expression of YUCCA4 (YUC4), a key auxin biosynthesis gene. The expression of YUC4 was essential for promoting xylem differentiation and vascular cell proliferation in RAM. Conversely, auxin biosynthesis was required for maintaining the expression levels of LHW, TMO5/T5L1 and their targets. Our results suggest that local auxin biosynthesis forms a positive feedback loop for fine-tuning the level of LHW–TMO5/T5L1, which is necessary for initiating vascular development.
In Vitro Enzymatic Activity Assays Implicate the Existence of the Chlorophyll Cycle in Chlorophyll b-Containing Cyanobacteria
Authors: Lim HyunSeok , Tanaka Ayumi , Tanaka Ryouichi , Ito Hisashi
Published: August 2019

In plants, chlorophyll (Chl) a and b are interconvertible by the action of three enzymes—chlorophyllide a oxygenase, Chl b reductase (CBR) and 7-hydroxymethyl chlorophyll a reductase (HCAR). These reactions are collectively referred to as the Chl cycle. In plants, this cyclic pathway ubiquitously exists and plays essential roles in acclimation to different light conditions at various developmental stages. By contrast, only a limited number of cyanobacteria species produce Chl b, and these include Prochlorococcus, Prochloron, Prochlorothrix and Acaryochloris. In this study, we investigated a possible existence of the Chl cycle in Chl b synthesizing cyanobacteria by testing in vitro enzymatic activities of CBR and HCAR homologs from Prochlorothrix hollandica and Acaryochloris RCC1774. All of these proteins show respective CBR and HCAR activity in vitro, indicating that both cyanobacteria possess the potential to complete the Chl cycle. It is also found that CBR and HCAR orthologs are distributed only in the Chl b-containing cyanobacteria that habitat shallow seas or freshwater, where light conditions change dynamically, whereas they are not found in Prochlorococcus species that usually habitat environments with fixed lighting. Taken together, our results implicate a possibility that the Chl cycle functions for light acclimation in Chl b-containing cyanobacteria.
Phylogeography of Neomysis americana (Crustacea, Mysida), focusing on the St. Lawrence system
Authors: Cortial GrÉgoire , Woodland Ryan , Lasley-Rasher Rachel , Winkler Gesche
Published: August 2019

Species characterized by low dispersal capacities, such as mysids, usually show evidence of genetic differentiation. Many mysids are broadly distributed and often show eurythermal and euryhaline traits. This study aimed to describe intraspecific genetic structure and the phylogeography of Neomysis americana, a key species of estuarine food webs in northwest Atlantic, using the mitochondrial cytochrome c oxidase subunit I gene. We sampled 26 populations across the St. Lawrence system (SLS) and two along the east coast of North America [Penobscot and Chesapeake Bay (CB)]. Sequencing of 420 individuals revealed three divergent (>3%) lineages (LA, LB, LC) across the sampling area suggesting that N. americana represents a cryptic species complex. The distribution of the lineages was geographically structured. LC occurred in the CB only, whereas LA and LB co-occurred along the SLS and Penobscot Bay. This suggests secondary contact after the last glacial maximum. In the SLS the lineage LA dominated the estuarine transition zone and the Gulf of St. Lawrence, whereas the lineage LB was prevalent in the lower St. Lawrence Estuary, potentially due to different eco-physiological preferences. These results might help to define reasonable entities for research and management.
Effectiveness of Deep Dry Needling vs Ischemic Compression in the Latent Myofascial Trigger Points of the Shortened Triceps Surae from Triathletes on Ankle Dorsiflexion, Dynamic, and Static Plantar Pressure Distribution: A Clinical Trial
Authors: Benito-de-Pedro María , Becerro-de-Bengoa-Vallejo Ricardo , Elena Losa-Iglesias Marta , Rodríguez-Sanz David , López-López Daniel , Palomo-López Patricia , Mazoteras-Pardo Victoria , Calvo-Lobo and César
Published: August 2019

Objective

To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability.

Design

A randomized simple blind clinical trial (NCT03273985).

Setting

An outpatient clinic.

Subjects

Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius.

Methods

Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment.

Results

There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment.

Conclusions

DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.
Homeless people and health: a qualitative enquiry into their practices and perceptions
Authors: Mc Conalogue Dave , Maunder Nicky , Areington Angelika , Martin Katherine , Clarke Vikki , Scott Sarah
Published: August 2019

Background

Homeless people experience poorer health and shorter life expectancies than the UK average, but their health needs and expectations have received little attention in research. This study aims to understand homeless people’s health perceptions and experiences.

Methods

Semi-structured interviews took place with 28 homeless people in Gloucestershire. The transcripts were thematically analysed drawing out key themes.

Results

Homelessness was often rooted in early trauma or an unstable family unit. Participants described poor support on leaving prison, termination of a cohabiting relationship or financial issues as factors precipitating homelessness. There was an expansive and positive understanding of health and its determinants. Mental health issues were common, often linked to traumatic life-events. Substance misuse issues were expressed as a mechanism to manage mental health issues. Participants were frustrated that this co-dependency was not recognized by support services. Participants’ living situation curtailed their ability to make health-enhancing choices, which was compounded by issues accessing mainstream healthcare services.

Conclusions

Mental health in homeless people must be recognized in the context of substance misuse and early trauma. Dealing with housing and addiction are critical to enable prioritisation of healthy behaviours. Healthcare services should recognize the chaotic nature of homeless people and their competing issues.
Mental wellbeing among people in prison in Scotland: an analysis of repeat cross-sectional surveys
Authors: Tweed Emily J , Gounari Xanthippi , Graham Lesley
Published: August 2019

Background

Mental wellbeing among people in prison is poorly studied, despite featuring in many health and justice policies. We aimed to describe for the first time mental wellbeing among an unselected national prison sample.

Methods

Since 2013, the Scottish Prisoner Survey—a biennial survey of people in custody in Scotland—has included the Warwick-Edinburgh mental wellbeing scale (WEMWBS), a 14-item scale with higher scores indicating greater wellbeing. We analysed data from sweeps in 2013 (n = 3158), 2015 (n = 2892) and 2017 (n = 2405) using Student’s t-test, ANOVA and multiple linear regression. We also used WEMWBS data from the Scottish Health Survey stratified by age, gender and deprivation to compare with the population at liberty.

Results

Mean WEMWBS scores overall were 43.4 in 2013 (SD = 12.2), 41.8 (SD = 11.9) in 2015 and 41.2 (SD = 12.3) in 2017. Mean scores were lower among people on remand and with multiple prison episodes. Age-standardized mean scores were lower among people in prison than their peers at liberty.

Conclusions

Poor mental wellbeing is an important, under-studied facet of the extreme health inequalities associated with imprisonment. These results identify that people on remand or with multiple episodes are particularly disadvantaged and provide a baseline for monitoring impacts of service or policy interventions.
Long-term outcomes in elderly patients with ANCA-associated vasculitis
Authors: McGovern Dominic , Williams Sam P , Parsons Katrina , Farrah Tariq E , Gallacher Peter J , Miller-Hodges Eve , Kluth David C , Hunter Robert W , Dhaun Neeraj
Published: August 2019

Objective

ANCA-associated vasculitis (AAV) is a small vessel vasculitis that commonly presents in the elderly. However, there are few long-term outcome data for these patients. Here, we assessed long-term outcomes in a single-centre cohort of elderly patients with AAV. Additionally, we tested whether a pre-morbid frailty score could aid prognosis.

Methods

Using a prospectively-compiled dataset, we investigated patients over the age of 65 who presented with AAV between 2005 and 2017 to a regional vasculitis centre. We used a Cox model to determine the factors associated with mortality. We also compared outcomes in pre-specified subgroups stratified by baseline frailty score, ANCA serotype and induction immunosuppression (with cyclophosphamide, rituximab or mycophenolate mofetil used as the main glucocorticoid-sparing agent).

Results

83 patients were included in the study and were followed for a median of 1203 days. Median age was 74 years (range 65–92). Two- and five-year survival in the overall cohort were 83% (95% CI 75, 92%) and 75% (95% CI 65, 86%), respectively. The median cumulative dose of oral prednisolone was 2030 mg during the first three months. Only one patient received intravenous glucocorticoids. Age, frailty score and CRP at presentation were independently associated with mortality; all deaths occurred in patients aged over 75 at presentation. Patients treated with a cyclophosphamide-based induction regimen tended to be younger than those treated with rituximab or mycophenolate mofetil. Survival was better in the cyclophosphamide-treated group.

Conclusion

In the contemporary era, the overall prognosis of AAV in elderly patients is good. Baseline frailty associates with disease outcomes including mortality. A low-dose glucocorticoid regimen (avoiding intravenous methylprednisolone) can be used to treat AAV effectively in elderly patients.
The performance of dual-energy CT in the classification criteria of gout: a prospective study in subjects with unclassified arthritis
Authors: Gamala Mihaela , Jacobs Johannes W G , Linn-Rasker Suzanne F , Nix Maarten , Heggelman Ben G F , Pasker-de Jong Pieternel C M , van Laar Jaap M , Klaasen Ruth
Published: August 2019

Objective

To establish the performance of (subsets of) the 2015 ACR/EULAR gout classification criteria in patients with unclassified arthritis, and to determine the value of dual-energy CT (DECT) herein. Reference was the MSU crystal detection result in SF at polarization microscopy.

Methods

We included subjects with acute, unclassified mono or oligoarthritis, who underwent SF analysis and DECT. Performance was assessed by calculating area under the receiver operating characteristic curve of (i) the clinical criteria subset, (ii) the clinical+serum urate subset and (iii) the full set (including DECT).

Results

Of the 89 subjects enrolled, 40 met the clinical+serum urate subset criteria, and 49 (55%) subjects did not. Of these 49, 30 had a negative microscopy result, of whom 15 had positive DECT; of these 15, 14 met the full set criteria only after adding the positive DECT result. For the clinical-only subset, the areas under the curves (AUCs) were 0.68 and 0.69 without and with DECT result, respectively, and for the clinical+serum urate subset without and with DECT, AUCs were 0.81 and 0.81, respectively (results not significant).

Conclusion

Adding the serum urate results to the clinical subset improves the performance, but adding the DECT result does not, neither does adding the DECT results to the clinical+serum urate subset. However, DECT seems to have an additive value in gout classification, especially when microscopy of SF is negative; 14/89 of patients (16%) only met the classification criteria with the use of DECT.

Trial registration

ClinicalTrials.gov, http://clinicaltrials.gov, NCT03038386.
Gender Attitudes in Africa: Liberal Egalitarianism Across 34 Countries
Authors: Charles Maria
Published: August 2019

This study provides a first descriptive mapping of support for women’s equal rights in 34 African countries and assesses diverse theoretical explanations for variability in this support. Contrary to stereotypes of a homogeneously tradition-bound continent, African citizens report high levels of agreement with gender equality that are more easily understood with reference to global processes of ideational diffusion than to country-level differences in economic modernization or women’s public-sphere roles. Multivariate analyses suggest, however, that gender liberalism in Africa may be spreading through mechanisms not typically considered by world-society scholars: Support for equal rights is largely unrelated to countries’ formal ties to the world system, but it is stronger among persons who are more exposed to extra-local culture, including through internet and mobile phone usage, news access, and urban residency. Forces for gender liberalism are conditioned, moreover, by local religious cultures and gender structures.
Regulation of BTB Dynamics in Spermatogenesis—Insights From the Adjudin Model
Authors: Mao Bai-Ping , Li Linxi , Yan Ming , Ge Renshan , Lian Qingquan , Cheng C Yan
Published: August 2019

During spermatogenesis, cell organelles, and germ cells, most notably haploid spermatids, are transported across the seminiferous epithelium so that fully developed spermatids line-up at the edge of the tubule lumen to undergo spermiation at stage VIII of the cycle. Studies have suggested that the microtubule (MT)-based cytoskeleton is necessary to support these cellular events. However, the regulatory molecule(s) and underlying mechanism(s) remain poorly understood. Herein, we sought to better understand this event by using an adjudin-based animal model. Adult rats were treated with adjudin at low-dose (10 mg/kg b.w.) which by itself had no notable effects on spermatogenesis. Rats were also treated with low-dose adjudin combined with overexpression of 2 endogenously produced blood-testis barrier (BTB) modifiers, namely rpS6 (ribosomal protein S6, the downstream signaling protein of mammalian target of rapamycin complex 1 [mTORC1]) and F5-peptide (a biological active peptide released from laminin-γ3 chain at the Sertoli-spermatid interface) versus the 2 BTB modifiers alone. Overexpression of these 2 BTB modifiers in the testis was shown to enhance delivery of adjudin to the testis, effectively inducing disruptive changes in MT cytoskeletons, causing truncation of MT conferred tracks that led to their collapse across the epithelium. The net result was massive germ cell exfoliation in the tubules, disrupting germ cell transport and cell adhesion across the seminiferous epithelium that led to aspermatogenesis. These changes were the result of disruptive spatial expression of several MT-based regulatory proteins. In summary, MT cytoskeleton supported by the network of MT regulatory proteins is crucial to maintain spermatogenesis.
A Comparison of Intracochlear Pressures During Ipsilateral and Contralateral Stimulation With a Bone Conduction Implant
Authors: Mattingly Jameson K. , Banakis Hartl Renee M. , Jenkins Herman A. , Tollin Daniel J. , Cass Stephen P. , Greene Nathaniel T.
Published: August 2019

Objectives:

To compare contralateral to ipsilateral stimulation with percutaneous and transcutaneous bone conduction implants.

Background:

Bone conduction implants (BCIs) effectively treat conductive and mixed hearing losses. In some cases, such as in single-sided deafness, the BCI is implanted contralateral to the remaining healthy ear in an attempt to restore some of the benefits provided by binaural hearing. While the benefit of contralateral stimulation has been shown in at least some patients, it is not clear what cues or mechanisms contribute to this function. Previous studies have investigated the motion of the ossicular chain, skull, and round window in response to bone vibration. Here, we extend those reports by reporting simultaneous measurements of cochlear promontory velocity and intracochlear pressures during bone conduction stimulation with two common BCI attachments, and directly compare ipsilateral to contralateral stimulation.

Methods:

Fresh–frozen whole human heads were prepared bilaterally with mastoidectomies. Intracochlear pressure (PIC) in the scala vestibuli (PSV) and tympani (PST) was measured with fiber optic pressure probes concurrently with cochlear promontory velocity (VProm) via laser Doppler vibrometry during stimulation provided with a closed-field loudspeaker or a BCI. Stimuli were pure tones between 120 and 10,240 Hz, and response magnitudes and phases forPICandVPromwere measured for air and bone conducted sound presentation.

Results:

Contralateral stimulation produced lower response magnitudes and longer delays than ipsilateral in all measures, particularly for high-frequency stimulation. Contralateral response magnitudes were lower than ipsilateral response magnitudes by up to 10 to 15 dB above ~2 kHz for a skin-penetrating abutment, which increased to 25 to 30 dB and extended to lower frequencies when applied with a transcutaneous (skin drive) attachment.

Conclusions:

Transcranial attenuation and delay suggest that ipsilateral stimulation will be dominant for frequencies over ~1 kHz, and that complex phase interactions will occur during bilateral or bimodal stimulation. These effects indicate a mechanism by which bilateral users could gain some bilateral advantage.
Lupus nephritis: challenges and progress
Authors: Davidson Anne , Aranow Cynthia , Mackay Meggan
Published: August 2019

Purpose of review

The management of lupus nephritis remains unsatisfactory due to insufficiently effective treatment regimens and the dearth of reliable predictors of disease onset or progression to guide individualized therapeutic decisions. This review summarizes new findings related to lupus nephritis over the last 18 months and discusses clinical needs that should be considered to advance trials of mechanism-based therapeutic strategies.

Recent findings

Collaborative teams are addressing how to improve disease definitions and are developing predictive models for disease onset, disease response and risk of flare in individual patients. More attention is being paid to clinical trial design. Advanced technologic approaches are allowing the analysis of small amounts of human tissue and urine in unprecedented detail so as to discover new pathogenic mechanisms and identify disease biomarkers. Novel therapies continue to be tested in disease models and include new strategies to protect renal tissue from cell damage and fibrosis.

The collaborative efforts of patients, clinical and translational researchers, the pharmaceutical industry and funding sources are needed to advance therapies for lupus nephritis. Specialized clinical centers can then deliver optimal and more personalized patient care that will improve patient outcomes.
Highlighting a Potential Pitfall: Positive Treponema pallidum Immunohistochemical Stain in a Patient Without Syphilis
Authors: Pettit Cory , McMurray Stacy , Randall Milton Barry , Jones Allison , Fisher Kristopher
Published: August 2019

The Treponema pallidum antibody immunohistochemical (IHC) stain has improved our ability to detect the organism histologically. We present a case of a man with genital condyloma acuminatum with a positive T. pallidum IHC stain but negative T. pallidum serologies and no syphilitic symptoms. It has been shown that the T. pallidum antibody IHC can cross-react, staining other spirochetes, including Borrelia burgdorferi and the Brachyspira family of intestinal spirochetes. Because of the proximity of our patient's lesions to the anus, and the persistently negative T. pallidum serologies, we believe nontreponemal spirochetes colonized the condyloma, giving a false-positive T. pallidum IHC. This cross-reactivity is a potential diagnostic pitfall and is important for the dermatopathologist to recognize, thereby avoiding false diagnosis of syphilis.
Reconstruction of the mandible for osteoradionecrosis
Authors: Haroun Kareem , Coblens Orly M.
Published: August 2019

Purpose of review

To describe current standard of care for osteoradionecrosis (ORN) of the mandible and report possible future trends.

Recent findings

Cutting guides may be used to reduce surgical time and possibly improve outcomes. There has also been recent investigation into the use of pentoxifylline and tocopherol or pentoxifylline, tocopherol and clodronate (a well known conservative medial regime) as a prevention for development of ORN after dental extractions and the first randomized controlled study is upcoming. Augmented reality has shown promise as a comparable and inexpensive possible alternative to cutting guides.

Current standard of care involves conservative/supportive therapy with antioxidants, antibiotics, steroids, and pain control for low-grade ORN with surgery reserved for high-grade/progressive ORN with refractory to conservative therapy and with significant oral dysfunction.
The Greater Omentum—A Vibrant and Enigmatic Immunologic Organ Involved in Injury and Infection Resolution
Authors: Wang Andrew W. , Prieto James M. , Cauvi David M. , Bickler Stephen W. , De Maio Antonio
Published: August 2019

Once thought of as an inert fatty tissue present only to provide insulation for the peritoneal cavity, the omentum is currently recognized as a vibrant immunologic organ with a complex structure uniquely suited for defense against pathogens and injury. The omentum is a source of resident inflammatory and stem cells available to participate in the local control of infection, wound healing, and tissue regeneration. It is intimately connected with the systemic vasculature and communicates with the central nervous system and the hypothalamic pituitary adrenal axis. Furthermore, the omentum has the ability to transit the peritoneal cavity and sequester areas of inflammation and injury. It contains functional, immunologic units commonly referred to as “milky spots” that contribute to the organ's immune response. These milky spots are complex nodules consisting of macrophages and interspersed lymphocytes, which are gateways for the infiltration of inflammatory cells into the peritoneal cavity in response to infection and injury. The omentum contains far greater complexity than is currently conceptualized in clinical practice and investigations directed at unlocking its beneficial potential may reveal new mechanisms underlying its vital functions and the secondary impact of omentectomy for the staging and treatment of a variety of diseases.
The Prognostic Impact of Primary Tumor Site Differs According to the KRAS Mutational Status
Authors: Margonis Georgios Antonios , Amini Neda , Buettner Stefan , Kim Yuhree , Wang Jaeyun , Andreatos Nikolaos , Wagner Doris , Sasaki Kazunari , Beer Andrea , Kamphues Carsten , Morioka Daisuke , Løes Inger Marie , Imai Katsunori , He Jin , Pawlik Timothy M. , Kaczirek Klaus , Poultsides George , Lønning Per Eystein , Burkhart Richard , Endo Itaru , Baba Hideo , Mischinger Hans Joerg , Aucejo Federico N. , Kreis Martin E. , Wolfgang Christopher L. , Weiss Matthew J.
Published: August 2019

Objective:

To examine the prognostic impact of tumor laterality in colon cancer liver metastases (CLM) after stratifying by Kirsten rat sarcoma 2 viral oncogene homolog (KRAS) mutational status.

Background:

Although some studies have demonstrated that patients with CLM from a right sided (RS) primary cancer fare worse, others have found equivocal outcomes of patients with CLM with RS versus left-sided (LS) primary tumors. Importantly, recent evidence from unresectable metastatic CRC suggests that tumor laterality impacts prognosis only in those with wild-type tumors.

Methods:

Patients with rectal or transverse colon tumors and those with unknown KRAS mutational status were excluded from analysis. The prognostic impact of RS versus LS primary CRC was determined after stratifying by KRAS mutational status.

Results:

277 patients had a RS (38.6%) and 441 (61.4%) had a LS tumor. Approximately one-third of tumors (28.1%) harbored KRAS mutations. In the entire cohort, RS was associated with worse 5-year overall survival (OS) compared with LS (39.4% vs 50.8%, P = 0.03) and remained significantly associated with worse OS in the multivariable analysis (hazard ratio 1.45, P = 0.04). In wild-type patients, a worse 5-year OS associated with a RS tumor was evident in univariable analysis (43.7% vs 55.5%, P = 0.02) and persisted in multivariable analysis (hazard ratio 1.49, P = 0.01). In contrast, among patients with KRAS mutated tumors, tumor laterality had no impact on 5-year OS, even in the univariable analysis (32.8% vs 34.0%, P = 0.38).

Conclusions:

This study demonstrated, for the first time, that the prognostic impact of primary tumor side differs according to KRAS mutational status. RS tumors were associated with worse survival only in patients with wild-type tumors.