bluuebunny/crossref_metadata_2025 huggingface dataset:
In Times of Trouble: A Framework for Understanding Consumers’ Responses to Threats
Authors: Campbell Margaret C , Inman J Jeffrey , Kirmani Amna , Price Linda L
Published: July 2020

The COVID-19 pandemic and the accompanying economic downturn have dramatically impacted the lives of consumers around the world. From a conceptual perspective, such health and economic threats can severely disrupt consumers’ sense of ontological security and elicit adaptive responses by both consumers and marketers. Given the opportune timing, this issue of the Journal of Consumer Research is focused on articles that address questions of consumers’ responses to external threats. The purpose of this introduction is to provide an organizing “conceptual tapestry” to connect the articles appearing in the issue. This framework is provided as a tool to help researchers structure their particular projects within the broader landscape of consumer threat response and to present some potential directions for future research. In conjunction with these articles, we hope that this conceptual framework will provide a point of departure for researchers seeking to enhance the understanding of how consumers and markets collectively respond over the short term and long term to threats that disrupt consumers’ routines, lives, or even the fabric of society.
Sharpening the Precision of Pest Management Decisions: Assessing Variability Inherent in Catch Number and Absolute Density Estimates Derived from Pheromone-Baited Traps Monitoring Insects Moving Randomly
Authors: Miller James R
Published: July 2020

During a trapping study interval, each target insect is either caught or not caught. Therefore, the current analysis treats trapping as a binomial process. Data from a binomial calculator, along with computer simulations of random walkers, documented that the inherent variance associated with estimates of absolute population density generated by a single catch number in a pheromone-baited monitoring trap becomes very high when catch probability averaged across the trap’s sampling area falls below 0.02, as is the case for most insect trapping systems operating in the open field. The imprecision associated with interpretations of single catch numbers renders many current pest management decisions risky and unsatisfactory. Here we reinforce how single-trap, multiple-release experiments can and should be used to measure catch probability, plume reach, and trap sampling area. When catch probability lies in the danger zone below 0.02, steps are suggested for how multiple traps might be deployed to raise composite catch probability to a level where estimates of absolute pest density become reliable. Heat transfer is offered as an appropriate conceptual model for the mechanics of trapping. A call is made for a radical rethinking in the designs of insect monitoring traps in light of their significant current deficits highlighted by this study.
Modeling endodermal organ development and diseases using human pluripotent stem cell-derived organoids
Authors: Pan Fong Cheng , Evans Todd , Chen Shuibing
Published: July 2020

Recent advances in development of protocols for directed differentiation from human pluripotent stem cells (hPSCs) to defined lineages, in combination with 3D organoid technology, have facilitated the generation of various endoderm-derived organoids for in vitro modeling of human gastrointestinal development and associated diseases. In this review, we discuss current state-of-the-art strategies for generating hPSC-derived endodermal organoids including stomach, liver, pancreatic, small intestine, and colonic organoids. We also review the advantages of using this system to model various human diseases and evaluate the shortcomings of this technology. Finally, we emphasize how other technologies, such as genome editing and bioengineering, can be incorporated into the 3D hPSC-organoid models to generate even more robust and powerful platforms for understanding human organ development and disease modeling.
Tumor organoids to study gastroesophageal cancer: a primer
Authors: Jin Ramon U , Mills Jason C
Published: July 2020

Gastroesophageal cancers are leading causes of cancer death. Our attempts at adopting molecularly based treatment approaches have been slow and ineffective even though we begin to identify specific targetable gene mutations and pathways. It is clear that we should no longer treat all gastroesophageal cancers as a homogeneous disease, which is what we do when we use non-specific chemotherapy. However, we currently cannot monitor successful gene/pathway targeting, nor understand how/when tumors develop resistance, nor predict which patients will derive maximal benefit. To improve outcomes, we must precisely detail the heterogeneity of these tumors to then individualize cancer therapy as well as develop novel avenues to study and predict treatment effects in individual patients. To this end, patient-derived organoids, in which tumor cells from individual patients are grown in a Petri dish, are a new versatile system that allows for timely expandability, detailed molecular characterization, and genetic manipulation with the promise of enabling predictive assessment of treatment response. In this review, we will explore the development and basic techniques for organoid generation, and discuss the current and potential future applications of this exciting technology to study the basic science of carcinogenesis and to predict/guide cancer patient care in the clinics.
Unexpected arteriovenous malformation of the thyroid resulting in significant intraoperative blood loss
Authors: Ajadi Ebunoluwa , Dueber Julie , Randle Reese W , Lee Cortney Y
Published: July 2020

A 49-year-old morbidly obese woman with metastatic endometrial carcinoma was referred for evaluation of an incidentally identified large right thyroid nodule found on computed tomography performed for cancer evaluation. Ultrasound revealed a 9.7 cm solid isoechoic homogeneous right thyroid nodule. Fine needle aspiration was benign. Given size, resection was recommended following completion of chemotherapy and radiation. At the time of right thyroid lobectomy, extremely large vessels were encountered, and the procedure was complicated by estimated blood loss of 2 L. Final pathology revealed a large, benign adenomatous nodule and vascular features consistent with arteriovenous malformation (AVM). Unlike previously reported cases, the diagnosis of a thyroid AVM was not known preoperatively.
Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility
Authors: Wilkes Sean , Ona Celia , Yang Michael , Liu Pingyang , Benton Amber , Lustik Michael , Coleman John
Published: July 2020

Introduction

Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment.

Materials and Methods

A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender.

Results

The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P < 0.001 15, 30, and 45 days after TMS treatment was initiated. Overall, 44% of patients experienced a reduction ≥10 points on BDI, and 38% experienced a reduction ≥10 points on PCL. Additionally, scores fell similarly regardless of whether or not patients had a comorbid diagnosis of PTSD.

Conclusions

Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications.
Clinical and functional characterization of CXCR1/CXCR2 biology in the relapse and radiotherapy resistance of primary PTEN-deficient prostate carcinoma
Authors: Armstrong Chris W D , Coulter Jonathan A , Ong Chee Wee , Maxwell Pamela J , Walker Steven , Butterworth Karl T , Lyubomska Oksana , Berlingeri Silvia , Gallagher Rebecca , O’Sullivan Joe M , Jain Suneil , Mills Ian G , Prise Kevin M , Bristow Robert G , LaBonte Melissa J , Waugh David J J
Published: July 2020

Functional impairment of the tumour suppressor PTEN is common in primary prostate cancer and has been linked to relapse post-radiotherapy (post-RT). Pre-clinical modelling supports elevated CXC chemokine signalling as a critical mediator of PTEN-depleted disease progression and therapeutic resistance. We assessed the correlation of PTEN deficiency with CXC chemokine signalling and its association with clinical outcomes. Gene expression analysis characterized a PTENLOW/CXCR1HIGH/CXCR2HIGH cluster of tumours that associates with earlier time to biochemical recurrence [hazard ratio (HR) 5.87 and 2.65, respectively] and development of systemic metastasis (HR 3.51). In vitro, CXCL signalling was further amplified following exposure of PTEN-deficient prostate cancer cell lines to ionizing radiation (IR). Inhibition of CXCR1/2 signalling in PTEN-depleted cell-based models increased IR sensitivity. In vivo, administration of a CXCR1/2-targeted pepducin (x1/2pal-i3), or CXCR2-specific antagonist (AZD5069), in combination with IR to PTEN-deficient xenografts attenuated tumour growth and progression compared to control or IR alone. Post-mortem analysis confirmed that x1/2pal-i3 administration attenuated IR-induced CXCL signalling and anti-apoptotic protein expression. Interventions targeting CXC chemokine signalling may provide an effective strategy to combine with RT in locally advanced prostate cancer patients with known presence of PTEN-deficient foci.
MinYS: mine your symbiont by targeted genome assembly in symbiotic communities
Authors: Guyomar Cervin , Delage Wesley , Legeai Fabrice , Mougel Christophe , Simon Jean-Christophe , Lemaitre Claire
Published: July 2020

Most metazoans are associated with symbionts. Characterizing the effect of a particular symbiont often requires getting access to its genome, which is usually done by sequencing the whole community. We present MinYS, a targeted assembly approach to assemble a particular genome of interest from such metagenomic data. First, taking advantage of a reference genome, a subset of the reads is assembled into a set of backbone contigs. Then, this draft assembly is completed using the whole metagenomic readset in a de novo manner. The resulting assembly is output as a genome graph, enabling different strains with potential structural variants coexisting in the sample to be distinguished. MinYS was applied to 50 pea aphid resequencing samples, with variable diversity in symbiont communities, in order to recover the genome sequence of its obligatory bacterial symbiont, Buchnera aphidicola. It was able to return high-quality assemblies (one contig assembly in 90% of the samples), even when using increasingly distant reference genomes, and to retrieve large structural variations in the samples. Because of its targeted essence, it outperformed standard metagenomic assemblers in terms of both time and assembly quality.
Brain-Responsive Neurostimulation for Loss of Control Eating: Early Feasibility Study
Authors: Wu Hemmings , Adler Sarah , Azagury Dan E , Bohon Cara , Safer Debra L , Barbosa Daniel A N , Bhati Mahendra T , Williams Nolan R , Dunn Laura B , Tass Peter A , Knutson Brian D , Yutsis Maya , Fraser Ayesha , Cunningham Tricia , Richardson Kara , Skarpaas Tara L , Tcheng Thomas K , Morrell Martha J , Roberts Laura Weiss , Malenka Robert C , Lock James D , Halpern Casey H
Published: July 2020

BACKGROUND

Loss of control (LOC) is a pervasive feature of binge eating, which contributes significantly to the growing epidemic of obesity; approximately 80 million US adults are obese. Brain-responsive neurostimulation guided by the delta band was previously found to block binge-eating behavior in mice. Following novel preclinical work and a human case study demonstrating an association between the delta band and reward anticipation, the US Food and Drug Administration approved an Investigational Device Exemption for a first-in-human study.

OBJECTIVE

To assess feasibility, safety, and nonfutility of brain-responsive neurostimulation for LOC eating in treatment-refractory obesity.

METHODS

This is a single-site, early feasibility study with a randomized, single-blinded, staggered-onset design. Six subjects will undergo bilateral brain-responsive neurostimulation of the nucleus accumbens for LOC eating using the RNS® System (NeuroPace Inc). Eligible participants must have treatment-refractory obesity with body mass index ≥ 45 kg/m2. Electrophysiological signals of LOC will be characterized using real-time recording capabilities coupled with synchronized video monitoring. Effects on other eating disorder pathology, mood, neuropsychological profile, metabolic syndrome, and nutrition will also be assessed.

EXPECTED OUTCOMES

Safety/feasibility of brain-responsive neurostimulation of the nucleus accumbens will be examined. The primary success criterion is a decrease of ≥1 LOC eating episode/week based on a 28-d average in ≥50% of subjects after 6 mo of responsive neurostimulation.

DISCUSSION

This study is the first to use brain-responsive neurostimulation for obesity; this approach represents a paradigm shift for intractable mental health disorders.
Spatial heterogeneity of cell-matrix adhesive forces predicts human glioblastoma migration
Authors: Rezk Rasha , Jia Bill Zong , Wendler Astrid , Dimov Ivan , Watts Colin , Markaki Athina E , Franze Kristian , Kabla Alexandre J
Published: July 2020

Background

Glioblastoma (GBM) is a highly aggressive incurable brain tumor. The main cause of mortality in GBM patients is the invasive rim of cells migrating away from the main tumor mass and invading healthy parts of the brain. Although the motion is driven by forces, our current understanding of the physical factors involved in glioma infiltration remains limited. This study aims to investigate the adhesion properties within and between patients’ tumors on a cellular level and test whether these properties correlate with cell migration.

Methods

Six tissue samples were taken from spatially separated sections during 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery. Navigated biopsy samples were collected from strongly fluorescent tumor cores, a weak fluorescent tumor rim, and nonfluorescent tumor margins. A microfluidics device was built to induce controlled shear forces to detach cells from monolayer cultures. Cells were cultured on low modulus polydimethylsiloxane representative of the stiffness of brain tissue. Cell migration and morphology were then obtained using time-lapse microscopy.

Results

GBM cell populations from different tumor fractions of the same patient exhibited different migratory and adhesive behaviors. These differences were associated with sampling location and amount of 5-ALA fluorescence. Cells derived from weak- and nonfluorescent tumor tissue were smaller, adhered less well, and migrated quicker than cells derived from strongly fluorescent tumor mass.

Conclusions

GBM tumors are biomechanically heterogeneous. Selecting multiple populations and broad location sampling are therefore important to consider for drug testing.
Drugs for Gram-Negative Bugs From 2010–2019: A Decade in Review
Authors: Pontefract Benjamin A , Ho Hong T , Crain Alexandria , Kharel Madan K , Nybo S Eric
Published: July 2020

A literature review spanning January 1, 2010, to December 31, 2019, was conducted using the PubMed and ISI Web of Science databases to determine the breadth of publication activity in the area of gram-negative bacteria antimicrobial therapy. The number of articles was used as a reflection of scholarly activity. First, PubMed was searched using the following Medical Subject Headings (MeSH): antibacterial agents, Enterobacteriaceae, Acinetobacter, and Pseudomonas. A total of 12 643 articles were identified within PubMed, and 77 862 articles were identified within ISI Web of Science that included these terms. Second, these articles were categorized by antibiotic class to identify relative contributions to the literature by drug category. Third, these studies were used to identify key trends in the treatment of gram-negative bacterial infections from the past decade. This review highlights advances made in the past 10 years in antibacterial pharmacotherapy and some of the challenges that await the next decade of practice.
Weak-lensing clusters from HSC survey first-year data: Mitigating the dilution effect of foreground and cluster-member galaxies
Authors: Hamana Takashi , Shirasaki Masato , Lin Yen-Ting
Published: July 2020

We present a weak-lensing cluster search using Hyper Suprime-Cam Subaru Strategic Program (HSC survey) first-year data. We pay special attention to the dilution effect of cluster-member and foreground galaxies on weak-lensing signals from clusters of galaxies; we adopt the globally normalized weak-lensing estimator which is least affected by cluster-member galaxies, and we select source galaxies by using photometric redshift information to mitigate the effect of foreground galaxies. We produce six samples of source galaxies with different low-z galaxy cuts, construct weak-lensing mass maps for each source sample, and search for high peaks in the mass maps that cover an effective survey area of ∼120 deg2. We combine six catalogs of high peaks into a sample of cluster candidates which contains 124 high peaks with signal-to-noise ratios greater than five. We cross-match the peak sample with the public optical cluster catalog constructed from the same HSC survey data to identify cluster counterparts of the peaks. We find that 107 out of 124 peaks have matched clusters within 5′ of peak positions. Among them, we define a subsample of 64 secure clusters that we use to examine dilution effects on our weak-lensing cluster search. We find that source samples with low-z galaxy cuts mitigate the dilution effect on weak-lensing signals of high-z clusters ($z \gtrsim 0.3$), and thus combining multiple peak catalogs from different source samples improves the efficiency of weak-lensing cluster searches.
Neurometabolic Correlates of Reactive and Proactive Motor Inhibition in Young and Older Adults: Evidence from Multiple Regional 1H-MR Spectroscopy
Authors: Weerasekera Akila , Levin Oron , Clauwaert Amanda , Heise Kirstin-Friederike , Hermans Lize , Peeters Ronald , Mantini Dante , Cuypers Koen , Leunissen Inge , Himmelreich Uwe , Swinnen Stephan P
Published: July 2020

Suboptimal inhibitory control is a major factor contributing to motor/cognitive deficits in older age and pathology. Here, we provide novel insights into the neurochemical biomarkers of inhibitory control in healthy young and older adults and highlight putative neurometabolic correlates of deficient inhibitory functions in normal aging. Age-related alterations in levels of glutamate–glutamine complex (Glx), N-acetylaspartate (NAA), choline (Cho), and myo-inositol (mIns) were assessed in the right inferior frontal gyrus (RIFG), pre-supplementary motor area (preSMA), bilateral sensorimotor cortex (SM1), bilateral striatum (STR), and occipital cortex (OCC) with proton magnetic resonance spectroscopy (1H-MRS). Data were collected from 30 young (age range 18–34 years) and 29 older (age range 60–74 years) adults. Associations between age-related changes in the levels of these metabolites and performance measures or reactive/proactive inhibition were examined for each age group. Glx levels in the right striatum and preSMA were associated with more efficient proactive inhibition in young adults but were not predictive for reactive inhibition performance. Higher NAA/mIns ratios in the preSMA and RIFG and lower mIns levels in the OCC were associated with better deployment of proactive and reactive inhibition in older adults. Overall, these findings suggest that altered regional concentrations of NAA and mIns constitute potential biomarkers of suboptimal inhibitory control in aging.
Bio-evaluation of the role of chitosan and curcumin nanoparticles in ameliorating genotoxicity and inflammatory responses in rats’ gastric tissue followed hydroxyapatite nanoparticles’ oral uptake
Authors: Mosa Israa F , Abd Haitham H , Abuzreda Abdelsalam , Assaf Nadhom , Yousif Amenh B
Published: July 2020

Hydroxyapatite has been extensively used in tissue engineering due to its osteogenic potency, but its present toxicological facts are relatively insufficient. Here, the possible gastric toxicity of hydroxyapatite nanoparticles was evaluated biochemically to determine oxidant and antioxidant parameters in rats’ stomach tissues. At results, hydroxyapatite nanoparticles have declined stomach antioxidant enzymes and reduced glutathione level, while an induction in lipid peroxidation and nitric oxide has been observed. Furthermore, DNA oxidation was analyzed by the suppression of toll-like receptors 2, nuclear factor-kappa B and Forkhead box P3 gene expression and also 8-Oxo-2′-deoxyguanosine level as a genotoxicity indicator. Various pro-inflammatory gene products have been identified that intercede a vital role in proliferation and apoptosis suppression, among these products: tumor suppressor p53, tumor necrosis factor-α and interliukin-6. Moreover, the hydroxyapatite-treated group revealed wide histological alterations and significant elevation in the number of proliferating cell nuclear antigen-positive cells, which has been observed in the mucosal layer of the small intestine, and these alterations are an indication of small intestine injury, while the appearance of chitosan and curcumin nanoparticles in the combination group showed improvement in all the above parameters with inhibition of toxic-oxidant parameters and activation of antioxidant parameters.
Intraoperative Fire Risk: Evaluating the 3-Minute Wait After Chlorhexidine-Alcohol Antiseptic Scrub
Authors: Ryan Sean P. , Adams Samuel B. , Allen Nicholas , Lazarides Alexander L. , Wellman Samuel S. , Gage Mark J.
Published: July 2020

Objective:

We sought to determine the flammability of the skin at different time intervals after chlorhexidine-alcohol antiseptic scrub application, to provide evidence for hospital protocols recommending a 3-minute drying time.

Methods:

Swine feet, which contain the skin, subcutaneous tissue, muscle, and bone, were used for an experimental cohort. The skin was prepped with chlorhexidine-alcohol solution. Attempted ignition with an open flame was then performed in the presence of visible pooling, as well as at time points 0, 30, 60, and 90 seconds after application, in addition to when the skin appeared visibly dry. Six samples were used for each time point tested.

Results:

At time 0 seconds and with gross pooling, ignition was achieved with all samples tested. However, at 30 seconds, only 2 of 6 samples were ignited (which appeared wet). No samples after 60 or 90 seconds were flammable. Samples appeared dry after an average of 40.5 seconds and were not able to ignite.

Conclusions:

Although our findings do support that a chlorhexidine-alcohol antiseptic scrub is a potentially flammable surgical prep solution, we found little support for a 3-minute time cutoff. More importantly, the presence of pooling and persistently wet appearing prep is a more important fire risk than the time elapsed after prep application. Caution should be used when working with any flammable solution, and efforts to minimize chemical burns and combustion should be sought based on evidence.
Radiotherapy for Adult Soft Tissue Sarcomas of the Head and Neck
Authors: O’steen Lillie , Saldivar Brittany , Kharod Shivam , Bassett Benjamin , Morris Christopher G. , Mendenhall William M.
Published: July 2020

Objective:

Surgery followed by postoperative radiation therapy (RT) is the standard of care for soft tissue sarcomas (STS) of the head and neck that are high grade or have close or positive margins.

Methods:

The authors retrospectively reviewed adult patients with head and neck STS treated with RT at a single institution between 1981 and 2017. All patients who were 19 years and older with STS of the head and neck—excluding rhabdomyosarcoma, angiosarcoma, and Ewing tumors—were included in this study. Toxicity was graded using Common Terminology Criteria for Adverse Events (CTCAE), version 4.

Results:

Among 34 patients with head and neck STS treated with postoperative RT (33) or primary RT (1) who met the inclusion criteria, the median age at diagnosis was 45 years (range, 20 to 83). Overall, 37% had T1 tumors, 50% had high-grade histology (grade 3), and 26% had microscopically positive margins. The median RT dose was 65 Gy to the primary site; 29% received elective nodal irradiation. The median follow-up for living patients was 16.6 years (range, 0.6 to 30). At 5 and 10 years, the local control rates were 88% and 80%, the regional control rates were 97% and 97%, the freedom from distant metastases rates were 100% and 100%, the cause-specific survival rates were 88% and 81%, and the overall survival rates were 85% and 69%. Two patients (6%) developed late grade 3+ complications.

Conclusion:

Our study demonstrates that surgery and radiotherapy for STS of the head and neck have excellent disease outcomes.
The Inflammatory Relationship Between Hepatitis C Virus With Coronary and Carotid Atherosclerosis
Authors: Broker Michael , Frager Shalom Z. , Patel Nayan S. , Lebovics Edward , Frishman William H.
Published: July 2020

Hepatitis C virus (HCV), a global health concern, has been linked to various hepatic and extrahepatic deleterious manifestations. Several observational studies have either supported the increased likelihood of coronary and carotid atherosclerosis after infection with HCV or refuted it. To date, there has been no clear consensus to support either train of thought, as randomized, controlled clinical trials have not been completed. In this review, we first discuss articles that support the notion that HCV infection leads to increased plaque formation due to systemic inflammation and then focus on articles that refute this idea. From the literature, we do know that both inflammatory and lipid processes play a role in plaque formation, and thus both components are important in the successful treatment of atherosclerosis. Based on our review of the literature, we do believe that HCV-infected individuals are at an increased risk for more severe coronary artery disease than their healthy counterparts. Although there is no irrefutable evidence that links HCV infection with plaque formation and/or rupture, cardioprotective measures should be taken to reduce poor health outcomes, especially in those individuals who are already at risk of coronary disease.
Postoperative atrial fibrillation following emergency noncardiothoracic surgery
Authors: Bjerrum Ellen , Wahlstroem Kirsten L. , Gögenur Ismail , Burcharth Jakob , Ekeloef Sarah
Published: July 2020

BACKGROUND

Postoperative atrial fibrillation (POAF) occurs frequently following cardiothoracic surgery and is associated with a higher mortality and a longer hospital stay. The condition is less studied following noncardiothoracic surgery as well as emergency surgery.

OBJECTIVE

The aim of this systematic review was to investigate the occurrence of atrial fibrillation following emergency noncardiothoracic surgery and associated risk factors and mortality.

DESIGN

We conducted a systematic review according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Observational studies and randomised controlled trials were assessed for risk of bias using the Downs and Black checklist and Cochrane Handbook for Systematic reviews of intervention.

DATA SOURCES

A systematic literature search of PubMed, EMBASE and Scopus was carried out in August 2019. No publication date- or source restrictions were imposed.

ELIGIBILITY CRITERIA

Observational and randomised controlled trials were included if data on POAF occurring after an emergency, noncardiothoracic, surgical intervention on adult patients could be extracted.

RESULTS

We identified 15 studies eligible for inclusion covering orthopaedic-, abdominal-, vascular-, neuro- and miscellaneous noncardiothoracic surgery. The occurrence of POAF after emergency noncardiothoracic surgery ranged from 1.5 to 12.2% depending on type of surgery and intensity of cardiac monitoring. Studies that investigated risk factors and associated mortality found emergency surgery and increasing age to be associated with risk of POAF. Moreover, POAF was generally associated with an increase in long-term and short-term mortality.

CONCLUSION

In this study, atrial fibrillation occurred frequently, especially following emergency orthopaedic, vascular and neurosurgery. Emergency surgery and age were independent risk factors for developing atrial fibrillation. POAF seems to be related to a higher risk of postoperative complications and mortality, though further studies with long-term follow-up are needed.

TRIAL REGISTRATION

CRD42019112090.
Circadian variations in blood pressure and their implications for the administration of antihypertensive drugs: is dosing in the evening better than in the morning?
Authors: Burnier Michel , Kreutz Reinhold , Narkiewicz Krzysztof , Kjeldsen Sverre , Oparil Suzanne , Mancia Giuseppe
Published: July 2020

Blood pressure (BP) follows a circadian rhythm with a physiological decrease during the night. Studies have demonstrated that nocturnal BP as well as its dipping pattern during night-time have a significant prognostic importance for mortality and the occurrence of cardiovascular events. Therefore, hypertension management guidelines recommend to ascertain that patients treated for hypertension have well controlled BP values around the clock. To improve hypertension control during the night and eventually further reduce cardiovascular events, it has been proposed by some to prescribe at least one antihypertensive medication at bedtime. In this review, we have examined the data which could support the benefits of prescribing BP-lowering drugs at bedtime. Our conclusion is that there is no convincing evidence that the administration of BP-lowering drugs in the evening provides any significant advantage in terms of quality of BP control, prevention of target organ damage or reduction of cardiovascular events. Before changing practice for unproven benefits, it would be wise to wait for the results of the ongoing trials that are addressing this issue.
A high normal ankle--brachial index is associated with electrocardiography-determined left ventricular hypertrophy: the Okinawa Peripheral Arterial Disease Study (OPADS)
Authors: Ikemiyagi Hidekazu , Ishida Akio , Kinjo Kozen , Ohya Yusuke
Published: July 2020

Objectives:

We aimed to determine if the ankle--brachial index (ABI) increased with age as a result of increased arterial stiffness and wave reflection, and whether this was associated with left ventricular hypertrophy (LVH).

Methods:

An observational cross-sectional study was conducted in 13 396 participants aged 19–89 years who attended a health check-up. Brachial and ankle blood pressures were measured by an automatic oscillometric method. Electrocardiography-determined LVH (ECG-LVH) was defined by computer-interpreted Minnesota codes using resting 12-leads ECG.

Results:

The mean age of the participants was 53 years (54% women). The prevalence of ECG-LVH was 13%; this was the lowest in participants with normal blood pressure and increased with an increase in the hypertension grade. The ABI was higher in participants with ECG-LVH than in those without (1.13± 0.07 vs. 1.15 ± 0.07, P < 0.001). The prevalence of ECG-LVH was the highest in participants with the highest quartile of ABI (16%), followed by those with the third quartile (14%), second quartile (12%), and the lowest quartile of ABI (9%). The odds ratio for ECG-LVH was significantly higher for participants with a higher quartile of ABI than those with the lowest, before and after adjustment for several covariates. Similar results were observed in sensitivity analysis of individuals with normal kidney function, younger than 65 years, and without diabetes mellitus, performed in order to reduce the influence of a medial arterial calcification-mediated increase in ABI.

Conclusion:

High ABI is a possible marker of arterial stiffness and/or wave reflection that, even in the normal range, is associated with ECG-LVH.
Effect of Contact Precautions on Staphylococcus aureus and Clinical Outcomes of Colonized Patients in the Neonatal Intensive Care Unit
Authors: Shahbaz Sevini , de St. Maurice Annabelle , Sim Myung-Shin , Rubin Zachary , Garg Meena
Published: July 2020

Background:

Staphylococcus aureus is a common pathogen in neonatal intensive care units (NICUs), yet little is known about the effect of contact precautions and clinical outcomes of colonized patients.

Methods:

Retrospective cohort study of all neonates from August 2014 to November 2018 colonized with either methicillin-resistant S. aureus (MRSA) or methicillin-susceptible S. aureus (MSSA) and select noncolonized patients at two neonatal intensive care units at the University of California, Los Angeles. Outcomes during two time periods (during and after the use of contact precautions) were assessed.

Results:

A total of 234 patients were included in the study: 83 colonized and 151 noncolonized patients. There was a fourfold higher incidence of MSSA colonization versus MRSA (P < 0.001). There was a higher incidence of positive surveillance cultures after contact precautions were discontinued (P = 0.01), but this did not correlate with a higher incidence of invasive cultures (P = 0.475). There were twice as many MSSA invasive cultures than MRSA, but a higher rate of invasion with MRSA (P < 0.05). Colonized patients were more likely to develop an invasive infection than noncolonized (P = 0.003 MRSA; P = 0.004 MSSA). When controlling for gestational age and surgical interventions, colonization was more likely to be associated with skin and soft tissue infections (P < 0.001) and a longer length of stay by a mean of 27.8 days (P < 0.0001).

Conclusions:

Contact precautions resulted in a lower incidence of colonization without a difference in invasive cultures in our NICUs. Those colonized with S. aureus had a higher incidence of skin and soft tissue infections and a longer NICU length of stay.
Effect of flap homogeneity on higher-order aberrations induction after femtosecond LASIK for myopia
Authors: Parafita-Fernandez Alberto , Gros-Otero Juan , Villa-Collar Cesar , García-González Montserrat , Teus Miguel
Published: July 2020

Purpose:

To assess the relevance of the homogeneity of femtosecond laser flap thickness regarding induction of higher-order aberrations (HOAs).

Setting:

Clínica Rementería & Clínica Novovisión, Madrid, Spain.

Design:

Prospective observational study.

Methods:

Two hundred thirty-one patients underwent in situ keratomileusis using 5 different femtosecond lasers. The flap thicknesses were measured using anterior segment optical coherence tomography 3 months postoperatively. The same masked observer measured 6 symmetrical points nasally and temporally 1.0 mm, 2.0 mm, and 3.0 mm from the center of the flap in each case. HOAs induced in the cornea were measured using tomography.

Results:

Positive and significant correlations were found between HOA induction and the flap thickness heterogeneity 3.0 mm from the center of the flap. Pearson correlation coefficients for the induction of HOAs were third-order 0.17112 (P = .0224), fourth-order 0.22474 (P = .0026), fifth-order 0.16449 (P = .0282), coma-like 0.17370 (P = .0204), and total HOAs 0.18182 (P = .0151).

Conclusions:

The amount of flap-thickness heterogeneity at 3.0 mm from the center of the flap created using femtosecond lasers was correlated with the magnitude of the HOAs induced.
Teriparatide for the Treatment of Medication-Related Osteonecrosis of the Jaw
Authors: Chopra Kirti , Malhan Namrita
Published: July 2020

Medication-related osteonecrosis of the jaw (MRONJ) is a painful and intractable disease of the jaw that clinically presents as an area of ulceration with exposed necrotic bone. In severe cases, it can predispose to jaw fracture, skin fistula, or osteolysis extending beyond the region of the alveolar bone. No effective treatment has been established for this condition. Recently, teriparatide, a recombinant parathyroid hormone, and the only FDA-approved osteoanabolic drug for the treatment of glucocorticoid-induced osteoporosis, has been used for the treatment of MRONJ. We review the literature highlighting the effectiveness of teriparatide alone or as an adjunct in the treatment of MRONJ. Twenty publications met our selection criteria, comprising 54 patients with stage 2 or 3 MRONJ secondary to antiresorptive/antiangiogenic drugs. Trauma due to implant placement was the most common triggering factor for the development of MRONJ. Patients were treated with subcutaneous injections of 20-μg teriparatide for 3–12 months (5 1/2 months average). Symptomatic relief was achieved in almost all cases, with lesions healing completely in 49 of 54 patients. Based on our findings, teriparatide can play an important role in the treatment of MRONJ.
Antipsychotics in Postpartum Psychosis
Authors: Teodorescu Andreea , Dima Lorena , Popa Mihaela Alexandra , Moga Marius Alexandru , Bîgiu Nicuşor Florin , Ifteni Petru
Published: July 2020

Background:

Psychotic episodes in the postpartum period are life-threatening psychiatric emergencies, requiring urgent medical attention and admission to a psychiatric hospital.

Areas of Uncertainty:

Although the postpartum psychosis (PPP) is the most severe psychiatric disorder associated with parturition, there is little information about what interventions are most effective. Because there are no specific guidelines for the treatment of PPP, the aim of the present review was to examine the available evidence regarding the treatment of PPP.

Data Sources:

The PubMed database was searched based on the title and the abstract, using the key words “postpartum psychosis,” “postpartum psychosis antipsychotics,” “postpartum psychosis treatment,” and “postpartum psychosis pharmacotherapy,” for both interventional and observational, irrespective of language.

Results:

A number of 14 publications met the study criteria, including case reports and case series. The antipsychotics (APs) use included both first generation APs, such as haloperidol and chlorpromazine, and second generation APs, mainly, olanzapine, quetiapine, and risperidone. The most frequently used AP was olanzapine. Olanzapine and quetiapine seem to be the most acceptable during breastfeeding. Proposed treatment algorithms for the successful management of PPP are discussed.

Conclusions:

The existing studies to date do not allow to draw a definitive conclusion regarding which treatment is the most effective or the most adequate. Existing evidence suggests that APs alone or in combination are responsible for sustained remission and that treated PPP has a higher pace of improvement of the mental status, with a rapid discharge from the hospital. Clinical studies to compare the efficacy and safety of different APs in the PPP are needed to provide guidance on treatment interventions.
Autoimmune pancreatitis type 2
Authors: de Pretis Nicolò , Frulloni Luca
Published: July 2020

Purpose of review

Type 2 autoimmune pancreatitis (AIP) is a rare inflammatory disease of the pancreas. Very few data have been published on this particular subtype, which differs from the ‘classical’ IgG4-related type 1 AIP in terms of pathological features, epidemiology and risk of relapse. The aim of the current review is to summarize the available literature, suggesting a diagnostic and therapeutic approach to this disease.

Recent findings

Based on the International Consensus Diagnostic Criteria, to achieve a ‘definitive’ diagnosis of type 2 AIP, histology is required. If a definitive histological diagnosis is lacking (not-performed or inconclusive), concomitant presence of inflammatory bowel disease (IBD) and effective response to steroids are needed for a ‘probable’ diagnosis of type 2 AIP.

Type 2 AIP is a selective pancreatic disease, without association to other organ involvement. The lack of validated serological markers makes the diagnosis challenging in clinical practice, particularly in focal forms. A careful evaluation of the clinical profile (especially of a concomitant IBD), associated with an accurate imaging, might help in clinical practice to suspect type 2 AIP. Response to steroids is crucial to achieve diagnosis in patients without a diagnostic histology.
New horizons in pancreatic genetics
Authors: Weiss Frank U. , Laemmerhirt Felix , Aghdassi Ali , Lerch Markus M.
Published: July 2020

Purpose of review

Pancreatitis remains an intractable disease because no causative treatment is yet available. Recent studies have uncovered some of its underlying pathophysiology, a requirement for identifying potential treatment targets. These advancements were achieved by human genetic studies and by introducing genetic mechanisms into experimental pancreatitis models.

Recent findings

Cationic trypsin mutations are the most prominent genetic risk factor for pancreatitis. Investigators have now introduced genetically modified trypsin variants into transgenic animals. In this manner they characterized the role of cellular defense mechanisms, for example degradation of active trypsin by chymotrypsin-C, but also found that increased autoactivation or decreased degradation, not only boost disease severity but also drive progression to chonic pancreatitis. Other studies found that harmful trypsin effects are not restricted to acinar cells, that other digestive enzymes, notably pancreatic elastase, can also induce cellular injury and that endoplasmic-reticulum-stress is an important mechanism when mutations induce protein misfolding.

Identifying genetic subsceptibility factors for a disease never completely uncovers its underlying pathogenesis or potential treatment targets. This requires studying the mechanisms suggested by genetic findings in experimentel disease models. Pancreatitis is a field, in which much progress has now been achieved by adopting this approach.
Intravenous fluid resuscitation in the management of acute pancreatitis
Authors: Machicado Jorge D. , Papachristou Georgios I.
Published: July 2020

Purpose of review

In the absence of proven effective pharmacologic therapy in acute pancreatitis, and given its simplicity, wide availability, and perceived safety, intravenous fluid resuscitation remains the cornerstone in the early treatment of acute pancreatitis. Herein, we will review the rationale of fluid therapy, critically appraise the published literature, and summarize recent studies.

Recent findings

Several observational studies and small clinical trials have raised concern about the efficacy and safety of aggressive fluid resuscitation. Early aggressive fluid therapy among acute pancreatitis patients with predicted mild severity appears to have the highest benefit, whereas aggressive resuscitation in patients with predicted severe disease might be futile and deleterious. Lactated Ringer's solution is the preferred fluid type based on animal studies, clinical trials, and meta-analyses. There is a wide variation of fluid resuscitation approaches in current guideline recommendations, quality indicators, and worldwide practice patterns.

There is lack of high-quality data that supports the use of early aggressive fluid resuscitation. Large, well designed, multicenter randomized controlled trials are needed to determine the optimal timing, fluid type, volume, rate, and duration of fluid resuscitation in acute pancreatitis.
Genetic, biochemical, and clinical features of LCAT deficiency: update for 2020
Authors: Pavanello Chiara , Calabresi Laura
Published: July 2020

Purpose of review

Genetic LCAT deficiency is a rare metabolic disorder characterized by low-plasma HDL cholesterol levels. Clinical manifestations of the disease include corneal opacification, anemia, and renal disease, which represents the major cause of morbidity and mortality in carriers.

Recent findings

Biochemical and clinical manifestations of the disease are very heterogeneous among carriers. The collection of large series of affected individuals is needed to answer various open questions on this rare disorder of lipid metabolism, such as the cause of renal damage in patients with complete LCAT deficiency and the cardiovascular risk in carriers of different LCAT gene mutations.

Familial LCAT deficiency is a rare disease, with serious clinical manifestations, which can occur in the first decades of life, and presently with no cure. The timely diagnosis in carriers, together with the identification of disease biomarkers able to predict the evolution of clinical manifestations, would be of great help in the identification of carriers to address to future available therapies.
Current state of kidney utilization in multiorgan transplants
Authors: Aziz Hassan , Kim Jim , Kwon Yong Kyong
Published: July 2020

Purpose of review

In the United States, the leading indication for kidney transplant is primary kidney dysfunction arising from chronic hypertension and diabetes. However, an increasing indication for kidney transplantation is secondary kidney dysfunction in the setting of another severe organ dysfunction, including pancreas, liver, heart, and lung disease. In these settings, multiorgan transplantation is now commonly performed. With the increasing number of multiorgan kidney transplants, an assessment of guidelines and trends for in multiorgan kidney is necessary.

Recent findings

Although the utilization of kidney transplants in combined liver–kidney transplant was sharply rising, following the introduction of the ‘safety net’ policy, combined liver–kidney transplant numbers now remain stable. There is an increasing trend in the utilization of kidney transplantation in heart and lung transplantation. However, as these surgeries were historically uncommon, guidelines for patients who require simultaneous heart or lung transplants are limited and are often institution specific.

Strict guidelines need to be established to assess candidacy for kidney transplantation in multiorgan failure patients, particularly for combined heart–kidney and lung–kidney patients.