bluuebunny/crossref_metadata_2025 huggingface dataset:
Retinal microvascular abnormalities in patients after COVID-19 depending on disease severity
Authors: Zapata Miguel Ángel , Banderas García Sandra , Sánchez-Moltalvá Adrián , Falcó Anna , Otero-Romero Susana , Arcos Gabriel , Velazquez-Villoria Daniel , García-Arumí Jose
Published: December 2020

Background

Global pandemic SARS-CoV-2 causes a prothrombotic state without fully elucidated effects. This study aims to analyse and quantify the possible retinal microvascular abnormalities.

Materials and methods

Case–control study. Patients between 18 and 55 years old with PCR-confirmed SARS-CoV-2 infection within the last 3 months were included. Risk stratification: group 1—mild disease (asymptomatic/paucisymptomatic); group 2—moderate disease (required hospital admission with no acute respiratory distress) and group 3—severe disease (subjects who developed an acute respiratory distress were admitted in the intensive care unit and presented interleukin 6 values above 40 pg/mL). Age-matched volunteers with negative serology tests were enrolled to control group. A colour photograph, an optical coherence tomography (OCT) and an angiography using OCT centred on the fovea were performed.

Results

Control group included 27 subjects: group 1 included 24 patients, group 2 consisted of 24 patients and 21 participants were recruited for group 3. There were no funduscopic lesions, neither in the colour images nor in the structural OCT. Fovea-centred vascular density (VD) was reduced in group 2 and group 3 compared with group 1 and control group (control group vs group 2; 16.92 vs 13.37; p=0.009) (control group vs group 3; 16.92 vs .13.63; p=0.026) (group 1 vs group 2; 17.16 vs 13.37; p=0.006) (group 1 vs group 3; 17.16 vs 13.63 p=0.017).

Conclusion

Patients with moderate and severe SARS-CoV-2 pneumonia had decreased central retinal VD as compared with that of asymptomatic/paucisymptomatic cases or control subjects.
Transcutaneous CO2application accelerates fracture repair in streptozotocin-induced type I diabetic rats
Authors: Oda Takahiro , Niikura Takahiro , Fukui Tomoaki , Oe Keisuke , Kuroiwa Yu , Kumabe Yohei , Sawauchi Kenichi , Yoshikawa Ryo , Mifune Yutaka , Hayashi Shinya , Matsumoto Tomoyuki , Matsushita Takehiko , Kawamoto Teruya , Sakai Yoshitada , Akisue Toshihiro , Kuroda Ryosuke
Published: December 2020

Introduction

Diabetes mellitus (DM) negatively affects fracture repair by inhibiting endochondral ossification, chondrogenesis, callus formation, and angiogenesis. We previously reported that transcutaneous CO2application accelerates fracture repair by promoting endochondral ossification and angiogenesis. The present study aimed to determine whether CO2treatment would promote fracture repair in cases with type I DM.

Research design and methods

A closed femoral shaft fracture was induced in female rats with streptozotocin-induced type I DM. CO2treatment was performed five times a week for the CO2group. Sham treatment, where CO2was replaced with air, was performed for the control group. Radiographic, histologic, genetic, and biomechanical measurements were taken at several time points.

Results

Radiographic assessment demonstrated that fracture repair was induced in the CO2group. Histologically, accelerated endochondral ossification and capillary formation were observed in the CO2group. Immunohistochemical assessment indicated that early postfracture proliferation of chondrocytes in callus was enhanced in the CO2group. Genetic assessment results suggested that cartilage and bone formation, angiogenesis, and vasodilation were upregulated in the CO2group. Biomechanical assessment revealed enhanced mechanical strength in the CO2group.

Conclusions

Our findings suggest that CO2treatment accelerates fracture repair in type I DM rats. CO2treatment could be an effective strategy for delayed fracture repair due to DM.
Glycemic excursion minimization in the management of type 2 diabetes: a novel intervention tested in a randomized clinical trial
Authors: Cox Daniel J , Banton Tom , Moncrief Matthew , Conaway Mark , Diamond Anne , Holmes Viola , Green Pastors Joyce , Wolf Anne , Fang Kun , McCall Anthony
Published: December 2020

Introduction

This study of adults with type 2 diabetes employed a non-inferiority hypothesis to investigate whether an innovative lifestyle focused on minimizing postnutrient blood glucose (BG) excursions (glycemic excursion minimization (GEM)) would be equivalent or superior to conventional weight loss (WL) therapy in regard to reducing HbA1c, and superior to WL when investigating physical, behavioral and psychological secondary outcomes. The impact of BG feedback on GEM efficacy was also investigated.

Research design and methods

178 adults with type 2 diabetes for ≤10 years, HbA1c ≥6.8%, and not using insulin were randomized to WL (n=40) or one of three versions of GEM. Didactic (GEM-D, n=39) taught participants to choose low-glycemic load foods, reduce sedentary time and increase moderate routine physical activity. GEM-S (n=51) received GEM-D and systematically measured BG before and after meals and physical activity to educate and motivate food and activity choices. GEM-C (n=48) received GEM-D with continuous glucose monitoring feedback. All participants received 6 hours of group training and BG and activity monitors. Before and 3 months after treatment, participants were assessed for HbA1c, lipids, weight, routine physical activity, nutrition, depression, diabetes empowerment and distress.

Results

GEM versions did not differ in primary or secondary outcomes, so they were combined for analyses. While WL reduced body mass index (BMI) (p=0.005), GEM demonstrated a greater reduction in HbA1c (p=0.005), BMI (p=0.013), carbohydrate intake (p=0.001), BG response to a glucose challenge (p=0.02), and cardiovascular risk (p=0.003). Only GEM participants significantly improved diabetes empowerment, diabetes distress, depressive symptoms, steps/day, and active hours and reduced calories/day. Neither intervention had negative side effects.

Conclusions

GEM is an effective alternative to WL with respect to physical, behavioral and psychosocial outcomes.

Trial registration number

NCT03196895.
Circulating sex hormone binding globulin levels are modified with intensive lifestyle intervention, but their changes did not independently predict diabetes risk in the Diabetes Prevention Program
Authors: Aroda Vanita R , Christophi Costas A , Edelstein Sharon L , Perreault Leigh , Kim Catherine , Golden Sherita H , Horton Edward , Mather Kieren J
Published: December 2020

Introduction

Sex hormone binding globulin (SHBG) levels are reported to be inversely associated with diabetes risk. It is unknown whether diabetes prevention interventions increase SHBG and whether resultant changes in SHBG affect diabetes risk. The purpose of this analysis was to determine whether intensive lifestyle intervention (ILS) or metformin changed circulating SHBG and if resultant changes influenced diabetes risk in the Diabetes Prevention Program (DPP).

Research design and methods

This is a secondary analysis from the DPP (1996–2001), a randomized trial of ILS or metformin versus placebo on diabetes risk over a mean follow-up of 3.2 years. The DPP was conducted across 27 academic study centers in the USA. Men, premenopausal and postmenopausal women without hormone use in the DPP were evaluated. The DPP included overweight/obese persons with elevated fasting glucose and impaired glucose tolerance. Main outcomes measures were changes in SHBG levels at 1 year and risk of diabetes over 3 years.

Results

ILS resulted in significantly higher increases (postmenopausal women: p<0.01) or smaller decrements (men: p<0.05; premenopausal women: p<0.01) in SHBG compared with placebo or metformin. Changes in SHBG were primarily attributable to changes in adiposity. There were no consistent associations of change in SHBG with the risk of diabetes by treatment arm or participant group.

Conclusions

Lifestyle intervention may be associated with favorable changes in circulating SHBG, which is largely due to changes in adiposity. Changes in circulating SHBG do not independently predict reductions in diabetes incidence.
Continuous EEG use and status epilepticus treatment in Australasia: a practice survey of Australian and New Zealand epileptologists
Authors: Laing Joshua , Lawn Nicholas , Perucca Piero , Kwan Patrick , O'Brien Terence J
Published: December 2020

Objective

Continuous electroencephalography (cEEG) is increasingly used to detect non-convulsive seizures in critically ill patients but is not widely practised in Australasia. Use of cEEG is also influencing the management of status epilepticus (SE), which is rapidly evolving. We aimed to survey Australian and New Zealand cEEG use and current treatment of SE

Methods

A web-based survey was distributed to Epilepsy Society of Australia (ESA) members, between October and November 2019. Adult and paediatric neurologists/epileptologists with ESA membership involved in clinical epilepsy care and cEEG interpretation were invited to participate.

Results

Thirty-five paediatric/adult epileptologists completed the survey, 51% with over 10 years of consultant experience. cEEG was always available for only 31% of respondents, with the majority having no or only ad hoc access to cEEG. Lack of funding (74%) and personnel (71%) were the most common barriers to performing cEEG. Although experience with SE was common, responses varied regarding treatment approaches for both convulsive and non-convulsive SE. Escalation to anaesthetic treatment of convulsive SE tended to occur later than international guideline recommendations. There was general agreement that formal training in cEEG and national guidelines for SE/cEEG were needed.

Conclusions

cEEG availability remains limited in Australia, with lack of funding and resourcing being key commonly identified barriers. Current opinions on the use of cEEG and treatment of SE vary reflecting the complexity of management and a rapidly evolving field. An Australian-based guideline for the management of SE, including the role of cEEG is recommended.
Ethnicity and impact on the receipt of cognitive–behavioural therapy in people with psychosis or bipolar disorder: an English cohort study
Authors: Morris Rohan Michael , Sellwood William , Edge Dawn , Colling Craig , Stewart Robert , Cupitt Caroline , Das-Munshi Jayati
Published: December 2020

Objectives

(1) To explore the role of ethnicity in receiving cognitive–behavioural therapy (CBT) for people with psychosis or bipolar disorder while adjusting for differences in risk profiles and symptom severity. (2) To assess whether context of treatment (inpatient vs community) impacts on the relationship between ethnicity and access to CBT.

Design

Cohort study of case register data from one catchment area (January 2007–July 2017).

Setting

A large secondary care provider serving an ethnically diverse population in London.

Participants

Data extracted for 30 497 records of people who had diagnoses of bipolar disorder (International Classification of Diseases (ICD) code F30-1) or psychosis (F20–F29 excluding F21). Exclusion criteria were: <15 years old, missing data and not self-defining as belonging to one of the larger ethnic groups. The sample (n=20 010) comprised the following ethnic groups: white British: n=10 393; Black Caribbean: n=5481; Black African: n=2817; Irish: n=570; and ‘South Asian’ people (consisting of Indian, Pakistani and Bangladeshi people): n=749.

Outcome assessments

ORs for receipt of CBT (single session or full course) as determined via multivariable logistic regression analyses.

Results

In models adjusted for risk and severity variables, in comparison with White British people; Black African people were less likely to receive a single session of CBT (OR 0.73, 95% CI 0.66 to 0.82, p<0.001); Black Caribbean people were less likely to receive a minimum of 16-sessions of CBT (OR 0.83, 95% CI 0.71 to 0.98, p=0.03); Black African and Black Caribbean people were significantly less likely to receive CBT while inpatients (respectively, OR 0.76, 95% CI 0.65 to 0.89, p=0.001; OR 0.83, 95% CI 0.73 to 0.94, p=0.003).

Conclusions

This study highlights disparity in receipt of CBT from a large provider of secondary care in London for Black African and Caribbean people and that the context of therapy (inpatient vs community settings) has a relationship with disparity in access to treatment.
Comparison of the effects of intravenous propofol and inhalational desflurane on the quality of early recovery after hand-assisted laparoscopic donor nephrectomy: a prospective, randomised controlled trial
Authors: Park Jaesik , Kim Minhee , Park Yong Hyun , Shim Jung-Woo , Lee Hyung Mook , Kim Yong-Suk , Moon Young Eun , Hong Sang Hyun , Chae Min Suk
Published: December 2020

Objectives

We compared early recovery outcomes between living kidney donors who received total intravenous (IV) propofol versus inhalational desflurane during hand-assisted laparoscopic nephrectomy.

Design

A single-centre, prospective randomised controlled trial.

Setting

University hospital.

Participants

Study participants were enrolled between October 2019 and February 2020. A total of 80 living donors were randomly assigned to an intravenous propofol group (n=40) or a desflurane group (n=40).

Intervention

Propofol group received intravenous propofol and desflurane group received desflurane, as a maintenance anaesthetic.

Primary and secondary outcome measures

The quality of postoperative functional recovery was primarily assessed using the Korean version of the Quality of Recovery-40 (QoR-40K) questionnaire on postoperative day 1. Secondarily, ambulation, pain score, rescue analgesics, complications and total hospital stay were assessed postoperatively.

Results

Our study population included 35 males and 45 females. The mean age was 46±13 years. The global QoR-40K score (161 (154–173) vs 152 (136–161) points, respectively, p=0.001) and all five subdimension scores (physical comfort, 49 (45–53) vs 45 (42–48) points, respectively, p=0.003; emotional state, 39 (37–41) vs 37 (33–41) points, respectively, p=0.005; psychological support, 30 (26–34) vs 28 (26–32) points, respectively, p=0.04; physical independence, 16 (11–18) vs 12 (8-14) points, respectively, p=0.004; and pain, 31 (28–33) vs 29 (25-31) points, respectively, p=0.021) were significantly higher in the intravenous propofol group than the desflurane group. The early ambulation success rate and numbers of early and total steps were higher, but the incidence of nausea/vomiting was lower, in the intravenous propofol group than the desflurane group. The total hospital stay after surgery was shorter in the intravenous propofol group than the desflurane group.

Conclusions

Intravenous propofol may enhance the quality of postoperative recovery in comparison to desflurane in living kidney donors.

Trial registration number

KCT0004365.
Improving primary care for diabetes and hypertension: findings from implementation research in rural South India
Authors: Lall Dorothy , Engel Nora , Srinivasan Prashanth N , Devadasan Narayanan , Horstman Klasien , Criel Bart
Published: December 2020

Background

Chronic conditions are a leading cause of death and disability worldwide. Low-income and middle-income countries such as India bear a significant proportion of this global burden. Redesigning primary care from an acute-care model to a model that facilitates chronic care is a challenge and requires interventions at multiple levels.

Objectives

In this intervention study, we aimed to strengthen primary care for diabetes and hypertension at publicly funded primary healthcare centres (PHCs) in rural South India.

Design and methods

The complexities of transforming the delivery of primary care motivated us to use a ‘theory of change’ approach to design, implement and evaluate the interventions. We used both quantitative and qualitative data collection methods. Data from patient records regarding processes of care, glycaemic and blood pressure control, interviews with patients, observations and field notes were used to analyse what changes occurred and why.

Interventions

We implemented the interventions for 9 months at three PHCs: (1) rationalise workflow to include essential tasks like counselling and measurement of blood pressure/blood glucose at each visit; (2) distribute clinical tasks among staff; (3) retain clinical records at the health facility and (4) capacity building of staff.

Results

We found that interventions were implemented at all three PHCs for the first 4 months but did not continue at two of the PHCs. This fadeout was most likely the result of staff transfers and a doctor’s reluctance to share tasks. The availability of an additional staff member in the role of a coordinator most likely influenced the relative success of implementation at one PHC.

Conclusion

These findings draw attention to the need for building teams in primary care for managing chronic conditions. The role of a coordinator emerged as an important consideration, as did the need for a stable core of staff to provide continuity of care.
How do we assess resilience and grit among internal medicine residents at the Mayo Clinic? A longitudinal validity study including correlations with medical knowledge, professionalism and clinical performance
Authors: Alahdab Fares , Halvorsen Andrew J , Mandrekar Jayawant N , Vaa Brianna E , Montori Victor M , West Colin P , Murad M Hassan , Beckman Thomas J
Published: December 2020

Background

There has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.

Objectives

To investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.

Methods

We evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).

Results

A total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=−3.4, 95% CI −6.2 to −0.5, p=0.02) and mini-CEX (β=−0.2, 95% CI −0.5 to −0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).

Conclusions

This study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.
Cardiovascular imaging of women and men visiting the outpatient clinic with chest pain or discomfort: design and rationale of the ARGUS Study
Authors: Groepenhoff Floor , Eikendal Anouk L M , Bots Sophie Heleen , van Ommen Anne-Mar , Overmars L M , Kapteijn Daniek , Pasterkamp Gerard , Reiber Johan H C , Hautemann David , Menken Roxana , Wittekoek Marianne E , Hofstra Leonard , Onland-Moret N Charlotte , Haitjema Saskia , Hoefer Imo , Leiner Tim , den Ruijter Hester M
Published: December 2020

Introduction

Chest pain or discomfort affects 20%–40% of the general population over the course of their life and may be a symptom of myocardial ischaemia. For the diagnosis of obstructive macrovascular coronary artery disease (CAD), algorithms have been developed; however, these do not exclude microvascular angina. This may lead to false reassurance of symptomatic patients, mainly women, with functionally significant, yet non-obstructive coronary vascular disease. Therefore, this study aims to estimate the prevalence of both macrovascular and microvascular coronary vascular disease in women and men presenting with chest pain or discomfort, and to subsequently develop a decision-support tool to aid cardiologists in referral to cardiovascular imaging for both macrovascular and microvascular CAD evaluation.

Methods and analysis

Women and men with chest pain or discomfort, aged 45 years and older, without a history of cardiovascular disease, who are referred to an outpatient cardiology clinic by their general practitioner are eligible for inclusion. Coronary CT angiography is used for anatomical imaging. Additionally, myocardial perfusion imaging by adenosine stress cardiac MRI is performed to detect functionally significant coronary vascular disease. Electronic health record data, collected during regular cardiac work-up, including medical history, cardiovascular risk factors, physical examination, echocardiography, (exercise) ECG and blood samples for standard cardiovascular biomarkers and research purposes, are obtained. Participants will be classified as positive or negative for coronary vascular disease based on all available data by expert panel consensus (a cardiovascular radiologist and two cardiologists). After completion of the clinical study, all collected data will be used to develop a decision support tool using predictive modelling and machine-learning techniques.

Ethics and dissemination

The study protocol was approved by the Institutional Review Board of the University Medical Center Utrecht. Results will be disseminated through national and international conferences and in peer-reviewed journals in cardiovascular disease.

Trial registration number

Trialregister.nl Registry NL8702.
Burnout and compassion fatigue among organ and tissue donation coordinators: a scoping review
Authors: Silva e Silva Vanessa , Hornby Laura , Almost Joan , Lotherington Ken , Appleby Amber , Silva Amina Regina , Rochon Andrea , Dhanani Sonny
Published: December 2020

Objectives

To collate and synthesise available literature on burnout and compassion fatigue (CF) among organ and tissue donation coordinators (OTDCs) and to respond to the research question: what is known about burnout and CF among OTDCs worldwide?

Design

Scoping review using Joanna Briggs Institute methodology for scoping reviews.

Data sources

Medline, EMBASE, PsycINFO, CINAHL, LILACS, PTSpubs and grey literature (ResearchGate, OpenGrey, Organ Donation Organization (ODO) websites, open access theses and dissertations) up to April 2020.

Study selection

Studies reporting aspects of burnout and CF among OTDCs, including risk and protective factors.

Data extraction

Two reviewers independently screened the studies for eligibility and extracted data from chosen sources using a data extraction tool developed for this study; NVIVO was used to perform a qualitative directed content analysis.

Results

The searches yielded 741 potentially relevant records, of which 29 met the inclusion criteria. The majority of articles were from the USA (n=7, 24%), Canada (n=6, 21%) and Brazil (n=6, 21%), published between 2013 and 2020 (n=13, 45%) in transplant journals (n=11, 38%) and used a qualitative design approach (n=12, 41%). In the thematic analysis, we classified the articles into five categories: (1) burnout characteristics, (2) CF characteristics, (3) coping strategies, (4) protective factors and (5) ambivalence.

Conclusion

We identified aspects of burnout and CF among OTDCs, including defining characteristics, demographic predispositions, protective factors, coping strategies, precursors, consequences and personal ambivalences. Researchers described burnout and CF characteristics but did not use consistent terms when referring to CF and burnout, which may have hindered the identification of all relevant sources. This gap should be addressed by the application of consistent terminology, systematic approaches and appropriate research methods that combine quantitative and qualitative investigation to examine the underlying reasons for the development of burnout and CF among OTDCs.
Different exposure metrics of rotating night shift work and hyperhomocysteinaemia among Chinese steelworkers: a cross-sectional study
Authors: Zhang Shengkui , Wang Yongbin , Li Qinglin , Wang Zhende , Wang Han , Xue Chao , Zhu Ying , Guan Weijun , Yuan Juxiang
Published: December 2020

Objective

To examine the associations of rotating night shift work with hyperhomocysteinaemia (HHcy) odds by different exposure metrics.

Design

Cross-sectional study.

Setting

Occupational physical examination centre for steel production workers, Tangshan, China.

Participants

A total of 6846 steelworkers, aged 22–60 years, from the baseline survey of a Chinese occupational cohort.

Primary and secondary outcome measures

Different exposure metrics of night shift work, including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month), average length of night shifts (hours/night) and percentage of hours on night shifts, were used to examine the effects of past and current night shift work on HHcy odds. The total homocysteine concentration in the plasma above 15 µmol/L was defined as HHcy.

Results

Compared with those who never worked night shifts, current night shift workers had elevated odds of HHcy (OR 1.23, 95% CI 1.06 to 1.44). Considering a person’s lifetime work schedule and compared with individuals who never worked night shifts, duration of night shifts >28 years (OR 1.35, 95% CI 1.12 to 1.61), average frequency of night shifts >7 nights/month (OR 1.25, 95% CI 1.07 to 1.47) and percentage of hours on night shifts >30% (OR 1.23, 95% CI 1.05 to 1.43) were associated with higher HHcy odds. The duration of night shifts >20 years and the average frequency of night shifts >7 nights/month could significantly increase the odds of HHcy regardless of whether the average length of night shifts was greater than 8 hours/night. After stratification by sex, no significant association was found in female workers between different exposure metrics of night shift work and HHcy.

Conclusions

Long duration and high frequency of night shift work are associated with higher HHcy odds among male steelworkers.
Information needs among women taking part in primary HPV screening in England: a content analysis
Authors: Marlow Laura , Forster Alice S , McBride Emily , Rockliffe Lauren , Kitchener Henry , Waller Jo
Published: December 2020

Objectives

Introducing primary human papillomavirus (HPV) testing to cervical screening programmes means changes to the results women receive. We explored additional information needs among women undergoing HPV primary screening.

Design

Women were sent a postal questionnaire shortly after receiving their results and 6 and 12 months later. Each questionnaire asked if women had any unanswered questions about cervical screening or HPV testing. Free-text responses constituted the data. Themes were identified using content analysis.

Setting

National Health Service (NHS) Cervical Screening Programme, England.

Participants

381 women who recorded one or more free-text responses.

Results

The most common theme represented women’s emotional responses and attempts to understand their results. This theme was raised by 45% of women overall, but was as high as 59% in the HPV cleared group. General questions about the cause and epidemiology of HPV were raised by 38% of women and were more common among those testing HPV positive with normal cytology (52%). Questions about the purpose and procedure for HPV testing were most common among HPV-negative women (40%, compared with 16%–24% of the other results groups). Questions about future implications of test results were raised by 19% of women, and this theme was most common among those with persistent HPV.

Conclusions

Despite provision of information alongside screening invitations, women can still have unanswered questions following receipt of their results. Details about the epidemiology of HPV and why cervical screening procedures are changing should be included with screening invitations. Some results groups may benefit from additional tailored information with their results letter.
A review of the non-indigenous Chinese mystery snail, Cipangopaludina chinensis (Viviparidae), in North America, with emphasis on occurrence in Canada and the potential impact on indigenous aquatic species
Authors: Kingsbury S.E. , McAlpine Donald F. , Cheng Y. , Parker E. , Campbell L.M.
Published: December 2020

Evidence suggests that the Chinese mystery snail, Cipangopaludina chinensis, a freshwater, dioecious, snail of Asian origin has become invasive in North America, Belgium, and the Netherlands. Invasive species threaten indigenous biodiversity and have socioeconomic consequences where invasive. The aim of this review is to synthesize the relevant literature pertaining to C. chinensis in Canada. In doing so, we (i) describe C. chinensis ecosystem interactions in both indigenous (Asia) and non-indigenous habitats (North America and Europe), (ii) identify gaps in the literature, and (iii) determine where the species potential distribution in North America requires further exploration. We also briefly discuss potential management strategies for this species, as an aquatic invasive species (AIS), in Canada. Due to the much larger relative size of adult C. chinensis, multiple feeding mechanisms, and resistance to predation, C. chinensis can out-compete and displace indigenous freshwater gastropods and other molluscs. Furthermore, C. chinensis can affect food webs through bottom-up interactions with the bacterial and zooplankton communities by changing nitrogen and phosphorous concentrations. Also, the Chinese literature indicates the potential for C. chinensis to act as a biotransfer of contaminants between polluted ecosystems and consumers. In its indigenous range, C. chinensis was identified as a host for numerous parasites harmful to human and animal consumers alike. A comparison of the Canadian geographical distribution of reported occurrences with that for the United States indicates several potential gaps in Canadian reporting, which merits further investigation and consideration, especially in regard to federal and provincial non-indigenous monitoring and regulations. Southern Ontario had the highest number of reports that were mostly from web-based photo-supported sources. This suggests that interactive citizen science through popular apps backed by well-supported educational campaigns may be a highly effective means of tracking C. chinensis spread, which can be complementary to traditional methods using specimen-vouchered taxonomically verified natural-history collections overseen by professional curators.
Solar System tests in Brans–Dicke and Palatini $$f({\mathcal {R}})$$-theories
Authors: Bonino A. , Camera S. , Fatibene L. , Orizzonte A.
Published: December 2020

We compare Mercury’s precession test in standard general relativity, Brans–Dicke theories (BD), and Palatini$$f({\mathcal {R}})$$f(R)-theories. We avoid post-Newtonian approximation and compute exact precession in these theories. We show that the well-known mathematical equivalence between Palatini$$f({\mathcal {R}})$$f(R)-theories and a specific subset of BD theories does not extend to a really physical equivalence among theories since equivalent models still allow a different incompatible precession for Mercury depending on the solution one chooses. As a result one cannot use BD equivalence to rule out Palatini$$f({\mathcal {R}})$$f(R)-theories. On the contrary, we directly discuss that Palatini$$f({\mathcal {R}})$$f(R)-theories can (and specific models do) easily pass Solar System tests as Mercury’s precession.
Synchronizing Almost-Group Automata
Authors: Berlinkov Mikhail V. , Nicaud Cyril
Published: December 2020

In this paper we address the question of synchronizing random automata in the critical settings of almost-group automata. Group automata are automata where all letters act as permutations on the set of states, and they are not synchronizing (unless they have one state). In almost-group automata, one of the letters acts as a permutation on [Formula: see text] states, and the others as permutations.

We prove that this small change is enough for automata to become synchronizing with high probability. More precisely, we establish that the probability that a strongly-connected almost-group automaton is not synchronizing is [Formula: see text], for a [Formula: see text]-letter alphabet.

We also present an efficient algorithm that decides whether a strongly-connected almost-group automaton is synchronizing. For a natural model of computation, we establish a [Formula: see text] worst-case lower bound for this problem ([Formula: see text] for the average case), which is almost matched by our algorithm.
Declining Life Expectancy in the United States: Missing the Trees for the Forest
Authors: Harper Sam , Riddell Corinne A. , King Nicholas B.
Published: December 2020

In recent years, life expectancy in the United States has stagnated, followed by three consecutive years of decline. The decline is small in absolute terms but is unprecedented and has generated considerable research interest and theorizing about potential causes. Recent trends show that the decline has affected nearly all race/ethnic and gender groups, and the proximate causes of the decline are increases in opioid overdose deaths, suicide, homicide, and Alzheimer's disease. A slowdown in the long-term decline in mortality from cardiovascular diseases has also prevented life expectancy from improving further. Although a popular explanation for the decline is the cumulative decline in living standards across generations, recent trends suggest that distinct mechanisms for specific causes of death are more plausible explanations. Interventions to stem the increase in overdose deaths, reduce access to mechanisms that contribute to violent deaths, and decrease cardiovascular risk over the life course are urgently needed to improve mortality in the United States.
The Impact of Different Substituents in Fluorinated Cyclic Carbonates in the Performance of High Voltage Lithium-Ion Battery Electrolyte
Authors: He Meinan , Su Chi-Cheung , Peebles Cameron , Zhang Zhengcheng
Published: December 2020

Ethylene carbonate (EC) has been used as the Solid-Electrolyte Interphase (SEI) former in the conventional electrolyte for decades. However, its low anodic stability leads to severe capacity decay during cycling under high voltage operation. Therefore, finding a viable electrolyte with high anodic stability and the ability to form robust SEI for high voltage lithium-ion batteries is of primary importance. In this study, a series of electrolytes containing various fluorinated cyclic carbonates as the SEI former have been designed, synthesized and evaluated. Linear sweep voltammetry study suggested that fluorinated cyclic carbonates generally possess higher anodic stability than EC. Based on the cycling performance of LiNi0.5Co0.2Mn0.3O2 (NMC532)/ graphite full cells, the electrolyte with DFEC/FEMC (1.0 M LiPF6) inhibited the oxidation side reaction on the cathode and forms a vigorous SEI on the anode. The high voltage NMC532/Graphite cell utilizing the novel electrolyte exhibits excellent cycling durability under both room and elevated temperature. The superior performance of the DFEC based electrolyte was further unveiled by SEM, EDAX and XRD. Both the anode and cathode of the full cell employing DFEC based electrolyte retained their intrinsic structures after cycling while the electrodes cycled in conventional electrolyte showed severe degradation.
Pavlovian eyeblink conditioning is severely impaired in tottering mice
Authors: de Oude Nina L. , Hoebeek Freek E. , ten Brinke Michiel M. , de Zeeuw Chris I. , Boele Henk-Jan
Published: December 2020

In this study, we confirm the importance of normal calcium homeostasis in neurons for learning and memory formation. In a mouse model with a mutation in an essential calcium channel that is abundantly expressed in the cerebellum, we found severely impaired learning in eyeblink conditioning. Eyeblink conditioning is a cerebellar-dependent learning task. During brief periods of brain-wide oscillatory activity, as a result of the mutation, the expression of conditioned eyeblinks was even further disrupted.
An Integrated Autophagy‐Related Long Noncoding RNA Signature as a Prognostic Biomarker for Human Endometrial Cancer: A Bioinformatics‐Based Approach
Authors: Wang Ziwei , Zhang Jun , Liu Yan , Zhao Rong , Zhou Xing , Wang Hongbo
Published: December 2020

Endometrial cancer is one of the most common malignant tumors, lowering the quality of life among women worldwide. Autophagy plays dual roles in these malignancies. To search for prognostic markers for endometrial cancer, we mined The Cancer Genome Atlas and the Human Autophagy Database for information on endometrial cancer and autophagy‐related genes and identified five autophagy‐related long noncoding RNAs (lncRNAs) (LINC01871, SCARNA9, SOS1‐IT1, AL161618.1, and FIRRE). Based on these autophagy‐related lncRNAs, samples were divided into high‐risk and low‐risk groups. Survival analysis showed that the survival rate of the high‐risk group was significantly lower than that of the low‐risk group. Univariate and multivariate independent prognostic analyses showed that patients’ age, pathological grade, and FIGO stage were all risk factors for poor prognosis. A clinical correlation analysis of the relationship between the five autophagy‐related lncRNAs and patients’ age, pathological grade, and FIGO stage was also per https://orcid.org/0000‐0001‐7090‐1750 formed. Histopathological assessment of the tumor microenvironment showed that the ESTIMATE, immune, and stromal scores in the high‐risk group were lower than those in the low‐risk group. Principal component analysis and functional annotation were performed to confirm the correlations. To further evaluate the effect of the model constructed on prognosis, samples were divided into training (60%) and validation (40%) groups, regarding the risk status as an independent prognostic risk factor. A prognostic nomogram was constructed using patients’ age, pathological grade, FIGO stage, and risk status to estimate the patients’ survival rate. C‐index and multi‐index ROC curves were generated to verify the stability and accuracy of the nomogram. From this analysis, we concluded that the five lncRNAs identified in this study could affect the incidence and development of endometrial cancer by regulating the autophagy process. Therefore, these molecules may have the potential to serve as novel therapeutic targets and biomarkers.
Expression, Prognosis, and Immune Infiltrates Analyses of E2Fs in Human Brain and CNS Cancer
Authors: Liao Pan , Han Shuzhen , Qu Honglan
Published: December 2020

Objective. We investigated the expression patterns, potential functions, unique prognostic value, and potential therapeutic targets of E2Fs in brain and CNS cancer and tumor‐infiltrating immune cell microenvironments. Methods. We analyzed E2F mRNA expression levels in diverse cancer types via Oncomine and GEPIA databases, respectively. Moreover, we evaluated the prognostic values using GEPIA database and TCGAportal database and the correlation of E2F expression with immune infiltration and the correlation between immune cell infiltration and GBM and LGG prognosis via TIMER database. Then, cBioPortal, GeneMANIA, and DAVID databases were used for mutation analysis, PPI network analysis of coexpressed gene, and functional enrichment analysis. Results. E2F1‐8 expression increased in most cancers, including brain and CNS cancer. Higher expression in E2F1, 2, 4, 6, 7, and 8 indicated poor OS of LGG. Higher E2F3–6 and E2F1–8 expressions correlated with poor prognosis and increased immune infiltration levels in CD8+ T cells, macrophages, neutrophils, and DCs in GBM and CD8+ T cells, B cells, CD4+ T cells, neutrophils, macrophages, and DCs in LGG, respectively. Conclusion. E2F1–8 and E2F2–8 could be hopeful prognostic biomarkers of GBM and LGG, respectively. E2F3–6 and E2F1–8 could be likely therapeutic targets in patients with immune cell infiltration of GBM and LGG, respectively.
Identification of miRNAs as the Crosstalk in the Interaction between Neural Stem/Progenitor Cells and Endothelial Cells
Authors: Wang Xin , Li Simin , Ma Yihong , Xu Yuzhen , Ogbuehi Anthony Chukwunonso , Hu Xianda , Acharya Aneesha , Haak Rainer , Ziebolz Dirk , Schmalz Gerhard , Li Hanluo , Gaus Sebastian , Lethaus Bernd , Savkovic Vuk , Su Zhiqiang
Published: December 2020

Aim. This study is aimed at identifying genetic and epigenetic crosstalk molecules and their target drugs involved in the interaction between neural stem/progenitor cells (NSPCs) and endothelial cells (ECs). Materials and Methods. Datasets pertaining to reciprocal mRNA and noncoding RNA changes induced by the interaction between NSPCs and ECs were obtained from the GEO database. Differential expression analysis (DEA) was applied to identify NSPC-induced EC alterations by comparing the expression profiles between monoculture of ECs and ECs grown in EC/NSPC cocultures. DEA was also utilized to identify EC-induced NSPC alterations by comparing the expression profiles between monoculture of NSPCs and NSPCs grown in EC/NSPC cocultures. The DEGs and DEmiRNAs shared by NSPC-induced EC alterations and EC-induced NSPC alterations were then identified. Furthermore, miRNA crosstalk analysis and functional enrichment analysis were performed, and the relationship between DEmiRNAs and small molecular drug targets/environment chemical compounds was investigated. Results. One dataset (GSE29759) was included and analyzed in this study. Six genes (i.e., MMP14, TIMP3, LOXL1, CCK, SMAD6, and HSPA2), three miRNAs (i.e., miR-210, miR-230a, and miR-23b), and three pathways (i.e., Akt, ERK1/2, and BMPs) were identified as crosstalk molecules. Six small molecular drugs (i.e., deptropine, fluphenazine, lycorine, quinostatin, resveratrol, and thiamazole) and seven environmental chemical compounds (i.e., folic acid, dexamethasone, choline, doxorubicin, thalidomide, bisphenol A, and titanium dioxide) were identified to be potential target drugs of the identified DEmiRNAs. Conclusion. To conclude, three miRNAs (i.e., miR-210, miR-230a, and miR-23b) were identified to be crosstalks linking the interaction between ECs and NSPCs by implicating in both angiogenesis and neurogenesis. These crosstalk molecules might provide a basis for devising novel strategies for fabricating neurovascular models in stem cell tissue engineering.
The Value of PD-L1 Expression in Predicting the Efficacy of Anti-PD-1 or Anti-PD-L1 Therapy in Patients with Cancer: A Systematic Review and Meta-Analysis
Authors: Chen Xiao-Jiang , Yuan Shu-Qiang , Duan Jin-Ling , Chen Yong-Ming , Chen Shi , Wang Yun , Li Yuan-Fang
Published: December 2020

Objectives. Recent trials have shown an overall survival (OS) benefit in 10-40% advanced cancer patients treated with programmed cell death 1 (PD-1) or programmed death-ligand 1 (PD-L1) inhibitors. Here, we aimed to evaluate the relationship between PD-L1 expression and the therapeutic efficacy of PD-1 or PD-L1 inhibitors in patients with cancer with recurrent or metastatic disease, compared with control treatments. Methods. We systematically searched Medline (PubMed), Embase, and Cochrane Library databases up to Jan 2019 and pooled the treatment effects (hazard ratio or relative ratio) of PD-1/PD-L1 inhibitors in patients with different PD-L1 expression. Results. Overall, twenty-four qualifying trials with over 14,860 subjects were eligible in this study. Compared with conventional agents, anti-PD/PD-L1 drugs significantly reduced the risk of death (hazard ratio 0.72, 95% CI 0.66 to 0.78), irrespective of the tumor type. Additionally, when PD-L1 expression ≥1% was defined as positive, anti-PD-1/PD-L1 monotherapy correlated with prolonged overall survival in patients with nonsmall cell lung cancer (NSCLC) (0.72, 0.61 to 0.86) and other cancer types (0.66, 0.57 to 0.76) patients with PD-L1 positive, rather than those with PD-L1 negative (hazard ratio for NSCLC and other cancer types: 0.84 and 0.87, respectively; all

P
>
0.05

). The subgroup analyses to experimental agents, PD-1/PD-L1 inhibitors, PD-L1 antibody clone, and type of IHC scoring method validated the robustness of these findings. However, anti-PD-1/PD-L1 combination therapies can reduce the risk of death for patients with different cancer types, regardless of PD-L1 expression (

P
<
0.05

for all PD-L1 expression status). Conclusions. We recommend PD-L1 expression as a predictive biomarker in patient selection for anti-PD-1/PD-L1 monotherapy, but not for combination therapies.
Online Simulation of Nuclear Power Plant Primary Systems
Authors: Xie Hongyun , Gu Haixia , Lu Chao , Ping Jialin
Published: December 2020

Real-time Simulation (RTS) has long been used in the nuclear power industry for operator training and engineering purposes. And, online simulation (OLS) is based on RTS and with connection to the plant information system to acquire the measurement data in real time for calibrating the simulation models and following plant operation, for the purpose of analyzing plant events and providing indicative signs of malfunctioning. OLS has been applied in certain industries to improve safety and efficiency. However, it is new to the nuclear power industry. A research project was initiated to implement OLS to assist operators in certain critical nuclear power plant (NPP) operations to avoid faulty conditions. OLS models were developed to simulate the reactor core physics and reactor/steam generator thermal hydraulics in real time, with boundary conditions acquired from plant information system, synchronized in real time. The OLS models then were running in parallel with recorded plant events to validate the models, and the results are presented.
Blue Light Irradiation Induces Human Keratinocyte Cell Damage via Transient Receptor Potential Vanilloid 1 (TRPV1) Regulation
Authors: Yoo Ju Ah. , Yu Eunbi , Park See-Hyoung , Oh Sae Woong , Kwon Kitae , Park Se Jung , Kim Hyeyoun , Yang Seyoung , Park Jung Yoen , Cho Jae Youl , Kim Youn-Jung , Lee Jongsung
Published: December 2020

Although blue light has been reported to affect skin cells negatively, little is known about its action mechanisms in skin cells. Therefore, we investigated the role of the transient receptor potential vanilloid 1 (TRPV1) in blue light-induced effects on human keratinocytes and its underlying mechanisms. Blue light decreased cell proliferation and upregulated TRPV1 expression. Blue light also suppressed the epidermal growth factor receptor- (EGFR-) mediated signaling pathway by reducing the protein levels of EGFR and suppressing the EGFR/PI3K/AKT/GSK3β/FoxO3a pathway. The blue light-induced effect in cell proliferation was reversed by TRPV1 siRNA, but not capsazepine, a TRPV1-specific antagonist. In addition, blue light irradiation increased the production of reactive oxygen species (ROS) and tumor necrosis factor-α (TNF-α). Blue light irradiation also increased both phosphorylation levels of TRPV1 and calcium influx. The blue light-induced increase in production of ROS and TNF-α was reversed by capsazepine. Furthermore, the blue light-induced increase in production of TNF-α was attenuated by SP600125 or PDTC. These findings show that blue light regulates cell survival and production of ROS and TNF-α; its effects are mediated via TRPV1. Specifically, the effects of blue light on cell proliferation are mediated by upregulating TRPV1, a negative regulator of EGFR-FoxO3a signaling. Blue light-induced production of ROS and TNF-α is also mediated through increased calcium influx via TRPV1 activation.