bluuebunny/crossref_metadata_2025 huggingface dataset:
Drought
Authors: Choi Woonsup
Published: January 2020

Drought is a natural disaster that has plagued human society throughout history. However, the meaning of drought varies by perspective and academic discipline, and the cause of drought is difficult to pinpoint. Despite the variation in its meaning, drought generally refers to the condition of an abnormally low amount of water for a given climate. Here the water can be precipitation, streamflow, soil moisture, groundwater, reservoir storage, and the like, but the lack of precipitation is a precursor for other types of drought. The lack of precipitation is often associated with anomalous atmospheric conditions such as atmospheric-circulation anomalies, higher-than-normal temperatures, and lower-than-normal relative humidity. Sea surface temperature anomalies may lead to sustained atmospheric-circulation anomalies. Drought defined as a lack of precipitation is often called meteorological or climatological drought. Other drought types can be classified within the context of the affected sectors, such as agricultural, hydrological, and socioeconomic drought. Agricultural drought generally refers to a lack of soil moisture, and hydrological drought refers to a lack of surface and subsurface water (e.g., streamflow and groundwater). Socioeconomic drought hampers human activities such as industry or water supply. As meteorological drought persists, other types of drought can follow. Such definitions of drought are regarded as conceptual definitions, but operational ones are also necessary for quantitative understanding and management of drought events. Operational definitions use quantitative indices to identify the occurrence and characteristics of drought events such as onset, duration, termination, deficit volume, and spatial extent of drought. Much of existing drought research concerns developing, revising, and applying drought indices to investigate spatial and temporal patterns of drought at various geographical scales. Drought research has progressed along several directions, such as causes and drivers of drought, characteristics of drought events, impacts, and mitigation. Each of these directions is represented by the works cited in this article.
Hydroclimatology and Climate Variability
Authors: Teale Natalie
Published: January 2020

The field of hydroclimatology was developed to synthesize many separate but related topics describing the storage and flux of water between and within the atmosphere and the land surface. By synthesizing these topics, including precipitation, evaporation, water vapor, streamflow, and soil moisture, among others, their interactions with each other and their effects on the earth surface can be assessed better across time and space. Hydroclimatology therefore can be defined as the interdisciplinary study of cyclical, multidirectional interactions between the climate system and the hydrologic cycle on a variety of spatial and temporal scales. Much of the research in the field of hydroclimatology is rooted in the identification of the baseline conditions of these interactions and deviations from those conditions. Because the movement, storage, and phase change of water between and within the terrestrial and atmospheric systems is closely linked to energy budgets, the components of hydroclimatology are sensitive to climate variability. This sensitivity to climate and weather patterns is particularly important because of the plethora of hydroclimatic feedbacks that have been modeled and observed. For example, there are notable feedbacks between water vapor and temperature, soil moisture and precipitation, and snow cover and air temperature, among others. Hydroclimatology as a subfield of climatology is well situated to investigate these feedbacks, as some involve interactions between multiple components in the atmosphere and land surface. The sensitivity of hydroclimatological interactions to climate variability is also important in a climate change context. Many studies demonstrate the intensification of the water cycle associated with a warmer atmosphere, resulting in changes in precipitation regimes, flood magnitude and frequency, and drought persistence and intensity, among others. These extreme events can be damaging and costly, and their impacts can be far reaching across human and environmental spheres. Hydroclimatology in this context is well situated within the discipline of physical geography. This article provides a general overview to the field of hydroclimatology, followed by sections addressing several individual components of hydroclimatology. The article concludes with a selection of papers investigating regional hydroclimatologies.
National survey of occupational advice for lower limb arthroplasty patients
Authors: Tsang B , McDonald D , McNamara I , Kottam L , Rangan A , Baker P
Published: January 2020

Background

Little is known what advice or support patients are given about return to work (RTW) after hip or knee replacement surgery.

Aims

This study aims to understand the delivery, timing and content of ‘RTW’ advice currently delivered by surgical teams offering hip and knee replacements across the UK.

Methods

National online survey exploring five specific areas relating to ‘RTW’ advice: (i) timings of interactions between hospital orthopaedic teams and patients prior to surgery, (ii) routine delivery of ‘RTW’ advice, (iii) methods used to deliver ‘RTW’ advice, (iv) confidence delivering advice and (v) need for an occupational ‘RTW’ advice intervention.

Results

A total of 152 participants including surgeons, physiotherapists, occupational therapists and nurses from 59 different public and private health providers responded. Only 20% (n = 30) of respondents reported that working patients were identified as a specific subgroup in need of additional support. Overall, 62% (n = 92) stated that they did not routinely offer ‘RTW’ advice. When given, ‘RTW’ advice was almost always verbal, generic advice using blanket timescales and based on the respondent’s anecdotal experience rather than the patients individualized needs. Overall, 116 (78%) felt an occupational advice intervention was needed.

Conclusions

This national survey demonstrated wide variation in the timing, content and delivery of information and advice for patients in work and intending to RTW after hip and knee replacement surgery. Current RTW advice provided to hip and knee replacement patients is inadequate.
Functional and taxonomic biogeography of phytoplankton and zooplankton communities in relation to environmental variation across the contiguous USA
Authors: Sodré Elder De Oliveira , Langlais-Bourassa Alexandre , Pollard Amina I , Beisner Beatrix E
Published: January 2020

For biomonitoring of aquatic ecosystems, the use of coarse group classifications, either taxonomic or functional, has been proposed as an alternative to more highly resolved taxonomic identification. We tested this proposition for phytoplankton and zooplankton using a pan-United States dataset, which also allows us to investigate biogeographic relationships between plankton groups and environmental variables. We used data from 1010 lakes composing the 2012 US National Lakes Assessment and compared relationships derived using genus-level, more aggregated taxonomic resolution and functional types. We examined responses nationally and by ecoregion. Differences in plankton assemblages among ecoregions were detected, especially at genus-level classification. Our analyses show a gradient of altitude and temperature influencing both phytoplankton and zooplankton, and another gradient of nutrients and anthropogenic activity influencing mostly phytoplankton. The overall variation in the planktonic communities explained by environmental variables ranged from 4 to 22%, but together indicated that aggregated taxonomic classification performed better for phytoplankton; for zooplankton, the performance of different classification types depended on the ecoregion. Our analyses also revealed linkages between particular phytoplankton and zooplankton groups, mainly attributable to similar environmental responses and trophic interactions. Overall, the results support the applicability of coarse classifications to infer general responses of plankton communities to environmental drivers.
The impact of life events on later life: a latent class analysis of the English Longitudinal Study of Ageing
Authors: Enwo O O , Player E , Steel N , Ford J A
Published: January 2020

Background

Inequalities in life events can lead to inequalities in older age. This research aimed to explore associations between life events reported by older people and quality of life (QoL) and functional ability.

Methods

Participants were grouped according to eight life events: parental closeness, educational opportunities in childhood, financial hardship, loss of an unborn child, bereavement due to war, involvement in conflict, violence and experiencing a natural disaster. Linear and logistic regressions were used to explore associations between these groups and the main outcomes of functional ability and QoL.

Results

7555 participants were allocated to four LCA groups: ‘few life events’ (n = 6,250), ‘emotionally cold mother’ (n = 724), ‘violence in combat’ (n = 274) and ‘many life events’ (n = 307). Reduced QoL was reported in the ‘many life events’ (coefficient − 5.33, 95%CI −6.61 to −4.05), ‘emotionally cold mother’ (−1.89, −2.62 to 1.15) and ‘violence in combat’ (−1.95, −3.08 to −0.82) groups, compared to the ‘few life events’ group. The ‘many life events’ group also reported more difficulty with activities of daily living.

Conclusions

Policies aimed at reducing inequalities in older age should consider events across the life course.
Pathogenesis of ANCA-associated vasculitis: an emerging role for immunometabolism
Authors: Leacy Emma , Brady Gareth , Little Mark A
Published: January 2020

ANCA-associated vasculitis (AAV) is a severe systemic autoimmune disease. A key feature of AAV is the presence of Anti-Neutrophil Cytoplasmic Antibodies (ANCA) directed against myeloperoxidase (MPO) or proteinase-3 (PR3). ANCA are key to the pathogenesis of AAV, where they activate innate immune cells to drive inflammation. Pre-activation or ‘priming’ of immune cells appears to be important for complete cellular activation in AAV. The burgeoning field of immunometabolism has illuminated the governance of immune cell function by distinct metabolic pathways. There is ample evidence that the priming events synonymous with AAV alter immune cell metabolism. In this review we discuss the pathogenesis of AAV and its intersection with recent insights into immune cell metabolism.
LOW BMI PATIENT DOSE IN DIGITAL RADIOGRAPHY
Authors: Efthymiou Fotios O , Metaxas Vasileios I , Dimitroukas Christos P , Panayiotakis George S
Published: January 2020

In this study, the radiation dose received by 364 low body mass index (BMI) adult patients undergoing chest, abdomen, lumbar spine, kidneys and urinary bladder (KUB) and pelvis X-ray examinations in an X-ray room with a digital radiography system was evaluated. The patients’ kerma area product (KAP) values were recorded, and the entrance surface air kerma (ESAK) was calculated based on the X-ray tube output, exposure parameters and technical data. The 75th percentiles of the distribution of ESAK and KAP values were also estimated. The dose values were compared with the corresponding values for normal patients obtained from a previous survey in our hospital, as well as with the national and UK diagnostic reference levels (DRLs). The correlation of dose values with patient size metrics (mass, height, BMI) was also investigated. A statistically significant difference was found in KAP and the ESAK values between low BMI and normal patients (Mann–Whitney test, p < 0.05), for all examinations studied. The percentage difference for chest PA, chest LAT, abdomen PA, lumbar spine AP, lumbar spine LAT, pelvis AP and KUB AP examinations was 40, 36, 48, 68, 57, 46 and 67% for median KAP and 26, 43, 52, 48, 19, 44 and 51% for median ESAK, respectively. The corresponding 75th percentiles for low BMI patients were 0.065, 0.349, 0.683, 1.54, 3.92, 1.11, 0.67 mGy and 0.042, 0.218, 0.450, 0.280, 0.598, 0.597, 0.267 Gycm2 in terms of ESAK and KAP values, respectively. They were 74–90% lower compared to the national diagnostic reference levels (DRLs), 35–84% and 58–82% compared to the UK DRLs, for ESAK and KAP values, respectively. Regarding the gender of the patients, no statistically significant difference was found in the dose values between female and male patients (Mann–Whitney test, p > 0.05), for all examinations studied. A statistically significant correlation was found between ESAK and KAP values with BMI for KUB AP, pelvis AP, lumbar spine AP, lumbar spine LAT and chest PA, while for chest LAT examinations, only the ESAK were significantly correlated with BMI. They also significantly correlated with the mass for KUB AP, lumbar spine LAT, abdomen PA and chest PA examinations, while no significant correlation was found between the dose values and patients’ height. It can be concluded that the low BMI patients received a significantly reduced radiation dose compared to normal patients. Additional studies need to be conducted for these patient groups, which could contribute to the further development of a radiation protection culture in diagnostic radiography.
Physiological, behavioral and subjective sadness reactivity in frontotemporal dementia subtypes
Authors: Hua Alice Y , Chen Kuan-Hua , Brown Casey L , Lwi Sandy J , Casey James J , Rosen Howard J , Miller Bruce L , Levenson Robert W
Published: January 2020

Frontotemporal dementia (FTD), a neurodegenerative disease broadly characterized by socioemotional impairments, includes three clinical subtypes: behavioral variant FTD (bvFTD), semantic variant primary progressive aphasia (svPPA) and non-fluent variant primary progressive aphasia (nfvPPA). Emerging evidence has shown emotional reactivity impairments in bvFTD and svPPA, whereas emotional reactivity in nfvPPA is far less studied. In 105 patients with FTD (49 bvFTD, 31 svPPA and 25 nfvPPA) and 27 healthy controls, we examined three aspects of emotional reactivity (physiology, facial behavior and subjective experience) in response to a sad film. In a subset of the sample, we also examined the neural correlates of diminished aspects of reactivity using voxel-based morphometry. Results indicated that all three subtypes of FTD showed diminished physiological responding in respiration rate and diastolic blood pressure; patients with bvFTD and svPPA also showed diminished subjective experience, and no subtypes showed diminished facial behavior. Moreover, there were differences among the clinical subtypes in brain regions where smaller volumes were associated with diminished sadness reactivity. These results show that emotion impairments extend to sadness reactivity in FTD and underscore the importance of considering different aspects of sadness reactivity in multiple clinical subtypes for characterizing emotional deficits and associated neurodegeneration in FTD.
Increased BNST reactivity to affective images is associated with greater α-amylase response to social stress
Authors: Pedersen Walker S , Kral Tammi R A , Rosenkranz Melissa A , Mumford Jeanette A , Davidson Richard J
Published: January 2020

While rodent research suggests that the bed nucleus of the stria terminalis (BNST) and centromedial amygdala (CM) coordinate the hormonal stress response, little is known about the BNST’s role in the human stress response. The human BNST responds to negatively valenced stimuli, which likely subserves its role in responding to threat. Thus, variation in BNST reactivity to negatively valenced stimuli may relate to differences in the stress response. We measured participants’ blood oxygenated level-dependent response to affective images and salivary cortisol and α-amylase (AA) levels in response to a subsequent Trier social stress test (TSST). Greater BNST activation to emotionally evocative images was associated with a larger TSST-evoked AA, but not cortisol response. This association remained after controlling for CM activation, which was not related to the cortisol or AA response. These results suggest that the BNST response to negatively valenced images subserves its role in coordinating the stress response, a BNST role in the stress response independent from the CM, and highlight the need for investigation of the conditions under which BNST activation predicts the cortisol response. Our findings are critical for the future study of mood and anxiety disorders, as dysregulation of the stress system plays a key role in their pathogenesis.
A Neural Signature of Parkinsonism in Patients With Schizophrenia Spectrum Disorders: A Multimodal MRI Study Using Parallel ICA
Authors: Wolf Robert C , Rashidi Mahmoud , Fritze Stefan , Kubera Katharina M , Northoff Georg , Sambataro Fabio , Calhoun Vince D , Geiger Lena S , Tost Heike , Hirjak Dusan
Published: January 2020

Motor abnormalities in schizophrenia spectrum disorders (SSD) have increasingly attracted scientific interest in the past years. However, the neural mechanisms underlying parkinsonism in SSD are unclear. The present multimodal magnetic resonance imaging (MRI) study examined SSD patients with and without parkinsonism, as defined by a Simpson and Angus Scale (SAS) total score of ≥4 (SAS group, n = 22) or <4 (non-SAS group, n = 22). Parallel independent component analysis (p-ICA) was used to examine the covarying components among gray matter volume maps computed from structural MRI (sMRI) and fractional amplitude of low-frequency fluctuations (fALFF) maps computed from resting-state functional MRI (rs-fMRI) patient data. We found a significant correlation (P = .020, false discovery rate [FDR] corrected) between an sMRI component and an rs-fMRI component, which also significantly differed between the SAS and non-SAS group (P = .042, z = −2.04). The rs-fMRI component comprised the cortical sensorimotor network, and the sMRI component included predominantly a frontothalamic/cerebellar network. Across the patient sample, correlations adjusted for the Positive and Negative Syndrome Scale (PANSS) total scores showed a significant relationship between tremor score and loadings of the cortical sensorimotor network, as well as between glabella-salivation score, frontothalamic/cerebellar and cortical sensorimotor network loadings. These data provide novel insights into neural mechanisms of parkinsonism in SSD. Aberrant bottom-up modulation of cortical motor regions may account for these specific motor symptoms, at least in patients with SSD.
When evidence does not matter: The barriers to learning from science in two cases of environmental policy change in Brazil
Authors: Donadelli Flavia
Published: January 2020

It is generally accepted in public policy debate that expert knowledge tends to contribute to more effective formulation and implementation of policy. Most of the literature, however, has tended to be exclusively focused on the science–policy interface, ignoring the necessary pre-conditions of the broader national and institutional context for the effective use of scientific evidence. This shortcoming becomes particularly pronounced in analysis of developing in less pluralist countries. This article analyses two cases of Brazilian environmental policy-making and discusses the institutional pre-conditions for learning from science. By textually coding instances of direct and indirect participation of scientists in congressional debates and assessing the extent of their influence in final decisions, this article shows that despite being largely consensual to the scientific community, clearly communicated, and relevant, scientific information had no influence on the policy-decisions taken in two highly-technical areas of environmental policy in Brazil: forestry and pesticides. This article engages with the literature on the necessary institutional structures for learning from science and provides support for the hypothesis that countries with lower levels of political openness, and medium-to-low consensus requirements for decision-making, will tend to have considerable barriers to effectively producing evidence-based policy-making.
Icotinib: efficacy in different solid tumors and gene mutations
Authors: Zhao Qian , Cheng Jie , Chen Pingping , Sun Jiewei , Guan Shengjiang
Published: January 2020

Icotinib is a first-generation inhibitor of epidermal growth factor receptor, which has been approved by the Chinese National Medical Products Administration, for the treatment of non-small cell lung cancer with epidermal growth factor receptor sensitive mutations. In addition, icotinib also shows moderate activity in other solid tumors driven by epidermal growth factor receptor, including non-small cell lung cancer with epidermal growth factor receptor rare non-resistant mutations, and esophageal cancer with epidermal growth factor receptor amplification or overexpression. This article reviews the efficacy of icotinib in different solid tumors with different epidermal growth factor receptor alterations.
Tea drinking and the risk of esophageal cancer: focus on tea type and drinking temperature
Authors: Lin Sihao , Xu Guoxi , Chen Zanluan , Liu Xudong , Li Jun , Ma Liya , Wang Xiaorong
Published: January 2020

The association between tea drinking and esophageal cancer is still contradictory. This study is to determine the association between tea drinking and esophageal squamous cell carcinoma focusing on drinking temperature and tea types. A population-based case-control study was conducted in a high esophageal squamous cell carcinoma risk area in China. A total of 942 incident esophageal squamous cell carcinoma cases with historical confirmation and 942 age- and sex- individually matched community controls were recruited from the study area. Trained interviewers using a structured questionnaire collected detailed information on tea drinking, diet, smoking and alcohol drinking habits. Habitual tea drinking temperature was measured with a thermometer during interviews. We analyzed the association between tea consumption, drinking temperature and esophageal squamous cell carcinoma, stratified by tea type, while adjusting for other potentially confounding factors. Drinking very hot tea (>65°C) was significantly associated with the increased risk of esophageal squamous cell carcinoma (odds ratio = 1.67, 95% confidential interval 1.25–2.24) relative to non-drinkers. Consumption of black tea, irrespective of the frequency, intensity and tea leaf amount, was significantly associated with a higher risk (P for trend <0.01). Compared to those who consumed <300 g/month tea leaves at ≤65°C, those who consumed more than 300 g/month tea leave at >65°C had a more than 1.8-fold higher risk of esophageal squamous cell carcinoma for both green tea and black tea. Our results provide more evidence that drinking very hot tea (above 65°C) are significantly associated with an increased risk of esophageal squamous cell carcinoma.
Impact of hepatitis C virus genotype 3 on liver disease progression in a Chinese national cohort
Authors: Wu Nan , Rao Hui-Ying , Yang Wei-Bo , Gao Zhi-Liang , Yang Rui-Feng , Fei Ran , Gao Ying-Hui , Jin Qian , Wei Lai
Published: January 2020

Background:

Hepatitis C virus (HCV) genotype 3, particularly subtype 3b, is increasing in prevalence and distribution in China. This study evaluated the prevalence, regional distribution, clinical characteristics, host factors, treatment outcomes, and disease progression of patients with HCV genotype 3 in China.

Methods:

A 5-year follow-up was preceded by a cross-sectional study. Treatment choices were at the discretion of treating physicians. Estimated infection time to overall-disease-progression (defined by ≥1 of: newly diagnosed cirrhosis; cirrhosis at baseline, Child-Turcotte-Pugh score increased 2 points or more; progression from compensated cirrhosis to decompensated cirrhosis; hepatocellular carcinoma; liver transplantation; or death) was calculated using the Kaplan-Meier method. Cox regression analyses were conducted to evaluate the risk factors for disease progression.

Results:

The cross-sectional study enrolled 997 patients, including 91 with HCV genotype 3 infection. Among them, subtype 3b (57.1%) was more dominant than subtype 3a (38.5%). Five hundred and twelve patients were included into the follow-up phase. Among patients analyzed for estimated infection time to overall-disease-progression, 52/304 (17.1%) patients with HCV genotype 1 and 4/41 (9.8%) with HCV genotype 3 (4/26 with genotype 3b, 0/13 with genotype 3a, and 0/2 with undefined subtype of genotype 3) experienced overall-disease-progression. Patients with HCV genotype 3 were younger than those with genotype 1 (mean age: 39.5 ± 8.7 vs. 46.9 ± 13.6 years) and demonstrated more rapid disease progression (mean estimated infection time to overall-disease-progression 27.1 vs. 35.6 years).

Conclusions:

HCV genotype 3, specifically subtype 3b, is associated with more rapid progression of liver disease. Further analysis to compare HCV subtype 3a and 3b is needed in high prevalence regions.

Trial registration:

NCT01293279, https://clinicaltrials.gov/ct2/show/NCT01293279; NCT01594554, https://clinicaltrials.gov/ct2/show/NCT01594554.
A new tool for comprehensive geriatric assessment in elderly patients with acute myeloid leukemia: a pilot study from China
Authors: Zhang Chun-Li , Feng Ru , Li Jiang-Tao , Wang Ting , Bai Jie-Fei , Liu Hui
Published: January 2020

Background:

Acute myeloid leukemia (AML) is a common type of hematological malignancy in elderly people. Geriatricians have developed comprehensive geriatric assessment (CGA) methods for elderly patients; however, the tools used for CGA in AML are not uniform. Thus, we aimed to validate the instrumental activities of daily living (IADL) scales, age, comorbidities (Charlson Comorbidity Index), and albumin (IACA) index, which is a new tool for CGA, in elderly patients with AML.

Methods:

Patients aged ≥60 years who had been diagnosed with AML were screened for eligibility. Among the IACA low-, intermediate-, and high-risk groups, continuous variables were compared using the Mann-Whitney U test, and categorical variables were compared using χ
2 and Fisher exact tests. In addition, probabilities of overall survival (OS) were estimated using the Kaplan-Meier method.

Results:

A total of 21, 34, and 6 patients were categorized into IACA low-risk (0 point), intermediate-risk (1–2 points), and high-risk (≥3 points) groups, respectively. The rates of relapse/progression-related mortality were 23.8%, 58.8%, and 100.0% in the IACA low-, intermediate-, and high-risk groups, respectively (χ
2 = 12.81, P < 0.001). The 2-year probabilities of OS were 47.7% (95% confidence interval [CI] 22.8%–72.6%) and 20.2% (95% CI 5.9%–34.5%) in the IACA low- and intermediate-risk groups, respectively (χ
2 = 5.99, P = 0.014), which were significantly higher than those in the high-risk group (low-risk [47.7% (95% CI 22.8%–72.6%)] vs. high-risk [0], χ
2 = 20.80, P < 0.001; intermediate-risk [20.2% (95% CI 5.9%–34.5%)] vs. high-risk [0], χ
2 = 7.56, P = 0.006; respectively). In the IACA low-risk group, the 2-year probability of OS in patients receiving induction chemotherapy (50.8% [95% CI 24.1%–77.5%]) was significantly higher than that in those receiving best supportive care (0, χ
2 = 25.74, P < 0.001).

Conclusion:

We suggest that the IACA index might be a simple and effective tool for comprehensive geriatric assessment in elderly AML patients.
The Long Noncoding RNA Metastasis-Associated Lung Adenocarcinoma Transcript-1 Regulates CCDC80 Expression by Targeting miR-141-3p/miR-200a-3p in Vascular Smooth Muscle Cells
Authors: Gong Duo , Zhao Zhen-Wang , Zhang Qiang , Yu Xiao-hua , Wang Gang , Zou Jin , Zheng Xi-long , Zhang Da-wei , Yin Wei-dong , Tang Chao-ke
Published: January 2020

Objective:

Our previous study showed that Coiled-Coil Domain Containing 80 (CCDC80) accelerates the development of atherosclerosis by decreasing lipoprotein lipase (LPL) expression and activity in apoE knockout mice. However, the regulatory mechanism for CCDC80 expression is unclear. This study was designed to evaluate whether noncoding RNAs involved the regulation of CCDC80 expression in vascular smooth muscle cells.

Methods and Results:

Bioinformatics prediction and luciferase reporter gene results showed that miR-141-3p/200a-3p bound to the 3′UTR of CCDC80. Furthermore, miR-141-3p/200a-3p mimics decreased the expression of CCDC80 but increased LPL expression. Opposite results were observed with miR-141-3p/200a-3p inhibitors. We also found that lncRNA metastasis-associated lung adenocarcinoma transcript-1 (MALAT1) interacted with the sequences of miR-141-3p/200a-3p and decreased their expression. RT-qPCR and western blotting results showed that MALAT1 overexpression increased CCDC80 expression and decreased LPL expression, while MALAT1 knockdown displayed an opposite phenotype. The effects of both MALAT1 overexpression and knockdown were blocked by miR-141-3p/200a-3p mimics or inhibitors.

Conclusions:

Thus, we demonstrated that lncRNA MALAT1 regulates CCDC80 and LPL expression through miR-141-3p/200a-3p.
Experience in Transitioning From Parenteral Prostacyclins to Selexipag in Pulmonary Arterial Hypertension
Authors: Parikh Kishan S. , Doerfler Sean , Shelburne Nicholas , Kennedy Karla , Whitson Jordan , Dahhan Talal , Fortin Terry , Rajagopal Sudarshan
Published: January 2020

Parenteral prostacyclin therapies remain first-line therapy for patients with pulmonary arterial hypertension (PAH) with class IV symptoms. In selected patients who have been clinically stabilized, switching to selexipag, a chemically distinct prostacyclin receptor agonist, may alleviate risks associated with long-term parenteral therapy. We report our experience with transition of patients from parenteral prostacyclin therapy to selexipag. From January 2016 to July 2017, patients with PAH at the Duke University Pulmonary Vascular Disease Center with functional class II symptoms on stable parenteral prostacyclin therapy were offered the opportunity to transition to selexipag. A standardized protocol was developed to guide titration of therapies. Patients underwent pre- and post-transition assessments of hemodynamics, echocardiography, laboratory biomarkers, and functional status. We studied 14 patients with PAH (11 women; median age 53 years) in total. Overall, 13 patients tolerated the switch to selexipag and remained on the drug at study completion, and 1 patient passed away due to progressive liver failure. Surrogate markers including NT-proBNP, 6MWD, RV function, and TAPSE, and right heart catheterization hemodynamics were similar before and after transition. The transition from parenteral prostanoid therapy to oral selexipag was overall well-tolerated in patients with stable PAH and functional class II symptoms. Finally, doses of selexipag up to 3200 μg twice daily were well-tolerated in patients who had been treated with prior parenteral prostacyclins.
Menopausal hormone therapy, blood thrombogenicity, and development of white matter hyperintensities in women of the Kronos Early Estrogen Prevention Study
Authors: Jayachandran Muthuvel , Lahr Brian D. , Bailey Kent R. , Miller Virginia M. , Kantarci Kejal
Published: January 2020

Objective:

Development of white matter hyperintensities (WMH) in the brain is associated with blood thrombogenicity in recently menopausal women. This study examined the influence of menopausal hormone treatments (MHTs) on this association.

Methods:

Measures of blood thrombogenicity were examined in women of the Kronos Early Estrogen Prevention Study (n = 95) who had brain magnetic resonance imaging before and during the 48 months of randomization to transdermal 17β-estradiol (n = 30), oral conjugated equine estrogen (n = 29) both with progesterone for 12 days per month or placebo pills and patch (n = 36). Principal components (PCs) analysis was used to reduce the dimensionality of 14 markers of platelet activation and blood thrombogenicity. The first 5 PCs were assessed for association with treatment and changes in WMH. Within-person slopes were obtained to capture the extent of WMH change for each woman.

Results:

WMH increased in all groups over the 48 months (P = 0.044). The partial effect of PC1, representing an average of six thrombogenicity variables (microvesicles derived from endothelium, leukocytes, and monocytes, and positive for tissue factor and adhesion molecules) on WMH was significant (P = 0.003). PC3, reflecting a contrast of platelet microaggregates and adenosine triphosphate secretion versus total platelet count, differed across groups (P = 0.006) with higher scores in the oral conjugated equine estrogen group. The global association between PCs and WMH increase, however, did not differ significantly by MHT (P = 0.207 for interaction between MHT and PC's).

Conclusion:

In recently menopausal women, the type of MHT did not significantly influence the association of markers of blood thrombogenicity with development of WMH in the brain.
Trajectory analysis of sleep maintenance problems in midlife women before and after surgical menopause: the Study of Women's Health Across the Nation (SWAN)
Authors: Kravitz Howard M. , Matthews Karen A. , Joffe Hadine , Bromberger Joyce T. , Hall Martica H. , Ruppert Kristine , Janssen Imke
Published: January 2020

Objective:

Investigate temporal patterns of sleep maintenance problems in women who became surgically menopausal (hysterectomy with bilateral oophorectomy) before their final menstrual period and examine whether presurgery trajectories of sleep maintenance problems are related to problems staying asleep postsurgery.

Methods:

Longitudinal analysis of sleep self-reports collected every 1 to 2 years from 1996 to 2013 from 176 surgically menopausal women in the Study of Women's Health Across the Nation, a seven-site community-based, multiethnic/multiracial, cohort study. Median follow-up was 15.3 years (4.2 years presurgery, 10.2 years postsurgery). Group-based trajectory modeling was used to identify patterns of problems staying asleep, and the presurgery trajectories were used to predict similar postsurgery sleep problems.

Results:

Four trajectory patterns of sleep maintenance problems were identified: low (33.5% of women), moderate (33.0%), increasing during presurgery (19.9%), and high (13.6%). One-fifth of women reported a presurgery increase in these problems. Postsurgically, problems staying asleep remained associated with similar levels of presurgical problems, even after adjusting for postsurgical early morning awakening, frequent vasomotor symptoms, and bodily pain score (βlow = −1.716, βmoderate = −1.144, βincreasing = −0.957, βhigh = −1.021; all P values <0.01).

Conclusions:

Sleep maintenance problems were relatively stable across time postsurgery. These data are remarkably consistent with our trajectory results across the natural menopause, suggesting that presurgical assessment of sleep concerns could help guide women's expectations postsurgically. Although reassuring that sleep complaints do not worsen postsurgically for most surgically menopausal women, referral to a sleep specialist should be considered if sleep symptoms persist or worsen after surgery.
Use of an Imaging Spectrometer for Characterization of a Cesium Dosimeter Calibration Facility
Authors: Champion Roger J. , Golduber Robert M. , Kearfott Kimberlee J.
Published: January 2020

Past investigations into the characterization of a space-constrained 137Cs dosimetry calibration facility did not provide detailed positional measurements of gamma ray spectra. In this paper, a commercially available Compton imaging system, or imaging spectrometer, was used to accomplish this. This resulted in both spectral information and point of origin information for the measured gamma rays. The relationship between measured spectra and position was explored relative to a dosimetry phantom. The Compton equation was found to accurately describe the relationship for positions associated with larger scattering angles and was found to be less reliable for those associated with smaller angles.
Characterization of Primary Human Dermal Fibroblasts to Ensure for Instance EMF Exposure Experiments under Comparable Cell Culture Condition
Authors: Franchini Valeria , Müller Thomas , Haupt Julian M. , Ostheim Patrick , Majewski Matthaeus , Lista Florigio , Port Matthias , Abend Michael
Published: January 2020

HDFa (human dermal fibroblasts) are used as cellular models for EMF exposure. To ensure reproducible in vitro experiments, comparable proliferation and differentiation cell conditions must exist, and different donors, passage numbers, culture time, and growth media must be considered. In this study, the authors cultured fibroblasts in DMEM or 106 medium. Growth curves, vitality, morphology, and gene expression of genes coding for proliferation (PCNA, CDKN2A, CDKN1A, SFN), differentiation (PDGFRA, TGM2, ACTA2, PDPN, NTN1, MGP, PPP1R14), and SFN target genes (TP63, MMP1, MMP3) were examined in both media and passage numbers 3–4, 5-6 and >6. At passages 3–4, proliferating cells can be observed in both media. While cells cultured in DMEM proliferate over the passages, from passage 5, cells in 106 medium persisted around the seeded number. TGM2 down-regulation over all passages in both media and cells morphology suggest papillary-type fibroblasts. Downregulation of SFN (negative regulator of mitotic translation and cell differentiation) coincided with proliferating fibroblasts over all examined conditions. Downstream SFN target genes in proliferating cells appeared upregulated (TP63) and downregulated (MMP1/MMP3), suggestive for a status characterized by increased stemnesses (upregulated TP63) and wound healing capacity (downregulated MMP1, MMP3). Resting cells (SFN control values) were associated with control values of TP63 and MMP1/MMP3 expression, suggesting a reduced stemness and wound healing capacity. In conclusion, a set of markers related to proliferation (SFN), differentiation (TGM2), stemnesses (TP63), and wound healing (MMP1/MMP3) allow a culture characterization so that cells under two different conditions can be exposed, thus enabling reproducible EMF experiments or experiments with other exposures.
Relationship of the Perme ICU Mobility Score and Medical Research Council Sum Score With Discharge Destination for Patients in 5 Different Intensive Care Units
Authors: Perme Christiane , Schwing Terrence , deGuzman Kirsten , Arnold Catherine , Stawarz-Gugala Agata , Paranilam Jaya , Estrada Cecilia , Lapnawan Jenny , Mondkar Rajashree , Ragsdale Judith
Published: January 2020

Background:

Measurement tools are increasingly used to quantify impairments in mobility and muscle strength of patients in the intensive care unit (ICU), yet little evidence exists to support the relationship between measurement tools and discharge destination.

Objective:

The aim of this study is to investigate whether a relationship between the Perme ICU Mobility Score (Perme Score) and the Medical Research Council Sum Score (MRC-SS) exists between either of these 2 measurement tools and discharge destination for patients in the ICU.

Design:

The Perme Score and the MRC-SS were performed on patients during the initial physical therapy (PT) evaluation in 5 different ICUs. Data were analyzed to determine whether a relationship exists between either of these scores and discharge destination.

Methods:

Data were collected on 250 patients in 5 ICUs during the initial PT evaluation.

Results:

Patients in the ICU with a higher Perme Score or MRC-SS at the time of PT evaluation were discharged home whereas those with lower scores required postacute care placement.

Conclusion:

The results from this study demonstrate the potential use of the Perme Score or the MRC-SS as standardized measurement tools to assist physical therapists in providing discharge recommendations in the ICU.
Knowledge of the Human Papillomavirus by Social Stratification Factors
Authors: Fernández-Feito Ana , Lana Alberto , Parás Bravo Paula , Pellico López Amada , Paz-Zulueta María
Published: January 2020

Background

Social determinants of health explain most health inequities. Intermediate determinants dictate differences in the exposure and vulnerability of people based on social stratification. Vulnerable women (lower education level, older age, uninsured, etc.) have lower adherence to recommended Pap smear screening guidelines. However, a gap remains concerning the effect of social determinants on human papillomavirus (HPV) infection.

Objectives

The aim of this study was to analyze the association between the level of knowledge about HPV infection and HPV vaccines with education level and residential setting among a sample of Spanish women.

Methods

A cross-sectional study at six primary care centers (Cantabria, Spain) was performed. All women >21 years consecutively attended by midwives for routine follow-up were invited to participate during the study period (2015–2016) until a convenience sample was recruited. Participants completed an anonymous questionnaire addressing sociodemographic variables (age, education level, and residential setting) and the level of knowledge regarding HPV infection, including general knowledge about infection and knowledge about the HPV vaccine. Associations between education level (primary, secondary, and university) and residential setting (urban, semiurban, and rural) with the level of knowledge of HPV infection and HPV vaccine were calculated using adjusted logistic regressions. Dose–response associations were estimated based on p-trend.

Results

Compared to university women, a lower education level was associated with limited or no knowledge of either HPV infection or the HPV vaccine. Women living in rural areas poorly identified “promiscuity” as a risk factor of HPV infection and “the use of condoms” as a protective factor. Moreover, living in rural areas was associated with limited or no knowledge of HPV infection and HPV vaccine. There were significant dose–response trends; those who were more educated and living in more urban areas had more knowledge about either HPV infection or the vaccine.

Discussion

In our sample, the level of knowledge of HPV infection and HPV vaccine was high. However, vulnerable women, defined by a lower education level and living in rural areas, presented a greater lack of knowledge regarding HPV infection and the HPV vaccine.
Weight Gain and Blood Pressure in Toddlers Born Very Preterm
Authors: Rodriguez Jeannie , Adams-Chapman Ira , Affuso Olivia , Azuero Andres , Downs Charles A. , Turner-Henson Anne , Rice Marti
Published: January 2020

Background

Preterm birth is a risk factor for elevated blood pressure in childhood and the development of hypertension and cardiometabolic disease in adulthood; however, mechanisms for the development of both are poorly understood. Rapid weight gain early in childhood may serve as a driver directly and indirectly through cortisol levels found to be elevated in early childhood in individuals born preterm.

Objectives

The objective of this pilot study was to examine the effect sizes of the relationships between weight gain and blood pressure in toddlers born very preterm. A secondary aim was to note any mediating effect of cortisol on the relationships between weight gain and blood pressure.

Methods

A cross-sectional design with a convenience sample of 36 toddlers who were born very preterm was used to examine the relationships between postnatal weight gain, cortisol, and blood pressure at follow-up.

Results

Many of the participants experienced rapid weight gain in the first 12 months of life. Mean systolic and diastolic readings were 94 and 56.6, respectively. Diastolic blood pressure readings were obtained from 23 participants, and the majority were elevated. Weight gain was associated with diastolic blood pressure with a medium effect size. A mediating role with cortisol was not supported.

Discussion

Although findings need to be validated in a larger sample, the blood pressure elevations in this sample were alarming. If readings continue to amplify as these children age, the fact that elevations are already present during the toddler period could indicate more significant cardiovascular disease in adulthood for this population. Rapid weight gain in early life may be a driver for elevated blood pressure even during early childhood in individuals born preterm.
Mismatch Repair Deficiency in Uterine Carcinosarcoma
Authors: Jenkins Taylor M. , Hanley Krisztina Z. , Schwartz Lauren E. , Cantrell Leigh A. , Stoler Mark H. , Mills Anne M.
Published: January 2020

Immunohistochemistry (IHC) for mismatch repair (MMR) proteins is recommended in endometrial carcinomas as a screening test for Lynch syndrome, and mismatch repair deficiency (MMRd) is reported in ∼30% of cases. However, few studies have evaluated the rate of MMR loss in uterine carcinosarcomas. A 5-year retrospective database search of uterine carcinosarcomas was performed at 3 academic institutions. The histologic diagnoses, type of carcinoma present, and MMR IHC interpretations were confirmed by a gynecologic pathologist. One hundred three cases of uterine carcinosarcomas with available MMR IHC results were identified. Ninety-nine cases (96%) showed intact expression and 4 cases (4%) showed loss of MLH1/PMS2. All MMRd carcinosarcomas identified in this series had an endometrioid carcinomatous component and wild-type p53 expression. In contrast, the majority of MMR intact carcinosarcomas had a serous morphology and aberrant p53 expression. Three additional cases initially diagnosed as carcinosarcoma also revealed MMRd; however, given the lack of clear mesenchymal differentiation, these cases were reclassified as dedifferentiated endometrial carcinomas and were subsequently excluded from the carcinosarcoma category. No cases of Lynch syndrome were identified among carcinosarcoma patients, as all 4 MMRd cases were due to somatic MLH1 hypermethylation. In summary, we found that the rate of MMRd is markedly lower in uterine carcinosarcoma when compared with endometrial carcinoma. In the setting of MMR loss, a diagnosis of dedifferentiated carcinoma should be considered as almost half of the MMRd tumors which were called carcinosarcomas initially were reclassified as dedifferentiated on review. However, given the interobserver variability in the classification of carcinosarcoma versus dedifferentiated carcinoma a universal screening approach that includes uterine carcinosarcoma is still recommended.
An Intraoperative Salvage After Transection of the Greater Palatine Artery During Cleft Palate Repair: A Case for Buccal Fat and Buccal Myomucosal Flaps
Authors: Ayyash Ali M. , Anstadt Erin E. , Dvoracek Lucas A. , Marji Fady P. , Lee Jonathan Y. , Losee Joseph E. , Goldstein Jesse A.
Published: January 2020

Recently, several adjunctive procedures have gained traction to aid cleft surgeons in repairing especially challenging palatal clefts. Buccal fat flaps and buccal myomucosal flaps have demonstrated particular utility in reinforcing thin palatal flaps or tissue deficits. Although their use has not been widely accepted, they may be particularly helpful in the setting of significant scarring or vascular compromise. Here the authors describe the case of an intraoperative salvage using bilateral buccal fat flaps and a right buccal myomucosal flap after transection of the right Greater Palatine artery (GPA) during palatoplasty on a 14-month old female with Pierre Robin Sequence and a wide Veau II cleft palate. For this operative salvage, bilateral buccal fat flaps were used to reinforce the hard-soft palate junction and a 4 cm × 2 cm flap of the right-sided buccal mucosa and buccinator muscle was inset along the majority of the right-sided soft and posterior hard palate. At 2 years follow-up, the patient had no significant complications and was doing well with healthy-appearing palatal tissue and age-appropriate speech.